China’s COVID-19 statistics fall outside of recognized and accepted medical norms. Here we estimated the incidence, death and starting time of the COVID-19 outbreak in Wuhan and China based on cremation related information.
Data sources included literature on COVID-19 in China, official Chinese government figures, and media reports. A range of estimates is presented by an exponential growth rate model.
For the cumulative infections and total deaths, under different assumptions of case fatality rates (from 2.5% to 10%) and doubling time 6.4 days, the estimates projected on February 7, 2020 in Wuhan range from 305,000 to 1,272,000 for infections and from 6,811 to 7,223 for deaths - on the order of at least 10 times the official figures (13,603 and 545). The implied starting time of the outbreak is October 2019. The estimates of cumulative deaths, based on both funeral urns distribution and continuous full capacity operation of cremation services up to March 23, 2020, give results around 36,000, more than 10 times of the official death toll of 2,524.
Our study indicates a potential significant under- and delayed reporting in Chinese official data on the COVID-19 epidemic in Wuhan in early February, 2020.