A recent spike in respiratory illnesses in China and a request from the World Health Organization (WHO) for more information may give some people an uneasy sense of deja vu. Almost four years ago, undiagnosed clusters of respiratory illness were one of the earliest signs of what would become an unprecedented global pandemic that shuttered economies and devastated health systems. Fast forward to last week, the WHO said it was aware of media reports of cases of undiagnosed pneumonia in children’s hospitals in Beijing and other areas of the country. It cited a warning from ProMed, a global outbreak surveillance system, that included some haunting similarities to one of the first notices it ever sent about SARS-COV-2. “Undiagnosed pneumonia — China: (Beijing, Lainong) children, reported epidemic, request for information,” ProMED said on November 22. Loading… Vision on state run news inside China has shown hundreds of people seated in the waiting room of a hospital in Nanjing, in China’s eastern Jiangsu province, with IV drips hanging from the ceiling. In another story, director of the outpatient department of Beijing Children’s Hospital Li Yuchuan is quoted as saying the internal medicine department was receiving 7,000 patients a day, far beyond hospital capacity. After monitoring media reports, the WHO requested more information to identify “whether these were separate events, or part of the known general increase in respiratory illnesses in the community”. WHO’s query and the public nature of the request was “a little unusual”, but “not surprising”, according to Christine Jenkins, a professor of medicine at the University of New South Wales. “When infections like these, such as [when the] first SARS occurred and subsequently when [SARS-CoV-2] occurred in China, initially it was exceptionally difficult to get information,” she said. “I think the WHO is taking a much more proactive approach to surveillance.” China had 24 hours to respond. Health authorities from the Chinese Center for Disease Control and Prevention (CDC) and the Beijing Children’s Hospital provided WHO with data indicating there “has been no detection of any unusual or novel pathogens or unusual clinical presentations”. A mysterious respiratory illness does not appear to be spreading around China, but a combination of pathogens, the lifting of restrictions and the onset of winter may all be fuelling a surge in sickness. Scientists say the situation warrants close monitoring and are “alert, but not alarmed”. China says multiple pathogens are circulating A post by the Beijing Friendship Hospital service earlier this month said the number of children attending the hospital was rising, reaching up to 1,800 daily outpatient and emergency patients across two districts. WHO said it had been advised by Chinese authorities that “the rise in respiratory illness has not resulted in patient loads exceeding hospital capacities”. As part of its response to the WHO, Chinese officials provided data, which included laboratory results from infected children, that indicated the clusters were due to multiple known pathogens. These included the flu, adenovirus, RSV and mycoplasma pneumoniae, a common bacterium that usually causes mild illness. Outpatient consultations and hospital admissions for children with mycoplasma pneumoniae had increased in China since May, according to the data provided to WHO. Known viruses such as RSV and the flu had begun circulating in October. Mycoplasma pneumonia and RSV are both known to affect children more than adults, which may explain the spike in younger patients. An explanation on the clusters provided to China’s government-run news outlet, The Global Times by Zhang Wenhong — a Shanghai infectious diseases doctor who is sometimes referred to as China’s Anthony Fauci — indicated the rise in infections was due to a reduction in public safety measures post-COVID-19. “Zhang explained the reason for prevalent respiratory illness infection is because various protective measures such as wearing masks and staying at home in the past years have greatly reduced the incidence of diseases,” the paper reported. Chinese officials say they did not detect any “unusual or novel diseases” in the country, the World Health Organization said.(AP: Ng Han Guan) The article went on to detail how the low incidence of diseases has “led to a decrease in the body’s pre-existing antibodies”. “The doctor noted that this winter, the incidence of respiratory infectious diseases will increase, but China still has the right tools to combat the rise in cases,” it said. Zhang also said the country had “sufficient technical expertise [and] public health resources” to deal with the current outbreak. In an effort to keep track of spreading cases, China’s National Health Commission spokesperson Mi Feng has called on local authorities to expand the number of relevant clinics and extend opening hours. Since mid-October, Chinese authorities have stressed the need to strengthen the capacity of the health system to manage patients, according to WHO, in addition to enhancing disease surveillance in health care facilities and community settings. “WHO is closely monitoring the situation and is in close contact with national authorities in China,” WHO said. Health experts are ‘alert but not alarmed’ Since the global pandemic sparked an increase in public health messaging designed to keep people safe, citizens around the world are on higher alert to the spread of viruses and illnesses. Increased hospital admissions and requests for more information can be alarming, but are an important part of keeping people alert and informed. “There’s just a huge potential increased risk if there is a serious pathogen that we don’t understand and don’t know how to treat,” Professor Jenkins said. “So I think transparency, openness, rapid communication and very rapid scientific response and medical response is what’s required.” China has pointed to the lifting of restrictions as one factor behind the rise in infections, a post-pandemic experience replicated in other countries around the world last year once governments began unwinding public health measures. Last winter, China was still pursuing a COVID-zero strategy and implementing strict lockdowns when cases were identified.(Reuters via China Daily) In one Australian study, scientists noted how non-pharmaceutical interventions and travel restrictions for controlling COVID-19 had “impacted the circulation of
