Coronavirus claims 15 more lives in China; first three cases reported in Europe; first case reported in Australia; 2 cases confirmed in U.S.

https://www.washingtonpost.com/world/coronavirus-china-live-updates/2020/01/24/4e678f9c-3e03-11ea-afe2-090eb37b60b1_story.html

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BEIJING — France confirmed three cases of coronavirus Friday, marking the first confirmed diagnoses in Europe, as China expanded its efforts to control its outbreak and announced 15 new deaths. Australia also confirmed its first case of coronavirus, and a second case was confirmed in the United States.

Travel bans were extended in central China to put tens of millions of people effectively on local lockdowns. In Wuhan, where the virus was first detected, workers are racing to build a 1,000-bed hospital to treat victims of the disease.

Authorities around China, including in the capital, Beijing, have canceled the temple fairs and festivals that accompany the Spring Festival to avoid having large public gatherings where the airborne virus could spread.

● There are at least 1,287 confirmed cases of infection, and at least 41 people have died. A total of 8,420 people are reported to be under observation.

● A young, previously healthy man died in Wuhan, raising concerns about the deadliness of the virus. Until now, the vast majority of victims have been older than 60 with preexisting conditions.

● Infections have been confirmed in Australia, France, South Korea, Japan, Nepal, Thailand, Singapore, Vietnam, Taiwan and the United States.

● Authorities are enforcing a lockdown across large parts of the province of Hubei, affecting more than 35 million people, but the precise number remains unclear.

● The Chinese medical system has clearly struggled to cope with the outbreak, with reports of crowded hospitals, stressed doctors and dwindling supplies.

Coronavirus live updates

WASHINGTON — Australian Health Minister Jenny Mikakos said Saturday that a Chinese national in Melbourne had a confirmed case of coronavirus, according to local news reports. The man, who is in his 50s, returned from Wuhan on Sunday and now is isolated at a hospital in stable condition.

Mikakos said that passengers on the man’s China Southern Airlines flight would be alerted as a precaution. The man did not exhibit symptoms on the flight, Mikakos said, and airport screening would not have detected the virus.

Coronavirus now has been confirmed on four continents: Asia, North America, Europe and Australia.

WASHINGTON — The French health ministry announced that a third case of coronavirus has been confirmed in that country, according to the state-owned television network France 24. The new patient is located in Paris, as was one of the previously announced patients. The other patient is in the southwestern city of Bordeaux.

The new patient is a parent of one of the other people diagnosed, the Associated Press reported. All three patients recently had traveled to China.

WASHINGTON — As new cases of coronavirus surge, health experts inside and outside the U.S. government say they believe the Chinese government is significantly underreporting the number of cases and deaths in that country.

By the end of Friday, local time, China said it had 1,010 cases and a total of 41 deaths. Many more cases are not being reported, experts believe, based on reports from nongovernment sources in China.

“We heard it was over 1,000 when they were only reporting a couple hundred cases,” said one HHS official who was not authorized to discuss internal conversations and spoke on the condition of anonymity. The official declined to say what the U.S. government estimate is for the true case count.

Some experts have said the discrepancy could stem from the initial focus on the most severely ill patients and could be the result of Chinese officials catching up with all the sick people, rather than a deliberate underestimate.

A policy report sent to clients by financial-services firm Raymond James estimated the number of cases to be “at least 10 times the number reported publicly.” The report author, Chris Meekins, a former HHS official, said the analysis is based on information from academic researchers and consultants working with Chinese hospitals.

“Our checks reveal that lines stretch outside of urban and rural hospitals and triage facilities have been set up,” Meekins wrote.

WASHINGTON — Hubei province announced 15 additional deaths in Wuhan attributable to the virus. There were also 180 new cases across the province. All patients were being kept in isolation, and people they had come into close contact with were being monitored.

All of the most recent people who died were at least 55 years old. As with the previous deaths, most of the victims had a history of serious illnesses.

The new information brought the total number of deaths from coronavirus to 41. More than 1,000 cases have been confirmed.

WASHINGTON — Infectious disease experts said that there’s little need to wear face masks in the United States, where just two cases of coronavirus have been confirmed and the patients are in stable condition in hospitals.

