About 80% of China’s population has been infected with Covid-19 since restrictions were lifted in early December, Chinese health authorities have said.
The figure, which would amount to about 1.2 billion people but cannot be confirmed by outside agencies, led some pandemic experts to estimate that more than 1 million may have died – far more than the government’s official figure of about 72,000.
A wave of Omicron cases swept China after the government abruptly ended its zero-Covid policy last December and lifted restrictions shortly before the start of the Lunar New Year and Spring Festival. On Saturday, China’s Center for Disease Control and Prevention (CDC) said about 80% of the country’s 1.41 billion people were infected during this wave.
In the week leading up to the Lunar New Year, the CDC reported 12,658 deaths, adding to the official pandemic toll of nearly 60,000, which most observers believe is well below the true figure. Until a dramatically increased update earlier this month, the official toll from this wave was reported as less than 60 deaths.
The rising number of cases in December quickly swamped data collection processes. Coupled with a narrow definition of a Covid-attributed death, official counts soon seemed far below the reality on the ground, and the government was accused by the WHO of lacking data transparency.
Beijing rejected the accusation and defended the zero-Covid policy and its sudden dismantling. Some health officials have acknowledged the discrepancies in the data, but said now is the time to focus on the health response.
Concerns about data and transparency have led experts to look for other ways to estimate the impact of the outbreak.
Prof Robert Booy, an infectious disease pediatrician at the University of Sydney, said the death toll was likely to be between 600,000 and 1 million. Booy and other experts who spoke to The Guardian said the virus was probably already spreading far beyond what was recognized before the restrictions were lifted.
“China may have dropped its zero-Covid policy in the first week of December, but they were probably already swinging and failing,” he said. “In 2022, China lost population for the first time since the Great Leap Forward – a drop of 850,000 people. In any case, they will lose that number in the coming weeks due to Covid, especially from very old people who have not yet been fully vaccinated.”
Dr. Xi Chen, an associate professor of health policy and economics at Yale, said no one had enough data to accurately measure China’s death toll, but conservative assumptions that it had the lowest death rate of 0.11% would suggest that about 1.23 million people were deceased.
“Of course, this assumes that China has healthcare facilities like South Korea and New Zealand,” he added.
Prof Antoine Flahault, the director of the institute for global health at the University of Geneva, based his estimate on extra death rates – the number of all-cause deaths that are above average – from other countries that have weathered their large initial waves of Covid.
“If you take Hong Kong, you have an excess mortality these days… that’s about 2,000 deaths per million. If you convert that figure to China, you come to just under 3 million deaths,” he said, adding that China’s health system had not been developed as consistently as systems in other places, including Hong Kong.
“If you take Brazil, the figure is close to 4,000 per million, so it’s double,” Flahault said.
James Trauer, the head of the epidemiological modeling unit at Monash University, cautioned against making estimates so early in the gulf, noting that it was not clear how China’s CDC was able to produce the 80% figure, given the difficulties with data collection.
The CDC report said vacation travel could further spread the virus in the short term, but that because so many were already infected, “the possibility of a large-scale epidemic resurgence or a second wave of epidemics across the country is very remote.”
Trauer cautioned against thinking that an Omicron surge brought high levels of herd immunity. “In Australia we had a huge first wave with BA1 last summer, and then the second wave with BA2 came on the heels within a few months. I don’t think they should assume they don’t have to worry because the numbers are falling,” he said.
“Probably the most important thing from a Chinese perspective right now is to better control the epidemic and increase the resources to treat the sick people.”