Hearses carrying black and yellow paper funeral flowers crawled in a steady stream toward Dongjiao Crematorium in eastern Beijing. Several dozen people crowded around the closed door waiting to be let in. A man unable to queue could only watch, wondering what to do with the body of a loved one who had just died of Covid.
The hospital couldn’t keep the body, there were already too many in their morgue. When he called the crematorium, an employee told him he had to wait a week. When he called back, no one answered.
A country trying to mourn its dead following a fast-spreading Covid outbreak is grappling with a system unprepared for rising deaths. Two weeks after China abruptly abandoned its “zero Covid” policy, cases have soared in cities like Beijing, along with reports of deaths.
Funeral home directors and sellers of funeral supplies describe a flood of phone calls from families needing help handling the bodies of their loved ones. On Chinese social media, people are sharing videos and photos of morgues filled with bodies, as well as their own personal stories of losing loved ones to the outbreak.
But the Chinese government paints a less gloomy picture. In its official statistics and propaganda reports, China has only acknowledged seven Covid deaths in the past two weeks, and only in Beijing. The National Health Commission even reduced the cumulative number of Covid deaths in the country on Wednesday by one, to 5,241. Officials explained that China only counts Covid deaths if the virus was the direct cause of the death. respiratory failure – a definition according to the World Health Organization would lead to a vast underestimation.
The ruling Communist Party may have a political incentive to downplay the toll of an epidemic it has suddenly stopped trying to control. Xi Jinping, China’s top leader, has described his country’s earlier success in limiting Covid deaths as proof of China’s superiority over the West, a claim that would be hard to sustain with many fatalities.
“If they were to go public with the death toll, it would be a huge blow to the prestige of the party,” said Willy Lam, China policy expert at the Jamestown Foundation, a research group.
But doctors and international health experts say understating the toll risks fueling public complacency about the risks of the virus. Chinese commentators and the public have widely criticized the death toll, saying it obscures reality and damages the government’s credibility.
“This is an example of ‘believing in your own lies,'” Mei Xinyu, an economist at a research institute affiliated with the Ministry of Commerce, wrote on her social media page, commenting on a daily report of Covid figures released by the government. He then released an announcement that the father-in-law of a prominent economist had died of Covid-induced pneumonia. The man’s family, he wrote, waited hours for an ambulance to arrive and take him to hospital.
Understand the situation in China
The Communist Party shelved the restrictive “zero Covid” policy, which sparked mass protests that were a rare challenge to the Communist leadership.
“In the end, he could only be left on the hospital morgue floor, awaiting cremation,” Mei wrote. He said the family was struggling to secure a cremation slot and hire a hearse. “The family members are heartbroken.”
As is the case elsewhere, deaths in China tend to rise in winter, due to an increase in flu and other respiratory infections, even in normal times. But people working in funeral services say they have noticed a bigger increase than usual. At the Yong’an funeral service business in Shijiazhuang, a city about 200 miles southwest of Beijing, an employee said he used to handle 10 deaths a month, but receives now about five calls a day.
Some Chinese media have acknowledged a handful of Covid-related deaths. Wang Ruoji, a 37-year-old retired soccer star, died after a Covid infection worsened an underlying condition. Caixin, a respected media outlet, wrote that Zhou Zhichun, a former editor of a Communist Party newspaper, died aged 77 after contracting Covid, with his doctors classifying the cause as sudden cardiac death.
But on social media, users have shared official obituaries for several other personalities who have died in recent days, including an opera singer and an artist who helped design sports mascots. Many have speculated that the true cause of these deaths was hidden under descriptions such as “severe cold infections”.
At a government press conference on Tuesday, Wang Guiqiang, an infectious disease expert, said China only counts people who have died of pneumonia or respiratory failure caused by Covid in its official toll. He said cases of fatal pneumonia are less common because the now prevalent Omicron variant mainly infects the upper respiratory tract.
Another official explained why China revised its Covid death toll down by one this week. A review by experts determined that a death reported on Tuesday was a person who died of other illnesses, said Yao Xiujun, publicity officer at the Beijing Municipal Health and Family Planning Commission, during a telephone interview.
China’s limited definition excludes deaths of people who had underlying conditions that were made worse by Covid. Deaths in China are also only attributed to Covid by expert panels convened by hospitals, potentially leaving out those who died at home or elsewhere.
By contrast, the US, Britain and Hong Kong tend to include people who have died with Covid, and not just from it, to varying degrees.
China may not be alone in its approach. When the Russian government was still releasing the Covid death toll, it said it only counted deaths confirmed to have been directly caused by the virus. It stopped reporting Covid deaths in October.
On Wednesday, Michael Ryan, head of health emergencies at the World Health Organization, suggested China’s definition was inadequate. “It’s quite focused on respiratory failure – people who die of Covid die of many different system failures given the severity of the infection,” he said.
China’s methodology, he said, “will grossly underestimate the true death toll associated with Covid”.
Such an understatement has its benefits, health experts say. This could limit public panic and reduce the burden placed on hospitals by people who are not seriously ill. Already, China is struggling to stock up on ibuprofen and other fever medications as people rush to hoard the drugs.
An understatement could also help businesses at a time when the government is trying to save an economy battered by nearly three years of disruptive shutdowns and costly testing programs. In some major cities, businesses and officials are encouraging people to go to work even when mildly ill with Covid.
But an undercount could also backfire by undermining the government’s own efforts to urge the public to take necessary precautions. Many older people in China may continue to avoid vaccination, and younger people may take the virus less seriously than they should, said Jin Dongyan, a virologist at the University of Hong Kong.
Professor Jin said China had been recording deaths from infectious diseases in a narrow way for decades, including SARS in 2003 and seasonal flu. He made an exception during Shanghai’s lockdown in the spring of this year, using a looser definition as authorities sought to justify what has become a deadly two-month lockdown.
Of the 588 Covid deaths reported by the Shanghai city government, one was attributed to a heart attack and the rest to “underlying conditions” or “tumors”. Despite this inconsistency, the National Health Commission has never removed these deaths from national data.
Whatever the official figures, China expects a wave of deaths.
“Although the overall case fatality rate is low, the number of people infected is very large, which may make the absolute number of deaths caused by this risk relatively large,” said Wang Guangfa, a respiratory disease specialist at Peking University First. Hospital. a meeting.
Already, the tension is fueling public frustration.
“The funeral directors are packed crazy,” said a Beijing resident who gave only her last name, Chen, for fear of government reprisals. Ms Chen said her grandfather died on Tuesday of complications from Covid, including pneumonia and kidney failure, after being in a coma for a week.
It took Ms. Chen’s family two days to find a funeral home in Beijing that would cremate her grandfather’s body. Ms Chen also expressed skepticism about the government’s Covid statistics.
“If there are only five Covid deaths in one day, I have experienced almost half of them,” she said. “It’s heartbreaking that we Beijingers are the first to experience the first impact of the massive spread of the virus.”
Li you, Claire Crazy and John Liu contributed to reporting and research.