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More Than 500 Coronavirus Cases Confirmed in China’s Prisons With 4 Deaths in Iran and More on 3 Continents, Fears of Coronavirus Pandemic Rise
(about 7 hours later)
HONG KONG — The Chinese authorities announced hundreds of new coronavirus cases in Chinese prisons on Friday, underscoring the fast-spreading and unpredictable nature of the virus, which has popped up in far-flung areas with little known connection to the outbreak’s epicenter. HONG KONG — An alarming surge of new coronavirus cases outside China, with fears of a major outbreak in Iran, is threatening to transform the contagion into a global pandemic, as countries around the Middle East scrambled to close their borders and continents so far largely spared reported big upticks in the illness.
At least 500 prisoners and guards, in at least four different prisons across three provinces, had been infected with the virus, officials announced on Friday. More than 200 have been detected in one prison in the city of Jining, 450 miles east of Wuhan, the city at the center of the epidemic. Officials suggested that the Jining outbreak may have been tied to a coughing prison guard who turned out to be infected. In Iran, which had insisted as recently as Tuesday that it had no cases, the virus may have reached most major cities, including Tehran, and has killed at least four people, according to health officials. Already, cases of travelers from Iran testing positive for the virus have turned up in Canada and Lebanon.
The new cases, confirmed in the previous 24 hours, raised the overall total of infections in China above 75,000. The death toll in the country rose by 118, to 2,236. The number of cases also soared in South Korea, with the sudden spread tied to a secretive church where hundreds of congregants attended services with numerous people infected with the virus.
The new clusters showed, once again, the difficulty in judging the scale of China’s epidemic, amid concerns about underreporting and rapidly shifting definitions of confirmed cases. Before the prisoners’ infections were announced, Hubei Province, where the outbreak began, had already released a count of new infections in the previous 24 hours. The United States now has 34 cases, with more expected, and Italy experienced a spike from three cases to 17 and ordered mandatory quarantine measures.
Later on Friday, officials there said they had revised the count, because they had received a handwritten tally of infected prisoners late on Thursday night. The prison system was not connected to the rest of the province’s disease reporting system, they said, renewing questions about the counting of cases and prompting a rare official acknowledgment that constantly changing tallies had sown confusion and mistrust. “The cases that we see in the rest of the world, although the numbers are small, but not linked to Wuhan or China, it’s very worrisome,” Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, said Friday at a news conference at the agency’s headquarters in Geneva. “These dots are actually very concerning.”
“The adjustment of these data has aroused great attention from the society and cast doubt on the numbers,” Tu Yuanchao, deputy director of the Hubei Provincial Health and Health Commission, said at a news conference on Friday, referring to both the addition of the prisoners’ cases and recent adjustments to how Hubei defines a confirmed case. As uneasiness about the breadth and duration of the outbreak grew, stocks fell for the second straight day on Friday amid worries the virus would drag down global demand and hurt the world economy.
The disturbing reports out of Tehran suggested the virus was being transmitted far more widely there than officials had previously acknowledged. While the country’s health officials confirmed only 18 cases by Friday, the number of deaths indicates the total is likely to be far higher.
Four reported deaths probably mean at least 200 cases, said Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. If the virus kills about 2 percent of known victims, as Chinese doctors have reported, then the number of deaths can be multiplied by 50 to get a rough case estimate, he explained.
“People don’t die right away of this virus — it usually takes two or three weeks after cases start to spread for the first death,” Mr. Osterholm said. “So there may be a lot more cases, and a lot more deaths on the way. And we didn’t even know there was a problem in Iran before yesterday.”
Minou Mohsrez, who is on the infectious disease committee of the Iranian Health Ministry, told BBC Persian on Friday that it was clear the virus was spreading across Iran’s cities.
Updated Feb. 10, 2020Updated Feb. 10, 2020
The infected prisoners were among several surging counts on Friday. The number of cases in South Korea continued to soar, as officials there confirmed 100 new cases and the country’s second death. The new figures brought that country’s total number of infections to 204, the world’s largest number of cases outside of China and Japan. “A coronavirus epidemic has started in the country,” she said. “It’s possible that it exists in all cities in Iran.”
Eighty-seven of the 100 new cases in South Korea were connected to a church in the southeastern part of the country. Officials said a 61-year-old woman who tested positive earlier this week, and who had attended services at the church, may have spread the virus there. A spokesman for the Health Ministry, Kianush Jahanpur, said on Friday there were more than 735 people hospitalized with flulike symptoms who were being tested for the virus.
