Scenes from a troubling recent Post report out of China: Nearly 100 people waiting in line at 3 a.m. outside a funeral home in the eastern province of Shandong. Scalpers selling slots for cremation in Shanghai, jacking up the price as though they were concert tickets. A Beijing funeral home that constructed an extra parking lot last month, with more than 100 cars visible in a satellite image.
These snapshots confirmed what most people already suspected — that China’s hasty exit from its “zero covid” policy has caused massive suffering and death — a fact China finally acknowledged on Saturday after intense international pressure. Until that point, Chinese officials had reported just 37 covid deaths since Dec. 7, when all testing, quarantine and lockdown measures were lifted. Suddenly that number has soared to 59,938.
Dishonesty about the true breadth of the pandemic in China constitutes a threat to public health worldwide. Scientists need to know whether transmission patterns have changed, new variants have emerged or the incidence of long covid has increased. Epidemiologists must be able to assess whether the world should prepare for a new global outbreak. And the people of China deserve to know the true scale of the calamity descending on their country.
Reliable coronavirus data is hard to come by in many parts of the world. But when it comes to undercounting, China has been in a class by itself. For three full years, right up to the day it ended zero covid, China had reported just over 5,200 covid deaths, an absurdly low number even considering the harsh measures instituted to keep the virus in check.
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Without the government providing reliable information, outside epidemiologists, public health experts, journalists and others stepped in, parsing through anecdotal accounts, online postings, statistical modeling and satellite images. Reports of overwhelmed hospitals and overflowing funeral homes circulated on the internet and in the international media. The World Health Organization called on Beijing to release more detailed information, warning that the way China categorized cause of death “will very much underestimate the true death toll associated with covid.”
Until now, China has counted only fatalities in which a scan showed lung damage caused by the virus — meaning if covid were merely a contributing factor, the death wasn’t counted, in defiance of WHO guidelines. With Saturday’s announcement, China acceded to the criticism and said the revised figure included 54,435 people who had covid but died of other underlying illnesses.
But even the acknowledgment of nearly 60,000 covid-related deaths should be considered an undercount. Notably, those deaths were reported from hospitals and did not include people who died at home. Some researchers estimated that China was already seeing 9,000 deaths a day during December.
From the beginning of the pandemic, the Chinese government has relied on secrecy, obfuscation, intimidation and fabrication to draw a veil over the origins of the virus as well as its contagion and death toll. In early 2020, it concealed the person-to-person transmissibility of the virus for more than 20 days, admitting it only when it became obvious. Once China acknowledged covid was indeed contagious, it introduced its zero-covid policy, in which people were forced to quarantine and take daily tests. Patients were forcibly removed from their homes to government-run covid centers. People who had been exposed sometimes had their doors welded shut. Buildings, and sometimes entire cities, were locked down, with residents forbidden to leave their homes.
These measures, the government said, kept the disease in check and the death rate low, proving the superiority of its repressive political system. While refrigerated trailers for the dead lined streets around New York hospitals beginning in the spring of 2020, no such scenes played out in China.
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But zero covid could not go on indefinitely. When the economy stalled and public frustration erupted, China abruptly dropped it. The turnabout left a populace especially vulnerable to the virus — with little previous exposure and protected by locally made vaccines that are based on the original virus rather than the omicron subvariants that are now dominant. They are markedly less effective than the mRNA vaccines developed in the West.
As expected, the disease exploded. China’s refusal to acknowledge what was obvious to the world led to an outpouring of criticism and dire forecasts.
A global health research institute based at the University of Washington in Seattle predicted the Chinese death toll could be “well over 1 million during 2023.” Worse, the British health data firm Airfinity predicted 1.7 million people will die across China just by the end of April.
Hundreds of millions of Chinese will be traveling for the Lunar New Year that begins Jan. 22, raising the likelihood that they will carry the disease to rural areas that are far less prepared to deal with it. Yet the Chinese announcement on Saturday asserted that “the national emergency peak has passed.”
Given China’s policy of concealment, there is little reason for anyone to believe this. Distrust of Chinese pronouncements has already led 20 countries, including the United States, to impose new requirements on Chinese travelers, including negative coronavirus tests. Chinese officials have called the measures discriminatory. But there is good cause for the world to be wary.
The international community should keep the pressure on Chinese officials to come clean about the real scale of the current crisis and allow independent outsiders access to make their own assessments. What China and the world need in a pandemic is truth and transparency all the time, not just when it is no longer possible to lie. The release of the new figures on Saturday was a start, but only just a start.