China is facing a rise in respiratory illnesses, particularly human metapneumovirus (HMPV), as winter begins. This outbreak comes five years after the start of the COVID-19 pandemic, and reports indicate that hospitals and crematories are having difficulty handling the growing number of cases.

Social media posts and online videos show overcrowded hospitals, with some people claiming that several viruses, such as HMPV, influenza A, Mycoplasma pneumoniae, and even COVID-19, are spreading at the same time. The scenario has raised concerns about overburdened medical facilities, especially in pediatric hospitals, which are said to be under stress as a result of a dramatic rise in pneumonia and "white lung" cases—a term used to characterise severe symptoms of pneumonia. Although there have been rumours that China has imposed a state of emergency, neither the Chinese government nor the World Health Organization (WHO) have provided any formal confirmation.

In response to the increase in cases, China's disease control authorities are taking action. The National Disease Control and Prevention Administration (NCDPA) has introduced a pilot monitoring system for pneumonia of unknown cause. This system is designed to better track and manage the rise in respiratory infections, especially during the winter months. This new approach is a significant improvement compared to five years ago when the country faced difficulties controlling the COVID-19 outbreak due to the absence of monitoring systems for new viruses. A statement from the NCDPA released this week highlighted a significant increase in respiratory infections during the week of December 16 to 22. According to the NCDPA's new protocols, laboratories are now required to report infections, while disease control agencies will verify and manage the cases. This approach ensures a more coordinated response to the ongoing crisis.

Kan Biao, an official from the NCDPA, mentioned at a press conference that although respiratory infections are expected to rise during the winter and spring, the total number of cases this year is expected to be lower than in 2024. The continuous outbreak is especially worrisome for vulnerable populations, including the elderly and young children. A higher risk of problems exists for older persons with pre-existing illnesses, such as asthma or chronic obstructive pulmonary disease (COPD), while children, whose immune systems are still growing, are particularly vulnerable to severe symptoms. 

HMPV and other respiratory viruses cause symptoms like fever, cough, runny nose, and wheezing, which are similar to the common cold or flu. In more serious cases, HMPV can lead to bronchitis or pneumonia, especially in children. The virus spreads through droplets from coughs or sneezes and close contact, making it easy to catch in crowded places. The respiratory virus known as human metapneumovirus (HMPV) frequently causes mild to moderate flu-like symptoms. 

The winter and early spring seasons are when it is most common. Although upper respiratory infections are the virus's usual symptom, it can occasionally cause more serious illnesses, especially in young children and the elderly. HMPV spreads through direct contact with infected people or surfaces. It is similar to other respiratory viruses like RSV, measles, and mumps. Unlike Covid-19, there is no vaccine for HMPV, and there are no specific antiviral treatments. Most cases are mild and can be treated at home with rest and fluids. However, severe cases may need hospitalisation, oxygen therapy or corticosteroid treatments to help manage the symptoms.