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Coronavirus study points to vast number of cases under the radar in China

  • Researchers in Hong Kong find that Covid-19 definitions make big differences to the pandemic’s bigger picture
  • Mainland China might have had four times as many infections as official total if broader criteria used, team says

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Medical staff in protective clothing try to cope with an influx of patients Wuhan Red Cross Hospital in the early days of the coronavirus epidemic. Photo: AFP
China’s official tally of coronavirus cases could have quadrupled in mid-February if one broader system for classifying confirmed patients had been used from the outset of the pandemic, according to researchers at the University of Hong Kong.

In a study published in the medical journal The Lancet on Tuesday, the researchers said China might have had 232,000 confirmed cases – rather than the official total of about 55,000 – by February 20 if a revised definition adopted earlier in the month had been applied throughout.

“We estimated that there were at least 232,000 infections in the first epidemic wave of Covid-19 in mainland China,” they said, referring to the disease caused by the coronavirus.

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“The true number of infections could still be higher than that currently estimated considering the possibility of under-detection of some infections, particularly those that were mild and asymptomatic, even under the broadest case definitions.”

The researchers – led by Peng Wu from the University of Hong Kong’s school of public health – looked at the various classification systems used by the government after the epidemic erupted in the central Chinese city of Wuhan in late December.

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China has published seven editions of diagnosis and treatment guidelines, changing the classification system as understanding of the disease developed.

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