Quotes from latest NY Times13 Feb 2020 07:02
Confronted by so many people with symptoms and no easy way to test them, authorities appear to have changed the way the illness is identified.
Hospitals in Wuhan, China — the largest city in Hubei Province and the center of the epidemic — have struggled to diagnose infections with scarce and complicated tests that detect the virus’s genetic signature directly. Other countries, too, have had such issues.
Instead, officials in Hubei now seem to be including infections diagnosed by using lung scans of symptomatic patients. This shortcut will help get more patients into needed care, provincial officials said. Adding them to the count could make it easier for the authorities to decide how to allocate resources and assess treatment options.
But the change also shows the enormous number of people in Hubei who are sick and have not been counted in the outbreak’s official tally. It also raises the question whether the province, already struggling, is equipped to deal with the new patients.
The few experts to learn of the new numbers on Wednesday night were startled. Lung scans are an imperfect means to diagnose patients. Even patients with ordinary seasonal flu may develop pneumonia visible on a lung scan.
Wuhan Coronavirus Map: Tracking the Spread of the Outbreak
Jan. 21, 2020
“We’re in unknown territory,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University in Nashville.
In China, health officials have been under exceptional strain. Hospitals are overwhelmed, and huge new shelters are being erected to warehouse patients. Medical resources are in short supply. It’s never been clear who is being tested.
Health workers have gone door to door in Wuhan to check people for symptoms. The prospect of forced isolation may be deterring some people with respiratory illnesses from presenting themselves at health facilities to seek health care, some experts say, making the dimensions of the epidemic even less clear.
“You have to be sick, the authorities need to find you, or you find them, and they need to test you,” said Dr. Arthur Reingold, an epidemiologist at the University of California, Berkeley.
The push to prioritize lung scans seems to have begun with a social media campaign by a physician in Wuhan, who last week called for using the scans to simplify the screening of patients and to accelerate their hospitalization and treatment.
Lung scans produce immediate results, she said, and Wuhan was running short of testing kits.
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