Swine flue deaths in China – are there any?

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Below is an email I received today from a reader in Australia. I am neutral on the topic, at least for now, but quite curious. Maybe someone in the know can contradict or verify it. If its numbers are accurate, they raise some important questions.

I work in the health sector and I have been monitoring the rates of H1N1 pandemic influenza in Asia since the infection appeared in May. I have been puzzled by the odd disparity in cases and fatalities in China compared to the rest of Asia. Here’s why, based on my own figures compiled on reported deaths in each country:

H1N1 influenza deaths/population (millions) = deaths per million

India 212/1,148 = 0.18
South Korea 5/49 = 0.10
Hong Kong 13/7 = 1.85
Taiwan 11/22 = 0.5
Vietnam 6/86 = 0.07
Philippines 28\96 = 0.3
Thailand 153/65 = 2.3
Japan 20/127 = 0.15

China 0/1,330,044,544 = 0

See a pattern emerging here? Very rough figures, but most countries seem to have a H1N1 pandemic flu mortality rate in the range of 0.1-0.5 per million population. Based on these rates, we would expect China to have 100-650 H1N1 deaths by now, or around 200 deaths as seen in other countries in the region with a similar population, such as India. And yet China has reported no H1N1 deaths at all, except for one in a woman from Zhejiang who was said to have recovered from the flu.

There are several possibilities here.

1. Have China’s quarantine policies been successful?
2. Is there a H1N1 influenza virus with Chinese characteristics that is less virulent?
3. Do Chinese people have some special immunity or life-saving treatment for influenza that other Asians lack?
4. Is China not reporting its 200+ swine flu deaths – perhaps because of a desire to avoid bad news in the run up to the forthcoming October 1 Anniversary?

I am surprised that none of the medical experts at WHO has commented on China’s immunity to swine flu. I would have expected SARS veteran Dr Margaert Chan to be very interested in any country that managed to achieve a zero mortality from what she described as a possible calamity.

I would be interested in what your readers have to say, and whether anyone ‘on the ground’ in China has other information.

I did a quick search and noticed a dearth of coverage of any swine flu deaths in China. Zero, to be precise. I did find a blog that had been questioning this, only to be blocked in China for its efforts.

Yet Xinhua’s reports are almost always just body counts: how many people are reported ill in one country or another. (For decades, Chinese media have been happy to report on disasters outside China.) And while Xinhua’s reported over 9,000 H1N1 cases in China itself as of mid-September, it still claims no one has died from the disease. Hong Kong, meanwhile, has reported over twice as many cases and 13 deaths.

(Currently, it appears China is actively blocking my site — and my other blogs as well. And all I’ve done is express surprise, not disbelief, at the lack of deaths.)

I’ll remain neutral until I know for sure whether mainland China has really reported no deaths from H1N1. If that turns out to be accurate, I’ll lean toward No. 4 on the list above, which strikes me as most likely considering both the improbability of the other three possibilities, coupled with China’s past history of lying about not being totally upfront about disease on the mainland. Is there a 5th possibility?

Update: It’s apparently true that China has registered zero deaths from H1N1. Striking that – link referred to Beijing, not all of China.

The Discussion: 23 Comments

Wow. Hard to believe. Apparently this strain of H1N1 is about as deadly as “ordinary” flu, so you would expect some deaths, just as with any flu strain.

September 18, 2009 @ 1:28 am | Comment

This flu thing had been there for a long time. Other bad news had been reported during the same period of time. I do not know why this particular bad news wuold get supprassed. The death from the flu should have been leaked somewhere.

September 18, 2009 @ 1:40 am | Comment

SARS turned out to be a hugh PR disaster for China. Hard to believe that they do the same mistake again.

September 18, 2009 @ 1:42 am | Comment

What’s even harder for me to believe is that we haven’t heard anything about this from the WHO.

September 18, 2009 @ 1:49 am | Comment


I don’t know about that.

