(NEW YORK) — Since the relaxation of its “zero COVID” restrictions earlier this month in the wake of unprecedented nationwide protests, China is facing its largest outbreak of the pandemic.

At the same time, mass testing has been dropped as Chinese authorities changed their criteria in counting cases and COVID-19 deaths, rendering elusive a clear picture of the state of coronavirus in China.

No longer including asymptomatic cases in their count, cases have been dropping officially in China, with only 2,966 symptomatic infections Wednesday. Cases peaked at some 40,000 daily cases earlier this month, but less than 10 official COVID deaths were reported since the beginning of December.

The congested streets, however, around the busy funeral homes in Beijing don’t seem to match the official toll.

Ambulances, hearses and vans lined the streets outside two of the main crematoriums in Beijing.

Workers at Beijing’s Dongjiao Funeral Parlor in the capital’s eastern suburbs told ABC News that their crematorium is operating around the clock.

The funeral home had run out of freezers to store the bodies, another worker surnamed Li told ABC News’ partners at TVBS News.

“New remains would be cremated right away,” Li said. “And if there are too many they have to be put on the floor to wait.”

Chinese health authorities in recent days clarified that they will now follow a strict criteria in classifying a case as a COVID-19 related death.

“Deaths caused by pneumonia and respiratory failure caused by the novel coronavirus are classified as deaths caused by COVID-19 infection,” Wang Guiqiang, director of the Infectious Diseases Department of Peking University First Hospital, told the media in a government press conference earlier this week. “Deaths caused by other diseases and basic diseases … are not classified as deaths caused by COVID-19.”

Despite the low official count, authorities have conceded that various sub-variants of Omicron are spreading rapidly across China. Shanghai-based medical expert Zhang Wenhong told an online forum over the weekend that the reproductive number around China stands at 16-18, meaning one positive patient can infect up to 18 others.

The streets around Beijing’s Chaoyang Hospital were quiet in below-freezing temperatures Thursday but inside ABC News observed packed halls in the emergency clinic with some patients on makeshift beds in the corridors. The fever clinic at the China-Japan Friendship Hospital in northeastern Beijing has been running 24 hours and ABC News saw the ward at near capacity, the majority of the patients being seniors.

Similar scenes are playing out across the country.

In the western metropolis of Chongqing, a nurse in the pediatric department of one of the city’s three main hospitals told ABC News that her department is at capacity, full of children with high fevers. The nurse, who declined to allow her name to used because she is not authorized to speak, said that parents are taking their children directly to the hospital because they have no fever medicine at home. Like many, they were caught off guard by China’s sudden shift in COVID policies to prepare.

Another doctor in Chongqing, also declining to use his name because of similar sensitivities, told ABC News that the fever clinic and respiratory medicine department at this hospital are inundated with many senior citizens having a “difficult time” and having to wait several hours just to get a numbered ticket to see a doctor. He added that many of the seniors “ have other illness” in addition to COVID.

China’s official vaccination rate is above 90% but the rate for boosted adults is only around 58%. Ahead of the relaxation of zero-COVID, China’s most vulnerable elderly population was already highly under-vaccinated. Over a third of over 80-year-olds were not fully vaccinated and 60% were not boosted.

Beijing has only allowed its population to use its homegrown vaccines which uses traditional vaccine technology and are less effective than the western-made mRNA vaccines like Pfizer’s and Moderna’s in preventing serious illness due to COVID. With Beijing’s mass-vaccination drive being almost two years ago, immunity protective from those vaccines are also waning.

The World Health Organization said Wednesday it was “very concerned” about severe coronavirus cases across China and warned the country’s lagging vaccination rate could result in large numbers of vulnerable people getting infected.

WHO Director-General Tedros Adhanom Ghebreyesus called for China to be transparent about the severity of COVID-19 across the country, in particular hospital and intensive care unit admissions, “in order to make a comprehensive risk assessment of the situation on the ground.”

A number of studies done in recent weeks point to an unavoidable toll caused by China’s ‘exit wave’ from zero-COVID. A study released by Hong Kong University last week warned that China would suffer nearly a million deaths if more isn’t done to slow the rapid release of COVID restrictions, the South China Morning Post reported.

Wu Zunyou, the chief epidemiologist for China’s CDC, said they are anticipating three waves over the few months. The current wave — hitting the major cities like Beijing, Shanghai, Chongqing and Guangzhou — will peak just before the Lunar New Year around early-to-mid January. These are the cities with the best healthcare and number of ICU beds. The next wave will be seeded by the Lunar New Year travel rush, when hundreds of thousands travel back to their hometowns, deeper into the less prosperous regions of the country. A third wave is expected when people head back to work in late February and early March.

China’s official state media has been focusing on re-opening the economy and stories of the recovered. Buried in the headlines have been an uptick of obituaries of prominent elderly Chinese citizens.

In just the last three days, there were obituaries for the artist who designed the mascots from the 2008 Beijing Olympic Games, a former politician who served as the deputy director of China’s National Sport Commission in the years leading up to the 2008 Games, a prominent economist, the former head of China Film Archives and a legendary film makeup artist who designed the look of the iconic Monkey King television series that many Chinese grew up with.

None of the obituaries mentioned their cause of death. At most, some mentioned that they were seeking medical treatment.

However, the personal toll for some cannot be obscured.

On Wednesday evening, television actor Wang Jinsong posted a lament on his Weibo saying “This is the time of day I video chat with my mother. My mother has been taken away by the pandemic. That video call will no longer be connected through.”

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