What is the Middle East Respiratory Syndrome (MERS)?

China recently discovered a new coronavirus strain that is similar to MERS.  Tell me about the symptoms of MERS, the incubation period for infection, and the lethality rate.  Information on vaccines and treatments is relevant.  Official sources of information on MERS also is relevant.  Information on the origins of MERS is not relevant nor are the specific locations of previous outbreaks.  Editorials are not relevant. If the document discusses a potential animal origin, please ignore the document.

Find authoritative sources to answer this health-related question.

Worried about MERS in South Korea? Visitors can (mostly) breathe easy.

Nurses wear masks as a precaution against the MERS virus as they attend an International Conference of Nurses in Seoul on June 19. (Baek Seong-Ryul/AP) The infectious disease du jour is Middle East Respiratory Syndrome (MERS), a viral respiratory illness that’s leaving some travelers hyperventilating about their vacation plans. “My husband is worried,” reports a woman who plans to visit Seoul next month. “But I think if we wash our hands all the time and stay away from hospitals, we should be fine. What do you think?” Travelers can breathe easy: Their chances of contracting MERS in South Korea are minimal. “We do not recommend that people avoid traveling to Korea,” says Lisa Rotz, the associate director for global health and migration in the Centers for Disease Control and Prevention’s division of global migration and quarantine. “So far, all transmission has been within health-care facilities, so the risk to most U.S. travelers is extremely low.” But medical professionals say it’s important to monitor the situation closely. And if you decide to cancel, it also helps to know your rights. Low risk doesn’t mean no risk, notes Robert Wheeler, chief medical officer at On Call International, a travel risk-management company. If you’re near the outbreak, he says, you need to take “serious” precaution, because there is risk of person-to-person transmission of the virus if you have close contact with an infected person. This could happen if someone provides direct care in the home of a person sick with MERS. “Those with weakened immune systems, chronic diseases and people of older age tend to be particularly at risk for more serious illness and fatality when infected, so it is vital for these groups to be conscious of their surroundings and those they are in contact with,” he says. “These workers, if infected, return to pass the virus on to their communities,” he says. “The current outbreak is troubling in that cases are coming in clusters, often in the same hospital. This pattern, along with the uncertainty regarding MERS’s mode of transmission, suggests that medical facilities have not yet formulated an effective plan to prevent spread.” The precise nature of MERS virus transmittal isn’t well understood, says Florence Comite, an endocrinologist based in New York. What we do know is that the MERS virus has an incubation period of five to six days, but that symptoms can appear as early as two days

Nurses wear masks as a precaution against the MERS virus as they attend an International Conference of Nurses in Seoul on June 19.  (Baek Seong-Ryul/AP)
The infectious disease du jour is Middle East Respiratory Syndrome (MERS), a viral respiratory illness that’s leaving some travelers hyperventilating about their vacation plans.
For now, the month-old outbreak — the largest recorded outside the Middle East — is confined to South Korean health-care facilities, which aren’t exactly popular summer destinations for Americans. But, as usual, the fear is spreading faster than the disease.
“My husband is worried,” reports a woman who plans to visit Seoul next month. “But I think if we wash our hands all the time and stay away from hospitals, we should be fine. What do you think?”
Travelers can breathe easy: Their chances of contracting MERS in South Korea are minimal. “We do not recommend that people avoid traveling to Korea,” says Lisa Rotz, the associate director for global health and migration in the Centers for Disease Control and Prevention’s division of global migration and quarantine. “So far, all transmission has been within health-care facilities, so the risk to most U.S. travelers is extremely low.”
But medical professionals say it’s important to monitor the situation closely. And if you decide to cancel, it also helps to know your rights.
The CDC publishes updates on the outbreak on its Web site, at wwwnc.cdc.gov/travel/notices/watch/mers-republic-of-korea. You can also find MERS information on the World Health Organization’s (WHO) site: www.who.int/csr/disease/coronavirus_infections. There is no evidence so far that this virus is spreading in the general community.
Low risk doesn’t mean no risk, notes Robert Wheeler, chief medical officer at On Call International, a travel risk-management company. If you’re near the outbreak, he says, you need to take “serious” precaution, because there is risk of person-to-person transmission of the virus if you have close contact with an infected person. This could happen if someone provides direct care in the home of a person sick with MERS.
“Those with weakened immune systems, chronic diseases and people of older age tend to be particularly at risk for more serious illness and fatality when infected, so it is vital for these groups to be conscious of their surroundings and those they are in contact with,” he says.
The problem with MERS is the uncertainty surrounding it. It’s an infectious disease especially likely to be seen in travelers, says Joe Alton, a physician and author of the book “The Survival Medicine Handbook.” The reason: Its area of origin, Saudi Arabia, hires skilled workers in various fields from all over the world.
“These workers, if infected, return to pass the virus on to their communities,” he says. “The current outbreak is troubling in that cases are coming in clusters, often in the same hospital. This pattern, along with the uncertainty regarding MERS’s mode of transmission, suggests that medical facilities have not yet formulated an effective plan to prevent spread.”
The precise nature of MERS virus transmittal isn’t well understood, says Florence Comite, an endocrinologist based in New York. What we do know is that the MERS virus has an incubation period of five to six days, but that symptoms can appear as early as two days and up to 14 days after an initial exposure.
“MERS is believed to spread from an infected person’s respiratory secretions; for example, through coughing or sneezing,” Comite says.
How do you protect yourself from MERS? Ronald St. John, who founded the travel health and safety site Sitata, says: the same ways you would minimize your exposure to any respiratory agent, such as the flu virus. “These include frequent hand-washing, cough and sneeze etiquette, maintaining a one-meter distance from someone who has a respiratory infection,” the physician says.
One just as urgent question for travelers to Northeast Asia is how to protect your trip in case the outbreak worsens. Insurance can help, but you have to make sure you’ve purchased the right coverage. A standard policy with named exclusions may limit a claim you have to make if there’s an outbreak. In other words, you can’t cancel a trip because you’re afraid you might contract MERS.
A “cancel for any reason” insurance policy allows you to recover a percentage of your trip for any reason, including a MERS outbreak. But those policies are usually pricey. Travel insurance typically sets you back by between 4 and 8 percent of your trip’s prepaid, nonrefundable cost. A “cancel for any reason” policy can cost 10 percent of the nonrefundable cost, or even more.
If an outbreak happens, then airlines, cruise lines and tour operators may cancel their trips. In that case, you should be entitled to a full, no-questions-asked refund, although some companies, notably tour operators, will try to persuade you to accept a credit. Refer to the terms and conditions of your purchase to see what your refund would be. Don’t rely on the verbal claims of a company representative.
But if there’s a consensus among health professionals, it’s that this isn’t the time to cancel a trip to Korea, or Northeast Asia. The WHO continues to advise that travel restrictions for South Korea are not warranted.
