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Talk:Chinese government response to COVID-19/Draft: Alleged undercounting of cases and deaths (v1)

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Papers from academic journals and publishers such as Science,[1] Nature,[2] The Lancet,[3][4] and Karger Publishers[5] have regarded China's measures to domestically contain COVID-19 to be effective. A study in March published in Science Magazine concluded that the Wuhan travel ban and national emergency response may have prevented more than 700,000 COVID-19 cases outside the city.[6] As of 31 December 2021, official statistics showed 102,083 cumulative confirmed cases[a] and 4,636 cumulative deaths in mainland China.[8] This corresponds to 3.2 deaths per million inhabitants.[9]

A study published in The BMJ found that 4573 additional pneumonia deaths occurred in Wuhan from January to March 2020, compared with the same period in 2019.[10] Outside of Wuhan, no measurable increase in pneumonia deaths was observed.[10] Though there were confirmed COVID-19 deaths outside of Wuhan, the authors speculated that lockdowns suppressed influenza transmission sufficiently to offset these deaths.[10]

A survey of seroprevalence conducted in April 2020 found that 4.4% of people in Wuhan had antibodies to SARS-CoV-2, indicating that they had been infected.[11] Seroprevalence fell with distance from Wuhan, indicating that the initial outbreak had been largely contained to the city.[11] Elsewhere in Hubei province, 0.4% of people had antibodies, while outside of Hubei province, less than 0.1% of people had antibodies.[11] These results imply that in the first wave, approximately 500,000 people were infected in Wuhan, 210,000 people were infected in the rest of Hubei province, and 120,000 people were infected outside of Hubei province.[11] A study conducted from March to April 2020 found that between 3.2% and 3.8% of people in Wuhan tested had antibodies to SARS-CoV-2.[12] A study of Hong Kong residents evacuated from Hubei province in March 2020 found that 4% of them had antibodies to SARS-CoV-2.[13][11]

According to British epidemiologist Ben Cowling, "due to the compulsory testing when there is an outbreak, the case numbers in China tend to include a lot of mild or asymptomatic infections that would never have been identified in other parts of the world", which explains China's relatively low case fatality rate.[14] Peer-reviewed antibody studies have found a seropositivity rate of around 3.8% for Wuhan inhabitants.[15][16][17]

In May 2020, a commentary article in the journal Global Public Health examined the possibility of inaccurate death counts due to alleged political censorship, but concluded that due to the lack of any known deaths of Hong Kong or Taiwan residents in Mainland China, which would be newsworthy, the discrepancy between the official and true death toll is likely not particularly large.[18]

Despite poor sanitary conditions and close quarters, 0 cases have been attributed to re-education camps in Xinjiang province.[19] US and UK politicians, scientists, and intelligence officials have expressed doubts about the accuracy of case counts provided by the Chinese government.[20][21][22][23]

Chinese Premier Li Keqiang reported on 24 March 2020 that the spread of domestically transmitted epidemic has essentially stopped and the outbreak has been controlled in China.[24][25][26][27] On 17 April 2020 the Wuhan government revised the number of COVID-19 deaths, accounting for previously unreported deaths that occurred at home.[28] This resulted in a net increase of 1,290 reported deaths in the city, bringing the overall total to 3,869 for Hubei province.[29][30]

