Deaths climb above 100 as China records new cases.
An outbreak of a new coronavirus that began in the Chinese city of Wuhan has already killed at least 106 people in China, according to data released early Tuesday. Infections have been confirmed in many other countries. But of the 4,500 people who have so far contracted the virus, the vast majority live in China.
◆ All but a small handful of those deaths were in the central province of Hubei, the center of the outbreak.
◆ Officials in the capital, Beijing, which has a population of about 21 million, announced the first death in the city from coronavirus on Monday. The patient, a 50-year-old man, had traveled to Wuhan on Jan. 8 and developed a fever after returning to Beijing a week later. He was diagnosed on Jan. 22 and died of respiratory failure, the Beijing Municipal Health Commission announced.
◆ Across China there have been more than 4,500 confirmed cases. The youngest confirmed case is a 9-month-old girl in Beijing.
◆ Thailand and Hong Kong have each reported eight cases of infection; the United States, Taiwan, Australia and Macau have five each; Singapore, Japan, South Korea and Malaysia each have reported four; France has three; Canada and Vietnam have two; and Nepal, Cambodia and Germany each have one.
◆ There have been no deaths from the virus reported outside China.
Stocks tumble as investors worry about the impact on global growth.
Stocks tumbled and oil prices fell on Monday as the virus’s spread worried investors around the globe.
The S&P 500 fell 1.6 percent, with shares of airlines and companies dependent on tourism from China particularly hard hit. It was the sharpest decline since Oct. 2, when the trade war was fanning fears of a slowdown.
American Airlines dropped more than 4 percent in early trading, and Wynn Resorts, which operates casinos in Macau, a special administrative region of China and a gambling haven for Chinese high rollers, dropped more than 7 percent.
Major stock benchmarks in Europe were down more than 2 percent. While many markets in Asia were closed for the holiday, Tokyo’s benchmark Nikkei 225 index also sank 2 percent.
The price of oil dropped, on fears that demand could slip. China’s currency also fell, while investors moved into safe havens like gold.
China’s economy, which is experiencing its worst slowdown in nearly three decades, is already hurting from the impact of the outbreak, and there are fears that consumer spending will go down as more residents stay home over the Lunar New Year.
C.D.C. urges travelers to avoid nonessential trips to China.
American health officials in Washington issued new guidance for travelers late Monday afternoon, recommending that they avoid all nonessential trips to China.
The warning, from the Centers for Disease Control and Prevention, notes that transportation in and out of Hubei Province may be restricted and that there is “limited access to adequate medical care in affected areas.”
The agency counseled travelers in China to avoid contact with sick people, animal markets and uncooked meats, and to talk to their health care provider and wash hands frequently.
110 people in the United States are being evaluated for infection.
Some 110 patients in 26 states are being evaluated for infection with the Wuhan coronavirus, officials at the Centers for Disease Control and Prevention said on Monday.
Five of the 110 have tested positive so far, and 32 have tested negative.
“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 moment, the risk of infection in the United States is low. But Dr. Messonnier cautioned that information about the outbreak is changing rapidly, and the C.D.C.’s response and guidance is constantly revised.
The C.D.C. continues to screen passengers arriving in the United States whose travel originated in Wuhan. Officials are considering broadening the effort and revising official guidance on travel to the region, Dr. Messonnier said.
Dr. Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, has arrived in Beijing to “understand the latest developments and strengthen our partnership with China in providing further protection against the outbreak,” he said in a tweet.
New York City is bracing for the coronavirus: ‘It’s inevitable.’
The city’s top health official, Dr. Oxiris Barbot, said that it was only a matter of time before someone in the city tests positive for the virus.
Hospitals have been on the lookout for patients with recent travel involving Wuhan, the Chinese city where the coronavirus is believed to have originated. And they have urged anyone who recently traveled there — or who have been in contact with someone who has — to quickly seek medical care if they have any respiratory or flulike symptoms.
So far, of nine patients for whom New York State officials have sought testing from the Centers for Disease Control and Prevention, four were found not to have the virus, and the tests involving the other five are pending, Gov. Andrew M. Cuomo said Monday in a statement.
When the first case in New York does arrive, health officials said, that patient may end up in a biocontainment unit in Bellevue Hospital or sent home to ride out the illness in their bedroom. That will depend largely on how sick they are, public health officials say.