“The risk for a tourist appears to be very low,” says Jeff Goad, an infectious diseases expert at Chapman University’s pharmacy school.
Just stay away from quarantined areas, take reasonable precautions, buy the right travel insurance and have a good time.
Elliott is a consumer advocate, journalist and co-founder of the advocacy group Travelers United. E-mail him at chris@elliott.org.
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Philippines confirms second MERS case: How serious is the threat?

Health officials at Soekarno-Hatta International Airport transport a simulated ill passenger during a drill as part of preparations in the event of a Middle East Respiratory Syndrome (MERS) outbreak, in Tangerang, Indonesia, on July 3. (Rivan Awal Lingga/Antara Foto

via Reuters)
Health officials in the Philippines reported Monday that the country's second case of Middle East Respiratory Syndrome was diagnosed in a 36-year-old foreign man who had flown in from Dubai.
The country has stepped up surveillance and quarantine measures at ports of entry and in the city of Muntinlupa, south of Manila, the country's capital. Patients at the hospital where the man is being treated were donning face masks, according to the Philippine Star.
Janette Garin,  secretary of health of the Philippines, told reporters that the man began showing symptoms July 2 and was admitted  July 4 to a hospital, where he tested positive for the virus.
Garin urged the public not to panic and said that the man had a low amount of virus in his body and that officials had  located and are monitoring eight people he had come into contact with. The government has declined to release any additional information about the man, including his nationality, occupation or the reason for his trip to the Philippines.
“[W]e appeal to the public to respect the privacy of the patient," she said in a media statement. "What is important now is for us to continue practicing proper hygiene, having adequate rest, balanced diet, all leading to a good resistance; allow us to emphasize that vigilance is still needed."
The Philippine government has emphasized that the World Health Organization does not recommend any type of travel or trade restrictions related to MERS but asked anyone entering the country to report to a hospital if they experience signs of a flu such as a fever with cough that are very similar to symptoms of MERS.
The first case of MERS was in February when a nurse who came from Saudi Arabia tested positive for the disease. She recovered and was declared free of the virus within a few weeks. South Korea is still grappling with an outbreak of MERS within its borders, and as of Monday 185 cases have been confirmed. Thirty-three of those patients have died, according to the WHO.
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Second case of MERS in U.S. is health-care worker in Saudi Arabia, visiting family here

Particles of the Middle East respiratory syndrome, MERS, coronavirus that emerged in 2012 are seen in a colorized transmission electron micrograph from the National Institute for Allergy and Infectious Diseases, NIAID. (Reuters/NIAID) “The patient is in good condition and is improving,” said Antonio Crespo, one of the hospital’s infectious-disease specialists. “We are taking every precaution but believe the risk of transmission from this patient is very low since his symptoms were mild and he was not coughing when he arrived at the hospital.” The man left Jiddah, Saudi Arabia, on May 1, and flew to London, then on to Boston, Atlanta and Orlando, where he is visiting family. U.S. health officials are attempting to contact more than 500 people in 20 states who may have been exposed to the patient, and international authorities are doing the same overseas. Officials said the virus does not appear to be transmitted by casual contact but instead requires close contact for transmission. “Our experience with MERS so far suggests that the risk to the general public is extremely low,” Frieden said. Sixteen personnel at the Orlando hospital are being monitored for symptoms, and family members of the man are staying at home, a hospital spokeswoman said. MERS, which was first reported in Saudi Arabia in 2012, can cause severe acute respiratory illness with fever, cough and shortness of breath. More than 30 percent of patients who have symptoms of MERS have died. The new patient worked at a Jiddah hospital that was treating MERS cases. While in Orlando, he did not visit any theme parks in the area, said John H. Armstrong, Florida’s secretary of health. Experts have worried that the recent increase in cases may be linked to mutations in the virus. But CDC officials said Monday they found no significant changes or mutations in the genetic sequence of the virus in a sample from the Indiana patient. Some of the increase in cases in the Middle East is because of better monitoring and tracking; the CDC and the WHO have teams in Saudi Arabia to help with the investigations. Airport and U.S. customs staff members are getting refresher training to look for symptoms among travelers, but the CDC is not recommending airport screening at this time, said Anne Schuchat, director of the CDC’s National Center for Immunization and Respiratory Diseases. Officials don’t know how many U.S. health-care personnel are working in the

Particles of the Middle East respiratory syndrome, MERS, coronavirus that emerged in 2012 are seen in a colorized transmission electron micrograph from the National Institute for Allergy and Infectious Diseases, NIAID. (Reuters/NIAID)
A second case of the deadly respiratory virus known as Middle East respiratory syndrome has emerged in the United States, once again involving a health-care worker who lives in Saudi Arabia and was visiting his family in the United States, health officials said Monday.
The 44-year-old man is in isolation at Dr. P. Phillips Hospital in Orlando, where he arrived on May 8 showing symptoms of the virus. The Centers for Disease Control and Prevention confirmed he had the virus Sunday night, agency Director Thomas Frieden said in a teleconference Monday.
“The patient is in good condition and is improving,” said Antonio Crespo, one of the hospital’s infectious-disease specialists. “We are taking every precaution but believe the risk of transmission from this patient is very low since his symptoms were mild and he was not coughing when he arrived at the hospital.”
The man left Jiddah, Saudi Arabia, on May 1, and flew to London, then on to Boston, Atlanta and Orlando, where he is visiting family. U.S. health officials are attempting to contact more than 500 people in 20 states who may have been exposed to the patient, and international authorities are doing the same overseas.
Officials said the virus does not appear to be transmitted by casual contact but instead requires close contact for transmission. “Our experience with MERS so far suggests that the risk to the general public is extremely low,” Frieden said.
Sixteen personnel at the Orlando hospital are being monitored for symptoms, and family members of the man are staying at home, a hospital spokeswoman said.
MERS, which was first reported in Saudi Arabia in 2012, can cause severe acute respiratory illness with fever, cough and shortness of breath. More than 30 percent of patients who have symptoms of MERS have died.
There is no vaccine or specific antiviral treatment for MERS, which comes from the same family of viruses as the one that caused severe acute respiratory syndrome. SARS killed almost 800 people around the world in 2003. As of Monday, there were 538 MERS cases in at least 12 countries that have been confirmed and reported to the World Health Organization, including 145 deaths. Of those, Saudi Arabia had 450 cases and 112 deaths, officials said.
The new patient worked at a Jiddah hospital that was treating MERS cases. While in Orlando, he did not visit any theme parks in the area, said John H. Armstrong, Florida’s secretary of health.
Monday’s announcement came just days after a health-care worker who was the first confirmed U.S. case of MERS was released from an Indiana hospital Friday. Health officials said he no longer had symptoms, tested negative for the virus and posed no threat to the community. The Indiana and Florida cases are not linked, authorities said.
