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Health officials scramble as the virus spreads across several continents.
In South Korea, Iran, Italy, France, Germany and now the United States, health officials are trying to stem the growing coronavirus epidemic, tracing those who had come into contact with infected patients, even as they struggled to get a handle on how far the virus had spread.
To date, American authorities have reported 100 cases nationwide, with six fatalities. But a genetic analysis of the virus in Washington State, where the deaths occurred, suggested that the illness could have been spreading within the community for as long as six weeks before the first case was detected.
The coronavirus, now present on every continent except Antarctica, has infected more than 90,000 people, killing more than 3,000.
In China, where the epidemic erupted and where the overwhelming majority of cases have been identified, officials continue to get the spread under control. On Monday, China recorded 125 confirmed infections of the coronavirus and 31 deaths from the virus. It is the lowest number of officially confirmed infections since Jan. 20, when President Xi Jinping issued his first public orders on the epidemic.
But in South Korea, site of the second-largest outbreak, the number rose on Monday to more than 4,300, nearly double the caseload on Friday. The rate of increase was even faster in Europe, where officials warned residents to prepare for large outbreaks.
And in Iran, the scale of the largest outbreak in the Middle East remained unclear, with the government confirming 1,501 cases and public health experts expressing concern that the official numbers were unreliable.
The first cases were also reported in Jordan, Senegal, Morocco and Saudi Arabia.
As coronavirus cases show up around the globe, the Organization for Economic Cooperation and Development cut its outlook for 2020, suggesting that global growth could be cut in half if infections spread more widely outside China.
Financial markets rebounded Monday, after a bruising week, on hopes that governments and central banks would act aggressively to counteract the economic blow of the epidemic.
Six people have died in the United States, including residents of a nursing care facility.
The coronavirus killed three more residents of a nursing care facility near Seattle on Monday, raising the death toll in the area to six. And as the number of new cases rose nationwide, officials around the United States raced to assess the risk to schools, medical centers and businesses.
All of the U.S. fatalities have been in Washington State, where leaders in the Seattle area said that they intend to open isolation centers. Four of those killed were residents of the Life Care Center nursing home in Kirkland, a Seattle suburb, that has become the focal point of fears that the virus may have been spreading for weeks undetected.
In Oregon, dozens of personnel at Kaiser Permanente Westside Medical Center in Hillsboro have been placed on paid furlough after coming in contact with coronavirus patients there. They have been asked to remain in self isolation at home for 14 days, officials with Kaiser Permanente said.
The number of cases nationwide climbed to 100, and infected patients have been treated in 14 states.
The new cases included a woman in Manhattan who contracted the virus while traveling in Iran, and a Florida man with no known contact with affected countries or people. After that man and another person tested positive, Florida declared a public health emergency.
C.D.C. tests face scrutiny after flaws and inconclusive results.
The number of coronavirus cases in the United States is rising not just because the virus is spreading, but because testing has been expanded. And the persistent drumbeat of positive test results has raised critical questions about the government’s management of the outbreak.
How is it possible that the world’s most medically advanced nation has struggled to diagnose this infection? Why weren’t more Americans tested sooner? How many may be carrying the virus now?
Most disturbing of all: Did a failure to provide adequate testing give the coronavirus time to gain a toehold in the United States?
The Centers for Disease Control and Prevention’s first attempt to produce a diagnostic test kit fell flat.
In February, the C.D.C. rolled out a three-step diagnostic test kit and distributed hundreds of kits to state and local health laboratories. But the third step in the diagnostic process was flawed, and produced some inconclusive results.
A full three-step replacement was promised but never arrived; the agency has not fully explained why, except to say that there was a manufacturing defect. As a result, diagnostic testing was only conducted at the agency’s labs in Atlanta, not state and local labs.
“The incompetence has really exceeded what anyone would expect with the C.D.C.,” said Dr. Michael Mina, an epidemiologist at Harvard University. “This is not a difficult problem to solve in the world of viruses.”
U.S. imposes stricter screening on travelers from South Korea and Italy.
The United States will require multiple fever checks of all passengers before they board U.S.-bound flights from Italy or South Korea, where thousands of coronavirus cases have emerged in recent weeks, Vice President Mike Pence said on Monday.
“Within the next 12 hours, there will be 100 percent screening, all direct flights at all airports across Italy and across South Korea,” Mr. Pence said on Monday evening at a White House briefing with top federal health officials.
Mr. Pence had announced on Saturday that the State Department would issue its highest-level warning, a “do not travel” alert, for areas of Italy and South Korea most affected by the virus.
