China facing 'tragic battle' as one million people predicted to die

A Shanghai hospital has told its staff to prepare for a "tragic battle" with COVID-19 as it expects half of the city's 25 million people to become infected by the end of the year while the virus sweeps through China largely unchecked.

After widespread protests and a relentless rise in cases, China this month took an abrupt shift in policies and began dismantling its "zero-COVID" regime, which has taken a great financial and psychological toll on its 1.4 billion people.

Still, China's official death count since the pandemic began three years ago stands at 5241 - a fraction of what most other countries faced.

China reported no new COVID-19 deaths for a second consecutive day for December 21, as funeral parlour workers said demand had jumped in the past week, pushing up fees.

Authorities - who have narrowed the criteria for COVID-19 deaths, prompting criticism from many disease experts - confirmed 389,306 cases with symptoms.

Some experts say official figures have become an unreliable guide as less testing is carried out across China following the easing of restrictions.

The Shanghai Deji Hospital, posting on its official WeChat account late on Wednesday, estimated there were about 5.43 million positives in the city and that 12.5 million in China's main commercial hub will be infected by the end of the year.

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"This year's Christmas Eve, New Year's Day and the Lunar New Year are destined to be unsafe," the hospital said.

"In this tragic battle, the entire Greater Shanghai will fall, and we will infect all the staff of the hospital! We will infect the whole family! Our patients will all be infected! We have no choice, and we cannot escape."

One million people could die in 2023

Experts say China could face more than one million COVID-19 deaths next year, given relatively low full vaccination rates among its vulnerable elderly population.

China's vaccination rate is more than 90 per cent, but the rate for adults who have received booster shots drops to 57.9 per cent and to 42.3 per cent for people aged 80 and over, government data shows.

The head of the World Health Organization said it is concerned about the spike in infections and is supporting the government to focus on vaccinating those at the highest risk.

WHO Director-General Tedros Adhanom Ghebreyesus told reporters the agency needed more detailed information on disease severity, hospital admissions and requirements for intensive care units for a comprehensive assessment.

China's policy U-turn caught a fragile health system unprepared, with hospitals scrambling for beds and blood, pharmacies for drugs and authorities racing to build special clinics.

Smaller cities away from the affluent eastern and southern coast are particularly vulnerable.

Cities across the country were distributing millions of ibuprofen tablets to medical institutions and retail pharmacies, according to a report in the state-run Global Times.

Germany said it has sent its first batch of BioNTech COVID vaccines to China to be administered initially to German expatriates.

Berlin is pushing for other foreign nationals to be allowed to take them.

These would be the first mRNA vaccines, seen as most efficient against the disease, available in China.

China has nine domestically-developed COVID-19 vaccines approved for use.

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