Hidden infections challenge China’s claim coronavirus is under control

China’s official figures for new cases of coronavirus suggest that transmission has virtually stopped in many regions, but local experts have warned that official figures omit important categories of cases.

Hubei, the province of origin of the epidemic, did not report more than one new case per day for more than a week, which allowed the government to signal the end of the period of crisis. Officials and disease control teams have been able to leave the area, and travel restrictions and quarantines have also been relaxed.

But interviews with doctors and local medical specialists reveal that the situation in the capital of Hubei, Wuhan, may be worse than official figures suggest, suggesting that a declaration of victory by Beijing against the pandemic would be premature.

Experts have pointed to the existence of unreported cases, as well as the large number of asymptomatic cases that the government refuses to publish in its official count.

It is extremely worrying to continue to publicize “zero new cases”

Two nurses from Wuhan, who wished to remain anonymous due to the sensitivity of the pandemic, informed the Financial Times of “hidden” infections that met national criteria for confirmed cases but were not recognized in the official count. of the city, helping to maintain it. at or near zero.

“The doctors I know all tell me that the hospital and the [National] The Health Commission is using all of its means to control the new number of cases, ”said one of the nurses.

“It is extremely worrying to continue to publicize“ zero new cases ”. It is very risky and will make the sacrifices made in Wuhan and in all of Hubei unnecessary. “

Chinese Premier Li Keqiang warned this week that “under no circumstances [should] cases must be concealed or omitted in order to pursue a zero counting strategy ”in Hubei.

At its peak in mid-February, more than 50,000 cases of active viruses were officially reported across China, which has resulted in the locking of Hubei, which is just slowing down. On Thursday, less than 3,947 cases were recorded.

However, a Beijing-based coronavirus researcher who wished to remain anonymous questioned official figures, saying the cases with symptoms were just “the tip of the iceberg”.

“China counts asymptomatic cases but does not make them public,” he said.

The National Health Commission, the government agency that establishes guidelines for how cases are reported and disclosed, has always argued that asymptomatic cases should not be counted towards the total confirmed case. Asymptomatic cases are patients who test positive for Sars-Cov-2, the virus that causes Covid-19 disease, but have “no clinical symptoms”.

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But a member of the Wuhan expert team told local newspaper Caixin this week that “every day we can still detect a few, if not a few dozen, asymptomatic carriers.” The person added, “We cannot yet conclude that the transmission from Wuhan is completely over.”

Over the past two weeks, Wuhan has gradually allowed some virus hospitals to return to normal. But a lack of transparency during the transfer of cases has led some doctors to wonder if their new patients with coronavirus are counted.

“Some hospitals nearby. . . have transferred their coronavirus patients to us, “said Cao Jingchao, a senior staff member in the inpatient pharmacy division of Wuhan West Union Hospital.

“But we were not informed whether these were new confirmed cases or the remaining patients from these hospitals and, if so, the length of their hospital stay,” added Dr. Cao, noting that his staff had not received medical records from new patients.

On March 15, Dr. Cao’s hospital admitted hundreds of patients infected with the virus, some of whom were confirmed cases transferred from other hospitals, but some suspected Dr. Cao of new cases. Four days later, another 20 transferred patients arrived. The local government announced the next day that there had been no new cases that day.

Many experts who point out the dangers of omitting asymptomatic cases from the official count have attributed the rapid spread of the pandemic to symptomless carriers who take less care, combined with the high rate of reproduction of the virus.

The Chinese government maintains that infections from detected asymptomatic cases are not a problem, as they are kept in central quarantine for 14 days and observed to see if they become symptomatic, and can be reclassified as confirmed cases if they do. Hidden infections challenge China’s claim coronavirus is under control 1

Recent academic work suggests that asymptomatic cases are a large number of total infections. An article by researchers at the Huazhong University of Science and Technology and others, not yet peer reviewed but published in Nature, estimated that at least 59% of cases infected in Wuhan before mid-February were ” probably asymptomatic or with mild symptoms, which could mostly recover without seeking medical attention. ”

An article published in the International Journal of Infectious Diseases, based on evidence from Japanese evacuees from Wuhan, estimated that almost a third of the total infections are asymptomatic.

However, an analysis by the Korean Centers for Disease Control and Prevention of people potentially exposed to a cluster of viruses in a quasi-Christian sect – which accounted for more than half of the country’s nearly 9,000 infections – estimated the proportion of asymptomatic patients only 8 percent. hundred.

But the experts stressed that the results were preliminary and that it was important to communicate information on asymptomatic cases to encourage social distancing.

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