Chinese officials confirmed Wednesday that the number of people infected by a new form of coronavirus in the country has reached 5,974, a total that surpasses the official cases tallied on the mainland during an outbreak of severe acute respiratory syndrome (SARS) in 2002 and 2003. SARS infected 5,237 people in mainland China, and killed almost 800 people across the world.
The new SARS-like form of coronavirus has killed 132 people in China. The disease, which is believed to have originated in a seafood market in the Chinese central city of Wuhan, has also spread to other countries, including the U.S., where five cases have been confirmed by the Centers for Disease Control and Prevention (CDC).
The disease, which is believed to have originated in a seafood market in the Chinese central city of Wuhan, has infected a few thousand people across China and has also spread to other countries, including the U.S., where five cases have been confirmed by the Centers for Disease Control and Prevention (CDC).
More than 3,500 cases have been confirmed in Hubei, the province where Wuhan is located, according to a virus tracker maintained by researchers at Johns Hopkins University, which uses numbers from China’s National Health Commission and, an online medical professional network.
But experts are skeptical that official numbers capture the full extent of the outbreak. Researchers in Hong Kong have warned that the actual number of people infected in Wuhan could already be more than 30 times higher than the official tally.
Experts say symptoms can be very difficult to detect and that many of those who died from the disease had underlying health conditions that involved weakened immune systems, like hypertension, diabetes or cardiovascular disease. They note that there is still a lot to be learned about the virus’ origins, clinical features and severity. Chinese health officials have said that the virus can be transmitted by touch, that young children can be infected and that the disease’s incubation period is usually between three to seven days.
The World Health Organization’s Director General Tedros Adhanom Ghebreyesus met President Xi on Tuesday in Beijing to discuss continued collaboration on containment measures and in Wuhan, public health measures in other cities, further research on the virus’ severity and transmissibility. and the sharing of data and biological material. They reached an agreement for the WHO to send international experts to visit China as soon as possible as part of their response.
Chinese President Xi Jinping has called the outbreak a “grave” situation and sent the country’s Premier, Li Keqiang, to Wuhan to assess the response to the virus. Li, who is head of a new task force that’s coordinating efforts to contain the disease, said Monday that the government would send 2,500 more medical workers to Wuhan over the next two days. As of Tuesday morning, 4,130 medical staff from around China had arrived in Hubei province; it is expected that a total of 6,000 will arrive. At least two makeshift hospitals created to respond to the virus are being constructed in Wuhan and national health officials have said more than 10,000 beds will be ready in Wuhan soon.
Videos appearing to originate from Wuhan show residents chanting from their homes , “Wuhan, stay strong” as cases across the country continued to increase.
Chinese officials have extended the Chinese New Year holiday in an effort to keep people at home.
At a joint conference Wednesday involving the CDC, U.S. Health and Human Services and other national health organizations, American health officials spoke about a desire to send experts to China, an expansion of airport screenings, public funding to respond to the outbreak and the possibility of asymptomatic transmissions of the disease.
HHS Secretary Alex Azar reiterated an offer made in early January to China to send an American CDC team to China to respond to the outbreak. Azar said he hopes the Chinese government will “take us up on” the “offer.” “CDC experts are standing by, ready, willing, able to go immediately to China either on a bilateral basis or under the auspices of the WHO,” Azar said.
Azar added that he was able to work with the White House’s Office of Management and Budget to allow for $105 million to immediately be directed towards the response to the virus.
“Americans should know this is a potentially very serious public health threat but at this point Americans should not worry for their own safety,” Azar said, noting that the nationwide risk was “extremely low.” He said he would not be declaring a public health emergency but would not hesitate to do so if appropriate.
Wuhan travel restricted
Gabriel Leung, the chair of public health medicine at the University of Hong Kong, said at a press conference Monday that the number of people infected is likely to be much higher than official figures — with as many as 44,000 people possibly infected in Wuhan alone, according to his team’s research models. Leung recommended that officials take “substantial draconian measures” to contain the virus, including canceling large gatherings, closing schools and asking people to work from home.
Chinese officials have shut down travel in and out of Wuhan — home to 11 million people — and enacted similar, strict transportation restrictions in a number of other cities. Immigration authorities say no passengers have left the Chinese mainland over the past four days through the Wuhan Tianhe International Airport or the Hankou Port. China’s Hubei Province has also suspended services to apply for passports and exit-entry permits.
