A deadly outbreak is growing. Here’s what you need to know.
- China restricts travel for 35 million people as the death toll rises, including a 36-year-old man.
- New cases are confirmed in the United States and France.
- Anger and mistrust spill over online
- Anxiety hangs over residents on Lunar New Year’s Eve.
- China reports two deaths outside the center of the outbreak.
- Experts are preparing for an outbreak that could last months.
- Overrun hospitals turn away residents, some displaying symptoms.
China restricts travel for 35 million people as the death toll rises, including a 36-year-old man.
The authorities on Friday greatly expanded a travel lockdown in central China to include 12 cities near the center of the outbreak, effectively penning in 35 million residents — nearly the population of Canada — in an effort to contain the dangerous coronavirus.
The virus has infected more than 900 people worldwide, according to government statistics.
The new travel limits — abruptly decreed ahead of the Lunar New Year holiday, China’s busiest travel season — were an extraordinary step that underlined the governing Communist Party’s deepening fears about the outbreak of a little-understood coronavirus.
Just one day after China restricted travel in and from the center of the outbreak, Wuhan, a city of 11 million and the capital of Hubei Province, and four nearby towns, the government announced plans to suspend public transportation services covering more than half the population of the province.
Maps: Where the Wuhan Coronavirus Has Spread
The virus has sickened more than 900 people in China and a handful in other countries.
The rapidly expanding outbreak has overwhelmed the Chinese province’s hospitals and fueled fears of a global pandemic. Chinese health officials reported on Friday that there had been 26 deaths from the outbreak and more than 900 cases of the coronavirus, a sharp increase.
All the deaths reported so far have been in China. Most have been older patients, but included a 36-year-old man.
On Thursday morning, the authorities imposed a travel lockdown in Wuhan, and airlines canceled hundreds of flights to the city, leaving thousands of people stranded.
Later in the day, officials said they would also halt public transportation in the nearby cities of Huanggang, Ezhou, Zhijiang and Chibi, which are together home to more than nine million residents. By Friday, restrictions had been announced in eight other cities.
New cases are confirmed in the United States and France.
The Centers for Disease Control and Prevention announced on Friday that a second case of the coronavirus had been confirmed in the United States: a woman in her 60s in Chicago who had recently traveled to Wuhan, China, the center of the outbreak.
The other case, a man in his 30s, was in Washington State.
The unidentified woman returned to Chicago on Jan. 13, officials said. She became ill days later. As of Friday, she was still hospitalized but was doing better. Officials at a news briefing declined to name the hospital.
The C.D.C. told reporters that 63 patients in 22 states were under investigation for the coronavirus; 11 have tested negative.
France became the first country in Europe to report the infections. Agnès Buzyn, the health minister, told reporters on Friday evening that the authorities had confirmed two cases in the country: a 48-year-old man who had been to Wuhan recently and returned to France on Wednesday, now in isolation at a Bordeaux hospital; and a man in Paris.
“We don’t have the history of this patient yet, but we know that his tests came back positive,” the minister said of the Paris patient. She said France reported the first European cases “because we were very quick in establishing the test and identifying the cases.”
Officials were watching for more cases: In the United States, a Texas A&M University student was being isolated at home on Thursday as health officials said they were examining whether he had the coronavirus infection.
The student had traveled from Wuhan, where the outbreak of the respiratory illness began, and health care providers determined that he met the criteria for coronavirus testing, health officials in Brazos County, Texas, said. They said they would promptly announce if testing confirmed the patient’s illness was a case of the coronavirus.
Federal officials have announced expanded screenings for the infection at major airports in the United States. In addition to New York, Los Angeles and San Francisco, airports in Atlanta and Chicago began examining passengers arriving from Wuhan for signs of illness.
Anger and mistrust spill over online
On Chinese social media, people across the country expressed mounting mistrust and resentment of the authorities in Wuhan, whom they blamed for mishandling the outbreak.
On the Twitterlike platform Weibo, Li Haipeng, a former journalist, wrote: “What is happening in Wuhan is really outrageous. Can it be hollow to this extent, incompetent to this degree?”
His post was shared more than 41,000 times and received more than 5,000 comments. One commenter wrote, “I hope the central government can take over before dawn. It’s almost like anarchy.”
Another wrote, “Wuhan’s party secretary and governor cannot soothe the people’s anger.”
Anxiety hangs over residents on Lunar New Year’s Eve.
The Lunar New Year is the most important holiday in the traditional Chinese calendar, and celebrations start on the eve, which this year falls on Friday. Chinese were expected to travel home in time to help wrap dumplings or fry sticky rice cakes for all-important reunion dinners with their extended families. At midnight, families around the country usually set off firecrackers and fireworks.
