Internationally lost COVID 19 cases
Abstract Background With its epicenter in Wuhan, China, the COVID 19 outbreak was declared a pandemic by the World Health Organization (WHO) While many countries have implemented flight restrictions to China, an increasing number of cases with or without travel background to China are confirmed daily. These developments support concerns on possible unidentified and unreported international COVID 19 cases, which could lead to new local disease epicenters. Methods We have analyzed all available data on the development of international COVID 19 cases from January 20th, 2020 until February 18th, 2020. COVID 19 cases with and without travel history to China were divided into cohorts according to the Healthcare Access and Quality Index (HAQ Index) of each country. Chi square and Post hoc testing were performed. Results While COVID 19 cases with travel history to China seem to peak for each HAQ cohort, the number of non travel related COVID 19 cases seem to continuously increase in the HAQ cohort of countries with higher medical standards. Further analyses demonstrate a significantly lower proportion of reported COVID 19 cases without travel history to China in countries with lower HAQ (HAQ I vs. HAQ II, posthoc p 0.01) Conclusions Our data indicate that countries with lower HAQ index may either underreport COVID 19 cases or are unable to adequately detect them. Although our data may be incomplete and must be interpreted with caution, inconsistencies in reporting COVID 19 cases is a serious problem which might sabotage efforts to contain the virus.
Journal of Microbiology, Immunology and Infection