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China Medicine

Some Recovered Coronavirus Patients In Wuhan Are Testing Positive Again (npr.org) 206

NPR is reporting that some Wuhan residents in China who had tested positive earlier and then recovered from the disease are testing positive for the virus a second time. It's raising concerns of a possible second wave of cases, as China prepares to lift quarantine measures to allow residents to leave the epicenter of its outbreak next month. From the report: Based on data from several quarantine facilities in the city, which house patients for further observation after their discharge from hospitals, about 5%-10% of patients pronounced "recovered" have tested positive again. Some of those who retested positive appear to be asymptomatic carriers -- those who carry the virus and are possibly infectious but do not exhibit any of the illness's associated symptoms -- suggesting that the outbreak in Wuhan is not close to being over.

NPR has spoken by phone or exchanged text messages with four individuals in Wuhan who are part of this group of individuals testing positive a second time in March. All four said they had been sickened with the virus and tested positive, then were released from medical care in recent weeks after their condition improved and they tested negative. One of the Wuhan residents who spoke to NPR exhibited severe symptoms during their first round of illness and was eventually hospitalized. The second resident displayed only mild symptoms at first and was quarantined in one of more than a dozen makeshift treatment centers erected in Wuhan during the peak of the outbreak. But when both were tested a second time for the coronavirus on Sunday, March 22, as a precondition for seeking medical care for unrelated health issues, they tested positive for the coronavirus even though they exhibited none of the typical symptoms, such as a fever or dry cough. The time from their recovery and release to the retest ranged from a few days to a few weeks.
One theory is that they were first given a false negative test result. Another theory is that, because the test amplifies tiny bits of DNA, residual virus from the initial infection could have falsely resulted in that second positive reading.
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Some Recovered Coronavirus Patients In Wuhan Are Testing Positive Again

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  • by timeOday ( 582209 ) on Friday March 27, 2020 @07:12PM (#59880310)
    This whole debate around the "true" case fatality rate - which depends so heavily on the number of asymptomatic 'cases' - is really making me question what it means to "have" a disease. Does testing positive - using this particular test - definitely mean you are contagious? Does it definitely mean you will have symptoms if left untreated? Does it mean your immune system is mounting a response? If nothing else you could have some virions in your nose and not go on to be infected. As the summary concludes, maybe the test is just too sensitive.
    • by lgw ( 121541 )

      This is complicated by the fact that we can't trust a single thing the Chinese government says. Does anyone really believe their number of infected people stopped rising a week ago? Right after foreign press were expelled from China? All their numbers are BS until proven otherwise.

      Is this re-infection a real thing? Could be, though we've mainly heard about it from China, it's at least a medically possible thing. Or is China looking for a way to fudge their numbers. As always, we'll have to look to Ita

      • by mrclevesque ( 1413593 ) on Friday March 27, 2020 @08:27PM (#59880558)

        "Does anyone really believe their number of infected people stopped rising a week ago? Right after foreign press were expelled from China?"

        Hardly all foreign press:

        "Its foreign ministry ordered reporters from the New York Times, the Washington Post and the Wall Street Journal to return media passes within 10 days. The papers criticised the move, which will affect at least 13 reporters."

        "Beijing has said that the expulsions were a response to the Trump administration’s decision to limit the number of Chinese citizens from five state-controlled media outlets who could work in the United States to 100"

      • The tests they are exporting for goodwill (=PR) purposes have a 70-80% failure rate. If that's anything to go on, these tests aren't characterized by sensitivity and specificity but rather two other things: jack and shit. and jack is having his organs removed for practicing falun gong.

        On top of that, yes, it could all be lies too.

      • This is complicated by the fact that we can't trust a single thing the Chinese government says.

        There is some truth to that in general. Definitely it was very true in the past.

        But now, once we got past the local Wuhan officials going into denial and hiding the problem, China has been one of the most reliable sources of information and advice we've had for covid-19. Without their sequencing data in particular testing would have been delayed. Their rapid scientific publishing of their experiences exemplary, their successful handling of the crisis a beacon of hope we can all look to.