But these celebrations are set to be far more muted this year, particularly in Wuhan and other parts of Hubei Province where the authorities have imposed travel restrictions.
In Wuhan, people waited anxiously on Friday outside Hankou Hospital, one of the medical facilities designated to test for the coronavirus, as their relatives sought treatment inside.
Several said the Lunar New Year would pass without the usual celebrations or vacation travel. They and other residents said that the city was now also confronting food supply problems because so many shops and markets had closed, adding to the hardships caused by the city shutdown.
“We won’t have a new year celebration tonight. There’s no feeling for it, and no food,” Wu Qiang, a resident in his 50s who was waiting outside the hospital entrance for word about his son, told a New York Times correspondent.
Mr. Wu said he understood the need to close off the city, but added that city authorities should ensure that enough shops and markets were selling fresh food. He said his son had been sneezing, setting off alarm at home.
“I think he’s O.K., but now even an ordinary sneeze makes you worry,” Mr. Wu said. “You start to think every cough or sneeze might be the virus.”
Chen Yanming, 47, who said her father might have contracted the coronavirus, said she was melancholic and anxious as the Lunar New Year came. She said her father had suffered a high fever for a few days and was being treated in the hospital.
“Today should be the Chinese people’s happiest day,” she said, “but this sickness has destroyed that feeling.”
China reports two deaths outside the center of the outbreak.
The official death toll from the mysterious coronavirus increased by more than a half-dozen in 24 hours, to 26, while the number of confirmed cases jumped by more than 200.
The majority of the deaths have occurred in Hubei Province, in central China, but two deaths have been confirmed outside the center of the outbreak.
One patient died in Hebei Province, more than 600 miles north of Wuhan, the authorities announced on Thursday. Another death was confirmed in Heilongjiang, a province near the border with Russia, more than 1,500 miles from Wuhan.
The youngest victim of the outbreak so far has been identified as a 36-year-old man identified only as Li. He died on Thursday after being admitted to the hospital on Jan. 9, the Hubei Health Commission said. He suffered a cardiac arrest less than two hours before he died, officials said.
The disease has now been detected in Nepal, Vietnam, Singapore, Japan, South Korea, Taiwan, Thailand, France and the United States, in travelers who had visited China.
On Friday, the authorities in Nepal said a student who had returned to the country from China had been confirmed to be infected with the coronavirus. He has already been treated and released.
Dr. Anup Bastola, a spokesman for the government-run Sukraraj Tropical and Infectious Diseases Hospital, said a 32-year-old doctoral student was admitted to the hospital on Jan. 13 after having some respiratory problems.
Concerned over his symptoms, the doctors sent sample of his blood and sputum for testing. Later, he was found to be infected with the virus that emerged from Wuhan, China.
After spending four days in the hospital, the student was discharged on Jan. 17.
In the aftermath, Nepal’s Health Ministry has activated health screenings at Tribhuvan International Airport.
Experts are preparing for an outbreak that could last months.
Dr. Gauden Galea, the representative of the World Health Organization in Beijing, said in an interview on Friday that while much was uncertain, health officials were preparing for an outbreak that could last for months. He said that eventually thousands of people would most likely be infected, citing models produced by public health experts.
“My own office is gearing up for a number of months,” Dr. Galea said. “We do not expect it to disappear in a number of days.”
He said much would depend on the patterns of infection over the holiday travel season. He said there was little precedent for the travel restrictions imposed by the Chinese authorities but that public health experts were hopeful that they could help contain the virus, along with efforts to expand screening, promote the use of masks and isolate sick patients.
Still, he acknowledged, health officials were being forced to improvise. “Part is science and part is hope,” he said.
Dr. Galea, who visited Wuhan this week before the lockdown, defended how Chinese officials had handled the outbreak, saying they had been transparent in sharing data. He said the Chinese authorities faced a daunting challenge.
“With the number of cases,” he said, “one would expect health systems to be stretched.”
Overrun hospitals turn away residents, some displaying symptoms.
As Wuhan residents waited in long lines at hospitals to be checked for possible coronavirus infections, some residents complained they were not able to get the treatment they needed.
Xiao Shibing, 51, has had a fever for 15 days and finds it difficult to breathe. When he went to a hospital, he was not tested for the coronavirus, said his daughter, Xiao Hongxia. He was told he had a viral chest infection and was sent home.
Mr. Xiao’s family has continued to seek treatment, visiting other hospitals, but has been turned away by at least three because of a shortage of beds, his wife, Feng Xiu, said. “It is like kicking a ball from here to there,” she said.
Cai Pei, 41, said his wife began coughing and developed a fever three days ago. He wrote on Weibo that hospitals would not admit her, and he had difficulty finding masks and cold medicine in pharmacies.
