Skepticism Remains Over Official COVID-19 Count as Wuhan Ends Lockdown

After punishing the first healthcare workers who voiced concerns about a mysterious new virus now known as the novel coronavirus responsible for COVID-19 in December, authorities in Wuhan, Hubei province continued to act as if all was well for weeks before officially acknowledging the threat. As the outbreak became endemic in the region and country, authorities cracked down on unauthorized information, detained critical voices, and silenced a massive online call for free speech from scared and frustrated citizens. On January 23, Wuhan authorities announced the lockdown of the city, a move the WHO called “new to science,” and public health experts criticized for being risky. The lockdown would soon expand to much of the province and become the “largest quarantine in human history,” affecting over 50 million people. Days later the WHO declared COVID-19 a “global health emergency” (a possibility censors in China had targeted days earlier to limit negative economic forecasts).

The WHO classified the outbreak as a pandemic on March 11. As global infection rates rapidly climbed, state media reported Wuhan’s first day of zero new cases on March 19 (four more days would follow), a statistic Beijing would use to promote itself as a leader in the global fight against the pandemic. Many local residents and external analysts were skeptical about the official numbers for Wuhan–due both to earlier COVID-19 censorship and propaganda, and to the fact that under Beijing’s updated prevention guidelines, daily tallies did not include positive test results from asymptomatic and recovered patients. Since then, Wuhan’s official COVID-19 death count has hovered just above 2,500.

Last week, authorities announced that the “brutal but effective” lockdowns in Hubei would be eased and fully lifted by April 8, and that other regions of China would be easing relevant restrictions on residents and businesses. At NPR, Emily Feng and Amy Cheng report that as many as 10% of Wuhan residents who had tested positive and were pronounced recovered, have tested positive a second time, raising concerns as authorities begin to lift the local quarantine measures:

Some of those who retested positive appear to be asymptomatic carriers — those who carry the virus and are possibly infectious but do not exhibit any of the illness’s associated symptoms — suggesting that the outbreak in Wuhan is not close to being over.

[…] Two [of the four people who retested positive that NPR spoke to …] are front-line doctors who were sickened after treating patients in their Wuhan hospitals. The other two are Wuhan residents. They all requested anonymity when speaking with NPR because those who have challenged the government’s handling of the outbreak have been detained.

[…] To leave Wuhan, residents must first test negative for the coronavirus, according to municipal authorities. Such screenings will identify some remaining asymptomatic virus carriers. But the high rate of false negatives that Chinese doctors have cited means many with the virus could pass undetected.

[…] “In terms of those who retested positive, the official party line is that they have not been proven to be infectious. That is not the same as saying they are not infectious,” one of the Wuhan doctors who tested positive twice told NPR. He is now isolated and under medical observation. “If they really are not infectious,” the doctor said, “then there would be no need to take them back to the hospitals again.” [Source]

Exceptionally long lines to recover the ashes of dead family members now that lockdown measures are easing  have added to earlier skepticism over the official case counts. Bloomberg reports:

The families of those who succumbed to the virus in the central Chinese city, where the disease first emerged in December, were allowed to pick up their cremated ashes at eight local funeral homes starting this week. As they did, photos circulated on Chinese social media of thousands of urns being ferried in.

Outside one funeral home, trucks shipped in about 2,500 urns on both Wednesday and Thursday, according to Chinese media outlet Caixin. Another picture published by Caixin showed 3,500 urns stacked on the ground inside. It’s unclear how many of the urns had been filled.

People who answered the phone at six of the eight funeral homes in Wuhan said they either did not have data on how many urns were waiting to be collected, or were not authorized to disclose the numbers. Calls were not answered at the other two.

[…S]ome in China have been skeptical of the accuracy of the official tally, particularly given Wuhan’s overwhelmed medical system, authorities’ attempts to cover up the outbreak in its initial stages, and multiple revisions to the way official cases are counted. Residents on social media have demanded disciplinary action against top Wuhan officials. [Source]

In a Twitter thread, Bloomberg’s James Mayger notes that state media has reported that a top-level Party meeting has called for the better monitoring, tracking, and control of asymptomatic COVID-19 patients, and that other Chinese media have reported those numbers will be released soon. He concludes:

An English report from Caixin explains how the onslaught of death in Wuhan has complicated logistics for funeral homes and mourning observations, and notes other standing regulations facing the bereaved as the lockdown eases in Wuhan. Flynn Murphy and Bao Zhiming report:

Liu’s father was […] already hospitalized with brain cancer when the city’s Covid-19 crisis deepened in late January. To make room for a surge in patients, Liu’s father returned home, but his condition deteriorated as he became unable to access the care he needed. Despite being readmitted to the hospital in early March, he died within a few days.

“Although my dad didn’t die because of Covid-19, it killed him indirectly,” Liu told Caixin.

