The elderly people struggling in Shanghai's quarantine centres

Thousands of elderly people in the Chinese city of Shanghai have been hit hard by a lockdown that has now dragged on for five weeks. Since the outbreak began in early March, more than 500,000 people have tested positive for the virus. Nearly 10,000 of those people have been aged over 80.

China's Covid rules demand that anyone who is infected, or a close contact, must be sent to a state-run quarantine centre. It is not uncommon for hundreds of people to be put together in such centres. Images shared on social media have showed unsanitary conditions, with clogged up toilets and overflowing rubbish bins.

One woman in Shanghai told the BBC that her 90-year-old grandmother who is in one such centre, is struggling with unsanitary conditions, unable to sleep properly, and has largely been left to fend for herself. She now fears her 91-year-old grandfather, who has also tested positive, will also be dragged to a centre - which she says will effectively be a death sentence.

'She wouldn't [be able to] survive at all'

Her grandmother was the first to fall sick, said the woman, who asked to remain anonymous. The lady tested positive on 17 April - despite having never left the house since the outbreak began. The past two weeks have been a real struggle.

A previous illness has left the 90-year-old with one numb leg, making walking difficult. The facility's toilet block is more than 100m from her bed, so she has been trying to avoid drinking too much water to spare herself a trip to the bathroom.

Rest is also fleeting in the strained, communal conditions. Fluorescent lights are on 24 hours a day and so she's been unable to sleep properly, her granddaughter says.

"Luckily there's a warm-hearted [woman] in the quarantine centre. She accompanies my grandma to the toilet and assists her with eating."

"If my grandma was there alone, she wouldn't [be able to] survive at all."

She added that her grandmother hasn't received any medical drugs or "proper treatment" - only supplies of traditional Chinese medicine which medical experts say have no documented effect in treating or relieving Covid symptoms.

However, desperate to recover and leave the centre, her grandmother has taken whatever she has been given. This, her granddaughter claims, has led to various medical conditions, including diarrhoea.

She's desperate to get her grandmother out, or at least to a hospital where she can be properly looked after. But community officials insist they will not let her out until she tests negative. "When I called her, she repeated 'I want to go home. I want to go home soon," she said. "She's also worried about my grandpa who's at home."

Forced against their will

Her biggest fear now is that her 91-year-old grandfather, who has now also tested positive for Covid, will be forced to enter the centre. On Wednesday, community officials warned this would happen soon.

Her grandfather is bedridden as a result of a stroke, and suffers from diabetes and hypertension. He can't go to the toilet without help, and relies on a live-in carer at home.

"He just can't go to quarantine centres or hotels," she said. "The hygiene situation there is worrying. Old people can't adapt to such environments. How can he live there?"

His granddaughter says his Covid symptoms have been minimal - with only a dry cough so far. Rest at home is all he needs, she said.

"We argued with a community official - that if you send him to quarantine centre, you are actually forcing him to [die]," she said. But officials say they have to follow government orders. Her family says they will take action if he is forcibly taken.

A community official contacted by the BBC said they have offered the family the option of home quarantine for him - his granddaughter told the BBC that officials called her an hour later and informed them of this offer.

She says she's heard of another elderly person in their neighbourhood, a 94-year-old woman who'd become infected, who had been taken against her wishes. Police came for her at midnight, she said.

"It's just terrifying," she said. "The government has to give us a solution. [At the moment] they're just using old people's lives to achieve this goal of 'zero Covid'."

The government she says, needs to allow old people to quarantine at home, instead of forcing them into such centres.

Other patients in such centres have also told the BBC about how hard it is for elderly people. "There's just not enough medical resources now. Old people can't be treated in hospital like in normal days," said the Shanghai resident, who wished to be identified only as Mr Wu.

However, he added that many physically-impaired elderly people were being cared for by staff and doctors to the best of their ability, adding that centres were also preparing special meals for them. "Quarantine centres are not as good as hospitals. But I feel the country has tried its best to look after them," he said.

The vaccination problem

The latest outbreak in Shanghai, first detected in early March, has seen around 500,000 cases recorded so far and 337 deaths. Nearly all victims have been elderly, unvaccinated residents with underlying health problems, according to Chinese officials.

In this instance, both the woman's grandmother and grandfather are unvaccinated. Their granddaughter says they want to take the vaccine as they were afraid of potential side effects.

China has given more than 3.3 billion doses of the Covid vaccine and vaccinated over 88% of its entire population.

But vaccine rates among people over the age of 80 - who are among the most vulnerable - remain a lot lower than other age groups.

In Shanghai, only around 62% of the elderly population are double vaccinated, with around 38% having received their booster.