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The death toll rises to 56, and Wuhan may have 1,000 more cases.
The mayor of Wuhan, the city at the center of the viral outbreak, said on Sunday that there could be about 1,000 more confirmed cases of the mysterious illness in the city — a sign that the country’s monumental efforts to halt the disease may only just be starting.
In a news conference, the mayor, Zhou Xianwang, said that the estimate was based on the assumption that around half of the city’s nearly 3,000 suspected cases of the coronavirus would eventually test positive for the disease. The youngest confirmed case involved a 9-month-old girl in Beijing, according to The People’s Daily, a state newspaper.
Mr. Zhou also said that five million people had left Wuhan before travel out of the city was restricted, leaving nine million people still living there.
As of Sunday morning, the official count of confirmed cases across China stood at 1,975. The death toll in China was 56.
China announced 15 more deaths from the new coronavirus on Sunday, including one in Shanghai, the first reported in the metropolis. Thirteen deaths were also announced in Hubei Province, where the outbreak began, and one was announced in Henan Province. Across the country, 688 new cases were diagnosed on Saturday, the government said early Sunday.
Deaths from the coronavirus had previously been reported outside of Hubei. But the death in Shanghai, which is among China’s most populous cities and a major commercial hub, is likely to fuel anxieties about the disease’s spread.
Shanghai’s municipal health commission said on Sunday that the patient who died was an 88-year-old man.
‘The epidemic has entered a more serious and complex period.’
The head of China’s National Health Commission, Ma Xiaowei, warned on Sunday that people who carried the disease but did not show flu symptoms could still infect others. That would be a major difference between the new virus and SARS, a coronavirus that spread in China and around the world nearly two decades ago, killing 800 people.
“The epidemic has entered a more serious and complex period,” said Mr. Ma, the director of China’s National Health Commission.
He also said on Sunday that the new coronavirus’s incubation period was about 10 to 14 days, and that the period is contagious.
“There have been mild cases where observation has shown that the patients were contagious during the incubation period. The incubation period is around 10 days,” he said. “The shortest time before the disease’s onset was one day. The longest was 14 days. This is very different from SARS.”
The rate of the current epidemic is accelerating, he added, and is “likely to continue for some time.”
A study by the medical journal The Lancet, published on Friday, had raised concerns that people infected with the coronavirus might be able to spread it even if they do not have flulike symptoms.
But a longtime adviser to the United States Centers for Disease Control and Prevention called Dr. Ma’s remarks a “game changer” and said the information called into question the United States’ strategy for containing the virus. Officials are set to repatriate Americans from the center of the outbreak.
“When I heard this, I thought, ‘Oh dear, this is worse than we anticipated,’” Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center, told CNN. “It means the infection is much more contagious than we originally thought.”
Dr. Schaffner added, “Assuming that Dr. Ma is correct, we’re going to have to re-evaluate our strategy, that’s for sure.”
A third U.S. case has been confirmed in California.
A person in Orange County, Calif., has tested positive for the novel coronavirus. The Orange County Health Care Agency, which received confirmation from the Centers for Disease Control and Prevention, said the person had been sent to a hospital and was in “good condition.”
The patient is a traveler from Wuhan, China, and “there is no evidence that person-to-person transmission has occurred in Orange County,” according to the agency. “The current risk of local transmission remains low,” it said in a statement.
It is the third confirmed case in the United States. The others involved a woman in her 60s in Chicago and a man in his 30s in Washington State.
Hong Kong bars residents from the center of the outbreak.
In Hong Kong — which was badly hit by the SARS coronavirus in 2003, with nearly 300 deaths — worries about the spread of infectious diseases run deep. On Sunday, the government said it would bar residents of Hubei Province, which includes Wuhan, and people who had been to the province in the past 14 days from entering Hong Kong until further notice.
The rule does not apply to Hong Kong residents, according to a government statement.
Five cases of the new coronavirus have been confirmed in the city, already hobbled by months of antigovernment protests. The local news media reported on Sunday that three other people appeared to have contracted it, although the authorities have yet to confirm those cases.
