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China has released new data on covid – but the WHO is pushing for more.

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The World Health Organization is stepping up pressure on China to share key data on its latest coronavirus outbreak, using public statements and behind-the-scenes meetings to push Beijing as it tries to map the most big push of the pandemic – even if it risks the wrath of the government.

It’s a stark contrast to the WHO’s approach in early 2020, when its head, Tedros Adhanom Ghebreyesus, praised China’s “transparency” on the new virus even as reports suggested Beijing had deliberately underestimated cases and silenced whistleblowers.

But the new approach could pay off. On Saturday, China’s National Health Commission announced a major overhaul of its data, raising the death toll in hospitals since tough coronavirus restrictions were lifted in December by 37 to nearly 60,000.

Meanwhile, Ma Xiaowei, director of China’s National Health Commission, shared much of the same data with Tedros, according to a WHO reading of a call between them.

WHO officials are unsure why China released the data now – and in interviews they were reluctant to take responsibility. The numbers appear to show an outbreak similar to the waves of omicron that swept through other countries a year ago. It also suggests the new wave of infections had peaked – perhaps reassuring news ahead of the Lunar New Year, a time of intense holiday travel.

China sharply revises covid-related death toll to 60,000 from 37

But there are also significant gaps, especially in detailed regional data and information over time. It also lacks the detailed genome sequencing that the WHO and others have requested to track any new variants.

“It’s really sad to see the number of hospital-related deaths of 60,000 in the last month, but this should be considered the minimum,” said Maria Van Kerkhove, WHO technical lead on the Covid-19. The data, she noted, does not appear to include deaths outside of hospitals.

Still, this is more information than China has typically provided. Before Saturday, Beijing had released little data on the outbreak, which grew exponentially after the government lifted its “zero covid” policy on Dec. 7, ending mass testing, harsh lockdowns and long quarantines. .

The secrecy surrounding the latest outbreak had heightened concern among global health officials and analysts that new variants could spread undetected.

Van Kerkhove said the publication confirmed one important thing to the WHO: “It tells us that this data exists.”

China’s National Health Commission stopped reporting daily case counts in December. From Nov. 1 to Jan. 13, the Chinese Center for Disease Control and Prevention reported fewer than 50 deaths, a figure analysts say is incredibly low.

J. Stephen Morrison, director of the Global Health Policy Center at the Center for Strategic and International Studies, called the data “ridiculous” and said it undermined China’s reputation. “Nobody believes it,” he told the Washington Post. “What’s the point?”

For much of the past three years, Chinese authorities have blocked international travel and imposed strict quarantines to eradicate the virus – and avoid the worst of the pandemic. But as this winter approached, more contagious offshoots of the omicron variant began to spread, despite the severe restrictions, and rare protests against the restrictions prompted authorities to back down, lifting nearly all of them.

Soon authorities in many major cities, including Beijing, were reporting fast-spreading outbreaks. Satellite images of crematoriums suggest China has suffered far more deaths than the government has acknowledged, The Post reported last week.

As the reports painted an increasingly dire picture, the WHO was increasing the pressure, publicly and privately. Tedros has repeatedly called on the Chinese government to release the number of hospital admissions and other information. The WHO has urged China to share data on the severity of the disease, the number of intensive care patients and genomic sequencing.

The WHO has also held several private meetings with Chinese officials, in addition to their regular contacts in Beijing, where the organization has an office.

The meetings have been professional, according to those involved, but the message is clear: where is the data?

Van Kerhove said the WHO and other officials are familiar with the quality of China’s health data, having seen it during visits in early 2020. “The scientific capacity in China is quite incredible.“, she says.

The WHO does not have the power to compel China to release data, but it can continue to ask.

One data gap is China’s way of counting its deaths, which WHO officials say is unusually restrictive. According to WHO emergencies chief Mike Ryan, China only registers deaths as coronavirus-related if the cause is respiratory failure and a positive coronavirus test has been recorded.

The new data is more extensive – it shows 5,503 people died from respiratory failure caused by the virus and 54,435 people died from underlying illnesses combined with covid-19 (54,435). Still, some analysts remain skeptical.

“The new official numbers most likely do not reflect the total number of covid-related deaths,” said Louise Blair, head of vaccines and epidemiology at Airfinity. The scientific forecasting group that said China’s omicron wave likely caused more than 413,000 deaths. “These numbers imply a far lower per capita death toll in China than any other major country has seen.”

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Liu Pengyu, the spokesperson for the Chinese Embassy in Washington, said last week that China had followed the same standard for counting deaths since 2020. Liu said China had shared “shared information and data with the international community in an open and transparent manner”. ” since covid-19 was first identified. including virus sequencing data.

“In the past month alone, we have had five technical exchanges with” WHO, Liu said.

WHO officials have confirmed an increase in meetings with China. Chinese CDC officials attended a virtual meeting of the WHO’s Technical Advisory Group for Virus Evolution, or TAGVE, this month to present genomic data. Chinese officials also provided an update on the situation at a meeting of member states.

According to TAGVE, Chinese CDC data showed a predominance of circulating omicron BA.5.2 and BF.7 lines. Both are already common in the world.

Elodie Ghedin, a Canadian virologist who was present at the meeting, said the discussion included an overview of how genomic surveillance works in China. CDC officials choose a hospital there in a key city in each province to monitor, then extrapolate a broader view.

“They run it through the same analytics pipeline as everyone else in the world,” Ghedin said. Sequencing has declined worldwide, so China’s approach isn’t unusual, but the scale of the surge there makes it worrying, she said.

“In China, I would have hoped there would have been a bit more surveillance,” she said. “That seems a little weak, in my opinion.”

Meeting attendees raised concerns that China was not sharing its genomic sequencing from the outbreak further with GISAID, a global coronavirus data platform. According to Ghedin, Chinese officials responded that they hoped to first study the data and then publish their own research.

“We’ve heard this argument for decades,” she said. “People are always going to get busted.”

So far, the Chinese response to pressure from the WHO has been relatively subdued compared to previous episodes.

Chinese officials reacted with fury in 2021 when Tedros criticized the results of a joint WHO-China investigation into the origins of covid-19 which dismissed the idea that the virus could be linked to a laboratory in Wuhan. Beijing censored Tedros on online platforms last year after it said its “zero covid” policy was unsustainable.

But at a press conference earlier this month, Chinese Foreign Ministry spokesperson Wang Wenbin called on the WHO to “examine China’s covid response in a scientific and rational manner and that his related statements will reflect objectivity and impartiality”.

In the meantime, Van Kerkhove said, work at the WHO office in Beijing’s diplomatic quarter continues. But the staff there are faced with another problem: their own epidemic.

“A lot of them got sick,” Van Kerkhove said. “You know, like most people across the country.”

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