        On the other hand, have you tried listening to the advice coming from the leader of the USA and his state departments? Pure, unadulterated bullshit. And I am using the technical definition of bullshit - it's not an attempt to lie, it's total disinterest in the truth. The bullshitter says whatever he thinks advances his interests at the time - whether it's true or not is irrelevant. In this case that means the truth about whether it will kill 100k or 10M fellow US citizens is irrelevant.

        For covid-19, there as been a complete inversion. China is one of the best sources of information, and US government one of the worst in the world if not the worst. I don't know how that has been perceived in the USA, but for the rest of us it's been gob smacking, disorienting, and a wake up call.

        • China does not report positive infected people that are asymptomatic.

          That right there, throws out all fatality rate numbers from them or as a whole.

          • China does not report positive infected people that are asymptomatic.
            You are an idiot.
            a) how would you know that?
            b) why would they?

            • by lgw ( 121541 )

              This is China. The burden of proof is on you if you assert they're not lying.

              Obviously, more sick people in China makes China look bad. Winnie the Pooh doesn't want to look bad. That's all that's needed.

              • This is China. The burden of proof is on you if you assert they're not lying.
                No it is not. The burden of proof is on the person who makes a claim.
                You think they are lying, so proof it.

              • by Admiral Krunch ( 6177530 ) on Saturday March 28, 2020 @03:31AM (#59881278)

                Simple logic ought to be enough.
                If China doesn't have it under control they would be suffering worse than Spain, Italy and the US.
                Their rate of deaths would be absolutely enormous by now. Way too big to hide. And every Chinese city would look like Wuhan did.

                A billion camera phones, where are all the pics?
                There are a huge number of people just like you who would love to show how bad it was. Why haven't any of them?

                It's very hard to prove they are telling the truth.
                But it should be quite easy to prove that they are lying on such a massive scale if they were.

                • "And every Chinese city would look like Wuhan did.

                  A billion camera phones, where are all the pics?"

                  The pictures are all in Chinese, you wouldn't understand them.

                • Simple logic ought to be enough.
                  If China doesn't have it under control they would be suffering worse than Spain, Italy and the US.
                  Their rate of deaths would be absolutely enormous by now. Way too big to hide. And every Chinese city would look like Wuhan did.

                  Well let's run through this one at a time. There's plenty of independent reports showing that there's ~45k urns waiting for pickup just in Wuhan. The normal of normal deaths per month is between 5k and 10k. By the big China telecom companies, there are between 10m-21m fewer customers on their networks today, and the numbers aren't increasing if "things are back to normal." Remember, in China your cell is pretty much required for everything.

                  A billion camera phones, where are all the pics?
                  There are a huge number of people just like you who would love to show how bad it was. Why haven't any of them?

                  That one is far easier. You heard about the riots yesterday in Wuhan and Hubei right? As fast as people were posting them on various chinese social media, the state censors were deleting them. A week prior there was another riot. Two weeks before that there were mass public protests. But you didn't hear about 2 of 3 of those events, but I'm sure you heard about the food being delivered in dirty garbage trucks. Why? It suits the politburo, and makes the local officials look bad - aka easier to get rid of them. Remember China's internet isn't. It's an intranet, which is heavily filtered to extremely limited internet.

                  It's very hard to prove they are telling the truth.
                  But it should be quite easy to prove that they are lying on such a massive scale if they were.

                  Well you don't send 40 incinerators to a single city if you're only dealing with medical waste either, but we know it happened. Their state media even promoted it. We also know that despite the claims that "everything is normal" pollution data shows otherwise, China is still 80-90% shutdown in a "everything is now normal" state.

            • I'm an idiot?

              Did you even... google it?

              Found it here: https://www.npr.org/sections/g... [npr.org]
              Quote in the article: "I have no idea why the authorities choose not to count [asymptomatic] cases in the official case count. I am baffled,"

              They do not count, infected people that are asymptomatic.
              With a little bit of googling, you'll see this mentioned multiple times.
              I found one as early as Feb. 20. But stopped digging there, might be mentions of this earlier as well.

