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A Chinese health official dismissed concerns from the WHO and others about China's apparently suppressed COVID death toll, which continued to climb in single digits while the country's leading institutions published dozens of obituaries in recent weeks.
"It is not necessary to look into the specific cause [of death] for each case at present. The priority during the pandemic should be treatment," said Liang Wannian, an epidemiologist who leads the COVID task force at China's National Health Commission.
The outbreak in the country of 1.4 billion people is posing a "serious challenge to the entire medical and health care system," but the peak of the first wave has passed, Liang told a press briefing on Wednesday. The mortality rate will fluctuate as the virus spreads, with an accurate count only possible after the pandemic is over, he said.
Beijing reversed its zero-COVID policy with little warning in early December, before proceeding to dismantle the rest of its years-long pandemic strategy in one month. Its discarding of regular testing has made infection dynamics difficult to assess, while new and stricter criteria for COVID deaths, to require proof of pneumonia or respiratory failure, has kept official fatalities at a minimum.
Chinese health authorities have reported only 37 COVID-related deaths since last month, for a pandemic total of roughly 5,000. British health analytics company Airfinity, which maintains a statistical model of the world's largest outbreak, estimated China was seeing 20,400 daily deaths as of January 11, with a projected death toll of 1.7 million by the end of April.
Unofficially, however, the virus has claimed the lives of dozens of mostly elderly public figures, including Communist Party cadres, ex-diplomats, leading academics and celebrities. Universities in Beijing and Shanghai were releasing frequent death notices about former professors, while at least two retired envoys died of COVID-related symptoms this month.
The Harbin Institute of Technology, one of China's top public research universities, published 23 obituaries for retired professors between Christmas Day and Tuesday. Few of the deaths, if any, were reflected in the government's count.
Tedros Adhanom Ghebreyesus, the director-general of the WHO, said on Wednesday there was "almost certainly" an underreporting of virus deaths in China. Maria Van Kerkhove, the agency's technical lead on COVID, said communication with Beijing was ongoing to fill "very important information gaps" related to hospitalizations, deaths and genome sequencing.
"WHO still believes that deaths are heavily underreported from China, and this is in relation to the definitions that are used, but also to the need for doctors and those reporting in the public health system to be encouraged to report these cases and not discouraged," said WHO emergencies director Mike Ryan.
"There is also a shift in the definition away from 'COVID pneumonia' as the reporting disease to 'COVID infection' as the main basis for disease reporting, and we hope that that will encourage more reporting, and more reporting to WHO of the true situation on the ground in China," he said.
Ryan previously said Beijing's criteria for counting COVID-related deaths, which also excludes those who die with preexisting illnesses, is "too narrow."
Liang, the infectious diseases expert, argued there remains no consensus on a definition: "It would be best if a global consensus can be reached. If a consensus cannot be reached, each country will classify [COVID-related deaths] according to its own situation."
Wang Guiqiang, who heads the infectious diseases department at Peking University First Hospital, told the same briefing that China's final COVID death toll could consider excess mortality, which would compare fatalities to pre-pandemic years.
In an interview with Chinese state broadcaster CCTV that aired on Sunday, Liang acknowledged that many elderly patients were dying of the disease due to the scale and speed of the outbreak, for which China, like some countries in the West, wasn't adequately prepared.
Liang nonetheless defended China's decision to reopen in winter, when medical resources are typically stretched. The vaccination rate among the country's elderly was too low last summer, and waiting for this summer could risk waning immunity, he said.
Government data from late November showed an overall vaccination rate exceeding 90 percent, but the booster rate among those aged 80 and above was just 40 percent.
China's first nationwide COVID surge, which has peaked in some urban areas, could spread rapidly through its vast hinterland in the coming weeks during the Lunar New Year break. Some 2 million passengers are expected to travel by air, road and train in the 40-day holiday rush known as "chunyun" between January 7 and February 15, according to the Chinese transport ministry.
The WHO said transmissions would be difficult to track without real-time data. "It's not possible for WHO to give you a detailed breakdown on that because we simply do not have that data," said Ryan.
"We continue to ask for that data, but at the same time can recognize the efforts being made by colleagues in China to beef up their clinical support to people affected with the disease," he said.
In the meantime, the U.N. health agency has backed governments that have imposed testing requirements on travelers from China, policies Beijing argues are politically motivated. Negative PCR tests are still required for entry into China.
This week, Chinese embassies stopped issuing visas in Japan and South Korea in retaliation. "The measures we've taken are entirely justified and reasonable. We once again call on relevant countries to follow the principle of science and make sure that their COVID response measures are science-based and proportionate," Wang Wenbin, China's foreign ministry spokesperson, said in Beijing on Wednesday.
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About the writer
John Feng is Newsweek's contributing editor for Asia based in Taichung, Taiwan. His focus is on East Asian politics. He ... Read more