‘Tip of the iceberg:’ Nations struggle to count virus toll

BEIJING — China acknowledged Friday that the coronavirus death toll in the one-time epicenter city of Wuhan was nearly 50% higher than reported, underscoring just how seriously the official numbers of infections and deaths around the world may be understating the dimensions of the disaster.

The undercount stemmed from several factors, according to a notification issued by Wuhan’s coronavirus response headquarters and published by the official Xinhua News Agency.

The reasons included the deaths of people at home because overwhelmed hospitals had no room for them, mistaken reporting by medical staff focused on saving lives and deaths at a few medical institutions that weren’t linked to the epidemic information network, it said.

In Italy, Spain, Britain, the United States and elsewhere, similar doubts emerged as governments revised their death tolls or openly questioned the accuracy of them.

“We are probably only seeing the tip of the iceberg,” said Barcelona University epidemiologist Antoni Trilla, who heads the Spanish government’s expert panel on the crisis.

Worldwide, the outbreak has infected more than 2.2 million people and killed over 148,000, according to a Johns Hopkins University tally based on figures supplied by government health authorities around the globe. The death toll in the U.S. topped 33,000, with more than 690,000 confirmed infections.

Authorities say infections and deaths have been underreported almost everywhere. Thousands have died with COVID-19 symptoms — many in nursing homes, which have been ravaged by a disease that hits the elderly the hardest — without being tested. Four months into the outbreak, nations are still struggling to increase their testing capacity, and many are still far from their goal.

In Italy, officials have acknowledged that the country’s official death toll of more than 22,000 understates the true number, primarily because it doesn’t include those who died in nursing homes and were not tested.

A government survey released Friday of about onethird of Italy’s nursing homes found more than 6,000 residents have died since Feb. 1. It was unclear how many were a result of COVID-19.

And in Spain, the country’s 17 autonomous regions were ordered to adopt uniform criteria on counting the dead. The country has recorded more than 19,000 deaths, but the system leaves out patients who had symptoms but were not tested before they died.

“There is a general feeling that the epidemiologists don’t have a clue of what’s going on, that experts know even less and that governments are concealing information, but I don’t think that’s true,” said Hermelinda Vanaclocha, an epidemiologist on Spain’s top virus advisory panel. “It’s simply not easy.”

China raised its overall death toll to over 4,600 after Wuhan, where the outbreak first took hold, added nearly 1,300 deaths.