So, how many people have the new coronavirus? We don't know.
Or, at least, we're not sure we know.
China's been playing politics. And that could be a problem.
The number of cases of the Wuhan coronavirus, now named Covid-19 by the World Health Organisation (WHO), has just surged dramatically.
That's despite Beijing insisting the number of new cases has been slowing down.
Now, Chinese officials have suddenly changed how they define and calculate the number of infected. Yesterday, the official figure in Hubei Province – a hotbed of the outbreak – leapt by some 15,000 cases. Similarly, the total of the dead suddenly jumped by 242.
That's an overnight increase of almost one-third.
And that raises questions about the reliability of outbreak reporting.
For weeks there have been unconfirmed stories of hospitals being overwhelmed by sufferers and dead being left in the streets. But Beijing insisted its unprecedented lockdown of infected cities and provinces was working.
Now, state-controlled media has suddenly shifted its generally optimistic tone to one of admonition: "Leaving no one unattended is the key to controlling the NCP outbreak. How come there were no Party members or officials accompanying the patients in severe condition Such behaviour is unforgivable," The China Daily quotes deputy secretary-general of the State Council Gao Yu as saying.
Just hours later, many key provincial Communist Party officials were unceremoniously axed.
IT DOESN'T ADD UP
Over the past week, the number of new cases of Covid-19 reported in China suggested the outbreak was slowing. Were Beijing's draconian containment methods working?
Apparently not.
The Hubei health commission announced yesterday that diagnostic kits were in short supply, limiting the official tally of infected. And the RNA test kits had also proven to be unreliable.
This has had a severe fallout on China's bureaucratic health system. Even those obviously presenting symptoms are not being admitted to hospital or given treatment without the prerequisite diagnosis.
So, now, patients suffering pneumonia-like symptoms are being given a CT scan instead. Suddenly, the number of those found to be infected has skyrocketed.
After weeks of attempting to suppress growing public uproar, Beijing appears to have shifted course. At least a bit.
"We've received more than 200 complaints about Hongshan failing to admit all people who need help to medical institutions. What does this say about your efforts?" state-run Xinhua news agency quoted a Beijing-based official as saying.
President Xi Jinping himself made an unusually rare public appearance earlier this week, calling for "more resolute measures" to contain the epidemic. He insisted that an "all-out effort" should be made to treat every patient.
The Hubei admission, however, raises new questions.
Will other Chinese provinces also revise their numbers?
Have international health authorities been misled about the new virus' characteristics?
What is the real rate of Covid-19 infection?
RUBBERY FIGURES
International concern remains over the reliability of the data coming out of China.
The numbers have serious implications.
Are the demographic details of the infected accurate? Are children mostly unaffected, as China's figures indicate? Which sectors of the population are the most vulnerable?
It's long been suspected that a large number of patients have not been officially diagnosed.
Now, that's being blamed on local officials.
"It's a long political tradition to blame local officials, to direct the people's anger toward local officials and not to the top leadership," Chinese politics expert Willy Lam at the Chinese University of Hong Kong told Reuters.
But Hubei Province wasn't the only province to suffer the wrath of the Communist Party Politbureau. Wuhan's party chief, Ma Guoqiang, has been purged as has the head of Hong Kong and Macau Affairs, Zhang Xiaoming.
Does this mean their accounting has been off, too?
Chinese politics lecturer at the University of California San Diego Victor Shih told Reuters the revised figures proved China had been keeping "two sets of numbers for confirmed infected all along".
"If that were not the case, the government could not have added so many new cases in one day," he said.
HOLDING THE PARTY LINE
Fears that China's centralised Communist government would succumb to the temptation of covering up the outbreak flared as soon as news of the new virus arose in late December.
It's done it before.
Beijing had initially tried to hide the full extent of the deadly SARS virus during the 2003 outbreak. Ultimately it produced 774 deaths – a number already far surpassed by Covid-19.
It also has a track record of attempting to conceal the impact of other natural disasters, including floods and earthquakes.
"China continues to struggle with transparency, and, in the absence of data, the international community is implementing a variety of inconsistent policies," Raphael Veit wrote for the Australian Strategic Policy Institute (ASPI).
"Put simply, we can't be sure whether China is using a sledgehammer to crack a nut, or whether this new coronavirus presents a serious international threat."
