Here’s what you need to know:
The death toll in China exceeds that of the SARS outbreak.
The death toll from the new coronavirus has exceeded that of the severe acute respiratory syndrome outbreak in 2002 and 2003 in mainland China. But the number of people who have recovered nationwide has also risen in recent days, suggesting that the new virus’s fatality rate is relatively low.
China’s Health Commission reported on Sunday that there were 475 recoveries and 361 deaths nationwide. During the SARS outbreak, 349 people died in mainland China.
Health experts say they are encouraged by the steady rise in the number of recoveries. They take it as evidence that the treatments meted out have been effective and that the virus does not appear to be as deadly as SARS.
SARS had a mortality rate of 9.6 percent, and about 2 percent of those reported to have been infected with the new coronavirus have died.
China first announced an outbreak of a mysterious pneumonia in the city of Wuhan on Dec. 31. It has been 12 days since the authorities began to place the city and much of the surrounding Hubei Province — home to tens of millions of people — under lockdown.
In Hubei, the epicenter of the outbreak, 80 patients had recovered on Sunday, compared with 56 deaths. On Saturday, 49 patients had left the hospitals, while 45 people had died.
Still, the number of infections from the new coronavirus continues to climb, suggesting that it could take awhile before the outbreak ends. China had 17,205 confirmed infections as of Sunday. During the SARS outbreak, it had 5,327 cases, according to the World Health Organization.
Stocks drop sharply in China, and global oil producers brace for falling demand.
Stocks in China fell about 8 percent in Monday trading as investors returned from a long holiday to the prospect of the world’s No. 2 economy virtually being shut down by the coronavirus epidemic. The markets had been closed since Jan. 23 for the Lunar New Year holiday.
Other markets in the region were also trading in the red. Shares in Tokyo finished the day down nearly 1 percent, while in Australia they closed down 1.3 percent. Stocks in Hong Kong opened down, but later pared those losses and were flat.
The market damage could be confined to Asia. European markets started the week in positive territory, and futures trading that predict the performance of stocks in the next day forecast a positive opening for Wall Street.
Separately, China’s central bank moved to pump $173 billion into its financial system on Monday in an emergency move to help government efforts to contain the coronavirus outbreak.
The world’s largest oil producers are also scrambling to stem a sharp fall in prices amid concerns over how the growing epidemic will affect demand from China.
Officials from the Organization of the Petroleum Exporting Countries and Russia plan to meet early this week to discuss the situation, and the big producers may also hold an emergency ministerial-level meeting this month.
“They are absolutely trying to put a floor under prices,” said Amrita Sen, chief oil analyst at Energy Aspects, a market research firm.
Experts say virus may turn into a pandemic.
Many of the world’s leading infectious disease experts say the outbreak is likely to become a pandemic, defined as an ongoing epidemic on two or more continents.
Scientists do not yet know how lethal the new coronavirus is, but there is a growing consensus that it is readily transmitted. Scientists have found that it is spreading more like influenza than its slow-moving viral cousins, SARS and MERS.
“It’s very, very transmissible, and it almost certainly is going to be a pandemic,” said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Disease.
“But will it be catastrophic? I don’t know,” he added.
The effects of a pandemic would likely be harsher in some countries than in others. While wealthier countries can direct their resources toward early detection and treatment, countries with fragile health care systems will not necessarily be able to offer the same level of care.
[Did you fly from China to the U.S. after Sunday evening? Or know someone who did? We’d like to talk to arriving travelers who are quarantined at a military base or who have self-quarantined, and their family members. Please contact us at coronavirus@nytimes.com.]
China aims to reassure its citizens on medical supplies and food.
Chinese officials tried to reassure the country on Monday that a shortage of medical supplies was being alleviated, that the food supply remained adequate and that food prices, which had been sharply rising, were stable.
Tian Yulong, an official from the industry and information technology ministry, acknowledged the shortages of basic medical and health supplies, but promised to fix them soon.
Describing the availability of medical protective clothing and masks as a “delicate balance,” he said that 154,500 sets of protective clothing and 133,600 high-quality masks had been shipped to Hubei Province, the center of the outbreak, by Sunday.