Given the low threat level, covering one’s face and nose isn’t necessary when outside or in a place with good ventilation, said Colleen Kraft, associate chief medical officer for Emory University Hospital, who helped treat the first U.S. Ebola cases in 2014.

Kraft said that people in the United States should instead be taking the same precautions they would to avoid contracting the flu, such as being vigilant about washing hands regularly and cautious about touching their faces and possibly infected surfaces.

In high-risk areas like Wuhan, wearing them pays off, experts said. There has been a run on masks in China, where the price is rising.

Read more here.

WASHINGTON — Trump weighed in Friday afternoon as impeachment hearings wore on in the Senate, commending Chinese President Xi Jinping in a tweet for his government’s efforts to contain the virus.

“China has been working very hard to contain the Coronavirus. The United States greatly appreciates their efforts and transparency. It will all work out well. In particular, on behalf of the American People, I want to thank President Xi!” Trump wrote.

Trump’s tweet came hours after senators were briefed on the outbreak by top health officials. Sen. Rick Scott (R-Fla.) called for the U.S. to declare a public health emergency shortly after the briefing.

BEIJING — As hospitals around the coronavirus ground zero of Wuhan struggle to deal with the outbreak, accounts are emerging of shortages of just about everything. There are not enough hospitals and not enough beds, not enough doctors and not enough nurses, not enough rubber gloves and not enough face masks.

There’s the infectious disease specialist who, having treated bird flu and influenza A and tuberculosis over the years, was felled during the coronavirus outbreak. An exhausted Jiang Jijun died of a heart attack Thursday while tending patients.

There’s the seven-months pregnant nurse who still went to work to treat those with coronavirus, only to be infected with it herself. When her 70-year-old mother got it, too, the nurse had to complain on social media to attract the attention needed to get her admitted.

There are the health-care workers wearing adult diapers because they don’t have time to go to the bathroom. Then there are those with the ever-whiter hands, bleached by all the disinfectant.

Many people are at breaking point in the city at the center of an expanding quarantine zone in central China.

“I don’t want do this job any more. Just fire me! Kick me out, send me back home,” a doctor at Wuhan No. 5 Hospital yelled into the phone, frustration and exhaustion exploding out of him.

“Don’t I want to go home to celebrate the new year?” he screamed in his Wuhan accent, presumably at his boss, that he’d done four back-to-back shifts as China made plans for the Lunar New Year holiday, which began Friday. “Don’t we want to live, too?”

A video of the unidentified doctor, filmed by a patient, was widely shared on Weibo, the microblogging site, this week but could not be independently verified by The Washington Post. Several people in Wuhan, however, vouched for its authenticity and there were many others like it that emerged from the quarantined city.

Together, they provide a window into the extreme levels of stress in the overburdened hospitals of Wuhan as they battle a new pneumonia-like coronavirus.

Read the full story here.

WASHINGTON — French Health Minister Agnes Buzyn told reporters Friday that two cases of coronavirus had been diagnosed in France, one case in the southwestern city of Bordeaux and another in Paris. Both patients were recently in China, she said, adding she suspects more cases will emerge.

Those diagnoses mark the first known cases of the virus in Europe, amid concerns that people may be contagious with the virus even before they exhibit any symptoms.

The Associated Press reported that Buzyn said she believes the virus was detected in France before any other European country in part because it has already developed a rapid test for patients exhibiting symptoms of the virus.

WASHINGTON — Panic over the new coronavirus has spread along with the disease. But reactions based on misinformation or partial information can make matters worse, underscoring the need for governments to be open from the start, say public health experts.

“It is very critical that [governments] are and appear to be honest and transparent with people,” said Vish Viswanath, a professor of health communication at Harvard University’s school of public health.

Such transparency builds trust among the public and curtails unwarranted, unproductive fear, experts say.

Viswanath described the new coronavirus as “an emerging infectious disease crisis” because its source and exactly how it spreads remain uncertain, as well as other unknowns.

“In such a crisis, when you have incomplete information, the question is how do you communicate risk,” he said. “You have to just go out and say this is what we know so far and this is what we don’t know.”

This works best, he said, when a government has one or two designated spokespeople to provide the public with continuous, credible information about what’s fact, fiction or still an open question.

Without clear updates from official sources, misinformation and rumors spread even more easily on social media.