September 18, 2009 @ 1:59 am | Comment

According to what I saw as I searched, Pug, there is still no official death registered by Chinese health authorities as being caused by swine flu. There was one death reported of a swine flu victim, but the cause of death was listed as being from something else, not swine flu. But maybe there was one death registered. If so, it’s still pretty close to zero and out of whack with the other numbers.

Zljn, the number should not have been leaked, is should have been reported. If it has to be leaked, then you’re acknowledging it’s being covered up.

September 18, 2009 @ 2:07 am | Comment


And one death according to this website.

September 18, 2009 @ 2:19 am | Comment

That is as suspicious as zero – and it’s proof that there is indeed a gigantic disconnect between China and the other countries. If you had found an official number of 100 or so I’d say the emailer didn’t know what he was talking about. The 1 tells me he has a point. Something doesn’t add up.

September 18, 2009 @ 2:30 am | Comment

Well you need to test the flu virus to see if it is H1N1 – if you do not test it, the patient just died from the flu…..maybe they forgot to test……

September 18, 2009 @ 3:14 am | Comment

I was in China during SARS I can tell you the policy is just lie, lie, and lie some more. Officially, Chaozhou, the city I was in, had four SARS cases. I went to the local hospital. It was jam packed and the halls were filled with patients being administered IV. I knew several Chinese who got sick at that time. They went to the doctor and were told they had appendicitis or some other implausible diagnosis.

September 18, 2009 @ 8:19 am | Comment

I wrote the email. It defies belief that China has had no deaths from the H1N1 influenza pandemic so far. Excuses such as ‘poor reporting’ by hospitals of swine flu cases don’t hold water because other developing countries such as Vietnam have had no problems in identifying and notifying cases where people have died after H1N1 infection. It looks like the SARS situation all over again, in that China’s health authorities are failing to disclose (or actively suppressing) data on a serious life-threatening infection. Fortunately this time the infection has not originated in China and the rest of the world is prepared.

This again underlines the lack of credibility of the Chinese government’s official figures. It also raises questions about why the World Health Organisation and infectious disease experts in the region have not questioned China’s remarkable ‘immunity’ to H1N1 influenza. Is there a ‘conspiracy of silence’ or at least an embarrassed reluctance to rock the boat?

China’s nominee to the WHO, Dr Margaret Chan, has from the outset mounted an alarmist campaign about H1N1 influenza, encouraging draconian (and non-scientific) measures such as China’s quarantine policy.
Perhaps Chinese authorities are embarrassed to admit that despite their hard-line methods they have had just as many fatalities as other countries.

September 18, 2009 @ 2:08 pm | Comment

Well, Exactly my point Richard. It is surprised that nothing has been leaked if you believed that there is a cover up. I mean it had been a long time (not like that the flu just began to spread yesterday), and it involved so many people. If there were a cover up, it would have been leaked long time ago, as far as I can see.

September 18, 2009 @ 8:55 pm | Comment

Peter Kauffner, Michal (and even Richard) and all the China bashers should think about what’s going on on our side of the pond before complaining h1n1 in China. How many of you know the approximate number of people who got the h1n1 flu here in the States? The real answer is that nobody knows because the CDC stop counting at around end of June because there is just too many cases and according to the CDC, the symptoms are ‘mild’. An recent article shows that in NYC there’s already 750,000 to 1 million infected already as of early September. That’s one in 10 people just in NYC and who knows the percentage who has h1n1 in the rest of the states.


Second, Margret Chan’s Draconian ways is the right way to deal with this h1n1 flu because is spreads very easily. I can tell you from personal experience that I got slight flu early this July and the next weeks my Son and Daughter has gotten the same symptoms. I can tell you that it is a flu because antibiotics didn’t help. I wish that the US government did something about guaranteeing people when people started getting sick. Given that there are many densely populated cities in China, they are right to do what they did otherwise the number of people who gets sick will explode.

September 19, 2009 @ 12:29 am | Comment

Chan’s quarantining was a hoax done for show. I credit it with nothing, because it looked draconian but was actually half-hearted, as many of the article by those who were quarantined attest. And the absurdity of picking up and quarantining Mexicans even if they hadn’t been back to Mexico – well, we discussed that before.

