bodyType

customContents

entityId

entityUuid

articlePageQuery

filter

article

articleBaseAdvertisingInfoArticle

articleListArticle

articleSeoArticle

hooksArticleAcknowledgementGateOverlayArticle

hooksTrackPageViewArticle

hooksContentInterestArticle

articleLinkingDataContent

hooksAmpRedirectArticle

articleSchemaContent

liveArticle

advertZone

sentiment

contentLock

topics

types

sections

paywallTypes

createdDate

publishedDate

sponsorType

urlAlias

moreOnThisArticles

commentCount

authorLocations

authors

corrections

displaySlideShow

multimediaEmbed

printHeadline

seriesContainer

articleSpeeches

socialHeadline

headline

images

flag

firstTopic

glossary

flattenTypeIds

image

relatedLinks

relatedNewsletters

__typename

sponsor

pdfFiles

seriesReverseOrder

series

disableOffPlatformContent

published

updatedDate

summary

subHeadline

body

keywords

readingTime

customTimezone

liveContents

SCMP Reporter

Mild symptoms are misdiagnosed, WHO claims

Beijing hospitals are releasing patients with marginal Sars symptoms too soon for safety, a World Health Organisation (WHO) expert said yesterday.

Concerned that infected people are returning home or switching hospitals after making a false recovery, the WHO has asked Beijing authorities to form a special taskforce to investigate.

If the city redefines Sars to include patients with mild symptoms, the drop in infections over the past 10 days could be reversed and may reignite panic.

The WHO said it did not know how many people may have been misdiagnosed.

The leader of the WHO Sars team, Daniel Chin, an American doctor who visited two frontline Beijing hospitals last week, linked the capital's declining caseload to the early release of Sars patients with mild symptoms.

The number of new confirmed cases in Beijing rose by 19 to 2,420 yesterday, continuing a downward trend since just after the May Day holiday. Thirteen of the 19 patients were previously suspected to have Sars.

Nationwide, the number of new infections fell to 28 - the lowest since the government began accurate reporting of Sars cases early last month.

Dr Chin said doctors in Beijing believed all Sars patients showed severe symptoms, whereas a 'spectrum of severity' could make some sick people appear to be free of the virus.

'Cases could go, should go up, given my understanding,' Dr Chin said. 'They should be probable cases, but [Beijing doctors are saying] 'look at that guy, he's not that serious'.'

Beijing's 67 fever clinics, the only places diagnosing Sars, test for fevers, evaluate coughs and take lung X-rays to decide who has the disease, which has killed 145 people in Beijing. Four died  yesterday.

Borderline diagnoses also hinged on patient testimony about contact with other people who had had Sars, Dr Chin said, but this measure failed because some patients gave incomplete information to avoid quarantine.

Patients with mild symptoms are first sent to hospital as suspect cases, according to a WHO statement. But as they get better, they go to general wards or return home too early.

'It's not a  small number of patients. They can infect the community, or if sent to another hospital they can infect the ward.'

Dr Chin said patients with milder symptoms should be treated with normal Sars precautions because there was no reliable test for the disease.

But not everyone backs the WHO view. David Liao, a  doctor with the Vista Clinic in Beijing, said because Sars was a syndrome rather than a disease, it behaved inconsistently.

'That's my complaint about the WHO in this regard. Lots of people have the Sars coronavirus without Sars,' Dr Liao said.

He said the city was 'a little bit over-aggressive, over-zealous in its diagnosis of Sars'. Broadening the Sars definition would put harmless people in hospitals, bringing 'pandemonium' to the medical system and the already shaken public.

The Beijing government has said there could be an over-diagnosis of Sars, which it fears will overload the health system. But city officials indicated on Thursday that they would follow up the WHO's inquiry about patients released too soon, Dr Chin said.



Beijing hospitals 'letting patients out too early'