Experts have worried that the recent increase in cases may be linked to mutations in the virus. But CDC officials said Monday they found no significant changes or mutations in the genetic sequence of the virus in a sample from the Indiana patient. Some of the increase in cases in the Middle East is because of better monitoring and tracking; the CDC and the WHO have teams in Saudi Arabia to help with the investigations.
Airport and U.S. customs staff members are getting refresher training to look for symptoms among travelers, but the CDC is not recommending airport screening at this time, said Anne Schuchat, director of the CDC’s National Center for Immunization and Respiratory Diseases.
Officials don’t know how many U.S. health-care personnel are working in the Middle East, “but we do know it is not rare,” Frieden said.
In the Indiana case, a U.S. citizen who had been living and working in Riyadh, the Saudi capital, flew to Indiana late last month to visit his family. The hospital where he worked in Saudi Arabia had treated some MERS cases, health officials said. The man flew from Riyadh through London to Chicago before boarding a bus to the Highland, Ind., area. He went to Community Hospital in Munster, Ind., on April 28 after becoming sick. He was kept in isolation.
Authorities contacted most of the passengers on the flights and the bus, and none are symptomatic, according to the Indiana health department.
CDC officials praised the Indiana hospital for its aggressive efforts to control the infection. Once the patient was a confirmed MERS case, hospital officials reviewed security tapes, monitored the sign-ins required of everyone — from doctors to housekeepers — who entered the patient’s room and tracked them through their ID badges, embedded with electronic chips, which show their locations at all times. About 50 employees were sent home and kept isolated until the hospital was sure they did not have MERS. They were planning to return to work Monday and Tuesday, according to Alan Kumar, the hospital’s chief information officer.
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How an Indiana hospital got it right when MERS showed up at the door

The exterior of Community Hospital in Munster, Ind., where a patient with the first confirmed U.S. case of Middle East Respiratory Syndrome (MERS) was discovered. (Jim Young/Reuters)
There are now two confirmed cases of deadly Middle East Respiratory Syndrome in the United States, and neither was discovered at a big teaching hospital like Massachusetts General in Boston or Mount Sinai in New York. Which only emphasizes the need for all health-care personnel to be ready to respond to new crises the way medical authorities at Community Hospital in Munster, Ind., did when this country's first MERS case showed up at its emergency room April 28.
Community Hospital is not some tiny facility in the middle of nowhere. It's in a bedroom community 30 miles from downtown Chicago, has 430 beds and sees 70,000 people in its emergency department annually. Still, MERS might not have been the first thing on the minds of doctors and nurses when a still-unnamed patient came into the emergency department with symptoms of what looked like a bad case of the flu.
And that's the point, Alan Kumar, the hospital's chief medical information officer, told me Monday: Staff are drilled on proper procedures for handling infectious diseases regardless of what they might be, so if they ever face a situation like this one, the danger can be contained.
"If they all know the protocols and standards, [and follow them]," he said, "when something like this comes in, the exposure is minimized."
Thomas Frieden, head of the Centers for Disease Control and Prevention
In fact, one of the most interesting aspects of Community's handling of the case is how it figured out who had been near the patient. Officials there reviewed security tapes, tracked the sign-ins required of everyone — from doctors to housekeepers — who entered the patient's room and tracked them via the RFID badges they wear, which show their locations at all times. About 50 were sent home and kept isolated there until the hospital could be sure they did not have MERS. They are returning to work Monday and Tuesday, Kumar said.
The patient, a U.S. resident who had been working in a health-care facility in Riyadh, Saudi Arabia, arrived in the Emergency Department on a busy Monday afternoon and was immediately taken to a triage room. (A bit of luck for the Community staff: The emergency room wasn't slammed with patients as it was when I talked to Kumar on Monday.) The room was private and equipped with a negative airflow system, so that even when someone opened the door, air flowed inward, not outward, containing the virus, Kumar said. The air is not vented through the hospital's regular ducts, but sent through a special system with filters designed to destroy bacteria and viruses.
Three hours later, the patient, who needed oxygen and fluids, was admitted to the hospital's medical floor, where he was again placed in a private room with special ventilation and seen by a primary care physician. By Tuesday, when an infectious disease specialist interviewed him over the phone, everyone who came in contact with him was required to wear gloves, gowns, masks and eye protection, Kumar said. The patient was put on a course of intravenous antibiotics because doctors weren't sure whether his symptoms, which looked like pneumonia, were bacterial or viral.
The specialist asked the patient about his recent travel — if that question was asked in the emergency department, it didn't trigger suspicions of MERS — and ordered a test for the virus, which has killed 145 people so far, the vast majority of them in Saudi Arabia. The specialist sent a sample of the man's sputum to the state Health Department, and the CDC confirmed the MERS diagnosis Thursday before holding a news conference on the situation Friday afternoon.
The patient was better within a week but spent a few extra days at the hospital as his discharge was planned, Kumar said.
"At this point, it appears that MERS picked the wrong hospital, the wrong state and the wrong country to try to get a foothold," Indiana Health Commissioner William VanNess said at a news briefing Monday.
Perhaps the most difficult problem for the hospital was reassuring the community after the news conference that the danger had been contained, Kumar said. For that, Community turned to an outside public relations firm for help, he said. By Monday, when officials were able to say that none of the 50 people exposed to the patient had shown signs of the virus, anxiety began to die down, he said. Now officials at the Dr. P. Phillips hospital in Orlando, who are caught up in the second U.S. MERS case, have asked Community Hospital for advice on how to handle relations with their surrounding area, he said.
Kumar said when the hospital does a post-mortem examination of its response to extraordinary events, "typically you find things that were done incorrectly that you want to fix the next time. We really haven't had much of that."


U.S. seeks to send expert team to China to combat coronavirus outbreak; Xi defends response

BEIJING — A top U.S. health official said Tuesday that he offered to send a team from the U.S. Centers for Disease Control and Prevention to China to help with the coronavirus outbreak. Health and Human Services Secretary Alex Azar did not describe the Chinese health minister’s response but said he hopes that Beijing will accept the offer.
The World Health Organization said Tuesday that China had agreed to allow global health experts into the country. Chinese leader Xi Jinping said Tuesday that his country is being “open, transparent, responsible” in its handling of the coronavirus outbreak, as the number of cases continues to increase. Here’s what we know:
● The death toll has risen to 132 in China, with more than 5,974 confirmed cases of infection as of Wednesday morning local time — a day-over-day increase of more than 1,000. Other countries in the region also are reporting more people infected — nearly all of them tourists from China.
● Germany reported three new cases late Tuesday, and said they are all connected to the country’s first patient, a 33-year-old man who was most likely infected by a Chinese business visitor from Shanghai who he met at a company workshop.
● Hong Kong announced dramatic measures to stem the flow of mainland Chinese into the territory, closing two railways, ferries and cross-border tour buses. Flights to mainland China will be slashed by half, and individual visas to Chinese will no longer be issued, starting Thursday. United Airlines suspended some flights from the United States to China after demand dropped.
