China’s narrow criteria for identifying deaths caused by COVID-19 will underestimate the true cost of the current wave of the pandemic there and could make it difficult to communicate the best ways for people to protect themselves, foreign health experts warn.
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Only deaths caused by pneumonia and respiratory failure after contracting COVID will be classified as caused by the coronavirus, a leading Chinese medical expert said on Tuesday.
Deaths from complications at other body sites, including underlying conditions made worse by the virus, would be excluded from the official figure, said Wang Guiqiang, head of the department of infectious diseases at Peking University First Hospital.
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Experts familiar with hospital protocols in China told Reuters that such cases were not always previously excluded, although COVID would sometimes be ruled out as a cause of death if a previously positive patient had tested negative a day or two before dying.
Wang said the criteria had changed because the Omicron variant is less likely to cause other life-threatening symptoms, although hospitals in China have yet to judge each case to determine precisely whether or not COVID was the final cause.
Methods for counting COVID deaths have varied between countries in the nearly three years since the pandemic began.
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However, disease experts outside of China say this targeted approach would miss several other widely recognized types of life-threatening complications of COVID, from blood clots to heart attacks, as well as sepsis and kidney failure.
Some of these complications can increase the chances of death at home, particularly for people who are unaware to seek care for these symptoms.
The new definition will “clearly not capture all COVID deaths,” said Dr. Aaron Glatt, an infectious disease expert at Mount Sinai South Nassau Hospital in New York and a spokesman for the Infectious Diseases Society of America. “Saying you’re going to ignore anything else going on in the body is nonsense and scientifically inaccurate.”
Last month, Korean researchers reported that 33% of Omicron-related deaths between July 2021 and March 2022 at a large hospital were due to causes other than pneumonia.
Can the Covid data from China be trusted?
With one of the lowest COVID death rates in the world, China has routinely been accused of minimizing infections and deaths for political reasons.
A June 2020 study of the country’s initial outbreak in Wuhan that began in late 2019 estimated that 36,000 may have died by that time, or 10 times the official toll.
A study published by The Lancet in April, which looked at COVID-related mortality in 74 countries and territories during 2020-2021, estimated that there were 17,900 excess deaths in China during the period, compared with an official number of deaths of 4,820.
Globally, the study estimated an excess of 18.2 million deaths in 2021-2022, compared to reported COVID deaths of 5.94 million.
China’s new announcement raised concerns that the government was trying to hide the true impact of relaxing its draconian “zero-COVID” controls after nearly three years of disruptive lockdowns and mandatory mass testing.
Despite widespread reports that funeral homes and crematoriums are struggling to keep up with a surge in demand, China’s official death figures have not skyrocketed, with no new deaths reported for December 21 and only reported seven deaths since the government announced on December 8 that “zero-COVID restrictions would be removed.
In fact, China reduced its cumulative death toll by one on December 20, bringing the total to 5,241.
China’s National Health Commission did not immediately respond to requests for comment on the country’s COVID statistics and excess mortality.
Even if China continued to define COVID deaths more broadly, official data is unlikely to reflect the situation on the ground given how quickly infections spread, said Chen Jiming, a medical researcher at Foshan University of China. China.
“Reported case and death counts are only a very small portion of the actual values,” he said.
Ben Cowling, an epidemiologist at the University of Hong Kong’s School of Public Health, said the official death count would be very low even if a broader definition were used, “because very little testing is being done” now that China has stopped mass surveillance. .
On the other hand, Cowling said, labeling every person who died while positive for COVID as having died of the disease could lead to an overcount. Such an approach “can also be criticized because it can, and has included, coincidental deaths, such as in people struck by a bus while with mild COVID.”
Dr. Mai He, a pathologist at Washington University in St. Louis who was involved in the Wuhan study published in 2020, said there was still a lack of faith in the integrity of China’s numbers.
“The persistent critical problem is a lack of transparency; people cannot use their data to conduct research and analysis, (or) provide guidance for the next step,” he told Reuters.
Lack of confidence in China’s statistics is also causing panic among members of the public, said Victoria Fan, senior fellow for global health at the Center for Global Development.
“The best thing for the government is to be more transparent, because a lot of the behaviors that the public exhibits are due to not having information,” he said.