  1. ^ Maier, Benjamin; Brockmann, Dirk (15 May 2020). "Effective containment explains subexponential growth in recent confirmed COVID-19 cases in China". Science. 368 (6492): 742–746. Bibcode:2020Sci...368..742M. doi:10.1126/science.abb4557. ISSN 0036-8075. PMC 7164388. PMID 32269067.
  2. ^ Cyranoski, David (17 March 2020). "What China's coronavirus response can teach the rest of the world". Nature. 579 (7800): 479–480. Bibcode:2020Natur.579..479C. doi:10.1038/d41586-020-00741-x. PMID 32203360. S2CID 214628991.
  3. ^ Burki, Talha (1 November 2020). "China's successful control of COVID-19". The Lancet Infectious Diseases. 20 (11): 1240–1241. doi:10.1016/S1473-3099(20)30800-8. ISSN 1473-3099. PMC 7544475. PMID 33038941.
  4. ^ Lancet, The (25 July 2020). "COVID-19 and China: lessons and the way forward". The Lancet. 396 (10246): 213. doi:10.1016/S0140-6736(20)31637-8. ISSN 0140-6736. PMC 7377676. PMID 32711779.
  5. ^ Cite error: The named reference :1 was invoked but never defined (see the help page).
  6. ^ "China's Controls May Have Headed Off 700,000 COVID-19 Cases: Study". U.S. News & World Report. April 2020.
  7. ^ ""无症状感染者""确诊病例"有何区别？疾控专家帮你答疑-湖南省人民政府门户网站". Hunan Provincial Center for Disease Control and Prevention. Retrieved 22 January 2022.
  8. ^ "Jiézhì 12 yuè 30 rì 24 shí xīnxíng guānzhuàng bìngdú fèiyán yìqíng zuìxīn qíngkuàng" 截至12月30日24时新型冠状病毒肺炎疫情最新情况 [The latest situation of the new coronavirus pneumonia epidemic as of 24:00 on December 30] (in Chinese). National Health Commission. 31 December 2021. Retrieved 31 December 2021.
  9. ^ "Coronavirus (COVID-19) Deaths". Our World in Data. 31 December 2021. Retrieved 31 December 2021.
  10. ^ a b c Cite error: The named reference BMJ-Liu-2021 was invoked but never defined (see the help page).
  11. ^ a b c d e Li, Zhongjie; Guan, Xuhua; Mao, Naiying; Luo, Huiming; Qin, Ying; He, Na; Zhu, Zhen; Yu, Jianxing; Li, Yu; Liu, Jianhua; An, Zhijie; Gao, Wenjing; Wang, Xiaoli; Sun, Xiaodong; Song, Tie; Yang, Xingfen; Wu, Ming; Wu, Xianping; Yao, Wenqing; Peng, Zhibin; Sun, Junling; Wang, Liping; Guo, Qing; Xiang, Nijuan; Liu, Jun; Zhang, Bike; Su, Xuemei; Rodewald, Lance; Li, Liming; Xu, Wenbo; Shen, Hongbing; Feng, Zijian; Gao, George F (6 February 2021). "Antibody seroprevalence in the epicenter Wuhan, Hubei, and six selected provinces after containment of the first epidemic wave of COVID-19 in China". The Lancet Regional Health Western Pacific. 8: 100094. doi:10.1016/j.lanwpc.2021.100094. PMC 7864613. PMID 33585828.
  12. ^ Xu, Xin; Sun, Jian; Nie, Sheng; Li, Huiyuan; Kong, Yaozhong; Liang, Min; Hou, Jinlin; Huang, Xianzhong; Li, Dongfeng; Ma, Tean; Peng, Jiaqing; Gao, Shikui; Shao, Yong; Zhu, Hong; Lau, Johnson Yiu-Nam; Wang, Guangyu; Xie, Chunbao; Jiang, Li; Huang, Ailong; Yang, Zhenglin; Zhang, Kang; Hou, Fan Fan (5 June 2020). "Seroprevalence of immunoglobulin M and G antibodies against SARS-CoV-2 in China". Nature Medicine. 26 (8): 1193–1195. doi:10.1038/s41591-020-0949-6. PMID 32504052. S2CID 219316608.
  13. ^ To, Kelvin Kai-Wang; Cheng, Vincent Chi-Chung; Cai, Jian-Piao; Chan, Kwok-Hung; Chen, Lin-Lei; Wong, Lok-Hin; Choi, Charlotte Yee-Ki; Fong, Carol Ho-Yan; Ng, Anthony Chin-Ki; Lu, Lu; Luo, Cui-Ting; Situ, Jianwen; Chung, Tom Wai-Hin; Wong, Shuk-Ching; Kwan, Grace See-Wai; Sridhar, Siddharth; Chan, Jasper Fuk-Woo; Fan, Cecilia Yuen-Man; Chuang, Vivien W M; Kok, Kin-Hang; Hung, Ivan Fan-Ngai; Yuen, Kwok-Yung (3 June 2020). "Seroprevalence of SARS-CoV-2 in Hong Kong and in residents evacuated from Hubei province, China: a multicohort study". The Lancet Microbe. 1 (3): e111–e118. doi:10.1016/S2666-5247(20)30053-7. PMC 7673299. PMID 33230504.
  14. ^ "China's COVID death rate is curiously low. An anonymous Beijing doctor told us how they're doing it". ABC News. 5 November 2021. Retrieved 26 December 2021.
  15. ^ Han, Huan; Yi, Junzhu; Cheng, Gongbo; Jiang, Wuhui; Brożek, Grzegorz M.; Jiang, Yingan; Zhu, Chengliang; Xia, Yuchen (28 April 2021). Bouvier, Nicole M. (ed.). "SARS-CoV-2 Antibody Seroprevalence in Wuhan, China, from 23 April to 24 May 2020". mSphere. 6 (2): e01062–20. doi:10.1128/mSphere.01062-20. ISSN 2379-5042. PMC 8546712. PMID 33883260.
  16. ^ Xu, Xin; Sun, Jian; Nie, Sheng; Li, Huiyuan; Kong, Yaozhong; Liang, Min; Hou, Jinlin; Huang, Xianzhong; Li, Dongfeng; Ma, Tean; Peng, Jiaqing (September 2020). "Author Correction: Seroprevalence of immunoglobulin M and G antibodies against SARS-CoV-2 in China". Nature Medicine. 26 (9): 1494. doi:10.1038/s41591-020-1058-2. ISSN 1078-8956. PMC 7433269. PMID 32812013.
  17. ^ Liu, Anding; Li, Ying; Wan, Zhengce; Wang, Wenjie; Lei, Xiaomei; Lv, Yongman (23 October 2020). "Seropositive Prevalence of Antibodies Against SARS-CoV-2 in Wuhan, China". JAMA Network Open. 3 (10): e2025717. doi:10.1001/jamanetworkopen.2020.25717. ISSN 2574-3805. PMC 7584925. PMID 33095246.
