BEIJING (AP) — Wang Jian is anxious to get back to work teaching basketball to children now that China has lifted anti-COVID-19 restrictions. But his gym in the eastern city of Shenyang has been closed for a month because all its coaches are infected.

The most optimistic forecasts say China’s business and consumer activity might revive as early as the first quarter of this year. But before that happens, entrepreneurs and families face a painful squeeze from a surge in virus cases that has left employers without enough healthy workers and kept wary customers away from shopping malls, restaurants, hair salons and gyms.

“I hope the situation will turn around in March or April with no more COVID shocks,” said Wang, 33, who went without a paycheck for four months when the gym closed during virus outbreaks. “If parents worry about possible reinfection, they simply won’t send their children for training.”

The abrupt decision by President Xi Jinping’s government to end controls that shut down factories and kept millions of people at home will move up the timeline for economic recovery, but might disrupt activity this year as businesses scramble to adapt, forecasters say.

“This will be a bumpy process,” said Dong Chen, chief Asia economist for Pictet Wealth Management.

“People still are struggling with infections, but we think this could be temporary,” Chen said. “Broadly, we think this is a positive surprise.”

The decision to accelerate China’s reopening is a boost for the global economy at a time when activity in the United States and Europe is weakening after repeated interest rate hikes by central banks to cool surging inflation.

It is likely to help revive auto sales and propel demand for imported consumer goods, oil and food in China, one of the biggest global markets. Countries including Thailand with big tourism industries look forward to an influx of Chinese travelers.

The World Bank and private sector forecasters have cut estimates of China’s economic growth last year to as low as 2.2% due to the infection spike that started in early October and challenged Beijing’s “zero-COVID” goal of isolating every case. The International Monetary Fund expects a recovery to 4.4% this year, but that still would be among the lowest levels of the past three decades.

“Zero-COVID” kept China’s infection numbers low but shut down Shanghai and other industrial cities last year for two months, disrupting manufacturing and shipping. Business groups said global companies were shifting investment plans away from China because rules that required visitors from abroad to quarantine for a week kept executives from visiting.

The ruling party promised Nov. 11 to reduce the cost and disruption. A series of surprise announcements rolled back travel and other restrictions that health experts and economists had expected to persist through mid-2023.

On Sunday, Beijing began allowing travelers to enter China without quarantines. The government has yet to say when China will resume issuing tourist visas.

“The sudden, chaotic way in which pandemic policies have been changed means that growth will be hampered in new ways,” Daniel H. Rosen, Charlie Vest and Rogan Quinn of Rhodium Group said in a report. High numbers of infections make it “realistic to expect production to be hampered for a substantial part of 2023.”

Forecasters say the economy probably contracted in the final quarter of 2022 as virus case numbers rose and retail spending and trade fell.

Exports shrank after American and European consumer demand was depressed by interest rate hikes. That forces Chinese planners to make up for lost foreign sales by trying to boost consumer demand.

“The key to rapid economic recovery” is to “convert income into consumption and investment as much as possible,” one of the country’s most prominent financial figures, Guo Shuqing, the ruling party secretary for the central bank, told the official Xinhua News Agency.

Informal measures show public and business activity improving but weak.

This month’s subway passenger numbers in 10 large cities recovered to 55-60% of the level a year ago, up from 30-35% last month, according to Macquarie Group. Roads are growing more congested.

Foreign companies that see China as a critical market welcome the change but are struggling, said Eric Zheng, president of the American Chamber of Commerce in Shanghai.

“Companies were not prepared for this abrupt change,” said Zheng, whose group has about 1,000 member companies. “It is hard to manage a workforce when a lot of people are getting sick.”

Still, “things are almost going back to normal,” Zheng said. “Once life goes back to normal and consumers are out shopping, things will definitely improve.”

Another business group, the American Chamber of Commerce in China, said more than 70% of companies that responded to a poll last month expressed confidence the infection wave would last no more than three months and end early this year.

The ruling party is trying to nudge up growth by easing restrictions on financing for real estate and winding down anti-monopoly and data security crackdowns on tech companies that caused their stock market values to plunge.

In December, regulators announced Ant Group, an online financial company that was forced to call off a planned multibillion-dollar public stock offering in 2020, would be allowed to raise 10.5 billion yuan ($1.6 billion) for its consumer unit, more than doubling its capital.

“These measures are helpful, but far from enough to move the needle,” Larry Hu and Yuxiao Zhang of Macquarie said in a report.

Hotels, restaurants and other businesses hoping for a boost from this month’s Lunar New Year holiday, the busiest tourism season, suffered a blow when some local authorities appealed to migrant workers to skip traditional visits to their hometowns that might spread infections.

The operator of the 12-room Oriental Hotel in the eastern city of Hefei, who would give only his family name, Huang, said he is losing 4,000 yuan ($550) a month. His occupancy rate is 20%, well below the 50% needed to break even.

“People stay home and maybe they worry about possible reinfection,” Huang said. “If it stays the same for another year, I will give up running the hotel.”

The National Health Commission stopped announcing case numbers last month, but reports by city and county governments suggest hundreds of millions of people might have been infected.

The Zhengtai Restaurant in the northwestern city of Jinzhong closed for two weeks because almost all its 57 employees were infected, according to the manager, Chang Zhigang. Chang said the business has lost about 2 million yuan ($300,000) per year since the start of the pandemic.

