As China relaxes its strict zero-COVID policy, with mass testing no longer obligatory, it has grown more difficult to gauge the true number of cases
As the Virus Surges, China Cuts Back on Reporting COVID-19 Case NumbersCFOTO/Future Publishing/Getty ImagesBEIJING — China’s National Health Commission scaled down its daily COVID-19 report starting Wednesday in response to a sharp decline in PCR testing since the government eased antivirus measures after daily cases hit record highs.
A Beijing resident surnamed Zhu said they developed a sore throat and a fever, but wasn’t able to confirm whether they had the coronavirus because of a lack of antigen test kits. At the China-Japan Friendship Hospital’s fever clinic in Beijing, a dozen people waited for nucleic acid test results. Nurses in full-body white protective gear checked in patients one by one.
China’s government-supplied figures have not been independently verified and questions have been raised about whether the Communist Party has sought to minimize numbers of cases and deaths. Despite relaxed rules, restaurants were mostly closed or empty in the capital. Many businesses are having difficulty finding enough staff who haven’t gotten infected. Sanlitun, one of Beijing’s most popular shopping districts, was deserted despite having its anti-COVID-19 fences taken down in recent days.
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What is the prevalence of COVID-19 detection by PCR among deceased individuals in Lusaka, Zambia? A postmortem surveillance studyObjectives To determine the prevalence of COVID-19 postmortem setting in Lusaka, Zambia. Design A systematic, postmortem prevalence study. Setting A busy, inner-city morgue in Lusaka. Participants We sampled a random subset of all decedents who transited the University Teaching Hospital morgue. We sampled the posterior nasopharynx of decedents using quantitative PCR. Prevalence was weighted to account for age-specific enrolment strategies. Interventions Not applicable—this was an observational study. Primary outcomes Prevalence of COVID-19 detections by PCR. Results were stratified by setting (facility vs community deaths), age, demographics and geography and time. Secondary outcomes Shifts in viral variants; causal inferences based on cycle threshold values and other features; antemortem testing rates. Results From 1118 decedents enrolled between January and June 2021, COVID-19 was detected among 32.0% (358/1116). Roughly four COVID-19+ community deaths occurred for every facility death. Antemortem testing occurred for 52.6% (302/574) of facility deaths but only 1.8% (10/544) of community deaths and overall, only ~10% of COVID-19+ deaths were identified in life. During peak transmission periods, COVID-19 was detected in ~90% of all deaths. We observed three waves of transmission that peaked in July 2020, January 2021 and ~June 2021: the AE.1 lineage and the Beta and Delta variants, respectively. PCR signals were strongest among those whose deaths were deemed ‘probably due to COVID-19’, and weakest among children, with an age-dependent increase in PCR signal intensity. Conclusions COVID-19 was common among deceased individuals in Lusaka. Antemortem testing was rarely done, and almost never for community deaths. Suspicion that COVID-19 was the cause of deaths was highest for those with a respiratory syndrome and lowest for individuals |19 years. Data are available upon reasonable request.
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