Whether China truly has passed a COVID-19 peak is hard to assess, said Dr Dale Bratzler, chief COVID officer at the University of Oklahoma and head of quality control at the university’s hospital.

“That’s difficult to know,” Bratzler said. “China quarantined people indoors, there are many people unvaccinated, the people are vulnerable.”

Dr. Albert Ko, an infectious disease physician and professor of public health at the Yale School of Public Health, said the number of COVID-19 deaths China is reporting may be a “significant underestimation” because of how they define them.

“They’re using a very narrow case definition for (COVID) deaths,” Ko said. “They have to have respiratory failure ... in order to be counted as a case you have to be at a place where they can say you fulfilled all the requirements, and that’s at a hospital.”

Hospitals in China, Ko said, are located mostly in large cities where COVID outbreaks have been reported, not in isolated rural areas.

“This is the Lunar New Year, people are travelling, going to the countryside where the population is vulnerable,” Ko said. “We’re really worried about what’s going to happen in China as this outbreak moves to the countryside.”

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For nearly three years, China had kept its infection rate and deaths far lower than those of the United States and some other countries at the height of the pandemic with a “zero-COVID” strategy that aimed to isolate every case. That shut down access to some cities, kept millions of people at home and sparked angry protests.

Those rules were suddenly eased in early December after some of the largest shows of public dissent against the ruling Communist Party in more than 30 years. That set off new problems in a country that relies on domestically developed vaccines that are less reliable than others used globally, and where older people — those more susceptible to dying from the virus — are less likely to be vaccinated than the general population.

The Health Commission said the average age of people who died since December 8 is 80.3 years, and 90.1% are aged 65 and above. It said more than 90 per cent of people who died had cancer, heart or lung diseases or kidney problems.

“The number of elderly patients dying from illness is relatively large, which suggests that we should pay more attention to elderly patients and try our best to save their lives,” said Jiao.

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The United States, South Korea, Japan and several other countries have imposed virus testing and other controls on people arriving from China. Beijing retaliated on Wednesday by suspending issuance of new visas to travelers from South Korea and Japan.

This month, WHO Director-General Tedros Adhanom Ghebreyesus said agency officials met with Chinese officials to underline the importance of sharing more details about COVID-19 issues, including hospitalisation rates and genetic sequences.

AP