The United States has also banned all travel from Iran, and barred entry to any foreign citizen who has visited Iran in the last 14 days.
At the same briefing, Stephen Hahn, the Food and Drug Administration commissioner, said close to a million coronavirus testing kits will be available by the end of this week.
Local and state health officials have complained of not having access to enough kits — which at first were made only by the Centers for Disease Control and Prevention — to test as many patients as they think they should. But Mr. Hahn said the F.D.A. had eased up on regulations to allow academic centers and private companies to prepare new test kits and speed them to market.
Stocks surge as central banks vow to act on coronavirus impact.
U.S. stocks surged on Monday, snapping back from one of the worst weeks for global markets since the 2008 financial crisis, as investors seized on promises that the world’s governments would step in to help if the global economy was slammed by the coronavirus.
The S&P 500 jumped 4.6 percent on Monday, with most of the gains coming in the final hour of trading. The rally followed news that central bankers from the world’s biggest economies would join a conference call with Group of 7 finance ministers on Tuesday to discuss a response to the outbreak, fueling expectations that governments might lower interest rates in tandem.
Shares in Europe also recovered from losses earlier in the day. Most indexes in Asia had ended higher.
Early Monday, both the Bank of Japan and Bank of England pledged to monitor markets closely and safeguard financial stability. Later, the International Monetary Fund and the World Bank issued a joint statement saying that they “stand ready to help our member countries address the human tragedy and economic challenge” posed by the virus, particularly “poor countries where health systems are the weakest and people are most vulnerable.”
Oil prices also rose, ending last week’s slide. Investors are hoping that a meeting between officials from the Organization of the Petroleum Exporting Countries and Russia in Vienna this week will lead to new and deeper production cuts.
Bonds yields fell to fresh record lows on Monday, suggesting that despite the stock rally, investors expected the Fed to lower rates in hopes of bolstering the economy. Yields on the 10-year U.S. Treasury note, which serves as a proxy for overall conditions in the bond market, fell to 1.09 percent.
Here is how the virus spreads.
Experts say four factors likely play some role determining your odds of getting the virus from someone else: how close you get to an infected person; how long you are near the person; whether that person projects viral droplets on you; and how much you touch your face.
What’s a viral droplet?
To infect you, the virus must hitch a ride on a droplet of mucus or saliva — most likely from a sneeze or a cough, some experts say — and enter through your eyes, nose or mouth.
How close is too close?
The World Health Organization says it’s best to stay three feet from a sick person, while the Centers for Disease Control and Prevention has said that standing within six feet could carry risk.
Can the virus last on a bus pole, touch screen or other surface?
Unfortunately, yes. A study of other, similarly shaped viruses found they remained on metal, glass and plastic for two hours to nine days. A person who touches that surface could pick it up. How much is required to infect a person is unclear.
Using a simple disinfectant on a surface is nearly guaranteed to break the delicate envelope that surrounds the tiny microbe, rendering it harmless.
Washing your hands before touching your face should protect you because viral droplets don’t pass through skin. And experts say the brand or type of soap you use does not matter. For more tips on how to protect yourself from the virus, read the full article here.
President Trump says his job is to protect American patients.
President Trump spoke about his efforts to limit the spread of coronavirus in the United States during a rally on Monday evening in Charlotte, N.C.:
My administration is also taking the most aggressive action in modern history to protect Americans from the coronavirus. You know about this whole thing, horrible. Including sweeping travel restrictions. Today, we met with the big great pharmaceutical companies, and they’re really working hard and they’re working smart, and we had some — we had a great meeting today with a lot of the great companies and they could have vaccines I think relatively soon.
And they’re going to have something that makes you better, and that’s going to actually take place we think even sooner. So it’s — a lot of good things are happening. But we have strong borders and really are tough, and early actions have really been proven to be 100 percent right. We went out, we’re doing everything in our power to keep the sick and infected people from coming into our country. We’re working on that very hard.
He later added:
My job is to protect the health of American patients and Americans first. Washington Democrats are trying to politicize the coronavirus, denigrating the noble work of our public health professionals, but honestly not so much anymore. Everyone appreciates — these are the greatest professionals in the world at what they do.
We’re going to reduce the severity of what’s happening. The duration of the virus, we discussed all of these things, we will bring these therapies to market as rapidly as possible. And I have to say with a thriving economy, the way it is, and the most advanced health system on Earth, America is so resilient, we know what we’re doing. We have the greatest people on Earth, the greatest health system on Earth.
San Antonio bars people who were previously quarantined after a mistaken release.
