The death toll for Wuhan, the first epicenter of the coronavirus pandemic, now stands at 3,869, up from 2,579. The total case count for the city also increased by 325, bringing Wuhan’s total confirmed cases to 50,333.

According to state news agency Xinhua, Wuhan’s coronavirus prevention and control task force said the jump in numbers was due to previously unaccounted deaths, like people who died at home instead of in hospitals, and people whose deaths were not counted or miscounted in the chaos of an overwhelmed medical system and staff.

The revised numbers come amid concerns that China is underreporting its COVID-19 infections and deaths. U.S. government officials have criticized China’s reporting of the disease’s spread within its borders; Secretary of State Mike Pompeo accused China of waging an “intentional disinformation campaign” about the virus.

Some Wuhan medical workers have also described “hidden” cases that contradict city and central governments’ recent claims of no new cases, the Financial Times reported.

As of Friday, the death tolls in the U.S., Italy, Spain, France, the U.K., Iran, and Belgium were each higher than the total for Hubei province, where Wuhan is located, and the total for China as a whole.

The death count in New York City, which has become a major coronavirus epicenter, also jumped on April 14 after officials added presumed positive cases—people who had not been tested for the virus but likely had it when they died—to the total number. The revision in New York led to a 3,700-person increase in the city’s death count.

In February, Wuhan’s COVID-19 cases also jumped dramatically when officials said they would include “clinically diagnosed” patients who had not been tested but had been diagnosed with the disease using a CT scan. One week later, Wuhan officials changed tack again and said only lab-tested positive cases would be counted, and others would be deemed “suspected” until tested.

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