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JAMA Open: Excess All-Cause Mortality in China After Ending the Zero COVID Policy
#17,636
In China, `bad news' - like the number of pigs lost to ASF, the number of human infections with avian flu (H5N6, H5N1, H3N8, etc.), when and where COVID first appeared, or China's true GDP - are treated as issues of national security, and are either hidden, heavily redacted, or made up out of whole cloth by the CCP.
During the first 3 years of the COVID pandemic, China - with a population of 1.4 billion - only admitted to 5242 deaths from the virus. Less than half of what the city of Hong Kong (pop. 7 million) had reported.
While they attributed this remarkable success to their `Zero-COVID' policies, few outside observers put much stock in those numbers. By last December, the wheels had come off, the public was near revolt, and China was forced to abandon `Zero-COVID'.
As a form of damage control, China created very narrow definitions for what qualified as a `COVID-related death' (see China: NHC - Only Respiratory Failure Due to COVID to Be Counted As A COVID Death).
Five days later (Dec. 25th, 2023) China simply stopped reporting COVID numbers altogether (see China: NHC Will No Longer Release Daily COVID Figures). Since then we've seen some outside attempts to quantify the impact of COVID on China last winter, but the full story will probably never be truly known.
Yesterday, a new investigative report was published by JAMA Open, which estimates 1.87 million excess deaths in China in the two months following the collapse of Zero COVID. I've only reproduced the Abstract below, so follow the link to read the report in its entirety.
I'll have a postscript when you return.
Original Investigation
Infectious Diseases
August 24, 2023
(Continue . . . )
All nations, to one extent or another, attempt to `manage' bad news. Some just do it more pervasively, and more effectively, than others. And since the COVID pandemic, it has become more `acceptable'.
We get suspiciously little news on MERS-CoVout of the Middle East, very little surveillance and reporting on avian flu from Asia, Africa, and the Middle East, and 90% of countries no
longer regularly report on COVID cases, hospitalizations, or deaths.
Some of this can be attributed to the limited ability many countries still have for surveillance (see Lancet Preprint: National Surveillance for Novel Diseases - A Systematic Analysis of 195 Countries), but a lot of it appears to be based on economic, societal, or political considerations.
While there may be some temporary advantages to these policies, eventually another global public health crisis will emerge, and we risk being caught flat-footed and unprepared.
Again.
https://afludiary.blogspot.com/2023/...tality-in.html
#17,636
In China, `bad news' - like the number of pigs lost to ASF, the number of human infections with avian flu (H5N6, H5N1, H3N8, etc.), when and where COVID first appeared, or China's true GDP - are treated as issues of national security, and are either hidden, heavily redacted, or made up out of whole cloth by the CCP.
During the first 3 years of the COVID pandemic, China - with a population of 1.4 billion - only admitted to 5242 deaths from the virus. Less than half of what the city of Hong Kong (pop. 7 million) had reported.
While they attributed this remarkable success to their `Zero-COVID' policies, few outside observers put much stock in those numbers. By last December, the wheels had come off, the public was near revolt, and China was forced to abandon `Zero-COVID'.
As a form of damage control, China created very narrow definitions for what qualified as a `COVID-related death' (see China: NHC - Only Respiratory Failure Due to COVID to Be Counted As A COVID Death).
Five days later (Dec. 25th, 2023) China simply stopped reporting COVID numbers altogether (see China: NHC Will No Longer Release Daily COVID Figures). Since then we've seen some outside attempts to quantify the impact of COVID on China last winter, but the full story will probably never be truly known.
Yesterday, a new investigative report was published by JAMA Open, which estimates 1.87 million excess deaths in China in the two months following the collapse of Zero COVID. I've only reproduced the Abstract below, so follow the link to read the report in its entirety.
I'll have a postscript when you return.
Original Investigation
Infectious Diseases
August 24, 2023
Excess All-Cause Mortality in China After Ending the Zero COVID Policy
Hong Xiao, PhD1; Zhicheng Wang, PhD2; Fang Liu, MD2; et alJoseph M. Unger, PhD, MS1 Author Affiliations Article Information JAMA Netw Open. 2023;6(8):e2330877. doi:10.1001/jamanetworkopen.2023.30877
Hong Xiao, PhD1; Zhicheng Wang, PhD2; Fang Liu, MD2; et alJoseph M. Unger, PhD, MS1 Author Affiliations Article Information JAMA Netw Open. 2023;6(8):e2330877. doi:10.1001/jamanetworkopen.2023.30877
Key Points
Question Was the sudden end of China’s zero COVID policy associated with an increase in population all-cause mortality?
Findings In this cohort study across all regions in mainland China, an estimated 1.87 million excess deaths occurred among individuals 30 years and older during the first 2 months after the end of China’s zero COVID policy. Excess deaths predominantly occurred among older individuals and were observed across all provinces in mainland China, with the exception of Tibet.
Meaning These findings suggest that the sudden lifting of the zero COVID policy in China was associated with significant increases in all-cause mortality.
Abstract
Importance In China, the implementation of stringent mitigation measures kept COVID-19 incidence and excess mortality low during the first years of the pandemic. However, China’s decision to end its dynamic zero COVID policy (a proactive strategy that deploys mass testing and strict quarantine measures to stamp out any outbreak before it can spread) in December 2022 resulted in a surge in COVID-19 incidence and hospitalizations. Despite worldwide attention given to this event, the actual impact of this sudden shift in policy on population mortality has not been empirically estimated.
