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China Covid: How many cases and deaths are there? China Covid: How many cases and deaths are there?
(21 days later)
There have been reports that hospitals in China are being overwhelmedThere have been reports that hospitals in China are being overwhelmed
There is concern over the spread of Covid in China following the recent easing of strict lockdown measures. China has experienced a surge in Covid infections and deaths across the country since a strict zero-Covid policy was lifted in December, but official data on the extent of the pandemic has been very limited.
There have been reports that hospitals across the country are under pressure amid a fresh wave of infections. What China says
How many Covid cases and deaths are there in China? Between 8 December and 12 January, China says there were 59,938 Covid-related deaths across the country.
Officially, there have only been 13 Covid deaths throughout December. This figure, published on 15 January, was the first update to its death toll since lockdown restrictions were lifted last year.
However, China has limited criteria for confirming Covid-19 deaths, which only includes those who die directly from respiratory illnesses caused by coronavirus, and not deaths caused by its knock-on effects. It's a big jump from the 13 deaths recorded in the previous month - in part because deaths from underlying conditions as well as respiratory failure caused by Covid have now been included.
The counting method does not correspond with WHO guidance, and results in a figure that is way below the death toll in many other countries. China has also only been recording Covid infections at hospitals and fever clinics for those with recognised symptoms. Asymptomatic cases and positive results from home testing kits are not recorded in the data.
China has already stopped mass testing and it is only recording positive cases at hospitals and fever clinics where the patient has Covid symptoms. Asymptomatic cases and positive results from home testing kits are not recorded in the data. People gathered outside a crematorium in Beijing
Currently the official count only records about 5,000 cases a day. How reliable is the data?
UK-based research company Airfinity said its model estimates cases in China could reach more than three million a day in January. The World Health Organization (WHO) has asked for more "rapid, regular and reliable" data on numbers of hospitalisation and deaths.
How much pressure are China's hospitals under? Beijing says it has been sharing Covid data in "a timely, open and transparent manner in accordance with the law."
Despite the official numbers being low, the World Health Organization has warned the healthcare system in China could be under severe pressure. Dr Louise Blair, of the UK-based research company Airfinity, says that although the new death toll is higher than earlier, it may still not represent the true number of deaths when you compare China's figures with those from other countries.
Reuters have reported that Chinese hospitals have been overwhelmed during the Christmas period, with footage showing long queues for clinics and patients on hospital beds in the middle of busy waiting rooms. "We would expect China to have higher mortality per capita than those countries as they had higher protection from vaccines and in many cases natural immunity than China."
"These numbers imply a much lower number of deaths per capita in China than all other major countries have experienced," she adds.
Health services under pressure
A study by Peking University estimated that as of 11 January, some 64% of the population were reported to be infected with the virus.
Reports in late December suggested hospitals were under growing strain from the number of cases, with long queues for clinics and patients on hospital beds in the middle of busy waiting rooms.
Images appear to show overrun hospitals, like this one in the city of Tianjin on 28 DecemberImages appear to show overrun hospitals, like this one in the city of Tianjin on 28 December
Videos have been emerging on social media throughout December appearing to show crowded hospitals. Videos emerged on social media throughout December appearing to show crowded hospitals as well as queues at funeral homes.
By cross-referencing with other images posted online, the BBC has been able to verify two videos of overcrowding at a children's hospital in the city of Tianjin in northern China. The BBC's team in Beijing has also reported on long queues outside health clinics and a high demand for fever remedies at pharmacies.
当下中国现状，天津儿童医院人满为患，闹哄哄的，患者得不到医治已经发生医疗冲突。 pic.twitter.com/GMXPadJmmo
However we have not been able to verify many of the other videos which have emerged.
It's difficult to confirm how severe the situation is compared with normal as China strictly controls information coming out of the country.
Ros Atkins on... China's Covid surge
Covid wave batters China's overstretched hospitalsCovid wave batters China's overstretched hospitals
The BBC's team in Beijing have reported on long queues outside health clinics, and on the high demand for fever remedies at pharmacies. Temporary health centres have been set up along with intensive care facilities across the country.
Temporary health centres are being set up along with intensive care facilities across the country.
National broadcaster CCTV has reported that Beijing's Chaoyang Hospital will boost its capability as the number of incoming patients increased by fourfold.
It's also been reported that in Shanghai an extra 230,000 hospital beds have been made available.
How has China's Covid policy changed?How has China's Covid policy changed?
There has been a sudden lifting of many of China's Covid restrictions following November's protests against strict lockdowns across the country. There was a sudden lifting of many of China's Covid restrictions following protests against strict lockdowns across the country in November.
Before the recent relaxation, China had one of the toughest anti-Covid regimes in the world - known as its zero-Covid policy. Before that, China had one of the toughest anti-Covid regimes in the world - known as its zero-Covid policy.
The measures included strict lockdowns even if only a handful of Covid cases had been found, mass testing in places where cases were reported, and people with Covid having to isolate at home or under quarantine at government facilities.The measures included strict lockdowns even if only a handful of Covid cases had been found, mass testing in places where cases were reported, and people with Covid having to isolate at home or under quarantine at government facilities.
Schools had been closed in ShanghaiSchools had been closed in Shanghai
Lockdowns have now been scrapped, and quarantine rules have been abolished.Lockdowns have now been scrapped, and quarantine rules have been abolished.
A negative Covid test is no longer required to enter public transport, restaurants, gyms and other public buildings (with the exception of orphanages and care homes).A negative Covid test is no longer required to enter public transport, restaurants, gyms and other public buildings (with the exception of orphanages and care homes).
Chinese authorities have also said they will fully open borders from 8 January with no travel restrictions or quarantine measures for arrivals. On 8 January, China fully opened its borders with no travel restrictions or quarantine measures for arrivals.
Several countries including the US have imposed Covid testing on visitors from China due to its ongoing Covid surge. However, several countries including the US and the UK, have imposed Covid testing on visitors from China due to its Covid surge in a move strongly criticised by China.
What are China's vaccination rates? China's vaccination policy
Overall, China says more than 90% of the population has been fully vaccinated.Overall, China says more than 90% of the population has been fully vaccinated.
However, less than half of people aged 80 and over have received three doses of vaccine. The vaccination rate back in April among this age group was much lower - less than 20%. However, around the time its zero-Covid policy was lifted, less than half of people aged 80 and over had received three doses of vaccine.
The authorities now say they require local health services to "strengthen immunization of the whole population, particularly the elderly".The authorities now say they require local health services to "strengthen immunization of the whole population, particularly the elderly".
There are doubts over whether the main vaccines used in China - Sinovac and Sinopharm - are effective against Omicron, the most widespread strain.There are doubts over whether the main vaccines used in China - Sinovac and Sinopharm - are effective against Omicron, the most widespread strain.
China has refused to use Western vaccines widely.China has refused to use Western vaccines widely.
The government has given no official explanation. However, national pride may be a factor according to Dr Yu Jie, Senior Research Fellow on China at the international affairs think tank Chatham House:The government has given no official explanation. However, national pride may be a factor according to Dr Yu Jie, Senior Research Fellow on China at the international affairs think tank Chatham House:
"I think it's Xi Jinping really thinking of things in terms of economic self-reliance - that need to have China produce and use its own vaccine, rather than import it from somewhere.""I think it's Xi Jinping really thinking of things in terms of economic self-reliance - that need to have China produce and use its own vaccine, rather than import it from somewhere."
Reporting by Wanyuan Song, Jake Horton and Jeremy Howell.Reporting by Wanyuan Song, Jake Horton and Jeremy Howell.