In an abrupt change of policy, this month China began dismantling the world’s strictest Covid regime of lockdowns and extensive testing, putting its battered economy on course for a complete re-opening next year.
The lifting of restrictions - which came after widespread protests against them - means Covid is spreading largely unchecked and likely infecting millions of people a day, according to some international health experts.
China reported just three new Covid-related deaths for Tuesday, up from one for Monday - numbers inconsistent with what funeral parlours are reporting, as well as with the experience of much less populous countries after they re-opened.
Car parks around the Dongjiao funeral home, one of the biggest in Chengdu, were full on Tuesday evening. Funeral processions were constant as smoke billowed from the crematorium.
“We have to do this about 200 times a day now,” one funeral worker told news agency Reuters.
“We are so busy we don’t even have time to eat. This has been the case since the opening up. Before it was around 30-50 a day.”
“Many have died from Covid,” said another worker.
Staff were equally busy at another Chengdu crematorium, privately-owned Nanling.
“There have been so many deaths from Covid lately,” one worker said.
“Cremation slots are all fully booked. You can’t get one until the new year, maybe January 3 at the earliest.”
Meanwhile staff at Huaxi, a large hospital in the southwestern city of Chengdu, said they were “extremely busy” caring for Covid patients.
“I’ve been doing this job for 30 years and this is the busiest I have ever known it,” one ambulance driver outside the hospital, who declined to be identified, told news agency Reuters.
There were long queues inside and outside the hospital’s emergency department and at an adjacent fever clinic on Tuesday evening. Most of those arriving in ambulances were given oxygen to help with their breathing.
”Almost all of the patients have Covid,” one emergency department pharmacy staff member said.
The hospital has no stocks of Covid-specific medicine and can only provide drugs for symptoms such as coughing, she said.
China has said it only counts deaths of Covid patients caused by pneumonia and respiratory failure as Covid-related.
Zhang Yuhua, an official at the Beijing Chaoyang Hospital, said most recent patients were elderly and critically ill with underlying diseases. She said the number of patients receiving emergency care had increased to 450-550 per day, from about 100 before, according to state media.
The China-Japan Friendship Hospital’s fever clinic in Beijing was also “packed” with grey-haired patients, state media reported.
Nurses and doctors have been asked to work while ill and retired medical workers in rural communities were being rehired to help. Some cities have been struggling to secure supplies of anti-fever drugs.
Meanwhile in a major step towards freer travel, China will stop requiring inbound travellers to go into quarantine from January 8, authorities said this week.
But the scale of China’s Covid outbreak and doubts over official data prompted some countries to consider new travel rules on Chinese visitors.
US officials cited “the lack of transparent data” as reasons for doing so.
India and Japan would require a negative Covid test for travellers from mainland China, with those testing positive in Japan having to undergo a week in quarantine. Tokyo plans to limit airlines increasing flights to China while the Philippines was also considering imposing tests.