The Philippines has reported the first death from the coronavirus outside China, adding to fears about the spread of the virus as more countries imposed travel restrictions.
The outbreak of the respiratory illness has killed 304 people in China since it was first detected in the central city of Wuhan late last year. Across China, there were 2,590 new confirmed infections on Saturday, bringing the total to 14,380, China’s National Health Commission said on Sunday. A study published on Saturday by scientists from the University of Hong Kong found that the virus may have infected as many as 75,815 people in Wuhan.
The virus, which has been declared a global public health emergency, has caused at least 100 infections in more than 20 countries, with Britain, Russia and Sweden confirming their first infections over the weekend. Japan has recorded 20 cases, including those involving human-to-human transmission, while the US on Sunday reported its eighth case.
Japan on Saturday confirmed an additional three cases among evacuees from Wuhan, including one, a man in his 40s, who initially tested negative, the health ministry said.
The fatality in the Philippines is a 44-year-old Chinese man from Wuhan who died in a hospital in Manila. He appears to have been infected before his arrival in the Philippines.
“This is the first reported death outside China,” Rabindra Abeyasinghe, the World Health Organisation representative to the Philippines, said. “However, we need to take into mind that this is not a locally acquired case. This patient came from the epicentre of this outbreak.”
The Philippine department of health said the man was admitted to hospital on 25 January with a fever, cough and sore throat. He developed severe pneumonia, but in the past few days, “the patient was stable and showed signs of improvement”, it said. However, his condition then deteriorated and he died within 24 hours.
The man was with a Chinese woman who also tested positive for the virus, health secretary Francisco Duque said. She was the Philippines’ first case of the virus and is recovering in a hospital isolation ward.
The news of the man’s death was released shortly after the Philippines announced it would immediately halt the arrivals of any foreign travellers from China, joining several other countries that have imposed similar bans in an attempt to contain the virus.
On Sunday, Indonesia also said it will temporarily stop flights to and from mainland China from Wednesday and bar visitors who have been in China for 14 days from entering or transiting.
Stricter border controls, along with the suspension of flights and business operations have sparked fears of a slowdown in China, the world’s second-biggest economy.
The US, Australia, Singapore and Israel have banned foreign nationals from visiting if they have been in China over the previous 14 days, and advised their own citizens not to travel there. Mongolia, Russia, and Nepal closed their land borders, while Papua New Guinea has banned anyone arriving from ports or airports across Asia. Other countries have imposed restrictions on people who have visited Hubei province in the past 14 days.
Vietnam declared a public health emergency over the coronavirus epidemic on Saturday and said it would halt all flights to and from China. The government said it would also stop issuing visas for foreign visitors who had been in China in the past two weeks.
On Sunday, New Zealand said it would bar entry to all foreign nationals arriving from mainland China. The ministry of foreign affairs and trade also raised its travel advice to New Zealanders for all of mainland China to “Do not travel”, the highest level.
Confirmation of the first death outside China comes after thousands of Hong Kong medical workers voted to go on strike, calling for the government to close the border with mainland China. The financial hub had 13 confirmed cases of the disease as of Saturday, with 112 patients isolated.
More than 3,000 public hospital staff, including doctors and nurses, agreed to a week of phased strike action starting on Monday if the government failed to meet their demands.
What is the virus causing illness in Wuhan?
It is a member of the coronavirus family that has never been encountered before. Like other coronaviruses, it has come from animals. Many of those initially infected either worked or frequently shopped in the Huanan seafood wholesale market in the centre of the Chinese city.
What other coronaviruses have there been?
New and troubling viruses usually originate in animal hosts. Ebola and flu are other examples – severe acute respiratory syndrome (Sars) and Middle Eastern respiratory syndrome (Mers) are both caused by coronaviruses that came from animals.
What are the symptoms of the Wuhan coronavirus?
The virus causes pneumonia. Those who have fallen ill are reported to suffer coughs, fever and breathing difficulties. In severe cases there can be organ failure. As this is viral pneumonia, antibiotics are of no use. The antiviral drugs we have against flu will not work. If people are admitted to hospital, they may get support for their lungs and other organs as well as fluids. Recovery will depend on the strength of their immune system. Many of those who have died were already in poor health.
