Announcement

**sharon sanders** · January 19, 2020, 08:54 PM

February 23, 2020: This list is suspended because many countries are lying their ***** off. Most unbelievable of late is China. They have changed their case definition 3 times. s.s.

Suspected cases are not included

Please note: We are updating the China case number only once a day despite various provincial announcements. Some of these provincial cases are already in the daily tally from the National Health Commission, and some are not. Also, hundreds of cases have not been reported during the day but appear in the NHC daily tally.

We wait for the daily NHC report. This usually occurs at 8:00 pm ET.

Australia:

21 cases link

Belgium:

1 case link

Cambodia:

1 link

Canada:

9 link

China:

76,288 "confirmed" cases and 2,345 "reported" deaths (from the report published 21/2/20) link

England:

9 cases link

***Egypt:

1 case (now testing negative several times) link

Finland:

1 case link

France:

12 cases, 1 death link

Germany

16 case link

Hong Kong:

69 cases, 2 deaths link

India:

3 case link

Iran:

18 cases, 5 deaths link

Israel:

1 case (returnee) link

Italy:

17 cases, 1 death link

Japan:

109 domestic cases link + 634 cases from cruise ship docked. 3 death link

Lebanon:

1 case link

Macau:

10 cases link

Malaysia:

22 cases link

Nepal:

1 case link

Philippines:

3 cases, including 1 death link

Russia:

2 cases link

Spain:

2 case link

Singapore:

86 cases link

South Korea:

346 cases link

Sri Lanka;

1 case link

Sweden:

1 case link

Taiwan:

26 case, 1 deathlink

Tibet:

1 case link

Thailand:

35 cases link

UAE:

11 case link

United States:

13 domestic cases, 18 repatriated link

Vietnam:

16 cases link

*** Not sure what is going on with Egypt case.

**Treyfish** · February 10, 2020, 09:57 PM

when asked about it at todays conference,, the WHO guy, Mike, said they were going to look into it...

**tetano** · February 11, 2020, 01:50 AM

Will the 'asymptomatic infected people' who have been diagnosed with more cases be the stealth killer?

Cases of asymptomatic infection have spread the virus in some areas.

The Beijing News (Reporter Ni Wei Dai Xuan) has no fever, cough, fatigue, etc., but the positive nucleic acid test of the new crown virus shows that it has been infected. The 'asymptomatic infection' of this kind of new coronary pneumonia occurs in many places.

Today (February 10), two cases of asymptomatic infection were disclosed in Guangxi and Henan. The asymptomatic duration reached 16 days and 17 days, respectively.

The Beijing News reporter found that according to the new version of the National Health and Health Commission's new prevention and control plan, asymptomatic infections have been reduced to the scope of confirmed cases. Heilongjiang reduced 13 confirmed cases, and Shanxi also reduced one, all of whom were asymptomatic.

This does not mean that asymptomatic people are completely safe.

According to the National Health Commission, asymptomatic infections may also become a source of infection, and at the same time, some asymptomatic infections will continue to show clinical manifestations. As of now, there have been multiple incidents of asymptomatic infection in many families.

Focus 1 Why subtract “asymptomatic people” from confirmed cases?

The new version of the prevention and control program is readjusted, and the 'asymptomatic infection' category is added.

On February 9, the Heilongjiang Provincial Health and Health Commission informed that 14 cases had been subtracted from the confirmed cases the previous day, of which 13 were asymptomatic infections.

Zhao Yuhui, a second-level investigator of the Heilongjiang Health and Medical Commission's Medical Affairs and Medical Administration Department, explained that the 13 cases without any symptoms but with a positive nucleic acid test were counted as asymptomatic infection by the National Health and Medical Commission on the 8th and will no longer be counted as confirmed cases .

The reporter noticed that in the 'New Coronavirus Pneumonia Prevention and Control Plan (Fourth Edition)' issued by the National Health and Medical Commission on the 7th, positive cases of nucleic acid detection were divided into confirmed cases and asymptomatic infections, and they are no longer collectively referred to as confirmed cases. .

