The homeopath Thomas Quak spread on November 28th Twitter the claim: “Every patient with pneumonia who has had contact with a person who tested positive is reported as a Covid19 case, even if he himself tested negative.” Document of the Robert Koch Institute (RKI). The tweet was distributed several times as a screenshot – via Messenger Telegram and up Facebook. However, the claim is wrong.
The posts show the tweet text and two sections from the Case definition of “Coronavirus Disease-2019” (Covid-19), which the RKI last updated in May. The original case definition is divided into six sections: “Clinical picture”, “Laboratory diagnostic evidence”, “Epidemiological confirmation”, “Case to be submitted to the RKI via the competent state authority”, “Reference definition” and “Legal basis”.
Screenshot in the tweet omits essential paragraph of the RKI document
However, the screenshot of the document that Thomas Quak distributed on Twitter was edited so that only the sections “Clinical picture” and “Case to be submitted to the RKI via the responsible state authority” can be seen. In between there was actually the information about what is necessary for laboratory diagnostic detection of the coronavirus – but this part was cut away in the picture.
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The section “Clinical picture” only defines how the disease Covid-19 can express itself clinically – pneumonia, “acute respiratory symptoms” or “illness-related death” are mentioned here.
The Original document of the RKI defines in the section “Laboratory Diagnostic Evidence” how a SARS-CoV-2 infection is to be detected. According to this, “laboratory diagnostic evidence” is a positive finding, for example through a PCR test (nucleic acid detection). Thomas Quak left out this information.
Which cases does the RKI count for the statistics?
In the screenshot on Twitter and Facebook, the section “Case to be transmitted to the RKI via the competent state authority” can be seen directly behind “Clinical image”. In the original document, the RKI defines five categories (A to E) of Covid 19 cases to be transmitted:
- Clinically diagnosed disease
- Clinically and epidemiologically confirmed disease
- Disease confirmed by clinical laboratory diagnostics
- Infection confirmed by laboratory diagnosis if the clinical picture is not fulfilled
- Infection confirmed by laboratory diagnosis with an unknown clinical picture
In Thomas Quak’s tweet, only categories A and B appear, the rest is cut off. A sentence under point “B. Disease confirmed clinically and epidemiologically ”was marked by Quak. It reads: “Specific or unspecific clinical picture of Covid-19, without laboratory diagnostic evidence, but with epidemiological confirmation (contact to a confirmed case).”
This means that cases without diagnostic evidence are also reported to the RKI. Yet it is not true that these cases are current in the statistics Case numbers of the RKI are counted.
Only laboratory-confirmed cases play a role in the statistics of the RKI’s current corona numbers
This is explained on page 2 in Original-Dokument in the “Reference definition” section. There it says that in RKI reports, which do not differentiate according to case definition categories, only cases of “Category C, D and E” are counted. According to the definition, laboratory diagnostic evidence is required for all three categories mentioned, for example a positive result in the PCR test.
Even in the daily Management reports of the RKI, attention is drawn to the fact that “the nationwide uniformly recorded data on laboratory-confirmed Covid-19 cases transmitted to the RKI” are presented.
Health authorities confirm that only laboratory-confirmed cases are counted there too
Since the data is collected by the local health authorities and forwarded to the RKI, we also asked the city of Dresden and Mannheim how the local health authorities are proceeding. Is the claim that a patient with pneumonia will be reported as a Covid-19 case even if they tested negative for SARS-CoV-2?
Mannheim press officer Beate Klehr-Merkl replied: “No, a person who has had close contact with a proven positive person is considered a close contact person in Category 1 – but not a positive case. Only people in whom the virus has been detected by means of a PCR test are considered positive cases – regardless of the symptoms of the disease. ”
The Dresden Health Department also said: “That is not correct. As a person who is infected with SARS-CoV-2, only laboratory-confirmed cases are counted – i.e. after a PCR test with a positive result. “
Edited by: Uschi Jonas, Alice Echtermann
The most important public sources for this fact check:
- Case definition of coronavirus disease, RKI (as of May 29, 2020): Link
- “What is notifiable?”, RKI (as of November 20, 2020): Link
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