China's Hubei province expanded its criteria for identifying new coronavirus infections on Thursday, causing a dramatic spike in reported cases at the epicenter of the disease, as Beijing moved to purge provincial party officials amid criticism of their handling of the epidemic.
Hubei, where the majority of the world's infections have been concentrated, added a new category of "clinical cases" to its reporting. Now, patients will be included who exhibit all the symptoms of COVID-19, the disease caused by the coronavirus — including fever, cough and shortness of breath — but have either not been tested or tested negative for the virus itself.
The change, likely a response to the scarcity of test kits and questions about their reliability, caused a ninefold increase in new reported cases in the province.
Hubei province reported 14,840 new cases Thursday, compared to 1,638 new cases the day before. Hubei also reported 242 new deaths, more than double the 94 reported on Wednesday.
So far, Hubei is the only province that has revised its definition of new cases. Others have not publicly reported "clinical" or asymptomatic cases. Beijing is expected later Thursday to report new nationwide statistics.
The new numbers from Hubei added significantly to the latest China-wide figures reported Thursday: 15,152 new cases and 254 deaths. In its latest situation report, the World Health Organization reported Wednesday a total of 441 confirmed cases and one death (in the Philippines) in 24 countries outside China. WHO's risk assessment for the virus is "very high" for China and "high" regionally and globally.
With the latest numbers, there have been nearly 60,000 cases worldwide and more than 1,300 deaths.
Earlier this week, China's senior epidemiologist, Zhong Nanshan, had said he believed the coronavirus pandemic would peak in late February and be finished by April. However, the new reporting criteria from Hubei have thrown previous estimates of the disease's progression in China into disarray.
If the same counting method is adopted nationwide, it would disrupt the trend lines even further.
Officials held accountable
Meanwhile, China's central government on Thursday appointed the former mayor of Shanghai, Ying Yong, to replace Jiang Chaoliang, the ruling Communist Party chief in Hubei, state-run Xinhua news agency said.
The high-level shakeup is testament to how seriously Beijing is taking widespread criticism from abroad and, most unusually, from the public at home, with many Chinese having taken to social media to express their frustration.
Academics in China, angered by the silencing of a whistleblower doctor who tried to sound the alarm in the early days of the epidemic and later succumbed to the disease himself, have also signed a public petition to "demand free speech," the South China Morning Post reports.
Jiang's ouster follows the firing of two of the province's top health officials earlier this week. The Communist Party's People's Daily reports that Ma Guoqiang, party leader in the city of Wuhan, Hubei's provincial capital, was also set to be dismissed and replaced by Wang Zhonglin, party secretary of Jinan, the provincial capital of Shandong province.
The appointment of Ying, Wang and Chen Yixin, the deputy head of the new national task force overseeing the handling of the crisis, could signal Beijing's concern over instability caused by the epidemic. Ying and Yixin are both close to Chinese leader Xi Jinping and all three officials have backgrounds in state security.
Chen said Tuesday that the situation in hardest-hit Wuhan was still uncertain and that "the scale of the spread has not been accurately estimated."
Centrally located Wuhan, a city of more than 11 million, has been under quarantine for weeks with transport in and out of the metropolis shut down to prevent the spread of the disease. At least a dozen other Chinese cities, home to more than 60 million people combined, have been put on similar lockdown.
Beijing has forecast that the economic impact of the pandemic could shave a full percentage point off its first-quarter GDP. Disruptions to Chinese manufacturers have also had a knock-on effect for factories around the world that are dependent on China as a key link in their supply chains. In many cases, the disease has simply compounded the problems already experienced by the ongoing U.S.-China trade war.
Businesses in Wuhan have been told to remain closed until at least Feb. 21. Schools and universities are also closed until further notice.
Fear of contagion has also caused the U.S., and much of Asia and Europe, to implement travel restrictions on visitors from China.
In Japan, the Diamond Princess cruise liner has been in quarantine for days in the port of Yokohama, near Tokyo, as the number of confirmed cases aboard continues to rise.
Japan's health ministry said Thursday that 44 new cases had been identified on the giant cruise ship, bringing the total to 218 among the vessel's 3,700 passengers and crew.