The mayor of San Antonio declared a “public health emergency” from coronavirus in the second-most populous city in Texas on Monday, days after a woman who had been quarantined and then released into the city later tested positive.
The declaration issued by the mayor, Ron Nirenberg, states that no previously quarantined person is allowed to enter the city “until further notice.” The move will delay the release of dozens of people who have been quarantined at Lackland Air Force Base in San Antonio and comes after the C.D.C. mistakenly released the woman on Saturday; she went to a hotel and shopping mall before being quarantined again.
State officials, including Gov. Greg Abbott, called on federal authorities to provide a written rationale for releasing people from quarantine and to increase the testing protocol from two consecutive negative test results to three.
After the infected person had been released on Saturday by the C.D.C. following two negative test results, the results of a third test were received, showing that she tested “weakly positive.” San Antonio health officials said that the risk of exposure to the public was low and that the patient interacted with very few people.
Dozens of quarantined people who had been evacuated from the Diamond Princess luxury cruise ship in Japan were set to be released from Lackland on Monday. The delay was a source of frustration for many of them.
Carol Montgomery and her husband, John, were packed and ready at 6:30 a.m for their final temperature check at Lackland on Monday morning, eager to leave after 25 days of quarantine, first aboard the cruise ship and then at the San Antonio base. But a C.D.C. official told them in a conference call that their release would be delayed.
“We’re probably the safest people to be out there right now,” said Ms. Montgomery, 67. “It’s ridiculous to hold us when we have been in quarantine that long and have tested negative.”
Spread in New York is likely, officials warn after first case.
New York officials warned on Monday that the coronavirus was likely to spread in New York City, a day after confirming that a Manhattan woman had contracted the virus while traveling in Iran.
“Community spread is going to be real,” Gov. Andrew M. Cuomo said at a news conference, alongside Mayor Bill de Blasio. “That is inevitable.” Both pleaded for residents to remain calm.
The patient, the city’s first confirmed case, has respiratory symptoms but is not in serious condition, the governor said, adding that she was a 39-year-old health care worker so “she knew to take precautions and stay in a controlled situation.”
She returned from Iran on Tuesday with her husband and was tested after going to Mount Sinai Hospital in Manhattan on Saturday with mild respiratory symptoms.
He said that she had not used public transportation since returning to New York, and had taken a private car from the airport. But Mr. Cuomo said the state would institute new cleaning protocols in crowded public places like schools and buses.
Countries should not give up on containing the virus, W.H.O. says.
The head of the World Health Organization said on Monday that the coronavirus could still be contained around the world, but that “the window of opportunity is narrowing.”
Asked at a news conference about concerns that the virus was no longer containable, Dr. Tedros Adhanom Ghebreyesus, director general of the organization, said the W.H.O.’s message has remained consistent: Countries should take a “comprehensive approach” that tries to contain the virus.
“Of course we can have concerns and worries, it’s understandable, but let’s really calm down and do the right things, and use the window of opportunity to contain this outbreak,” he said.
He added, without identifying countries, that “in some places we are not seeing the level of response that we expected.” For that reason, he said, the W.H.O. was reminding the world “that the window of opportunity is narrowing and that we still have to do our best to catch up.”
Dr. Tedros said there were “positive signals” that nations could contain the virus, such as the dozens of countries with fewer than 100 cases. He also cited the slowdown of infections in China as a sign that the virus could be contained.
“There is a point in any epidemic where you believe you can no longer contain the virus, or like it was influenza and you have to shift your resources to saving lives,” said Dr. Michael Ryan, the executive director of the W.H.O.’s health emergencies program. “Now W.H.O. does not believe that we’re there yet.”
Coronavirus kills an adviser to Iran’s Ayatollah Khamenei.
An adviser to Iran’s supreme leader died from coronavirus illness on Monday, state media reported — the first fatality of a top Iranian official from the scourge that has hit the country especially hard and made it a hub of contagion in the Middle East.
The adviser, Mohammad Mirmohammadi, 71, is a member of the Expediency Council, which provides advice to the supreme leader, Ayatollah Ali Khamenei, 80. It was unclear from state media accounts whether Mr. Mirmohammadi, who died at a Tehran hospital, had been in direct contact with Ayatollah Khamenei when he was contagious.
The state media accounts also said Mr. Mirmohammadi’s mother had died in recent days from the coronavirus and an uncle — his mother’s brother — was being monitored in quarantine for possible infection.
At least six other members of the hierarchy in Iran, including a vice president who is the top woman official in the country, have fallen ill from the coronavirus.