Infections in prisons may be especially concerning because of the risks of rapid transmission among people in close quarters. Kuwait’s civil aviation authority on Friday stopped all flights to and from Iran, which shares a long border with both Afghanistan and Iraq, where health officials have a limited capacity to stop the spread of the virus should it find its way to those countries.
There might be limited space available to isolate patients, who would likely be crowded indoors, in high density situations, said Dr. Benjamin Cowling, a professor of epidemiology at the University of Hong Kong. “It’s a really difficult situation to prevent transmission from occurring,” he said. Dr. Sylvie Briand, the director of infectious hazards management for the W.H.O., said the rapid increase in cases in Iran was disquieting.
In a sign of the risks posed by the clusters in prisons, nearly a dozen officials were dismissed on Friday in relation to the outbreaks, according to state media reports. Among them were the party secretary of the provincial justice department in Shandong Province, home to Jining, and a warden and party secretary at a prison in Zhejiang. “We are wondering what the extent of the outbreak in Iran is,” she told reporters on Friday. “We are wondering about the potential for more cases to be exported in the coming days. We want all countries to be aware of this and to put in place detailed measures to pick up these cases as early as possible.”
Also on Friday, the Communist Party’s Central Committee, a group of about 370 senior officials, sent an investigative team to Shandong Province, to probe the prison outbreak there, according to People’s Daily, the party’s main newspaper. As concern grew that Iran was emerging as an important new vector of transmission, the country where the coronavirus originated was also responding to significant negative developments.
The authorities in Shandong said in a statement that they would “quickly set up a hospital” on prison grounds to treat those infected. Officials in China, already straining to deal with an outbreak that has infected more than 76,000 people and resulted in 2,300 deaths, announced a new front in its war on the virus on Friday as officials reported clusters of infections in at least four prisons in three provinces.
Still, some expressed skepticism about the quality of prisoners’ care. The outbreaks, affecting at least 512 prisoners and guards, raised the specter of the disease spreading through the country’s extensive prison system.
“Prisoners are routinely denied of access to adequate medical care even during normal times,” Yaqiu Wang, a China researcher at Human Rights Watch, said. “Now with medical resources stretched to the limit in many areas in China, it is hard to imagine prisoners’ medical needs would be a priority of the government.” More than 200 of the infections occurred in one prison in the city of Jining, 450 miles east of Wuhan, the capital of Hubei Province and the center of the outbreak; officials there suggested that the cluster may have been tied to a prison guard.
Nursing homes have also emerged as potential transmission hotspots, prompting concern given the virus’s documented toll on the elderly. In South Korea, the total number of cases surpassed 200 on Friday, and the authorities were racing to trace all the people who have come in contact with members of the Shincheonji Church of Jesus, whose members account for two-thirds of the new infections in the country.
In the city of Qiqihar, near the Chinese border with Russia, a district party secretary was removed from his post because he had not done enough to prevent the epidemic, according to an official notice on Feb. 15. Of 10 confirmed cases in the district he oversaw, the notice said, one occurred in a nursing home. More than 540 other church members have reported potential symptoms, health officials said, raising the possibility that the nation’s caseload could skyrocket.
In Zhejiang, an official said recently that the province had been the first in the nation to seal off nursing homes, barring all except some essential staff from entering. As of Friday, more than 340 members of Shincheonji, which mainstream South Korean churches consider a cult, still could not be reached, according to health officials, who were hoping to screen them for signs of infection.
“Everyone knows that the elderly are the key group for epidemic prevention and control, and nursing homes are a place where the elderly live in high concentration,” the official, Li Jie, said. In response, the government is shutting thousands of kindergartens and community centers, even banning the outdoor political rallies that are a feature of life in downtown Seoul.
The virus is also spreading even in places that might be expected to have the closest monitoring and prevention. In Beijing, a spike in cases at two hospitals raised fears that the epidemic could be growing in a city so far largely spared from extensive infections. All four virus-related deaths in Iran occurred in Qom, a holy city popular with Shiite pilgrims across the Middle East.
An outbreak in this city would have great symbolic resonance, especially as the central authorities have urged workers to restart the economy, and China’s leader, Xi Jinping, recently touted “visible progress” in fighting the epidemic. People have already tested positive in Qom, Tehran and Gilan, near the Caspian Sea, said Mr. Jahanpur, the Health Ministry spokesman.
In Beijing’s Fuxing Hospital, on the city’s western side, at least 36 people are infected. They include eight medical workers, nine janitorial workers and 19 patients or their relatives. “Most of these people were residents of Qom or they had traveled to Qom in the past days or weeks,” he said.
