AN INTRIGUING PAPER crosses our desk from the medical journal, The Lancet. Academics from the Li Ka Shing Faculty of Medicine at The University of Hong Kong led by Dr Tim K Tsang have recalculated the early Covid-19 case rate in China by applying a consistent definition of a confirmed case to the official numbers augmented with data from the World Health Organization. They conclude:
If the fifth version of the case definition had been applied throughout the outbreak with sufficient testing capacity, we estimated that by Feb 20, 2020, there would have been 232,000 confirmed cases in China as opposed to the 55,508 confirmed cases reported by that date.
It is worth noting that the official count, at time of writing, is approaching 84,000, barely one-third of what the paper says was the total two months ago. The academics also say that 232,000 may still be an underestimate because many mild cases were neither tested nor confirmed, and some infections were asymptomatic
The official count was gradually broadened to include milder cases and those without epidemiological links to other known cases. Nonetheless, in the early phases of the pandemic, China’s published numbers undercounted the real total.
Whether this counts as a ‘cover-up’ will be in the eye of the beholder. It is not uncommon for the case definition in a viral outbreak to change as the clinical spectrum of infection evolves. However, in public health terms, the cost of not accurately tracking how quickly the virus is spreading is not being able to judge which are the optimal interventions to counter it or how effective they are proving to be.