Canadian officials believe they’ve identified a second case of the new coronavirus
Health officials identified a “presumptive” second case of the new virus: the wife of the first identified case, a man who was hospitalized on Jan. 23. The couple had returned to Toronto after visiting Wuhan a day earlier.
The woman’s symptoms were not severe enough to require hospitalization, Dr. Barbara Yaffe, the province’s associate chief medical officer of health, said at a news conference. She was in isolation at home.
The man is in his 50s and is now in stable condition. Laboratory tests confirmed that he was infected with the new coronavirus, and tests are pending for his wife, officials said.
Health officials are now tracking down people who sat near the couple on a flight to Toronto from Guangzhou, and questioning the travel history of people seeking medical help for respiratory problems around Ontario, Dr. Yaffe said.
Social media users criticize the Chinese government’s response.
The Chinese government usually keeps a tight grip on what is said, seen and heard about it. But criticism on social media over its handling of the coronavirus outbreak has been difficult to contain.
Some critics of the government have found clever ways to dodge censors, such as referring to Xi Jinping as “Trump” or comparing the outbreak to the Chernobyl catastrophe.
The vitriol has been most intense in Hubei, the home province of Wuhan. After the provincial governor, Wang Xiocaodong, gave a news briefing on Sunday, online commenters mocked Mr. Wang for misstating the number of face masks that the province could produce.
They also circulated a photo from the briefing of him and two other officials, pointing out that one of them did not cover his nose with his mask. Another wore his mask upside down, and Mr. Wang did not wear a mask at all.
The crisis has turned a spotlight on China’s overburdened health system.
The Chinese health care system strains to serve patients even under normal circumstances. Those weaknesses are most pronounced in the poorer areas of China — like Wuhan, the epicenter of the coronavirus outbreak.
Panicked residents of the city are heading to the hospitals if they have any sign of a cold or cough.
Videos circulating on Chinese social media show doctors straining to handle the enormous workload and hospital corridors loaded with patients, some of whom appear to be dead. Wuhan hospitals have posted messages online urgently appealing for medical equipment. The situation is even more desperate in nearby rural areas.
Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations, said China had invested a lot in building infrastructure to deal with infectious diseases.
“But they apparently didn’t anticipate something so sudden, so acute, and so tremendous,” he said.
Some public health experts are skeptical of China’s efforts to contain the virus
China’s efforts to contain the spread of the disease by keeping tens of millions of people corralled in the major cities in Hubei Province have drawn skepticism from some experts in public health and epidemiology.
The lockdown will pose tremendous challenges, starting with getting food, fuel and medical care to those affected.
“At this stage of the outbreak, the things that make the most difference are finding people, diagnosing people, and getting them isolated,” said Dr. Tom Inglesby, an infectious diseases specialist and director of the Johns Hopkins Center for Health Security.
“If you isolate the city, then my question and my concern is that you’re making it harder in a number of ways to do those things you need to do,” including getting sick people to the hospital and getting supplies into medical facilities, he said.
Other experts said that the travel restrictions had probably come too late and that the barriers would prove too permeable. Five million people had left Wuhan before travel out of the city was restricted, said the city’s mayor, Zhou Xianwang.
“You can’t board up a germ,” said Lawrence O. Gostin, a law professor at Georgetown University and director of the O’Neill Institute for National and Global Health Law. “A novel infection will spread.”
Some experts, however, said the lockdowns could help, at least in theory.
“Anything that is done that increases social distancing can help decrease the spread of the virus,” said Dr. Thomas R. Frieden, a former director of the United States Centers for Disease Control and Prevention. “If you do it right, it’s not impossible it will have positive impact.”
Hong Kong hospitals in turmoil as workers prepare for possible coronavirus cases.
Hospital workers in Hong Kong are trying to prepare for an outbreak of coronavirus cases — with memories of the SARS epidemic of the early 2000s still fresh.
In the past week, doctors and nurses have drawn straws to determine when they would work in coronavirus isolation wards for six-week shifts. A hospital rearranged its cafeteria so that all tables faced the walls, a precaution from the SARS era to prevent employees from infecting each other during their meals.
The SARS outbreak killed eight medical workers in the city. Some still suffer from lung damage 17 years later.
Many hospital workers are calling for stricter border checks as Lunar New Year holidays come to a close this week, and a wave of visitors and residents are expected to return from the mainland.
A new union, HA Employees Alliance, threatened to go on strike if the government did not close its borders to the mainland.
