The latest data indicates that there are 87,137 infected by Covid-19 in more than 40 countries, a figure that everyone observes with skepticism.
In Spain, for example, we have accounted for 81 cases, but if we used the calculation methods used by China – which rules out positive for coronaviruses that have not shown symptoms – we would only carry four or five cases: the most serious. If we used Iran's methods, we would confirm our first case within a week.
In the country where this new type of coronavirus emerged, the majority of those affected are registered, 79,698 citizens. Experts, however, talk about the fact that most real cases are going unnoticed for official statistics.
"We estimate that about two-thirds of Covid-19 cases exported from mainland China have remained undetected worldwide, potentially resulting in multiple human-human transmission chains outside of China, still undetected," they explained a few days ago. Imperial College researchers sent by WHO.
How many sick people have left China?
First, when the virus appeared in December, many doctors did not know how to detect it. Or rather, how to distinguish it from conventional pneumonia. The protocols have been changing, from laboratory test to PCR – too slow to practice and not always as accurate as necessary – to chest scanners, a method that, according to a recent study, diagnoses Covid-19 more quickly and reliably That analyzes.
At one point, between February 12 and 13, the cases in Hubei they suddenly went from 45,000 to 60,000. The reason was that the authorities began to count all those cases with symptoms but that had not been subjected to a test. However, the criteria changed again and two days later, those cases that were clinically confirmed (but not through a test) stopped thickening the list of those affected.
To end up entangling things, the Hubei authorities announced that week that cases that had retroactively been removed from the list of "infected" because they did not meet the new requirements would be added to the global count anyway. The same is happening in the rest of China. In Heilongjiang, northeast China, 13 people tested positive for the virus, but having not developed symptoms, they were not counted.
Wu Zunyou, the director of the Chinese Center for Disease Control and Prevention, insists that what they are doing is the right thing, because having the presence of the virus does not automatically amount to being infected, simply that that person has Covid-19 remains in nose or mouth because he took it from the environment. In addition, Zunyou has argued that only people with symptoms – a sign that the virus is hatching – are able to transmit the disease to others.
Outside of China, scientists disagree. In the first place, because in order to achieve detectable levels of coronavirus in the body, it has to enter incubation and replicate. And secondly, because as it seems increasingly clear, individuals who have tested positive for Covid-19 are able to transmit it despite having no symptoms.
It is just what happened with the 'zero case' in Germany: a seemingly symptomless woman who arrived from Shanghai at the end of January and infected a 33-year-old executive, who in turn transferred the disease to two of her partners. At first, this chain displaced the researchers, who could not even talk to the woman and decided to put their conclusions in 'stand by'. But days later, the case of a 20-year-old Chinese woman (positive without symptoms) who infected five relatives eventually supported this theory.
The case of Iran, a very closed regime with little history of transparency in public crises is especially representative. The nonsense between their official number of infected with coronavirus and the real one deserves a separate chapter. As in China, the only sure thing we have – and with nuances – is the number of confirmed deaths: 54, the second place in the world with more deaths after the 'outlier' of Hubei.
This number, however, is also disputed. The BBC published last Friday a real estimate, based on hospital sources, of 210 victims
On February 19, in Qom, the holy city for Shiite Islam and a pilgrimage center, the first two infections were reported: two people with no history of having traveled to China or contact with Chinese citizens. Just five hours later, they had died. This lack of liaison with China has caused, as admitted by the Iranian authorities themselves, a delay in diagnosing the coronavirus. The lack of a chain of clear contagion from China to Iran in these first two cases would imply, for example, that these two people are not the 'zero patient' of the epidemic in Iran. And the rapidity of disease progression in these two patients, which they died in just a few hours after being informed of the infection, It implies that the virus was detected very late: they had almost two weeks to infect their environment.
Just two days later, the country held parliamentary elections, while the number of infected and dead – offered by the authorities – remained stable. Affirming that the outbreak was "under control", the Iranian government encouraged the population to go out to vote even in Qom, where almost all those infected were concentrated and without finding the 'zero patient' who started the infection. Politically, they needed elections with strong participation. Only one day after the polls closed, on Monday 24, deaths rose sharply to 12 and those infected to 61, making Iran in just a few hours the deadliest focus of the coronavirus outside of China (percent, the death rate would be then 20%). In front of the official figures, local authorities in Qom claimed that the dead were already at 50, a number almost at the level of the official contagions declared.
To date, Iran has already admitted 978 infected (compared to 254 admitted on Friday, a rise of almost 400 in 24 hours) and 54 dead. Among those infected there are even high positions of the Iranian political apparatus, from a vice president – who the day before announcing the contagion had held a cabinet meeting in which the president himself, Hasan Rohaní was present – to the vice minister of health or to the former ambassador to the Vatican, which finally passed away.
The Persian country outperforms any other Chinese region or country in the world, but its 'official' number of those affected was on Friday, 338. Far below Italy or South Korea. Does the coronavirus in Iran have an excessive mortality? No, rather an alarming cover-up exercise of new cases.
A 'pre-print' —study not subject to peer review— appeared these days and elaborated in Canada was trying to alleviate that official silence by calculating in what figures those infected in Iran may be moving. His initial data spoke of 18,300, then updated to 23,070.
They can be even more. The study calculates an arc of victims that exceeds 50,000 infected people, but government measures remain incomplete, that is, totally ineffective in stopping an epidemic.
In the sanctuaries, as a sign of religious fervor, pilgrims rest their faces on the windows that surround the mausoleums. Despite the measures Iran has taken – closing schools or canceling Friday's prayer – sanctuaries such as Fatima's in Qom, sister of Shia Imam Reza, remain open. Theological center city of Shia Islam, where Ayatollah Khamenei lived, receives students from all over the world, including Chinese citizens.
Iran has, in fact, become a source of contagion in the region. At least eleven countries have reported more than 90 cases of coronavirus in people who had recently traveled to Iran: Kuwait (43), Bahrain (33), Iraq (6), Oman (2), Pakistan (2), Afghanistan (1), Canada (1), Estonia (1), Georgia (1), Lebanon (1) and even Spain, in Valladolid.
Entering numbers …
European countries are, in that sense, the most reliable for assessing the real morbidity or mortality of this new disease. However, this week Italy has also decided to change its counting system. Will start with exclude, like China, people without symptoms (although they may be suspicious by proximity) of the diagnostic tests in the hope that this will result in a drastic reduction in the number of infected people.
A separate chapter deserves those countries that have not reported cases: in North Korea for its isolationism may be understandableBut can anyone believe that Indonesia, the fourth most populous country in the world and with constant connection with China, has not yet declared a single case? Equally unlikely (according to a study done in this regard) are the figures from other countries in Southeast Asia such as Cambodia, which has only declared one case of Covid-19.
In the United States, after their second unimported case, experts ask how much will be the bag of patients not detected in the country. In total, 66 cases have been declared, but they have performed only 445 tests to confirm the coronavirus. South Korea, the second country in the world with more cases, is testing 10,000 people a day.
Everything – science, statistics, common sense – suggests that the number of people infected by Covid-19 in China and the rest of the world far exceeds those 83,074 people. This is bad news, in the sense that all those messages about efforts to control the epidemic can be useless.
But it is also good news, because if we carry the same 2,977 dead with probably double or triple infected people, it means that the virus is much less lethal of what the international medical community feared at first.