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  • #16
    The same question regarding the reclassification of case definitions and China's openness came up again in the last question in today's WHO briefing (link in post 14) and there was a long explanation from the DG, Mike and Sylvia.

    Comment


    • #17

      Apparently China officials got the message:

      China - Hubei Province: 14,840 new #COVID19 cases and 242 new deaths reported today. Total is 48,206 confirmed cases and 1,310 reported deaths. link


      I will change the title of this thread.

      Comment


      • #18
        the decisive question is, whether they can contain it, whether the cases are declining.
        To decide this they should on days (intervals) where they change the criteria give _both_ counts,
        the old one and the new one. When did they start to include more cases than before
        and how many approximately ?
        Is the decline since Feb.05 real or not ?
        I'm interested in expert panflu damage estimates
        my current links: [url]http://bit.ly/hFI7H[/url] ILI-charts: [url]http://bit.ly/CcRgT[/url]

        Comment


        • #19

          Overnight 14’840 cases, including 13’332 clinically diagnosed cases were reported from Hubei. (Because they issued a new guidance on this since last Friday - the 5th one.)

          But WHO is not counting the additional 13,332 cases.


          "This is the first time China has reported clinically diagnosed cases in addition to laboratory-confirmed cases.

          For consistency, we report here only the number of laboratory-confirmed cases.

          WHO has formally requested additional information on the clinically diagnosed cases, in particular when these have occurred in the course of the outbreak and whether suspect cases were reclassified as clinically diagnosed cases."


          https://www.who.int/docs/default-sou...rsn=9a7406a4_2
          Last edited by sharon sanders; February 13th, 2020, 07:11 PM. Reason: added emoticon

          Comment


          • #20
            Continuing to track only confirmed cases as WHO is doing at least gives a consistent baseline for time series comparisons. While it would have been beneficial to have each contact tested beginning with the 41 cases in in Wuhan, that did not happen. Also, there have been questions about the accuracy of the testing protocols in China. We are in the midst of flu season and only using clinical definitions (without testing) can inflate the number of cases. How much trust can we put in the counts presented by China.

            After all, there is a clear advantage to maximizing the number of infected cases for the Chinese, it automatically lowers the CFR.
            http://novel-infectious-diseases.blogspot.com/

            Comment


            • #21
              CFR is not so important at the moment, the main issue is to stop it. And it's only temporary ... the death-lag had been estimated at 22 days.

              > WHO has formally requested additional information on the #COVID19 clinically diagnosed cases, in particular when these
              > have occurred in the course of the outbreak and whether suspect cases were reclassified as clinically diagnosed cases.

              Feb.10-Feb.14, daily new cases, old method only
              Hubei_old,2097,1638,1508,1728,1282
              Wuhan_old,1552,1104,1072,1330,1001
              H-W_old , 545,534, 436, 398, 281


              everything is going down, except deaths because of the death-time-lag

              -------------edit-------------
              well, hospitalisations in Hubei are still going up, this also has changed a bit
              with the new cases - they have different sorts of hospitals.
              The correction-number was first given today

              hospitalised in Hubei on that day , Feb10-Feb14
              25087,26121,33693,36719,38107-including 8309 with the new diagnosis

              I'm interested in expert panflu damage estimates
              my current links: [url]http://bit.ly/hFI7H[/url] ILI-charts: [url]http://bit.ly/CcRgT[/url]

              Comment


              • #22
                hat tip Shiloh to the change

                hat tip to a FluTracker for the translation


                Apparently diagnostic criteria for Hubei province changed again. 3rd change in 12 days.

