China’s care homes rush to protect elderly from Covid surge

Administrators of the Xiangfu Nursing Home, a high-end facility for the elderly in Shanghai’s Changning district, are struggling to keep pace with the abrupt end of China’s Covid Zero policy. Their simple solution for now: shut the doors.

To buy time while the virus spreads rapidly throughout the country, Xiangfu in late November banned entry to relatives and other visitors. Staff members who have completed their shifts cannot leave and instead must sleep on-site.

The same hunkering down is taking place across China, as its under-vaccinated elderly suddenly find themselves surrounded by infection after three years of little threat. In cities including Beijing, Shanghai and Nanjing, local governments are enforcing on care homes the same closed-loop system that factories adopted during earlier outbreaks. No one comes, and no one goes.

Time is running out. Evidence from around the world shows that facilities for seniors often see the biggest waves of deaths, which is why countries prioritized vaccinating care home occupants first.

That’s not been the case in China, where 38,000 homes provide beds for 8.2 million seniors according to 2020 data. Only 42% of those aged over 80 have had booster shots. That’s well below the levels seen in other countries that reopened after abandoning strict approaches toward the virus.

“It’s just the start of a real tough time,” read a statement from Pudong Shinan Nursing Home in Shanghai explaining its new rules this week. “When the experts say 80-90% of the population will eventually get infected, we are scared!”

China’s ‘Let It Rip’ Covid Approach Is Confounding Experts

National Health Commission officials last week gave rudimentary advice to care homes facing potential outbreaks of Covid. Minimize the risk of infection by improving ventilation, practicing hand hygiene, wearing masks and avoiding gatherings. They also urged the elderly to get vaccinated, without making shots mandatory.

Persuading the elderly has proven to be a tough task. Many older Chinese are reluctant to get vaccinated, said Feng Wang, a sociology professor at the University of California, Irvine. Forcing them to get vaccinated risks creating a backlash in a society that traditionally has emphasized respecting seniors, he said.

“It’s a tremendous gamble,” said Wang. “If an elderly person resists, I’m pretty sure there will be a lot of reluctance among the nurses, the local neighborhood committees and officials to force elderly people to take the vaccine.”

The cost of such hesitation may be large. China could see some 5 million people hospitalized and up to 700,000 deaths after abandoning Covid Zero, according to Bloomberg Intelligence chief pharmaceutical analyst Sam Fazeli.

When omicron overwhelmed Hong Kong early this year, under-vaccinated residents at care facilities accounted for many of the thousands of deaths that followed.

How Hong Kong Went From Covid Zero to World’s Deadliest Outbreak

At Xiangfu in Shanghai, staff are settling in for the long haul.

“Faced with menacing outbreaks, we have to remain alert and respond anytime to what the government calls for, to ensure Covid control and safety of the elderly,” Xiangfu said in a statement.