China’s abrupt dismantling of ‘Zero Covid’ measures caused almost 1.9m deaths, say researchers

aziqbal · Aug 26, 2023

China’s abrupt dismantling of ‘Zero Covid’ measures caused almost 1.9m deaths, say researchers

Sudden decision to end restrictions was followed by an explosion of infections, according to new study estimating country's death toll

Workers in personal protective equipment (PPE) prepare test kits a neighborhood during a lockdown due to Covid-19 in Shanghai, China

The sudden introduction of widespread infection had a devastating impact on a population with limited immunity CREDIT: Bloomberg
China’s abrupt move to lift all Covid restrictions in late 2022 caused almost 1.9 million deaths in just two months as the virus exploded across the vast country, researchers have estimated.

According to a US paper published in the journal JAMA Network Open, in December 2022 and January 2023 alone there were 1.87 million excess deaths among adults over the age of 30. A surge in fatalities was seen in every province bar Tibet, with the elderly worst hit.
The study is among the first to estimate the toll associated with China’s decision to abruptly dismantle its “Zero Covid” restrictions in early December 2022.
While there had already been an increase in cases – and the stringent measures were becoming increasingly unsustainable – the explosion of infections that followed the move devastated a country with limited prior exposure to Sars-Cov-2 and huge gaps in vaccine take-up, especially among the elderly.
Although widespread reports of overwhelmed hospitals and morgues gave an insight into the toll, the Chinese government narrowed the official definition of a Covid death shortly after restrictions were lifted, making it hard to track.

Patients on stretchers are seen at Tongren hospital in Shanghai on January 3, 2023

Patients on stretchers were forced to wait in hallways after hospitals were swamped with Covid cases in Shanghai CREDIT: HECTOR RETAMAL/AFP via Getty Images
Beijing has previously said that 60,000 people died from early December to mid January, and declared a “decisive victory” over the virus in February.
But these figures were widely seen as vast underestimates and global health experts have repeatedly called for the government to release more data. One Chinese province did briefly publish data in July showing cremations jumped by 70 per cent in the first quarter of the year, but this rare release was later taken down.
Yanzhong Huang, senior fellow for global health at the Council for Foreign Relations, said: “Based on leaked cremation data of Zhejiang province, there could be 1.5 million Covid related death in the first quarter of 2023 alone.
“Since the exit wave started in early December, the actual number would be larger if December is included. The two million deaths would be 24 times of the official tally – close to 84,000. These extra deaths could be avoided with a more orderly and better prepared exit.”

‘A devastating impact’

To assess excess deaths – which looks at how many more people died than the historical average – researchers at the Fred Hutchinson Cancer Center in Seattle performed a statistical analysis using data from obituaries and the popular search engine Baidu.
“The measure of excess deaths reflects both the direct and indirect effects of Covid on a population,” Joseph Unger, senior author of the paper and a biostatistician and health services researcher at Fred Hutchinson Cancer Center in Seattle, told Bloomberg. “This is important because the true underlying mortality burden of Covid is routinely underestimated by simply counting deaths known to be attributable to Covid itself.”
He added that “because the Chinese population had been largely shielded from infection with limited natural immunity and was not fully or well vaccinated, the sudden introduction of widespread Covid-19 infection had a devastating impact”.
Dr Tishya Venkatraman, an analyst at the data firm Airfinity who was not involved in the study, added that the new figures are almost double the excess deaths seen in the US and South Korea during their first omicron-driven waves in the winter of 2021/2022.
She suggested that lower population immunity, an ageing population and inequalities in access to healthcare – especially in rural areas – likely contributed.
The paper added that the results provide “valuable insights for policy makers and public health experts”, and are critical to help understand how the sudden, largely uncontrolled spread of Covid-19 can affect mortality rates.
Prof Devi Sridhar, chair of global public health at the University of Edinburgh, said the high death toll demonstrates that China got its policy wrong.
“They needed to vaccinate and open up instead of waiting too long for mass vaccinations,” she told the Telegraph.