                Link to 6th version:

                http://www.gov.cn/zhengce/zhengceku/...nt_5480948.htm


                from page 4 of the attached pdf at the link above


                SUSPECTED CASE - either fulfills one of the criteria under epidemiology and 2 under clinical; or no epidemiological evidence but fulfills all 3 of clinical signs

                1 EPIDEMIOLOGY up to 14 days before symptom onset, has
                1) history of travel to Wuhan or other places with reported cases, or reside in such areas
                2) contact with confirmed case, by RT-PCR
                3) contact with patients with fever or respiratory symptoms from Wuhan and adjacent areas or other areas with confirmed cases
                4) part of a cluster with other confirmed cases

                2 CLINICAL SIGNS
                1) fever and/or respiratory symptoms
                2) radiological evidence of coronavirus infection
                3) normal or low white cell counts in early stage of illness, with low lymphocytes

                CONFIRMED CASE

                suspected case, plus either RT-PCR or genome sequence confirmation.

                Comment


                • #23
                  I have followed China for 14 years and I would not believe one thing that they say unless it is supported by independent sources.

                  Comment


                  • sharon sanders
                    sharon sanders commented
                    Editing a comment
                    Originally posted by JJackson View Post
                    Sharon the cumulative case curve only ever goes up and up. The daily case curve will rise peak and fall exactly as it does in the graph of Chinese cases. Both are however misleading because the normal distribution curve we saw for 1918 or 2009 are a reflection of a disease reaching a natural R(0) of one or less due to acquired herd immunity post mitigation with no serious attempt at containment. For a disease with a natural R(0) of 2 half the population needs to be immune for it to fall to one by this means. China, if you believe the real number of cases to be a million, would have 1/1,400 or 0.0007% of its population immune if antibodies give complete immunity. For COVID herd immunity would require nearer a billion infection. No country has reached a point where herd immunity is playing any significant role. If the exponential growth is blunted, or reversed, it is due to social distancing and associated containment measure. Some of the comments I am seeing imply this will peak in a few months I would say 'you ain't seen nothing yet'.

                    The graph below shows the UK 2009 pandemic curve, the point to note is the numbers on the y axis, over a 100,000 cases at the peak for 50 million population. We are currently entering a shutdown mode (better late than never) with this being the last day of school for most. There are 30 data points over 7 months i.e. if yesterday's UK new case count was real it would need to be multiplied by 25 to match the graphs scale which would be ~17,000 which would put us at about the 1st of Jul on this epidemic curve. Even the drop from the high peak is only due to flu's extreme seasonality and there is no evidence to support this for COVID, just wishful thinking and hope. Increased UV will definitely help cut fomite transmission but other seasonal factors are an unknown.

                    Click image for larger version  Name:	2009.JPG Views:	17 Size:	62.4 KB ID:	839156
                    I agree with your UK graph and this is exactly what we are not seeing in China despite their claim of no new cases. Their case growth simply stopped on a dime and flattened. Magic! No new growth anymore!

                    Maybe they have some vaccine to prevent COVID-19 that they should be telling the world about.



                    Click image for larger version

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                    Attached Files

                  • JJackson
                    JJackson commented
                    Editing a comment
                    Sharon looking at the graph the point I would take from it is the individual case curves for China and Italy are identical they both went from negligible to 2000 cases in 14 days. The slight drop in China growth rate from the about the 10th to 20th is not real but due to limited testing and needs the mental massaging to smooth over the jump on the 13th. but the flattening to almost zero increase in daily case number I think is real and due to the draconian measures taken. I read this graph as showing it has taken about a month for China's measures to control the epidemic and expect Italy to follow a similar trajectory but will have to put up with another months growth as per China's curve first. Iran's numbers I would interpret as deviating due to insufficient testing in a badly damaged economy. The US and UK have the same growth curve but, for the reasons given above, it just is not showing up yet. Our public's are due for an unpleasant shock once they find out that they are actually about to become Italy but did not know it because their governments did not contact trace or test as rigorously.
                    Sharon feel free to come back in a month or two with an 'I told you so' because it should be more than clear by then which of us is closer to the truth.
                    For the rest of you Sharon and I are good friends and I am sure we will still be long after all of this is over. She has far more experience watching how China reports disease outbreaks in their area where I have only followed this outbreak in detail so I take her concerns very seriously I am just viewing the available data and interpreting it in light of standard epidemiological modelling.