Objective To assess the association of the sudden shift in China’s dynamic zero COVID policy with mortality using empirical and syndromic surveillance data.
Design, Setting, and Participants This cohort study analyzed published obituary data from 3 universities in China (2 in Beijing and 1 in Heilongjiang) and search engine data from the Baidu index (BI; weighted frequency of unique searches for a given keyword relative to the total search volume on the Baidu search engine) in each region of China from January 1, 2016, to January 31, 2023. Using an interrupted time-series design, analyses estimated the relative change in mortality among individuals 30 years and older in the universities and the change in BI for mortality-related terms in each region of China from December 2022 to January 2023. Analysis revealed a strong correlation between Baidu searches for mortality-related keywords and actual mortality burden. Using this correlation, the relative increase in mortality in Beijing and Heilongjiang was extrapolated to the rest of China, and region-specific excess mortality was calculated by multiplying the proportional increase in mortality by the number of expected deaths. Data analysis was performed from February 10, 2023, to March 5, 2023.
Exposure The end to the dynamic zero COVID policy in December 2022 in China.
Main Outcomes and Measures Monthly all-cause mortality by region.
Results An estimated 1.87 million (95% CI, 0.71 million-4.43 million; 1.33 per 1000 population) excess deaths occurred among individuals 30 years and older in China during the first 2 months after the end of the zero COVID policy. Excess deaths predominantly occurred among older individuals and were observed across all provinces in mainland China except Tibet.
Conclusions and Relevance In this cohort study of the population in China, the sudden lifting of the zero COVID policy was associated with significant increases in all-cause mortality. These findings provide valuable insights for policy makers and public health experts and are important for understanding how the sudden propagation of COVID-19 across a population may be associated with population mortality.
Question Was the sudden end of China’s zero COVID policy associated with an increase in population all-cause mortality?
Findings In this cohort study across all regions in mainland China, an estimated 1.87 million excess deaths occurred among individuals 30 years and older during the first 2 months after the end of China’s zero COVID policy. Excess deaths predominantly occurred among older individuals and were observed across all provinces in mainland China, with the exception of Tibet.
Meaning These findings suggest that the sudden lifting of the zero COVID policy in China was associated with significant increases in all-cause mortality.
Abstract
Importance In China, the implementation of stringent mitigation measures kept COVID-19 incidence and excess mortality low during the first years of the pandemic. However, China’s decision to end its dynamic zero COVID policy (a proactive strategy that deploys mass testing and strict quarantine measures to stamp out any outbreak before it can spread) in December 2022 resulted in a surge in COVID-19 incidence and hospitalizations. Despite worldwide attention given to this event, the actual impact of this sudden shift in policy on population mortality has not been empirically estimated.
Objective To assess the association of the sudden shift in China’s dynamic zero COVID policy with mortality using empirical and syndromic surveillance data.
Design, Setting, and Participants This cohort study analyzed published obituary data from 3 universities in China (2 in Beijing and 1 in Heilongjiang) and search engine data from the Baidu index (BI; weighted frequency of unique searches for a given keyword relative to the total search volume on the Baidu search engine) in each region of China from January 1, 2016, to January 31, 2023. Using an interrupted time-series design, analyses estimated the relative change in mortality among individuals 30 years and older in the universities and the change in BI for mortality-related terms in each region of China from December 2022 to January 2023. Analysis revealed a strong correlation between Baidu searches for mortality-related keywords and actual mortality burden. Using this correlation, the relative increase in mortality in Beijing and Heilongjiang was extrapolated to the rest of China, and region-specific excess mortality was calculated by multiplying the proportional increase in mortality by the number of expected deaths. Data analysis was performed from February 10, 2023, to March 5, 2023.
Exposure The end to the dynamic zero COVID policy in December 2022 in China.
Main Outcomes and Measures Monthly all-cause mortality by region.
Results An estimated 1.87 million (95% CI, 0.71 million-4.43 million; 1.33 per 1000 population) excess deaths occurred among individuals 30 years and older in China during the first 2 months after the end of the zero COVID policy. Excess deaths predominantly occurred among older individuals and were observed across all provinces in mainland China except Tibet.
Conclusions and Relevance In this cohort study of the population in China, the sudden lifting of the zero COVID policy was associated with significant increases in all-cause mortality. These findings provide valuable insights for policy makers and public health experts and are important for understanding how the sudden propagation of COVID-19 across a population may be associated with population mortality.
(Continue . . . )
All nations, to one extent or another, attempt to `manage' bad news. Some just do it more pervasively, and more effectively, than others. And since the COVID pandemic, it has become more `acceptable'.
We get suspiciously little news on MERS-CoVout of the Middle East, very little surveillance and reporting on avian flu from Asia, Africa, and the Middle East, and 90% of countries no
longer regularly report on COVID cases, hospitalizations, or deaths.
Some of this can be attributed to the limited ability many countries still have for surveillance (see Lancet Preprint: National Surveillance for Novel Diseases - A Systematic Analysis of 195 Countries), but a lot of it appears to be based on economic, societal, or political considerations.
While there may be some temporary advantages to these policies, eventually another global public health crisis will emerge, and we risk being caught flat-footed and unprepared.
Again.
https://afludiary.blogspot.com/2023/...tality-in.html
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