MICHEL MARTIN, HOST:

China's strict COVID policies have been in the news after they sparked some of the largest demonstrations there in memory. But now a very different story - analysts say the country is facing an explosion of COVID cases and could see as many as 1 million deaths from the virus by the end of next year. That's according to projections from the Institute of Health Metrics and Evaluation at the University of Washington. Experts are warning the country is about to experience the largest COVID surge in the world, with as many as 800 million cases over the next few months. It's a stunning turnaround for a country that, until a few weeks ago, was following a strict zero-COVID policy.

For more on how this happened and how it's playing out, we called Helen-Ann Smith, a correspondent for Sky News in Beijing, and she's with us now. Helen-Ann Smith, thanks so much for joining us.

HELEN-ANN SMITH: Hi. Thanks for having me.

MARTIN: So could you just tell us what's the situation regarding COVID right now in Beijing, where you are? And then, of course, I want to ask you about, you know, the rest of the country.

SMITH: It's very difficult to say exactly how many people have COVID in this city because the numbers aren't being reported in the way that they have been. But what we do know anecdotally from living here is that there is an enormous wave of COVID-19 infections sweeping through this city at the moment. Just anecdotally, to sort of tell you through some of my friends and people I know in the city, I mean, I was having a drink with a friend last night who said his office are down to just 30 people of an office of 130 who don't have the virus.

There's a joke going around that the only people in the city that don't have the virus is expats who had it back in their home countries previously and have some sort of immunity. I mean, it's slightly trite. It's a joke. But that really is how it feels at the moment. The streets are completely empty. People are either isolating, or they're frightened and staying at home. So there is a really strange feeling about what's going on here.

But unfortunately, we don't know exactly how bad things are because the government have essentially stopped reporting the numbers in the way that they were. And people are also not really going to get themselves tested in the way they were either. So it's incredibly difficult to say exactly how big it is. But, my goodness, on the ground, anecdotally, it feels really, really big.

MARTIN: Wow. So that sounds quite extreme. So in the absence of any official reporting that anybody can have confidence in from the government about the true extent of this, what are people saying? I mean, are people that you've spoken with - do they have a sense of the kinds of projections that we're hearing outside of the country? This projection, for example, that there could be 800 million cases in the next few months, that there could be a million deaths over the next year - do people have any sense of the scope of it?

SMITH: I think it feels quite likely, according to the modelling, that that's the sort of numbers that we're going to be looking at. Remember, this is a very large population who actually have extremely low levels of community immunity because this country has adhered to its strict zero-COVID policy for so long. Add into that the fact that the vaccination here in China has been proved by the WHO, World Health Organization, and others to be less effective than some Western vaccines. And that all amounts to a population that don't have particularly high levels of immunity. And that's why I think you're seeing these just huge explosions in the numbers.

And also, it's important to remember that in this country, the health care system is very rickety. It's under-resourced. There are not enough intensive care beds here. There is not a kind of general practitioner system here in China. People tend to go straight to hospital when they have a problem. So it all amounts to a system and a situation where the hospitals could quite quickly become overwhelmed. I think a lot of people here are aware that things could get really quite serious. Just how serious is just unsure.

MARTIN: What else can you tell us about how people are adjusting to this across the country? Do you have a sense of whether people aren't going to work or that business has slowed? What can you tell us about that, how people are adjusting to all this?

SMITH: Well, I think a lot of Chinese people actually feel really quite frightened because they've been told to be frightened of this virus. And then things have suddenly changed, almost as if people have a bit of a sense of whiplash. They're sort of unsure how to suddenly adjust from being told that getting the virus was one of the worst things that could happen to being told, don't worry. It's not a problem. You just treat yourselves at home, buy some cold and flu medicine and all will be fine. It's a rapid, rapid turnaround. Some people definitely feel relieved. There was an enormous amount of weariness about zero COVID, real anger from some people as well, so there is a bit of relief. But I think there's a sense of trepidation about what comes next.

MARTIN: Do you have a sense of how the government is going to respond to this latest development? I mean, are they sending any signals about it?

SMITH: Well, that is a fascinating question because this is a really, really major challenge for the government. Now, this sudden change in policy really came about, I think, because fundamentally, the regime in here in China values stability above all else. And I think up until now, essentially, the Chinese government have made the calculation that very low numbers of infections and deaths from COVID-19 was one of the best ways to maintain that stability. And for a decent part of 2020 and 2021, that was the case. People in China were actually pretty supportive.

But as time has ground on and the restrictions around people's lives and liberty became harsher and more tiring, you know, you couldn't do anything in this country without a negative COVID test. You had to show your digitized health code to go to any restaurant, pub, bar, park, even into the compounds where people live. You had to have your health code, and in order to get your health code green, you had to have a COVID test every 48 hours or so. So people got increasingly weary, increasingly frustrated. And, you know, it led to that kind of the protests that we saw just three weeks ago now, and there were other kind of scuffles. And instances of people sort of losing their patience were getting sort of higher in number and increasing.

And it's almost as if that government made that calculation that zero COVID was actually now more destabilizing than allowing some people to die from COVID. And that seesaw really tipped. But it is a moment of huge challenge for the government because if we start to see hospitals overwhelmed, people dying in corridors, you know, that will be infuriating for the Chinese people. They will ask legitimate questions like why this was all happened so very quickly without any sort of staging.

There are a lot of accusations about a lack of preparedness. There isn't particularly good vaccination rates. There hasn't been a big vaccination campaign. There are not enough ICU beds. And there could have been a lot of time and money put into building that extra capacity during this nearly three years of zero COVID. The government bought itself a lot of time, and people might quite reasonably ask, why didn't you use that time a bit better to prepare?

MARTIN: That was Helen-Ann Smith, a correspondent with Sky News based in Beijing. Helen-Ann, thank you so much for talking with us and sharing this reporting with us.

SMITH: Yeah, no worries at all. It was a pleasure. I'm happy to help.

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