How test conditions slowed down China’s response to coronaviruses

By Yawen Chen and Cate Cadell

BEIJING (Reuters) – Yang Zhongyi was still waiting for a coronavirus test in the Chinese city of Wuhan on Monday, two weeks after she showed signs of fever, although doctors privately told her family that she was almost certainly infected, son Zhang Changchun told Reuters ,

The 53-year-old Yang is just one of many Wuhans who have difficulty getting tested or receiving treatment for the new form of the coronavirus. According to the authorities, 2,800 people in China have been infected and at least 80 people have died spreading the disease.

Yang did not get full-time admission to a hospital, her son said. She was dropped in four different hospitals in the city in non-quarantined areas to treat her deteriorating lungs, he said, doing what he can to have her tested or referred to full-time.

“My brother and I queued up in the hospital every day. We leave at 6:00 am and 7:00 am and stand in line all day, but we don’t get any new answers,” Zhang told Reuters. “Every time the answers are the same: ‘There is no bed, wait for the government to let you know and follow the news to see what is going on.’ The doctors are all very frustrated too. “

Officially known as the 2019 nCoV, the new form of coronavirus was first identified as the cause of death for a 61-year-old man in Wuhan on January 10 when China exchanged genetic information about the virus with other countries. Some, like Japan and Thailand, started testing travelers from China for the virus within three days.

However, test kits for the disease were not distributed to some hospitals in Wuhan until January 20, an official from the Hubei Provincial Center for Disease Control and Prevention (Hubei CDC) told Reuters. Previously, the samples had to be sent to a laboratory in Beijing for testing. According to Wuhan health officials, the test took three to five days to get results.

During this gap, hospitals in the city reduced the number of people under medical supervision from 739 to just 82, according to Reuters from the Wuhan health authorities. No new cases were reported in China.

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Despite the lack of reliable data and testing capacity in Wuhan, the Chinese authorities assured citizens in the days after the virus was identified that it was not generally transferable. In the past few weeks, it had censored negative online comments on the situation and arrested eight people accused of “spreading the rumor”.

“The doctor wasn’t wearing a mask, we didn’t know how to protect ourselves … nobody told us anything,” a 45-year-old woman with the last name Chen told Reuters. The virus was confirmed to her aunt on January 20, five days after her hospital stay. “I posted my aunt’s photos on the Chinese social media website Weibo and the police called the hospital authorities. They told me to turn them off.”

National, regional, and city health agencies did not respond to Reuters requests to treat the virus outbreak. National officials said at a press conference last week that there were some “loopholes” in primary care methods.

Wuhan’s mayor, Zhou Xianwang, told Chinese state television Monday that “not all parties were satisfied with the disclosure of our information.” However, he pointed out the requirements imposed on him by provincial and state leaders.

“After I have received information, I can only share it with the local administration if I am authorized to do so,” he said. Zhou reported at a press conference on Sunday that a further 1,000 people could be diagnosed with a virus in Wuhan, based on the number of patients still to be tested.

DELAYED RESPONSE

China blocked the affected region in Hubei province last week as part of the largest quarantine operation in history and is building two new hospitals to treat virus patients. President Xi Jinping has set up a special committee to combat the outbreak.

The country has received international acclaim for the rapid sequencing of the virus gene. However, the slow scale-up of the tests was questioned.

Once a virus has been identified: “You need to make sure you have all the reagent samples (a substance used for chemical analysis) and you have to bring everything to the place where you want to run the tests,” said Amesh Adalja , a Senior Scientist at the Johns Hopkins University Center for Health Security, who focuses on emerging infectious diseases and preparing for pandemics.

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Although information from the region is scarce, Adalja suggested that China had problems with this phase of fighting the outbreak. “We are already hearing that there is a shortage of medical professionals, that there is a shortage of test kits and medication,” he said.

John Edmunds, a professor at the Center for Mathematical Modeling of Infectious Diseases at the London School of Hygiene & Tropical Medicine, said China didn’t provide enough detailed data after the first outbreak.

“We have a very incomplete picture of what’s going on,” he told Reuters. “I don’t know if it’s incompetence, secrecy or intent, but it would be very useful if we had basic epidemiological data.”

The lack of test equipment and China’s initial reluctance have raised criticism that the country is still learning from the 2002 outbreak of Severe Acute Respiratory Syndrome (SARS), which killed nearly 800 people.

“The improvements were more about the hard scientific side – finding out the genome of the virus, building new hospitals – than the gentle scientific side of information management and people handling,” said Mary Gallagher, a professor of political science who heads the Center for Chinese Studies University of Michigan.

City administrators had little incentive to escalate problems to political superiors. The week in which no new virus cases were reported in Hubei coincided with preparations for the lunar new year and meetings of the Provincial National People’s Congress and the Chinese Political Consultative Conference.

STILL WAITING

Seven of the largest hospitals in Wuhan are now equipped with virus test kits that theoretically deliver results in a day, said Hubei CDC official.

However, four people informed Reuters that they had been refused tests because the procedure involved a complex reporting system that included the health authorities of hospitals, districts, and cities, as well as disease control officers.

To qualify for the test, patients must meet certain criteria, e.g. B. Symptoms of fever and pneumonia. An increase in patients means that it is “impossible to take the test immediately,” a Wuhan Center for Disease Control and Prevention official told Reuters.

Three hospital and local government employees who were told how doctors handle tests and confirm cases told Reuters that the official number of infections and deaths does not reflect the actual number of victims.

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Health authorities in Wuhan have limited testing, mainly due to the lack of test kits. They review patient lists before deciding who gets a test. This takes several hours, a hospital employee told Reuters.

“Some seriously ill patients have been excluded from the final list for testing because they know they cannot be treated,” the worker told Reuters. “The actual deaths were higher.”

Reuters was unable to independently confirm the hospital worker’s account. Hubei and Wuhan health officials did not respond to Reuters requests for comment.

Zhang, whose mother is still waiting for a test, said doctors in three Wuhan hospitals have privately told her family that she is almost certain that she has been infected with the corona virus.

However, he said that two of these hospitals told him they did not have test kits, and the other informed him that there was no bed available for his mother for the test.

None of these hospitals responded to Reuters’ request for comment.

69-year-old Xu Enen, who has had fever and pneumonia since January 8, was refused testing by six hospitals in Wuhan because they said they were out of bed, his daughter Reuters said. Xu’s symptoms have worsened recently and he is beginning to have difficulty breathing.

On January 22, he was finally queued for the test at Hankou Hospital in Wuhan after his daughter made his case public at Weibo.

Lancaster University researchers estimate that only 5.1% of infections were identified in Wuhan. By January 21, an estimated 11,341 people in Wuhan had been infected since the beginning of the year. According to the city’s health authorities, more than 30,000 people are observed in Wuhan.

“We just want to confirm whether the case is a virus or not,” said a 33-year-old Wuhan woman with the last name Liu, whose father has been on a ventilator in the hospital since January 14 and has not been tested on Monday. “At least when it is confirmed, we have a direction. If there is no direction, there is no hope.”

(Reporting by Yawen Chen and Cate Cadell in Beijing; Additional reporting by Kate Kelland in London; Editing by Bill Rigby)

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