Such crises are best managed by “public health officials working through community leaders in a culturally appropriate way,” Brendan Nyhan, a professor of government at Dartmouth College focused on misperceptions about politics and health care, told The Post.

In health emergencies, especially in places where trust in the government is low, “it becomes especially important to marshal trusted sources and community leaders to help reinforce the messages that are backed by science,” he said.

WASHINGTON — Sen. Rick Scott (R-Fla.) called on President Trump on Friday to declare the coronavirus outbreak a public health emergency after senators received a briefing from top health officials and a second case of the virus was confirmed in the United States.

“We have to get serious about the threat of coronavirus coming from China. I don’t trust Communist China to coordinate in a transparent and efficient manner,” Scott said in a statement. “I’m calling on the administration to declare a national public health emergency to stop the coronavirus from spreading within the United States.”

WASHINGTON — Taiwan warned Friday that China’s influence on the world stage could block the island from participating in the response to the coronavirus.

“Due to China’s political interference, Taiwan is not able to attend the World Health Assembly, WHO’s annual meeting, since President Tsai took office in 2016,” Longman Chung, a representative of the Taipei Economic and Cultural Representative Office in the United States (TECRO), wrote in an email to reporters. He referred to the World Health Organization and newly reelected Taiwanese President Tsai Ing-wen.

Although the United States does not maintain formal diplomatic relations with the Taiwanese government, TECRO represents Taiwan unofficially in Washington.

Taiwan confirmed its first case of the virus on Tuesday. The following day, Tsai convened a high-level meeting to discuss the outbreak and called on the WHO to not exclude her country.

“Taiwan has been on the front line of fighting previous disease outbreak in the region from SARS to swine flu,” Chung wrote in the email.

WASHINGTON — About two dozen senators attended a special briefing with top health officials Friday to hear the latest developments on the coronavirus outbreak.

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said he “wouldn’t be surprised if there are additional cases.” But he said public health authorities acted quickly in Illinois after a case emerged there. They “identified, isolated and did contact tracing on the people with whom that person came into contact,” he said. “That’s how you get your handle on an outbreak.”

After the meeting, Sens. Lamar Alexander (R-Tenn.), Patty Murray (D-Wash.), James E. Risch (R-Idaho) and Robert Menendez (D-N.J.) released a bipartisan statement.

“We are monitoring the outbreak of a novel coronavirus closely and are in close communication with United States government agencies on actions and precautions needed to prevent further spread of this virus,” the senators said.

They added that the safety of U.S. citizens in the United States, China and other countries where cases have emerged is their “first priority.”

“The Chinese government has taken steps to share information with international health experts, and we encourage their cooperation and transparency as this situation unfolds,” they said. “We will continue to work closely with administration officials to ensure the United States is prepared to respond.”

WASHINGTON — It’s a tall order: construct and equip a 1,000-bed hospital in less than a week, even as existing Chinese hospitals are experiencing shortages of supplies.

As workers scramble to finish the new facility in about a week, travel bans in Wuhan and other areas could further complicate the delivery of crucial equipment.

Cai, who lives in Wuhan, hopes his company can lend a hand.

He is the business manager of a Wuhan-based medical supply company, and he said in a phone interview with The Washington Post that he plans to work through the holiday in China to help manufacture and deliver 1,000 bedside monitors to the local government for the new hospital.

“We have the material; we need to gather workers to produce [the monitors] in a short time,” Cai said, asking that he be identified by only his family name. “We will consider first safety, then, second, production.”

Will he be able to pull it off in a matter of a week? “We will see,” Cai said.

BEIJING — Senior Chinese Communist Party officials in Wuhan have come under heavy criticism for their slow response to the outbreak.

The mayor of Wuhan, Zhou Xianwang, allowed a huge potluck banquet to go ahead in the city on Sunday, over a weekend when the number of confirmed cases of infection shot up dramatically. The city had arranged a Lunar New Year meal featuring 14,000 dishes for more than 40,000 people, an event it hoped to get listed in Guinness World Records.

“It is only with hindsight that everyone can see how dangerous the virus is,” he said, trying to defend his actions in an interview with state-run CCTV. “If we’d known from the outset that the situation would be so serious, of course we would have tried to find effective ways to control and prevent the outbreak.”