They still do not know if she is infected with the coronavirus or some more common ailment.
“Sometimes I can only hide and cry, but I couldn’t tell her and had to reassure her that it is not the virus,” Mr. Cai said by phone. “It is very scary. If it’s real, we have a child and elderly parents at home. What if we all get sick?”
Wuhan hospitals make urgent appeals for supplies and help.
Hospitals and medical workers at the center of the outbreak in Wuhan made urgent appeals for supplies, as stocks of surgical masks and other equipment quickly flew off shelves.
“Shortage of medical supplies, request help!!!” the Wuhan Children’s Hospital said on Thursday in a post on Weibo, the Chinese social network.
The hospital asked for donations of surgical masks, disposable garments, protective goggles and gloves.
Several others, including Hubei General Hospital, Renmin Hospital of Wuhan University and the Central Hospital of Wuhan, posted similar notices.
The central government on Thursday acknowledged the severe strain on resources, and the Ministry of Finance announced an urgent allocation of one billion renminbi, about $144 million, for epidemic prevention and control work.
State news media also carried reports of people volunteering to help ease the strain on health workers. Young doctors at the Renmin Hospital of Wuhan University volunteered to take on additional shifts or to take over from colleagues with children, the state broadcaster CCTV reported.
A team of 30 volunteers in Wuhan mobilized to drive doctors to and from hospitals, while others have offered to help the local Red Cross answer phone calls and publicize requests for help from hospitals, according to a report by the China Business Journal.
Britain and the U.S. warn citizens to avoid the outbreak zone.
The American and British governments on Friday urged travelers to avoid the city of Wuhan and the surrounding area amid growing signs that the outbreak of the coronavirus was worsening.
The American Embassy in Beijing advised travelers from the United States to avoid Hubei Province, where Wuhan is the capital. It said the State Department had already ordered nonemergency government personnel to leave the city. It further warned that the Chinese government might prevent travelers from arriving or leaving.
The State Department notice was a Level 4 advisory, the sternest warning the United States government issues regarding travel. Other Level 4 warnings issued by the State Department cover travel to Syria, North Korea, Afghanistan, Iraq, Venezuela and Yemen, among other places. The warning is a step up from Washington’s earlier cautions. Just a day before, the American government had been advising travelers to “exercise extreme caution” when traveling to the Wuhan area.
The British government, in a notice dated Thursday, similarly advised against all but essential travel to Wuhan. The warning came a day before the government’s Cobra committee was to meet in Downing Street to discuss the threat posed by coronavirus to Britain, according to local news reports.
Fourteen people in Britain were tested for the disease, and all came back negative, the chief medical officer, Chris Whitty, announced on Friday. But checks on others were continuing.
Some British universities have also warned students considering traveling home to China that they could face quarantine on their return. The University of Chester had warned its Chinese students that if they return to their homeland, they would not be readmitted without a quarantine period, The Guardian reported.
In a statement on Friday, however, a spokeswoman for the university said in an email: “The University of Chester has a relatively small Chinese student cohort and they are being appropriately supported. All students have been advised they must not interrupt their studies to return to China at this point.”
Universities UK, which represents 136 universities in England, Scotland, Wales and Northern Ireland, said in an emailed statement on Friday: “U.K. universities have been monitoring the coronavirus situation as it unfolds and universities with students in affected areas are working to identify appropriate actions. Universities will continue to follow the latest FCO advice and to monitor the situation, which is evolving rapidly.”
Shanghai Disneyland and other major attractions will shut down.
Shanghai Disneyland, one of the biggest tourist attractions in China, will shut down on Saturday as the Chinese authorities and others look for ways to reduce crowds to stop the spread of the coronavirus.
In a notice on its website on Friday, Shanghai Disney Resort, the arm of the Walt Disney Company that runs Shanghai Disneyland, blamed the outbreak for the shutdown and said it would reopen at an unspecified date.
The shutdown adds to the tourist and cultural attractions closing across China at the beginning of the Lunar New Year holiday, when many families head out of the house to spend quality time together.
On Friday, the authorities operating the Badaling section of the Great Wall of China, a popular tourist destination north of Beijing, said it would temporarily close beginning on Saturday. Shanghai Huangpu River Cruise, the company that operates boat tours along Shanghai’s scenic Bund area, said the same. On Thursday, film companies said they would pull new releases planned for the peak film-going period.
A prolonged Shanghai Disneyland shutdown could add to the problems in the region for Disney, the American entertainment giant. Attendance at its Hong Kong Disneyland theme park has been battered by anti-Beijing protests that have swept through Hong Kong’s streets in recent months, frightening away many tourists from mainland China.
