In China, doctors say they are discouraged from citing COVID-19 on death certificates

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During a busy shift at the height of Beijing’s COVID wave, a physician at a private hospital saw a printed notice in the emergency department: doctors should “try not to” write COVID-induced respiratory failure on death certificates. | Reuters

Some relatives of people who have died with COVID say the disease did not appear on their death certificates, and some patients have reported not being tested for coronavirus despite arriving with respiratory symptoms.

On Saturday, officials said 60,000 people with COVID-19 had died in hospitals since China’s policy U-turn, a roughly ten-fold increase from previously reported figures, but still short of expectations of international experts, who have said China could see more than a million COVID-related deaths this year.

Several said they were told such guidance came from “the government”, though none knew from which department, a common situation in China when politically sensitive instructions are disseminated.Three other doctors at public hospitals in different cities said they were unaware of any such guidance. Michael Baker, a public health scholar at the University of Otago in New Zealand, said the updated death toll still “looks low” compared with the high level of infection in China.

The World Health Organization on Monday recommended that China monitor excess mortality to gain a fuller picture of the impact of the surge in COVID. Patients, including his aunt, were rigorously tested, although not for COVID, before being told they had pneumonia. But the hospital told him it had run out of medicine, so they could only go home.Medical staff at public hospitals in several cities in China said PCR testing, which under “zero COVID” was a near daily requirement for large parts of the population, has now been all but abandoned.

 

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