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Paradigm Shift Intervention Monitoring
Confirmed In KSA
Further to its previous statements and within the framework of the continuous monitoring and epidemiological surveillance of Coronavirus, MOH would like to point out that two new confirmed cases of Coronavirus have been detected among health practitioners in the Eastern Region, and they are currently still under the medical observation receiving the proper treatment.
The above comments from the Kingdom of Saudi Arabia Ministry of Health website on MERS-CoV cite the confirmation of two health care workers in the eastern region of KSA (see map). Some media reports have said they were nurses, but more detail on location, age, gender, and disease onset dates has not been released.
However, such SARS-like infections are not unexpected. As seen in the above graphic, the number of confirmed MERS-CoV cases has been increased to 30, which includes 21 recent cases in the eastern region (see map). However, media reports have cited many additional coronavirus cases not included in the above tally, including two recent deaths of younger residents (9F and 21M), who were cited at a press conference. The age and gender of the youngest matches the case cited on May 5. Classmates have also developed symptoms, suggesting community transmission, which is supported by multiple media reports describing additional student infections, as well as school closures due to MERS-CoV.
The explosion of hospitalized cases has created a testing backlog. Multiple media reports cited testing of 30 new cases, including four each in Qatif (Qatif Central Hospital – see map) and Dahran (Aramco Hospital – see map). Many, or all, of the recently described cases appear to be transfers from Al Moosa or King Saud hospital in Al Hofuf (see map), where one wing may be closed because of MERS-CoV spread within the hospital(s). This spread may account for the two health care workers cited above.
The explosion of cases within multiple hospitals in Al Hofuf, as well as deaths of children and closing of schools, signals significant human to human transmission in hospitals and schools, raising concerns that the number of serious cases is much higher than the 30 confirmed cases cited above, and milder cases which are either not tested or generate false negatives.
Media reports indicate samples from 560 suspect cases have been test this month alone, raising concerns that many cases are producing fakse negatives and are not being reported.
WHO has recently visited KSA and reported no sustained community transmission. The recent explosion of confirmed, probable, and suspect MERS-CoV cases do not support the WHO or KSA statements on transmission.