A questionnaire survey released by Sichuan Province on December 28 showed that the COVID-19 infection rate in Sichuan has passed 63.5%. This figure is basically reliable; it probably only omits some asymptomatic patients. So roughly two-thirds or more of people have already had Omicron, and most have recovered; in some regions over 90% may already have had it.
Before the Ten New Measures were announced, Jiaxing CDC conducted a survey. It showed that in this wave, fully asymptomatic people made up 15.87% and symptomatic people 84.13%. I believe this figure is reliable; it closely matches what we observe around us.On December 6, Huang Chaolin, president of Wuhan Jinyintan Hospital, told reporters that in this wave, the patients admitted to Jinyintan Hospital were overwhelmingly asymptomatic or mild cases, reaching over 90%. Those with lung inflammatory changes were about 4.45%, but generally mild and mostly resolving within a week; a tiny minority (about 0.5%) later became severe, mostly the elderly, unvaccinated, or those with serious underlying disease. This figure is also reliable; he merely spoke with technical caution by lumping asymptomatic and mild cases together.From these three sets of statistics, we can roughly estimate that over two-thirds of the country may have been infected, with infection rates in some regions possibly over 90%. This wave has peaked; fever-clinic visits are falling fast in most places, and fever medicines are no longer as hard to buy as before.A conservative estimate puts current infections in China at over one billion. If we use one billion, roughly 44.5 million people have lung inflammatory changes (because of the medical crunch, most of these pneumonia patients cannot get timely treatment and must rely on self-recovery; a minority will turn severe), and another roughly five million severe patients are currently being treated in hospitals. In fact most of these severe patients are hard nuts: even before COVID they had all kinds of problems, and treatment is quite tricky.COVID also triggers sudden myocardial infarction, cerebral infarction and myocarditis, but generally these patients do not impose much medical burden: once they strike, they are hard to rescue and mostly die within 24 hours, without occupying resources. What truly occupies resources are the various chronic-disease patients.Many patients who got injections at small clinics earlier are now seeking care; whether or not IV drips temporarily relieved their symptoms, a good number picked up bacterial infections during the drips. During the pandemic, Western countries also saw similar bacterial infections from medical crunches, adding hundreds of thousands of deaths. With China large population and severe medical crunch, nosocomial bacterial infections have led some COVID patients to develop secondary bacterial infection.In addition, winter is the high season for many respiratory diseases, and a fair number of severe patients from other respiratory diseases are also crowding hospitals. The number of severe patients in China now surely far exceeds the capacity of medical institutions. But the pressure is on hospitals for now, and society is gradually returning to normal.My village has about 3,000 people; 4 have died recently, all COVID-related. Another village of 2,600 has had 3 deaths. Deaths basically all occurred on December 25–27; the crude death rate has already exceeded one per thousand. They basically died of sudden myocardial or cerebral infarction after infection; no death from lung infection has occurred yet.Of my village four deaths, the youngest was in his seventies, one in his eighties, and one 90. Of the other village three deaths, the youngest was 72 and the other two both nearly 90. There are young deaths in the county, but the dead are mainly people over 70.Myocardial and cerebral infarction usually give doctors no chance to rescue, so few are saved; we can only prevent them through public education on keeping warm, avoiding overwork, and so on. Lung infection (including white lung) is different: doctors still have a chance to intervene, and a fair number can be saved. Over the years I have studied the treatment of severe cancer; cancerous pleural effusion causes many cases of white lung, and many of those can be saved—so there is even more hope for infectious white lung.The unfavorable factor is that every department in hospitals is now doing respiratory work; many respiratory patients are treated by orthopedists, dermatologists and others with almost no prior respiratory experience, who have only had brief training, so mortality is bound to be somewhat high. During the Wuhan outbreak, integrated Chinese-Western treatment of white lung worked very well. But then the whole nation supported Wuhan; now every region is in the same emergency state, so results are hard to make ideal.Winter is also the peak season for deaths from cardiovascular and respiratory disease; after the epidemic, subtracting the regular annual deaths, the excess deaths attributable to COVID may be only around one per thousand. The now-circulating strain in mainland China is no more lethal than strains circulating in other countries or than the strain circulating this summer. But right now even some doctors are panicking excessively, to say nothing of the public.Doctors are exhausted and cannot rotate off; many work while ill, and in some places doctors have already died of overwork or collapsed into ICU. This is a hard battle. At the peak of the US outbreak, about a quarter of doctors resigned; in China such desertion is rare, which is already remarkable.Though Omicron is weak in virulence, some US doctors pointed out that because of its high transmissibility, among all COVID variants Omicron has killed the most people. Some patients have very severe Omicron symptoms, so members of the public suspect the original strain and earlier high-fatality variants are still circulating in China; the feeling is understandable, but it is not the fact.About 20% of patients still have many uncomfortable symptoms beyond 10 days; according to some international data, these patients may need 2–3 months to fully recover. Their situation is also extremely complex; most have mild underlying disease, and COVID combining with it makes treatment quite tricky.The global medical profession is basically at a loss with these patients, but if a doctor sees them, it can at least ease their mental burden somewhat. Yet there are nowhere near enough medical workers to comfort this group right now; they must rely on learning self-rescue methods themselves.Over the next 1–3 months, in-hospital severe patients will either improve and go home or deteriorate and die; the inpatient count will rise first, then fall, gradually returning to normal. Right now medical staff are all diverted to rescue severe patients, so hundreds of millions of symptomatic patients cannot reach doctors. Over the next 1–3 months these too will recover naturally. But about 1% of infected people will have symptoms lasting over a year, some even losing the ability to work—tens of millions of patients who, though not dead, will have their lives utterly changed by COVID.Whole society is in a state of alarm; data are opaque; the figures published by the Health Commission diverge widely from what people see around them; some medical guidelines are ineffective in practice. Many medical experts talk irresponsibly. Some unscrupulous drug merchants profiteer by pushing ineffective drugs. All this has badly damaged the credibility of the medical profession, so rumors are inevitable.These leave the public in a sub-healthy psychological state; most people feel depression and alarm, and this social mood may take time to ease. Easing these emotions depends on transparent information and credible science communication.Also important is promptly spotting problems in practice and updating COVID diagnosis-and-treatment guidelines. Effective regimens that experts hit upon for various symptoms should be promptly shared with the public; this can help many people relieve symptoms and anxiety, reduce future severe cases, and ease the burden on medical institutions.Most recoverees can resume social life in moderation; as long as they avoid strenuous exercise, overwork and cold, the great majority will have no sudden death. Sudden death is, after all, a low-probability event, and sequelae will not erupt on a mass scale.Finally, I hope everyone will put themselves in doctors' shoes: in this period, do not come for chat-style consultations; minimize taking up doctors time; once you get a solution, go execute it rather than asking more questions; give doctors more rest.Medical workers are already overworked; some have passed away, and many others are at risk. The great majority are at a high pitch of nervous tension and have no bandwidth to tend to your feelings. If you panic, seek comfort from your family; do not lay everything on the medical staff.