The new figures reflected a large jump since Feb. 3, when city officials first announced that five medical workers had tested positive for the virus. In Qom, schools and religious seminaries were shut down on Thursday as officials urged people to avoid gathering in large groups. But on Friday, as Iranians went to vote in parliamentary elections, polling stations were open and the communal pools of ink for people to dip their fingers proving they voted were in wide use.
Another medical center, Peking University People’s Hospital, also recorded its first three cases: a woman who had previously been hospitalized and her daughter and son-in-law who had visited her after traveling to Xinjiang, the western region. With rumors spreading across the country on instant messaging services like Telegram, a confused and increasingly worried public watched as Tehran’s largest metro station was suddenly closed. Workers wearing protective gear descended on the station, apparently responding to reports of sick commuters. It remained closed Friday night.
Beijing, compared to other provinces and provincial-level cities, has had comparatively few cases: 396 as of Thursday and only 4 deaths. There was growing skepticism over the government’s handling of the outbreak. Mahmoud Sadeghi, an outspoken member of Parliament from Tehran, accused the government of “covering up the spread of an epidemic.”
Dr. Cowling, in Hong Kong, said that though medical staff treating confirmed patients might be highly vigilant and well protected, infection could still occur in other wards of a medical center, if staff members there did not know they were treating someone with exposure to the virus. While the source of the outbreak in Iran could not be pinned down, officials speculated that it began in the large population of Chinese workers in the country.
The infection — and in some cases, deaths — of medical workers has for many Chinese become a potent symbol of the epidemic’s toll. On Thursday, another doctor in Wuhan died. The doctor, Peng Yinhua, was just 29 years old and had postponed his wedding to continue treating patients, according to a statement from the hospital he worked and local media reports. Critics accused the government of playing down the disease, and failing to take strict precautions to prevent its arrival in the country, in order to avoid provoking China, a key trading partner and a lifeline for Iran’s economy in the face of U.S. sanctions.
Earlier this week, another high-profile doctor, Liu Zhiming, died. Dr. Liu was the director of the Wuchang Hospital in Wuhan. The sanctions against Iran could hamper its ability to contain the spread of the virus and diminish the country’s ability to mobilize international support.
Choe Sang-Hun contributed reporting. Amber Wang, Claire Fu, Yiwei Wang and Zoe Mou contributed research. “Iran does have problems accessing specialized medication for rare and special diseases because of sanctions — either private companies or banks refuse to work with Iran in fear of U.S. secondary sanctions,” said Tara Sepehri Far, an Iran researcher at Human Rights Watch.
The new global clusters showed, again, the difficulty in judging the true number of infections, amid concerns about underreporting and rapidly shifting definitions of confirmed cases.
Further bolstering the idea that the virus is spreading widely, an epidemiological modeling team from Imperial College in London estimated Friday that two-thirds of the people infected with coronavirus who left mainland China before restrictions were imposed had traveled throughout the world without being detected.
The team, one of several modeling groups regularly consulted by the W.H.O., calculated how many cases were detected in different countries and how many should have been detected based on flights that left Wuhan just before most air travel out of China ended.
Detection failures “potentially resulted in multiple chains of as-yet-undetected human-to-human transmission,” the modeling team’s study concluded.
The virus is spreading even in places that might be expected to have the closest monitoring and prevention. In Beijing, a spike in cases at two hospitals raised fears that the epidemic could be growing in a city so far largely exempt from extensive infections.
The infections — and in some cases, deaths — of medical workers have become a potent symbol of the epidemic’s toll for many Chinese. On Thursday, another doctor in Wuhan died. The doctor, Peng Yinhua, 29, had postponed his wedding to continue treating patients, according to a statement from the hospital where he worked.
Earlier this week, a high-profile doctor, Liu Zhiming, the director of the Wuchang Hospital in Wuhan, died.
The almost random nature of new reports and new deaths is an indication the virus is moving much faster than countries are reporting to the W.H.O., Dr. Osterholm said.
“How many of these clusters and travel cases and prison outbreaks do we have to see before we realize that we’re just seeing the tip of the iceberg?” he said. “Testing is just getting set up around the world. There’s barely any in Africa right now. Even in the U.S., we’re testing travel cases — but we’re not testing in any meaningful way that will pick up cases that we didn’t suspect were there.”
Vivian Wang reported from Hong Kong, Donald G. McNeil Jr. and Farnaz Fassihi from New York, and Steven Lee Myers from Beijing. Marc Santora contributed reporting from London.