Confirmed cases are suspected cases of Covid-19 whereas those declared positive are people who actually have the Covid-19 virus.
Individuals who test positive for COVID-19 are considered as confirmed cases.
During a late-night discussion on UTV’s Late News Discussion on May 24, 2020, Kwame Baffoe Abronye, NPP Regional Chairman for Bono East, stated that coronavirus cases declared or placed under the ‘confirmed’ bracket actually refers to suspected cases while those under the ‘positive’ bracket are cases that have been taken through the necessary procedures and found to be carrying the coronavirus.
“…the doctors say that when you see “confirmed”, it means they suspect but that doesn’t mean that the person has the coronavirus. Once you see that it means they suspect you have it, it doesn’t mean you have. We also have positive…we have three things: we have confirmed, positive and we have death. When you see “confirmed” it means it has gotten to the stage where they quarantine you to see if you have the disease in your system...We had the experts…we’ve had the former Director-General, Dr Nsiah-Asare, explain to us that when we see confirmed it does not mean the person has tested positive but that “confirmed” means we suspect it,” Mr Abronye said.
When asked by the host of the show if the word “confirmed” really means a person does not have Covid-19, Mr Abronye responded that it depends on the interpretation one wants to give it.
But what do experts mean by “confirmed” in relation to Covid-19 cases?
Dubawa spoke to Dr James Aboagye, a postdoctoral fellow at the Noguchi Memorial Centre, who stated that from the Noguchi’s end, a confirmed case is a case that has tested positive.
“A confirmed case is a positive case because what we are looking for is the virus and once a person is confirmed, he or she is positive for the virus,” Dr Aboagye said.
He further stated that unlike suspected cases where the individual is assumed or thought to have the virus, confirmed cases are for scenarios where the individual tests positive for the virus after tests have been run.
The Public Relations Officer of Ghana Health Service (GHS), Jacob Andoh, said a person who has been tested and found positive is the same as a confirmed case.
“A confirmed case is the same as a positive case,” Mr Andoh said.
Case definitions or classifications for diagnosis
The WHO case classifications are categorized into suspected cases, probable cases and confirmed cases.
Suspected Case refers to three situations: 1) a patient with acute respiratory illness (fever and at least one sign/symptom of respiratory disease, e.g., cough, shortness of breath) and a history of travel to or residence in a location reporting community transmission of COVID-19 disease during the 14 days prior to symptom onset; 2) a patient with any acute respiratory illness and has been in contact with a confirmed or probable COVID-19 case in the last 14 days prior to symptom onset; and 3) a patient with severe acute respiratory illness (fever and at least one sign/symptom of respiratory disease, e.g., cough, shortness of breath, requiring hospitalization) and in the absence of an alternative diagnosis that fully explains the clinical presentation.
Probable Case: A suspect case for whom testing for the COVID-19 virus is inconclusive or a suspect case for whom testing could not be performed for any reason.
Confirmed Case: A person with laboratory confirmation of COVID-19 infection, irrespective of clinical signs and symptoms.
The CDC also categorises Covid-19 diagnoses into three stages:
Person Under Investigation: This is a person who has exhibited symptoms of COVID-19 and is in the process of being tested.
Presumptive Positive: This is an individual who tested positive for COVID-19 at a state or local laboratory. At least one respiratory sample must be positive for a case to be labelled presumptive positive.
Confirmed Positive: This is a person who tested positive for COVID-19 at a CDC laboratory. At least one respiratory sample must be positive by the CDC for it to be labelled confirmed positive.
In Ghana, reports on the coronavirus surveillance are based on the confirmed cases, recoveries, and deaths as seen on the GHS website. Confirmed cases have been regarded as positive cases and not suspected as claimed by Mr Abronye.
Therefore, Mr Abroye’s incorrect claim on the definition of ‘confirmed’ cases is a misleading semantic confusion that should be disregarded.
WHO’s classifications are unambiguous and remain the standard for the whole world facing the same virus. The denotative meaning of the word confirm in English–British or American–dictionary is semantically too distant from ‘suspect’ in standard English usage.