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| Wuhan City - Credit Wikipedia |
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A little over two months ago, in COVID-19 - Dealing With Imperfect Numbers, we looked at a familiar topic topic in this blog; the massive underreporting of cases and deaths during an infectious disease outbreak.
Even when public health official are trying their best to get it right, surveillance is going to miss a lot of mild and moderate cases and misattributed deaths.The reality is, a lot of countries - including China - have a history of withholding, or modifying, bad news for a variety of economic, political, and even national security reasons. So, on top of the inherent inadequacies of public health surveillance systems, we often get an additional `filter', which can badly skew the data.
In the Imperfect Numbers blog, we looked at an analysis by researchers at the MRC Centre for Global Infectious Disease Analysis at Imperial College London - a WHO Collaborating Center - that estimated that only 1 in 19 infected people in Wuhan were being tested for the virus.
And since only deaths of those who have tested positive for the virus were reported by China, the 1,116 deaths cited by China at that time was also highly suspect.
Between the `real' number of cases being estimated at up to 20 times greater than reported by China, and numerous anecdotal reports suggesting a much higher death toll in Wuhan (see Newsweek WUHAN COVID-19 DEATH TOLL MAY BE IN TENS OF THOUSANDS), there has always been a low level of confidence in China's COVID-19 numbers.When even a small country like Belgium (pop. 11 million, approx. the size of Wuhan City) has already reported double the deaths (n=5,163) of Wuhan City (n=2579), the veracity of China's numbers have increasingly come under fire.
While it is unlikely to fully satisfy their critics, overnight China revised upwards the death toll in Wuhan City by 50% - jumping 1,290 cases to 3,869, while increasing the number of infections by 325.First, the following brief statement from China's National Health Commission website:.
Correction of new coronary pneumonia epidemic data in Wuhan City, Hubei Province
Release time: 2020-04-17 Source: Health Emergency Office
At 11:00 on April 17th, Wuhan City, Hubei Province issued the "Notice on the Correction of the Number of New Coronary Pneumonia Cases Diagnosed and the Number of Diagnosed Deaths in Wuhan" and "The Correction of the Number of New Coronary Pneumonia Cases Diagnosed and the Number of Confirmed Deaths in Wuhan City Answer The reporter asked. As of 24:00 on April 16, a total of 50,333 confirmed cases (an increase of 325 cases), 3,869 death cases (an increase of 1,290 cases), and a cumulative discharge of 4,635 cases (a decrease of 965 cases) were registered in Wuhan.
According to the summary statistics of the revised epidemic situation data in Wuhan, as of 24:00 on April 16, Hubei Province had a total of 68,128 confirmed cases, 4512 deaths, and 63487 discharges; 31 provinces (autonomous regions and municipalities) and Xinjiang production and construction The Corps reported a total of 82,692 confirmed cases of new coronary pneumonia, 4,632 cumulative deaths, and 76,979 cumulative discharges.
Related links:
1. Notification on the revised number of confirmed cases and deaths ofnewly diagnosed pneumonia in Wuhan
2. Answers to reporters on the revised number of confirmed cases and deaths of confirmed cases in Wuhan
Xinhua News carried an English language Q & A report on how, and why, these changes were made. I've only included a brief excerpt, so follow the link to read it in its entirety.
Full Text: Questions and Answers on the Revisions to the Numbers of Confirmed Cases and Fatalities of COVID-19 in Wuhan
Xinhua, April 17, 2020
WUHAN, April 17 (Xinhua) -- An official of the Wuhan municipal headquarters for COVID-19 epidemic prevention and control on Friday answered relevant questions about the revisions to the numbers of confirmed cases and deaths of COVID-19 in Wuhan.
The following is the full text of Questions and Answers on the Revisions to the Numbers of Confirmed Cases and Fatalities of COVID-19 in Wuhan.
(EXCERPT)
Question 3: What changes have been made to the number of confirmed cases of COVID-19 in Wuhan after the revision?
Answer: Previously, Wuhan reported a total of 50,008 confirmed cases of COVID-19 by the end of April 16. A total of 217 repeatedly counted cases should be deducted from the previous figure due to the fact that there were patients who saw doctors in different districts or visited more than one hospital. Meanwhile, a total of 542 cases that were previously not tallied due to belated or missed reporting should be added to the figure. The accumulative number of confirmed cases was revised to 50,333.
Question 4: What is the change to the number of deaths of confirmed COVID-19 cases after the revision?
Answer: Previously, Wuhan had reported 2,579 deaths of confirmed COVID-19 cases by the end of April 16. A total of 164 deaths should be removed from the total figure due to repeated reporting and the deaths mistakenly attributed to COVID-19. In the meantime, a total of 1,454 deaths should be added to the number due to the fact that non-hospitalized deaths had not been registered at the disease control information system as well as the fact that some confirmed cases had been reported late or not been reported at all by some medical institutions. The number of deaths of confirmed COVID-19 cases in Wuhan was revised to 3,869.
(Continue . . . )
While these revised numbers are moving in the right direction, based on mathematical modeling and numerous anecdotal reports, they still appear to fall far short of reality.