[…] Many of the bereaved regret that they weren’t able to give their loved ones proper sendoffs. Strict quarantine requirements prevented friends and relatives from being at their bedsides when they died. At the height of the city’s epidemic, some undertakers were so busy that deceased patients lay in their hospital beds for hours before being removed.

Even now, people are far from free to pay their respects however they want. On Thursday, as smoke billowed from the chimney of the Hankou Funeral Parlor’s crematorium, mourners sat on widely spaced plastic chairs to minimize human contact, while workers in full-body protective gear reunited them with the deceased. To prevent another surge in infections, city authorities plan to suspend in-person visits to grave sites through Qingming Festival, a traditional festival to honor the dead also known as Tomb Sweeping Day that this year falls on April 4. [Source]

At Radio Free Asia, Qiao Long, Lau Siu-fung, and Luisetta Mudie report that some online estimates of the city’s actual death toll are nearly 20 times higher than the government statistics. The report also includes other anecdotes leading to skepticism around the official Wuhan statistics:

[…] Such an estimate [based on 3,500 urns handed out daily for the 12 days before Tomb Sweeping festival] would mean that 42,000 urns would be given out during that time.

[…] Another popular estimate is based on the cremation capacity of the funeral homes, which run a total of 84 furnaces with a capacity over 24 hours of 1,560 urns city-wide, assuming that one cremation takes one hour.

This calculation results in an estimated 46,800 deaths.

[…] [The official number is 2,500 people,] “But during the epidemic, they transferred cremation workers from around China to Wuhan keep cremate bodies around the clock,” he said.

A resident surnamed Gao said the city’s seven crematoriums should have a capacity of around 2,000 bodies a day if they worked around the clock.

“Anyone looking at that figure will realize, anyone with any ability to think,” Gao said. “What are they talking about [2,535] people?”

“Seven crematoriums could get through more than that [in a single day].” [Source]

At The Atlantic, Kathy Gilsinan outlines Beijing’s recent statistics-based attempt to declare the worst over at home while internationally promoting itself as a global leader in COVID-19 response to warn that “China’s purported success against the virus, and its help to others in similar circumstances, may prove less than meets the eye“:

[…] For one thing, the Chinese model of mass roundups of citizens and extensive surveillance with no real public-health purpose is not, or shouldn’t be, exportable to democracies—and democracies like South Korea and Taiwan have, through their own successes against the virus, proved that authoritarianism is not the required ingredient. The crackdown may not even have succeeded as well as China wants to advertise. Nurses in Wuhan have told the Financial Times of “hidden infections” going unreported in China’s official statistics. “If China prematurely declares victory and they’re wrong, that could lead to a second wave of infections,” Doshi said. “It’s quite sobering to think what that would mean for the world’s pandemic response and the global economy.”

[…] Most immediately, it could mean that the coronavirus ground zero continues to generate and export more cases.

[…] The real short-term risk of China’s leadership exercise is that, should the country make the calculation to prize its economic health over public-safety concerns, other countries contending with the pandemic’s economic devastation may find themselves tempted to follow suit. Trump has already said he’d like to get the United States back to work by Easter, about three weeks from now—though China’s lockdown lasted months. As the crisis drags on, more and more leaders will find themselves facing gruesome calculations about the severe economic toll of keeping a low death toll. At that point, the China model may look even more tempting. [Source]

With lockdown restrictions lifting in Wuhan despite palpable safety concerns, the Financial Times’ Sun Yu reports on widespread citizen opposition to the easing of restrictions stemming from a lack of trust in the government:

The violence on Friday [on the Hubei/Jiangxi border against local authorities not following central orders to allow migrant workers to cross the border] and the sudden requirement for large amounts of additional documentation before people could move around the country underlined a growing distrust of authorities as Beijing struggled to restore credibility undermined by its cover-up of the pandemic that has killed more than 30,000 people worldwide.

[…] The present difficulties faced by migrant workers, said a Beijing-based sociologist, are rooted in fears that the virus remains prevalent, especially in Hubei, even though official statistics have been showing zero new cases of infection in the province for many days.

[…] Authorities are unlikely to be able to reassure Chinese citizens because authorities only test those with symptoms, which means official statistics are unable to capture asymptomatic virus carriers.

[…] “We have paid a steep price for believing in the government,” said the academic. “Now people would rather overreact than not act to protect against the virus.” [Source]

At Al Jazeera, Shawn Yuan reports that despite concerns of a second spike in infections in Wuhan, “there is a sense that the worst has past,” and relays three stories of life slowly returning to normal as the restrictions are eased. A video report from Al Jazeera’s Florence Looi shows customers returning to thoroughfares as businesses reopen, subject to virus screening. The AP also reports on life in Wuhan as restrictions lift.

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