The Doctor's Diary: A Selection of Blog Articles on Health and Medicine

Why China's COVID-19 Data Are Inaccurate Compared to World's Standards?

China's recent relaxation of its zero-COVID strategy, which had been in place for nearly three years, has caught the country's fragile health system unprepared, leading to a surge in cases and overwhelming hospitals, pharmacies, and authorities. On Thursday, a senior World Health Organisation (WHO) official stated that China might be struggling to accurately report cases as it faces a significant increase in infections. Experts predict that China could see more than a million COVID deaths in the coming year. However, despite evidence of overwhelmed hospitals and crematoriums, China's government has reported fewer than 10 COVID deaths in the past two weeks.

China's narrow criteria for identifying COVID deaths have raised concerns that the toll is underestimated. Currently, only deaths caused by pneumonia and respiratory failure after contracting COVID are classified as having been caused by the virus. Deaths from complications in other parts of the body or underlying conditions made worse by the virus are excluded from the official toll. Foreign health experts have criticized this approach as it misses several widely recognized types of potentially fatal COVID complications, including blood clots, heart attacks, sepsis, and kidney failure. Some of these complications can increase the chances of dying at home, particularly for individuals unaware that they should seek care for these symptoms.

Currently, the case definition and criteria have changed in China (not the first time) due to the Omicron variant being less likely to cause other life-threatening symptoms. However, China's hospitals are still required to judge each case to determine whether COVID was the ultimate cause of death. The methods for counting COVID deaths have varied across countries during the nearly three years of the pandemic.

China has a history of downplaying infections and deaths for political reasons. The current definition of COVID deaths has raised concerns that the government is attempting to hide the impact of easing its strict controls. A June 2020 study of China's initial outbreak in Wuhan estimated that 36,000 individuals could have died at the time, ten times the official figure. A study published in the Lancet in April 2021, which looked at COVID-related mortality in 74 countries and territories over 2020-2021, estimated that there were 17,900 excess deaths in China over the period, compared with an official death toll of 4,820.

The WHO has warned that China may be struggling to accurately report its cases as it faces a significant increase in infections. However, China's official statistics show fewer than 10 COVID deaths in the past two weeks, leading experts to believe that the toll is underestimated. The WHO has called on China to adopt a more comprehensive approach to counting COVID deaths to ensure that the true impact of the virus is understood and that the best ways to protect individuals are communicated effectively.

The recent relaxation of China's zero-COVID strategy has led to a surge in cases, overwhelming the country's fragile health system and leading to shortages of hospital beds, drugs, and the need to build special clinics. The WHO has stated that China may struggle to keep a tally of COVID-19 infections as it faces a significant increase in cases. Experts predict that China could see more than a million COVID deaths in the coming year. However, China's official statistics show fewer than 10 COVID deaths in the past two weeks, leading experts to believe that the actual toll is underestimated due to the country's narrow criteria for identifying COVID deaths. The WHO has called on China to adopt a more comprehensive approach to counting COVID deaths to ensure that the true impact of the virus is understood and that the best ways to protect individuals are communicated effectively.

*This article was written in December 2022.