Outside of the city of Wuhan, overall deaths did not increase in China during the first three months of the coronavirus pandemic, research by the Chinese Center for Disease Control and Prevention and Oxford University has shown.

The study has found that the rise in deaths due to the disease was offset by the decline in mortality from other causes. Deaths from pneumonia declined by 47% and road traffic accidents by 23%, largely as a result of a national lockdown in China from January through to April. 

However, the situation in Wuhan itself was very different, with the overall death rate up by 56%. The combined effects of pneumonia and COVID-19 are being blamed for the rise, although there were additional small increases in deaths from cardiovascular disease and diabetes.

The study has also found that there were more excess deaths among men than women, and that mortality was higher in central areas and among the over 70s. There was a drop in hospital deaths, but a rise in mortality outside healthcare settings, which researchers have suggested highlights either difficulties or reluctance to access professional healthcare.

These findings highlight the importance of rapid, large scale actions to combat the pandemic, with the Chinese national lockdown proving effective in reducing both COVID and non-COVID related deaths. 

The senior author for the study at the China Centre for Disease Control and Prevention, Professor Maigeng Zhou, said “The data showed that during these first three months of the COVID-19 outbreak, there were totally different situations in Wuhan city and in the rest of China. Within Wuhan city, there were also major differences in the severity of the outbreak between central and suburban districts.”

Dr Jiangmei Liu, another study author at the China CDC, added: “This was the first nationwide study in China to systematically examine the excess mortality during the COVID-19 outbreak, not only from pneumonia but also from a range of other conditions across different regions of China.”

Researchers examined data from the Chinese death registries from January to March 2020, as well as the Chinese Surveillance Point System, which represents over 20% of the entire population of the country. 

The new strain of coronavirus was first discovered in mid-December in Wuhan, China. It has since killed over 2.5 million globally, with over 100 million cases recorded.

The senior author for the study, Zhengming Chen, who is the Professor of Epidemiology at the Nuffield Department of Population Health at Oxford University, said: “It would appear that the lockdown and associated behavioural changes – such as wearing facemasks, increased hygiene, social distancing and restricted travel – actually had unintended additional health benefits beyond those of reducing the spread of SARS-CoV-2.”