Is the virus being transmitted from one person to another?
Human to human transmission has been confirmed by China’s national health commission, and there have been human-to-human transmissions in the US and in Germany. As of 5 February, the death toll has climbed to 490 in mainland China. There remains one additional fatality in Hong Kong and one in the Philippines. There are 24,505 confirmed cases around the world, with 24,292 being in mainland China. The mortality rate stands at 2.1%.
Two members of one family have been confirmed to have the virus in the UK, after more than 400 were tested and found negative. The Foreign Office has urged UK citizens to leave China if they can.
The number of people to have contracted the virus could be far higher, as people with mild symptoms may not have been detected. Modelling by World Health Organization (WHO) experts at Imperial College London suggests there could be as many as 100,000 cases, with uncertainty putting the margins between 30,000 and 200,000.
Why is this worse than normal influenza, and how worried are the experts?
We don’t yet know how dangerous the new coronavirus is, and we won’t know until more data comes in. The mortality rate is around 2%. However, this is likely to be an overestimate since many more people are likely to have been infected by the virus but not suffered severe enough symptoms to attend hospital, and so have not been counted. For comparison, seasonal flu typically has a mortality rate below 1% and is thought to cause about 400,000 deaths each year globally. Sars had a death rate of more than 10%.
Should I go to the doctor if I have a cough?
Unless you have recently travelled to China or been in contact with someone infected with the virus, then you should treat any cough or cold symptoms as normal. The NHS advises that people should call 111 instead of visiting the GP’s surgery as there is a risk they may infect others.
Is this a pandemic and should we panic?
Health experts are starting to say it could become a pandemic, but right now it falls short of what the WHO would consider to be one. A pandemic, in WHO terms, is “the worldwide spread of a disease”. Coronavirus cases have been confirmed in about 25 countries outside China, but by no means in all 195 on the WHO’s list.
There is no need to panic. The spread of the virus outside China is worrying but not an unexpected development. The WHO has declared the outbreak to be a public health emergency of international concern, and says there is a “window of opportunity” to halt the spread of the disease. The key issues are how transmissible this new coronavirus is between people and what proportion become severely ill and end up in hospital. Often viruses that spread easily tend to have a milder impact.
Sarah Boseley Health editor and Hannah Devlin
In China, cities began to implement more extreme restrictions on residents. In Huanggang – the second most affected city after Wuhan – authorities barred residents from leaving their homes. Families in the city, also in Hubei province, were to choose one person from their household to leave and buy food and other necessities. The city of Wenzhou in neighbouring Zhejiang province announced similar measures.
In Huanggang, six officials were fired over “poor performance” in handling the outbreak, the official Xinhua news agency reported. It cited the mayor as saying the city’s ability to treat patients remained inadequate and that there was a severe shortage of medical supplies such as protective suits and medical masks.
The situation across Hubei province remains “severe and complicated” and medical resources at county level are relatively weak, vice governor Xiao Juhua told a news conference on Sunday.
China’s military said it would send 1,400 medical personnel to Wuhan, the epicentre of the outbreak. The personnel will staff one of two new hospitals built in the past two weeks, scheduled to open on Monday.
China is facing increasing global isolation as dozens of airlines suspended flights. Some countries are still trying to evacuate hundreds of their citizens. On Sunday Australia backed down on plans to charge its evacuees $1,000 to be taken to quarantine on Christmas Island, while a plane repatriating 250 French and European nationals landed at a military airbase in Istres in southern France.
The Russian military will start evacuating Russian citizens on Monday, domestic media reports said.
In China itself, cities and villages are becoming ghost towns, with about 50 million people in Hubei province alone under lockdown and many more living under self-imposed quarantine.
In Hubei, roads have been sealed off and public transport shut down, and the province extended its Lunar New Year holiday break to 13 February. However, people are leaving Hubei on foot over a bridge spanning the Yangtze river.
Associated Press, Reuters and Agence France-Presse contributed to this report