So far, asymptomatic infections have occurred in many places including Liaoning, Zhejiang, Shandong, Henan, Hubei, Guangdong, Shaanxi, Jilin, Heilongjiang, Hunan, Hainan, Sichuan, Chongqing, Inner Mongolia, and Guangxi.

Cases of asymptomatic transmission of the virus have also occurred in some areas.

In Cixi, Ningbo, Zhejiang, a group of 'Mahjong' playing mahjong had no contact history in Wuhan and had no contact with cases, but they were successively diagnosed. Among them, a 65-year-old woman was first infected. He then infected 'Mah You' and neighbors by playing mahjong, resulting in 4 confirmed cases and 2 asymptomatic infections.

After investigation, the old lady was infected by son-in-law. The son-in-law met with a friend who had been active in Wenzhou from January 17th to 19th and had a meal together. He was infected but did not have fever and was an asymptomatic person.

On January 27, the earliest reported case of asymptomatic infection in the country also infected his family. After a woman returned to Anyang, Henan, from Wuhan on January 10, five relatives in the family became ill and were diagnosed with new coronary pneumonia. She did not show symptoms.

Focus 2 Why do people with asymptomatic infections appear?

It is related to the degree of immune response of the infected person, and inhibits the growth of the virus before the damage is caused, and the human body does not respond significantly.

Why don't people show obvious symptoms after infection? Ding Xinmin, chief physician of the Department of Respiratory Medicine, Beijing Shijitan Hospital, analyzed that this was related to the degree of immune response of infected persons.

If the virus that invades the human body is regarded as the 'enemy' and the human immune cells are regarded as 'our army', when the virus load is low, that is, the 'enemy' is weak, and the immune cells are strong, the virus will cause greater damage. Inhibiting its growth before, or even extinguishing it quickly, the human body's response is not typical or obvious, and is considered asymptomatic.

'It is difficult to distinguish between asymptomatic or mild symptoms. Some people may have symptoms of weakness, but it is difficult to judge the infection from this.' Ding Xinmin said.

Wang Linghang, chief physician of the emergency department of infectious diseases of Beijing Ditan Hospital, believes that asymptomatic infection is not the same as 'false positive'. Finding and proposing 'asymptomatic infection' is actually a process in which we gradually recognize new things, and it is closely related to clinical detection methods.

Advances in clinical testing have provided the gold standard for diagnosis. Since January 17, nucleic acid tests have been performed in suspected cases, and PCR methods and related kits have been used to determine whether they are infected. Later, through medical observations of close contacts of confirmed patients, it was found that some nucleic acid tests were positive, but mild cases were even 'asymptomatic', which was called asymptomatic infection.

In this process, the knowledge of the disease spectrum has gradually expanded from the initial cases of pneumonia to the continuous disease spectrum of 'asymptomatic infection-mild cases-severe critical cases'.

Focus 3 Who is vulnerable to becoming asymptomatic?

It is mainly close contacts of confirmed patients, mostly family members, and those with infection are asymptomatic for 17 days.

Asymptomatic infections can also become a source of infection, as indicated by the fourth edition of the National Health Commission's prevention and control plan and the fifth edition of its treatment plan.

Li Xingwang, chief expert of the Infectious Disease Diagnosis and Research Center of Beijing Ditan Hospital, said that at present, asymptomatic infections are mainly close contacts of confirmed patients, and more often occur in family members.

On February 9, the first case of asymptomatic infection occurred in Taiwan, namely by a family member.

This is the 18th person diagnosed in Taiwan. It was the son of a couple in their 50s who had been diagnosed with New Crown Pneumonia announced on February 6. This case had no respiratory symptoms and no fever. However, after isolation and testing, it was confirmed that the test result of the new coronavirus was positive. However, after testing, it was found that the amount of virus in the body is very high, which is equivalent to that of parents. It does not rule out that subsequent symptoms will occur.

On the same day, one case of asymptomatic infection was confirmed in Changyuan, Henan Province, which was asymptomatic for 17 consecutive days.