But the city’s efforts to contain the virus have also been met with resistance. A plan to convert an unused public housing block into a quarantine site incited protests on Sunday, with demonstrators setting fires in the lobbies of two of the buildings.
The government condemned the fires set at the public housing complex, in Hong Kong’s New Territories. But it also backed away from its plan to use the buildings for quarantine, saying that it would use government-owned sites first.
The unrest came a day after Carrie Lam, the leader of the semiautonomous territory, declared a health emergency and said that Hong Kong schools would be closed until February. She also said that trains and flights between Wuhan and Hong Kong would be halted.
Although the antigovernment protests have eased in recent weeks, calls have also been circulated for demonstrations this past week to demand the barring of new arrivals from the mainland. Mrs. Lam initially said it would be “inappropriate and impractical” to block people from the mainland,” but on Sunday the government changed course.
Fears about the spread of the virus are also affecting tourism in the city — whose economy depends significantly on money spent by visitors at malls, hotels and restaurants, and which is now in a recession.
Two of Hong Kong’s biggest attractions, Disneyland and Ocean Park, said on Sunday that they were closing until further notice. A notice on Hong Kong Disneyland’s website called it a “precautionary measure.”
Shanghai’s Disneyland park had earlier been shut indefinitely. China said on Saturday that it would suspend all tour groups and the sale of flight and hotel packages for its citizens headed overseas starting on Monday.
The weeklong Lunar New Year holiday, which began on Saturday, is usually a peak travel period in China. Some officials have raised the idea of extending the holiday, meaning keeping people away from workplaces, schools and other public buildings for a longer period.
China halts the trade in wildlife across the country.
China has banned the wildlife trade nationwide until the epidemic passes, three government departments said on Sunday.
The outbreak has drawn fresh attention to China’s animal markets, where the sale of exotic wildlife has been linked to epidemiological risks. The Wuhan virus is believed to have spread from one such market in the city. The SARS outbreak nearly two decades ago was also traced back to the wildlife trade.
A statement issued by China’s markets regulator, agriculture ministry and forestry bureau said that all transactions of wildlife would be forbidden immediately in wholesale markets, supermarkets, restaurants and e-commerce platforms. It also encouraged consumers to understand the health risks of eating wild animals.
The consumption of exotic creatures has been driven partly by beliefs about their supposed health benefits, although such ideas are starting to lose their grip, particularly on younger people.
A popular travel blogger, Wang Mengyun, apologized recently for eating bat soup in a video from a few years ago. Ms. Wang, who has more than two million followers on the social platform Weibo, said that she had been unaware of the health risks of eating bats when she made the video in the Pacific island nation of Palau. She said she had been trying to highlight the local cuisine.
In her post, Ms. Wang emphasized that the bat had been locally raised and was not wild. “Many countries around the world eat these,” she wrote.
Her post has since been deleted.
Americans in Wuhan are being evacuated to San Francisco.
The United States government offered details on its plan to evacuate American diplomats and other citizens from Wuhan, saying on Sunday that it was arranging a flight that would leave on Tuesday and travel to San Francisco.
The State Department has ordered all American employees at the United States Consulate in Wuhan to leave the city. In an email sent on Sunday to Americans living in China, the department asked all other citizens who wanted a spot on the plane to contact the embassy. Capacity would be “extremely limited,” the message said, and priority would be given to people at greater risk from the virus.
It is unclear who will fall into that category.
Jonny Dangerfield, 30, an American who came to Wuhan to celebrate the Lunar New Year with his wife and children, said he hoped his family might be given priority because his three children are all under 5.
“If it weren’t for them, we maybe would not have much worry at all,” Mr. Dangerfield, who works in finance in Phoenix, said in a telephone interview.
He and his family are staying with his in-laws in Wuhan. With rising food prices in the city less of a burden on him than for the city’s poorer residents, he said he felt like one of the lucky ones in the situation. “Just to keep ourselves sane,” he said, “we have low expectations about getting on that plane.”
