In recent weeks, China has become a source of encouraging news about COVID-19. As the U.S. and Europe face a swell of cases, China has reported ever-lower numbers of new infections and made moves to loosen its strict containment measures.
But as TIME’s Charlie Campbell and Amy Gunia report from Shanghai and Hong Kong, respectively, China’s claims are “clouded by a fog of skewed data, political imperatives—and unreported cases and possibly deaths.”
Since the first coronavirus cases were reported in Wuhan, China, at the very end of 2019, concerns about the Chinese government’s notorious lack of transparency have been swirling. How much, public-health authorities wondered, could they really trust China’s official counts and case reports? As countries across the world look to China for guidance on how to contain COVID-19, those questions take on more gravity than ever.
The situation does not look encouraging. TIME reporters spoke to multiple Wuhan residents who got sick, or knew people who did, but never made it into official case counts, bolstering an increasing belief among residents that China’s death toll may be larger than has been reported. The government is doing little to help its image: it has eight times changed the definition for what constitutes a COVID-19 case and left out many asymptomatic ones, meaning many patients have likely slipped through the cracks.
But with no other blueprint to go on, researchers and governments have little choice except to look to China for clues about how COVID-19 spreads, who gets it and how best to limit its wake. If the situation in China is worse than authorities are letting on—even as they flaunt lower transmission rates as evidence of their draconian containment measures’ success—it could have disastrous effects not only for the people of China, but also for countries following its lead.
Concerns about the way China is (or is not) counting COVID-19 cases have cast doubt on global numbers. The South China Morning Post reports that China may have left 43,000 asymptomatic cases out of its count as of February, which would greatly skew both the national and worldwide total—even without considering asymptomatic cases from March. Insufficient testing in the U.K. has also likely led to underestimates there.
Based on what has officially been reported, however, the total worldwide number of cases was above 850,000 as of the evening of March 31. The U.S., Italy, Spain, China and Germany have reported the most cases worldwide.
Here is every country with over 5,000 confirmed cases, as of Tuesday night, 8 PM eastern time:
As diagnoses climb, major international events continue to be canceled or postponed. The Wimbledon tennis tournament has been canceled for the first time since World War II. The Edinburgh Fringe festival, billed as the world’s largest arts fair, has also been canceled, even though it was not supposed to take place until August.
The Situation in the U.S.
As many as 240,000 Americans could die of COVID-19, according to projections cited by the White House, even if residents follow containment directives such as social distancing “almost perfectly,” says Deborah Birx. More than three-quarters of the country’s population is under a stay-at-home order of some kind, and municipalities including New York City are stepping up punishments for those who violate them.
The White House’s grim estimate is nonetheless a marked improvement over earlier models, which suggested more than 2 million Americans could die if nothing was done to slow the virus’ spread. But it’s considerably higher that estimates for an average flu season, which typically results in up to 60,000 deaths in the U.S.
Strain on the U.S. health care system can explain many of those expected deaths. Hospitals continue to battle through supply and staffing shortages, and more and more states are calling on medical students and recently retired health care workers to join the relief effort.
The economy is hurting too, with the country’s manufacturers facing unprecedented challenges and the stock market continuing to plummet. March was the worst month for the U.S. stock market since the 2008 recession, and April is already off to a similarly poor start, with prices dropping even further on Wednesday, the New York Timesreports.
All numbers are from the Johns Hopkins University Center for Systems Science and Engineering, and are accurate as of March 31, 8 PM eastern time. To see larger, interactive versions of these maps and charts, click here.
WHAT ELSE YOU SHOULD KNOW
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Alix Monteleone has found herself alternately glued to her window and rushing to close the blinds since Wyckoff Heights Medical Center put up a mobile morgue across the street from her Brooklyn apartment, she tells TIME correspondent Simon Shuster. Read more here.
Air Pollution Is Dropping During the COVID-19 Outbreak, But Don’t Celebrate Yet
As huge swaths of the world halt travel and retreat inside, you’ve likely seen photos of usually polluted, suddenly clear air and waterways around the world. But experts say these shifts aren’t likely to be permanent, or cause for much optimism. Read more here.
Alaska’s Remote Villages Are Taking Isolation to a New Level
Remote Alaskan communities are all but sealing themselves off from the outside world, fearing that even one case of COVID-19 could tear through their tiny and tight-knit populations. Read more here.
What It’s Like to Clean Professionally During COVID-19
Housekeepers, janitors and sanitation workers have unexpectedly found themselves on the frontlines of a pandemic, tasked with sanitizing the virus away. But as one hospital housekeeper told TIME, “no one ever mentions the people who clean it up after [the doctors and nurses] are gone.” Read more here.
The Stimulus Bill Won’t Solve Hospitals’ Problems
The U.S. government’s coronavirus relief package included a $100 billion bump for hospitals. But as TIME health care reporter Abigail Abrams learned, that money may not help much with critical shortages in supplies and equipment. Read more here.
The Truth About Underlying Conditions and COVID-19
Doctors have routinely warned that preexisting health conditions can make you more susceptible to COVID-19 and its complications. But which conditions do you really need to worry about? Read more here.
Thanks for reading. We hope you find the Coronavirus Brief newsletter to be a helpful tool to navigate this very complex situation, and welcome feedback at coronavirus.brief@time.com.
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