There hasn’t been a “significant change in the trajectory of the outbreak” of COVID-19, global health officials said Thursday, even as China reported thousands more cases under new criteria that officials adopted, Japan reported its first death from the disease and the number of U.S. cases continued to climb.
The Centers for Disease Control and Prevention said the 15th American case was confirmed in a person who flew to Texas for quarantine on a State Department flight from Wuhan, the Chinese city at the center of the outbreak.
Wuhan is the capital of Hubei province, where officials have started confirming cases based on chest imaging instead of relying on lab results alone, according to the World Health Organization.
It’s a way to cope with a backlog in lab testing and a faster way to track down people in the region who had contact with those infected. However, the switch added over 13,000 cases to the count in one fell swoop and may have clouded the overall picture for those trying to gauge the trajectory of the outbreak.
Officials of the Geneva-based WHO said the newly reported cases may date from days or weeks ago. They are treating the newly reported cases as adjacent to the normal count, which on Thursday tallied 1,820 newly confirmed cases in mainland China, for a total of more than 46,550.
Dr. Mike Ryan, executive director of the WHO Health Emergencies Program, said the U.N. agency will assess all numbers. He said it’s important to distinguish between clinically diagnosed cases, which would bring the global case count to over 60,000, and the lab-confirmed cases that officials had been counting from the start. The new block of clinical cases may date back days or weeks.
“We’re not dealing, from what we understand, with a spike of 14,000 on one day,” Dr. Ryan said.
China reported 254 deaths Thursday compared with about 100 in recent days. The uptick was attributed to the new criteria in Hubei. On Friday, China reported a further 5,000 new cases and 121 new deaths.
Although the increase in deaths is alarming, the corresponding jump in diagnoses overall suggests the mortality rate is not worse than initially feared.
WHO officials said they were trying to determine whether the change in standards roped in pathogens besides the new coronavirus.
“Mixed among this might be other causes of pneumonia,” Dr. Ryan said.
Dr. William Schaffner, an infectious diseases specialist at Vanderbilt University Medical Center in Nashville, Tennessee, said a lung scan might be a good way to determine what type of care a patient needs but is a far less precise way to assess the outbreak than lab confirmation. Changing the criteria, he said, makes it difficult to assess progress in fighting the virus that causes COVID-19.
Global responders had been using the same criteria as they sized up the outbreak and instituted quarantine measures.
“What criteria are we going to use to turn them off? You’d like to have some sustained metrics that are comprehensible and relatively easy to follow,” Dr. Schaffner said.
Outside of China, there are 447 confirmed cases in 24 countries.
Forty-four more passengers aboard the Diamond Princess have tested positive as the cruise ship remains docked and quarantined near Yokohama, Japan. The ship has been linked to 218 cases, making it the largest cluster outside of China.
Only the sick have been taken off the ship, leaving crew members and passengers to hope they make it to the end of the quarantine period on Wednesday without becoming infected. Health authorities said they will try to test people for infection, starting with those who are medically frail, and let them off the ship before Wednesday.
South Korean President Moon Jae-in, meanwhile, expressed confidence that COVID-19 would be “terminated before long” in his country. He cited a winding-down of quarantines for patients and a lack of new cases, according to the Yonhap News Agency.
He said business leaders must rejuvenate the economy once the virus is under control.
In the U.S., officials said they weren’t surprised to hear about a new case among the evacuees from Wuhan, who spent 14 days at military bases, because anyone who lived or traveled in Hubei province was at high risk. Two additional Wuhan evacuees in California have tested positive.
Officials said the epidemic is still intensely centered in China. The ruling Communist Party fired top officials in charge of Hubei province and Wuhan as it struggled to overcome public skepticism of the initial handling of the crisis. The moves followed the dismissals this week of two leaders of the provincial health commission and reports from state media about a slew of others expelled from the party for missteps related to the epidemic.
The outbreak was traced to a live animal market in Wuhan, though scientists are still exploring its origins and what species might have served as a natural reservoir for the pathogen.
Wuhan has been hit hard by COVID-19 because the outbreak started in Hubei and spread locally. Still, other factors may be exacerbating locals’ illnesses.
“We have to ask about pollution and the prevalence of smoking, both of which are very, very common in China,” Dr. Schaffner said. “Therefore, it might well be the case you’re more likely to get a severe case because you may have some predisposing lung injury already.”
⦁ This article is based in part on wire service reports.
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