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How the Coronavirus Numbers Changed So Sharply How the Coronavirus Numbers Changed So Sharply
(3 days later)
The number of cases and deaths in the coronavirus epidemic in China jumped sharply on Thursday as the authorities there changed how they keep track of the disease, and not, primarily, because of any change in the shape of the outbreak.The number of cases and deaths in the coronavirus epidemic in China jumped sharply on Thursday as the authorities there changed how they keep track of the disease, and not, primarily, because of any change in the shape of the outbreak.
There is still a lot of uncertainty about the true numbers — as with any new disease — and that will continue for the foreseeable future. Underscoring that point, hours after China revised its figures, the World Health Organization put out a lower set, saying that for now, it would not change the way it counts.There is still a lot of uncertainty about the true numbers — as with any new disease — and that will continue for the foreseeable future. Underscoring that point, hours after China revised its figures, the World Health Organization put out a lower set, saying that for now, it would not change the way it counts.
But experts say there were good reasons for changing the way patients with the disease, newly named Covid-19, were counted, and the new approach should catch many cases that had been missed before. That will allow more patients to get treatment and be quarantined faster.But experts say there were good reasons for changing the way patients with the disease, newly named Covid-19, were counted, and the new approach should catch many cases that had been missed before. That will allow more patients to get treatment and be quarantined faster.
Here is a look at what we know — and what we don’t — about the new coronavirus numbers and what they say about the scope of the crisis.Here is a look at what we know — and what we don’t — about the new coronavirus numbers and what they say about the scope of the crisis.
For several days, the Chinese government had reported figures that suggested the spread of the disease was slowing, but that changed abruptly on Thursday.For several days, the Chinese government had reported figures that suggested the spread of the disease was slowing, but that changed abruptly on Thursday.
Officials in Hubei, the Chinese province that is the epicenter of the outbreak, said there had been more than 48,000 cases there, a 44 percent jump from the day before. They also reported 1,310 deaths, a 23 percent increase. The trend continued on Friday, though not as markedly, when Hubei officials disclosed another 4,800 cases and 116 more deaths.Officials in Hubei, the Chinese province that is the epicenter of the outbreak, said there had been more than 48,000 cases there, a 44 percent jump from the day before. They also reported 1,310 deaths, a 23 percent increase. The trend continued on Friday, though not as markedly, when Hubei officials disclosed another 4,800 cases and 116 more deaths.
[Read: China says 1,700 health workers have contracted coronavirus.][Read: China says 1,700 health workers have contracted coronavirus.]
Previously, cases were counted only if patients tested positive for the new virus. Now, the figures appear to include anyone who has a CT scan of the lungs showing a telltale pattern of pneumonia.Previously, cases were counted only if patients tested positive for the new virus. Now, the figures appear to include anyone who has a CT scan of the lungs showing a telltale pattern of pneumonia.
In the short run, the new accounting may deepen confusion about the true size of the epidemic. It also complicates efforts to track the growth of the disease over the last several weeks.In the short run, the new accounting may deepen confusion about the true size of the epidemic. It also complicates efforts to track the growth of the disease over the last several weeks.
“We need to be careful in interpreting these numbers,” Dr. Michael Ryan, the World Health Organization’s emergency responses chief, said on Thursday. The larger number of cases, he said, “does not represent a significant change in the trajectory of the outbreak.”“We need to be careful in interpreting these numbers,” Dr. Michael Ryan, the World Health Organization’s emergency responses chief, said on Thursday. The larger number of cases, he said, “does not represent a significant change in the trajectory of the outbreak.”
The W.H.O. then released its own figures, leaving out the diagnoses made without a positive test for the virus — and indicating that it did not fully understand the change China had made.The W.H.O. then released its own figures, leaving out the diagnoses made without a positive test for the virus — and indicating that it did not fully understand the change China had made.
“For consistency, we report here only the number of laboratory-confirmed cases,” the organization said in a situation report. “W.H.O. has formally requested additional information on the clinically diagnosed cases, in particular when these have occurred in the course of the outbreak and whether suspect cases were reclassified as clinically diagnosed cases.”“For consistency, we report here only the number of laboratory-confirmed cases,” the organization said in a situation report. “W.H.O. has formally requested additional information on the clinically diagnosed cases, in particular when these have occurred in the course of the outbreak and whether suspect cases were reclassified as clinically diagnosed cases.”
