You’ve probably noticed that coronavirus panic has increased several notches over the past week. The revelation of a cluster of cases in northern Italy last weekend, seems to have triggered a media frenzy across Europe. That is very much the case in Ireland too. This has shone a light on testing for the disease and it is something that I want to focus on today.
The current laboratory testing methods have only a 70% sensitivity rate. In other words scientists are only confident the test is successful 70% of the time. You can be tested and possibly have the infection. So not alone is there no vaccine for the virus in the short term, doctors are STILL trying to develop more exact testing methods to identify the coronavirus. The key to controlling COVID-19 spread is early detection and scientists are working around the clock to refine and improve the current processes. The simple fact is testing is time-consuming, costly, laborious and a danger to medical personnel. This is one of the reasons testing numbers have been so low globally.
So how many people are actually being tested around the world?
The answer is not as many as you would think. In Europe, Italy and the UK are leading the way in terms of the numbers tested. See Below.
You will notice that the United States has only tested 445 people as of yesterday. This will increase massively over the coming days as 49 new facilities have been announced to begin a more systematic and statewide approach to testing. The US policy on testing was very similiar to Ireland’s approach until yesterday – basically only people that were showing symptoms AND were recent visitors to China and in particular Wuhan tested.
South Korea have been leading the way on testing. Outside of China, South Korea has the 2nd highest level of infections in the world. They are in the process of testing 210,000 people.
Remember, COVID-19 has very mild, in some cases, negligible symptoms in over 80% of the people that are infected. It is difficult to differentiate the symptoms of this disease from other common respiratory infections and conditions. So in South Korea, it stands to reason that the high volumes being tested are uncovering more people infected with the virus through community transmission. The transparency from South Korea has been superb and to the benefit of the wider world and they should be applauded. If we had this level of co-operation from China 6 weeks ago the world would be in a lot better shape today. As testing for the virus ramps up around the world the global numbers of COVID-19 will soon start to dwarf the numbers coming out of China as we can start to see below.
February 27th – Global Infection numbers outside China.
It is very clear, even at this early stage, that certain countries are not reporting accurate numbers or worse are not in a position to test large tracts of their own countries. For example Iran has admitted to 22 deaths. At least 3 high-ranking Iranian government officials have died from the disease, it is inconceivable that they account for 15% of the deaths in that country. But even if that number is true, based on the commonly accepted death/ Infection rate of 2% in China – The numbers of infected must be closer to 1,400 than the reported 140.
To date Russia has only reported two cases of the coronavirus. Reports leaking out of the Baltic countries ( Lithuania and Latvia) suggest that the problem there is much, much higher. One newspaper source put the number at 20,000 – and point to the fact that on February 20th Russia quickly and abruptly shutdown the land border between China and Russia.
One of the significant issues that Health authorities around the globe are facing is quickly determining How and When to test a person for coronavirus . The protocols rightly demand that medical practitioners carry out the testing in highly protective clothing and masks so as not to infect themselves and other patients in their environment. There is a massive shortage of the necessary protective equipment everywhere and of course it is not clothing that is easily re-usable. For example, China produces at least 90% of the specific type of mask required in this environment.
On a positive note, a report issued on February 26th from China indicates that chest CT scans may be more accurate than laboratory testing in early diagnosis. They have tested over 1,000 patients and found that CT scans were a lot more sensitive to picking up COVID-19 early. Then laboratory testing and blood testing are utilised to confirm the virus. Expect this methodology to be increasingly used around the world in the days ahead.
In summation, the coming days and weeks will see big increases in the numbers infected globally as more accurate testing methods are adapted and rolled out. Coronavirus has had a 6 week head start, what we are seeing now is global health authorities attempting to catch up. The first step in that is to quantify the size of the problem.