              • Yes, you are an idiot.
                Because you claim things no one can know ...
                Simple.

                Why you believe such a stupid link is beyond me.
                If they had uncounted asymptomatic cases, their death rate would look superb!!! Because instead of something close to 5% it would be somewhere around 0.1% ... or even less. Surprisingly Italy has 50% death rate for people older than 70, and USA has an overall death rate of 65% ... why the funk would China hide asymptomatic cases??????????? Are you retarded?

                If China would claim it has 100

          • by ras ( 84108 )

            how would you know that?

            He knows that because a Chinese newspaper reported it: A third of coronavirus cases may be ‘silent carriers’, classified Chinese data suggests [scmp.com].

            But notice the contradiction: the Chinese effectively self reported it via their newspapers. You could go all conspiratorial about it, or you can look around and notice everyone has a different way of reporting the figures. Where I live, Australia, the state of NSW does the best job of reporting the data. I have no idea how many

          • China does not report positive infected people that are asymptomatic.

            That right there, throws out all fatality rate numbers from them or as a whole.

            ~cbeaudry

            The rate as measured in China is insignificant to the losses of human life in Italy (9x that of Wuhan) and Spain (approaching twice).

            Why do you ignore Italy and Spain's metaphorical forest to speculate about a Tree in Beijing? Is it to believe you're doing something to protect your investments?

            This thread is about indicators of COVID-19's pesistence. What are you contributing exactly?

        • Re: (Score:3, Informative)

          by Anonymous Coward

          And I am using the technical definition of bullshit - it's not an attempt to lie, it's total disinterest in the truth. The bullshitter says whatever he thinks advances his interests at the time - whether it's true or not is irrelevant. .... I don't know how that has been perceived in the USA, but for the rest of us it's been gob smacking, disorienting, and a wake up call.

          A lot of us see it. We saw it before he was elected. He spits out whatever will get a positive reaction, and if questioned about any uncomfortable details, just handwaves it away.

          That pattern has been constant through his whole presidency. There hasn't been a wake up call for me, or many people I know, because this isn't anything new. Anything he says has zero basis in reality. If it happens to be true, it's only because it happened to benefit him.

          It's immediately apparent to many of us, but it's becom

    • The true numbers of who was infected will come out if they start a wide screen for antibodies. If you were actually infected you'll have antibodies whether you were symptomatic or not. Unfortunately, the bean counters will likely come up with a good reason not to spend the money on a screen for antibodies to collect just such data.

    • Generally speaking, having a contagious infection means it's living in you, and you're likely spreading it. Though yes, a sensitive enough test could detect a viral load that your body is already eradicating and would never reach the contagious stage. On the other hand, there's not really any way to know that except to allow it to run its course. It only takes a single virus and a bit of bad luck to establish an infection - viruses breed fast enough to make bacteria look celibate in comparison (typically

      • Generally speaking, ...Like any parasite - killing your host is counterproductive.

        ~Immerman

        How do all three hypotheses virus-first, escape, and reduction support your claim?

        • They're largely irrelevant. How viruses started has little to do with the parasitic niche they've evolved into.

          Parasitic behavior shares a large number of traits across wildly different species - and one of the really common themes is that killing your host, directly or indirectly, is a bad thing. Even humans have incorporated the lesson into our cultures "Don't kill the goose that lays the golden eggs" as one manifestation.

  • Rebound (Score:5, Informative)

    by phalse phace ( 454635 ) on Friday March 27, 2020 @07:15PM (#59880322)

    Dr. Fauci said yesterday that this (a rebound) might happen, and if it didn't rebound it would cycle into the next season.

    https://www.youtube.com/watch?v=ZrWAqpPGAxQ

  • Most likely explanation is that one of the tests was a false positive.
    • by djinn6 ( 1868030 )

      I would imagine that when you see it come back positive, indicating a potential reinfection, you'd run a second test to make sure of it before you announce it to the whole world.

