According to Reuters, when Saudi Arabia announced last week it had found 113 more cases of the deadly Middle East Respiratory Syndrome (MERS), it didn't just force a serious rethinking of the disease. It "flagged" serious institutional failings.
Saudi health sources and international virologists said poor communication and a lack of accountability in government departments, inadequate state oversight and a failure to learn from past mistakes have all hindered Saudi Arabia's battle against the SARS-like virus.
Saudi Arabia has been host to the vast majority of cases of MERS - a viral infection which can cause coughing, fever and pneumonia: since it was first found in humans two years ago.
International concerns over Saudi Arabia's handling of the outbreak grew last week when it said it had under-reported cases by a fifth and revised the case numbers to 688 from 575.
People in Saudi Arabia are still becoming infected with and dying of MERS every day and sporadic cases have been found outside Saudi Arabia as infected people travel. The worldwide death toll from MERS now stands at more than 313 people.
International scientists have complained of a lukewarm response from Saudi authorities to offer help with the scientific research needed to get a handle on the outbreak, and have questioned the quality of data collection and distribution that could help reveal how the disease actually operates.
Another 22 cases tested positive at the King Faisal Specialist Hospital in Jeddah, but duplicate samples were not sent to government laboratories and the institution did not communicate the results to the Ministry of Health, he said.
COMMENT: Ian MacKay, an associate professor of clinical virology at Australia's University of Queensland who has been tracking the MERS outbreak since the virus was first identified in 2012, is skeptical about the notion that it is normal for 20% of cases to go unreported.
The new acting Health Minister Adel Fakieh has changed that policy. From now on, positive tests from any laboratory accredited by the Health Ministry will count as confirmed cases.
The appointment of Fakieh has also led to other changes, he said. Authorities have brought in tighter infection procedures in hospitals and are trying to be more transparent about how they are tackling MERS.
But some international scientists still complain that data published online by Saudi authorities, which includes daily updates on confirmed new infections and deaths in different cities, is not comprehensive enough to allow them to research the disease.
The European Center for Disease Prevention and Control (ECDC), for example, said it was not clear whether the new cases listed by Saudi authorities met the World Health Organization's (WHO) definition of confirmed cases. The ECDC also noted the absence of detail such as age, gender, residence, probable place of infection and other information are critical.