Zhou only enraged people further.

Residents were also astonished to see photos and video of the two top officials in Hubei province — the Communist Party secretary and the governor — at a dance performance in Wuhan to celebrate the arrival of the Spring Festival holiday. They were sharply criticized for enjoying themselves instead of working on the response to the health crisis.

All mention of the performance and the officials’ attendance was scrubbed from the Chinese Internet.

BEIJING — Amid shortages of medical supplies, some doctors in Wuhan have been promoting highly questionable remedies.

Zhang Jinnong, a doctor at Wuhan Union Hospital who claimed to have “almost recovered” from coronavirus after quarantining himself and taking pills for a week, recommended that people who suspect they have the virus stay home and eat chicken soup. Separately, a Wuhan Xinhua Hospital physician, Sun Guobin, prescribed four eggs a day as the remedy for the virus.

At a news conference Thursday at the provincial government buildings, a respiratory expert from Hubei People’s Hospital recommended people make prevention tea following the principles of traditional Chinese medicine.

Hu Ke gave a precise recipe involving roots and flowers and tangerine peels, which he said should be consumed twice a day for seven to 10 days. The two recipes were included in Hubei’s list of recommended treatments, published Thursday.

WASHINGTON — U.S. officials said Friday they are assessing the extent and duration of screening travelers from Wuhan at San Francisco, Los Angeles, New York’s John F. Kennedy, Atlanta and Chicago’s O’Hare international airports. The lockdown in the central Chinese city of Wuhan, where the outbreak began, and nearby cities means fewer travelers from there are arriving in the United States.

The labor-intensive airport screening is being conducted by the Centers for Disease Control and Prevention (CDC). But sick patients with no symptoms might not be detected.

To control the spread of the coronavirus, resources also need to be focused at the state and local levels, where front-line health officials are trying to rapidly identify cases, said Martin Cetron, director of CDC’s division of global migration and quarantine.

WASHINGTON — Health officials are making contingency plans for a virus outbreak that could last months and possibly infect thousands of people, said the Beijing-based representative of the World Health Organization.

Gauden Galea, in various interviews, sketched out some of the potential trajectories of the coronavirus based on what is known so far about its transmission and symptoms. Galea told the New York Times that there are still many unknowns about the virus, but “health officials were preparing for an outbreak that could last for months.”

Galea told the Associated Press it was clear that the number of cases would rise.

“Even if they are in the thousands, this would not surprise us,” he said in the AP interview. “That is not an indicator of seriousness. Indeed, it is very, very good to get and identify as many cases as possible.”

WASHINGTON — The British government held a meeting of its “Cobra” emergency committee Friday. “The clinical advice is that the risk to the public remains low,” Health Secretary Matt Hancock tweeted after the meeting, adding that the country’s chief medical officer will make a further statement.

Cobra refers to the Cabinet Office Briefing Rooms (COBR) in Britain’s Cabinet Office, where senior members of the British government coordinate their actions and responses to crises.

WASHINGTON — Animal rights activists are calling for bans on live animal markets like the one in Wuhan that Chinese authorities have cited as the likely source of the latest coronavirus outbreak.

“Governments must recognize the global public health threats of zoonotic diseases,” said the New York City-based Wildlife Conservation Society in a statement, using the technical term for infectious diseases that can spread from animals to humans. “It is time to close live animal markets that trade in wildlife, strengthen efforts to combat trafficking of wild animals, and work to change dangerous wildlife consumption behaviors, especially in cities.”

At such markets, known as wet markets, fresh meat, poultry and fish are sold and slaughtered, in contrast to dry markets that sell nonperishable goods.

“We’ve known for two decades now that these wildlife markets are really a cauldron for contagion,” Christian Walzer, executive director of the WCS Health Program, told The Post. “It’s a perfect setup for new viruses to spill into human populations.”

Waltzer said that from a public health perspective, one of the main concerns is that a wide array of animals are kept in cramped and stressed conditions in which “they all exchange excretions and secretions.”

“The immune system fails and they just start shedding viruses in huge numbers,” he said. “You put them in cramped conditions. You put them all together. And you’ve stressed them out of their minds.”

The prescription isn’t simple: Live-animal markets are part of a storied tradition as a core part of commercial, cultural and culinary networks.