● Several countries, including France, South Korea, Canada, Britain and the United States, are putting together plans to evacuate their citizens from the outbreak epicenter in Wuhan.
● Thailand has confirmed six more cases, bringing its total to 14 amid calls by many Asian populations to close the borders to Chinese visitors. Infections have been confirmed in France, South Korea, Japan, Nepal, Cambodia, Singapore, Vietnam, Taiwan, Canada and Sri Lanka. We’re mapping the spread here.
10:00 PM: Australia to evacuate some citizens from Wuhan and quarantine them on a remote island
Responding to the deadly coronavirus outbreak, Australia said it would evacuate some of its nationals from Wuhan and hold them in quarantine on a remote island where the country has operated an immigration detention center.
Prime Minister Scott Morrison announced the details Wednesday, adding that Australia had been working with the Chinese government to evacuate “isolated and vulnerable” Australians trapped in Hubei province, the epicenter of the health crisis.
The evacuees would be transferred to Christmas Island, an Australian territory hundreds of miles from the mainland in the Indian Ocean, where Australia has operated a controversial detention facility for asylum seekers.
It wasn’t immediately clear how many people would be evacuated, though officials have said about 600 Australians have registered as being in Hubei province. Priority would be given to the young and the elderly, Morrison told reporters in the Australian capital Canberra Wednesday.
“Anyone who under this plan is transported to Christmas Island would be there, we envisage, for up to 14 days,” Morrison said. “But that will be subject to the medical advice we receive.”
By: David Crawshaw
9:30 PM: Can the coronavirus be contained? Unknowns complicate U.S. response.
China has ordered an unprecedented quarantine of more than 50 million people. It has closed schools and shut down live animal markets. Airports across the globe are screening passengers coming from the world’s most populous country.
But three weeks after the new coronavirus emerged as a health crisis, experts can’t yet say whether these efforts will succeed at containing an infection that now threatens at least 15 countries.
Some early signs are discouraging: Six countries, including China, have confirmed human-to-human transmission of the infection. Those include four cases in Germany connected to a single person — a worrisome sign for containment of the disease. Cases in China continue to multiply, and 5 million residents of Wuhan, where the virus originated, have left the city, some of them surely carrying the disease.
But so far, the mortality rate is less than the rate of other severe respiratory coronaviruses. In China, where 5,974 people are infected, 132 have died through Tuesday. That is a high rate, but far less than the fatality rate of SARS and MERS. And countries like the United States that quickly began screening travelers, isolating sick people and tracing their contacts have just a handful of cases. There have been no fatalities outside China.
Public health officials said Tuesday that they are grappling with a long list of unknowns that will determine how successful they are in limiting the toll of the widening outbreak. Those questions include how lethal the virus may be, how contagious it is, whether it is transmitted by people who are infected but show no symptoms, and whether it can be largely contained in its country of origin.
Some experts are encouraged that no case outside China seems to be severe, and that no fatalities have been recorded outside China so far.
Read more about the outbreak’s unknowns and public health officials’ response here.
By: Lena H. Sun and Lenny Bernstein
8:45 PM: Two college basketball games postponed after Miami (Ohio) students tested for coronavirus
WASHINGTON — Officials at Miami University in Oxford, Ohio, have called off two college basketball games after administrators announced two students who had recently traveled to China were being tested for coronavirus.
One of the students visited the campus health center on Monday and exhibited flulike symptoms, prompting staff to test him and his travel companion, a university statement said. The two students are now isolated in their off-campus residences while they await their test results from the CDC.
The school’s men’s and women’s basketball teams were set to face Central Michigan and Western Michigan, respectively, over the next two days, but the athletic department announced on Tuesday that those games would be postponed.
The statement
“The health and safety of our student-athletes is always a top priority and, out of abundance of caution, it was decided to cancel tonight’s men’s basketball game,” Alford said in a statement. “I appreciate the diligence that the staff at Miami have shown and this serves as a reminder of how serious these issues are.”
One of the students tested was an international student, the school statement said. The university, a public institution in southwest Ohio, has about 25,000 students enrolled at four campuses. More than 80 percent of its 3,000 international students are from China.
Spring semester classes began on Monday, after a month-and-a-half-long break and winter term when many students traveled abroad. As news of the outbreak spread, the university contacted students to ask about their travels, Jayne Brownell, the vice president for student life, said at a Tuesday news conference.
“We are following all of those CDC and Department of Health guidelines,” Brownell said. “We are in touch multiple times a day.”
By: Reis Thebault
8:10 PM: White House warns airlines a ban of all China-U.S. flights is possible amid growing concerns with outbreak
WASHINGTON — The White House on Tuesday warned airlines that it may suspend all China-U.S. flights if the coronavirus outbreak become a bigger public health threat to the United States.
In a meeting with airline executives Tuesday afternoon, White House officials said they are not banning flights just yet, but said the U.S. government will assess the situation daily, leaving open the possibility of a ban on all flights from China, people familiar with the meeting said.
Airlines in recent days have already canceled hundreds of flights scheduled from China’s Wuhan International Airport, giving U.S. health officials a brief respite as they focused on the logistics of rerouting U.S.-bound travelers from the region to one of five airports for special screening.
Travelers are being funneled to airports in Atlanta, Chicago, Los Angeles, New York and San Francisco, where they are being screened for the virus. If cleared, they are allowed to continue to their final destination, officials with the U.S. Centers for Disease Control and Prevention said.
The State Department has issued a Level 4 advisory for Wuhan, meaning “no American should travel to Wuhan while this virus continues to have impact,” Vice President Pence said Monday. Later Monday, the State Department issued a Level 3 travel advisory for all of China, urging Americans to reconsider or postpone travel to any part of the country.
Public health officials continue to say the coronavirus poses a low risk to the American public, but say the enhanced screenings at airports are part of “proactive preparedness precautions.”
Officials familiar with Tuesday’s meeting with the airline executives said the White House made clear any decision to ban flights will be based on public health.
By: Luz Lazo
7:45 PM: Charter plane with more than 200 evacuated Japanese citizens lands in Tokyo
TOKYO — A charter plane carrying 206 Japanese from the Chinese city of Wuhan arrived at Tokyo’s Haneda Airport on Wednesday morning, as the evacuation of foreign nationals from the coronavirus-hit city gets underway.
Television reports said two of the passengers are suffering from cough and/or a fever, and video showed more than a dozen ambulances lined up outside the airport.
Japanese officials say any passengers showing symptoms will be taken directly to a hospital specializing in infectious diseases, while the rest will be taken to another hospital and tested for signs of the virus.
The second group will then be allowed to go home but urged not to venture outdoors for two weeks during the incubation period of the virus, with health officials visiting them on a daily basis to monitor their condition.
But on social media and comments sections of news reports, many people asked why the rest of the group is not also being isolated.
