China is reporting its first deaths linked to COVID-19 in weeks as cases surge amid the country lifting many of its so-called "zero COVID" policies.
No information was available about the deaths including the names, ages, sex and vaccination status of the patients.
For most of the pandemic, China has implemented strict measures, including widespread lockdowns and mass testing in an attempt to prevent outbreaks.
But over the past few months, there have been large outcries and growing public resentment over the disruption to daily life, leading Beijing to ease some restrictions such as people being allowed to isolate at home and schools without known infections being able to resume classes.
However, a public health expert told ABC News a combination of under-vaccination and large swaths of unprotected vulnerable populations will lead to more deaths.
"What will happen with the new policy right now is most of the population in China will be infected by COVID," said Dr. Ali Mokdad, an epidemiologist and chief strategy officer at the University of Washington Population Health Initiative. "In one way or another, they'll be infected."
According to the NHC, China has only recorded 5,237 COVID-19 deaths -- much lower than the tolls reported by other Western countries -- since the pandemic began, but experts agree this is likely an undercount. According to data from Johns Hopkins, China has had over 16,000 deaths since the pandemic started.
Mokdad said health officials only include those who died directly from COVID-19 in the official death count. Those with underlying medical conditions that were exacerbated by the virus or who incidentally tested positive for COVID are excluded.
However, he expects the number of deaths will rise over the next several weeks and months.
One mathematical model from the University of Washington's Institute of Health Metrics and Evaluation suggests there could be almost 323,000 total COVID-19 deaths in China by April 1 as a result of the shift in policy.
One reason deaths could rise is because of the lack of an effective vaccine.
In China, the Sinovac COVID-19 vaccine has been administered since June 2021 when it received emergency use authorization. According to the World Health Organization, 87% of the population has been vaccinated, but the government says more than 90% are vaccinated according to China Daily, a state-run newspaper.
"Whatever China does, the simple fact they have a very susceptible population, a vaccine that's not as effective against omicron, waning immunity and many of the elderly population not vaccinated, there will be lots of hospitalization and more deaths," Mokdad said.
Another reason deaths could rise is because of under-vaccination and lack of exposure to the virus, due to lockdowns under the zero COVID policy, many people don't have natural or vaccine-derived antibodies.
"They know nothing about COVID like you and I have been vaccinated or have gotten COVID-19 or both," he said. "So, we're not naive to cope with it and our body will remember it and then will mount a defense."
He continued, "Many Chinese don't have that luxury. And we are most concerned about the elderly, simply because they're not vaccinated and the zero COVID policy protected them from infections in the past."