                  • sharon sanders
                    sharon sanders commented
                    Editing a comment
                    Originally posted by JJackson View Post
                    Sharon looking at the graph the point I would take from it is the individual case curves for China and Italy are identical they both went from negligible to 2000 cases in 14 days. The slight drop in China growth rate from the about the 10th to 20th is not real but due to limited testing and needs the mental massaging to smooth over the jump on the 13th. but the flattening to almost zero increase in daily case number I think is real and due to the draconian measures taken. I read this graph as showing it has taken about a month for China's measures to control the epidemic and expect Italy to follow a similar trajectory but will have to put up with another months growth as per China's curve first. Iran's numbers I would interpret as deviating due to insufficient testing in a badly damaged economy. The US and UK have the same growth curve but, for the reasons given above, it just is not showing up yet. Our public's are due for an unpleasant shock once they find out that they are actually about to become Italy but did not know it because their governments did not contact trace or test as rigorously.
                    Sharon feel free to come back in a month or two with an 'I told you so' because it should be more than clear by then which of us is closer to the truth.
                    For the rest of you Sharon and I are good friends and I am sure we will still be long after all of this is over. She has far more experience watching how China reports disease outbreaks in their area where I have only followed this outbreak in detail so I take her concerns very seriously I am just viewing the available data and interpreting it in light of standard epidemiological modelling.
                    We will never know the truth about China. Ever.

                    Deaths we won't know for sure - because they cremated all the bodies. I bet the gov doesn't even know how many have died. Dead people were taken out of their homes and cremated with no COVID-19 test done even though they had the symptoms. Same for many in the hospitals pre-testing.

                    Compared to Italy the China death per case ratio looks like a bad joke.

                    China case official cumulative case count = 80,967
                    deaths = 3,268

                    Italian official cumulative case count = 41,035
                    deaths = 3,405

                    I rest my case.

                    I will not be engaging in this convo anymore.


                • #24
                  China 'didn't report 43,000 silent carriers'

                  3 hours ago

                  A Hong Kong newspaper says China's government excluded from its statistics about one-third of people who tested positive for the new coronavirus but showed no symptoms.

                  The South China Morning Post reported on Monday that classified government data it obtained show that more than 43,000 so-called silent carriers were not counted in the number of confirmed cases by the end of February....The authorities also said they would not disclose the number of silent carriers in the country......https://www3.nhk.or.jp/nhkworld/en/news/20200323_37/
                  CSI:WORLD http://swineflumagazine.blogspot.com/

                  treyfish2004@yahoo.com

                  Comment


                  • #25
                    Should China count recovered coronavirus patients who test positive again?
                    • Hubei health official says the cases aren’t considered new but the people will be sent back to hospital for observation
                    • Estimates vary but Guangdong says about 14 per cent of those discharged test positive again

                    Authorities in Hubei say they will not count patients who test positive again after discharge as fresh cases. Photo: Xinhua
                    Patients who test
                    positive for coronavirus
                    after being discharged from hospital will not be classified as fresh cases and there is no evidence that they remain infectious, according to a top health official in the central Chinese province where the pathogen was first detected.


                    Tu Yuanchao, deputy director of the health commission in Hubei province, said people who tested positive and showed coronavirus symptoms a second time would be sent to designated hospitals for treatment until they met discharge conditions again, the official Hubei Daily reported on Monday. They would then be observed for two weeks in isolation.

                    But they would not be counted as new cases, Tu was quoted as saying.

                    “Those who retest positive have already been reported as confirmed cases in their initial test, so they will not be repeatedly counted as new cases,” he said.....
                    ...
                    Wang Xinhua, president of Guangzhou Medical University, said there were usually two reasons discharged patients tested positive again for coronavirus.

                    “One is because they were only carrying a small amount of virus when they were discharged. More tests will need to be conducted on such patients for accuracy,” Wang said.

                    “The other possible situation is that the patients get reinfected. It’s not clear if they have acquired a strong immunity after recovery. [Reinfection] is not a high possibility but it is still possible.”