The Vatican also said on Monday that it had sent “several hundred thousand” face masks to Hubei and to Zhejiang and Fujian Provinces to help contain the virus’s spread.
Regarding rising food prices in China, which were a concern even before the coronavirus crisis, Lian Weiliang, a deputy director of national development, said that most of China’s basic necessities, especially food, would be guaranteed.
He said that the average retail prices of pork, beef, mutton and eggs in 36 large and medium-sized cities nationwide had fallen from previous highs.
Confirmed cases in the U.S. rise to 11 as airport quarantines take effect.
The handful of American airports still permitted to receive flights from China were scenes of confusion and uncertainty on Monday as the first federally mandated quarantine in more than a half-century — since the era of smallpox — took effect.
“It feels like trying to leave Paris in 1940 or something — there’s a bit of panic settling in,” said Jeffrey Phillips, 41, who was unsure when his wife, Sue, would be able to return to the United States after a trip to visit her family in China.
Americans whose flights took off from China after 5 p.m. Eastern time on Sunday and who had spent time recently in Hubei Province, the epicenter of the epidemic, will be subject to a quarantine of up to two weeks under restrictions announced by the Trump administration. Four United States military bases said they were expecting to house about 1,000 such “evacuees.”
China’s foreign ministry on Monday sharply criticized the United States for its overall response to the epidemic, saying that it was “creating and spreading fear” instead of helping contain the coronavirus.
“In the face of the public health crisis, countries should work together to overcome the difficulties and not shift one’s troubles onto others, let alone take advantage of people’s precarious position,” said Hua Chunying, a ministry spokeswoman.
Secretary of State Mike Pompeo, traveling in Uzbekistan, said on Monday that the United States was coordinating with Beijing to organize more flights for Americans in Wuhan, and possibly citizens from other countries. He said the administration hoped to use those flights to also deliver medical supplies.
“We’re working closely and hand-in-hand with the Chinese Government to try and resolve what is now this global epidemiological challenge,” he said, according to a State Department transcript.
The U.S. plans to speed up testing for the virus.
As more cases of the new coronavirus surface in the United States, federal health officials hope to speed up test results for the virus by distributing kits to public health laboratories around the country.
At a news briefing on Monday, the federal Centers for Disease Control and Prevention said the kits should be distributed to state health labs by the end of this week. In the last few weeks, all tests have been conducted at the C.D.C.’s labs, sometimes resulting in delays of several days for individual results.
The Food and Drug Administration first has to approve the test for wider distribution, the C.D.C. said. The United States has 11 confirmed cases so far.
Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, said that 167 “patients under investigation” who had symptoms like cough or fever, and had traveled to Wuhan or been in contact with a patient, had negative test results. Another 82 tests are pending, including some with samples in transit to the agency’s labs.
The severity of the disease has varied in patients in the United States, Dr. Messonnier said. Some have had mild illness, but a few have been more severely ill, with some needing oxygen. None has died.
Of the 11 patients, nine had been to Wuhan and two were close contacts of patients who had traveled, indicating that person-to-person spread of the virus has occurred in the United States. “We expect to find additional cases in the United States and we expect more cases of person-to-person spread among close contacts,” Dr. Messonnier said.
The State Department plan to repatriate more people from Wuhan, and the C.D.C. has sent four teams to military locations where their flights will land, Dr. Messonnier said. She said she did not know yet how many passengers would be returning.
The travelers will be quarantined for 14 days.
Dr. Messonnier said the C.D.C. has been working with state and local health departments to find places to keep people under quarantine. She said the possibilities could include military bases and hotels, and could vary from state to state.
“We want to make sure they’re comfortable, but also make sure they’re safe and their families and communities are safe,” Dr. Messonnier said.
Referring to the outbreak inside China, she said: “A couple of weeks ago there were 41 cases. This morning there were 17,000. This is a novel coronavirus that the population doesn’t have immunity to.”
She said: “Our goal is to slow this thing down. We have the opportunity to slow it down before it gets into the United States.”
Xi demands urgency and says officials who resist orders could be punished.
China’s leader, Xi Jinping, has not appeared much in public in recent days. But on Monday he oversaw a Communist Party leaders meeting that demanded greater urgency and coordination in the fight against the coronavirus epidemic — which they called “a major test of China’s system and capacity for governance.”