“It’s really hard to understand why they do not isolate the returnees for two weeks,” one person commented. “If some are already coughing and feverish, are not the other 200 plus people who are with them subject to infection? Are they allow to go home without isolation? What about their family members? What about their school or workplace?”
Officials say more than 650 Japanese citizens have asked to be evacuated from the central province of Hubei, and other flights will be laid on as soon as possible.
By: Simon Denyer and Akiko Kashiwagi
7:15 PM: Number of confirmed cases in China rises by more than 1,000 overnight
WASHINGTON — The death toll in China continues to rise, as health agencies reported 26 more fatalities on Wednesday morning local time. As of about 6:30 a.m. in Beijing, coronavirus had killed 132 people — all but six of whom were from Hubei province, where the outbreak began, according to a tally from national and local health commissions.
The number of confirmed cases also rose dramatically, by more than 1,000, to 5,974, according to the Chinese health agencies, which also reported that 103 people have been successfully treated for the disease.
The day-over-day increase comes as countries scramble to evacuate their citizens from Wuhan, the disease’s epicenter, and as Chinese President Xi Jinping pledged international cooperation to stop its spread.
“The virus is a devil and we cannot let the devil hide,” Xi said, according to a Reuters report.
By: Reis Thebault
6:45 PM: Apple CEO says company expects coronavirus to disrupt its supply
SAN FRANCISCO — Apple chief executive Tim Cook addressed the coronavirus in a conference call Tuesday with analysts, saying the company limited employee travel to “business critical” areas in China last week and is monitoring the situation closely. Cook said Apple does have some suppliers in the Wuhan area, the disease epicenter that is under quarantine, but he said the company has alternative options that are based elsewhere.
Still, Apple expects some disruption to its supply because of the virus, the effects of which have been felt across the country. Factories that make Apple products and components were set to reopen at the end of the month, following the Lunar New Year celebrations, but that date has been delayed until Feb. 10, Cook said on the call.
Apple is also seeing a disruption in retail sales in China because of the virus, Cook said. While Wuhan only contributes a small portion of sales to Apple’s overall China business, and Apple has closed only one store, a number of stores outside Wuhan that sell Apple products have also closed. Many of the stores that haven’t closed have reduced their operating hours. Apple has begun deep-cleaning its stores and conducting temperature checks of employees, he said, which is one way of determining whether someone may have contracted the virus.
Amid the uncertainty, the company gave investors a wider range for revenue guidance next quarter, in anticipation of a possible disruption in its China sales.
By: Reed Albergotti
6:00 PM: Sen. Warren releases plan for containing infectious diseases as coronavirus spreads
WASHINGTON — As countries across at least four continents reported new cases of the novel coronavirus, U.S. Democratic presidential candidate Elizabeth Warren released a plan for combating infectious diseases in the United States and abroad.
The plan, unveiled Tuesday, offers a brief history of deadly global outbreaks and takes shots at President Trump, whom Warren hopes to face in the November 2020 election and whose policies she says could make it more difficult for the world to deal with coronavirus and other diseases.
“The world is watching closely to determine if this will be designated as our next global Public Health Emergency,” Warren said, referring to coronavirus in a statement outlining her plan. “Instead of building capacity to combat these problems, Donald Trump has deprioritized global health security and risked putting us on our heels in a crisis.”
Warren, along with former vice president Joe Biden, has criticized Trump’s disbanding of the White House’s global health security team and the abrupt departure of the top U.S. official in charge of the country’s response in the event of a deadly pandemic.
If she were elected president, Warren said she would increase funding to the agencies charged with responding to outbreaks and increase funding for international fights against HIV, tuberculosis and malaria. She said she would also push the CDC to develop vaccines for infectious diseases, such as a universal flu vaccine.
Part of the money for these initiatives, she said, will come from a “swear jar” that requires drug companies that break the law to pay a portion of their profits to the National Institutes of Health, which will use that money to research infectious disease treatments.
“Diseases like coronavirus remind us why we need robust international institutions, strong investments in public health, and a government that is prepared to jump into action at a moment’s notice,” Warren said.
By: Reis Thebault
3:45 PM: German officials confirm three new coronavirus cases
BERLIN — German authorities confirmed three new coronavirus cases in the southern state of Bavaria on Tuesday evening, increasing the total number of cases in Germany to four.
The three new cases are connected to Germany’s first patient, a 33-year-old male, who was confirmed to have the virus Monday and is in a “medically good state,” according to regional health officials. Authorities did not immediately provide details on the three other infected individuals. All of them work for the same company, an automotive supplier in Bavaria.
The initial patient was most likely infected there Jan. 21 by a Chinese business visitor from Shanghai, who had entered Germany on Jan. 19 and did not display symptoms caused by the virus during her stay in southern Germany, according to preliminary details provided by German officials. She and the 33-year-old met at a workshop at the company.
Authorities said Tuesday that around 40 individuals had come into close contact with him and the Chinese visitor. All of them are now being tested for the virus.
By: Rick Noack
3:35 PM: WHO says China will allow global health experts into country
China will allow the World Health Organization to send a team of experts into the country to study the coronavirus, the WHO said in a statement Tuesday, after a meeting between the organization’s director general and Chinese leader Xi Jinping.
“The two sides agreed that WHO will send international experts to visit China as soon as possible to work with Chinese counterparts on increasing understanding of the outbreak to guide global response efforts,” the statement said.
When asked whether the group would include American experts from the Centers for Disease Control and Prevention, Tarik Jasarevic, a WHO spokesman, told The Washington Post that there’s “No further information about composition or technical expertise of this group at this point.”
By: Siobhán O’Grady
3:30 PM: In China, still more risk of dying from flu than the coronavirus, expert says
WASHINGTON — As cases of the coronavirus continue to spread, global health experts say people in China — and around the world — are currently more at risk of dying of influenza.
“The flu is a big deal in China,” said Yanzhong Huang, senior fellow for global health at the Council on Foreign Relations.
People there are “more at risk of dying of the flu right now than they are of coronavirus,” he said, although incomplete government data makes it hard to assess the full effect of flu in China.
Flu takes a substantial toll around the world, including in the United States. According to the Centers for Disease Control and Prevention, there have been at least 15 million cases of the flu and 8,200 deaths in the United States this season.
Huang said that getting a flu shot probably wouldn’t keep individuals from contracting the coronavirus, but could have systemic benefits by bringing down the rate of those presenting flulike symptoms and seeking treatment, thus preserving hospital resources.
Fear, Huang said, “could itself be as contagious as the virus.”
By: Ruby Mellen
3:10 PM: Robot delivers food to people in quarantine in China
WASHINGTON — Travelers who flew from Singapore to Hangzhou, China, are being held in quarantine in a hotel this week, where they received a visit from a special guest: Little Peanut, a food delivery robot.
“Hello, everyone. Cute Little Peanut is serving food to you now,” the robot said as it made its way down a hotel hallway. “Enjoy your meal. If you need anything else, please message the staff on WeChat.”
