Hong Kong reported its first death from the coronavirus and four major Chinese cities hundreds of miles from the centre ordered lockdowns as concerns about the spread of the disease mounted.
The country’s leadership admitted “shortcomings” in its handling of the outbreak, with the number of infections and deaths still mounting daily. The death toll inside China has passed 420 and Britain has advised its citizens to leave the country.
A 39-year-old man with an underlying health condition died in Hong Kong on Tuesday morning, according to the public broadcaster RTHK.
His death is the second outside the mainland after a Chinese national from Wuhan was confirmed on Sunday to have died in the Philippines.
China announced 64 more deaths on Tuesday – surpassing Monday’s record to confirm the biggest daily increase since the virus was detected late last year in the central province of Hubei.
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 7 February, the death toll stands at 636 inside China, one in Hong Kong and one in the Philippines. Infections inside China stand at 31,161 and global infections have passed 280 in 28 countries. The mortality rate is 2%.
Two members of one family have been confirmed to have the virus in the UK, and a third person was diagnosed with it in Brighton, 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
The virus has killed at least 426 people, exceeding the 349 mainland deaths from the severe acute respiratory syndrome (Sars) outbreak of 2002-03, which killed nearly 800 globally.
The total number of infections in China also rose, to more than 20,000. The World Health Organization (WHO) has declared the crisis a global health emergency, with at least 151 cases in 23 other countries and regions.
The vast majority of cases are still concentrated in and around Wuhan, the Hubei provincial capital, which has been on lockdown for nearly two weeks. But with increasing numbers of infections registered in other parts of China, some of the worst-hit areas are also bringing in radical measures.
Several cities in Zhejiang, a coastal province with a strong trade and manufacturing heritage, have shut schools, businesses, markets and shopping centres, cut off most public transport and barred residents from leaving their homes except to buy necessities or seek medical treatment.
The coastal city of Wenzhou, hundreds of miles east of Wuhan, was the first to bring in “special measures”, Reuters reported. On Sunday it had 291 confirmed cases of coronavirus, the highest number of any city outside Hubei.
Since then the city of Taizhou, and several districts in the cities of Ningbo and historic Hangzhou have also been locked down. They include the base of the Chinese tech giant Alibaba, city officials said.
The virus is taking an increasing economic toll, shutting businesses, curbing international travel and affecting production lines of global brands.
China’s currency and stock markets steadied in choppy trade after anxiety over the virus hit the yuan on Monday and erased about £308bn in market value from Shanghai’s benchmark index. Macau, the world’s biggest gambling hub, said it had asked all casino operators to suspend operations for two weeks to help curb the spread of the virus.
Wuhan, a bustling industrial hub where the virus first infected humans, has been turned into a near ghost town as a de facto quarantine continues.
Residents say they are unable to find hospitals to care for their sick relatives. Several hospitals require patients to first get a referral from local community health centres, many of which are also overwhelmed. As the city remains under lockdown, with public transport and roads shut, people are also struggling to get to health facilities.
Authorities have been racing to build two hospitals to treat the infected. The first of those – a 1,000-bed facility – began to receive patients on Monday, the People’s Daily reported, only 10 days after construction began. A second hospital is due to open this week.
Authorities in Wuhan have also started converting a gymnasium, exhibition centre and cultural complex into makeshift hospitals with more than 3,400 beds for patients with mild infections, the official Changjiang Daily said.
As the crisis has developed, people from Wuhan and Hubei have faced increasing discrimination in other parts of the country. Many say they have been kicked out or turned away from hotels.
Passengers on a flight from Japan to Shanghai in late January reportedly refused to board a flight that had passengers from Wuhan on it. Neighbourhood committees have placed signs on the doors of those recently returned from the province advising other residents not to visit them.
Experts say much is still unknown about the pathogen. The mortality rate for the new coronavirus is lower than the 9.6% rate for Sars, but it appears to be more contagious. Reports of deaths not counted in official statistics have also cast doubt on the mortality rate.
Such uncertainties have spurred extreme measures by some countries to stem the spread. On Tuesday the UK urged all its citizens to leave China if they can, while Australia sent hundreds of evacuees to a remote island in the Indian Ocean, and Japan ordered the quarantine of a cruise ship with more than 3,000 onboard after a Hong Kong man who sailed on it last month tested positive for the virus.
France recommended that its citizens – particularly those with families – should leave China “temporarily,” and recommended against all but “essential” travel to the country.
There have been 15 confirmed cases in Hong Kong, where authorities announced new border closures after hundreds of medical workers went on strike on Monday over the government’s refusal to stop travellers from mainland China.
Late on Monday, China’s elite Politburo Standing Committee called for improvements to the “national emergency management system” following “shortcoming and difficulties exposed in the response to the epidemic”.
The Chinese president, Xi Jinping, who led the meeting, said the outbreak was a “major test” of China’s system and ability to govern.