The Chinese Communist Party (CCP) has repeatedly attempted to dispel such fears.
In January, Foreign Ministry spokesperson Geng Shuang insisted China had been "acting with openness, transparency and a high sense of responsibility towards global health security".
Now, world health experts still have little idea of the true nature of the virus.
"This outbreak could still go in any direction," director-general of the World Health Organization Dr Tedros Adhanom Ghebreyesus said on Wednesday.
Now, the chances of it going the wrong direction seem even higher.
GOING VIRAL
Mr Xi has put his best – and most loyal – men on the job.
Leading them is Chen Yixin, Mr Xi's protégé. He's been given responsibility for containing the outbreak, along with Premier Li Keqiang.
"Chen is supposed to be the guy with the emperor's sword," political scientist Chen Daoyin told the South China Morning Post.
"He is expected to help restore discipline for the party and government, to oversee law and policy enforcement and control consensus, as well as co-ordinating relief efforts across the provinces."
Mr Chen's appointment comes hot on the heels of the death of popular doctor Li Wenliang.
He had been reprimanded by police and the Communist Party for trying to warn health officials in December of the SARS-like nature of the virus outbreak. Despite attempts to stigmatise and punish him, Dr Li quickly became a hero to China's quarantined populace.
Now, the move to accept CT scan results follows an outspoken appeal by a female doctor in Wuhan asking them to be used to speed up the isolation of patients.
She also said she was running out of diagnosis kits.
THE EMPEROR'S SWORD
Mr Chen arrived in Wuhan earlier this week, tasked with tackling the outbreak – and civil unrest. One of his highest priority tasks is to impose strict new controls on local and social media.
He is ideally qualified for the job: He is secretary-general of the Central Political and Legal Affairs Commission … a Communist Party law enforcement agency.
Among his credentials is the seizure of crucifixes and closure of Christian churches in the city of Wenzhou in 2014. But he's also spent time in Wuhan as its party secretary and as Hubei Province's deputy party secretary.
Political commentator Hu Xingdou told the South China Morning Post that Mr Chen's appointment was the result of "government dysfunction and social disorder".
"It will help improve the situation, by (Mr Chen) directly telling local officials what to do and watching them do it," he said.
He also presents Mr Xi with a potential fall-guy. State media has recently stopped depicting Mr Xi as personally co-ordinating the coronavirus response. Now, he's just part of a "collective" decision making process.
KNOWN UNKNOWNS
Even as Covid-19 numbers soar, there is still much we don't know about its potential impact.
"There are many known unknowns, and not yet enough useful indicators, to properly judge how dangerous this virus is," the ASPI essay reads. "For example, beyond the elderly and those with pre-existing medical conditions, how many are getting infected and dying? A useful measure of the severity of the virus might be statistics of medical personnel and first responders who have fallen ill and died."
Deconstructing a new virus isn't easy.
Statistics only become evident – and reliable – as the numbers grow.
And it takes months to isolate, contain and grow samples.
Professor of epidemiology at Imperial College London Neil Ferguson says in a video released by the university that only the most severe cases were likely being diagnosed.
That meant as few as 10 per cent of cases were likely being detected, he said.
In the case of Wuhan, Professor Ferguson believes that figure is as low as one out of every 19 infected being diagnosed.
It's a fear that has been expressed on the ground in Wuhan.
NUMBERS GAME
Communist Party medical adviser Tong Chaohui told local state media that the official test kits produced positive results just 20-30 per cent of the time. Hospital facilities were recording a 50 per cent rate, he added, but admitted field kits could return results as low as in 10 per cent of cases.
"The testing kits are not very accurate, so we need to do multiple tests," one anonymous coronavirus researcher said.
Part of the problem is the broad range of symptoms the virus elicits.
Some have only very mild symptoms. Others suffer acute pneumonia.
And it can take up to 14 days for an infection to express itself, causing carriers to be missed by medical scans.
So far, estimations of the rate of death remain steady at about 2.1 to 2.2 per cent.
Wuhan is reporting the worst rate – 5 per cent – but that may have been due to it not reporting less severe cases.
"For the vast majority of people it will just be a mild illness but still treat it with respect," said Dale Fisher, chair of the Global Outbreak Alert & Response Network that is co-ordinated by the World Health Organisation.
Jamie Seidel is a freelance writer | @JamieSeidel
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