The W.H.O. reported almost 47,000 confirmed cases worldwide, fewer than 1 percent outside mainland China. The Chinese figures put the total at more than 61,000 cases.The W.H.O. reported almost 47,000 confirmed cases worldwide, fewer than 1 percent outside mainland China. The Chinese figures put the total at more than 61,000 cases.
In a word, plenty.In a word, plenty.
Kits to test for the virus are not being produced quickly enough to keep up with demand, and they take days to produce results. Using CT scans means more patients can be checked, with the results available almost immediately.Kits to test for the virus are not being produced quickly enough to keep up with demand, and they take days to produce results. Using CT scans means more patients can be checked, with the results available almost immediately.
And the tests for the virus have not been very reliable. Many sick people have tested negative, only to test positive later. That appears to be, at least in part, because standard testing involves swabbing nasal passages and the throat, while the virus may be lodged in the lungs.And the tests for the virus have not been very reliable. Many sick people have tested negative, only to test positive later. That appears to be, at least in part, because standard testing involves swabbing nasal passages and the throat, while the virus may be lodged in the lungs.
In the United States, the Centers for Disease Control and Prevention shipped hundreds of testing kits to state laboratories — and days later revealed that some of them were faulty. It is not clear whether China has experienced similar problems in making the tests.In the United States, the Centers for Disease Control and Prevention shipped hundreds of testing kits to state laboratories — and days later revealed that some of them were faulty. It is not clear whether China has experienced similar problems in making the tests.
No.No.
There are several ways cases might still be missed. Some people get sick, and die or recover, without ever seeing a doctor. CT scans allow doctors to identify people whose infections have caused pneumonia, which can be fatal, but the scans will not catch people with milder symptoms.There are several ways cases might still be missed. Some people get sick, and die or recover, without ever seeing a doctor. CT scans allow doctors to identify people whose infections have caused pneumonia, which can be fatal, but the scans will not catch people with milder symptoms.
There is another source of confusion about the numbers. It was reported this week that China is no longer counting as confirmed cases people who test positive for the virus yet show no symptoms. But some experts said they were not sure what had actually changed.There is another source of confusion about the numbers. It was reported this week that China is no longer counting as confirmed cases people who test positive for the virus yet show no symptoms. But some experts said they were not sure what had actually changed.
The Chinese health authorities say they can distinguish, on a CT scan, pneumonia brought on by the coronavirus from some other serious lung diseases. But it is not clear that they can tell it from pneumonia caused by other diseases, like seasonal influenza; the accuracy may vary with the skill of the doctor reading the scan.The Chinese health authorities say they can distinguish, on a CT scan, pneumonia brought on by the coronavirus from some other serious lung diseases. But it is not clear that they can tell it from pneumonia caused by other diseases, like seasonal influenza; the accuracy may vary with the skill of the doctor reading the scan.
Updated June 5, 2020Updated June 5, 2020
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Quite possibly.Quite possibly.
Right now, labs are testing for the virus itself, and viruses can be hard to detect. What is often easier to identify is the immune system's own response.Right now, labs are testing for the virus itself, and viruses can be hard to detect. What is often easier to identify is the immune system's own response.
When a patient contracts an infection, the body produces antibodies to it — proteins in the blood that recognize a particular pathogen and trigger an immune system attack on it. Labs around the world are working to develop a test for antibodies to the new coronavirus, but none is available yet.When a patient contracts an infection, the body produces antibodies to it — proteins in the blood that recognize a particular pathogen and trigger an immune system attack on it. Labs around the world are working to develop a test for antibodies to the new coronavirus, but none is available yet.
It could be tricky.It could be tricky.
There are several strains of coronavirus in humans, including ones that cause common colds, SARS and MERS. Antibodies to the new virus may be hard to distinguish from the antibodies people already have to other coronaviruses.There are several strains of coronavirus in humans, including ones that cause common colds, SARS and MERS. Antibodies to the new virus may be hard to distinguish from the antibodies people already have to other coronaviruses.
In any case, it can take days or weeks before a patient tests positive for antibodies to a new infection, so the test may not be useful in diagnosing current illnesses.In any case, it can take days or weeks before a patient tests positive for antibodies to a new infection, so the test may not be useful in diagnosing current illnesses.
So while an effective antibody test may produce a fairly comprehensive picture of an outbreak, that picture will lag a bit behind the reality.So while an effective antibody test may produce a fairly comprehensive picture of an outbreak, that picture will lag a bit behind the reality.