“Epidemic prevention and control must stick to treating the country as a grand chessboard,” Mr. Xi said, according to an official account issued by the Xinhua news agency. Officials who resist orders and “lack boldness” could be punished, he said.
Mr. Xi’s comments suggested that at least some regions have been reluctant to devote resources and personnel to the effort.
The focus of the fight remains Hubei, the central Chinese province that has been worst-hit by the virus. The meeting emphasized that other regions must be willing to send medical supplies and workers to Hubei, whose capital, Wuhan, is where the outbreak began.
Party leaders also called for more stringent monitoring to identify and treat carriers of the virus, including policies to track people traveling after China’s Lunar New Year holiday, which had been extended until Monday because of the epidemic.
The senior officials called for “well managed propaganda and instruction, as well as opinion guidance,” suggesting that the government may step up censorship after a surge of reporting and online commentary critical of the government.
Virus is a close cousin of SARS, new studies say.
The Wuhan coronavirus is a close cousin of the one that caused SARS in 2003, and may have originated in bats, according to two studies published on Monday in the journal Nature.
That is not to say that bats directly infected humans with the new virus: Many scientists believe there was an intermediate host animal, which was infected by bats and then infected humans. Based on the new virus’s genetic sequence, researchers showed that the virus can bind to receptors in civets and pigs, although they ruled out mice.
The researchers, working in two separate teams from the Wuhan Institute of Virology and Fudan University in Shanghai, isolated the virus’s genome from people who were working at the wet market in Wuhan, China, where the first cases were reported in December 2019. They found that the genetic makeup of the new virus, temporarily called 2019-nCoV, is 79.5 percent similar to that of the SARS coronavirus — a cousin of Wuhan virus that seems to spread more easily, but is less lethal.
The Wuhan coronavirus uses the same receptors, or entry points, to infect human lung cells, which explains how transmission occurs and why some people develop pneumonia.
The Wuhan team, led by Zheng-Li Shi, showed that the novel virus is genetically 96.2 percent similar to a coronavirus that circulates in bats, which served as the origin for the SARS virus. The Fudan University group, led by Yong-Zhen Zhang, reported that the novel coronavirus was 89.1 percent similar to SARS-like coronaviruses in bats.
But the Wuhan coronavirus evolved different mutations than SARS before jumping to humans.
Together, the studies describe early steps toward understanding the novel coronavirus and its evolutionary history. They also provide hope that treatments and vaccines developed for SARS may work for the new virus, experts said.
Duterte urges people not to discriminate against Chinese.
President Rodrigo Duterte of the Philippines on Monday urged the country not to discriminate against the Chinese amid the coronavirus outbreak, a day after his government reported the death of a Chinese man in Manila.
His government has imposed restrictions travel to and from China. But he said on Monday that Chinese flying in from elsewhere would be allowed entry to the Philippines.
“We are a community of nations,” Mr. Duterte said in a late-night news briefing after an emergency cabinet meeting. “We cooperate. China has been kind to us — we can also show the same favor to them. Stop this xenophobia thing.”
He said that the spread of the virus “was not the fault of anybody, not of the Chinese, not of the Filipinos, not of anyone.” Although the first cases of this coronavirus originated in Wuhan, China, he said that the virus could have also incubated elsewhere.
Hong Kong tightens border to further cut arrivals from mainland China.
Hong Kong’s government said Monday that it would close four more border crossing points with mainland China, leaving open just three, as the number of coronavirus cases in the city continues to grow.
Carrie Lam, Hong Kong’s top official, has been under increasing pressure from hospital employees, businesses and even some pro-government lawmakers to further tighten border controls.
More than 2,400 medical workers in Hong Kong went on strike Monday morning to pressure the government to bar entries from mainland China, a number that was expected to grow if the government did not relent.
The medical workers, members of a newly formed union, said they worried that hospitals would be overwhelmed as mainland Chinese seek to use Hong Kong’s well-respected health care system. Hong Kong itself has 15 confirmed cases of infection.
Mrs. Lam announced measures last week to reduce arrivals from mainland China, but she has resisted a complete closing, calling such a move “a discriminatory approach” and not in line with recommendations from the World Health Organization.