Arisina Ma, the president of the Hong Kong Public Doctors’ Association, called for stricter border checks, and for possibly requiring visitors and residents to stay home for 14 days, the incubation period for the disease, after returning from the mainland.
“We are waiting for the worst to come,” she added. “Of course we will try to stop it but I am not sure if our government is efficient and determined enough to stop the worst to come.”
At the same time, the city’s hospitals are still reeling from the anti-government protests that flooded their wards with patients over the past seven months.
Early Monday morning, hours after protesters set fire to unused public housing units designated to be medical quarantine areas, a handmade bomb exploded inside a hospital toilet cubicle, a police official said. The two small explosions filled the emergency ward with smoke but caused no injuries.
Wuhan mayor claims responsibility and offers to resign.
Wuhan’s top government and Communist Party officials offered to step down on Monday amid growing criticism in the city that the local authorities’ response to the outbreak was too slow.
Mayor Zhou Xianwang said in an interview with the state broadcaster CCTV that he and Ma Guoqiang, the city’s party secretary, would take responsibility for the crisis and resign to “appease public indignation.”
“Our names will live in infamy, but as long as it is conducive to the control of the disease and to the people’s lives and safety, Comrade Ma Guoqiang and I will bear any responsibility,” Mr. Zhou said in the interview.
Medical workers in the city have accused the local government of reacting too slowly to the crisis, and residents have used social media to complain about a ban on travel that has made it difficult to get access to food and health care.
The mayor defended the travel ban, which was enacted last week and effectively cut off the city of 11 million people. He called the restriction “unprecedented in human history.”
China’s No. 2 official visits Wuhan as anger at the government grows.
China’s second-highest ranking official, Premier Li Keqiang, on Monday visited Wuhan to inspect local efforts to contain the disease, the government said.
In pictures released by the state-run news media, Mr. Li is seen wearing a face mask and a blue protective gown while posing for photos with health workers. He was also seen speaking with a patient in an isolation ward via video conference.
The premier’s visit comes as the central government is under increasing pressure to prove it is adequately coping with the crisis.
On Saturday, Xi Jinping, China’s leader, convened a meeting of the Politburo’s standing committee, the senior-most executive body of the Chinese Communist Party, as a demonstration of the government’s hands-on approach to the outbreak.
Hospitals in Wuhan have posted messages online urgently appealing for medical equipment. Mr. Li, who has been assigned to oversee the national response to the outbreak, pledged to provide Wuhan’s health centers with 20,000 pairs of safety goggles.
China extends long Lunar New Year holiday to limit travel.
Trying to temporarily limit travel, the Chinese government extended the weeklong Lunar New Year holiday by three days, meaning it will go through next Sunday rather than ending on Thursday. Workers will return to work on Feb. 3.
The holiday, China’s biggest annual celebration, began on Friday, the eve of the Lunar New Year.
Hundreds of millions of Chinese people travel during the holiday, either for tourism or to visit family. The week, known in China as Spring Festival, typically includes large public events, but many festivities have been canceled this year.
Many tourist attractions have been shuttered including the Disney theme parks in Shanghai and Hong Kong, along with the Forbidden City and sections of the Great Wall in Beijing.
Wuhan residents venture outside only out of necessity or boredom.
Residents of Wuhan have largely hunkered down to quietly wait out the crisis, mostly staying inside their homes, and venturing out only for supplies and food, medical visits and occasional bursts of exercise away from other people.
Cities, towns and even villages have erected checkpoints and roadblocks intended to ward off any outsiders who might carry the coronavirus.
On Monday, most shops remained closed, but supermarkets, fresh produce stores and pharmacies remained open — although many pharmacies have run out of protective masks, hand disinfectant and other supplies intended to protect against the virus.
Residents with fevers and coughs who worried that they may have contracted the coronavirus continued to line up at clinics and hospitals, but in fewer numbers than on previous days. The streets were mostly free of cars, and many residents walked or rode bicycles to do their shopping.
“It’s possible to live, but it’s not a real New Year,” said Qiu Dongjun, 38, a construction worker from rural Hubei Province who was carrying a bagful of shopping, mostly instant noodles and tins of precooked porridge.
A dark humor emerges on social media.
As health officials race to contain the dangerous virus, social media users in China are responding to the outbreak with dashes of gallows humor.
