How Bad Is China’s Covid Outbreak? It’s a Scientific Guessing Game

As Covid barrels through China, scientists around the world are searching for clues about an outbreak with sprawling consequences — for the health of hundreds of millions of Chinese people, the global economy and the future of the pandemic.  But in the absence of credible information from the Chinese government, it is a big scientific guessing game to determine the size and severity of the surge in the world’s most populous country.  In Hong Kong, one team of researchers pored over passenger data from five Beijing subway lines to determine the potential spread. In Seattle, a group of modelers tried in vain to reverse-engineer an unverified government leak detailing case numbers from Chinese health officials. In Britain, scientists are coming up with their own efficacy estimates of Chinese vaccines.  Any personal anecdote or social media report from China — scarce   medicines,            overrun hospitals, overflowing crematories,  is possible fodder for researchers’ models. They are all attempting to understand the same things: How quickly is the virus spreading in the country? How many people are dying? Could China be the source of a new and dangerous variant?  As scientists sift through varied sources of shaky information, they are bracing for potentially catastrophic outcomes. Barring new precautionary steps, some worst-case estimates suggest that Covid could kill as many people in China in the next four months as it has Americans during the entire three-year pandemic.  Without satisfying answers, some countries are putting limits on Chinese travelers, albeit based in part on unfounded fears or political motivations. The United States, Italy and Japan have said they will require a negative Covid test for those coming from China, citing concerns that the surge in cases in China could produce new, more threatening variants. On Friday, France and Britain announced similar measures. While researchers and virologists said the new measures would most likely do little, if anything, to blunt the spread, the policies reflect the limited visibility into the outbreak. Scientists’ models generally point to an explosive spread and a high death rate, given how many people in China have little to no immunity to Omicron sub variants. But even their estimates are all over the place.  Until this month, the world seemed to have a reasonably clear understanding of what was happening with the virus in China. The ruling Communist Party proudly published low daily case numbers and deaths as a testament to its stringent “zero Covid” policy. A countrywide system of lockdowns, quarantines and mass testing largely kept the virus at bay. But in early December, the government abruptly abandoned “zero Covid,” leaving the scientific community largely in the dark.  “Nobody, nobody has a clue,” said Siddharth Sridhar, a clinical virologist with a focus on emerging infectious diseases.  Predicting the path of the pandemic has always been difficult. Even in places like Britain with reliable data, forecasts have often been far off the mark. But scientists have generally used reported Covid deaths as a dependable barometer to determine the potential size of an outbreak.  The data coming from the Chinese government can’t be trusted anymore. Officially, China has claimed just 12 deaths from Covid since Dec. 1. The country has said it will only count those who die from respiratory failure directly linked to an infection, leaving out vast numbers who died because Covid aggravated underlying diseases or caused heart or liver failure.  Experts say the sheer speed of the spread would suggest a much higher number of deaths. One city last week reported half a million cases in one day. Another reported a million.  There are also indications that officials are pressuring doctors and crematories to avoid categorizing even respiratory deaths as virus related.  One doctor at a private hospital in Beijing said he and his colleagues found a typed note on a hospital desk in recent days urging them to “try not to write respiratory failure caused by Covid” as the primary cause of death. The note was shared with The New York Times. The doctor said it was not clear if the message was generated internally or sent from government officials. But similar warnings have been circulating on Chinese social media,  telling doctors not to “carelessly write Covid” on death certificates.  Several modelers have even been skeptical of leaked information from government officials on case counts, which have been used to assess the scale of China’s outbreak. One recent estimate, making the rounds in news reports and on Chinese social media, cited data from national health officials that 250 million people had been infected in the first 20 days of December.   Some scientists said that such massive figures indicated either that China had been suppressing data for months or that it was trying to make it seem like the outbreak had peaked.  “Either they know something we don’t,” said Dr. Christopher Murray, the director of the Institute for Health Metrics and Evaluation at the University of Washington, “or they’re trying to say the worst is already over.”  “I suspect it’s now the latter,” he said, referring to the idea that China was trying to make it look like the worst had passed. It seems unlikely that China would have been able to fake the numbers for months without raising suspicions, he said.