Yuan Guoyong, a member of the high-level expert group of the National Health and Medical Commission and professor of the Department of Microbiology at the University of Hong Kong, and his colleagues published in The Lancet that asymptomatic SARS patients are rare, but in their retrospective study of SARS, Some asymptomatic SARS patients were also recorded.

Focus 4 Will people with asymptomatic infection become the 'invisible killer'?

This type of infection is less viral and has less transmission than diagnosed cases, and is not the main communicator

Will asymptomatic infections that can not be detected through body temperature testing become the 'invisible killer' in the crowd?

Both WHO and experts believe that although there have been cases of asymptomatic infection of the virus, they are generally not the main communicators and the transmission is weak.

The World Health Organization responded to this question on February 4, stating that, according to observations of the Middle East Respiratory Syndrome (MERS), transmission of other coronaviruses through asymptomatic infections is very rare. Therefore, asymptomatic infections may not be the main spreaders of the virus.

Li Xingwang explained at the press conference of the National Health and Medical Commission that asymptomatic infections occur more often in close contact with patients, especially the phenomenon of family gathering is more obvious, so there is no need to panic if you do not contact the infected people. Such close contacts have also achieved good control through isolation and medical observation. 'There is a certain correlation between the amount of virus and the severity of the disease. Asymptomatic infections are milder, and the amount of virus will be less, so the ability to transmit will be weaker than those of severely ill patients. On the other hand, the new crown pneumonia mainly through short-range droplet Spread, asymptomatic infections usually have less cough, so the spread is not very strong. '

However, patients with asymptomatic infection may also develop clinical symptoms and become confirmed patients. The fourth edition of the National Health and Construction Commission's prevention and control plan states that the reported asymptomatic infections should be corrected to “confirmed cases” if they appear clinically.

Ding Xinmin suggested that regardless of whether the infected person is 'asymptomatic', they should pay attention to rest and avoid strenuous activities. Once immunity declines, the virus may counterattack and cause infection. The human body will also initiate a stronger immune response. If the reaction is too strong, in addition to killing the virus, it may also accidentally damage normal human cells, leading to myocarditis, liver and kidney damage, and even multiple organ damage.

Focus 5 How should people with asymptomatic infection be prevented?

Pay attention to self-monitoring, pay attention to the health status of the surrounding people, and isolate if the nucleic acid test is positive

Asymptomatic infections lack obvious symptoms, are not easy to cause alertness, and some are still active, posing challenges to disease prevention and control and public protection.

How were such asymptomatic infections found?

The fourth edition of the National Health and Construction Commission's prevention and control plan revealed that asymptomatic infections were found mainly through clustered epidemic investigations and follow-up investigations of infection sources.

Sun Wei, deputy director of the Heilongjiang Provincial Center for Disease Control and Prevention, said that to find asymptomatic infected persons, frontline epidemiological investigators need to use big data platforms to work closely with grass-roots community organizations and medical and health institutions to isolate and manage close contacts. Make medical observations.

Wang Linghang believes that the public should not be overly alarmed or take it lightly.

First, pay attention to health monitoring. The so-called asymptoms, if they are closely questioned, they often still have discomfort, such as low fever and cough, but they have not affected life. Still pay attention to self-monitoring, pay attention to the health status of the surrounding people.

Secondly, in the complex environment where people gather, adequate respiratory protection should be done. The spread of the virus is related to the speed of airflow and the amount of secretions. Be vigilant when someone coughs. If you talk closely without a mask, there may be risks.

Zhong Nanshan, a high-level expert group leader of the National Health and Medical Commission and an academician of the Chinese Academy of Engineering, also said in an interview that there are not many asymptomatic infections, and that most of them have been in contact with confirmed patients or have a history of exposure in Wuhan. There are reports that some asymptomatic infections can be cured by themselves, and some asymptomatic infections can be transmitted to others. So as long as the test is nucleic acid positive, it must be isolated.

