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Coronavirus cases worldwide: coronavirus count may be the tip of the iceberg while patients are not tested | World News


Nizana Brautmann discovered that her 6-year-old son had been exposed to the coronavirus through a note on the closed door of his Berlin daycare on Monday morning. He told the parents to take their children home and wait.

That was the last clear information he got. The center asked parents to decide whether to quarantine their families. Her doctor told her to stay away from her office and take over-the-counter cold remedies. A herbal hotline advised herbal tea. Although her son had a cough and Brautmann had a mild fever and had trouble breathing completely, one test was surprisingly difficult to perform.

Brautmann is just one among many. As the focus of the new pandemic shifts to Europe, authorities have been slower to accept aggressive evidence attributed to helping curb the spread in Asia. The UK changed its rules on Thursday night to assess only the most serious cases, people requiring hospitalization, as officials warned that as many as 10,000 Britons may be infected.

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Meanwhile, the paucity of evidence in the United States has made clear the true extent of the pandemic. While restrictions help prevent authorities from wasting precious screening kits and staff time on hypochondriacs, failing to shed a wide enough net can give the pathogen a chance to spread undetected. The World Health Organization issued a severe warning on the matter this week when the numbers of cases increased.

“You can’t fight a virus if you don’t know where it is,” WHO Director-General Tedros Adhanom Ghebreyesus said Thursday. “That means robust surveillance to find, isolate, test, and treat every case, to break the chains of transmission.”

Coronavirus outbreak: latest updates

Although four out of five people will likely have mild symptoms, the new coronavirus can be deadly to the elderly and people with conditions like diabetes and high blood pressure.

There are signs that things could start to improve in the US. USA Roche Holding AG has obtained emergency approval from the federal government for a highly automated test, which can accelerate the ability to diagnose patients tenfold. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told MSNBC on Friday that testing will be accelerated within the next week due to increased coordination with private companies.

Coronavirus outbreak: full coverage

Meanwhile, the challenge of tracing the chains of infection when this coronavirus gives some people hardly any symptoms means that the existing number of global cases, currently above 135,000, is insufficient. The UK estimate of 10,000 is more than 12 times the official number of confirmed cases as of Friday.

“Disastrous” decision

“Testing only the most severe cases is a disastrous public health decision,” said Ralph Baric, a professor at the University of North Carolina School of Global Gillings School of Public Health and a veteran coronavirus researcher. People with few or no symptoms can easily transmit the virus, he said, predicting “hundreds of thousands of additional infections” from uncontrolled spread without further evidence.

When Spain expanded its criteria in early March beyond those with a link to recent trips to China, its number of cases increased from just a few to several hundred. A death that had been attributed to another cause was quickly discovered. In the Seattle area, the virus began circulating in January, but remained undetected until patients in a nursing home began to die.

In France, health authorities easily recognize that official figures do not reflect reality. Only “the tip of the iceberg” is visible, says Jerome Salomon, France’s chief health officer. But it points to other ways to identify groups: One person in the hospital means that at least six or seven others must have a more benign form of the virus, he said Wednesday in a briefing. One death indicates that at least 100 other people are infected in the area.

In European countries such as France, Germany, Switzerland, and Austria, the authorities adhere to the policy of primarily evaluating those who have traveled to a point of virus or have had contact with a confirmed Covid-19 patient, even when the infection is spread more widely through the community. .

The WHO urges countries to go further and evaluate anyone with unexplained respiratory disease who has been in an area where the virus is transmitted locally. Such community transmission is occurring in much of Europe, as well as in the United States.

“Diagnostic testing algorithms that only test a small proportion of people who are likely Covid-19 are not the way to go in this epidemic,” said Michael Ryan, head of the WHO emergency program.

In Germany, authorities are doing some more extensive testing as part of an influenza task force. Patient samples are also being tested for coronaviruses, according to the Robert Koch Institute, the country’s public health authority.

Success stories

There is evidence that the broader tests help. In South Korea, where authorities screen 10,000 people a day, there were more coronavirus recoveries than recent infections for the first time this week. Proactive testing was part of the arsenal that Taiwan and Singapore used to limit the outbreak in their countries despite strong ties to China, where the virus originated.

However, launching a larger network could create its own set of problems, according to Rosanna Peeling, director of the London School of Hygiene and Tropical Medicine’s Center for International Diagnosis. Random tests would certainly uncover additional cases, but they could also cause panic.

“I would like to isolate them or quarantine them, but it is still too late for when we know that the virus has already taken off,” Peeling said in an interview last week.

Brautmann, the mother of Berlin, could have taken her sick son to a test station in Berlin. The line at his district site was more than four hours long on Monday. She chose not to go, reasoning that if they were positive, they would expose others. Instead, she and her son were quarantined for two weeks.

They go out once a day, before the neighborhood starts moving, to run around a nearby soccer field. Her son’s daycare will be closed until March 20, operator Kindergaerten NordOst said.

Brautmann, 40, believes the official number of cases that have been identified in Berlin, 158 as of Friday, is misleading.

“It’s a joke because nobody is testing us,” he said.

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