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China’s abrupt lifting of stringent COVID-19 restrictions could result in an explosion of cases and over a million deaths through 2023, according to new projections from the U.S.-based Institute of Health Metrics and Evaluation (IHME).

According to the group’s projections, cases in China would peak around April 1, when deaths would reach 322,000. About a third of China’s population will have been infected by then, IHME Director Christopher Murray said.

China’s national health authority has not reported any official COVID deaths since the lifting of COVID restrictions. The last official deaths were reported on Dec. 3.

Total pandemic fatalities stand at 5,235.

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