Wuhan’s mayor acknowledged that information was not disclosed quickly enough at the virus’ outset, and said he is willing to resign if it would help contain the outbreak.
Authorities have also banned all forms of wildlife trade and implemented strict regulations on activities related to wild animals. The virus was first detected as a form of viral pneumonia centered on a seafood market in Wuhan on Dec. 12. Many of the first reported cases were people who worked at the market, which also sold wild animal meat. Officials closed down the market.
So far, no deaths from the virus have been reported outside the Chinese mainland. The city of Beijing reported its first death on Monday and last week confirmed that a 9-month-old tested positive for the disease.
International cases
Dozens of patients have tested positive for the illness across at least 18 international locations. They include 14 confirmed cases in Thailand, eight confirmed cases in Hong Kong, six confirmed cases in Macau and five confirmed cases in Singapore, Australia and Taiwan. Governments and health officials in Germany, Nepal, Canada, Cambodia, Vietnam, France, South Korea, Malaysia, Sri Lanka and Japan have also reported patients testing positive for the virus. Mongolia’s official news agency has said the country closed border crossings with China on Monday, according to the Associated Press.
In a bid to curb the spread of the deadly virus, Hong Kong announced Tuesday that it will deny entry to individual travelers from the mainland, dramatically expanding a ban that had previously applied only to visitors from Hubei province. The semi-autonomous city will also sharply reduce cross-border transit, shutting down rail and ferry service to China, halving flights and decreasing tour buses. Several border checkpoints will also close in what Hong Kong’s leader Carrie Lame termed a “partial shutdown” during a livestreamed press conference. The measures will go into effect on Jan. 30.
Chinese authorities have said they will suspend tour groups and travel packages.
Multiple countries are also warning against unnecessary travel to China, and some are putting in place plans to evacuate their citizens from Wuhan.
Two planes will be mobilized to repatriate EU citizens from the Wuhan area to Europe, according to the European Commission.
The United Kingdom has advised against all non-essential travel to Hubei province and stated they are working on ways to evacuate British nationals to leave the province. Canada has advised avoiding all travel to the province. France plans to send a plane to start evacuating its citizens from Wuhan on Thursday; the country’s deputy transport minister Jean-Baptiste Djebbari, told CNews television the flight would bring only passengers “who do not have any symptoms” of illness.
The U.S. State Department escalated a travel advisory warning for Hubei province to level four on Friday, advising visitors not to travel to the province because of the coronavirus. On Monday, a level three advisory to “reconsider travel” was issued for any travel to China in general.
On Sunday, the agency indicated plans to evacuate staff and some private citizens. The U.S. state department said that it is making arrangements to relocate personnel at the U.S. Consulate General in Wuhan to the United States and noted that there would be “limited capacity to transport private U.S. citizens on a reimbursable basis” on a flight leaving Wuhan’s international airport Tuesday and arriving in San Francisco.
Azar said at Tuesday’s press conference that individuals on the flight from Wuhan to the U.S. would be screened and evaluated “constantly.” “There will be physicians on the flight and we’ll take whatever the appropriate evidence based public health measures are with them as we would with any other situation,” he said.
The WHO previously decided not to declare the outbreak a “public health emergency of international concern” after convening an emergency committee that met last week, saying that it was still “too early” to do so. They previously praised China’s swift response and encouraged them to remain transparent in sharing data regarding the outbreak.
The stock market has also taken a hit, as major US indexes fell more than 1% on Monday; the Dow Jones Industrial Average dropped as many as 500 points, the Associated Press reported.
CDC confirms 5 cases in U.S.
The CDC has confirmed five cases of the coronavirus infection in the U.S. — one in Arizona, two in California, one in Washington state and one in Illinois. The agency said all of these patients, the first of whom was diagnosed in Snohomish county, Wash., traveled from China. “It is likely there will be more cases reported in the U.S. in the coming days and weeks, likely including person-to-person spread,” the CDC said in a statement.
The agency said Monday that 110 individuals across 26 states were considered to be “persons under investigation.” “That is a cumulative number and will only increase,” said Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases at the CDC. Of these 110, five had tested positive, 32 tested negative and 73 determinations are still pending. The people being investigated could include those who have a fever and respiratory illness after traveling to Wuhan and individuals who have had contact with a patient who tested positive for the disease and have a fever and respiratory illness.