                    Peng Zhiyong, director of intensive care at Wuhan University’s Zhongnan Hospital, said that only 1 per cent of patients fell into the category.

                    “It is extremely rare for patients to retest positive after they recover,” Communist Party mouthpiece People’s Daily quoted Peng as saying on March 14.

                    In another article on Sunday, People’s Daily reported that 5 to 10 per cent of cases in “certain isolation areas in Wuhan” tested positive again after being discharged. But it did not specify the total number or locations.

                    Apart from Hubei and Guangdong, similar cases have be...https://www.scmp.com/news/china/soci...ients-who-test
                    CSI:WORLD http://swineflumagazine.blogspot.com/

                    treyfish2004@yahoo.com

                    Comment


                    • #26
                      hat tip Gert van der Hoek




                      Yuan Yang

                      @YuanfenYang

                      9h
                      China's plummeting coronavirus case count looks v promising. But local medics tell us the numbers are too rosy: “the [authorities] are using all their means to control the new case count,” & the detected symptomatic cases are “the tip of the iceberg” -
                      @ft

                      Hidden infections challenge China’s claim coronavirus is under control
                      Official figures suggest a breakthrough but local medics reveal unreported cases
                      ft.com
                      61
                      896
                      1.1K
                      Show this thread
                      Yuan Yang

                      @YuanfenYang

                      8h
                      Replying to
                      @YuanfenYang
                      4/ I'm personally surprised that the National Health Commission won't just release the asymptomatic patient count, since this has been called for for over a month now, and it would not cost the NHC anything to do so.
                      5
                      23
                      57
                      Yuan Yang

                      @YuanfenYang

                      8h
                      5/ A silver lining: if there are indeed a large number of unreported asymptomatic carriers in Wuhan who have since recovered, that increases the chances that immunity has developed in the population to guard against a second wave.
                      7
                      20
                      80Yuan Yang Retweeted

                      Comment


                      • #27
                        posted with permission.

                        hat tip to Jason Gale


                        Stacks of Urns in Wuhan Prompt New Questions of Virus’s Toll
                        2020-03-27 05:06:05.974 GMT


                        By Bloomberg News
                        (Bloomberg) -- The long lines and stacks of ash urns
                        greeting family members of the dead at funeral homes in Wuhan
                        are spurring questions about the true scale of coronavirus
                        casualties at the epicenter of the outbreak, renewing pressure
                        on a Chinese government struggling to control its containment
                        narrative.
                        The families of those who succumbed to the virus in the
                        central Chinese city, where the disease first emerged in
                        December, were allowed to pick up their cremated ashes at eight
                        local funeral homes starting this week. As they did, photos
                        circulated on Chinese social media of thousands of urns being
                        ferried in.
                        Outside one funeral home, trucks shipped in about 2,500
                        urns on both Wednesday and Thursday, according to Chinese media
                        outlet Caixin. Another picture published by Caixin showed 3,500
                        urns stacked on the ground inside. It’s unclear how many of the
                        urns had been filled.
                        People who answered the phone at six of the eight funeral
                        homes in Wuhan said they either did not have data on how many
                        urns were waiting to be collected, or were not authorized to
                        disclose the numbers. Calls were not answered at the other two.
                        Some families said they had been forced to wait for several
                        hours to pick up the ashes. The photos circulated as mass deaths
                        from the virus spiked in cities across the west, including
                        Milan, Madrid and New York, where hospitals were erecting tents
                        to handle the overflow as global infections soar past 500,000,
                        with 24,000 dead.
                        According to Chinese government figures, 2,535 people in
                        Wuhan have died of the virus. The announcement that a lockdown
                        in place since January would be lifted came after China said its
                        tally of new cases had hit zero and stepped up diplomatic
                        outreach to other countries hard hit by the virus, sending some
                        of them medical supplies.
                        But some in China have been skeptical of the accuracy of
                        the official tally, particularly given Wuhan’s overwhelmed
                        medical system, authorities’ attempts to cover up the outbreak
                        in its initial stages, and multiple revisions to the way
                        official cases are counted. Residents on social media have
                        demanded disciplinary action against top Wuhan officials.
                        China’s Hidden Symptom-Free Virus Cases Means Epidemic Not
                        Over
                        Many people who died had Covid-19 symptoms, but weren’t
                        tested and excluded from the official case tally, Caixin said.
                        There were also patients who died of other diseases due to a
                        lack of proper treatment when hospitals were overwhelmed dealing
                        with those who had the coronavirus.
                        There were 56,007 cremations in Wuhan in the fourth quarter
                        of 2019, according to data from the city’s civil affairs agency.
                        The number of cremations was 1,583 higher than those in the
                        fourth quarter of 2018 and 2,231 higher than the fourth quarter
                        of 2017.

