What is happening with the case of China's coronavirus and death numbers?

BEIJING: China has exceeded expectations around the epidemic this week with changes in the data and the way cases are diagnosed, forcing a dramatic recalculation of where the country is to contain the spread.

On Friday, the National Health Commission of China reduced the number of deaths across the country by more than 100 and the number of infected cases by more than 1,000 due to double counting in the province at the epicenter of the outbreak.

The decline came a day after Hubei reported a 45% increase in new cases of almost 15,000 due to the inclusion of a revised method to diagnose infections.

Changing numbers, and the reluctance of Chinese health officials to sufficiently explain the inconsistencies, has crushed the optimism that the epidemic is declining.

What happened?

On Friday, China revised its total number of deaths to 1,380, saying 108 cases had been removed due to double counting in Hubei.

It also eliminated 1,043 cases of the official national infection count, raising the total number to 63,851, for the same reason.

The reviews occurred one day after Hubei added 14,840 additional cases of people infected with the new coronavirus in his daily information publication, the biggest peak in the crisis.

This increase was attributed to the inclusion of a new group of patients diagnosed through the use of computed tomography images, the so-called clinical diagnosis, along with those confirmed by the previous method of nucleic acid test kits.

The additions increased the total number of people infected in Hubei by 45% in one day and increased the world total to more than 60,000 cases.

On Friday, the second day of the adjusted methodology, Hubei reported 4,823 additional cases, of which 3,095 were diagnosed with the computed tomography method.

What does it mean for numbers in the future?

While it is now clear that the almost 15,000 additions on Thursday were a unique adjustment, the latest figures are still roughly double what the province reported daily before the new method was used, and reveals that the scale of the outbreak is larger than previously thought.

But the elimination of double counting cases further confuses things, which increases the possibility that the new numbers have inflated the real image.

Why was the change made?

It has been widely reported that nucleic acid test kits used worldwide may be unreliable. There is also a severe shortage of tests and medical personnel to carry out the procedure in Hubei.

The nucleic acid test is used to see if the virus can be detected in a sample of a patient's respiratory tract. But the virus can concentrate in deep areas of the lung, which means that a sample of the upper respiratory tract can lead to false negatives.

A patient can be found negative for the first or second test, and then be positive the third time, said Jonathan Yu, a doctor at a university hospital in an interview last month. It's like fishing in a pond: you didn't catch a fish once, but that doesn't mean the pond doesn't have fish.

There are also not enough test kits and medical personnel to clean the sample, where the medical facilities are at the point of rupture. People reported having been in line for hours to get tested, only to be sent home if the result is negative, even if they have a fever and cough.

Is the clinical diagnostic method using CT scans more accurate?

Not necessarily. CT scans may show signs of pneumonia in a patient, but this could be caused by another virus such as the common flu, said Sanjaya Senanayake, an infectious disease specialist at the National University of Australia in Canberra.

Therefore, the new counting method may include patients with pneumonia, but not the coronavirus. To make matters worse, there is a possibility that such patients may end up in the same hospital wards as those who actually have the virus, which puts them at risk of infection because they are close.

One advantage of CT scans over nucleic acid tests is speed, said Bloomberg Intelligence industrial and medical analyst Nikkie Lu. Each machine can examine approximately 100 to 300 patients per day, while nucleic acid tests take approximately two hours each.

Why didn't Hubei make the change before?

In an update of its treatment guidelines on February 5, the National Health Commission of China added the category of clinically diagnosed cases in recognition of the shortage of nucleic acid tests. But Hubei province did not include this category in its case count until Thursday, a week later.

A spokesman for the National Health Commission said doctors in Hubei should have started diagnosing patients using CT images shortly after the update was published on February 5, and it is not known why Hubei did not start reporting the case number clinically diagnosed before. .

Chinese authorities also announced the replacement of senior officials in Hubei on Thursday. The fact that previous officials did not update the count could be the reason why they were eliminated. Or, the extended account time may represent an attempt to allow the new party secretary to start with a new list.