Intended for healthcare professionals

Feature Coronavirus

Could rural China’s healthcare deal with covid-19?

BMJ 2021; 375 doi: (Published 25 November 2021) Cite this as: BMJ 2021;375:n2759

Read our latest coverage of the coronavirus pandemic

  1. Andrew Silver, freelance journalist
  1. New Taipei City
  1. aesilver360{at}

What happens if SARS-CoV-2 reaches the less developed parts of China, asks Andrew Silver

Nearly 40% of China’s population of about 1.4 billion people live outside urban areas, 2020 statistics show. China’s strategy in the pandemic is to interrupt community transmission of SARS-CoV-2 by isolating infected people and their close contacts, wherever they may be.1 The worry is what will happen if transmission can’t be detected quickly, especially in the face of more transmissible new variants, such as delta, and particularly in rural areas that may have even less robust medical capabilities than urban areas.

China has “a general issue with capacity for people with medical conditions,” says Benjamin Cowling, an epidemiologist at the University of Hong Kong. “It’s not specific to covid, generally an ageing population and insufficient resources and economic downturn perhaps.”

The country significantly increased investment in community based services after the 2003 SARS outbreak,2 introduced comprehensive healthcare reforms in 2009,3 made new investments for covid-19, and aims to boost capacity under its Healthy China 2030 Plan, such as by increasing the number of general practitioners.4 For now, however, analysts say that there’s still a way to go to tackle the overall medical needs of people around the country.5

Medical care

Village doctors in China can provide basic medical services such as care for colds and cuts. When people in rural areas are sick they are supposed …

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