Signaling concerns among business executives in the territory, more than half of American business leaders questioned said they wanted Hong Kong’s government to shut down the border with the mainland, according to a survey of 156 executives by the American Chamber of Commerce in Hong Kong.
Russia and North Korea coordinate on stopping the spread from China.
Russia on Monday suspended passenger rail links to China and North Korea, postponed a major business conference and laid the groundwork to deport foreigners diagnosed with the coronavirus.
All passenger train travel to and from China is halted until further notice, said regional authorities in Russia, which shares a 2,600-mile border with China.
Russia’s main train operator said it was also suspending passenger service to North Korea in response to a request from Pyongyang. The Russian state-run news service Tass said the move was part of North Korea’s effort to combat the spread of the virus.
North Korea, which borders both China and Russia, had not officially reported any coronavirus cases to the World Health Organization as of Sunday, but the isolated country has been quarantining people arriving from China. North Korea had also already decided to close its borders to all foreign tourists amid the outbreak.
Two coronavirus cases have been confirmed in Russia — both of them Chinese citizens — and it was not immediately clear whether Moscow would seek to deport them.
Russia’s new prime minister, Mikhail Mishustin, said on Monday that he would postpone an annual economic forum scheduled to be held at the Black Sea city of Sochi this month. Among the 4,000 registered attendees, about 250 are from countries where coronavirus cases have been confirmed, officials said.
A hospital built in days is opening, but some of the ill have been turned away.
From Amy Qin, a China correspondent, and Elsie Chen, a researcher, on the ground in Wuhan:
People desperate for treatment started descending on a new hospital in Wuhan on Monday that was built within 10 days to fight the coronavirus outbreak. But with workers still trying to finish its construction, many potential patients were turned away.
Road checkpoints were set up to screen cars heading to the hospital. A sign at one read, “Only diagnosed patients transferred from other hospitals can be admitted.” Officers at that checkpoint told sick people and their relatives to instead call China’s emergency number.
One man, Xue Ying, was driving toward the hospital with his cousin, who had been tested for the coronavirus and was awaiting the results.
Mr. Xue believes his mother died from the coronavirus, but they could not secure a bed in a hospital and she was never tested for it. His aunt and uncle were also in a hospital.
“I can’t afford to lose anyone else,” he said.
About 1,400 military medics will begin working at the new hospital, which covers roughly 365,000 square feet and has been fitted with 1,000 beds. A second facility in Wuhan, with 1,500 beds, is expected to be completed this week.
Residents are waging a daily battle to survive the illness.
From Amy Qin, a China correspondent, and Elsie Chen, a researcher, on the ground in Wuhan:
Weak with fever, An Jianhua waited in line for seven hours outside the hospital in the cold, hoping to be tested for the new coronavirus, which doctors suspected she had contracted.
Ms. An, 67, needed an official diagnosis from a hospital to qualify for treatment, but the one she and her son raced to last week had no space. The next hospital they were referred to in Wuhan, the city of 11 million people at the center of the outbreak, was full, too, they said. They finally got an intravenous drip for Ms. An’s fever, but that was all.
Since then, Ms. An has quarantined herself at home. She and her son eat separately, wear masks and are constantly disinfecting their apartment. Ms. An’s health is declining rapidly, and even keeping water down is a struggle.
“I can’t let my mom die at home,” said her son, He Jun. “Every day I want to cry, but when I cry there are no tears. There is no hope.”
For some people, like Gan Hanjiang, the city’s new hospitals for treating the coronavirus cannot be built fast enough.
Last month, his father came down with a severe fever and cough. He was tested for the coronavirus, but the results were negative. Ten days after the onset of symptoms, however, his father died, Mr. Gan said.
The hospital classified the cause as “severe pneumonia,” Mr. Gan said, but he believes it was the coronavirus. Several experts have conceded that several rounds of testing may be needed for an accurate diagnosis.
On the day his father died, Mr. Gan began to show the same symptoms, he said. But without a car, he has not been able to go to one of the designated hospitals to be tested.
“Getting treatment is so difficult,” he whispered slowly by telephone from a small hospital near his home where he was being treated for viral pneumonia. “We can’t get admitted to the hospitals. And there’s not enough medicine.”