The authorities in France have said that they plan to provide a bus service for French nationals and their families who want to leave Wuhan. The Russian Embassy is also working with the Chinese authorities to evacuate Russian citizens from the area.
Global concern grows as the outbreak spreads.
Public health officials in Toronto on Saturday night announced test results showing that Canada had its first “presumptive” case of the coronavirus.
Dr. Barbara Yaffe, Ontario’s associate chief medical officer of health, said the patient was a man in his 50s who returned to Toronto on Jan. 22 after visiting Wuhan, China. The next day, he was admitted to a hospital with a respiratory infection. He is now in stable condition.
Dr. David Williams, Ontario’s chief medical officer of health, said that while they were convinced that they have a positive case, a government laboratory would run additional tests for confirmation.
Taiwan, which on Sunday confirmed its fourth case of the coronavirus, said that it would bar all visitors from China’s Hubei Province to the self-governing island. Taiwan’s government also said it would suspend applications from Chinese citizens for travel permits except in special cases, such as disease control or humanitarian medical assistance.
Macau announced that starting from Monday, it would restrict travelers from Wuhan.
The Ivory Coast said on Sunday that an Ivorian woman who had recently returned from China was suspected of being infected with the coronavirus, although tests have not yet fully confirmed it.
Dr. Eugène Aka Aouele, the Ivorian health minister, said in a statement that on Saturday the authorities had been informed by the airport in Abidjan, the capital, that the woman, a 34-year-old student, had been living in Beijing for the past five years.
After arriving on a Turkish Airlines flight to Abidjan, and exhibiting flulike symptoms including coughing and respiratory difficulties, she was taken to a special facility at the airport for a medical examination, the statement said.
“Her general state is satisfactory,” the ministry said. “There are, at this stage, suspicions of a case of pneumonia tied to the coronavirus. The final diagnosis will be established after the results of analysis from the samples that were taken.”
Prime Minister Shinzo Abe of Japan said that his government would help repatriate all Japanese citizens wishing to leave Wuhan amid the deadly outbreak.
“As soon as our arrangements with the Chinese government are set, we have decided to bring back all Japanese citizens who wish to return, by charter planes and all other means,” Mr. Abe told reporters at his official residence on Sunday.
Public health experts warn against mass anxiety.
Despite the rising number of coronavirus cases and the 56 deaths, public health experts say there is no cause for panic. The common flu kills roughly 35,000 people a year and hospitalizes about 200,000 in the United States alone.
Yet the unknowns around the current outbreak are causing widespread worry. And there are signs that this outbreak could be more serious than the common flu. Other coronaviruses have far higher mortality rates than the flu, and have led to global outbreaks.
In addition, conclusive evidence about how this outbreak started is lacking. Although officials in Wuhan first traced it to a seafood market, some who have fallen ill never visited the market. Researchers have also offered disparate explanations about which animals may have transmitted the virus to humans.
China’s record doesn’t help. During the SARS epidemic in 2002 and 2003, officials covered up the extent of the crisis, delaying the response. The Chinese government has promised far more transparency this time, and the World Health Organization has praised its cooperation with scientists.
But mistrust of the local and national authorities, compounded by missteps and mistakes in handling the illness, runs deep. Though China’s initial delay in reporting cases of the new virus may suggest a cover-up, experts see something more worrying: weaknesses at the heart of the Chinese political system.
China’s central government deploys hundreds of workers.
In a sign that the central government is ramping up its response to contain the outbreak, China’s National Health Commission said it would send 1,230 medical experts to Wuhan to assist in treatment.
The army has sent another 450 people from three military medical universities, according to a state media article that the health commission shared on its website. And the air force sent military transport aircraft to the cities of Shanghai, Xi’an and Chongqing to pick up emergency airlifts of medical team members and medical supplies for Wuhan.