Little Peanut moved along the carpeted hallway with ease, pausing when a man in slippers and a face mask opened his door to retrieve his meal. As the robot moved ahead, another door opened, and another man reached for his meal. The robot continued down the hall, and two more men popped out of doors opposite one another, each retrieving their meals as well.
The delivery system, which reduces human contact with the people in quarantine, was captured in cellphone footage shared this week on Chinese state media.
By: Siobhán O’Grady
2:30 PM: Canada confirms third case of coronavirus
TORONTO — A third person has tested positive in Canada for the novel coronavirus, the British Columbia Center for Disease Control said Tuesday.
The man, who is in his 40s, travels regularly to China for business and was in Wuhan during his most recent trip, said Bonnie Henry, the provincial health officer. He began experiencing symptoms of the virus more than 24 hours after his arrival in Vancouver last week and contacted his primary health-care provider. He is being kept in isolation at home, where he is “doing well,” she added, and does not require hospitalization.
Henry said the case “is not unexpected to us,” given travel patterns and family ties between British Columbia and China, and is unlikely to be the last. She stressed that the risk of contracting the virus remains “extremely low.”
Despite claims from some Chinese officials, Henry said that there is no evidence that the coronavirus can be spread while a carrier is asymptomatic and that the virus is not as infectious as influenza or measles.
“You have to be in relatively close contact with somebody to inhale those droplets if they cough or sneeze,” she said.
The man’s case is considered a “presumptive positive” pending confirmation from the National Microbiology Laboratory in Winnipeg, Manitoba, but Henry said she is “confident” it is a case of the virus given the man’s travel pattern and symptoms.
By: Amanda Coletta
2:00 PM: Wall Street bounces back after coronavirus-fueled sell-off
WASHINGTON — U.S. stock markets rebounded Tuesday after investors appeared to shake off immediate anxiety around the growing coronavirus outbreak.
The Dow Jones industrial average was up 250 points at midday, one day after shedding more than 450 points in its worst one-day sell-off since October. The Standard & Poor’s 500 and tech-heavy Nasdaq also rallied back, and were trading up 1.2 and 1.4 percent, respectively.
Still, investors are keeping close watch on the coronavirus. Analysts worry that China’s economy, which depends heavily on consumer spending, could take a hit given the massive slowdown in travel. There’s also concern that it could disrupt global supply chains.
The U.S. economy could be cushioned from any major damage, analysts say, especially if the 2002-2003 SARS outbreak is any indication. The spread of Severe Acute Respiratory Syndrome, which killed nearly 800 people and infected more than 8,000 others, temporarily stifled growth in China.
By: Rachel Siegel
1:25 PM: United Airlines suspends some flights to China as demand drops
WASHINGTON — United Airlines, the largest U.S. carrier operating in China, said Tuesday afternoon that it is adjusting its near-term schedule and canceling 24 round-trip flights between the United States and China because so few people are traveling to China.
The cancellations affect flights from San Francisco International Airport, Newark Liberty International Airport, Dulles International Airport and Chicago O’Hare International Airport.
“Due to a significant decline in demand for travel to China, we are suspending some flights between our hub cities and Beijing, Hong Kong and Shanghai beginning Feb. 1 through Feb. 8,” the airline said in a statement. “We will continue to monitor the situation as it develops and will adjust our schedule as needed.”
By: Hannah Sampson
12:50 PM: Top U.S. health official says early cases may ‘skew’ understanding of coronavirus
WASHINGTON — Azar said experts are scrambling to understand how quickly the novel coronavirus spreads, as well as its lethality, based on limited information.
In a news conference on Tuesday, the health secretary emphasized that officials’ assessments are based on the publicly reported cases and that those “are naturally the most severe cases, because patients presented themselves to health-care providers.”
Another challenge is figuring out lethality without knowing what the total universe of cases might be. Right now, China is reporting more than 100 deaths from the more than 4,500 cases.
But Azar noted that those cases, too, “skew severe, including patients who are older or have other illnesses. The mortality rate may drop over time as we identify a broader set of cases.”
For those reasons, Azar said, “We are still determining the real speed of spread. … We are also still learning about the severity of the virus.”
By: Yasmeen Abutaleb and Lenny Bernstein
12:35 PM: Authorities in Germany caution against ignoring flu risk as coronavirus spreads
BERLIN — Authorities in Europe urged citizens Tuesday to not ignore risks posed by the flu, after public focus largely shifted to the spreading coronavirus.
In Germany, which confirmed its first coronavirus case in southern Bavaria on Monday night, officials have sought to keep the coronavirus in perspective by citing flu figures.
“Severe flu seasons can kill up to 20,000 people annually in Germany,” said German Health Minister Jens Spahn. But health officials said they also did not want to diminish the risks posed by the coronavirus, even as the threat level across Europe remains relatively low.
The growing focus on the new virus may skew perception of the real risks it poses, but that doesn’t mean the public interest has been unhelpful, said Susanne Glasmacher of the Robert Koch Institute, a German government health agency.
“Some of the means of protecting against influenza are the same as against coronavirus: keeping a distance, washing your hands,” she said.
Encouraging more citizens to take such measures seriously “might in fact be beneficial for keeping influenza numbers low — perhaps it might even help to increase influenza vaccination coverage,” she said.
By: Rick Noack
11:50 AM: Top U.S. health official says he offered to send CDC team to China
WASHINGTON — Health and Human Services Secretary Alex Azar said on Tuesday that he reiterated an offer to China’s minister of health to send a U.S. Centers for Disease Control and Prevention team to China to aid with the public health response to the coronavirus outbreak.
In a news conference Tuesday, Azar said he spoke with the Chinese minister of health on Monday and repeated an offer he made on Jan. 6 to send a CDC team.
Asked about the minister’s response, Azar did not respond directly, saying he “hopes the Chinese government will take us up on” the offer. “We are urging China that more cooperation and transparency are the most important steps you can take toward a more effective response,” Azar said.
Azar said health officials wanted more isolates of the virus from China to help better understand its transmission and to help in the development of vaccines and diagnostics. Top health officials also said that no option was off the table on further restricting travel from China, but they did not announce any new limitations.
By: Yasmeen Abutaleb and Lenny Bernstein
11:30 AM: As outbreak spreads, Africa prepares for possible cases
WASHINGTON — Despite rapidly growing ties between China and many African countries, no coronavirus cases have been recorded anywhere in Africa since the outbreak began in China in late December. Still, John Nkengasong, director of the Africa Centers for Disease Control and Prevention, warned Tuesday that it’s “very possible that there are cases on the continent that have not been recognized.”
Speaking to reporters in Addis Ababa, he noted that cases were suspected in several countries but that none has been confirmed. As is true elsewhere, preparedness for the virus will vary country by country, Nkengasong said.