  18. ^ Lin, Timothy P. H.; Wan, Kelvin H.; Huang, Suber S.; Jonas, Jost B.; Hui, David S. C.; Lam, Dennis S. C. (2 October 2020). "Death tolls of COVID-19: Where come the fallacies and ways to make them more accurate". Global Public Health. 15 (10): 1582–1587. doi:10.1080/17441692.2020.1808040. PMID 32787510. S2CID 221127847. Currently, around 1.5 million Hong Kong and Taiwan citizens are long term residents working in China, which comprise slightly over 0.1% of China's population. Meanwhile, COVID-19 death toll from China is 4641 (Johns Hopkins Coronavirus Resource Center, 2020; worldometer, 2020). This should theoretically translate into around five cases of COVID-19 death of such Hong Kong or Taiwan citizens. Should there be even one single case of COVID-19-related death for Hong Kong or Taiwan citizen living in China, it would be highly publicised because of political reasons. As a matter of fact, up to this date, there have been no such reports in Hong Kong or Taiwan. Therefore, while it is acknowledged that there was discrepancy in the COVID-19 death toll during the initial outbreak for reasons discussed in previous sections, our hypothesis herein suggests that the reported Chinese death toll would probably be not far from the actual number.
  19. ^ Austin Ramzy (30 March 2020). "Xinjiang Returns to Work, but Coronavirus Worries Linger in China". The New York Times. Retrieved 3 April 2020. No reports have emerged of conditions in the facilities since the outbreak began. But former detainees have previously described poor food and sanitation and little help for those who fell ill.{...}"According to my personal experience in the concentration camp, they never helped anyone or provided any medical support for any kind of disease or health condition," said Ms. Sauytbay, who fled to Kazakhstan two years ago, in a phone interview this month. "If the coronavirus spread inside the camps, they would not help, they would not provide any medical support."{...}Now the region is being jolted back to work. Labor transfer programs, in which large numbers of Uighurs and other predominately Muslim minorities are sent to work in other parts of Xinjiang and the rest of China, have resumed in recent weeks.
  20. ^ "Experts are questioning China's reported coronavirus case and death counts. Here's why it's so important to get the data right". Business Insider. 4 April 2020. Retrieved 5 April 2020. experts and locals are questioning China's case counts.
  21. ^ "China accused of under-reporting coronavirus outbreak". Financial Times. Health experts question the timeliness and accuracy of China's official data, saying the testing system captured only a fraction of the cases in China's hospitals, particularly those that are poorly run. Neil Ferguson, a professor of epidemiology at Imperial College London, said only the most severe infections were being diagnosed and as few as 10 per cent of cases were being properly detected, in a video released by the university.(subscription required)
  22. ^ Sobey, Rick (31 March 2020). "Chinese government lying about coronavirus could impact U.S. business ties: Experts". Bostonherald.com. Retrieved 6 April 2020.
  23. ^ "China Says It's Beating Coronavirus. But Can We Believe Its Numbers?". Time. 1 April 2020. The move follows criticism from health experts and the U.S. and other governments that it risked a resurgence of the deadly pandemic by downplaying the number of cases within its borders.
  24. ^ "China deploys measures to curb imported COVID-19 cases, rebound in indigenous cases". State Council Information Office of China. 24 March 2020.
  25. ^ "Doubts over China's claim of beating coronavirus". Don't lift quarantine measures too fast: government expert
  26. ^ "China's Wuhan is touting 'zero' new coronavirus cases. But is the battle over?". The Washington Post. 25 March 2020. Retrieved 6 April 2020.
  27. ^ "Hidden infections challenge China's claim coronavirus is under control". Financial Times. 27 March 2020.
  28. ^ "China denies cover-up as Wuhan coronavirus deaths revised up 50%". the Guardian. 17 April 2020. Retrieved 20 March 2022.
  29. ^ "湖北省武汉市新冠肺炎疫情数据订正情况" [Revision of the data of the new coronary pneumonia epidemic situation in Wuhan City, Hubei Province] (in Chinese (China)). National Health Commission. 17 April 2020. Archived from the original on 15 May 2020. Retrieved 2 June 2020.
  30. ^ "Coronavirus: China outbreak city Wuhan raises death toll by 50%". BBC News. 17 April 2020. Retrieved 20 March 2022.


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