Disney owns a 43 percent stake in Shanghai Disney Resorts, while state-owned Shanghai Shendi Group holds a majority stake.
The closings at a peak spending time could come at a considerable cost to the Chinese economy, though it isn’t clear how big that toll might be.
The Economist Intelligence Unit projects that the coronavirus could reduce China’s growth by 0.5 percent to 1 percent, compared with its projected growth rate of 5.9 percent before the outbreak, if the disease worsens on the level of SARS, the outbreak that killed hundreds in 2003.
That hit would be smaller than the blow from SARS. On the other hand, China’s growth is already slowing, unlike during the SARS outbreak, adding to Beijing’s problems.
Masks may help, but experts say it’s more important to wash your hands.
Many infectious disease specialists say that cheap, disposable masks that cover the nose and mouth can help prevent the spread of infections if they are worn properly and used consistently.
But there isn’t much high-quality scientific evidence on their effectiveness outside health care settings, experts say.
Dr. Julie Vaishampayan, chairwoman of the public health committee for the Infectious Diseases Society of America, said surgical masks are “the last line of defense.”
The masks will, however, block most large respiratory droplets from other people’s sneezes and coughs from entering your mouth and nose, said Dr. Amesh Adalja, an infectious disease physician at the Johns Hopkins Center for Health Security. Coronaviruses are primarily spread through droplets, he said.
Dr. Mark Loeb, an infectious disease specialist at McMaster University in Hamilton, Ontario, said a study during an outbreak of the SARS coronavirus found that any type of protection — whether a mask or a respirator — reduced the risk of infections in health care workers by about 85 percent.
“The most important message was that the risk was lower if they consistently used any mask,” he said.
But washing hands — frequently and before eating — is universally recommended. Hand sanitizer is effective against respiratory viruses.
China’s propaganda arm features smiles and praises sacrifices as the disease spreads.
China’s propaganda machine has ramped into overdrive as the authorities fight the spread of the coronavirus, praising the sacrifices of responders and everyday people amid continued criticism online of the government’s efforts to address the disease.
Mainstream Chinese news outlets have covered the outbreak closely, though censorship prohibits them from taking a critical look, while official news media like CCTV and The People’s Daily newspaper have played it down. State news media issued herograms to the patriotic Chinese citizens who canceled their trips home to Wuhan and would spend the Lunar New Year holiday alone. It praised doctors heading off to Wuhan.
“People of Wuhan are making sacrifices,” Hu Xijin, the editor of The Global Times, a nationalist tabloid controlled by the Communist Party, wrote on Twitter. “No matter how all of this happened, I want to express my sympathy and salute to them.”
On what may be the most watched television show on earth, the Spring Festival Gala, the Chinese government on Friday cheered on Wuhan and praised the country’s leader, Xi Jinping.
Each year, on the eve of the Lunar New Year, the state broadcaster China Central Television shows the gala, a four-hour marathon of speeches, skits and song and dance, all conducted at a stately pace to accommodate a graying audience. Watching the gala while making dumplings — or falling asleep in front of it — is a tradition for many families across the country.
On Friday night’s broadcast, China’s propaganda minders addressed the coronavirus outbreak head on. During the first half of the broadcast, six prominent CCTV anchors stood onstage and praised the instructions of Mr. Xi and the Communist Party.
They showed images of doctors and nurses treating patients, of trucks of supplies festooned with banners that said, roughly translated, “Go, Wuhan!”
They cited the example of Wang Qiang, the Chinese tennis player who earlier on Friday upset Serena Williams in the Australian Open. “As long as we’re not afraid and dare to confront challenges,” said Hai Xia, a longtime CCTV anchor, “we will win.”
Then they declared that the fight against the coronavirus was open, transparent and a testament to the competence of the government. Ms. Hai cited “the most transparent information disclosure, the strong leadership of the party’s Central Committee, the efforts of the whole nation.”
By featuring the response on the gala, the government gave its message a broad platform. The anchors ended their presentation with their own cheer: “Go, Wuhan!”
Reporting was contributed by Chris Buckley, Javier Hernández, Vivian Wang, Austin Ramzy, Elaine Yu, Tiffany May, Carlos Tejada, Russell Goldman, Gillian Wong, Paulina Villegas, Steven Lee Myers, Denise Grady, Karen Zraick, Roni Caryn Rabin, Carl Zimmer, Rick Gladstone, Yonette Joseph, Bhadra Sharma, Alexandra Stevenson, Adam Nossiter and Aurelien Breeden. Research was contributed by Amber Wang, Albee Zhang, Claire Fu, Elsie Chen, Yiwei Wang and Zoe Mou.