China is facing an increasingly precarious situation as new COVID cases soar and the population seems to be hitting a breaking point with the government's stringent zero-tolerance policies.

Why it matters: The world's most populous nation has massive vulnerabilities heading into this winter, starting with the fact the vast majority of its population has yet to be exposed to the virus and has little 'natural immunity.'

• China's vaccines didn't work well compared to those distributed in the West, and the government refused to approve foreign vaccines and doesn’t have a version to combat Omicron.
• Vaccine uptake was particularly low among the elderly.
• And now, public outrage over new COVID lockdown restrictions has fueled rare protests, Axios' Herb Scribner writes, with residents demanding the government to lift restrictions quickly and some calling for President Xi Jinping's resignation.

State of play: Overall, China's number of reported COVID cases and COVID deaths are far lower than other nations, but there have been recent reported spikes in overall numbers of cases and some new deaths.

• It came after the Chinese government announced some easing of its zero-COVID policy, such as reducing mass testing and quarantine requirements, earlier this month.

Reality check: China’s doctors have warned that the health care system isn't prepared for the huge outbreak likely to follow any easing of public health measures, Axios' Bethany Allen-Ebrahimian writes.

• That includes worries the nation doesn't have enough ICU bed capacity to handle such outbreaks, according to the Financial Times.

Between the lines: Another concern is the potential evolution of a new, more dangerous variant if there’s a huge surge of infections, Christian Drosten, Germany’s most prominent virologist, told Bloomberg.

• “Xi Jinping knows very well that he can't simply let the virus loose," Drosten said. "The Chinese population first needs to be as well vaccinated as we are."

Be smart: China's officials are scrambling to address the vaccine problem.

• For instance, they are launching more aggressive vaccine drives and limiting movement among at-risk groups, including the elderly, the Washington Post reports.
• They've also approved the use of the first inhaled COVID-19 vaccine in dozens of cities earlier this month in a bid to boost uptake, WSJ reported. Experts have said the vaccine, which was found to stimulate a mucosal response, may create more durable protection against the virus, although more data is needed.
• But they have yet to open up the availability of mRNA vaccines from Pfizer-BioNTech and Moderna, opting to focus on their own, per the Post.

The bottom line: China's zero-COVID policy has kept cases in China relatively low compared to the rest of the world.

• But even as the societal and economic consequences of shutdowns become apparent, it faces a very difficult path ahead in unwinding strict public health policies.