The number of funerals in China and Japan – both aging societies – has dropped during the COVID-19 pandemic, despite widespread speculation that the virus would lead to a steep spike in deaths among the aging population. 

While Japan reported the lowest death rate in the last 11 years, China witnessed a marginal drop in the number of deaths during the initial months of the outbreak.

As people took preventive measures, including wearing masks, washing hands and regularly disinfecting surfaces, infections from other diseases dropped drastically. Lockdowns, which restricted the movement of traffic, also prevented deaths in both countries.

Overall, the death rate in China dropped to 675 per 100,000 from January to March last year, against an average of 715 in previous years. 

A sharp reduction in pneumonia-related deaths by 47 percent and respiratory diseases by 18 percent prevented many deaths. The number of road accidents came down by 23 percent, said a joint study by the University of Oxford and the Chinese Center for Disease Control and Prevention (China CDC) published in the British Medical Journal (BMJ) on Wednesday. 

"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," wrote Dr. Liu Jiangmei, a study author, from the China CDC.

But the death rate in the city of Wuhan, once the epicenter of the outbreak, reported an increase of 56 percent compared to previous years. During the initial pandemic months, there were 6,000 additional funerals, increasing the city's average death rate from 735 to 1,147 per 100,000.

This was mainly due to an eightfold increase in deaths from pneumonia, most of which were COVID-19 related, researchers said.

The city also witnessed a steep jump in deaths from other diseases, including cardiovascular disease, which increased by 29 percent and a steep rise in diabetes-related deaths by 83 percent.

Most of these deaths were in central districts, and the majority of victims were over the age of 70. More men died than women. 

"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," said Professor Zhou Maigeng, senior author for the study at the China CDC.

"Within Wuhan city, there were also major differences in the severity of the outbreak between central and suburban districts."

In order to assess the death rate during the initial pandemic period in China, researchers used data from official records from China CDC's nationally-representative Disease Surveillance Point (DSP) system.

The study covers more than 300 million people from 605 urban districts and rural counties, representing more than 20 percent of China's population.

Japan is also witnessing a similar trend, with the number of deaths last year decreasing by 0.7 percent or 9,373 compared to the previous year. The country is seeing the lowest number of deaths for the first time in the last 11 years, according to preliminary health data released by the government on Monday.

While the government didn't provide exact reasons for the death rate reduction, health experts believe measures taken to prevent COVID-19 transmission contributed to saving lives.

Like China, the use of face masks, disinfectants and lockdowns prevented transmission of other viruses and traffic accidents.

Among the world's high-income countries, Japan has the oldest population. China, a developing country, has the world's largest number of senior citizens, with a rapidly aging population.

But countries with a young population, including India, which has 62 percent of the people in the working-age group of 15-59 years, are witnessing a large number of deaths due to COVID-19.

The difference may be related to societies taking COVID-19 precautions seriously. 

In countries like the UK and U.S., which both have sizable populations over the age of 65, 21.8 percent and 65.5 percent respectively, deaths are soaring, as people are reluctant to follow pandemic protocols.

"It would appear that the lockdown and associated behavioral changes – such as wearing face masks, increased hygiene, social distancing and restricted travel – actually had unintended additional health benefits beyond those of reducing the spread of SARS-CoV-2," said Zhengming Chen, professor of Epidemiology at the University of Oxford and senior author for the BMJ study.

(Pedestrians wearing protective masks walk past a statue with a mask on in front of a department store, amid the coronavirus disease (COVID-19) pandemic in Tokyo, Japan August 18, 2020. /Reuters)