Revision of infection numbers made for accuracy, public interest

After city-wide data verification, the revision of the death toll of the novel coronavirus and the number of confirmed infections in Wuhan, Hubei province answers concerns of the public and will help with scientific decisions of epidemic prevention and control in the future, a local official said.

The people of Wuhan were understanding of the changes, with many believing it is right and respectful to record and remember every death from COVID-19.

A total of 1,290 people were added to the death toll of the novel coronavirus in Wuhan, after the city government included those who died at home and corrected some inaccuracies in reporting occurring in the early stages of the outbreak, the Wuhan headquarters for COVID-19 epidemic prevention and control said in a notification on Friday.

By the end of Thursday, the COVID-19 fatalities in Wuhan, the hardest hit city by the outbreak in China, amounted to 3,869. The total number of confirmed infections was revised up 325 to 50,333.

After the revision, the total number of deaths resulting from COVID-19 on the Chinese mainland has climbed to 4,632 by the end of Thursday, and that of confirmed infections to 82,692, said Mi Feng, spokesman for the National Health Commission, at a news conference held in Beijing on Friday.

The notification from Wuhan headquarters said the increase was due to a comprehensive examination and verification of figures from various departments such as funeral parlors, medical institutions, public security authorities and communities in Wuhan.

In the early stage of the outbreak, a rapid rise in number of patients and quick spread of the disease overwhelmed the city's medical system, making data collecting difficult. Some data reporting was delayed and errors were made in the early stage, so the numbers should be amended according to relevant Chinese laws and regulations, the notification read.

Since the transmission of the disease has been basically contained and the lockdown of the city has been lifted, it has become possible to look back and comprehensively re-examine the data to ensure its accuracy, an official in charge of the matter said in a written interview. The official's name was not revealed.

In late March, the Wuhan headquarters established a special group working on data verification and epidemiological surveying, which has extensively examined and compared statistics from various sources to make sure every single person affected is counted, he said.

The work group has collected information from all facilities related to the epidemic, including fever clinics, hospitals, quarantine areas and communities, as well as some special places like prisons and elder care homes. Every single case has been checked and reviewed with medical institutions, communities, police stations, employers and family members, according to the notification.

The revision is based on relevant Chinese laws and regulations, and conducted under the principle of "being responsible to history, the people and the deceased", it said.

The notification said the miscalculation was due to various causes. In the early stage of the outbreak, the capability of nucleic acid testing and medical resources was very limited in the city, so some patients died at home without being treated. Medical staff was too busy to treat patients, so there had been some delayed reporting. Also, as various types of medical institutions were used to admit COVID-19 patients, a few had not been linked with the online direct reporting system.

"The timely revision of the death toll and infection number of COVID-19 not only helps safeguard the rights and interests of the people, and facilitates scientific decisions of epidemic prevention and control. It also answers public concern and shows respect to every life lost in the epidemic," the official in charge of the work said.

He added providing accurate epidemic control data is important for people's lives and health, but also matters for government credibility.

Tang Zhouping, a professor in neurology at Tongji Hospital in Wuhan, said a major reason for the previous imprecise calculation of the numbers in Wuhan was the lack of capacity to offer nucleic tests to all patients.

And hospital beds in Wuhan were in shortage at that time, resulting in many patients unable to be immediately admitted to hospitals for diagnosis and treatment. Some patients infected with the coronavirus died at home and were left uncalculated, he said.

"I think it is understandable that initial calculations of the numbers was not precise due to many difficulties, and the same problem may also have occurred in other countries," Tang said.

Liu Bende, director of the emergency department of Wuhan Union Hospital, said in the initial period, hospital staff was extremely busy  saving patients, so it's natural the calculation on the epidemic numbers might be imprecise.

"We were facing an unprecedented situation then, and our staff was working around the clock to save patients before medical staff from other parts of the country came for help," he said. "They were by no means intended to conceal or underreport the true numbers of deaths."

Jin Qi, director of the Pathogen Biology Institute under the Chinese Academy of Medical Sciences, also said he believes the Chinese government has not concealed any information on the number of COVID-19 cases, as there is no reason to do so.

On Friday, the revision was among the most discussed topics among local residents in Wuhan.

Wu Zhifang, whose brother was infected, said it's understandable to have discrepancies in initial statistics. "At the early stage of the outbreak, the city's health system was overloaded and there was panic, so it's understandable to have some errors in reporting patients' conditions," she said. "There had been no precedent and nobody was prepared for it. Generally speaking I think the government has done a good job, and of course the Wuhan people have made a great effort and sacrifice."

Xu Zesheng, a Wuhan taxi driver who lost his sister-in-law to the novel coronavirus, said an increase in a death toll is never a good thing, "but it's important to make sure every death is recorded and remembered".

"Behind every death, there is a Wuhan family," he said, adding he hopes the family could gather to hold a funeral as soon as epidemic control measures loosen in the city.