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Coronavirus breaks another tragic milestone after change to diagnosis method

Just when it seemed like the spread of coronavirus was peaking, health authorities in China have dashed any such hopes.

The death toll in China's Hubei province from the deadly outbreak has broken another milestone by leaping by a record 242 to 1310 fatalities as of Thursday afternoon.

The sharp rise in confirmed deaths, in the epicentre of the epidemic, came after the adoption of new methodology for diagnosis, Chinese health officials said.

The rise in the toll more than doubled the prior provincial daily record of 103 set on Monday, while the number of new cases soared by 14,840 – also a daily record – to a total of 48,206 cases.

Health officials in the province said they had started including people diagnosed using the new methods.

Excluding cases confirmed using the new methods, the number of new cases rose by only 1508, the official data showed. About 10 times less than under the new diagnosis method.

Local health authorities said last week it would begin recognising computerised tomography (CT) scan results as confirmation of infections, allowing hospitals to isolate patients more quickly.

The health commission also said it had revised its old data and previous assessments of suspected cases.

China had ‘two sets of numbers all along’

It is not uncommon for scientists to refine diagnostic criteria as understanding of a new disease grows, but the sudden change in confirmed cases has exacerbated fears that Chinese authorities have not been completely upfront about the seriousness of the coronavirus outbreak after the first case was reported from Wuhan on December 31 last year.

The sudden jump in deaths raises questions about China's commitment to transparency as it deal with the epidemic, Victor Shih, a specialist in Chinese politics at the School of Global Policy & Strategy at the University California San Diego, said.

“The adjustment of the data today (Thursday) proved without doubt that they have had two sets of numbers for confirmed infected all along,” he told Reuters.

“If that were not the case, the government could not have added so many new cases in one day.”

A doctor reads the computed tomography (CT) scans of a woman's lungs in a fever clinic in Yinan County, in east China's Shandong province, 12 February 2020.
A doctor reads the computed tomography (CT) scans of a woman's lungs in a fever clinic in Yinan County, in east China's Shandong province, on February 12. Source: AAP

“A very disturbing aspect of today's new numbers is that the vast majority of new cases accrued to Wuhan, but what if the rest of Hubei Province still did not adjust their reporting methods?”

Many observers, including ANU student Helen Chen who has been stuck in Hubei province, have expressed concern about the potential lack of transparency from the Chinese government, which is well known for its heavy-handed censorship and tight control of the media and internet users.

On Thursday, it was announced that two senior Hubei officials had been sacked as Beijing moves to assert its control of the situation.

Jiang Chaoliang, the secretary of the Hubei Provincial Committee of the Communist Party of China, has been removed from his role, China’s state media reported. Wuhan party chief Ma Guoqiang has also been fired.

How new diagnosis method has caused a spike in cases

Hubei had previously only allowed infection to be confirmed by RNA tests, which can take days to process and delay treatment. RNA, or ribonucleic acid, carries genetic information allowing for identification of organisms like viruses.

Using CT scans that reveal lung infection would help patients receive treatment as soon as possible and improve their chances of recovery, the commission said.

It could also lead to a spike in the death toll, according to Raina McIntyre, head of biosecurity research at the Kirby Institute at the University of New South Wales in Sydney.

“Presumably, there are deaths which occurred in people who did not have a lab diagnosis but did have a CT. It is important that these also be counted,” she told Reuters.

Ms McIntyre said the numbers could all be revised retrospectively from December and it now depended on whether the more severely ill patients were confirmed by lab diagnoses and therefore included in the original numbers. If many of them were diagnosed using the newly included CT method and only now added to the total number of cases, then the death rate could rise.

"I think the new category 'positive test' (which is different from 'confirmed case') is more likely to reflect asymptomatic cases. Ideally these should be reported too, or we do not get a complete picture,” she said.

A shortage of RNA test kits in Hubei's capital Wuhan has been a problem and may have delayed patients from being properly diagnosed and treated, contributing to the spread of the virus in the early days of the outbreak.

A Chinese couple wearing plastic coats and protective masks shop for groceries at a Beijing supermarket.
A Chinese couple wear plastic coats and protective masks as they shop for groceries at a supermarket in Beijing, China. Source: Getty

All coronavirus patients in NSW discharged

The last person diagnosed with coronavirus in NSW who was still in hospital has now been discharged, health authorities say, meaning all four cases detected in the state have now been cleared of the disease.

“All four patients diagnosed with novel coronavirus COVID-19 in NSW have now been discharged from hospital,” NSW Health said in a statement on Thursday.

The final patient to be sent home was a 43-year-old man.

“NSW Health is extremely proud of its medical response to date with prompt, expert care to all patients, a comprehensive screening program and extensive information campaign,” the department said.

The four NSW cases were among 15 confirmed coronavirus cases detected in Australia in recent weeks. There has also been five cases in Queensland, four in Victoria and two in South Australia.

All of the cases in Australia have come from Wuhan except one in NSW who had contact in China with a confirmed case in Wuhan.

Meanwhile a travel ban preventing Chinese visitors and students from entering Australia, which was due to end this weekend, will be extended for a further week.

"We did not take this decision lightly," Prime Minister Scott Morrison told reporters in Canberra on Thursday after a national security committee meeting.

"We are very mindful of the disruption and economic impacts of these arrangements, but I note Australia is one of 58 countries that has introduced some form of travel restrictions."

with Reuters and AAP

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