While acknowledging their centrality to Chinese cuisine and communities, Waltzer said that his group’s petition reflected the public health communities’ evolving understanding of how diseases and pathogens develop

WASHINGTON — The CDC has deployed a team to Chicago to help state and local officials after a woman was diagnosed with coronavirus there.

Officials said they expect to see additional cases. Although the outbreak is a “very serious public health threat, the immediate risk to the U.S. public is low at this time,” said Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases.

U.S. officials have been screening travelers from Wuhan at five airports. More than 2,000 people had been screened from about 200 flights as of Thursday, officials said. But so far, no coronavirus cases have been identified from that effort.

In both confirmed U.S. cases — in Seattle and Chicago — patients were not showing symptoms when they returned on flights from the Wuhan area. In both cases, they began feeling unwell and reached out to health-care providers.

Chicago health officials declined to identify the hospital where the Chicago patient is being evaluated. The woman had limited close contacts, who are also being monitored. She did not take public transportation and did not attend any large gatherings.

“She has not had any extended close contact with anyone outside her home since returning, and that should be very reassuring to the public,” Allison Arwady, Chicago’s public health commissioner, told reporters Friday.

Officials said they do not know how the woman became infected.

WASHINGTON — A cluster of pneumonia cases was reported from people who attended a seafood market in Wuhan on Dec. 31, and 10 days later, a full genomic sequence of the virus was made public, “exemplifying prompt datasharing in outbreak response,” Fauci, the National Institute of Allergy and Infectious Diseases (NIAID) director, wrote in the medical journal JAMA this week.

Early studies of the viral genome suggest a molecular similarity to severe acute respiratory syndrome (SARS), the 2002 viral outbreak that sickened more than 8,000 people and killed 774.

“The extent, if any, to which such transmission might lead to a sustained epidemic remains an open and critical question,” Fauci wrote.

The new coronavirus is from a family of pathogens that were long thought to be relatively benign, typically causing the common cold. But in recent years, global health threats have emerged from different types of coronavirus, which include SARS and Middle East respiratory syndrome (MERS), which has caused a slow-burning outbreak since 2012.

Fauci noted that antiviral treatments that showed promise against MERS are being tested in animal models to see if they could be used as a treatment for the new coronavirus. Vaccines are also being pursued at the NIAID.

During the SARS outbreak, the time from getting the genome of the virus to a clinical trial of a vaccine took 20 months — a timeline that Fauci said now takes about 3.25 months for other viral diseases. Now, using a different vaccine strategy, they hope to bridge the gap from genome to vaccine even more quickly.

WASHINGTON — The Centers for Disease Control and Prevention revealed that a second person in the United States has been diagnosed with the coronavirus.

The woman, now in Chicago, traveled to Wuhan in late December and returned Jan. 13. A few days later, she began to feel unwell and went to a doctor. After being asked about her travel history, she was referred to a hospital that has infection-control procedures. The hospital put her in isolation and arranged for testing with the CDC.

She is in stable condition but is remaining in the hospital primarily to make sure the infection cannot be spread. The CDC said she has been very helpful in providing information about her contacts, and she was not symptomatic while she flew from China.

The CDC said its concern is “low” that she spread the disease. She has had limited close contacts and little movement outside her home since returning from China.

At least 50 people are reported to be under monitoring in 22 U.S. states.

WASHINGTON — In sealed-off Wuhan, crews are scrambling to build a 1,000-bed hospital to treat coronavirus patients.

The goal announced by Chinese officials Friday is ambitious: finish the facility by Feb. 3. That super-fast timetable is aided by use of a prefabricated structure and other ready-to-build materials. At the same time, getting materials and equipment to Wuhan could be complicated by travel bans in place for the city and other areas in attempts to contain the virus.

The planned 270,000-square-foot hospital is modeled after a medical facility specially built in 2003 for patients with SARS, another respiratory infection that began in China and claimed more than 750 lives in more than a dozen countries.

China’s state-run Xinhua News Agency said the new Wuhan hospital is needed “to address the insufficiency of existing medical resources.”

BEIJING — Chinese authorities broadened a lockdown of Wuhan and two surrounding cities on Friday in their efforts to contain the coronavirus.