Beijing News reporter Ni Wei Dai Xuan

405

http://www.bjnews.com.cn/feature/2020/02/10/687510.html

**gsgs** · February 11, 2020, 02:00 AM

I couldn't find numbers for "'clinical diagnosis cases' (only in Hubei Province)
or 'asymptomatic infected persons'
but they do give "suspected cases" , although not for Wuhan

http://www.nhc.gov.cn/yjb/

“临床诊断病例” = clinically diagnosed cases
“轻型”、“普通型”、“重型”或“危重型”进行报“临床严重程度”
= report "clinical severety" for "light" "normal" "heavy" "critical
武汉 = Wuhan

======these Chinese words into searchengine gave==============

According to the Hubei Provincial Health and Health Committee's report on the 10th, Hubei has revised some data on confirmed cases of new coronary pneumonia, and subtracted 87 clinically diagnosed cases from confirmed cases. At the same time, Hubei ruled out a large number of suspected cases for two consecutive days. ... [detailed]
At present, 10.59 million people have been investigated in Wuhan, and all suspected patients will be cleared on the 11th.
Dean of Wuhan Jinyintan Hospital: New crown pneumonia is a self-limiting disease

湖北资讯_武汉资讯_资讯中心_新浪湖北_新浪网

http://hb.sina.com.cn/news/

湖北资讯,武汉资讯,资讯中心,新浪湖北,新浪网

According to the Hubei Provincial Health and Health Committee's report on the 10th, Hubei has revised some data on confirmed cases of new coronary pneumonia and subtracted 87 clinically diagnosed cases from confirmed cases. At the same time, Hubei ruled out a large number of suspected cases for two consecutive days.
It is understood that according to Hubei Province ’s case diagnostic criteria in the “Diagnosis and Treatment of Pneumonia of New Coronavirus Infection (Trial Fifth Edition)” issued by the National Health and Medical Commission and the State Administration of Traditional Chinese Medicine, February 10, Hubei cities and states reported 2 When the number of confirmed cases was on the 9th, the cumulative number of confirmed cases reported at 24:00 on February 8 (the cumulative number of confirmed cases in the province) was revised the previous day: 87 clinically diagnosed cases in the province on February 8 were confirmed from the confirmed diagnosis The number of cases was reduced, that is, as of 20:00 on February 8th, there were 27,013 confirmed cases in the province.
At the same time as tritium was diagnosed, Hubei also made efforts to exclude suspected cases in accordance with relevant standards. Among them, 1,128 suspected cases were excluded on February 8; 7,194 suspected cases were excluded on February 9. (Finish)
-------------------------------
Special attention should be paid to the different requirements of Hubei Province and other provinces in terms of the epidemic situation of Hubei Province, the diagnostic criteria of the disease, and the detection, reporting and exclusion of cases.
In Hubei Province, in addition to suspected and confirmed cases, clinically diagnosed cases have been added. As long as the suspected cases have pneumonia imaging features, they are judged as clinically diagnosed cases and treated according to the severity of clinical classification; once suspected cases are found in the province And clinically diagnosed cases, immediately isolate, treat, and collect specimens for pathogenic testing as soon as possible.
Suspected or confirmed cases in other provinces outside Hubei should be quarantined immediately,
Suspected diseases and clinically diagnosed cases in Hubei Province must be immediately isolated and treated in a single room, and confirmed cases can be treated in the same ward.
The body temperature returned to normal for more than 3 days, the respiratory symptoms improved significantly, the lung imaging showed obvious absorption of inflammation, and the nucleic acid test for respiratory pathogens was negative for two consecutive times (sampling interval at least 1 day). The patient can be released from the hospital or transferred to the appropriate department for treatment according to the condition other illnesses. 3
According to the fifth edition of the diagnosis and treatment plan, the diagnostic criteria of Hubei Province and other provinces are different.
3.1 Provinces outside Hubei: They are still divided into suspected cases and confirmed cases. For the specific standards, see the fifth edition of the diagnosis and treatment plan.
3.2 In Hubei Province: In addition to suspected and confirmed cases, clinical diagnosis cases have been added. As long as the suspected case has imaging characteristics of pneumonia, it is judged as a clinically diagnosed case, and its clinical classification and treatment principles are consistent with those of the confirmed case. It emphasizes the importance of clinical diagnosis of imaging, which is conducive to early isolation and early treatment. details as follows:
(1) Suspected cases
Comprehensive analysis of the following epidemiological history and clinical manifestations:
Epidemiological history:
① Travel history or residence history of Wuhan City and surrounding areas, or other case-reporting communities within 14 days before the onset of illness; ② Contact history with people with new type of coronavirus infection (positive nucleic acid test) within 14 days before the onset of illness; ③ Before onset of illness Patients with fever or respiratory symptoms from Wuhan and surrounding areas, or from communities with case reports within 14 days; ④ Aggressive on

