A Research Team from Hong Kong University published a thesis in The Lancet Journal, pointing out, “If China had adopted the fifth version of its coronavirus infection definition from the beginning of the outbreak and had sufficient detection capabilities, we estimate that by February 20, China would have reported 232,000 infection cases, rather than the 55,008 it officially announced.”
The thesis also stated that “considering that some infections, especially those mild or asymptomatic infections, can still remain undetected under the most lenient definition, the actual infection count is likely be higher than the estimated number.”
From January 15 to March 3, China issued seven versions of the “Novel Coronavirus Pneumonia Treatment Plan,” which covered the case definition, clinical characteristics, and diagnosis. The first version, the most rigid definition, required that the patient must have an epidemiological link to the South China Seafood Market and must have four types of symptoms. The fourth revision started allowing the patients to have an epidemiological link to other regions that had confirmed infection cases, not limited to Wuhan. The fifth revision allowed the doctor to use a clinical diagnosis to decide if the patient was infected.
Their research concluded that the loosening of rigid requirements had a “substantial impact” on the infection count. The infection count increased 7.1 times after switching from the version 1 definition to version 2 and 4.2 times after switching from version 4 to version 5.
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