A medical worker administers a COVID-19 vaccine to a senior resident at a health center in Fengyi Town, Yunnan Province, on January 12 (COURTESY PHOTO) 

Since 2017, 55-year-old Li Ruiying has been the only doctor at the clinic in Erdaohe Village in northern suburban Beijing, where she has been stationed since 1999. The clinic is like a beacon for villagers with Li ready to provide medication and treatment at any time.

Erdaohe is in Taishitun Town, Miyun District. According to Li, a native of Miyun, the village is home to around 300 residents, many of whom are seniors. Unlike doctors in hospitals who hone their craft in specific disciplines, Li treats villagers who come in with all sorts of minor ailments.

In the previous two years, the clinic usually received about a dozen people per day, Li said. Recently, she noticed a rise in patient numbers.

"The number of people who contract COVID-19 has increased. Right now, we're seeing nearly 40 people coming in to get medication or an intravenous drip every day," Li told Beijing Review on January 6.

A tsunami of Omicron infections swept across Beijing last December, and the storm has now touched down in its rural areas. COVID-19 may have already infected more than 80 percent of Beijing's over 20 million residents, Zeng Guang, former chief epidemiologist of the Chinese Center for Disease Control and Prevention, told news portal iFeng.com on December 29, 2022.

The rural battle 

Infections have surged across China after Chinese authorities issued 10 new measures to optimize the country's COVID-19 response early last December, given the pathogenicity of the Omicron variant has weakened compared with the original strain of the coronavirus and its other variations.

But the rapidly growing number of infected people has posed challenges to medical services, especially in rural areas with inadequate medical resources. 

To help villagers cope with COVID-19, Li began to dispense, and give instructions on the use of, fever medication and painkillers like ibuprofen and paracetamol starting from late December 2022, with the support from the local government and villagers' committee, China's primary mass organization of self-management consisting of local villagers, who manage local affairs.

As the virus continues to spread, the Chinese Government has focused on guaranteeing sufficient medication supplies and treatment options for senior residents in rural and remote areas. On December 31, 2022, it issued a guideline on COVID-19 control in rural areas, especially important in light of the upcoming Spring Festival holiday—from January 21 to 27 this year. According to the guideline, the government will ensure drug supplies, treatment of severe cases and protection of seniors and children, as well as antigen tests, in rural areas. 

As a veteran doctor, the progress of the village's medical services gives Li a sense of reassurance. "The clinic has changed a lot over the past decades. It has gradually been fortified with medical facilities, more diverse medicines and other equipment in recent years. Our services cover the whole village," she said.

Besides providing medical treatment, Li also assists villagers in getting their medical expenses reimbursed. Over the past years, the government has been improving support for rural residents in need of healthcare services. China has updated the national reimbursement medicine list six times since 2000, with 2,860 medicines included in 2022, up from 1,535 in 2000. And the new rural cooperative medical care system, launched in 2003, helps finance farmers who face high medical costs for severe diseases or injuries. It is a health insurance system funded by the central and local governments, village collectives and individuals.

As the Spring Festival holiday draws closer, the break's travel rush has resumed as domestic travel restrictions were lifted late last year. Li has been stressing the necessity of prevention and working to improve villagers' awareness on reducing social gatherings and wearing masks when leaving the house.

According to Li, some villagers have no longer been wearing masks following the country's adjustment of its COVID-19 control policies. She herself fell ill in early January and had recovered a week later. But the clinic's influx of people in need has not regressed.

"Our medicine stock can meet demand. I also make sure villagers with severe COVID-19 symptoms immediately get the help they need to avoid any delays in treatment and the risk of things spiraling out of control," she said.

Prevention and cure 

The recent waves of infection have already reached some rural areas of Yunnan Province in southwest China. While Li is busy at the village clinic in suburban Beijing, Luo Shumei, the deputy head of a rural healthcare center in Yunnan, also works hard to treat people infected with COVID-19. The healthcare center is in Fengyi Town in Dali Bai Autonomous Prefecture. According to Luo, the town has a population of about 60,000. The region served by the healthcare center has around 13,000 people aged 60 and above, many of whom have mild symptoms. 

"Nowadays, around 250 patients come to the center every day. In the past month, the number of people infected with COVID-19 coming to our healthcare center reached about 80-90 per day (at most)," Luo told Beijing Review on January 10. He added the villagers receive a reimbursement of 85 and 50 percent for their hospitalization and outpatient service expenses, respectively.

The center has 89 medical staff members. Over the past month, they have been working more than 10 hours a day. Seventy-six of them only recently recovered from infection themselves, Luo said.

Prior to our interview, Luo had pulled an all-nighter treating an 89-year-old villager of the Bai ethnic group. Already an asthma patient, the villager got extremely sick after contracting COVID-19. Upon learning the news, Luo didn't hesitate and drove to the villager's house to treat him—at 10 p.m.

According to Luo, the local government has pooled medical resources and provided free COVID-19 vaccines for senior residents not yet infected as of this January. Medical staff went door to door to administer the shots. The government has also been educating locals, especially seniors, about the importance of prevention through flyers and radio broadcasts.

"We experienced a medication shortage from December 22 to 28 last year as many patients were visiting this health center—given it's a designated one for COVID-19 treatment. But sooner rather than later, local medical authorities started allocating drugs, allowing us to resume our medication distribution on January 1 this year," Luo said.

In an interview with China Central Television in December 2022, Jiao Yahui, head of the Bureau of Medical Administration under the National Health Commission, said that population movement during the Spring Festival holiday may lead the virus to spread from the cities to the rural areas. Local healthcare centers and practitioners should make sure they stock up on medication and transfer those seriously ill to nearby hospitals in time, she added.

"County-level hospitals play a key role in the rural response to COVID-19. Higher-level hospitals should also provide support in terms of instructions and personnel," Jiao said.

For this upcoming Spring Festival holiday, the expression "safe travels" takes on deeper meaning.   

(Print Edition Title: A Tale of Two Doctors) 

Copyedited by Elsbeth van Paridon  

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