**penguinsix** · February 11, 2020, 10:45 AM

At the press conference today the W.H.O. claimed that China was broadening their definition to include mild and asymptomatic cases, but the answer seemed a bit confused. I suspect we'll get a clarification soon.

Video here:

World Health Organization (WHO) @WHO

https://www.pscp.tv/w/cRK5ujI2MTAyMHwxWmtLekx3ZUxsWkp2UyshzLCVq_ErT2xAeYCeULUJhJmytWGPWcOvr7qJusc=

Daily media briefing on #2019nCoV with @DrTedros

**penguinsix** · February 11, 2020, 11:05 AM

The specifics of the answer are at this point in the press conference, 23 minutes in:

World Health Organization (WHO) @WHO

https://www.pscp.tv/WHO/1ZkKzLweLlZJv?t=22m58s

Daily media briefing on #2019nCoV with @DrTedros

**JJackson** · February 11, 2020, 04:19 PM

The title of the first post is alarmist, I do not see a problem here. Due to the lack of testing capacity it has not been possible up till now to test people who are asymptomatic. Now we are getting positive test results from know contacts who are both healthy and infected who now have their own classification. We need this data separated out so we can begin to see how common being infected without symptoms is compared to the confirmed cases which, until now, could only be symptomatic or they would never have been tested. If you want to know how many have tested positive add the confirmed to the asymptomatic, if you just want to know how many have sickened just use the confirmed case numbers. Any of the asymptomatic who subsequently sicken would be moved to the confirmed column. Once serological testing can start we should get a clearer picture but for now this is our best tool for seeing how many cases are flying under the radar.
All of this should be consider alongside the fact that the current test are showing almost half the negatives are in fact false. This is a problem relating to specimen collection and lab reagents. Dry cough is a normal symptom but produces little sputum and not much of that has come from the deep lung, where the virus is concentrated. A low virus count in the sample falls below the detection sensitivity of the assay. BALF collection from the lower lung is more reliable but is not normally available until the pneumonia sets in, so is not much use for early detection. The lab problems are increased demand for reagents causing the use of secondary suppliers whose quality control is not as reliable, similarly for those running the test - new people with less experience and the probes and primers may need fine tuning.

**sharon sanders** · February 11, 2020, 08:34 PM

II see it as a problem because it differs from the W.H.O. case definition and it gives an excuse not to test asymptomatic people who are contacts of confirmed cases. In one city there are thousands of people who may have had contact with a confirmed case at a mall. Why test any of them now? This policy says, "Hey - you are not a confirmed case even with a positive result on the test." Can't asymptomatic people who test positive infect others? Haven't we seen that?

Moving forward, all confirmed case numbers will give an artificially low impression of how widespread this disease is.

It is not a coincidence that prominent you tubers such as Fang Bin and Chen Qiushi have been arrested and disappeared in the last couple of days.

This is a program of reducing visibility to the world.

**sharon sanders** · February 11, 2020, 09:18 PM

Honestly, people - use common sense.

Does it make sense that people who test positive are not confirmed cases?

No. It does not.

**tetano** · February 12, 2020, 12:55 AM

Sylvia Briand at the WHO's briefing : ""We asked about the change in case definition and indeed it's normal to adapt the case definition to the reality. Recently they have done the forth adaptation to include mild cases and asymtomatic cases. If asymptomatic cases became positive at the laboratory testing then they include them in the confirmed cases number. They have indeed broaden the case definition, because before the testing was only done on people that were hospitalized or attending some medical attention but now because they are following up contact apparently they have also included some asymtomatic people that are followed up or paucosintomatic in the contact list."

