By December 2022, China had ended its strict zero-COVID policy, which resulted in a wave of infections. A new analysis published in Emerging Infectious Diseases estimates that 1.41 million COVID-19 deaths occurred in the 35 days following the relaxation of China's policy.
The number comes from a model researchers in the US and Hong Kong developed using daily test positivity reports from the Chinese Center for Disease Control and Prevention (China CDC) sentinel household surveillance system from December 16, 2022, to January 19, 2023. Those numbers were paired with known data on vaccination numbers in China, infection fatality rates, vaccine effectiveness, and rates of immunity waning.
90% of population infected
According to the researchers, the sentinel surveillance report from China CDC suggests that roughly 90% of China’s population were infected during the study’s 35-day period. Based on the model, this would have caused 1.41 million deaths (95% credibility interval [CrI], 1.14 to 1.73) across China; 0.80 (95% CrI, 0.60 to 1.05) million of those deaths occurring among those 80 years and older.
China's official reports may underestimate the COVID-19 death toll by a factor of 17 (95% CrI 14 to 22), the authors said. The findings are in line with another model estimate published last week in JAMA Network Open, which suggested 1.87 million excess deaths within 2 months of the end of zero-COVID. China reported 60,000 excess deaths in December 2022.
The decision to relax China's zero-COVID policies without adequate measures to protect high-risk populations had severe consequences.
"The decision to relax China's zero-COVID policies without adequate measures to protect high-risk populations had severe consequences," the authors of the current study wrote. "Other countries prioritized vaccines for older age groups and other vulnerable populations, and many studies have indicated that targeting medical countermeasures and protective measures toward groups with high infection-fatality rates can be life and cost saving."