“Some countries have very strong surveillance systems, some have weak surveillance systems, and some we are working with them to strengthen those systems there,” he said. “This will be a test case of how those systems have been strengthened over the years.”
Large numbers of Chinese citizens live and work in Africa, running shops and restaurants and working on Chinese infrastructure projects. And in the last decade, airlines have accounted for the rapidly growing exchange: Air traffic between Chinese and African cities surged more than 630 percent in the last decade, Quartz reported last year.
Meanwhile, tens of thousands of African students are studying in China, with more than 4,000 believed to be studying in Hubei province alone, according to the Associated Press.
As of Tuesday, Nkengasong said, there is “no need to charter flights to evacuate Africans out of Wuhan city.”
But some African students have expressed concerns they are trapped in the epicenter of the outbreak. Samson Opoku, a Ghanaian student leader in Wuhan, told Ghanaian radio station Joy FM that he and others “want evacuation back home to Ghana.”
“When the outbreak subsides or ends then we return and continue our academic work,” he said.
By: Siobhán O’Grady
10:40 AM: Millions tune in to watch live stream of Chinese hospital construction
WASHINGTON — Blocked from traveling and encouraged to stay indoors, millions of Chinese have found an unusual way to pass the time: watching hospitals get built — in real time.
On Tuesday, remarkable numbers of Chinese netizens watched grainy, wide-angle footage of workers flattening earth at the site of two temporary hospitals being built to treat the growing number of patients in Wuhan.
Twin live streams showcasing work on the Huoshenshan and Leishenshan hospitals together had an average of 18 million concurrent views on Tuesday, according the South China Morning Post. The footage was hosted by CCTV, China’s state broadcaster.
Facing public anger, authorities promised to build two hospitals in 10 days — a response calibrated to show resolve and showcase Chinese know-how. The live streams appear to be a nod to calls for transparency.
The fact that so many people chose to watch the slow-moving coverage shows both the extent to which boredom is taking hold, as well as public interest in how the Chinese Communist Party is responding.
China’s leaders have vowed to use the hulking architecture of the state to help those affected. The footage, boring as it may be, gives ordinary people a rare chance to show they’re keeping watch.
By: Emily Rauhala
10:10 AM: Xi defends China’s handling of outbreak in meeting with WHO
BEIJING — Chinese leader Xi Jinping defended his country’s handling of the coronavirus epidemic as “open, transparent, responsible” on Tuesday in a meeting with World Health Organization director general Tedros Adhanom Ghebreyesus, even as the Chinese mayor at the epicenter of the outbreak apologized for withholding information from the public.
Calling the coronavirus a “demon,” Xi told Tedros that he would not “let a demon hide” as he vouched for his government’s ability to handle the crisis.
In return, China’s official Xinhua News Agency described Tedros as praising Xi for “personally commanding” the outbreak response and “showing excellent leadership.”
Although international experts have largely praised the speed and methods with which Chinese scientists have carried out research into the novel virus, the Communist Party leadership has come under growing criticism about its handling of the epidemic in its critical early days and its politicization of the international public health response.
Xi’s meeting with the WHO chief came a day after the mayor of Wuhan triggered a firestorm by publicly suggesting that he had not been allowed to speak out earlier about the epidemic.
China in recent days has also been criticized by Taiwan’s president for trying to block the self-ruled island from meetings at the WHO, a United Nations agency, for political reasons at a sensitive moment. China, which has considerable clout at the U.N., views Taiwan as its own territory and has sought to diplomatically isolate the island.
Taiwan reported late Tuesday that it had a first case of coronavirus transmission between two people on the island, raising fears of the virus’s spread. The majority of cases so far have involved people who became infected while traveling in central China.
By: Gerry Shih
9:30 AM: Taiwan reports first case of domestic transmission
WASHINGTON — Taiwan’s Central Epidemic Command Centre confirmed Tuesday that one of its eight confirmed coronavirus patients appeared to be the first case of transmission on the island. All previous cases had been infected first in China, Taiwan said. But the new patient, a man in his 50s, was infected by his wife after she returned from working in China, Reuters reports.
Taiwan, despite its political divide with the government in Beijing, has close cultural and economic ties with mainland China. On Monday, an official at Taiwan’s Mainland Affairs Council told reporters that there were as many as 300 business people from Taiwan in Wuhan.
By: Adam Taylor
8:45 AM: Charter flight carrying medical supplies leaves Japan for Wuhan as evacuations begin
TOKYO — A charter flight left Japan at 8 p.m. on Tuesday to evacuate around 200 people from Wuhan, officials said.
The plane is carrying masks, plastic gloves, protective clothing and food.
It was scheduled to leave Wuhan at 3 a.m. local time Wednesday and arrive back in Tokyo’s Haneda airport at 7:30 a.m. Officials said 650 Japanese citizens living in the worst-affected province of Hubei have asked to come home, with the initial 200 selected among those living closest to the airport and the market from which the disease is believed to have spread.
Those with symptoms will be taken directly to a hospital that specializes in treating infectious diseases, while those without symptoms will be taken to another hospital for tests.
The second group will then be allowed to go home, but urged not to venture outdoors for two weeks during the incubation period of the virus, with health officials visiting them on a daily basis to monitor their condition.
Other flights will be added as soon as possible, officials told reporters.
South Korea will send four flights to Wuhan on Thursday and Friday to evacuate around 700 of its nationals who have asked to come home.
The government plans to send provide some 2 million masks and other medical relief items, including 200,000 items of protective clothing and goggles, on the planes, Yonhap news agency reported.
By: Simon Denyer
8:30 AM: Countries move forward with evacuation plans
BERLIN — Several countries continued to move forward with plans to evacuate their citizens from the coronavirus epicenter Wuhan.
Among the nations pursuing or considering such plans are France, South Korea, Morocco, Britain, Germany, Canada, the Netherlands and Russia, Reuters reported.
French authorities said they will initially focus on the evacuation of citizens who are not showing any symptoms of the virus, with a flight from Wuhan expected to arrive back in France on Thursday. The second flight for infected citizens has yet to be scheduled.
In neighboring Germany, the Der Spiegel magazine reported that at least one military aircraft was expected to leave for Wuhan later this week to evacuate German citizens. The plans were not officially confirmed and the German Foreign Ministry did not immediately respond to a request for comment.
British authorities were still finalizing their own plans, too. Via its Twitter account, the British embassy in Beijing urged British nationals in Hubei province willing to leave the region to call a 24/7 hotline before 11 a.m. on Wednesday.
The British government had previously faced pressure to enact a plan. The opposition Labour Party’s Emily Thornberry accused Prime Minister Boris Johnson of “not doing whatever it takes to protect our citizens from harm,” according to the Evening Standard newspaper on Monday.
By: Rick Noack
7:30 AM: Chinese embassy in Copenhagen demands apology over coronavirus cartoon
BERLIN — The Chinese embassy in Denmark has demanded an apology over a coronavirus cartoon published in one of the country’s highest-circulation newspapers, Jyllands-Posten.
