I think it is a combination of under reporting and culture.
1. It's hard to believe anything they say, especially when there is not a third party looking at the numbers.
2. If you have ever visited Asia, you see people walking around wearing masks even in "normal" times. In the cities, country, etc. You don't feel good or have a cold, you put a mask on. If you see others around you with colds, you put a mask on. Once in Hong Kong, I asked the woman at the hotel why so many were wearing masks in the streets. She said a lot of people had colds and people don't want to catch if from others. She reached under the counter and showed me hers.
Here, the mask seems to be the last resort. In Asia, it's not uncommon to see many people wearing them.
Rub a Dub