On the messaging platform WeChat, people circulated images of improvised face masks made of plastic water jugs. One video on WeChat and the social platform Weibo showed a group of people playing mah-jongg, the popular tile-based game, while wearing what appeared to be plastic bags over their heads.
Another video on WeChat appeared to show a person emerging from an airport baggage claim clad in a full-body space alien costume, complete with green skin and bulging eyes.
Masks are a common motif in virus-related memes. They have been added to traditional greetings exchanged for the Lunar New Year, and photoshopped into classic paintings like Vermeer’s “Girl With a Pearl Earring.” They appear in propaganda posters done in the style of the Mao era and updated to reflect the times.
A video on Twitter appeared to show a taxi driver wearing goggles and a hazmat suit while taking a woman to the airport.
The woman asks the driver whether his outfit might scare off potential fares. He replies serenely: “Safety first, right?”
Foreign governments make plans to evacuate citizens.
Foreign governments with nationals stranded in Wuhan scrambled to evacuate their citizens from the epicenter of the outbreak, even as China imposed official travel bans.
The State Department said it had chartered a flight to take consular staff members and other American citizens to San Francisco from Wuhan on Tuesday. The department said priority would be given to those at greater risk from contracting the virus because of the flight’s “extremely limited” capacity.
At least one American, a father of three young children, declined the offer after the United States government said his wife, a Chinese national, would not be offered a seat.
France, Japan, Spain and Sri Lanka also said they would bring home nationals. Once in France, evacuated nationals would be required to spend 14 days in quarantine.
Russia was in talks with China about evacuating its citizens, local news media reported. Russian tour operators have stopped selling trips to China following recommendations from the country’s tourism watchdog and would work only to evacuate travelers, Reuters reported.
Why is there so much concern?
Though the number of coronavirus cases and deaths is alarming, public health experts have so far warned against mass anxiety. After all, the common flu kills roughly 35,000 people a year and hospitalizes about 200,000 in the United States alone.
It is too soon to know the mortality rate of the virus in the new outbreak. But there are signs that this outbreak could be far more serious than the common flu.
For one, other coronaviruses have far higher mortality rates than the common flu, and have also led to global outbreaks.
Chinese citizens are also haunted by the memory of the SARS epidemic in 2002 and 2003, a coronavirus outbreak that also started in China and eventually killed more than 800 people worldwide. During that epidemic, Beijing at first played down the crisis and withheld information, eventually drawing widespread criticism.
And there is no conclusive evidence about how the outbreak started is lacking. While officials in Wuhan first traced it to a seafood market, some patients who have fallen ill never visited the market. Researchers have also offered disparate explanations for what animals may have transmitted the virus to humans.
Bureaucracy slowed the response to an emerging crisis.
The coronavirus outbreak seemed to be a full-blown crisis by the time the first news reports emerged: Dozens of people had been infected, even some abroad.
Though China’s initial delay in reporting cases of the new virus may suggest a cover-up, experts see something more worrying: weaknesses at the heart of the Chinese political system.
China’s rigid bureaucracy discourages local officials from raising bad news with central bosses, and it silos officials off from one another, making it harder to manage, or even see, a crisis in the making.
“That’s why you never really hear about problems emerging on a local scale in China,” said John Yasuda, who studies China’s approach to health crises at Indiana University. “By the time that we hear about it, and that the problem reaches the central government, it’s because it’s become a huge problem.”
Those systemic flaws appear to have played a role in the pace at which officials responded to the outbreak, and the country’s inability to address the health risks from its so-called wet markets, which are stuffed with livestock living and dead, domesticated and wild.
China is now mobilizing a nationwide response involving hundreds of personnel, one of the system’s strengths. But the country’s political weaknesses can have serious consequences for the world. Disease and pollution don’t respect borders, so a unified national policy is typically needed to prevent or stop them.
For any health or environmental regulation to work, Mr. Yasuda said, “you want it to be standardized, you want it to be transparent, you want it to be accountable.”
Reporting was contributed by Elaine Yu, Russell Goldman, Alexandra Stevenson, Tiffany May, Steven Lee Myers, Vivian Wang, Chris Buckley, Raymond Zhong, Denise Grady, Roni Caryn Rabin, Sheri Fink, Katie Robertson, Sui-Lee Wee, Ian Austen and Karen Zraick. Zoe Mou, Albee Zhang, Amber Wang, Yiwei Wang and Claire Fu contributed research.