Despite a recent viral surge that occurred after China ended its strict "zero COVID" policy in December, the country's official COVID-19 death toll for the entire pandemic remains remarkably low at 83,150 people as of Feb. 9.
Researchers believe that number is a massive undercount and have been working to calculate the true cost.
The New York Times reported that four separate academic teams estimate that China's COVID-19 wave might have killed between 1 million and 1.5 million people.
Researchers who spoke with the Times said that without reliable data from China, the estimates should be treated as educated guesses.
Just how many people died has enormous political significance for the country's ruling Communist Party. Chinese President Xi Jinping has touted the country's earlier success of managing the virus with lockdowns as evidence of the communist nation's superiority over the West.
According to the official numbers, China had the lowest death rate per capita of any major country throughout the pandemic; the estimated numbers show that China would have already exceeded the official death rates in several Asian countries that did not respond as harshly.
China would also rank below the United States, Germany, Italy, and other countries where outbreaks worsened before the introduction of vaccines.
According to the Times, researchers used a number of methods to determine how many people were potentially infected and how effective China's vaccines were at preventing death. Some centered on previous viral behavior in past outbreaks in Hong Kong and Shanghai, while others simulated the epidemic using sophisticated computer models.
Other methods developed a model that used official sampling data, which was based on China's regular testing of hundreds of thousands of people.
"If the data say what we think they say, this was an explosive wave," Lauren Ancel Meyers, professor of biology and statistics at the University of Texas at Austin, told the Times.
With crematories overwhelmed in December, Chinese officials omitted infected people who died of liver, kidney or heart failure – counting only those whose deaths involved respiratory failure.
The government began releasing data on other deaths in mid-January, but the numbers are still incomplete.
The most conspicuous exclusion from the data consists of people who died outside hospitals. From 2018 to 2020, approximately one-fifth of all deaths in China happened in hospitals.
Yong Cai, a demographer at the University of North Carolina at Chapel Hill who studies mortality in China, told the Times that the official death toll is "certainly an underreport of all COVID deaths. There's no question about that."
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