Soon after the 2019 novel coronavirus appeared near Wuhan, regional authorities detained and attempted to silence Dr. Li Wenliang and at least seven other health officials who tried to make the public aware of the emerging threat. Since then, the World Health Organization has praised China’s reporting from hard-hit Hubei province, and has treated the numbers as reliable. However, there have been many who have expressed concern.
China was anything but accurate in reporting information during the SARS outbreak. And while the central government says they have rushed an anti-corruption team to Hubei, there is one thing they’re not bringing to the place it’s needed most—external medical assistance. Both WHO and the Centers for Disease Control have offered to send experts and workers to China. Both have been refused.
Meanwhile, there are numbers. And none of them are particularly good.
In past days, I’ve waited for the afternoon publication of the daily WHO Situation Report to make an update on the global incidence of 2019-nCoV. But as several people have pointed out in comments, the regional data from China is usually available in the late afternoon or early evening for the U.S., meaning that by far the most important data in the situation reports is essentially a day behind. While using this information creates a small difference between previous reports—there are often small changes made due to errata and additional reports from outside China—it’s not enough to generate false trends or to significantly effect the trends revealed by tracking the daily values.
So beginning today, I’m using the data available at the time of reporting to get out something that’s at least a few hours closer to representing the current situation. Unfortunately, today also happens to be a day when none of that information looks particularly encouraging.
Confirmed cases of 2019-novel coronavirus
That top number doesn’t look like much of a break from past day’s growth, but here’s where the difference shows up.
Confirmed cases by day of reporting
After two days in which the rate of new cases hinted that the situation might be improving in Hubei, the Saturday numbers out of China indicate an uptick in confirmed cases. This may be, in part, because of new policies that have officials going door to door. So people who were previously treating themselves or family members at home may now have been added to the total—and forced into quarantine conditions that seem little better than warehouses for the ill. But these numbers don’t look good.
There’s another number that needs to be explained when it comes to cases outside of China. Friday brought news that 64 passengers on the cruise ship “Diamond Princess” had been confirmed as carrying the virus (demonstrating, for what seems the one-thousandth time, the germ spreading power of cruise ships). That resulted in a bump for the number of reported cases, but when reviewing the numbers at WHO or elsewhere, these numbers can be hard to resolve, because Japan is not counting those passengers on their official tally.
One thing that is happening is that more information is becoming available on outcomes, both inside and outside China. So today I’m attempting a short table …
Novel Coronavirus Outcomes
|
Recovered |
Died |
| China |
2,050 |
724 |
| Outside |
22 |
1 |
While the mortality for confirmed cases of novel coronavirus in China remains under 3%, these numbers suggest a very different picture in looking at the actual outcome. That picture is supported by more than 6,100 cases in China now listed as “serious” and over 1,000 cases in Hubei considered “critical.” The percentage of outcomes ending in death within China has not, so far, declined, with 83 deaths on Saturday. Even if not a single person was infected beginning on Saturday, it’s clear that the number of deaths would not remain stable. Instead, the number of deaths is likely to be counted in the thousands, even if the infection does not develop additional epicenters outside Hubei. Outcomes outside of China certainly look better, but these are often individual cases getting a very large amount of attention and care. It’s still unclear what the mortality rate would be in a more general pandemic of 2019-nCoV.
Meanwhile, The New York Times is reporting that China is continuing to reject outside assistance. That includes offers from the CDC’s crack Epidemic Intelligence Service and WHO teams that have moved quickly to arrest epidemics elsewhere around the world. Officials seem to believe that China doesn’t want to be seen as unable to handle it’s own problems, but in situations like this, it’s typical for international teams to respond — that’s why there are international teams.
China’s reluctance to open the doors to outside help is also fueling suspicions that the numbers being provided are not accurate, either because they’re not adequately tracking the situation, or because they are deliberately underplaying the severity of the outbreak. China both suppressed initial information on the emergence of SARS, and did not provide numbers that were considered accurate for months after the disease had been brought under control.
There is also concern that China may be covering up the ease with which 2019-nCoV has spread among health professionals and how, despite hastily erecting new facilities, patients may not be getting adequate care. Those concerns were bolstered by the death of Dr. Li who died from complications related to novel coronavirus even though he was only 34.
Since his death, Dr. Li has become a symbol of free speech and the importance of transparency.
