China’s National Health Commission has clarified that only Covid-19 patients who die from respiratory failure will be counted towards the official death toll after this week reporting the first deaths since the easing of pandemic controls . Many elderly had other chronic illnesses and very few people died directly from respiratory failure caused by the coronavirus, experts from the NHC said. Toll of Covid-19 in China is a concern for world: US State Department The clarification follows media reports that many more people had died after becoming infected and of rising demand at funeral homes and crematoriums. The commission has issued a notice clarifying how it is calculating the death toll from the disease in what it calls a “scientific and realistic manner”. The new guidelines narrow the criteria for counting Covid deaths, removing cases such as patients who had a heart attack after becoming infected. “Deaths caused by pneumonia and respiratory failure resulting from Covid-19 will be classified as Covid deaths, while deaths caused by other underlying diseases, such as cardiovascular and cerebrovascular diseases, will not be counted as Covid-induced deaths,” Wang Guiqiang, an adviser to the NHC and director of the infectious diseases department at Peking University First Hospital, said on Tuesday. China has seen cases skyrocket since it relaxed its zero-Covid policy, with the new rules allowing home quarantine for mild cases and encouraging residents to use rapid antigen test kits instead of PCR mass testing. Health authorities stopped reporting asymptomatic cases last week and until this week had not reported any Covid-related deaths since December 4 – three days before the policy change was announced. On Monday it reported two Covid-related deaths and five more on Tuesday – all in Beijing which has been hit by a surge in infections . Meanwhile, the country officially logged 2,656 new infections on Tuesday as reports suggested hospitals around the country were filling up and demand was rising in funeral homes. Wang also said the authorities had been organising training exercises across health departments to better standardise statistical work regarding Covid deaths, including how to determine whether a patient died from the disease or other causes. Wang said Omicron, the variant fuelling the current surge in cases, was becoming less lethal and China was increasing the vaccination rate, which meant the pattern of infections and deaths was changing. In the initial stages of the outbreak, which began in the central city of Wuhan in December 2019, most deaths were caused by coronavirus-induced respiratory failure. But now, he said, Omicron mainly attacked the upper respiratory tract and while some patients may develop pneumonia, few will suffer respiratory failure. ‘Hurting like hell’: China’s Covid patients feel the pain of drugs crunch “From clinical practice it can be seen that the main cause of death after infection with Omicron is chronic illness, while respiratory failure directly caused by the Covid-19 infection is rare,” Wang said. “We don’t avoid [talking about] the hazards of Covid-19, but at the same time we must view it from a scientific perspective.” China used to have a wider definition of Covid-19 deaths and included elderly people with several comorbidities, including those who had suffered heart attacks after being infected with the virus, in the official death toll. Other countries also follow broader guidelines when tallying the death toll. The United States follows World Health Organization guidelines where “probable” and “presumed” cases can be included as a Covid death, while countries such as Britain and Australia also include people who died from other causes but where Covid was a contributing factor. In Hong Kong, a person who dies within 28 days of the first positive test will be counted as a Covid-19 death.