As Deaths Mount, China Tries to Speed Up Coronavirus Testing

Dr. Zhang Xiaochun, who works in a hospital in Wuhan, was in dismay. Her patient had been running a fever for nine days, and a CT scan showed signs of pneumonia — symptoms of the new coronavirus sweeping across the central Chinese city.

But a test to confirm the diagnosis would take at least two days. To Dr. Zhang, that meant a delay in isolating her patient — and getting potentially lifesaving treatment.

This past week, Dr. Zhang started a social media campaign with an urgent call to simplify screening for the new coronavirus. It was an unusually public effort that quickly found support among public health experts and the government as China grapples with one of the deadliest epidemics in its recent history.

“The purpose is to isolate and treat quickly,” Dr. Zhang said in a telephone interview. “It amounts to extraordinary measures taken in extraordinary times.”

Two days after Dr. Zhang posted her proposal online, the Chinese government issued the fifth and latest edition of its national diagnosis and treatment plan. It included a significant change: Doctors in Hubei Province should use CT scans to make a clinical diagnosis of suspected coronavirus infections. The testing kits would then be used to confirm the coronavirus infection.

The government’s decision to modify the protocol, unusual in its swiftness, underscored the pressure it is under, particularly in Hubei’s capital, Wuhan, a city of 11 million where pleas from residents desperate for medical help have caused widespread public anger. The vast majority of deaths in China from the coronavirus have been recorded in Wuhan.

  • Updated Feb. 10, 2020

    • What is a Coronavirus?
      It is a novel virus named for the crown-like spikes that protrude from its surface. The coronavirus can infect both animals and people, and can cause a range of respiratory illnesses from the common cold to more dangerous conditions like Severe Acute Respiratory Syndrome, or SARS.
    • How contagious is the virus?
      According to preliminary research, it seems moderately infectious, similar to SARS, and is possibly transmitted through the air. Scientists have estimated that each infected person could spread it to somewhere between 1.5 and 3.5 people without effective containment measures.
    • How worried should I be?
      While the virus is a serious public health concern, the risk to most people outside China remains very low, and seasonal flu is a more immediate threat.
    • Who is working to contain the virus?
      World Health Organization officials have praised China’s aggressive response to the virus by closing transportation, schools and markets. This week, a team of experts from the W.H.O. arrived in Beijing to offer assistance.
    • What if I’m traveling?
      The United States and Australia are temporarily denying entry to noncitizens who recently traveled to China and several airlines have canceled flights.
    • How do I keep myself and others safe?
      Washing your hands frequently is the most important thing you can do, along with staying at home when you’re sick.

Dr. Joe Chang, a specialist at the department of radiation oncology at MD Anderson Cancer Center in Houston, said the use of CT scans to screen patients in Hubei made sense.

“The issue now is the number of patients,” he said. “No country can be prepared for these kinds of numbers.”

In Wuhan, long lines of people snake around the city’s hospitals, and many residents with fevers, coughs and other symptoms of the virus say they can’t get tested.

Yuan Xiuhua, a 49-year-old Wuhan resident, came down with a fever on Jan. 22 and went to a hospital, where CT scans showed lesions in her lungs. She has repeatedly asked her community district, which prioritizes who gets tested for the coronavirus, to give her one, but was told that because there were too many possible cases, she was better off isolating herself at home. Her husband, she said, recently came down with a fever and diarrhea.

Ms. Yuan said she was still calling her community district every day to ask for a test.

“They keep on saying that there are no free spots,” she said. “They didn’t provide me with any help. They’ve just made me wait.”

Faced with criticism over the slow response in the first weeks of the outbreak, Beijing has ordered increasingly extreme measures. The government in Wuhan was to hospitalize or place in mass quarantine centers all confirmed infected patients.

Chinese doctors diagnose the new coronavirus by taking a throat or nasal swab from a person showing symptoms, such as a fever. Samples are transported in batches to laboratories run by the local centers for disease control, where they are put through machines that use a polymerase chain reaction — a form of D.N.A. analysis — to detect the virus.

In Hubei, it takes hours for samples to be sent to the laboratories and days for the results to be issued. The local health department says the labs can run 6,000 tests a day, but even with staff working around the clock, there aren’t enough laboratories to keep up with the workload. The province is seeking outside help.

More crucially, Hubei is running short of testing kits and reagents. Only seven manufacturers have government approval to make test kits for the coronavirus. Their employees have been working overtime to deliver the kits, according to local news reports. More newly developed testing kits are in the pipeline, but it is unclear when they will be ready for use.

Dr. Joseph Tsang Kay Yan, an infectious disease specialist in Hong Kong, said the health authorities in China should use the testing kits more widely to get a clearer picture of the epidemic. He warned that the main disadvantage of using CT scans would be missing patients with mild symptoms, raising the risk of spreading the infection.

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