# 4040
A hat tip to Crof at Crofsblog for picking up this Reuters report overnight out of Beijing, which quotes Zhong Nanshan – a hero of China’s SARS crisis in 2003 – on his doubts over the official death counts coming out of that country.
China's official H1N1 death count suspect: report
Wed Nov 18, 2009 11:43pm EST
Thursday, 12 Nov 2009 05:24pm EST
BEIJING (Reuters) - China may have had more H1N1 flu deaths than have been reported, with some local governments possibly concealing suspect cases, a prominent Chinese medical expert said in an interview published on Thursday.
Zhong Nanshan, a doctor based in the far southern province of Guangdong, said he doubted the current official death toll from the influenza strain, also called "swine flu," that has medical experts worldwide worried.
"I just don't believe that nationwide there have been in all 53 H1N1 deaths," Zhong told the Southern Metropolis Daily, a popular Guangdong newspaper.
Zhong said that "some areas have not been testing deaths from severe (pneumonia) and treating them as cases of ordinary pneumonia without a question," the paper reported.
While valid, the same criticism could be levied at nearly every nation around the globe. The degree of undercounting may vary from one country to the next, but quite obviously the numbers we get are but a fraction of the real death toll.
The US is the only country that I’m aware of that has at least tried to come up with an estimate of deaths. And as of more than a month ago, that mid-level estimate was roughly 4,000 deaths.
Most countries insist on counting only laboratory confirmed deaths, and then do very little testing or surveillance. Their numbers, therefore, remain reassuringly low.
As of November 12, the UK had only reported 124 flu related deaths, or a per capita death rate that is 1/6th of that estimated by the US. The DOH even provides this disclaimer:
This figure represents the number of deaths in individuals with swine flu but does not represent the number of deaths that can be attributed to swine flu.
Canada, with a population half that of the UK, as of late last week had reported 161 deaths. And while twice the rate of the UK, that is still far below the US estimates.
And France, with a population comparable to the UK, is only reporting about 70 deaths, or a per capita death rate 1/10th that estimated in the US.
When the World Health Organization releases weekly global case and death counts, it comes with this disclaimer:
Given that countries are no longer required to test and report individual cases, the number of cases reported actually understates the real number of cases.
Admittedly, counting flu deaths isn’t easy. For all practical purposes, it probably isn’t even possible. Which is why we rely on estimates and mathematical models to come up with a reasonable figure.
While many look at the WHO global counts of just over 6,000 dead and wonder what the fuss is about this pandemic virus, the real impact probably won’t be calculated until this pandemic is over.
For more on the difficulties of counting flu-related deaths – something I’ve written about extensively - you might wish to read When No Number Is Right.
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