China reported more than 20,000 COVID-19 cases on Wednesday, the highest daily tally given since the start of the pandemic, as millions in locked-down Shanghai began a new round of testing.

The country’s “zero-COVID” strategy has come under immense strain as cases spike, with around 25 million residents of Shanghai—China’s largest city and economic engine room—ordered to stay-at-home as the authorities struggle to contain the outbreak.

Until March, China had kept daily cases low with snap localised lockdowns, mass testing, and strict restrictions on international travel.

But the caseload has hit thousands per day in recent weeks, with Shanghai driving the surge of the highly transmissible Omicron variant.

The city locked down its residents in phases last week, prompting scenes of panic-buying and mass testing.

But state broadcaster CCTV reported that the city will launch a fresh round of tests on the entire population on Wednesday.

Shanghai is “testing its strength against the virus,” senior city health official Wu Qianyu said at a press conference Wednesday, the latest dour warning from authorities suggesting a long run in lockdown may be ahead.

The city is converting its landmark National Exhibition and Convention Center into a makeshift COVID hospital for 40,000 people, state news agency Xinhua reported Wednesday, just days after setting up a temporary quarantine centre in another expo hall.

Extended lockdown

China recorded 20,472 infections on Wednesday, the National Health Commission said in a statement.

It is the country’s highest-ever daily infection number given by authorities, even during the peak of the initial outbreak which centred around Wuhan.

The majority of the cases are, however, asymptomatic.

Authorities reported no new deaths, in a country which says only one person has died of the virus in nearly two years.

Yet China faces low vaccination rates, especially among the elderly, leaving officials with a high-wire act of balancing maintaining public health with keeping the economy moving.

In Shanghai quarantine facilities are bulging with people who test positive—even if they are asymptomatic—as city officials stick rigidly to virus protocols.

Those include separating COVID-positive babies and children from parents who test negative, a policy that has stirred anxiety and anguish from worried families.

City officials said on Wednesday that parents of some child patients with “special needs” would now be allowed to remain with their COVID-positive children.

Meanwhile anger over lack of fresh food and curtailed movements is rising among residents as officials extend what was originally intended to be a short lockdown.

Shanghai, China’s largest city, accounted for more than 80 percent of the national tally, city officials said on Wednesday.

A top Shanghai official has conceded that the financial hub had been “insufficiently prepared” for the outbreak.

China, the country where the coronavirus was first detected in the central city of Wuhan in late 2019, is among the last remaining places following a zero-COVID approach to the pandemic.

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