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WHO Defends China’s Repeated Coronavirus Diagnostic Changes Despite Hubei Health Official’s Complaints

Director-General of the World Health Organization (WHO) Tedros Adhanom Ghebreyesus speaks next to Michael J. Ryan, Executive Director of the WHO Health Emergencies Programme, during a news conference on the coronavirus in Geneva, Switzerland, January 29, 2020. (Denis Balibouse/Reuters)

The World Health Organization said China’s third change to its coronavirus diagnostic process in just eight days was the “best possible decision,” despite a health official from China’s Hubei province claiming that the government was not being transparent and accurate in reporting case numbers.

“As we observed in other epidemics, it’s not unusual to count things in different ways as an epidemic evolves,” WHO official Sylvie Briand said of the change. “ . . . What is important in epidemiology when you observe an epidemic is to remember that surveillance or monitoring a disease aims at taking the best possible decision. It’s really numbers for action, not numbers for numbers.”

Hubei, the epicenter of the outbreak, reported nearly 15,000 new cases on February 13 after changing the criteria to diagnose cases from requiring a lab test to requiring just a simple physical exam. The spike caused Beijing to fire Jiang Chaoliang, the party secretary of the province, and replace him with Ying Yong, the mayor of Shanghai.

The guidelines were changed again earler this week: health officials reverted to only counting cases in which the individual was diagnosed by lab test, and not by physical examination. The heightened diagnostic standard led to a substantial drop in reported cases: only 394 new cases were reported on Wednesday — the lowest number since January 23.

But Tu Yuanchao, deputy director of Hubei’s health commission, told state news agency Xinhua on Friday that Yong is now changing the counting regulations yet again to include those individuals diagnosed solely by physical exam.

“Next, we will further strengthen discipline and tighten management to ensure the openness and transparency, timeliness and accuracy of epidemic statistics,” Tu was quoted saying. He added that “some cities in the province calculated new confirmed infections based on the new guidelines and deleted cases that had been reported previously.”

Yong’s decision to once again count cases in which the individual was diagnosed solely through a physical exam resulted in 889 diagnosed cases in just the last 24 hours.

The WHO’s director general, Tedros Adhanom, took the fluctuations as good news, and praised the new criteria.

“This may indicate the system in Wuhan has regained ability to test all suspected cases,” he said. “As a result, some cases that had been clinically confirmed have now been subtracted from the total because they have tested negative.”

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