New study suggests few COVID-19 deaths outside of Wuhan in early 2020

by Chia-Yi Hou | Feb. 24, 2021 | Feb. 24, 2021

Story at a glance

A new study published today reports the death rate in Wuhan in early 2020 was 1,147 per 100,000 people.
The researchers report the number of deaths outside of Wuhan at the same time was 675 per 100,000.
Previous studies and reports suggest that the official numbers from China were underreported, which may not have been accounted for in the new study.

Researchers from the University of Oxford and the Chinese Center for Disease Control and Prevention (China CDC) have examined the change in overall and cause-specific death rates from the first three months of the coronavirus outbreak in China in early 2020. The results, published in the medical journal BMJ, suggest that there was not an increase in overall deaths in regions outside of Wuhan during that time period.

Deaths in Wuhan did increase in relation to the COVID-19 outbreak and were up by about 56 percent with a death rate of 1,147 per 100,000, according to the study. Overall, there were about 6,000 additional deaths, 4,573 of which were caused by pneumonia related to COVID-19, from January through March 2020 compared to past death rates.

Deaths outside of Wuhan did not increase similarly with a rate of about 675 per 100,000, according to the study. The authors found a reduction in death from non-COVID related pneumonia, chronic respiratory diseases and traffic accidents.

“This was the first nationwide study in China to systematically examine the excess mortality during the COVID-19 outbreak, not only from pneumonia but also from a range of other conditions across different regions of China,” says Jiangmei Liu, who is one of the study’s authors and is based at the China CDC, according to a press release.

The authors think that the reason deaths outside of Wuhan did not increase like they did in Wuhan is because the lockdown measures did the job of keeping the novel coronavirus from spreading widely outside of Wuhan.

“It would appear that the lockdown and associated behavioural changes – such as wearing facemasks, increased hygiene, social distancing and restricted travel – actually had unintended additional health benefits beyond those of reducing the spread of SARS-CoV-2,” says Zhengming Chen, a professor of epidemiology at the Nuffield Department of Population Health, University of Oxford and senior author for the study, according to the press release.

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However, there may be issues with the data used in the study overall. The number of deaths may be underreported in Wuhan as well as outside of Wuhan. A preprint study — meaning it has not yet gone through the peer review process for publication — from June 2020 found that, by looking at cremation services, the estimates of the number of deaths could be up to 36,000 for the time period from October 2019 to March 23, 2020. This is more than 10 times the 2,524 reported deaths during the time.

A report published by TIME in March 2020 suggests that the number of urns stacked at funeral homes may also indicate a higher death count than officially reported. Families were also told to wait before going to pick up their loved ones’ ashes.

Documents leaked to CNN in December 2020 showed that the publicly reported number of new cases was much lower than the actual recorded number in February 2020. The publicly reported number of new cases on Feb. 10 was 2,478 while the private records say it was 5,918, according to the documents obtained by CNN.

A group of experts sent to Wuhan by the World Health Organization said that the coronavirus could have been spreading in China before the outbreak in Wuhan in Dec. 2019 and early 2020. They reported that the mission found signs that the coronavirus was spreading more widely in Wuhan than previously thought and that there were several strains circulating by then, according to CNN. The team hopes they can go back to study blood samples collected during 2019 to gain better understanding of how widely COVID-19 might have been spreading leading up to Dec. 2019.

For up-to-date information about COVID-19, check the websites of the Centers for Disease Control and Prevention and the World Health Organization. For updated global case counts, check this page maintained by Johns Hopkins University or the COVID Tracking Project.

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