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China is underreporting deaths from Covid-19, a senior official of the World Health Organization said Wednesday as he urged use of a broader definition that would more fully capture the mortality impact of the country’s first big wave of Covid infection.

Mike Ryan, head of the WHO’s health emergencies program, stressed that doctors and nurses should not be discouraged from reporting Covid cases and deaths.


“We believe the current numbers being published from China underrepresent the true impact of the disease in terms of hospital admissions, in terms of ICU admissions, and particularly in terms of death,” Ryan said during the WHO’s weekly press conference. “And we would like to see more data on a more geographic basis across China.”

China abandoned its zero-Covid policy late last year after nationwide protests against the extraordinarily restrictive measures it entailed. As the disease races through the country, authorities are reporting low levels of deaths — five or fewer a day — which outside experts say defies credulity.

Ryan said the country is using a too-narrow definition to tally deaths from Covid, counting only those that involve respiratory failure.


“There are certainly issues in terms of the criteria for recording and reporting deaths attributable to Covid-19,” he said. “That is a very narrow definition.”

The WHO’s guidance for defining Covid deaths states that Covid should be listed as a cause of death if the disease “caused, or is assumed to have caused, or contributed to death.”

It also says that deaths from Covid should not be attributed to other diseases — for instance cancer — and should be counted even if it is suspected that preexisting medical conditions contributed to the severity of the Covid illness.

The WHO has been calling on China to be more forthcoming with information about the status of its Covid outbreak. A meeting of WHO member countries on Thursday will provide an update on the global outbreak, including on the situation in China, Ryan said.

On Tuesday, the WHO’s Technical Advisory Group on Virus Evolution met to discuss the surge of cases in China and data from viral sequences that Chinese scientists have shared via global databases. The Omicron subvariants BA.5.2 and BF.7 are the dominant strains currently circulating, data presented by scientists from the China Center for Disease Control suggested.

“No new variant or mutation of known significance is noted in the publicly available sequence data,” the expert committee said in a statement about the meeting.

A number of countries, including the United States, have put in place requirements that people traveling from China must produce a negative Covid test to gain entry — a move Chinese authorities have criticized. But the WHO’s director-general, Tedros Adhanom Ghebreyesus, appeared to endorse or at least justify the measures, saying that “with circulation in China so high and comprehensive data not forthcoming,” it is understandable that some countries would take steps they believe will protect their own citizens.

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