Opinion | We Don’t Really Know How Many People Have Coronavirus

There were, of course, some genuine barriers to understanding what exactly was happening in Wuhan: Pneumonias are not unusual in winter, and there was no way to know that there was a novel virus. (Dr. Lipkin’s group is working on building a new test that distinguishes between different cause of viral pneumonias, with a researcher headed to China next week for testing.)

Lest Americans feel that it could never happen here, Dr. Lipkin points out that it took many months for health officials in the United States to acknowledge and recognize H.I.V. as a new virus, despite the fact that gay men were turning up at alarming rates with unusual pneumonias and skin cancers.

Scientific competition has also slowed reaction and response, experts fear — leading to the extraordinary editors’ plea in Nature. For a young researcher, a paper in Nature or the New England Journal of Medicine is gold in career currency. Scientific prestige may encourage perfecting data for peer review, but preparedness requires rapid dissemination of information.

While federal officials in the United States warn Americans to be ready for the virus, there are some important aspects of its spread about which we have little information — even though they have likely already been studied by scientists and officials, in China, in Japan and elsewhere. Scientists in various countries are presumably gathering large amounts of data day by day and the world deserves to see more of it.

“Were there patterns around infections, places, procedures? Maybe that is being collected and readied for the medical literature. But it would be hugely important to know,” said Dr. Tom Inglesby, director of the Center for Health Security of the Johns Hopkins Bloomberg School of Public Health, which studies epidemics.

For example: Of the more than 1,700 health workers who were infected in China, did those infections occur before they knew to wear protective equipment? Were they doing procedures that might lead to exposure? Those answers would quell fears about how the virus spreads and how to protect front line workers.

Likewise, there were hundreds of people who tested positive aboard the Diamond Princess cruise ship and were transferred to the hospital. But there has been little public information released about what shape they were in. How many in the cohort were really sick, how many just had minor symptoms and how many just needed isolation? Does the pattern of infection suggest a role for transmission via plumbing on the ship?


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