In Wuhan, health officials said that they would assign 24 hospitals to treat potential coronavirus patients only, according to People’s Daily, the Communist Party’s main newspaper. National officials had called for patients to be concentrated in specialized hospitals, and new hospitals were being built specifically to treat patients.
A minister pleads for hundreds of thousands more masks.
A top Chinese official warned on Sunday that the nation needs many more masks and protective suits than it can currently produce.
His remarks, in a news conference, came as more local governments around the country mandated that citizens wear masks in public as the coronavirus outbreak grows. On Sunday, the government in Guangdong, China’s most populous province, became the latest to require people to wear masks in public — specifically, in hotels, restaurants, bars, hair salons, movie theaters, karaoke parlors, parks and many other places.
Wang Jiangping, China’s vice minister of industry and information technology, said that Hubei Province alone needed 100,000 protective suits a day to fight the illness, but that Chinese manufacturers could supply only 30,000 suits each day.
The Lunar New Year holiday is also making it difficult for factories to produce at full capacity, Mr. Wang said.
Chinese companies that manufacture items to export could produce an additional 50,000 suits a day, he said. But he said it would take time to make that change.
‘Every village around here is now putting up barriers.’
Roads were quiet. Where cars, trucks and motorbikes once roared and honked, there was the sound of birds tweeting and dogs barking. Shoppers mostly hauled their baskets home by foot or on bicycle.
Wuhan, the city at the center of China’s viral epidemic crisis, has been subdued since the government put it under a smothering net of travel restrictions on Thursday. It was even quieter on Sunday, after the city announced heavy restrictions on the use of cars, even within the urban limits.
But along with general silence, there was confusion.
The announcements about which vehicles were allowed on the roads was murky, leaving even police officers befuddled about what to do.
First, the Wuhan authorities said that most cars should stay off the roads and that a fleet of 6,000 taxis would be on call to transport people in need and deliver food and medicine. Then, the authorities said drivers would be notified by text message if they had to stay off the roads. Nobody seemed to receive text messages on Sunday.
“My understanding,” a police officer said, “is that you can drive in your district if you don’t get a text message telling you that you can’t. But you should check that with the transport authorities.”
In the end, most drivers stayed off the streets. But as the day went on, more ventured out, and the police did not seem to do much about it.
For some residents, it was another exasperating fumble by Wuhan officials who many believe have mishandled the epidemic. But most seemed to accept the restrictions with the same stoic fortitude that many have shown over the past several days as the city imposed bans on leaving for all but a select few.
On Sunday morning, many grocery shops in Wuhan were crowded with residents queuing to stock up, especially on fresh vegetables, fruit and meat. Many said they worried that even tighter rules that could deter them from leaving home or impede food supplies.
“Because it’s the New Year, a lot of stores close anyway, and now we have the disease and now this,” said Ai Wenjun, who had lined up to pay for a basket of turnips, cabbage and beans. “Each extra thing makes me worry more.”
So far, shops still have supplies, though some residents said prices had risen despite government warnings to keep them steady.
“If we can’t bring in produce, it will become more expensive, or we might even have to close up,” said Zuo Qichao, who was selling piles of cucumbers, turnips and tomatoes. As he spoke, a woman accused him of unfairly raising the price of the turnips.
“Every county, every village around here is now putting up barriers, worried about that disease,” Mr. Zuo said. “Even if the government says it wants food guaranteed, it won’t be easy — all those road checks.”
For now, the Wuhan city authorities have the benefit of a population willing to endure restrictions to slow the epidemic. But that mood could shift if the measures hamper food supplies and worsen medical shortages.
“Now is not the time for recriminations,” said Li Xiandu, a retired business manager. “The local government wasn’t forthcoming with information and didn’t take vigorous enough measures. But we need to get through this first, and then we can assign blame.”
Reporting was contributed by Raymond Zhong, Chris Buckley, Motoko Rich, Austin Ramzy, Ezra Cheung, Max Fisher, Vivian Wang, Ian Austen, Josh Keller, Yonette Joseph and Aurelien Breeden. Claire Fu and Wang Yiwei contributed research.
