26/04/2020
- City at centre of outbreak finally able to declare itself clear of disease after months in lockdown and thousands of deaths
- Risk of infection remains, however, with some patients testing positive for coronavirus that causes disease without showing symptoms
Ferries and other public transport services resumed in Wuhan last week. Photo: Xinhua
The city of Wuhan, the initial epicentre of the coronavirus pandemic, no longer has any Covid-19 patients in hospital after the last 12 were discharged on Sunday.
Their release ended a four-month nightmare for the city, where the disease was first detected in December. The number of patients being treated for Covid-19, the disease caused by a new coronavirus, peaked on February 18 at 38,020 – nearly 10,000 of whom were in severe or critical condition.
“With the joint efforts of Wuhan and the national medical aid given to Hubei province, all cases of Covid-19 in Wuhan were cleared as of April 26,” Mi Feng, a spokesman for the National Health Commission said on Sunday afternoon.
The announcement came only one day after the city discharged the last patient who had been in a severe condition. That patient also was the last severe case in Hubei province.
The last patient discharged from Wuhan Chest Hospital, a 77-year-old man surnamed Ding, twice tested negative for Sars-CoV-2, the virus that causes Covid-19, and was released at noon on Sunday.
“I missed my family so much!” Ding told Changjing Daily.
Another unidentified patient exclaimed as he left the hospital: “The air outside is so fresh! The weather is so good today!”
Wuhan faced a long journey to bring its patient count down to zero.
The city of 11 million, the capital of Hubei province and a transport hub for central China, was put under a strict lockdown on January 23 that barred anyone from entering or exiting the city without official approval for 76 days until it was officially lifted on April 8.
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Residents were ordered to stay in their apartments as the city stopped public transport and banned private cars from city streets. As the epidemic worsened, more than 42,000 medical staff from across the country were sent to the city and to Hubei province to help ease the burden on the local health care system.
Wuhan was the hardest hit city in China, accounting for 50,333 of the 82,827 locally transmitted Covid-19 cases recorded in China. More than 4,600 died in the country from the disease.
On March 13, the city reported for the first time that there were no new suspected cases of the infection, and five days later there were no confirmed cases.
The number of discharged patients bottomed out at 39.1 per cent at the end of February, gradually climbing to 92.2 per cent by last Thursday.
“Having the patients in the hospital cleared on April 26 marks a major achievement for the city’s Covid-19 treatment,” the Wuhan Health Commission said in a statement.
However, having no severe cases in hospital does not mean all the discharged patients will require no further treatment as they may still need further care.
“Clearing all the severe cases marks a decisive victory for the battle to safeguard Wuhan,” health minister Ma Xiaowei told state broadcaster China Central Television on Saturday.
“Some patients who have other conditions are being treated in specialised hospitals. It has been properly arranged.”
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Ten patients aged between 42 and 85 who have been declared coronavirus-free are still in intensive care at the city’s Tongji Hospital where they are being treated for kidney problems and other complications arising from Covid-19. Some still need ventilators to help them breathe.
These 10 patients are under 24-hour care, with 190 nurses on four-hour rotations. There are other patients in a similar condition in two other hospitals in Wuhan, according to the Hubei Broadcasting and Television Network.
However, the discharge of the last batch of Covid-19 patients does not mean that the risk of infection is gone.
The city reported 20 new cases of people testing positive for Sars-CoV-2, the official name for the coronavirus that causes the disease, but who do not yet show symptoms.
There are 535 such carriers under medical observation. Past data shows some of these asymptomatic carriers will develop symptoms, and so will be counted as Covid-19 patients under China’s diagnosis and treatment plan.
China’s coronavirus infection curve has flattened out with about 694 imported cases of Covid-19 on top of about 800 locally transmitted ones now under treatment.
The national health commission spokesman warned that people still need to be on high alert as the virus is continuing to spread around the globe, with no sign yet of a slowdown.
“[We] must not drop our guard and loosen up. [We] must discover cases in time and deal with them quickly,” Mi said, citing the continued pressure from cases imported by people returning from overseas.