      • That would be a rigorous scientific thing to do, but these reports are not rigorous. The article gives no indication that they did that.
  • by eclectro ( 227083 ) on Friday March 27, 2020 @07:27PM (#59880366)

    Researches have done a test on a handful of monkeys. They infected the monkeys with Covid19 and then they ran a bunch of tests on the monkeys. One of them had some negative tests. They examined the monkey and they found that he continually had the virus I.e. with a test that is wrong 30% of the time some false negatives will pop up at some point. All monkeys had all signs of the virus expelled from their immune system 28 days later.

    Even with a test that is 85% accurate, when you test thousands of people you are going to have a significant number of false negative tests.

    • There is no such thing as a perfect test. EVERY test will either have a nonzero false positive rate or a nonzero false negative rate. The trick is to design the test so that it give you USEFUL false results.

      For a screening test, you want NO false negatives, which means you are willing to accept a certain false positive rate. Those false positives are just notifications that you need to take a closer look at this patient, using a different test or set of tests.

      The concept is similar to constant false alar

  • I don't know how these tests work, but I thought if you recovered you would always test positive from then on.
    • There are two types of tests, one test for the presence of Virus RNA (RT-PCR) and once you no longer have any virus in your body this test will immediately give a negative answer. The other test (that is fairly uncommon as of yet) is to test for the presence of antibodies aka you draw blood from the patient and mix that with the actual virus in a testtube and see if the blood reacts to the virus, it's AFAIK still unknown how long after you been recovered that this later test will show positive but at some t
  • It was fortunate that even UK backed off from the stupidity of trying to get through with "herd immunity".

  • leadership (Score:4, Informative)

    by BlindWillieMcTell ( 5553362 ) on Friday March 27, 2020 @07:45PM (#59880426)

    FEB 25

    “You may ask about the coronavirus, which is very well under control in our country. We have very few people with it, and the people that have it are getting better. They’re all getting better. As far as what we’re doing with the new virus, I think that we’re doing a great job.”
    — Donald Trump

    https://www.whitehouse.gov/bri... [whitehouse.gov]

  • Comment removed based on user account deletion
    • This thing has a high Mutation Rate; already known and they are tracking many variations of it not the two mentioned a month ago. Not to say that it'll be as deadly but you'll get this thing's decendants multiple times over the span of your life; vaccine or not. It's the flu, they never stop it for long and as every expect said forever, a bad variation will happen someday. This isn't the worst it can be either.

      We should have spent more $ developing generic solutions to all flu instead of all this BS we wa

      • Another fearmonger who just conveniently forgot to provide any links...
        It mutates slower than flu [npr.org]

        So far, researchers who are tracking the genetic changes in SARS-CoV-2 — the official name for the coronavirus — say it seems relatively stable. It acquires about two mutations a month during this process of spread, Harrison says — about one-third to one-half the rate of the flu.

  • Will wait for more thorough vetting of these topics. Slashdot better for tech discussions, seems more Engineers then infectious disease experts. So where is the discussion on ramping up the PPE supply? For instance, a billion $ for how many ventilators, how quick? Medical suits, showers, etc...
  • by LynnwoodRooster ( 966895 ) on Friday March 27, 2020 @08:23PM (#59880550) Journal
    Were those "recovered" people really recovered in the first place, or "deemed" recovered since there are always Government targets and quotas to meet for any issue. You need 80% recovered? Don't be surprised that 80% are considered recovered, whether they were or not.
  • by hey! ( 33014 ) on Saturday March 28, 2020 @06:34AM (#59881536) Homepage Journal

    require two successive negative PCR tests. The test can give a false negative in rare instances, for example if the swab is not properly administered or the sample mishandled or the test bungled.

    There may be other rare things going on, like reinfections, or false positive tests due to sample contamination, but a 5% false negative rate under the conditions testing was being conducted in Wuhan at the height of the outbreak would not be surprising.

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