Abstract
BackgroundThe extent to which the Omicron variant of SARS-CoV-2 raised death rates in China during its viral wave of December 2022-January 2023 remains undocumented.MethodsWe worked with an established national survey organization to survey 8,004 adults in all 31 administrative areas of China to ask about deaths in families since January 2020. We examined agespecific death rates, focusing on deaths above age 60 years, and at 15-59 years. We compared these to the United Nations (UN) estimates of age-specific mortality in 2019.FindingsThe survey participants were broadly similar to the 2020 census and other national surveys in age, sex, region, and smoking status, but had lower SARS-CoV-2 vaccination rates and higher education levels. There were no differences between reporting of deaths during the Omicron period versus earlier. The survey captured 456 deaths, of which 329 occurred at ages 60+ years and 212 were women. At ages 60+ years, death rates per 1000 rose 242% (95%CI 128-398%) during December 2022-January 2023. Deaths at ages 15-59 years did not rise appreciably. The UN estimates approximately 675,000 deaths per month at ages 60+ years in 2019. If rates doubled nationally as in our survey, China had approximately 1·35 million excess deaths over the two months.InterpretationChina experienced a sharp but short increase in excess deaths among its elderly during the Omicron wave. If death registry data corroborate our estimates of substantial excess deaths in China, the worldwide estimates of excess deaths to 2023 may need upward adjustment.FundingCanadian Institutes of Health Research
Publisher
Cold Spring Harbor Laboratory
Reference19 articles.
1. China’s COVID-19 Response. 2023. https://en.chinacdc.cn/news/latest/202301/W020230126558725888448.pdf (accessed August 4 2023).
2. Liu J , Zhang L , Yan Y , et al. Excess mortality in Wuhan city and other parts of China during the three months of the covid-19 outbreak: findings from nationwide mortality registries. BMJ 2021; 372: 415.
3. The WHO estimates of excess mortality associated with the COVID-19 pandemic;Nature,2023
4. COVID mortality in India: National survey data and health facility deaths;Science,2022
5. The State Council of the People’s Republic of China. China’s internet users total 1.079 bln with vibrant digital infrastructure, internet app growth. August 28, 2023. https://english.www.gov.cn/archive/statistics/202308/28/content_WS64ec5126c6d0868f4e8dee21.html (accessed October 11 2023).