“The next step will be to implement the requirements of the central government and continue to guard against imported cases and a rebound of domestic transmitted cases.”
Source: SCMP
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20/03/2020
- The country’s only new infections confirmed in the past two days have been imported from overseas, suggesting containment measures worked
- But there are still likely to be infected people with mild or no symptoms, and questions over how the data was compiled, experts say
A makeshift hospital in Wuhan, converted from a sports arena, closed on Sunday after its last patients were discharged. Photo: Xinhua
China reached an apparent milestone this week in the fight against the
Covid-19 pandemic, announcing zero new non-imported infections on Thursday and Friday, but experts said the figures needed to be treated with caution.
After reporting thousands of daily new infections for much of February, China had a sharp decline this month while the wider world experienced the opposite trend as the coronavirus spread.
As China closes makeshift coronavirus hospitals in the outbreak’s initial epicentre of Wuhan because of a lack of patients, and eases some quarantine restrictions in the city and the broader Hubei province, there is consensus that its unprecedented measures changed the direction of the epidemic, offering hope for other countries.
But there are concerns over whether China’s rock-bottom case numbers reflect the full picture in the country. The high incidence of mild cases of Covid-19 is one reason, health experts said, warning that there could be infected people who were not counted but still able to spread the disease.
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“It is important that China is doing a good job testing and screening throughout the country to ensure that there are no pockets of infection remaining,” virologist Jeremy Rossman, of Britain’s University of Kent, said, adding that the news was “exciting” but needed to be “treated with caution”.
“With many of these cases having mild to no symptoms, ensuring that the whole country remains prepared and is actively looking for new cases is essential,” he said. “While it is possible there are no new cases, it is also very possible that somewhere in the country there are mildly infected people.”
Missing mild cases, and those infected but showing no symptoms, are a “legitimate concern”, according to Xi Chen, an assistant professor at the Yale School of Public Health.
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“Eighty per cent of cases have mild symptoms, so zero cases is a milestone, but not the end of the epidemic in China,” he said. Patients with mild symptoms or who are asymptomatic can still spread the disease to others, he added, and this needed to be monitored carefully in the coming weeks.
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China has come under scrutiny for how it treats asymptomatic cases. The National Health Commission excludes patients who test positive yet show no symptoms from its number of confirmed cases, although it monitors those cases when it knows of them.
The extent to which asymptomatic carriers contribute to spreading the disease is yet to be understood by scientists.
In addition, Hubei province in mid-February changed how it classified its confirmed cases, which caused a surge in infection numbers. This decision, which allowed doctors to diagnose a person by a clinical examination, not only by a positive laboratory test, was later reversed, leaving confusion about the true extent of the disease.
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Other commentators said it could not be ignored that political considerations may play a part as China looks to highlight its communist governance model and portray itself as a global leader in combating the disease.
“We are in the midst of the most intensive propaganda operation of the [Communist] Party state in living memory, in trying to project its success in dealing with the virus,” Steve Tsang, director of the University of London’s SOAS China Institute, said. “That narrative requires statistical backup.
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“I’m not saying [the zero number] is necessarily wrong; I’m simply saying we don’t know. What we do know is that there is now a political imperative for the statistics to be [low], and now we have statistics that serve the political imperative.”
Data can be trusted when it comes with transparency about how it was collected, so that it can be independently evaluated, Tsang said.
Nis Gruenberg, an analyst with Berlin-based independent think tank the Mercator Institute for China Studies, said that the numbers could be viewed as an “indicator” of a reduction of cases in China.
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“Some [Western critics] have been saying China and its system are ill-equipped to handle this outbreak, and now the Chinese government is trying to invert that argument and say, ‘Look at you, you are not doing it well enough,’” Gruenberg said.
The message from the Chinese government that it has succeeded in containing the virus may “politicise” the figures and is a potential driver for under-reporting around the country, according to Gruenberg.
“If history is any guide in China then there is a massive history of under-reporting for various reasons, both within the system and internationally,” he said. “I’m sceptical that this is the true number, or that anyone really knows the true number.”
Source: SCMP
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