China Says 'Difficult to Tell' True COVID Death Toll As It Begins Surveys

A Chinese official in the United States has acknowledged the difficulty in ascertaining the exact number of COVID-19 cases and the associated death toll amid outbreaks that have followed an easing of years-long restrictions in the world's most populous nation.

"After the adjustment of COVID-19 responses, China stopped conducting COVID tests for all residents, which makes it difficult to know accurately what the case number is," said Liu Pengyu, spokesperson for the Chinese Embassy in Washington, D.C., in response to a number of media questions.

He noted that China was not alone in this practice, however, given global trends of the pandemic.

"This is the same case in many countries around the world," Liu said. "The U.S. government stopped releasing COVID-19 case numbers in October 2022."

And when it comes to concerns expressed by foreign experts and officials, including those in the United States, regarding data transparency, specifically what appeared to be a low reported fatality rate, Liu explained China's process for identifying casualties of the coronavirus.

"There are two main criteria for determining death from COVID-19 globally," Liu said. "One is death directly caused by respiratory failure because of infection with COVID-19, the other is death within 28 days of infection — to put it simply, 'deaths due to COVID-19' and 'deaths with COVID-19.' China has adopted the first category of death criteria since 2020."

Here too, however, he said the current conditions were not conducive to attaining an exact figure, though officials were conducting a mass campaign to investigate the number.

"In times of pandemic and rapid transmission, it is difficult to tell exactly what the case fatality rate is," Liu said. "However, China has started to collect information through questionnaires and surveys and will continue to disclose information on deaths and severe cases in accordance with the principle of truth, openness and transparency."

China's National Health Commission first announced in November that the country would begin to ease the far-reaching anti-epidemiological measures that began to take hold across the country shortly after COVID-19 was first detected there three years ago. Since then, further relaxations of what comes to be known as President Xi Jinping's "zero-COVID" policy have been announced.

These include what Liu referred to as "new provisional measures" for international travel that he hoped "will better facilitate the safe and orderly cross-border travel and exchanges and cooperations between Chinese and American people."

At the same, however, he criticized what he called "misunderstandings and misrepresentations about China's COVID situation" emerging in the words of foreign media outlets and comments by foreign officials, including those of the U.S.

Liu went on to defend China's record on sharing health data at a time when the World Health Organization (WHO) has also called for greater transparency from the People's Republic. He argued that "China has always shared its information and data responsibly with the international community" and said Beijing has been in regular contact with the WHO in recent days.

"Since COVID-19 is treated as a Class-B instead of Class-A infectious disease in China, there is an adjustment in COVID data updates and the frequency of their publication," Liu said. "Information about hospitalizations, severe cases, critical cases, and cumulative deaths are regularly released by the Chinese CDC [Center for Disease Control and Prevention]."

He argued that the recent reforms being taken in China's COVID-19 strategy did not mark a departure from the country's approach adopted in the beginning of the pandemic. Rather, he asserted, that this was the latest of "nine or ten versions" of a consistent effort to establish protocols "more targeted and suited to the things on the ground."

Liu also sought to dispel the notion that China was unprepared for the sharp rise in COVID-19 cases wrought on after the easing of longstanding restrictions. He said the Chinese government "has been closely monitoring the pandemic trains both at home and abroad" and was sensitive to growing internal calls for change that saw rare demonstrations emerge nationwide late last year.

"As Omicron becomes much less fatal, the call for normal life and for normal work becomes louder and the Chinese government has heard this call," Liu said, "and so on the basis of scientific assessment of the pandemic, also of course, in reference to some other countries' experiences, China has shifted the focus of the of the policies."

And while he said "it may take some time for people to get used to this shifting trend, with a sharp rise in cases and shortage of medical staff at the beginning," he felt that "now China is in a better position to go through this transition, thanks to the rising vaccination rate, especially for the elderly, stronger treatment capability and experience, expanded production capacity, and sufficient supplies."

"Though infections are still spreading," he added, "the pandemic is on the whole predictable and under control in China, which will soon lead to a new stage of stable and orderly economic and social development."

Liu described the current situation as "a new phase of COVID response, where I think tough challenges remain, but also the light of hope is right in front of us."

"I think life and work has come back to normal in Beijing, Shanghai, Guangzhou and some other megacities," he added.

The three cities have a combined population exceeding 60 million people and Liu cited scenes of crowds in public venues such as shopping malls and subways, as well as New Year's Eve celebrations as evidence that the nation was already on the road to recovery.

"Now, we are now closely monitoring the COVID situation in some other parts of China, especially in the rural areas, some in the countryside," Liu said. "We are now focusing on strengthening the protection of key groups like the elderly and vulnerable people, we are providing classified medical and health services and we believe that normal production and life can be restored."

This is a developing news story. More information will be added as it becomes available.