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Increasing Respiratory Disease Cases in China: What’s the Truth?

Hospitals in China are becoming overcrowded as the number of pneumonia cases rises.

With the seasons changing, respiratory illnesses are expected to increase among the public, especially among children. Still, there has been a rise in the number of detected respiratory illness cases in China compared to last year. The increase is most evident in northern cities like Beijing and the Liaoning province, and it has been monitored by the World Health Organization (WHO) since the middle of October 2023. The Chinese National Health Commission also touched on this issue at a press conference on November 13, 2023. The commission believes that the sudden increase in numbers is not because of the emergence of another virus, like COVID-19, but rather because of reasons like COVID-19 restrictions being lifted, the cold season making its appearance, and the circulation of already known pathogens such as Mycoplasma pneumonia, influenza, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and respiratory syncytial virus (RSV).

Even though these names may look a little scary, most people don’t need hospital care because of the above-mentioned pathogens. To illustrate, another name for influenza is flu; viruses like RSV only cause cold-like symptoms; there is already a vaccine for SARS-CoV-2, and serious cases of it are now rare; and lastly, Mycoplasma pneumonia is, most of the time, mild and only requires hospital care if the lungs are infected (however, it is also important to note that it is one of the major reasons for child death due to neglect). Although these pathogens don’t pose much of a risk at first sight, the Chinese public was not late to take action, probably because China was one of the countries that suffered most seriously from the COVID-19 epidemic. China already has systems in action that detect trends in most of the known pathogens and report them to the Global Influenza Surveillance and Response System (GISRS) led by WHO. The additional actions the public took included improving disease surveillance in hospitals and common settings and stressing the need to improve the capacity of the healthcare system to handle patients.

Common symptoms of respiratory illnesses include coughs, sneezing, stuffy or runny nose, sore throat, headaches, muscle aches, thigh chest, high temperature, and overall weakness. It is anticipated that the Chinese government will not impose any restrictions because, as the symptoms make evident, the majority of the cases are related to common seasonal illnesses like the flu or cold. The most basic advice for decreasing the spread of respiratory illnesses includes getting vaccinated, keeping a distance from people who are ill, staying home when ill, being careful about personal hygiene, maintaining adequate ventilation, getting tested or visiting the doctor if needed, and wearing masks again if necessary.

On the ProMed website, the increase in pneumonia cases was first labeled as a reported epidemic on November 21, 2023, and new information about the issue was added to the website in the following days.

So, if the increase in cases is not that important, why is it causing this big of a fuss on social media with many known media outlets reporting on the issue? The commotion is mainly caused by the unusually high number of undiagnosed pneumonia cases among children, which ProMED and Chinese media outlets reported first. It is also written on the ProMED website that some school classes have been shut down because most of the students had pneumonia, and the increase in pneumonia cases was labeled as a reported epidemic on the website on November 21, 2023. The increase in cases was then verified by the WHO after the news grabbed their attention and led them to get in touch with the Chinese government. The authorities stated that the increase in cases happened earlier in the year than usual, but the probable reasons were the same as the ones for the increasing respiratory illness cases. The authorities also reported that there were no changes in the presentation of the disease, nor did they detect any unusual or novel pathogens. There was only a rise in the number of cases, which they said didn’t pose a problem since the patients didn’t exceed the capacity of hospitals. Healthcare professionals beg to differ, as most of them state that hospitals are completely filled with worried parents, and some even express that they get 1,000 calls a day. We also know for a fact that these are not baseless statements since photos and video clips from Beijing hospitals posted on social media display patient waiting rooms filled to the brim with children and their parents. Media outlets like Foreign Policy and Chinese citizens on social media also stated that this wasn’t a pneumonia outbreak but rather an antibiotic-resistant pneumonia outbreak, which again contradicts the official statement given by the Chinese authorities since they had stated there were no mutations to the pathogen nor were there any abnormalities. Therefore, it isn’t really possible to guess the risks the outbreak will cause since most details are still very vague and the information obtained contradicts each other.

It is also important to get into further detail about the death risks of pneumonia. Even though pneumonia cases are usually mild and don’t require hospital attention, severe cases can be very deadly if not treated properly. It is even considered to be the most deadly infectious disease for children and is the main cause of death for approximately 700,000 children under the age of five every year, which equals approximately 2,000 deaths every day. Cases are most common in South Asia, with 2,500 cases per 100,000 children, and in West and Central Africa, with 1,620 cases per 100,000 children. Progress in reducing pneumonia-caused deaths has also been slower compared to other infectious diseases because, most of the time, the cases are mild. The critical part to note about these deaths is that they were all preventable. The deaths caused by pneumonia are most of the time linked to poverty, not having access to clean water, insufficient access to healthcare, and air pollution. The fact that very few children who show symptoms are seen by a medical professional is another serious issue. This is because symptoms are often misdiagnosed as a cold, which makes sense given that they share almost the same symptoms.

Therefore, it makes sense that media outlets and the general public would be afraid of a potential epidemic given that the disease is still one of the leading causes of infant mortality, even though most of the time it’s easily treated. With many rumors surrounding the epidemic, it is again important to note that the situation in China is not very clear, and therefore it is not possible to make an accurate assumption about this probable epidemic.

Works Cited

NHS . “Respiratory Tract Infections (RTIs).” NHS, 2020,

ProMED. “Undiagnosed Pneumonia - China (04): (BJ, LN) Children, Reported Epidemic.” ProMED-Mail, 25 Nov. 2023, Accessed 9 Dec. 2023.

UNICEF. “Pneumonia in Children - UNICEF Data.” UNICEF DATA, Dec. 2022,

Sparrow, Annie. “Chinese Hospitals Are Housing Another Deadly Outbreak.” Foreign Policy, 27 Nov. 2023,

World Health Organization. “Pneumonia.”, Accessed 9 Dec. 2023.

World Health Organization. “Upsurge of Respiratory Illnesses among Children-Northern China.”, 23 Nov. 2023,

World Health Organization. “WHO Statement on Reported Clusters of Respiratory Illness in Children in Northern China.”, 22 Nov. 2023,


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