I am suspicious of the numbers because there is such a big disconnect. I said I’m also neutral on the issue because maybe there’s something I don’t understand, and I wanted to put it out for discussion. Of course, it’s now being discussed purely as a political issue.

Well, Exactly my point Richard. It is surprised that nothing has been leaked if you believed that there is a cover up.

Not every cover-up has a leak. It took months for the SARS doctor to finally get his story to Time magazine in 2003 and he did so at great personal peril. The fact that there hasn’t been a leak – and this applies to all sorts of situations in every country – doesn’t negate the possibility that something is being covered up. By that logic, we should swallow everything governments tell us until someone leaks contradictory information.

September 19, 2009 @ 12:39 am | Comment

Richard, the story of “quarantining Mexicans ” is so out of date. Cannot believe that you still cited that to support your opinion. Try the more recent one, written by Peter Foster, http://blogs.telegraph.co.uk/news/peterfoster/100006017/swineflu-does-battle-with-the-chinese-superstate/

September 19, 2009 @ 1:25 am | Comment

And about cover up. Yes I believe that there are lots of things that gov does not tell us. Usually when those covered-up problems are leaked, it is the first time that you even hear of them.

But the flu is so old news, I remembered that you even complained that the state media spent too much time on that issue. Seriously, if there were cover-ups, odds are they would have been leaked.

September 19, 2009 @ 1:28 am | Comment

Zjln, that blog post you cite doesn’t erase the idiocy of the Mexican quarantine. What’s the point, that the government is taking H1N1 seriously? I don’t doubt that. That doesn’t make their pseudo-quarantining any less pseudo.

About whether there’s a coverup, I don’t know. The numbers, if you look at the chart, are peculiar. But I am not drawing any conclusions.

September 19, 2009 @ 2:05 am | Comment


We’re not talking about the number of cases we’re talking about the number of deaths from H1N1 pandemic influenza. All countries gave up testing and counting cases a while ago, not just the US, because as the new strain (in Australia it now accounts for 90% of all flu) became the predominant it became a meaningless and impractical exercise to test everyone.

And it’s not about China bashing, it’s about fundamental standards of transparency and accountability. Why are Chinese citizens the only people in Asia not being told about the death toll from a pandemic? If I was a Chinese citizen I would be very angry about being kept in the dark about this.

And Margaret Chan’s policies were NOT the right way to deal with a pandemic. The WHO should support EVIDENCE BASED methods – ie methods that have been proven to work. Airport scanners and quarantine simply don’t work because many H1N1 infected people pass through airports before they are symptomatic. Having public health staff dress up in biohazard suits and respirators to baord every aircraft and test all passengers for fever was just a piece of theatre – and Chinese infectious disease specialists knew that.

China is not the only country to mount a poor response to the pandemic. The Australian government also made a complete hash of it. At least in Australia there has been open debate about how badly we got it wrong:

September 19, 2009 @ 4:06 pm | Comment

zero death is suspicious, but everything is possible. If you have no evidence, please don’t say they are lying. I think china government did the best job in the swine flue issue.

September 20, 2009 @ 1:24 pm | Comment

abc, whom are you addressing?

September 20, 2009 @ 1:30 pm | Comment

Here is a fifth possibility:

In other countries, a patient with terminal cancer who caught swine flu and died is classified as died from swine flu.

In China, the same patient is classified as died from cancer.

September 20, 2009 @ 10:16 pm | Comment


@Richard #14

I know that I am digging up an old thread but China’s so called ‘draconian’ measures did what they have to do, slowed down the spread the virus until they were able to distribute the vaccine.

November 12, 2009 @ 1:59 am | Comment

Yes, they should have quarantined more Mexicans, simply because they were Mexicans. That’s not draconian, it’s stupid. And if you follow the links, you’ll see how ridiculous the quarantining was – more for show than for public health.

November 12, 2009 @ 2:06 am | Comment

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