Friday, 24 January 2020

CHINA'S CHERNOBYL

Relatives Wonder Whether Pneumonia Deaths Were Tied to Coronavirus

Families describe discrepancies between information from doctors and death certificates

Medical staff work to sterilize a hospital in Wuhan, China, on Jan. 24. PHOTO: XIAOLU CHU/GETTY IMAGES
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HONG KONG—A 53-year-old fitness trainer died on Wednesday after checking into a hospital in Wuhan a little more than a week earlier, said his niece. His family had expected the death certificate to reflect the deadly coronavirus, because as his condition deteriorated, his doctors told his family he was suffering from an untreatable virus in his lungs.
Instead, it recorded “severe pneumonia” as the cause of death, she said. The relatives of two other people who died in separate hospitals in Wuhan this week also described similar situations, saying the causes of death had been given as “viral pneumonia.”
The relatives of all three said the deceased hadn’t been included in China’s official count of 41 deaths attributed to coronavirus.
Those infected with the new strain of coronavirus in Wuhan typically have a fever, cough and other symptoms of pneumonia, but it couldn’t be determined whether these people had been tested for the new strain. If they were tested, the results might eventually be reflected in the official count.
The hospitals and China’s National Health Commission couldn’t be reached for comment on Friday.
“There are likely to be many times more cases in Wuhan than officially confirmed,” said Neil Ferguson, a disease modeler at Imperial College London, who estimated as many as 4,000 people may have been infected in Wuhan. “Clearly, the hospitals are overwhelmed.”
He added that reporting may be more complete in other areas of China.
China’s diagnosis and reporting system—criticized for being slow as the SARS virus spread in 2003—has been praised by the World Health Organization and other experts since the new coronavirus outbreak was discovered last month. The latest epidemic, which Chinese officials have said originated in a food market in Wuhan, is serving as a test of how much it has improved.
On Saturday morning, local time, the number of confirmed infections had risen to at least 1,287, an increase of more than 400 from the previous day. China has said it would hold officials accountable for any delays or omissions in reporting cases.
The WHO declined on Thursday to declare the outbreak a global public health emergency, citing the limited number of cases outside China.
Some Chinese media with reporters on the ground in Wuhan have said they have found cases that weren’t included in the official reporting. Caixin, a business journal, reported in early January that a doctor in Wuhan had been infected, 11 days before officials confirmed that medical staff had been infected. The Beijing News, a newspaper, reported this week that many patients weren’t officially labeled as carrying the new virus, even though their doctors and nurses said they were.
On Thursday, China state-run TV cited doctors in Wuhan who said the number of patients with fever was too many to be treated and patients hospitalized couldn’t get the pathogenic test in time, because the samples needed to be sent to the provincial offices of the Chinese Center for Disease Control and Prevention.
China’s health ministry updated its protocol for identifying infections on Thursday with a simplified process for registering cases as suspected or confirmed. An earlier version, viewed by the Journal, required several steps of testing before a patient could be called a suspected case.
Some of the relatives of the deceased who spoke to the Journal declined to give their names.
One woman, a 63-year-old retiree in Wuhan, died on Tuesday, her nephew said. The death certificate, viewed by the Journal, shows the cause of death as “pneumonia obtained from the community.”
Doctors at the hospital that treated her told the family she had the new coronavirus, the nephew said, but she wasn’t counted as a case. The instance has also been reported by the Beijing News.
In another case, a 72-year-old former doctor was in the hospital for three days before he died on Tuesday, his nephew said. The doctors told the family he had caught viral pneumonia, he said.
The niece said her uncle, the fitness trainer, first noticed symptoms of what he thought was a common cold in early January, which he believed he had caught at a banquet. He didn’t pay much attention initially, but a few days later, he decided to go to the hospital after seeing blood when he coughed. His niece said he had never been to the food market believed to be the epicenter of the virus.
“The doctor told us repeatedly that he caught the viral pneumonia that no medicine could treat,” she said. A patient’s immune system is the only defense, she said the family was told.
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“But after he died, the death certificate only said ‘severe pneumonia,’ ” she said, adding that she had expected the record to reflect the newly detected coronavirus.
There were no available rooms in the hospital, so her uncle stayed on a makeshift bed in a corridor, along with many other coughing patients.
He was transferred to the infectious diseases unit on Wednesday, the niece said. Hours later, the family was informed that his condition was critical. Two days after her uncle died, China’s health ministry released the profiles of 39 deaths in Hubei due to the new virus, with two deaths listed in other provinces. She couldn’t find her uncle on the list.
The family hasn’t been able to determine whether he was tested for the new coronavirus. She said several people that had close contact with her uncle have been quarantined, including one person who has been hospitalized after being diagnosed with the virus.
Write to Wenxin Fan at Wenxin.Fan@wsj.com

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