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Can China’s COVID-19 Statistics be Trusted?

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From GDP figures to coronavirus counts, China’s government has a long history of manipulating data for political gain.

Scott N. Romaniuk and Tobias Burgers

The Wuhan coronavirus, officially named COVID-19, originally appeared as pneumonia illnesses in the first week of December 2019 and were associated with the Huanan Seafood Wholesale Market in Wuhan, China. The emergence of what was eventually assessed as “novel,” follows on a wave of disease outbreaks over previous decades and comes roughly 60 years after Mao Zedong’s “farewell to the God of Plague” and his crusade to eradicate Schistosomiasis (bilharzia) in the People’s Republic of China (PRC). COVID-19 is not simply a public health problem. Indeed, it has become a major economic challenge for every state while for others it poses a serious socio-political question and tests the relationship between political (regime) control, science, and public awareness.

As the number of COVID-19 cases in countries rises, China continues to report a reduction in cases and hundreds of patients “cured” and discharged from hospitals daily, according to information disseminated by the Ministry of Foreign Affairs of the PRC. Leading Chinese epidemiologist, Zhong Nanshan, who discussed the potential for a second wave of the virus, highlighted the “intervention mechanism invented by China” and “[t]he core points are the ‘four earlys:’ early prevention, early detection, early diagnosis, and early quarantine.”

The number of new cases reportedly dropped below 100 on March 6 and has consistently decreased. The PRC also conveyed data indicating that the country has seen zero new local cases (in Wuhan, Hubei) over the course of several days. China’s total active cases from February 17 against those of March 22 yields a percentage change of approximately 91%. While statistics show that the PRC has done much to contain and reduce the effects of COVID-19, these data are prepared by PRC officials. Are these data reliable? If not, what do they say about COVID-19 in China?

Given that the PRC’s GDP data tend to be inflated, casting the illusion of impressive growth to Chinese citizens and observers around the world, the same could also apply to COVID-19 statistics. Economists at the University of Hong Kong and the University of Chicago calculated China’s economic growth independently and showed that the PRC’s numbers were swollen by roughly 1.7%, with more than 10% added to the country’s overall economic size. One ought to acknowledge the internal consistency of epidemiological statistics related to China. Data shared and presented by the PRC is suffused with missing methodologies, data breaks and numerical peculiarities. Positive characterizations of the economy, military, labor force, “development aid,” housing, and so on are typically rewarded internally by a governance system that rewards positive news. At the same time, the fear of having to report negative news has created a loop in which those at the bottom of the governance system – local leaders – seek to avoid negative developments and news. As was the case in the initial outbreak, where local leaders sought to curtail and limit much of the info, and existence of the COVID-19 virus. This reaffirms the notion that statistical data from autocratic and dictatorships are often unreliable. China reveals no exception to this general line of reasoning.

China’s early-detection/warning system for outbreaks has basically proved a failure. The country’s CDC system has been touted as one of the best in the world, developed over many years and through trial and error with seminal cases such as “Asian Flu” (as a separate historic case that originated in China in 1957 and lasting until 1958), H5N1 in 1996, SARS in 2002, H1N1 in 2009, and H7N9 in 2012. Chen, Bu, and Wang, in their article title, “Epidemiology and Control of H5N1 Avian Influenza in China,” explain the emergence of multiple genotypes of H5N1 since 1999 and that in 2004, 2005, and 2006, respectively, Chinese officials observed 50, 31, and 10 outbreaks in domestic poultry. Just one year ago, Gao Fu, Director General of the China CDC announced that he is, “very confident that the SARS incident will not recur. This is due to our country’s well-built infectious disease surveillance network; we can block the virus when it appears.”

The PRC claimed the system works and was effective. Form their perspective, atypical pneumonia cases were identified early and the Wuhan and Hubei CDCs collated and imparted the information to their superiors at the national CDC in December. Thus, the PRC was fully-aware of the cases that emerged in Hubei. Zhang Jixian was praised and awarded by the PRC for her role in cases having been reported, which enabled national authorities to pass critical data on to the World Health Organization (WHO).

COVID-19 bistleblower, Li Wenliang, garnered global attention after being reproached by the WHC and various authorities for his role in the spread of “false rumors.” Li, who was forced by law enforcement authorities to sign a document promising not to continue his actions, died suspiciously (and conveniently for the PRC) as a result of the disease he warned people about. Li was not the only one as many other doctors and medical experts in Wuhan were reprimanded for their role in countering economic development and social order in China. Chinese officials originally dismissed the idea of COVID-19 case clusters and instead elected to acknowledge the existence of several infections.

The major problem with statistics related to COVID-19 cases in China is that the numbers are easy to misrepresent in favor of political or regime image. Publicly available data is dependent on data fed into a public data system by the PRC, in this case. Health statistics and data are easy to distort in China and there is a strong reason for the PRC to do so. There may be an expectation that the health status of the population is commensurate with the technological and economic development of the country. Any adjustments made to public health statistical data may be undertaken in line with projected (rather desired) growth in other areas of the country. With the initial suppression of public health concern, any subsequent data could be based on inaccurate numbers.

