As China enters its peak flu season, authorities are warning local hospitals to tell the truth about the spread of the H1N1 flu virus. They are threatening to punish anyone who fails to report new flu cases or deaths.
The threats came after a prominent Chinese doctor, Zhong Nanshan, questioned why China's official H1N1 death toll remains in the double digits while other countries with much smaller populations post much higher numbers. He's convinced the government is covering up the spread of the virus.
Special Report: H1N1 Virus
That's a serious accusation in China, which suffered global embarrassment after attempting to conceal the deadly SARS virus in 2003. This time, China's sheer size may contribute to the problem of under-reporting.
"We realize that given the nature of this pandemic, it's hard to really count every case or diagnose every case because there's just so many cases out there. Many of them are not coming to see doctors or getting diagnosed," said Vivian Tan of the World Health Organization.
Chinese officials have been battling the H1N1 virus for months, aggressively quarantining travelers who might be infected and researching their own home-grown vaccine.
China was the first country to approve a vaccine, which is now in full production.
Fan Jianfen, 53, and her family are seizing their chance to get it. They're among 1.5 million people getting vaccinated every day across China, part of a huge immunization project that's sweeping the country.
"The government's taking care of us," Jianfen said through a translator.
The authorities aim to inoculate 80 to 90 million people by the end of the year. That will account for only 7 percent of mainland residents.
But it's the other 93 percent of the population that's causing concern. Most of China's 200 million migrant workers don't qualify for the free shot, leaving them vulnerable as they travel all over the country.
Migrants don't have the official city residence papers required to get a vaccine. But the government insists it will vaccinate as many people as possible, including migrants. Right now, the manufacturer has hit its production limits, which means there's not enough vaccine to go around.
Even so, some are not worried.
"We've been through SARS," said one man. "The flu is nothing."
So far there's little evidence the H1N1 virus has taken a deadly toll in China. But there could be many more tears if the true count and cost of the outbreak is being concealed.