Some countries evacuate their citizens, and unease grows among those left behind.
Hundreds of citizens from countries including Australia, France, Italy, Brazil, Britain and Rwanda have been evacuated from Wuhan, the center of the outbreak, over the past few days.
Australia flew 243 passengers from Wuhan to an air base in Western Australia on Monday, including 89 passengers under 16 years old and five passengers younger than 2, according to Australia’s foreign minister, Marise Payne. From there, they will be transported by military planes to Christmas Island, a location previously used to house asylum seekers, where they will be quarantined for two weeks.
The French authorities said on Monday that they had helped repatriate more than 400 people from Wuhan since the beginning of the coronavirus outbreak. France’s foreign ministry said that a plane carrying 64 French passengers, 135 from other European Union countries, 55 from countries like Brazil, Britain and Rwanda, plus several dozen consular workers, had landed in southern France on Sunday.
In Italy, a military plane carrying 56 Italian evacuees from Wuhan landed at a military airport about 20 miles south of Rome on Monday morning.
Italy’s health minister, Roberto Speranza, said that his counterparts from the Group of 7 industrialized nations planned to further discuss the coronavirus in a telephone conference call.
As more governments evacuate their citizens from Wuhan, those left behind in the locked-down city are growing uneasy. Among them are about 50 Nigerians, many of them teachers or students at universities in Wuhan. Some have young children with them.
Lawal Bappah, an official at the Nigerian Embassy in Beijing, said the embassy was monitoring the situation and had been in touch with the Nigerian citizens in Wuhan.
“What we have recommended so far is that they should continue to maintain their self-isolation,” Mr. Bappah said. “The protocol for the evacuation is a very long process. So we are waiting for directives from our authorities.”
A day after New York City’s health authorities said that a woman hospitalized at Bellevue Hospital Center might have the new coronavirus, the authorities said on Sunday that two more patients might also have the virus.
Samples from all three patients must be tested at an Atlanta laboratory run by the Centers for Disease Control and Prevention to determine whether any of them have the coronavirus.
The turnaround time for receiving the results is usually at least 36 hours, and often longer. Local health departments are not yet able to test for the new illness.
Based on the type of symptoms, the patients’ recent travel in China and the exclusion of influenza and other common illnesses, the New York City health authorities are taking seriously the possibility that these patients may have the virus.
Three more cases were confirmed in California on Sunday, bringing the total in the United States to 11.
A growing threat to Southeast Asia.
While much attention is focused on China’s handling of the coronavirus outbreak, medical experts worry about looming problems in Southeast Asia, which has the largest cluster of patients with the coronavirus outside China.
The Times’s Southeast Asia bureau chief, Hannah Beech, reports that some governments in the region have either played down the threat of the epidemic or openly expressed worry about offending China, a superpower whose economic heft can propel their economies.
On Sunday, the first overseas death from the virus, a 44-year-old Wuhan resident who had died a day earlier, was reported in the Philippines. The virus has spread to about two dozen countries.
Medical experts worry that a delayed response to the coronavirus in Southeast Asia could hasten the spread of the disease.
“Our greatest concern is the potential for the virus to spread to countries with weaker health systems,” said Tedros Adhanom Ghebreyesus, the World Health Organization’s director general.
In Cambodia, Prime Minister Hun Sen told a packed news conference last week that he would kick out anyone who was wearing a surgical mask because such measures were creating an unwarranted climate of fear. And in Indonesia, the health minister advised citizens to relax and avoid working overtime to stay free of the disease, saying that “to prevent it is very easy as long as your immunity is good.”
Reporting was contributed by Alexandra Stevenson, Austin Ramzy, Steven Lee Myers, Chris Buckley, Raymond Zhong, Carlos Tejada, Cao Li, Gerry Mullany, Amy Qin, Anton Troianovski, Tess Felder, Jason Gutierrez, Joseph Goldstein, Damien Cave, Hannah Beech, Aurelien Breeden, Elisabetta Povoledo, Stanley Reed, Choe Sang-Hun, Miriam Jordan, Vivian Lin, Thomas Fuller, Richard Fausset, Knvul Sheikh, Vivian Wang, Mariel Padilla and Denise Grady. Claire Fu contributed research.