                        Mourning Restrictions

                        The families of the deceased may not be able to say a
                        proper goodbye to their loved ones just yet. Wuhan’s government
                        issued a statement on Thursday prohibiting individuals in the
                        city from tomb-sweeping activities until April 30, meaning they
                        would not be able to observe the traditional April 4 Ching Ming
                        Festival, or tomb sweeping holiday. Other provinces including
                        Guangxi and Zhejiang have also announced similar restrictions.
                        Two locals in Wuhan who have lost family members to the
                        virus said online that they were informed they had to be
                        accompanied by their employers or officials from neighborhood
                        committees when picking up the urns, likely as a measure against
                        public gatherings.
                        “I was told by district government to wait until further
                        notice on when I can pick up my father’s ashes,” one Wuhan
                        resident using the name “Xue Zai Shou Zhong,” meaning “snow in
                        hand,” posted on Weibo. “There is a staggered arrangement for
                        urn collecting.”
                        Another Weibo user using the handle Adagier said she lost
                        her husband to the coronavirus and had since been contacted by
                        police warning her not to be too emotional -- and to stop
                        posting online.
                        “I have only one demand,” she wrote. “I want to give my
                        husband a proper burial as soon as possible.”

                        --With assistance from Dandan Li and Claire Che.

                        Comment


                        • #28
                          China reports asymptomatic cases -- nearly 150 -- for first time

                          APRIL 1, 2020 / 5:35 AM / UPDATED AT 3:05 PM

                          By
                          Darryl Coote & Danielle Haynes April 1 (UPI) -- China reported a surge in new COVID-19 infections on Wednesday after it included asymptomatic cases in its daily update for the first time.

                          Beijing's National Health Commission reported 36 confirmed infections of the novel coronavirus, 33 of which were imported, continuing a trend of more cases entering from outside the country than those transmitted locally.



                          However, the daily tally included 130 people who tested positive for COVID-19 without exhibiting any symptoms.

                          The move to include asymptomatic cases follows Premier Li Keqiang urging health officials on Saturday to pay close attention to patients without symptoms, who can spread the virus without detection.

                          On Tuesday, China's National Health Commission announced it had more than 1,500 asymptomatic patients under medical observation, and most of those cases were locally transmitted.

                          The combined 166 new cases China reported Wednesday is its highest increase since early last month.


                          Beijing said Wednesday it has recorded more than 81,500 confirmed cases since the pandemic began in December, although that number hadn't accounted for the asymptomatic cases. The commission also said two formerly asymptomatic patients were reclassified as confirmed cases after they began to exhibit symptoms....https://www.upi.com/Top_News/World-N...728453/?mpst=2
                          Last edited by Treyfish; April 2nd, 2020, 01:30 PM.
                          CSI:WORLD http://swineflumagazine.blogspot.com/

                          treyfish2004@yahoo.com

                          Comment


                          • #29
                            asymptomatic infections have not been announced in the past. Once the decision is made, there are still some data and conditions that need to be clarified, so there is no cumulative number of asymptomatic infections nationwide, and nearly half of the provinces have not announced asymptomatic infections.
                            This situation shows that those who report asymptomatic infections still need to do more work and implement it quickly.
                            http://opinion.china.com.cn/opinion_6_220406.html

                            Comment

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