Another cruise ship, the MS Westerdam, which made port calls last month in Singapore and Hong Kong — two places that have reported coronavirus cases — has prompted fear and concern from officials in many countries. Despite having no reported cases of coronavirus among its 1,455 passengers and 802 crew members, the vessel, operated by Holland America, has been turned away by Japan, Taiwan, the Philippines, Guam and Thailand.
The saga of the wayward Westerdam had been going on for days until Cambodia finally allowed it to dock there. Marinetraffic.com on Thursday listed the Westerdam as anchored at the port of Sihanoukville, where Holland America said in a statement Wednesday that the cruise would end.
"Guests will disembark in Sihanoukville over the next few days and transfer via charter flights to Phnom Penh for forward travel home," the statement on the cruise operator's website said. "Holland America Line will arrange and pay for all flights home, in addition to the full cruise refund and 100% future cruise credit already communicated."
RACHEL MARTIN, HOST:
There are grim numbers coming out of China today. Health officials say there are more than 15,000 new cases of the coronavirus, and 254 people have died since yesterday. Almost all the new cases are in Hubei province, which is the center of the epidemic. NPR's Emily Feng is reporting this story. She joins us now from Shanghai.
Emily, so these numbers are just startling. Yesterday, the increase was about 1,600 new cases - today, more than 15,000. What's happening?
EMILY FENG, BYLINE: It all comes down with the difference in how they're counting cases now. It sounds very technical. It kind of is. But it has huge implications for how we understand where this outbreak is going. Basically, what happened was, about a week ago, health authorities in China decided that they were going to ask local provinces to give them four different types of numbers - confirmed cases of people with the virus, suspected cases, asymptomatic cases, meaning people were - had tested positive for the virus but weren't showing illness, and people who were showing symptoms of the illness but had not yet tested positive or could not be tested. Today, Hubei province became the first province to disclose the last category that I just mentioned, these so-called clinical cases. And because they are now disclosed (inaudible).
MARTIN: We're trying to get NPR's Emily Feng back. She is on the line from Shanghai talking about the new numbers out of China related to the coronavirus. There've been 15,000 new cases defined today, and 254 people have died. That is just since yesterday. We're trying to get Emily back on the line. Emily, can you hear me?
FENG: Oh, yeah. Sorry.
MARTIN: OK, you're back. That's OK.
FENG: I didn't realize I disconnected.
MARTIN: That's OK. We've got you back on the line. Can you explain this new way of counting the coronaviruses? Does that mean the disease is spreading more rapidly, or it sounds like they're just lowering the standard for how they're incorporating people into this category?
FENG: We don't know. The - what they're now disclosing are what they're calling clinical cases. These are people who display all the symptoms of the virus but either have not yet been officially tested or have been tested and have turned up negative. Hubei is the only province so far to do this. That's why we've seen that huge spike in numbers from Hubei province alone. Other provinces may follow.
But a big reason behind why they're now disclosing this new category of cases is because the testing kits that local governments have been using are running out. And to be honest, they're not very good. They often turn up negative results even when a person has the virus.
MARTIN: So, I mean, is this changing at all how the government is dealing with the epidemic?
FENG: We shall have to see. It's definitely turned the models upside down of when authorities in China thought this outbreak was going to peak. A few days ago, the country's top epidemiologist, Zhong Nanshan, said he expected the outbreak to peak sometime in late February, so just in two weeks' time. Now that we see the surge in numbers from Hubei, that model likely does not hold, and China's going to have to think of more long-term options of how to quarantine people and treat people as hospitals are overloaded.
MARTIN: So there's obviously this massive human toll with the coronavirus, but I know you have also been looking into the economic impact. What can you tell us?
FENG: Yeah. I'm actually on the streets of Shanghai right now, which is why the connection is so bad. But we've been visiting major electronics factories in Shanghai and around Shanghai. These factories supply things like our Apple iPhones and the electronics we use day to day. Unfortunately, they have not been able to restart because workers are currently under quarantine. They haven't been able to travel freely. Cities themselves are not taking migrant workers. And so we're seeing this huge slowdown of some of the biggest companies in China that have multinational clients whose products we use every day. So we are going to be feeling the impact as well from this outbreak.
MARTIN: NPR's Emily Feng reporting from Shanghai. Thank you, Emily.
FENG: Thanks, Rachel. Transcript provided by NPR, Copyright NPR.