As cases explode, China’s low Covid death toll convinces no one

The hearses carrying black and yellow mourning paper flowers crept in a steady stream toward Dongjiao Crematorium in eastern Beijing. Several dozen people crowded around the closed gate, waiting to be let in. A man who couldn’t get a spot in the queue could only watch and wonder what to do with the body of a family member who had just died of Covid.

The hospital couldn’t keep the body – there were already too many in the morgue. When he called the crematorium, an employee told him to wait a week. When he called again, no one answered.

A country trying to mourn its deaths from an explosive Covid outbreak is grappling with a system unprepared for the wave of deaths. Two weeks after China abruptly abandoned its “zero Covid” policy, cases in cities like Beijing have skyrocketed, along with reports of people dying.

Funeral directors and funeral equipment vendors describe a deluge of calls from families needing help handling relatives’ bodies. On Chinese social media, people are sharing videos and photos of morgues full of bodies, as well as their own personal stories of losing loved ones to the outbreak.

But the Chinese government paints a less gloomy picture. In its official statistics and propaganda reports, China has acknowledged only seven deaths from Covid in the past two weeks, and only in Beijing. The National Health Commission even lowered the country’s cumulative death toll by one to 5,241 on Wednesday. Officials have explained that China only counts Covid deaths if the virus was the direct cause of respiratory failure — a definition the World Health Organization says would lead to a massive underestimation.

The ruling Communist Party may have a political incentive to downplay the toll of an epidemic it suddenly stops trying to contain. Xi Jinping, China’s top leader, has portrayed his country’s previous success in limiting Covid deaths as evidence of China’s superiority over the West, a claim that would be hard to sustain with the many deaths. to be.

“If they published the death toll, it would be a major blow to the party’s prestige,” said Willy Lam, an expert on Chinese politics at the Jamestown Foundation, a research group.

But doctors and international health experts say an underestimation of the toll risks is fueling public complacency about the risks posed by the virus. Chinese commentators and the public have widely criticized the death toll, saying it clouds the real picture and damages the government’s credibility.

“These are an example of ‘believing one’s own lies,'” Mei Xinyu, an economist at a research institute affiliated with the Department of Commerce, wrote on his social media page, commenting on a daily report of Covid figures released by the government. government released. He later posted an announcement that the father-in-law of a prominent economist had died of pneumonia caused by Covid. The man’s family, he wrote, waited hours for an ambulance to take him to hospital.

“Eventually he could be left alone on the floor of the hospital morgue, awaiting cremation,” Mr. May. He said the family struggled to secure a place for cremation and rent a hearse. “The family members are heartbroken.”

As is the case elsewhere, deaths in China rise in winter due to an increase in flu and other respiratory infections, even in normal times. But people who work in funeral services say they see a larger increase than usual. At the Yong’an Funeral Home in Shijiazhuang, a city about 200 miles southwest of Beijing, an employee said he used to handle 10 deaths a month but now receives calls for about five a day.

Some Chinese media reports have acknowledged a handful of Covid-related deaths. Wang Ruoji, a 37-year-old retired soccer star, died after a Covid infection exacerbated an underlying condition. Caixin, a respected news outlet, wrote that Zhou Zhichun, a former editor-in-chief at a Communist Party newspaper, died at age 77 after contracting Covid, with his doctors classifying the cause as sudden cardiac death.

But on social media, users have shared official obituaries of several other prominent people who have passed away in recent days, including an opera singer and an artist who helped design sports mascots. Many speculated that the true cause of these deaths was being concealed with descriptions such as “severe cold infections.”

Speaking at a government press conference on Tuesday, Wang Guiqiang, an infectious disease expert, said China is counting only those who died from pneumonia or respiratory problems caused by Covid in its official toll. He said cases of fatal pneumonia are less common because the Omicron variant that is now common primarily infects the upper respiratory tract.

Another official explained why China cut its number of Covid deaths by one this week. An expert assessment determined that one of the deaths reported Tuesday was a person who had died of other illnesses, Yao Xiujun, a publicity officer at Beijing’s municipal health and family planning committee, said in a telephone interview.

China’s narrow definition excludes the deaths of people with underlying illnesses exacerbated by Covid. Deaths in China are also being attributed only to Covid by panels of experts convened by hospitals, potentially excluding people who have died at home or elsewhere.

By contrast, the United States, Britain and Hong Kong tend to take in varying degrees of people who died with Covid, and not just from it.

China may not be alone in its approach. In Russia, the government is counting only deaths confirmed to be directly caused by the virus.

On Wednesday, Michael Ryan, head of the Health Emergencies Division at the World Health Organization, suggested that the definition of China was inadequate. “It’s quite focused on respiratory failure — people who die from Covid die from a lot of different system failures, given the severity of the infection,” he said.

China’s methodology, he said, “will greatly underestimate the true death toll associated with Covid.”

Such an underestimation has its advantages, say health experts. It could limit public panic and reduce the burden on hospitals from people who are not seriously ill. China is already struggling to supply ibuprofen and other fever-reducing drugs as people scramble to hoard such drugs.

An underestimation could also help companies at a time when the government is trying to rescue an economy battered by nearly three years of disruptive lockdowns and costly testing programs. In some major cities, businesses and officials are encouraging people to go to work even if they are mildly ill from Covid.

But an undercount can also backfire by undermining the government’s own efforts to urge the public to take necessary precautions. Many seniors in China may continue to avoid vaccinations, and younger people may be taking the virus less seriously than they should, said Jin Dongyan, a virologist at the University of Hong Kong.

Professor Jin said China has had record deaths from infectious diseases for decades, including SARS in 2003 and seasonal flu. It made an exception during Shanghai’s lockdown in the spring of this year, using a looser definition as authorities tried to justify what became a bloody two-month lockdown.

Of the 588 Covid deaths reported by the Shanghai city government, one was attributed to a heart attack and the rest to “underlying conditions” or “tumors.” Despite this inconsistency, the National Health Commission has never expunged those deaths from the national data.

Whatever the official figures show, China expects a wave of deaths.

“Although the overall death rate is low, the number of infected people is very large, so this may make the absolute number of deaths caused by this risk relatively large,” Wang Guangfa, a respiratory specialist at Peking University First Hospital, said in an interview.

The tension is already fueling public frustration.

“The funeral parlors are insanely full,” said a Beijing resident who declined to give only her last name, Chen, for fear of government retaliation. Ms Chen said her grandfather died on Tuesday from complications of Covid, including pneumonia and kidney failure, after being in a coma for a week.

It took two days for Ms. Chen’s family to find a funeral home in Beijing where her grandfather’s body would be cremated. Ms Chen also expressed skepticism about the government’s Covid statistics.

“If there are only five Covid deaths in one day, I have known almost half of them,” she said. “It is heartbreaking that we people of Beijing have to bear the initial impact of the massive spread of the virus.”

Li you, Claire Fu and John Liu contributed to reporting and research.