Officials and global health experts outside China are watching the COVID-19 outbreak in China with alarm, fearing that the country of 1.4 billion people is under-vaccinated and may not have the medical means to treat a wave of the disease that is expected to kill more than one million people by 2023, Reuters reported.

Some U.S. and European officials are struggling to see how they can help alleviate a crisis they fear will hurt the global economy, further limit corporate supply chains and spawn new variants of the coronavirus.

"We have made that point that we are prepared to help in any way they might find acceptable," U.S. National Security Council spokesman John Kirby said on Wednesday.

Advance preparation of the public health system, collection of accurate and common data, and open communication are important to combat massive coronavirus infections, public health experts say. Many of these elements are lacking in China, they say.

European and U.S. officials have engaged in cautious behind-the-scenes talks with their Chinese counterparts, issuing deliberately worded public statements designed to make it clear that the ball is in Beijing's court.

Washington and Beijing officials discussed how to deal with COVID earlier this month at talks in China in preparation for Secretary of State Antony Blinken's visit early next year, U.S. National Security Adviser Jake Sullivan said. He declined to give details, citing secret diplomatic channels.

One area of potential Western assistance involves whether China will accept an updated BioNTech mRNA vaccine designed to target currently circulating variants of the virus, akin to Omicron, which many experts say is more effective than Chinese vaccines.

German Chancellor Olaf Scholz discussed the issue during a visit to Beijing last month with BioNTech Executive Director Ugur Shahin.

But the United States and other Western countries are not openly encouraging China to accept Western-made mRNA vaccines, White House Coronavirus Response Coordinator Dr. Ashish Jha told reporters. 

"We stand ready to help any country in the world with vaccines, treatments, anything else that we can be helpful with," he said.

Beijing said "institutional advantages" would help it deal with the epidemic without foreign aid, and the estimated number of deaths from COVID in China is still lower than the 1.1 million deaths in the United States and 2.1 million in Europe.

But U.S. drug maker Pfizer (PFE.N) reached an agreement last week to export its COVID antiviral drug Paxlovid to China through a local company, saying it was working with all interested parties to ensure adequate supplies.

The rivalry between the United States and China, two of the world's largest economies, has intensified in recent months as the Biden administration attempts to bring China's semiconductor sector to its knees and politically displace Beijing from Asia and Africa.

But the two countries remain closely intertwined, and China is the largest U.S. trading partner and a major customer for many American companies.

"We want China to get COVID right," Blinken said earlier this month. "It’s in the interests of the Chinese people first and foremost, but it’s also in the interests of people around the world."

Health experts outside China despair that it may be too late to prevent the tragedy.

"This pandemic is just going to blow through (China) in the next weeks," he said. “It's unfortunate they didn't think about this six or 10 months ago. They could have bought themselves time to be in a better position.”