Coronavirus: World waits for number of infected to surge after China buckles and will report asymptomatic cases
China might begin to see a surge in infection cases in the country yet again after it decided to include a group of patients to their official tally: people who test positive and yet do not show symptoms for the disease.
This move comes amid allegations of a cover-up by the country and concerns that infected people without symptoms, otherwise called silent carriers of the disease or asymptomatic, could be driving the pandemic. What's more? Chinese health officials recently admitted that their official figures might not be telling the whole story.
On March 30, 2020, China's National Health Commission said it had detected 1,541 asymptomatic cases. These people will be quarantined for 14 days, Chang Jile, senior official from Chinese National Health Commission, told reporters during a press briefing.
However, experts are still skeptical. Derek Scissors, chief economist at China Beige Book, told CNBC that the Chinese Communist Party is not honest about anything that is politically sensitive.
"There’s been no mass testing, which means the numbers should not be compared to the United States, where we are now doing, late, mass testing," Scissors told CNBC.
With US and Italy crossing 100,000 cases each and Spain fast approach the 100,000 mark, experts suspect that China might be hiding data. What is concerning is that the US, Italy, and Spain have reported more deaths than China.
Even Secretary of State Mike Pompeo pointed out that China's numbers were not accurate, according to FOX. "When you hear (doctors) talk about risk and talk about fatalities trying to think about how to model, what they need is data. And they need data from Italy, data from China, data from Iran," Pompeo said. "We need every country to step up and provide accurate, transparent information. And we can’t have that if we have disinformation instead. More lives will be at risk not only today but in the weeks ahead as we battle this enormous challenge," he added.
Additionally, China is slowly opening its doors to business after over two months of lockdown. But many are concerned if the coronavirus will bounce back, wreaking havoc in the country.
"I don’t think that’s very safe," a shopkeeper from Wuhan told Reuters, talking about the plan to lift restrictions in the city on April 8.
Why did China stop counting silent carriers?
In February, China reported a drop in cases. This was not because the virus was losing steam in the country but it was due to a change in how the country was reporting confirmed cases. Chinese health officials began excluding people who showed no symptoms — even after testing positive for the disease.
Official tallies from other countries like South Korea, Japan and Singapore, on the other hand, included people, regardless of whether they have symptoms for the disease or not.
"I’m very suspicious about anything they're saying," coronavirus expert Ralph Baric from University of North Carolina told STAT, pointing to the low numbers China is reporting from other provinces in the country.
In China's defense, health authorities believe this measure could help them take care of sick patients who are spreading the disease. Some experts believe that China is probably also prioritizing care for the sick and maintaining quarantines, rather than measuring the epidemic’s dynamics. "If I put on my medical hat for a moment, I can understand the decision not to count these individuals," Michael Mina, an infectious-disease immunologist and epidemiologist at Harvard T H Chan School of Public Health in Boston, Massachusetts, told Nature.
Why is it important to include asymptomatic cases?
Several reports suggest that asymptomatic carriers could be unwittingly infecting others, which might explain the rapid spread of the disease in China. One study found that about 86% of people infected early in the outbreak in China might have escaped detection.
"The explosion of COVID-19 cases in China was largely driven by individuals with mild, limited, or no symptoms who went undetected," said co-author Dr Jeffrey Shaman, professor of environmental health sciences at Columbia University Mailman School.
He also added that some people might not see a doctor despite experiencing symptoms. "We find for COVID-19 in China, these undetected infected individuals are numerous and contagious. These stealth transmissions will continue to present a major challenge to the containment of this outbreak going forward," added Dr Shaman.
One study supported the idea that carries might be infectious. It said that some people with no or very mild symptoms release a significant amount of virus.
In the US, one study traced a cluster of infections in Massachusetts to people who were not showing symptoms yet. Data of passengers from the Diamond Princess cruise ship also suggest that a small number of people who are infected do not develop symptoms.
Data from other countries also support the theory. In Italy, of the people diagnosed with the disease, 25% of them did not experience the main symptoms such as cough or fever.
One of Singapore's top doctors said asymptomatic carriers are spreaders. "What we have seen is that we had very large clusters of sick people that stemmed from asymptomatic carriers going out and spreading the disease," said Dr Vernon Lee, the Director of Communicable Diseases at Singapore’s Ministry of Public Health, during a conference call organized by Caixin Global, a Chinese financial news publisher.