The Health Ministry reported at least 1,501 confirmed cases in the country as of Monday — nearly four times as many as on Friday. The ministry said at least 66 people had died from the infection, the highest toll outside of China, where the coronavirus outbreak began two months ago.
The European Union moves to high alert.
The European Union raised its alert level from moderate to high on Monday as the number of cases continued to soar and infections cropped up in more places across the Continent.
The coronavirus has now spread to 18 of the 27 member states, with more than 2,200 confirmed cases of infection, according to bloc officials, costing member states about $1 billion a month in lost tourism revenues.
In a news conference, the president of the European Commission, Ursula von der Leyen, praised European coordination in the crisis and urged calm. Announcing the new level of risk, she said, “In other words, the virus continues to spread.’’
Still, she added, the union was not considering shutting borders.
In Italy, the epicenter of the European outbreak, the number of new infections jumped on Monday to 1,835 — more than double the number on Friday — with 52 deaths. The government announced plans to inject billions of dollars into the economy to mitigate the effects of the virus.
The economics commissioner, Paolo Gentiloni of Italy, said that the bloc would consider Rome’s request for flexibility on European Union fiscal rules on debt, “in the spirit of solidarity and understanding.”
Elsewhere, the authorities in Berlin and Moscow reported their first cases of the virus.
An infected man in Berlin has been placed in isolation in the city’s main research hospital, where he was said to be in stable condition.
France reported that it has had 191 cases since January — three times as many as it had on Friday — and three deaths. The Louvre remained closed to visitors on Monday as museum officials discussed how to handle large crowds in ways that would limit the potential spread of the virus.
Which is worse, coronavirus or flu?
The coronavirus and the flu are often compared these days. But what are their basic similarities and differences?
So far, the coronavirus seems to be deadlier. On average, the seasonal flu strain kills about 0.1 percent of people who become infected. Early estimates of the death rate in the coronavirus outbreak’s epicenter in Wuhan, China, have been around 2 percent.
The rate could fall if it turns out that many cases aren’t detected because they are so mild or even symptom-free.
As with influenza, the coronavirus is most dangerous to people over the age of 65, or who have chronic illness or a weak immune system.
So far in the current season, the flu has sickened more people than the coronavirus. In the United States, there have been 32 million cases of flu, several hundred thousands of hospitalizations and 18,000 deaths, according to the C.D.C. By contrast, about 100 people in the United States have been infected with the new coronavirus, and there have been two deaths.
One area where the two ailments diverge is treatment. There is no approved antiviral drug for the coronavirus, but several are being tested. For those infected with any viral illness, doctors recommend rest, medicine to reduce pain and fever, and fluids to avoid dehydration. For the flu, doctors can offer four prescription medicines and they tend to work best within a day or two of when symptoms start.
There are no coronavirus vaccinations available, but one may be available in a year or two. Flu vaccines are widely available and generally 40 percent to 60 percent effective.
Church leader at the center of South Korea’s epidemic offers an apology.
Lee Man-hee, the founding leader of the church at the center of South Korea’s explosive coronavirus outbreak, bowed in supplication at a news conference on Monday and apologized amid growing anger at his handling of the crisis.
“I have never imagined this kind of thing would happen,” Mr. Lee, 88, said in a choking voice during a nationally televised news conference. “I am still trying to understand how this could happen.”
Mr. Lee called the news conference after Seoul and other cities asked prosecutors to investigate him for potential criminal charges, including murder through willful negligence. They accused Mr. Lee and his Shincheonji Church of Jesus of contributing to the nation’s rising death toll — 22 as of Monday — by impeding the government’s efforts to fight the outbreak.
Among other things, the church was accused of failing to provide a full list of its members fast enough for the government to track them down for testing.
By Monday, South Korea reported more than 4,000 total cases. At least 60 percent of the cases were among members of a Shincheonji branch in Daegu, a city in southeast South Korea, and people they had been in contact with.
Mr. Lee denied the accusations against his group, saying that his church was fully cooperating with the government.
Reporting was contributed by Steven Erlanger, Melissa Eddy, Marc Santora, Anton Troianovsky, Elisabetta Povoledo, Steven Lee Myers, Clair Fu, Russell Goldman, Sheri Fink, Mitch Smith, Richard C. Paddock, Aurelien Breeden, Rick Gladstone, Jesse McKinley, Joseph Goldstein, Alan Yuhas, Richard Pérez-Peña, Heather Murphy, Mike Baker, Roni Caryn Rabin, Knvul Sheikh and Katie Thomas.