China only counts deaths from pneumonia or respiratory failure in its official COVID-19 death toll, a Chinese health official said, a narrow definition that limits the number of deaths being reported as the virus surges following the easing of pandemic-related restrictions.
Deaths that occur in patients with pre-existing illnesses are not counted as COVID-19 deaths, said Wang Guiqiang, the head of infectious disease at Peking University’s No. 1 Hospital.
China has always been conservative in how it counts illnesses, whether the flu or COVID-19. In most countries, including the United States, guidelines stipulate that any death in which COVID-19 is a factor or contributor is counted as a COVID-19-related death.
In effect, Wang’s comments on Tuesday clarified publicly what the country has been doing throughout the pandemic.
On Wednesday, China reported no new COVID-19 deaths and subtracted one death from its overall toll, lowering it to 5,241, according to a daily tally issued by the National Health Commission, which did not explain the decrease.
The clarification of how China officially records COVID-19 deaths comes as cases have soared across the country amid the loosening of restrictions. Yet the overall count remains blurry, as China has stopped requiring daily PCR tests and many people are testing at home. Anecdotally, many people have fallen ill in cities such as Beijing and Shanghai.
Different countries count cases and deaths differently, and patchy testing means that direct comparisons are often misleading.
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But experts have repeatedly advised that authorities should err on the side of caution while counting deaths. The World Health Organization states in guidelines that “probable” COVID-19 cases and deaths where COVID-19 was a contributing factor should also be counted as COVID-19 deaths. Problems in death counts have raised questions in countries ranging from South Africa to Russia.
The WHO estimated in May that nearly 15 million people died from COVID-19 or due to overwhelmed health systems in the first two years of the pandemic. That is significantly more than the official death toll of over 6 million for that period.
