Yao Ruyan paced frantically outside the fever clinic of a county hospital in China's industrial Hebei province, 70 kilometres southwest of Beijing. Her mother-in-law had COVID-19 and needed urgent medical care, but all nearby hospitals were full.
"They say there's no beds here," she barked into her phone.
As China grapples with its first national COVID-19 wave, emergency wards in small cities and towns southwest of Beijing are overwhelmed. Emergency rooms are turning away ambulances, relatives of sick people are searching for open beds, and patients are slumped on benches in hospital corridors and lying on floors for a lack of beds.
Yao's elderly mother-in-law had fallen ill a week ago with the coronavirus. They went first to a local hospital, where lung scans showed signs of pneumonia. But the hospital couldn't handle serious COVID-19 cases, Yao was told. She was told to go to larger hospitals in adjacent counties.
As Yao and her husband drove from hospital to hospital, they found all the wards were full. Zhuozhou Hospital, an hour's drive from Yao's hometown, was the latest disappointment.
Yao charged toward the check-in counter, past wheelchairs frantically moving elderly patients. Yet again, she was told the hospital was full, and that she would have to wait.
'Terrified' over elderly woman's condition
"I'm furious," Yao said, tearing up as she clutched the lung scans from the local hospital. "I don't have much hope. We've been out for a long time and I'm terrified because she's having difficulty breathing."
Over two days, Associated Press journalists visited five hospitals and two crematoriums in towns and small cities in Baoding and Langfang prefectures, in central Hebei province. The area was the epicentre of one of China's first outbreaks after the state loosened COVID-19 controls in November and December. For weeks, the region went quiet, as people fell ill and stayed home.
Many have now recovered. Today, markets are bustling, diners pack restaurants and cars are honking in snarling traffic, even as the virus is spreading in other parts of China. In recent days, headlines in state media said the area is "starting to resume normal life."
But life in central Hebei's emergency wards and crematoriums is anything but normal. Even as the young go back to work and lines at fever clinics shrink, many of Hebei's elderly are falling into critical condition. As they overrun intensive care units and funeral homes, it could be a harbinger of what's to come for the rest of China.
The Chinese government has reported only seven COVID-19 deaths since restrictions were loosened dramatically on Dec. 7, bringing the country's total toll to 5,241. On Tuesday, a Chinese health official said the country only counts deaths from pneumonia or respiratory failure in its official COVID-19 death toll, a narrow definition that excludes many deaths that would be attributed to COVID-19 in other places.
Experts have forecast between a million and two million deaths in China through the end of next year, and a top World Health Organization official warned that Beijing's way of counting would "underestimate the true death toll."
At Baoding No. 2 Hospital in Zhuozhou on Wednesday, patients thronged the hallway of the emergency ward. The sick were breathing with the help of respirators. One woman wailed after doctors told her that a loved one had died.
The ER was so crowded, ambulances were turned away. A medical worker shouted at relatives wheeling in a patient from an arriving ambulance.
"There's no oxygen or electricity in this corridor," the worker said. "If you can't even give him oxygen, how can you save him?
"If you don't want any delays, turn around and get out quickly," she said.
The relatives left, hoisting the patient back into the ambulance. It took off, lights flashing.
In two days of driving in the region, AP journalists passed around 30 ambulances. On one highway toward Beijing, two ambulances followed each other, lights flashing, as a third passed by heading in the opposite direction. Dispatchers have been overwhelmed, with Beijing city officials reporting a six-fold surge in emergency calls earlier this month.
Employee says crematorium struggling to cope
Some ambulances are heading to funeral homes. At the Zhuozhou crematorium, furnaces are burning overtime as workers struggle to cope with a spike in deaths in the past week, according to one employee. A funeral shop worker estimated it is cremating 20 to 30 bodies a day, up from three to four before COVID-19 measures were loosened.
"There's been so many people dying," said Zhao Yongsheng, a worker at a funeral goods shop near a local hospital. "They work day and night, but they can't burn them all."
At a crematorium in Gaobeidian, about 20 kilometres south of Zhuozhou, the body of one 82-year-old woman was brought from Beijing, a two-hour drive, because funeral homes in China's capital were packed, according to the woman's grandson, Liang.
"They said we'd have to wait for 10 days," Liang said, giving only his surname because of the sensitivity of the situation.
Liang's grandmother had been unvaccinated, Liang added, when she came down with coronavirus symptoms, and had spent her final days hooked to a respirator in a Beijing ICU.
Over two hours at the Gaobeidian crematorium on Thursday, AP journalists observed three ambulances and two vans unload bodies. A hundred or so people huddled in groups, some in traditional white Chinese mourning attire. They burned funeral paper and set off fireworks.
"There's been a lot," a worker said when asked about the number of COVID-19 deaths, before funeral director Ma Xiaowei stepped in and brought the journalists to meet a local government official.
As the official listened in, Ma confirmed there were more cremations, but said he didn't know if COVID-19 was involved. He blamed the extra deaths on the arrival of winter.
"Every year during this season, there's more," Ma said. "The pandemic hasn't really shown up" in the death toll, he said, as the official listened and nodded.
'It's all under control,' official says
Even as anecdotal evidence and modelling suggest large numbers of people are getting infected and dying, some Hebei officials deny the virus has had much impact.
"There's no so-called explosion in cases, it's all under control," said Wang Ping, administrative manager of Gaobeidian Hospital, speaking by the hospital's main gate. "There's been a slight decline in patients."
Wang said only a sixth of the hospital's 600 beds were occupied, but refused to allow AP journalists to enter. Two ambulances came to the hospital during the half hour the journalists were present, and a patient's relative told the AP they were turned away from Gaobeidian's emergency ward because it was full.