“We don’t expect the situation to turn around within a short time, given there are very few people on the street,” Chang said.

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The U.S. has seen a string of COVID-19 outbreaks tied to summer camps in recent weeks in places such as Texas, Illinois, Florida, Missouri and Kansas, in what some fear could be a preview of the upcoming school year.

In some cases the outbreaks have spread from the camp to the broader community.

The clusters have come as the number of newly confirmed cases of the coronavirus in the U.S. has reversed course, surging more than 60% over the past two weeks from an average of about 12,000 a day to around 19,500, according to data from Johns Hopkins University.

The rise in many places has been blamed on too many unvaccinated people and the highly contagious delta variant.

Gwen Ford, a 43-year-old science teacher from Adrian, Missouri, was cautiously optimistic when she eyed the dropping case numbers in the spring and signed up her 12-year-old daughter for the West Central Christian Service Camp.

But one day after the girl got home from a week of playing in the pool, worshipping with friends and bunking in a dormitory, Ford got an email about an outbreak and then learned that her daughter’s camp buddy was infected.

“It was very nerve-wracking. It kind of seems like we finally felt comfortable and it happened,” Ford said, adding that her daughter ultimately tested negative.

Ford said she definitely plans to get her daughter vaccinated but hadn’t done so because there wasn’t much time between the start of camp and the government’s authorization of the Pfizer vaccine for 12- to 15-year-olds in May.

A note posted on the camp’s Facebook page showed that the camp nurse and several other staff members and volunteers were among those infected. Staff members at the camp did not return a call for comment.

JoAnn Martin, administrator of the public health agency in surrounding Pettis County, lamented the difficulty in getting people to take the virus seriously and get vaccinated.

“It has been a challenge since the first case,” she said. “You have people who still say it is not real. You have people who say it is a cold. You have people who say what is the big deal. You have people who say it is all a government plot.”

Dr. William Schaffner, a Vanderbilt University infectious disease specialist, said he isn’t surprised by the outbreaks as camps reopen this year after being closed last summer. He said he had his doubts that some camps “thought through all the implications of camping during COVID.”

Ideally, he said, camps would require vaccinations for adults and for campers who are old enough, and would take other measures such as serving meals in shifts, putting fewer youngsters in the cabins and requiring anyone unvaccinated to wear masks indoors.

In the Houston area, health officials reported more than 130 youths and adults tested positive for the virus in cases connected to a church camp. The pastor of Clear Creek Community Church in League City said the outbreak happened in two waves, first at the camp and then when people returned home in late June.

“In some cases, entire families are sick,” pastor Bruce Wesley said on the church’s Facebook page.

In Illinois, health officials said 85 teens and adults at a Christian youth camp in mid-June tested positive, including an unvaccinated young adult who was hospitalized, and some people from the camp attended a nearby conference, leading to 11 additional cases.

The Illinois Department of Public Health said all the campers were eligible for the vaccine, but only “a handful” of campers and staff had received it. The camp didn’t check people’s vaccination status or require masks indoors, according to the department.

The health department in Leon County, Florida, which includes Tallahassee, tweeted this month that an increase in cases there also was tied in part to summer camp outbreaks.

And in Kansas, about 50 people have been infected in an outbreak linked to a church summer camp held last month not far from Wichita.

Elsewhere the situation is better. The roughly 225 overnight camps and thousands of day camps run by local YMCAs are mostly open this summer, though with slightly reduced capacity, said Paul McEntire, chief operating officer for YMCA of the USA.

McEntire said he is aware of a few cases of Y camps where people tested positive for the virus, but no instances of significant spread. He said many camps are taking precautions such as serving meals in shifts or outside and trying to keep youngsters in separate groups. Most are requiring masks indoors, but he acknowledged it can be a challenge.

“To be frank, there are some parents that didn’t want to send their kids unless they were assured that masking was being used indoors,” he said. “There were others that took the exact opposite viewpoint.”

Ahead of the school year, the Centers for Disease Control and Prevention updated its guidance last week to say vaccinated teachers and students don’t need to wear masks inside and 3-foot distancing of desks is not necessary for the fully vaccinated.

Summer camp outbreaks “certainly could be a precursor’’ to what happens when youngsters return to classrooms in the fall, said Dr. Michelle Prickett, a pulmonary and critical care specialist at Northwestern Memorial Hospital in Chicago. The outcome will depend on vaccination rates and which virus variants are prevalent, she said.

“We just need to be vigilant,’’ Prickett said.

Schaffner said he thinks schools won’t face similar outbreaks because they tend to be more structured and disciplined than camps and because most got used to making adjustments over the past year and a half. But he said the best way to reduce the risk is to get most people vaccinated.

“There are many parts of the country that simply have not grasped this,’’ he said.

It could be several months before regulators make a decision on authorizing shots for children under 12. Studies on such youngsters are still going on.

Ford, the teacher whose daughter narrowly escaped getting COVID-19 at a Missouri summer camp, is worried.

“With the uptick in cases, I am concerned that we won’t be able to go back to normal, and we will have to ask people to mask and stuff,” she said, “and I have a feeling that there is going to be a huge argument.”

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