WHO says China is undercounting Covid deaths, asks for more reliable data

Patients are treated in the emergency department of a hospital in Beijing
Patients are treated in the emergency department of a hospital in Beijing


Agency’s chief says testing requirements adopted by some countries for travelers from China are understandable

WHO Says China Is Undercounting Covid Deaths, Asks for More Reliable Data


Agency’s chief says testing requirements adopted by some countries for travelers from China are understandable

The World Health Organization in a briefing Wednesday urged Beijing to be more transparent about its Omicron outbreak, with some officials questioning the accuracy of the country’s Covid-19 data.

WHO Director-General Tedros Adhanom Ghebreyesus said the agency is concerned about the surge in Covid-19 infections in China and again urged the Chinese government to deliver rapid and reliable data on hospitalizations and deaths.

“WHO is concerned about the risk to life in China," Dr. Tedros said. He said the testing requirements adopted by some countries for people who travel from China were understandable.

China’s top health authority, the National Health Commission, no longer publishes daily case tallies and has reported fewer than a dozen Covid-19 deaths since the beginning of December. It has relegated the tally of cases to the Chinese Center for Disease Control and Prevention, which over the past week has been reporting daily new local cases of around 5,000 and between one and five deaths a day.

Meanwhile, notes of a National Health Commission meeting on Dec. 21 seen by The Wall Street Journal and confirmed as authentic by officials familiar with the matter showed the commission citing nearly 250 million infections with the coronavirus between Dec. 1 and Dec. 20.

In a separate statement, the WHO said that during a meeting Tuesday scientists from the Chinese Center for Disease Control and Prevention shared genomic data from December that showed a predominance of Omicron lineages BA.5.2 and BF.7 in its recent outbreak—known variants that have already been circulating in other countries. There had been concern that a new subvariant of Omicron, XBB, which is rapidly spreading across the U.S.’s northeast, would also spread to China.

Several officials of the United Nations agency said in the Wednesday briefing that China needs to improve the transparency and accuracy of its Covid-19 reporting.

“We believe that the current numbers being published from China underrepresent the true impact of the disease…particularly in terms of deaths," said Michael Ryan, executive director of the WHO’s health-emergencies program.

Authorities around the world shouldn’t adopt a nanny-state approach where the state believes that it knows what is best for people, Dr. Ryan said. “People need credible accurate information on which to base their own risk management and manage their own risks to their own health," he said.

Chinese health authorities said last month that it classifies Covid-related deaths as fatal cases of pneumonia or respiratory failure linked directly to the coronavirus, excluding deaths involving other illnesses and underlying causes.

That definition is unusually narrow by global standards. The U.S. Centers for Disease Control and Prevention distinguishes deaths depending on whether Covid-19 is an underlying or a contributing cause, though both are included in the nation’s pandemic toll. The Beijing-ruled territory of Hong Kong defines a Covid-related death as one in which a patient dies within 28 days of first testing positive for the virus, even if the ultimate cause of death isn’t directly related to Covid-19.

The Chinese government’s definition of deaths caused by Covid-19 is too narrow, Dr. Ryan said.

A spokesman for the Chinese Embassy in Washington said in a written statement that the recent scrapping of widespread nucleic acid testing made gathering accurate case data difficult, but the country is now collecting data through surveys “and will continue to disclose information on deaths and severe cases in accordance with the principle of truth, openness and transparency."

The spokesman, Liu Pengyu, also repeated Beijing’s criticism of testing requirements for Chinese travelers, saying any travel restrictions should be science-based and “not be used for political manipulation."

Liang Wannian, head of the Covid-response expert panel under China’s National Health Commission, told state media last week that it was difficult to accurately judge fatality rates while infections were spreading so rapidly. He said accurate estimates may not be possible until after the current outbreak wanes.

The Chinese CDC is currently evaluating excess deaths and will publish the data, according to a statement posted on the website of the Chinese Embassy in France early this month.

Despite Tuesday’s meeting with Chinese scientists, the WHO needs more information on sequencing around China so that deeper analysis can be done, said Maria Van Kerkhove, WHO’s technical lead on Covid-19.

The agency is scheduled to meet with Chinese scientists again on Thursday as part of a broader briefing among its member states on the global Covid-19 situation.

Many countries have grown concerned about the scale of China’s Covid-19 outbreak ahead of the country’s planned border opening on Jan. 8, which will effectively mean an influx of Chinese who for three years had largely been unable to travel. Countries including the U.S., Australia, Canada, Japan, South Korea and Italy, have imposed testing requirements on passengers from China, prompting China to warn of countermeasures and calling the travel curbs unacceptable and politically motivated.

State Department spokesman Ned Price defended the U.S. travel requirements as “an approach that is based solely and exclusively on science."

“The pre-departure testing requirements that we’ve put in place are a result not only of the prevalence of Covid within the [People’s Republic of China] but also the lack of sufficient transparency from the PRC," Mr. Price said Tuesday. “If the PRC wants to see countries do away with various requirements that have been put in place, there is a way to help bring that about, and that is with additional transparency."

Australian government officials expressed similar concerns about China’s lack of transparency, with Treasurer Jim Chalmers describing the government’s decision to impose Covid-19 testing for China travelers as an “abundance of caution."

On Wednesday, the European Union issued a statement saying EU countries are strongly encouraged to demand pre-travel tests from arrivals from China, though it left the decision on whether to do so to national authorities.

Japan said Wednesday that it would impose new restrictions on travelers from China starting this Sunday, requiring them to show a negative Covid test before departing. People visiting Japan from China already need to take a Covid test upon arrival, a rule that took effect Dec. 30. In addition, Japanese officials said they expected that airlines wouldn’t add flights to Japan from China for now.

The WHO’s frustrations with data out of China have dated back to early 2020, when the then-mysterious virus first started to spread internationally, despite Chinese statements that there was no clear evidence of human-to-human transmission. At the time, Dr. Tedros praised China for its strict efforts to control the outbreak in Wuhan, an approach agency officials hoped would encourage more cooperation from Beijing.

Over time, Dr. Tedros became more openly frustrated with Beijing, particularly after Chinese protocol stalled a team of disease experts sent to probe the origins of the virus in January 2021. Dr. Tedros has also clashed with China over whether the virus could have plausibly spread from a Wuhan lab, a hypothesis he has repeatedly said should be investigated. China, which denies the Wuhan outbreak could have resulted from a lab accident, has said its experts have already done their part to trace the virus’s origins and has pushed the WHO to probe whether the pandemic could have begun in another country.

There was also discord between Beijing and the WHO over China’s sticking to its zero-Covid approach last year. Dr. Tedros criticized the Chinese handling of the pandemic as not sustainable, while a Chinese Foreign Ministry spokesman called the WHO chief’s comments “irresponsible."


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