Chinese authorities’ initial response to the news of what was happening within the PRC’s borders is indicative of a concern turning to fear that China’s economic performance would sustain a serious impact, even Xi’s leadership (position) directly. This would ultimately drive headlong into the persistence of Xi’s “Chinese Dream (Zhongguo meng, 中国梦)” – a term that redirects the focus of hundreds of millions of Chinese from self-sacrifice for the benefit of the state to endless dreaming and personal happiness, ambition, and material reward. The PRC received part of the blame by Wuhan mayor, Zhou Xianwang, who attested to the need for Beijing to approve data prior to any dissemination. Xi’s position is one that provides protection but also puts him in the crosshairs. As the supreme leader of the PRC, Xi’s ultimately responsible for events of this nature and their impacts on the state, though his vulnerability in this regard is tempered by his removal of ruling terms. Concomitantly, Xi will always be able to point the finger to lower ranking members of the governance for poor performances, including Wuhan’s mayor or Hubei Province Governor and Deputy Party Committee Secretary, Wang Xiaodong, and chief epidemiologist for China’s CDC, Wu Zunyou.

Efforts to downplay the novel virus and its potential implications, including the difficult-to contain costs of political image, collided with concern, anxiety, and fear about the ramifications for public health and the possible spread of the virus to other regions of China and beyond the PRC’s borders. As such, failing to contain another unknown disease held the potential to seriously undermine the PRC’s efforts to under Xi to achieve growth continuity and rise from state, to power, to great power status. China’s development, stability, and geopolitical interests and objective-seeking have coalesced and coupled with the emergence of diseases such as COVID-19 to generate the increasing need to sustain its previous gains. As economic growth is the cornerstone to China’s strength as a country, militarily, politically, and future opportunities, data falsification and statistical fraud will likely remain constant features of the PRC and all levels of governance within the country. This directs one’s focus to the number of reported cases. Having responded to the emergence of the disease on January 7, Xi’s first public statement did not follow for another two weeks, when on January 20, he underscored need to take the outbreak seriously. When SARS infections were initially detected, the PRC under Jiang Zemin endeavored to conceal its severity until the efforts to do so were derailed by one of China’s leading doctors, and the PRC was no longer prudent in acting on that initial decision.

China’s COVID-19 infection numbers are likely much higher than previously stated as a result of pictures, videos, and leaked documents indicating a much different picture than what the PRC portrays. A considerable drop in mobile phone usage in China (approximately 21 million) is likewise telling of a possible difference in official PRC statistics of COVID-19 infections and deaths, and those who have actually contracted the virus and consequently died from it. One might reasonably expect to see an increase in mobile phone and landline usage by citizens, especially in times of quarantine and lockdown, not a decrease. Whereas mobile phone and landline usage increased nearly 24.37 million and 6.6. million, respectively. Turning to the situation in Italy, the mortality rate in that country (approximately 9%) suggests that the numbers (not including asymptomatic cases) in China are seriously misrepresented. This is even more plausible given the lack of testing instruments at the disposal of Chinese authorities and mass-testing was not undertaken or practical given the immediate lockdown of tens of millions of Chinese citizens.

The situation in Italy and other countries brings another item of interest to the fore: virus “hotspots.” In China, the outbreak and epidemic centered on Wuhan. In the United State (US), the so-called hotspots so far include New York, California, Washington. In Italy, the hotspots are, so far, Lombardia (Milan, Bergamo, Como, Brescia, Pavia). Transposing this to the regional level, the European Union (EU), approximately half the total area of China, shows multiple concentration points. Despite the peculiarity of the spread of the virus in China, regime efforts in that country have certainly done much to contain it. Owing in part to the ability of a dictatorship to implement measures without much constraint, the PRC through its continuous “war footing” management, has resulted in an appreciable suppression capacity. This verity resides alongside recent efforts by the PRC to deflect the impact of the virus, absolving China of the responsibility for virtually everything (even subtly demanding praise for measures implemented) COVID-19 related by pointed to the US military as the impetus for the pandemic, and foreigners who are importing the virus to China.

Furthermore, the risk exists that incentives would develop within China to underreport, or even to ignore, a possible new outbreak linked to imported cases, or domestic cases. Local and regional leaders, once more, as happened with the initial outbreak, would seek to hide new and emerging cases. After all, the governmental (propaganda) apparatus seems now to have concluded that China is winning its war against the virus and that its time to restart its economic engine. In such a scenario, it remains in doubt if a local or regional leader would have the incentive to report possible new cases. Why risk exposure and throwing sand into soon-to-restarted machine? Finally, with China having embarked on a global good will and PR tour, as noted above, seeking to absolve its responsibility, new cases of a possible re-emergent of the virus, would not fit in the governmental propaganda mantra and would actively counter its message that China, its high-tech healthcare approach and its governance system, are uniquely suited to combat the virus.

While China has made enormous gains in combatting the virus, and seems to have managed to flatten the curve, the world should not automatically stare itself blind on the new numbers coming from the country. With a cautious note on China’s statistical (un)reliability on its mind, the world should remain to closely observe the country’s health situation and watchful of future (health) developments.

Dr. Scott N. Romaniuk is a Postdoctoral Research Fellow in Security Studies at the China Institute, University of Alberta.

Dr. Tobias Burgers is a project assistant professor at the Cyber Civilization Research Center, Keio University, Tokyo, Japan.

*This article was originally publisher in The Diplomat on March 26, 2020.
https://thediplomat.com/2020/03/can-chinas-covid-19-statistics-be-trusted/


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Scott N. Romaniuk

Dr. Scott N. Romaniuk completed his PhD at the School of International Studies, University of Trento. He holds an MRes in Political Research, an MA in Terrorism, Crime and Global Security, and an MA in Military Studies (Joint Warfare). His teaching and research specializations include International Relations, Military and Strategic Studies, Security Studies, Terrorism and Political Violence, and Research Methods. He is a Senior Research Affiliate with the Canadian Network for Research on Terrorism Security and Society (TSAS) and a member of the Conflict, Terrorism and Development (CTD) Collaboratory at Michigan State University.

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