China tweaks rules and procedures to keep Covid death figures low

The credibility of the official Covid-related death count in China has stuck in controversy after some development showed the Beijing government resorting to tactics to hide the ground realities. Besides censorship, changes in rules and procedures have been carried out to compel doctors to hide Covid-related mortalities or delay updating them in the death certificates. Chinese authorities also have stopped counting the Covid deaths that occurred outside hospitals in the official count.

Amid the growing global pressure, China revealed around 60,000 Covid-related deaths between early December and mid-December, 2022.  It was a big number considering China maintained the death toll of around 5,000 since the beginning of the coronavirus pandemic. Yet, many felt the actual number be much higher and accused Beijing of under reporting. Even the World Health Organisation (WHO) urged China for “more detailed” data as it expressed concerns over the under representing the severity of the viral outbreaks in the country.

At December-end, the infections saw an unprecedented surge and hospitals began to fill. Many patients did not find beds and were seen sleeping on floors. Even, funeral homes and crematoriums were overwhelmed, and bodies were seen in the queue for days. The China Communist Party-run government in Beijing kept mum on the rising number of covid patients. It suddenly stopped issuing routine health bulletins, leading to confusion over the Covid situation. However, a social media post by eminent Chinese scientist and government official Wu Zunyou revealed over 80 percent of the country’s population was covid-infected.

Even a study by the Beijing-based Peking University suggested that over 900 million people in China were infected by mid-January. Yet, Beijing continued to report not over 10,000 new cases and single-digit deaths daily until December.  When the global community including powerful countries and organisations like (WHO) demanded the truth, China came up with the 60,000 figure. However, looking at the magnitude and severity of coronavirus spread, the recent figures about the deaths given by China appeared unbelievable to many observers.  

There are fears that the actual number of Covid-related deaths in China is much higher; some researchers claimed it to be ten times the official count. “This reported number of Covid-19 deaths might be the tip of the iceberg,” said Zuo-Feng Zhang, chair of the department of epidemiology at the University of California.  Various reports showed that medical authorities were pressurized into hiding Covid-related deaths. Chinese doctors were instructed not to be write Covid as the reason for death.

Notices and circulars have been issued to instruct doctors to not mention Covid as a reason for death. “On the death certificate, we fill in one main cause of death, and two to three sub-causes of death, so we basically leave out Covid,” a doctor in a Shanghai-based hospital said. Liu Chen (pseudonym), a doctor from Liaoning Province, said government rules bar them from counting death of Covid patients due to aggravation of underlying diseases as Covid deaths. “That is the standard we all have to follow. So, from the top to the bottom, no one knows the exact mortality rate of COVID-19,” he said. This appears to be a major reason for the lower-than-expected number of Covid deaths declared by Beijing.

Many people have complained online that the official medical reasons for deaths following coronavirus infection are being written as “heart diseases”, “pneumonia” or “underlying disease”. Song Guo-cheng, a researcher at National Chengchi University, said the latest death figures announced by Beijing were still suspicious. “The information obtained from various sources and online reports is in sharp contrast with the Covid figures disclosed by the Chinese Communist Party. This underscores that the CCP is still playing with the data, covering up the true scale of the outbreak,” Song said.

WHO has already criticised the Chinese government for making a “very narrow” definition of Covid deaths. China has declared that those coronavirus patients who die of pneumonia and respiratory failure would be considered as Covid deaths. The infected people who die of cardiovascular or other diseases however will not be classified as Covid deaths. Experts slammed China as the new definition would not capture all deaths from Covid and showed only a very small portion of the true values.  A doctor from Guangzhou said “I don’t understand it, but this is what the hospital leaders told us to do. Perhaps it’s just to save face.”