New Coronavirus Cases in China Reveal the Difficulties in Diagnosing the Disease

People are waiting for medical attention at Wuhan Red Cross Hospital in Wuhan, China on Jan. 25, 2020. Hector Retamal/AFP via Getty Images

Chinese media recently reported two coronavirus cases that reveal the challenges in detecting infections among patients who may not exhibit symptoms for several weeks after initial exposure to the virus.

The 2019 Novel Coronavirus (2019-nCov) first broke out in Wuhan, located in central China’s Hubei Province, in early December 2019. At least tens of thousands have been infected within China, with over 900 deaths, though experts say the true numbers are likely higher.

New cases in China show the difficulties in diagnosing patients and preventing patients from spreading it further.

Conflicting Diagnoses

On Feb. 9, the government of Meihekou City in the northeastern province of Jilin issued a public notice explaining an unusual coronavirus case.

Meihekou has a population of roughly 600,000 and is more than 1,250 miles north of the coronavirus epicenter Wuhan.

An unnamed female patient returned to the northern city on Jan. 23 after visiting Wuhan.

On Jan. 27, the patient began to have a fever. An initial diagnosis performed on Jan. 29 came back positive.

But a second diagnosis performed on Jan. 31 revealed that the patient was free of the coronavirus. Due to the unusual results, doctors performed four more diagnoses on her.

The four diagnoses all came back negative, but the patient presented symptoms of the coronavirus.

After analyzing the results, several doctors concluded that the patient was infected with the coronavirus.

According to the notice, the patient’s is now in stable condition, and could be released from the hospital soon.

Medical workers and security personell stand at a checkpoint as the country is hit by an outbreak of the novel coronavirus in Anqing, Anhui province, China, on Feb. 6, 2020. Thomas Peter/Reuters

No Fever At All

Chinese state-run broadcaster CCTV reported on Feb. 9 that Mr. Yi, from Shehong County within Suining City of Sichuan Province, did not develop a fever after he was infected with the coronavirus.

Yi, 35, and his five-member family live in Wuhan. He started coughing on Jan. 13.

On Jan. 16, the whole family returned to their hometown in Sichuan by train. After arriving at home, Yi and his wife Xiao began to feel unwell. They visited a clinic in their local village. Then, they visited an acupuncture clinic and a small hospital in a nearby town for better treatment.

Because both of them didn’t have a fever, doctors thought they had caught a cold and only gave them medicines to treat their coughing. Because they didn’t think they were infected with the coronavirus, they visited friends and relatives, participated in big dinners, went shopping, had meals in different restaurants, played badminton with neighbors, and so on.

Chinese officials recently confirmed that the virus can be spread through aerosol transmission, that is, when one inhales very tiny droplets in the air containing the virus.

In February, their neighbor in Sichuan, Mr. Du, began to exhibit symptoms. He was diagnosed with the coronavirus on Feb. 7. The doctors investigated and believe that Yi and Xiao are the only sources that could have transmitted the virus to Du.

That day, Yi and Xiao were placed under quarantine at a local hospital. On Feb. 8, they were diagnosed with the coronavirus. Yi’s body temperature was still normal.

A laboratory technician working on samples from people to be tested for the new coronavirus at "Fire Eye" laboratory in Wuhan, China on Feb. 6, 2020. STR/AFP via Getty Images

CT Scan Vs Nucleic Acid Detection

Currently, Chinese authorities recommend using diagnostic kits to confirm infections. Doctors would swab patients’ throats and run a nucleic acid test to determine whether the genetic sequence in the sample contains the virus’s sequence.

But since Feb. 3, some Wuhan doctors have suggested performing CT scans of patients’ lungs as a more definitive way to diagnose.

Their reasoning is that all diagnosed patients’ lungs have ground glass opacity, meaning the organ is filled with fluid.

Furthermore, they say CT scan results can come out faster than diagnostic kits. CT scanning machines are also available in most hospitals of Wuhan.

On Feb. 7, Hubei Province began to use CT scan results as a standard to identify confirmed infections, though some experts disagree and say that CT scans can only determine that there is viral pneumonia, but not the coronavirus that caused it.