COVID-19 in China: Low mortality in Shanghai intrigues experts

The low mortality – only 190 deaths per more than half a million infected people – of the wave of covid-19 registered in Shanghai, the largest city in China, intrigues many experts.

– What is the balance? –

The Asian giant has contained the balance less than 5,000 fatalities since the detection of the coronavirus at the end of 2019 in the city of Wuhan, in the center of the country.

As for confirmed infections, they rise to 200,000 symptomatic cases and 470,000 asymptomatic according to official balances.

Shanghai, the city most punished in the country by the omicron variant, registers a mortality rate of 0.036%, that is, 36 deaths per 100,000 infected since March 1.

The rate is lower than that of countries that have become an example of managing the pandemic, such as New Zealand (0.07%).

If Shanghai had had the same fatality rate as the oceanic country, the metropolis should have “more than 300 deaths,” epidemiologist Michael Baker, of New Zealand’s Otago University, said skeptically.

Prabhat Jha, an epidemiologist at the University of Toronto, said that the mortality of the current outbreak could be “a very high number” given the large number of unvaccinated older people and the low efficiency rate of the immunizers used in the country.

– What is the explanation? –

Since the beginning of the epidemic, China has followed a strategy of covid zero which is based on early lockdowns when cases are detected and massive tests to identify all those infected and isolate them.

This method allowslimit to the maximum” contagion and “avoid” a saturation of medical resources that would cause more deathsestimated the epidemiologist Wu Zunyou, one of the figures in the anticovid fight in China.

Repeated large-scale screening of part of the population also increases “the chances of detecting (early) asymptomatic” or mild cases, according to Singapore-based virologist Leong Hoe Nam.

According to this theory, the distortion would not be due to the mortality figure but to that of officially detected infections, which would be higher thanks to its strategy to combat the pandemic.

– What part of truth? –

“Even so, there is still a gap between the identified cases and the people who end up sick and die” of covid, Baker said, suggesting that the balance of Shanghai could grow even more.

In Wuhan, the first city confined at the beginning of the pandemic, the authorities subsequently revised the number of fatalities to increase it by 50%.

Another explanation may be the criterionvery strict classification of covid-19 related deaths″ said Paul Tambyah, president of the Asia-Pacific Society for Clinical Microbiology and Infection.

According to this criterion, people with previous pathologies that are aggravated by covid are not included in the official balance if they die after being cured of the virus.

In other countries, the count is broader. The United Kingdom, for example, includes as a victim of the virus anyone who has died within 28 days of testing positive, “including victims of road accidents,” Tambyah said.

The figures in China are “very political”says the infectologist Mai He, from the University of Washington.

Especially in this crisis in which the communist power has tried to present its management of the pandemic as proof of the superiority of its authoritarian political system against the deadly balance sheets of many Western democracies.

– Cases unaccounted for? –

China is “timid” about mortality figures, Ariel Karlinsky, WHO adviser at the Hebrew University of Jerusalem, told AFP.

Comparing the number of deaths from any cause in China since 2020 and comparing it with the years preceding the pandemic would give a fairer view of the situation, this expert estimated.

But these figures are not public and were only communicated in detail to “selected researchers”, he lamented.