After spending weeks in a crowded hospital in eastern Jiangsu province nursing his 53-year-old father as he died of pneumonia caused by Covid-19, Wang was shocked to learn the disease that took his life on Saturday could not be printed at the time of his death. certificate.
“Stupid. Someone died and we can’t accurately write down the cause,” said the 23-year-old, who asked to be identified only by his first name.
Since the lifting of zero-Covid controls in China, hospitals have been flooded with patients and crematoria have struggled to keep up with demand. As a result, many analysts were surprised that the official death toll was not higher.
In the period from December 8 to January 12, the number of official deaths was 59,938, according to the revised figures for deaths in health facilities that were forwarded by the National Health Commission last weekend, from the initial claim of only 37 deaths.
Airfinity, a health data analytics group, estimated the death toll to be 10 times that figure, or 641,000 deaths, assuming 104 million infections in the month to January 18. January 11, but has not yet published an estimate of the death toll.
One of the reasons for the lower-than-expected number, according to some relatives and medical professionals around the country, is that Chinese officials kept “Covid-19” off the death certificates of many people who died with the virus.
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Six relatives who lost loved ones to the coronavirus in recent weeks said they were disappointed to see death certificates filled with “pneumonia” or “heart disease” or other causes of death than Covid.
Some medical professionals told the Financial Times that local officials did not advise against including the coronavirus in official documents by complicating the process or actively told medical institutions not to include the word.
In China, a death certificate is issued by a local community hospital or clinic or a neighborhood committee in case of death at home. In some cases, the police can issue a death certificate, which is required for the body to be cremated.
In Wang’s case, the hospital referred the family to a community clinic for the death process. Officials there entered “viral pneumonia (unspecified)” as the official cause of death.
“They said it couldn’t include Covid. My mother was a bit frustrated and asked – can ordinary pneumonia kill someone… but we didn’t want to argue with them, so we just agreed to write pneumonia,” he said.
The account was shared by hundreds of people who posted online and interviewed family members who lost loved ones to Covid and asked not to be named.
In Beijing, the grandson of a 90-year-old man who died in hospital after three days of fever from Covid said doctors had written off “heart disease”, a pre-existing condition, as the cause of death. Another woman in the capital said her 93-year-old mother-in-law died after a 10-day stay in hospital due to Covid, but the family could only put “pneumonia” on the certificate. The grandson of an elderly man who died in eastern Jiangsu province of Covid-related respiratory failure has said he officially died of an “underlying illness”.
In the northern province of Jilin, a woman told the FT that scans showed Covid had damaged her grandmother’s lungs, but the hospital refused to allow Covid tests and officially classified her death as “coronary heart disease”, a previous medical problem.
The omission sparked complaints on Chinese social media. “What are you trying to hide? Why is covid a taboo? We have a positive test result, which is actually Covid,” said a Weibo user in Liaoning province.
This effort to abandon the coronavirus death certificate calls into question the reliability of China’s latest Covid death toll, especially given the delay in updating it.
Jiao Yahui, a top NHC official, said on Saturday that it had taken a long time to publish updated figures because hospitals had to comb through death records, generating “a relatively large amount of data and information” to analyze. He did not say whether he relied on the death certificate and the NHC did not respond to a faxed request for comment.
Doctors who spoke to the FT said the official push to count Covid deaths was clear. An emergency medicine doctor in a small town in southern Guangdong province said he and his colleagues had been told: “Death certificates cannot include ‘Xinguan‘ [Covid-19] these two characters.”
Another doctor at a large hospital near Guangzhou added: “I don’t know, but this is it [hospital] leaders tell us what. Maybe it’s just to save.”
In the Chinese capital, three nurses at a community clinic charged with writing death certificates for people who died at home said they were not “qualified” to attribute the deaths to Covid or give other reasons why they could not be included. “The best we can do is write ‘suspected Covid’ if we have a PCR test,” said a nurse in central Beijing.
While a doctor at a large hospital in Shanghai said he had never received a direct order to exclude Covid from death certificates, “they made it strict and complicated” to include it, he said. “To be included [Covid-19] these cases should be reviewed by the local Centers for Disease Control. There is no benefit whatsoever from issuing this certificate with Covid.
For relatives of those suffering from Covid, the failure to acknowledge the cause of death adds to the traumatic experience.
Wang said the hospital where his father died has been overwhelmed with sick Covid patients. “Until the end, they couldn’t get a ventilator,” he said. “I feel weak. We are in the hospital, but I can’t treat my father.”