Wednesday, May 20, 2020

A Curious COVID-19 Report From Northern China


#15,274

A week ago, in Jilin City, China On Lockdown After Small Uptick In COVID-19 Caseswe looked at what appeared to be an unusually aggressive response to a small number of COVID-19 cases in Jilin City, China including the shuttering of public venues, the banning of gatherings, the shutdown of public transportation, and the sale of antibiotics, and fever reducing medications.
Since then, these restrictions have been expanded to include Shulan - roughly 100 km to the north of Jilin City - and to other parts of Jilin province. 
Overnight, Dr. Qiu Haibo - a nationally-renowned expert in critical care medicine who was deployed to Wuhan City on January 20th - in an interview on state run media CCTV, suggested the recent cases in Jilin Province are displaying some unusual manifestations.
Patients are apparently incubating the virus longer, and taking longer to clear the virus, than cases seen in Wuhan City earlier this year.  Jilin patients also appear to mostly have lung damage, as opposed to the multi-organ involvement we've seen reported previously. 
A smattering of English language news reports include:
Coronavirus behaving differently in China's northeast clusters, expert says - Reuters
China's new outbreak shows signs that coronavirus could be changing - Japan Times
China’s New Outbreak Shows Signs the Virus Could Be Changing - BloombergQuint
It isn't at all clear what changes -  if any - have occurred in the SARS-CoV-2 strain circulating in Northern China. The number of patients is relatively small, and atypical presentations are not unusual with coronaviruses (see here, here, and here)
This may prove to be much ado about nothing. 
But, when one of the most experienced COVID-19 doctors in China makes a point of mentioning these differences on state run media, it is certainly worthy of our attention. 
A longer incubation period would complicate contact tracing, a longer time to clear the virus would increase hospitalization times, and more lung involvement could require more ventilator support.  All potential challenges going forward. 
Hopefully, more details will be forthcoming.  Stay tuned