China's Hubei reports 242 new coronavirus deaths, new cases up 14,840 due to new clinical methods of diagnosis

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The total number of deaths at the epicenter of the coronavirus, in Hubei province, rose to 1,310 after 242 new deaths were announced.
A medical worker in a protective suit pushes a coronavirus patient in a wheelchair at a hospital in Wuhan, Hubei province, China, on Feb 10, 2020. PHOTO: REUTERS

SINGAPORE - The number of confirmed coronavirus infections in China's Hubei province spiked drastically on Wednesday (Feb 12) after new diagnostic guidelines for confirming cases kicked in, Chinese doctors said Thursday (Feb 13).

Under the broader criteria now used to "clinically diagnose" cases, the death toll in central China's Hubei province rose by 242 to 1,310 as of Wednesday, the provincial health commission said on Thursday. These figures have been revised to include cases that have not been lab-confirmed.

The new guidelines have been similarly applied to the tabulating of confirmed infections, which rose by 14,840. Of this, 13,332 cases were diagnosed under the new category. As of Wednesday, there are 48,206 confirmed infections in Hubei, according to official figures, with 3,441 discharged from hospital.

In a circular last Saturday, China's National Health Commission and National Administration of Traditional Chinese Medicine said it was revising the way cases are confirmed in Hubei province, the hardest hit area in the country believed to be where the pathogen originated.

Instead of simply relying on laboratory testing, cases can now be confirmed through clinical diagnosis, the guidelines said.

This means that a patient can be confirmed to be suffering from Covid-19, as the disease has been officially termed, if they exhibit symptoms of severe respiratory tract disease and a CT scan shows lesions in their lungs.

Till now, only infections confirmed by specialised testing kits were considered accurate. But those kits have been in such short supply - and so many sick people have gone untested - that the authorities in Hubei have now started counting patients whose illness have been screened and identified by doctors.

Hubei health authorities said the new methodology will "allow patients to receive standard treatment as a confirmed case of infection as soon as possible".

A confirmed infection means that patients would be given space in a specialised ward in a hospital, instead of being redirected to a quarantine centre or sent home while awaiting lab results.

The previous methodology resulted in a large number of suspected cases, said Dr Tong Zhaohui, who is on a special team directing Hubei's response to the outbreak.

"When we diagnosed pneumonia, 20 to 30 per cent of the diagnosis is from laboratory testing, and the remaining 70 to 80 per cent depends on clinical diagnosis," he said in an interview with state broadcaster CCTV.

"From a clinician's perspective, it's helpful to allow clinic diagnosis of cases so there is an additional tool in dealing with the disease."

As of the end of Wednesday in mainland China, more than 59,800 people had been confirmed to have contracted the disease and at least 1,360 people had died from it, according to its National Health Commission on Thursday afternoon.

Results from Chinese trials testing a combination of antiviral drugs used to treat HIV against the new coronavirus are due in weeks, but experts say a vaccine could still be months away.

World Health Organization chief Tedros Adhanom Ghebreyesus on Wednesday warned any apparent slowdown in the spread of the epidemic should be viewed with "extreme caution".
"This outbreak could still go in any direction," he said in a briefing in Geneva.

Another expert said that while the coronavirus may be peaking in China, this was not the case elsewhere.

"It has spread to other places where it's the beginning of the outbreak," Professor Dale Fisher, head of the Global Outbreak Alert and Response Network coordinated by the WHO, said in an interview in Singapore. "In Singapore, we are at the beginning."

Singapore now has 50 cases, including one found at its biggest bank, DBS, on Wednesday that prompted the bank to vacate employees from the head office.

Hundreds of infections have been reported in more than two dozen other countries and territories, but only two people have died from the virus outside mainland China - one in Hong Kong and another in the Philippines.

The MS Westerdam cruise ship arrives near a sea port in Preah Sihanouk province, Cambodia, on Feb 13, 2020. PHOTO: EPA-EFE

The biggest cluster of cases outside China is on a cruise ship quarantined off the Japanese port of Yokohama, with 174 of about 3,700 people on board having tested positive. One quarantine officer was also found infected.

There was a happy ending in sight for another cruise ship, the MS Westerdam, which Thailand, Japan, Taiwan, Guam and the Philippines had refused to let dock over fears one of its 1,455 passengers and 802 crew might have the virus.

Cambodia agreed on Wednesday to let it land, the ship's owner Holland America Line said. The ship docked in the port town of Sihanoukville early on Thursday morning.

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