Hartford Courant (Sunday)

China low on medicine after COVID-19 pivot

Millions struggle to find treatment as outbreaks flare up

- By David Pierson, Isabelle Qian and Olivia Wang

When demand for fever-reducing drugs more than quadrupled the price of ibuprofen, a city in eastern China began rationing sales by selling the pills individual­ly.

When a popular Chinese online pharmacy offered the antiviral drug Paxlovid, it sold out within hours.

And when word of the medicine shortages in China reached friends and relatives in Hong Kong and Taiwan, they quickly bought vast quantities of drugs from local sellers to ship to the mainland.

As COVID-19 rips through parts of China, millions of Chinese are struggling to find treatment — from the most basic cold remedies to take at home to more powerful antivirals for patients in hospitals. The dearth of supplies highlights how swiftly — and haphazardl­y — China reversed course by abandoning its strict “zeroCOVID” policies about two weeks ago.

The whiplash of change has caught the nation’s hospitals, clinics and pharmacies off guard. Across many cities, pharmacies have sold out of the most common fever and cold medicines. Many health facilities were unprepared for the onslaught of demand from patients after they were given little to no notice about needing to stockpile drugs. The shortages are fueling anger and anxiety among Chinese who until recently had been warned by the government that an uncontroll­ed spread of COVID-19 would be devastatin­g.

“The doctor told me there

was no fever medicine,” said Diane Ye, 28, a COVID-19 patient in Beijing who lined up outside a hospital for hours with a fever only to be sent home with a bottle of sore throat medicine.

For nearly three years, the country maintained some of the toughest pandemic controls in the world, mandating mass testing and locking down cities such as Shanghai for months. Then, with little warning, the government announced a broad easing of restrictio­ns on Dec. 7, seemingly bowing to economic pressure and rising social discontent following widespread protests in late November.

In many cities, signs of outbreaks have emerged. China reported only seven deaths from COVID-19 so far by midweek, but reports of crowded crematorie­s and funeral homes have raised concerns about the accuracy of government data. Lines of

people have formed at hospitals, and medication has flown off drugstore shelves.

“Opening up is great, but it happened too fast and without preparatio­n. People don’t have these common medicines stocked up at home,” said a pharmacist working at a public hospital in Beijing who only provided his last name, Zhang, given the political sensitivit­y of the issue.

Even before the policy pivot, stocks of fever medicines had already been low, he said, because the government had strictly controlled the sale of cold and flu medication under “zeroCOVID.” The policy had required buyers to register their names, a rule aimed at preventing residents from using over-the-counter drugs to reduce fevers and avoid detection by the country’s pervasive health tracking system.

“If you ease these restrictio­ns

first, say for two months, and open up once people have stuff prepared, then this rush wouldn’t have happened,” Zhang said.

Many Chinese are now confrontin­g the specter of a massive COVID-19 outbreak that could stretch through the winter, and have been forced to improvise to fill in the gaps. Some are turning to folk remedies like canned peaches, believing they can ward off illness. One group of volunteers organized a social media campaign to deliver aid to older adults in rural areas. The group received plenty of cash donations, but little medicine because of shortages.

In recent days, some Chinese have ventured across the border to Macao to receive the one thing they have less chance of finding than ibuprofen: a foreign-made mRNA vaccine. China has failed to approve such vaccines despite their

availabili­ty, in an apparent effort to protect the domestic industry.

Social media users have resorted to dark humor to cope with crisis, twisting a government slogan under “zero-COVID” that reminds people that “Anyone who should be transferre­d for quarantine will be transferre­d for quarantine.” The new version? “Anyone who can have COVID will have COVID.”

The government has tried to reassure the public, saying it is prioritizi­ng efforts to increase the nation’s medicine stocks.

State media reports called the shortages temporary and highlighte­d a recent push by Chinese drugmakers, under the direction of the central government, to increase supplies. China is one of the world’s largest producers of pharmaceut­icals, making roughly one-third of the world’s supply of ibuprofen, a painkiller and fever reducer.

Local government­s are also pledging to procure more drugs and distribute them to pharmacies. In the eastern city of Nanjing, officials announced they would add 2 million tablets of fever-reducing medicine to the market each day, starting Dec. 18. To stretch out supplies, pharmacies were instructed to unseal packages to sell the tablets individual­ly and to limit purchases to six pills per person.

In the central city of Wuhan, the Hubei provincial government said it would supply 3 million ibuprofen tablets a week mostly to medical facilities. And in the northeaste­rn city of Jinan, more than 1 million tablets of ibuprofen were distribute­d to clinics and pharmacies, state media reported.

China’s rush to address the shortfalls in medicine mirrors the flurry of last-minute deals to bring more vaccines and foreign-made treatments onto the market.

Authoritie­s have approved four domestic vaccines in the past two weeks alone, and the state-owned pharmaceut­ical company China Meheco Group announced last week it had struck a deal to import and distribute Pfizer’s Paxlovid, an oral treatment found to significan­tly cut the risk of hospitaliz­ation and death. (In April, Pfizer had also signed a separate deal with another Chinese pharmaceut­ical company, Zhejiang Huahai, to manufactur­e Paxlovid for the China market.)

The approval of Paxlovid contrasts with China’s treatment of foreign COVID-19 vaccines. The difference in this case is that China has several domestical­ly produced alternativ­es for COVID-19 jabs, but no antiviral substitute as effective as Paxlovid.

 ?? GILLES SABRIE/THE NEW YORK TIMES ?? A customer purchases medicine Tuesday at a pharmacy in Beijing. Since China dropped its strict “zero-COVID” policies about two weeks ago, medication has flown off drugstore shelves across the country.
GILLES SABRIE/THE NEW YORK TIMES A customer purchases medicine Tuesday at a pharmacy in Beijing. Since China dropped its strict “zero-COVID” policies about two weeks ago, medication has flown off drugstore shelves across the country.

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