**JJackson** · February 12, 2020, 07:24 AM

Originally posted by sharon sanders View Post

Honestly, people - use common sense.

Does it make sense that people who test positive are not confirmed cases?

No. It does not.

Sharon I think it is more a case of the wording of definitions maybe 'infected (symptomatic)' and 'infected (asymptomatic)'. The term asymptomatic here is being used in the sense of an asymptomatic carrier and not just someone like me who is asymptomatic for anything. Asymptomatic carriers would be treated as confirmed cases and some will go on to display symptoms, all may shed virus, but symptomatic cases are likely to be much more infectious.
I have seen no evidence that it is a ploy not to test contacts, quite the opposite, it is evidence that RT PCR capacity is getting on top of testing and beginning to have the slack to start expanding to the less severe cases and wider contact groups. I am sure they would love to trace and test 1000s in the mall but it is unrealistic given the current situation in Hubei, they barely have the test capacity or personnel to follow up 'close contacts' let alone all 'contacts'.

**sharon sanders** · February 12, 2020, 09:38 AM

Originally posted by tetano View Post

Sylvia Briand at the WHO's briefing : ""We asked about the change in case definition and indeed it's normal to adapt the case definition to the reality. Recently they have done the forth adaptation to include mild cases and asymtomatic cases. If asymptomatic cases became positive at the laboratory testing then they include them in the confirmed cases number. They have indeed broaden the case definition, because before the testing was only done on people that were hospitalized or attending some medical attention but now because they are following up contact apparently they have also included some asymtomatic people that are followed up or paucosintomatic in the contact list."

What is the date of this quote? Last Friday the NHC decided not to include asymptomatic cases in their numbers (for sure outside of Hubei province) and the provinces started to follow that order. I have not seen any official announcement rescinding their order from last week.

If anyone has a link to a new order regarding this matter on the NHC site, please post it.

**sharon sanders** · February 12, 2020, 09:56 AM

Originally posted by JJackson View Post

Sharon I think it is more a case of the wording of definitions maybe 'infected (symptomatic)' and 'infected (asymptomatic)'. The term asymptomatic here is being used in the sense of an asymptomatic carrier and not just someone like me who is asymptomatic for anything. Asymptomatic carriers would be treated as confirmed cases and some will go on to display symptoms, all may shed virus, but symptomatic cases are likely to be much more infectious.
I have seen no evidence that it is a ploy not to test contacts, quite the opposite, it is evidence that RT PCR capacity is getting on top of testing and beginning to have the slack to start expanding to the less severe cases and wider contact groups. I am sure they would love to trace and test 1000s in the mall but it is unrealistic given the current situation in Hubei, they barely have the test capacity or personnel to follow up 'close contacts' let alone all 'contacts'.

I am reading the NHC order and it says not to count people who are test positive but asymptomatic. There is only one way to read that.

Look at the man who, while asymptomatic, infected (at least) 6 people, "Five are hospitalized in France and one man on the Spanish island of Majorca." link

And while we are at it - does the WHO delegation to China have any US CDC people included? I read that it does not. The CDC has offered several times to send a delegation. Every other country in the world asks for CDC help. Why wouldn't China want some of the world's experts who have a long history of battling dangerous outbreaks like Ebola? Any reasonable person knows that answer.

**JJackson** · February 12, 2020, 09:57 AM

Sharon that quote is from the WHO daily press conferences which I have been following. I forget if it was from the 10th or 11th but they can all be found here https://www.cnbc.com/search/?query=W...20Organization and today's should be up-linked shortly.
The team being sent to China is small (10ish) and hand picked by the WHO. It is they who decided whom to include based on the expertise needed in each of several fields. China has many of the worlds top experts in the field already and the aim is to learn from them and report back. From the linked videos the advanced team is of 6 and the members of the rest of the team are yet to be confirmed but will be selected from those free to go (many are bogged down in their own countries preparations) and balanced on the advanced team's assessment of where additional expertise is required. China is not seeking outside help from individual countries' CDCs as far as I know.

Announcement

China - Controversy about the counting of COVID-19 cases

China - Controversy about the counting of COVID-19 cases

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