China coronavirus deaths and cases spike - BBC News

Feb 18, 2020

the number of

coronavirus

cases

has risen sharply following changes in the way it is diagnosed The World Health Organization is seeking clarity in China after 15,000 more infections were recorded on Wednesday 254 more

deaths

were confirmed, more than double from the above daily record, almost all of them are in Who Bay province, now nearly 60,000 people in China are known to be infected and the death toll is over 1300. Also officials in Vietnam have put to the city of 10,000 people in quarantine after five

cases

of virus infection. Vietnam declared a public health emergency over the epidemic earlier this month and in Japan a Diamond Princess cruise ship remains in quarantine in Yokohama after a virus outbreak on board 218 passengers and crew members are now believed to be missing. among those infected our correspondent Rupert wingfield Hayes is in port so the number of infections aboard the Diamond Princess behind me here in Yokohama has risen again today 44 new confirmed cases today which followed 39 cases yesterday and that raises the ship's total number of infections to 218 and that means we now know that this is now the largest outbreak of the Cova 19 virus anywhere outside of mainland China, the Japanese government has made a small concession to the criticism that has been mounting people over the age of 80 will be able to disembark if they have underlying health conditions or if they are in one of those inside cabins that don't have windows or outside balconies so expect to see that that starts maybe tonight or friday. but there are a lot of questions that remain first of all obviously if our infection is still going on if the virus is still circulating around the ship no one really knows and the other big question is why hasn't the Japanese government managed to test yet all passengers and crew on board we're going to give you some real experience now David Heyman is Professor of Infectious Disease Epidemiology at the London School of Hygiene and Tropical Medicine David previously led the World Health Organization's response to the outbreak of SARS in 2003 David first I want to talk to you about the death rate that the reports were seeing put the death rate from this virus at about two percent, that's correct, and that would be at the level of influence of seasonal influenza every year it's about one or two percent of the people who died unfortunately but what happened in China is the case definition that's the way they define a disease has included pneumonia so they're they miss all the less severe cases of the disease and only look at the ones that are more severe, so of course the mortality is higher among those people. so the case definition was recently changed in China and now they also include less severe symptoms in their diagnosis and something that is important now is the way that they are testing what has to do with these lab kits beforehand and what what has been the problem with them, well they have been using test kits that detect nucleic acid, the problem with them is that it takes a long time to get a result, longer than they want, it takes a few times a day to get a result , TRUE? it takes some experience to manage and reading absolutely requires experience and skill and making sure there's no contamination from the lab around you so what they've done recently are two things that have developed a quicker point The use test for the nucleic acid that they implemented, it's not clear how effective it is, but they're using it, and they've also changed the way they diagnose, and in some cases just diagnose based on symptoms. and an x-ray, which means there's no nucleic acid diagnosis, that means the number of diagnoses, the number of confirmed cases, will absolutely go up because they're not only finding

coronavirus

cases, but they're finding other diseases that are also other infections rather than also causing pneumonia, so you're seeing an increase in the number of cases and a decrease in what we call the specificity of diagnosis, so in real world terms, David, what does that mean?

Does it mean only that? doctors can better detect the coronavirus or that we should be alarmed at the way it's spreading because of the speed at which it's spreading well it's certainly spread throughout

china

and

china

is doing everything they can to stop it. However, the important thing about the disease is those 24 sites outside of China and also the cruise ships, that's where the information about the severity of the disease comes from because the patients here are being monitored very closely as are their contacts and we are learning a As much as we see what happens in these situations that will hopefully lock down the disease in these countries and not allow it to spread further, is there a problem here that is obviously controlled by the Chinese Communist Party state, you know, command and control to some degree for others? countries are not the case and it could be that there is less control over how the centers are run the ability to build the medical facilities also clearly in the SARS outbreak China had the same type of lockdown and quickly got rid of the infection in other countries where there was a different approach, sometimes it was repeated after they thought they had it under control, so there are benefits to authoritarianism, but there are also downsides, and the downsides of course are a violation of human rights, are you? how would you describe your level of concern about the corona virus outbreak I think we are all concerned about what we don't know well, we know so far what is happening and what we can see, but what we don't know is the real potential of this virus, whether it eventually can or not. become an endemic disease in humans like tuberculosis, influenza or others because influenza also spreads from animals to humans and sometimes becomes a permanent resident.