“At this time in the U.S., the virus is not spreading in the community. For that reason we continue to believe that the immediate health risk to the general American public is low at this time,” Messonnier said during a telebriefing on Monday.
The CDC’s travel precaution is currently at a level three, recommending that travelers avoid all nonessential travel to China because of the disease.
The CDC is continuing to screen passengers from Wuhan at five major airports in the U.S. and has screened about 2,400 people so far, Messonnier said on Monday, adding that the number of people coming from Wuhan is declining with the recent travel restrictions. (Since direct flights out of Wuhan have stopped, the agency said it is screening those with “broken itineraries” who may be transiting from Wuhan through another country back to the U.S.) The CDC announced at Tuesday’s press conference that it would expand airport screenings from five to 20 airports as part of a “multi-layered” response.
These screenings provide opportunities to detect and rapidly respond to the illness, as well as educate returning travelers on the signs and symptoms of the disease, she explained. The five airports where the CDC is conducting entry screenings of passengers on direct and connecting flights from Wuhan are New York City’s John F. Kennedy International Airport, Los Angeles International Airport, San Francisco International Airport, Chicago O’Hare International Airport and Hartsfield-Jackson Atlanta International Airport .
There is still more research and analysis needed before the CDC can be confident about how exactly the outbreak started but experts will likely look to MERS and SARS to guide them, Messonnier said.
Companies tell employees to work from home, avoid travel
Companies across China are taking precautions, as well. Chinese gaming giant Tencent and the tech company ByteDance, which owns the app TikTok, have told staff to work from home, according to the BBC.
The co-working company WeWork is temporarily shutting more than 50 offices across China, it said in a statement on Tuesday.
Facebook has stopped non-essential travel to China, and Starbucks is temporarily closing some of its China stores, according to Bloomberg. Several major cruise lines have also suspended some voyages leaving from China.
Flight attendants working for Cathay Pacific, Hong Kong’s flagship airline, will be allowed to wear facemasks while working.
In Hong Kong, the government notified its workers on Monday that all workers except essential public servants and emergency services personnel can work from home until Feb. 2.
American response
HHS Secretary Azar laid out the U.S.’ “relatively simple and multi-tiered” internal response to the outbreak at a press conference on Tuesday. “You identify cases, isolate people, diagnose them and treat them,” Azar said. “Then you track down all the contacts of the infected person and you do the same with those people and the same with contacts of contacts if necessary.”
Azar indicated that China had been much more transparent in its handling of the novel coronavirus compared with the SARS response; the Chinese government had been accused of covering up SARS, which killed nearly 800 people and infected more than 8,000 after beginning in Southern China in 2002. “The posture of the chinese government and levels of cooperation and interaction with us is completely different from what we experienced in 2003 and I want to commend them for that,” Azar said.
Officials and experts are still working to determine whether the virus involves asymptomatic transmission, in which individuals catch the disease from somebody who doesn’t appear to show symptoms. There have been isolated reports of asymptomatic infection from several countries but in the U.S. there have only been five cases, according to Messonier with the CDC, who noted none of them involved evidence of human-to-human transmission and all patients had traveled to China.
Chinese officials have reported evidence that that disease may be transmitted in its asymptomatic phase but the CDC has not yet been given the opportunity to review that data or confirm this observation, said Robert Redfield, director of the National Center for Immunization and Respiratory Disease, at the press conference.
“We would really like to see the data because if there is asymptomatic transmission it impacts certain policies that you do regarding screening,” said Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, at the event. But Fauci notes that “in all the history of respiratory borne viruses of any type, asymptomatic transmission has never been the driver of outbreaks. The driver of outbreaks is always a symptomatic person.”
Fauci said the NIH has already started on the development of a vaccine that he anticipates “with cautious optimism” that will be in a phase one trial within the next three months. But he notes that it would still take time to prepare a vaccine that is ready for deployment and that there would be an additional three months required to get safety and immunogenicity data before moving into phase two. “What we do from that point on will be determined by what has happened with the outbreak over those months,” Fauci said. And he adds, this all applies in a “worst case scenario” if the disease becomes a bigger outbreak.
Write to Amy Gunia at