Experts are questioning China’s reported coronavirus case and death counts. Here’s why it’s so important to get the data right.

Medical staff of China's national emergency medical team prepare to board at the Tianhe airport on March 17, 2020 in Wuhan, Hubei province, China.
Medical staff of China’s national emergency medical team prepare to board at the Tianhe airport on March 17, 2020 in Wuhan, Hubei province, China.

Stringer/Getty Images

The first epicenter of the coronavirus pandemic, Wuhan, China, is finally declaring victory over the virus and beginning to allow its residents to emerge from their homes.

In total, China has reported more than 82,000 infections and 3,300 deaths. But as outbreaks in Italy and the US have rocketed past that benchmark, experts and locals are questioning China’s case counts.

The US intelligence community filed a report to the White House indicating that China had given “intentionally incomplete” statistics, Bloomberg News reported on Tuesday.

Scientists reportedly told UK Prime Minister Boris Johnson that China could have up to 40 times the number of cases the country says.

The official death toll in Wuhan “can’t be right … because the incinerators have been working round-the-clock,” one resident, who identified himself by his surname, Zhang, told Radio Free Asia. Residents have reported funeral homes handing out thousands of urns daily, according to RFA and South China Morning Post.

Based on the nonstop activity of Wuhan’s 84 furnaces, the city’s true death toll could be as high as 46,800, according to RFA and The Washington Post.

China’s early numbers informed other countries’ responses

A sports stadium that was converted into a makeshift hospital to treat coronavirus patients in Wuhan, China March 1, 2020.
A sports stadium that was converted into a makeshift hospital to treat coronavirus patients in Wuhan, China March 1, 2020.

China Daily via Reuters

Of course, many countries don’t know how many coronavirus cases they really have. In the US, that’s largely due to weeks of delays in testing rollout, brought on by errors and bureaucratic delays. More broadly, people with no symptoms are unlikely to seek testing, but CDC director Robert Redfield has suggested they could comprise one in four COVID-19 cases.

But China was the first country to battle the new virus, and its reports set a precedent for how the rest of the world viewed the threat. If China had reported higher numbers early on, it’s possible that officials in other countries would have made different decisions.

“The medical community interpreted the Chinese data as: This was serious, but smaller than anyone expected,” Dr. Deborah Birx, a State Department immunologist who is one of the faces of the White House coronavirus task force, said at a press conference on Tuesday.

“I think probably we were missing a significant amount of the data, now that what we see happened to Italy and see what happened to Spain,” she added.

Read more: The top scientist at J&J told us how the $350 billion pharma giant will have a coronavirus vaccine ready at ‘warp speed’, then pump out 1 billion doses

As the virus spread through China, early data informed estimates of its death rate and its r0 (pronounced “r-naught”), the measurement of the number of people an average person with the virus infects. The more data epidemiologists have, the more accurately they can make those estimates.

Both US officials and UK leaders say China’s underreporting may impact the effectiveness of their response to outbreaks in their own countries.

“Some of the reporting from China was not clear about the scale, the nature, the infectiousness of this,” UK Minister for the Cabinet Office Michael Gove told the BBC.

“This data set matters,” US Secretary of State Mike Pompeo said in a press conference on Thursday. “The social distancing, all the things that we’re doing — limiting transportation, all those things we’re doing — to figure out if they’re working, so that we can save lives, depends on the ability to have confidence and information about what has actually transpired.”

‘We need to know how to interpret the numbers which are reported’

People wearing face masks ride an escalator as they exit a subway station during the coronavirus outbreak in Beijing, China, March 30, 2020.
People wearing face masks ride an escalator as they exit a subway station during the coronavirus outbreak in Beijing, China, March 30, 2020.

Carlos Garcia Rawlins/Reuters

Dr. Ben Cowling, an epidemiologist at the University of Hong Kong who researches influenza transmission and control measures, told Business Insider that case counts and death tolls are “often misleading.” He added that scientists know how to work around that.

“Most countries have not relied on data from China to make their policies,” Cowling said in an email. “A number of expert scientists used information on infections in Chinese travelers as a more accurate way to measure the occurrence of infections in China … because travelers were being monitored very carefully in some countries.”

Cowling said that officials and experts should be able to work with the numbers they get.

“I don’t think we need accurate numbers from China,” Cowling said. “We need to know how to interpret the numbers which are reported, and that is true for every country.”

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