The lockdowns now extend to a total of 14 cities in Hubei province with a population of more than 35 million as part of extraordinary measures amid growing fears of greater contagion.

NEW DELHI — Nepal became the first country in South Asia to report a confirmed case of coronavirus in a sign of the widening reach of the illness.

Anup Bastola, an infectious disease specialist at Sukraraj Tropical and Infectious Disease Hospital in Kathmandu, told The Washington Post that a 32-year-old student had arrived in Nepal from Wuhan on Jan. 9. He came to the hospital four days later complaining of a fever, cough and shortness of breath.

Because of his travel history, the hospital isolated him, Bastola said. It also sent a sample of his blood to Hong Kong for testing by the World Health Organization, which confirmed the presence of the coronavirus. Bastola said the patient was discharged from the hospital on Jan. 17. As of now, none of the patient’s close contacts or any hospital workers are showing symptoms of the virus, Bastola said. “We are monitoring closely,” he added.

India, Nepal’s much larger neighbor, has yet to report any confirmed cases. But according to local news reports, authorities have quarantined two people in a Mumbai hospital who traveled from China and developed potential symptoms of the virus. Tests have yet to confirm whether they are infected with the coronavirus.

SEATTLE — There is only one confirmed case of a coronavirus patient in the United States, in Snohomish County, Washington. But the patient’s contacts who are being monitored for signs of the illness jumped from 16 to 43.

Authorities provided no information about the types of individuals being monitored, but the fact that the list expanded is not unexpected.

“This is an evolving investigation, similar to peeling back an onion,” said Heather Thomas, Snohomish Health District spokeswoman. “Our disease investigators, in coordination with other public health partners, are doing daily symptom monitoring and contact investigations.”

Washington state Secretary of Health John Wiesman described the patient’s contacts as being under “active monitoring.” Public health officials call them daily to see if they have a fever, cough or other respiratory issues. If they are experiencing symptoms, they are instructed to call public health officials, who will facilitate medical evaluations.

The contacts are people in both Snohomish and King counties and represent individuals who have had “prolonged contact” with the patient — eating meals or holding meetings together, for example.

The patient, in his 30s, remains in isolation at Providence Regional Medical Center in Everett, Wash. At a Wednesday news conference, Jay Cook, Providence’s chief medical officer, said the man is not confined to his hospital bed and is walking around his room.

The staff in the isolation unit are nurses who volunteer to work with patients who are barred from contact with other patients or staff.

Cook said he expects the man to be able to be discharged soon, assuming he continues to improve. “We hope he will continue on his excellent clinical course and hopefully will be able to return to his home in the very near future,” he said.

BEIJING — Amid calls for people to avoid public gatherings during the Spring Festival, the state broadcaster, CCTV, led its midday news program with a report about a huge banquet in Beijing attended by President Xi Jinping and other Communist Party leaders.

None of them were wearing masks, and the report made no mention of the virus outbreak.

He had no chronic diseases or other existing health conditions, and had been treated with anti-virus medication and antibiotics since being admitted to a hospital on Jan. 9.

Another death occurred in Suihua in Heilongjiang province, near the border with Russia and some 1,500 miles from Wuhan.

BEIJING — Wuhan shut down tunnels under the Yangtze River to stop the flow of traffic. That comes in addition to travel bans imposed on Wuhan and seven other areas in Hubei province Thursday, with trains and buses canceled and highways closed.

All ride-hailing services in Wuhan were cut off from midday Friday in attempt to stop transmission of the virus, and only half of taxis are allowed on the road every day, alternating between tags ending in odd and even numbers.

China Southern, the country’s biggest airline, had already canceled all flights in and out of Wuhan airport on Thursday. The other two main carriers, Air China and China Eastern, said they would cancel all Wuhan flights from Friday to at least Feb. 8.

New year festivals and temple fairs around the country have been canceled, and the Forbidden City in Beijing, which can admit 80,000 people a day and was already entirely sold out for the holiday, has been closed until further notice.

Production companies have postponed the release of seven blockbuster films that were to be released over the holiday, prompting Chinese cinema companies to close the country’s 70,000 movie theaters.

Schools in Hubei province, due to begin the spring semester after the holiday, will not open their doors as planned but will wait for further guidance from health authorities. And the Education Ministry instructed universities around China to delay their opening dates if necessary.