Nearly 11 million stressed-out Chinese students began taking the country's gruelling annual college entrance exam on Tuesday following a month-long coronavirus delay, with inspectors this year checking both for cheaters and fevers.

The two-day test -– known in Chinese as the "gaokao" -- is an annual moment of great anxiety for students and parents who dream of sending their children to university, but the coronavirus added another layer of pressure by closing schools for months.

At a testing centre in Beijing, students took selfies and exchanged hugs and high-fives with family and friends before going in for the exam. Some students stood outside the venue, poring over their study materials for some 11th-hour cramming.

"I'm actually more nervous than my son," said a 49-year-old parent who gave her surname, Yi. "The pandemic did impact him. He hasn't gone to school for seven months since the school closed in January. He is too young to swiftly adapt to these big changes in our society."

More than 7,000 exam sites have been set up across China, with nearly one million invigilators or other workers to watch over the students, according to state media. Officials were not just looking for cheaters. They watched students for fevers or coughs. Test-takers who show symptoms are to be taken to an isolation room with disinfectant, according to the official Xinhua news agency.

The students and invigilators had to track their health during the 14 days prior to the exam. Students from high-risk areas have to wear masks during the tests. "At first, I felt it was a bit hard to breathe, but after I was completely focused on the exam, I wouldn't notice the mask," said a student surnamed Tan.

Students could not even escape the subject while taking the exam, with two of the national essay questions asking students to draw on their experiences of the pandemic. One question listed the lockdowns and social distancing measures implemented in China and asked candidates to write about the topic of "distance and connection during a pandemic".

'Bit nervous'

Zhao Kexin, who is taking the exam in Beijing, had to report her temperature to her school every day leading up to the exam. "Though there are enough measures to protect us from contracting the virus, I am still feeling a bit nervous about gathering in a public area, but I have to take the test," Zhao said.

A new outbreak in Beijing last month raised fears of a second wave but authorities appear to have brought it under control after locking down dozens of residential areas in the capital.

Xiao Wang, an 18-year-old student in southwestern Sichuan province, was able to focus on her studies again as nationwide cases were brought under control in the spring. "But the recent cases in Beijing made me worried again," Xiao said.

Getting a high score remains the sole way for many students to get into top universities in China, placing intense pressure on young students. "The stress not only comes from students' fear of underperforming on the test, but also comes from family and society," said Ye Minjie, a committee member of the Chinese Psychiatrist Association.

"The narrative that gaokao is the battlefield of one's life prevails sometimes, making students nervous," Ye said. "This year is quite different. The pandemic has intensified the pressure students suffer as millions of them have been confined to home for a very long time before coming back to normal studying."

Some students fear that online schooling put them at a disadvantage, Ye said. Another stress factor was not getting along with parents while being confined at home. "I have always been stressed when I prepare for the gaokao even in normal time and the pandemic took a toll on my studies," Xiao said. "This is the second time I take the gaokao. For me, it is the easiest way to change my life."