The cartoon showed a Chinese flag with what appeared to represent five coronavirus particles instead of the five typical yellow stars.
The illustration — published by the same paper that drew international attention with the satirical Muhammad cartoons in 2005 that sparked rioting across the Middle East — struck a nerve with Chinese officials in Denmark.
In a release, a spokesperson for the embassy called the cartoon “an insult to China” that “hurts the feelings of the Chinese people.”
“Without any sympathy and empathy, it has crossed the bottom line of civilized society and the ethical boundary of free speech and offends human conscience,” the statement read, adding that the cartoonist Niels Bo Bojesen and the paper should “reproach themselves for their mistake and publicly apologize to the Chinese people.”
The paper stood by the cartoon on Tuesday, with its editor in chief Jacob Nybroe saying that “there is no mockery or scorn in the drawing.”
“We can’t apologize for something we don’t think is wrong,” Nybroe added, according to the paper’s own coverage of the controversy.
Danish Prime Minister Mette Frederiksen defended the country’s freedom of expression and satire, even though she did not directly comment on the cartoon in question itself.
By: Rick Noack
6:00 AM: Philippines restricts visas for Chinese nationals
MANILA — In the Philippines, immigration authorities temporarily suspended the issuance of visas upon arrival for Chinese nationals. Immigration commissioner Jaime Morente said that this was “to slow down the influx of group tours,” and possibly prevent the entry of the virus.
China is one of the country’s top sources of tourists, accounting for over a million visits in 2018. The country is hoping to record 9.2 million international arrivals this year. Tourism Secretary Bernadette Romulo Puyat said that her department did not find it necessary to adjust tourism targets just yet.
“We remain optimistic that the tourism industry will be resilient,” said Puyat. “Nevertheless, we continue to monitor the situation. Our primary concern is the safety of visitors and locals.”
Political analyst Antonio La Viña says that these countries’ precautionary measures are expected to have economic impacts, but he cautioned against these actions possibly taking on racist tones.
“Countries have no choice but to take such an approach as there is no alternative,” he said. “What would be temporary economic impacts could have long term consequences if that happens and not corrected.”
By: Regine Cabato
5:30 AM: Infected German man came into contact with Chinese visitor, authorities say
BERLIN — German authorities have confirmed the first coronavirus case in the country. The 33-year-old male patient in southern Bavaria has been isolated and is being monitored, officials said in a news conference on Tuesday.
He is in a “medically good state,” according to the regional health ministry.
The patient was most likely infected by a Chinese business visitor from Shanghai, who entered Germany on Jan. 19 and did not display symptoms caused by the virus during her stay in southern Germany, according to preliminary details provided by German officials.
She and the 33-year old met at a workshop in the offices of a German automotive supplier where the man works.
Authorities said Tuesday that around 40 individuals had come into close contact with him and the Chinese visitor.
Germany is the second European nation to confirm a coronavirus case. French authorities have so far reported three cases.
German health minister Jens Spahn said “it was to be expected that the virus would reach Germany.”
“After the [coronavirus] suspicion was confirmed, everyone who was in close contact with him is being examined,” Spahn said, adding that the risk to Germans “remains low.”
By: Rick Noack
5:05 AM: Three Russian regions close borders with China
MOSCOW — Russia has closed its border with China in three of its Far East regions amid fears of the coronavirus outbreak, according to state-run news agency Tass.
It’s one of a number of precautions Russia has taken, though the country’s consumer safety regulator, Rospotrebnadzor, said Tuesday morning that there haven’t been any cases of coronavirus recorded here yet. The border crossings in the Jewish Autonomous Oblast, Khabarovsk and Amur regions will be closed until Feb. 7.
Moscow Mayor Sergei Sobyanin wrote on his website Tuesday that monitoring of hotels and popular tourist sites has been heightened.
“If any alarming signals are identified, medical brigades will be dispatched to these sites immediately to carry out all-round checks,” he said.
Russia is also blocking organized tour groups from China, according to Tass, which cited Russia’s travel industry union. Meanwhile, Russia’s embassy in China has contacted 158 citizens in the Hubei province, including 113 in the city of Wuhan, which is on lockdown in an effort to contain the spread of the disease.
By: Isabelle Khurshudyan
4:55 AM: Japan announces first coronavirus case for someone not from Wuhan epicenter
TOKYO — Japan on Tuesday recorded its first case of coronavirus in someone who had not visited the Chinese city of Wuhan, the epicenter of the outbreak, but had come into contact with tourists from there.
The Japanese man, a tour bus driver in his 60s, drove two groups of Chinese tourists from Wuhan earlier this month, Health Minister Katsunobu Kato said.
Kato told a news conference the man had worn a mask when he was working.
He was one of two new cases of coronavirus confirmed on Tuesday, bringing the total of cases in Japan to six.
The other cases involved four Chinese tourists from Wuhan, and a Chinese national living in Japan who returned home after visiting Wuhan.
By: Simon Denyer
4:10 AM: Hong Kong leader restricts flow of mainland Chinese into city over virus fears
HONG KONG — Facing public pressure across the political aisle, Hong Kong Chief Executive Carrie Lam on Tuesday announced dramatic measures to stem the flow of mainland Chinese into the territory, including the closure of railways, ferries and cross-border tour buses.
Flights to mainland China will be slashed by half, and the Hong Kong government will stop issuing individual travel visas to mainland Chinese, starting from Thursday.
The decision, Lam said, was made along with authorities in Beijing. All in all, about half of Hong Kong’s border checkpoints with mainland China will be closed.
“The flow of people between the two places needs to be drastically reduced,” Lam said.
By: Shibani Mahtani
3:45 AM: North Korea imposes one-month quarantine on recent arrivals
TOKYO — North Korea, which already banned foreign tourists from entering the country, has now imposed a one-month quarantine on any foreigners who come in, including diplomats and aid workers.
The Russian Embassy in Pyongyang said it had been informed by North Korea’s Foreign Ministry that “all foreigners” who have recently visited China will be isolated and kept under medical supervision for a month.
The measures mirror steps taken by the country during the 2002-2003 outbreak of SARS (severe acute respiratory syndrome). During the Ebola outbreak in West Africa in 2014, entry requirements were even stricter, with anyone entering the country, including North Korean nationals and regime officials, held in quarantine for 21 days.
In a post on its Facebook page spotted by the NK News service, the Russian Embassy said foreigners arriving by air will be placed under quarantine at a hotel just north of the capital Pyongyang, while those crossing by train will be kept a hotel in the border town of Sinuiju.
“These measures are aimed at protecting the life and safety of our employees accredited to the DPRK diplomatic missions and international organizations, as well as the prevention of a pandemic of a new type of coronavirus,” the Russian Embassy said, referring to the country’s official name, the Democratic People’s Republic of Korea.
Ruling party newspaper Rodong Sinmun reported earlier that quarantine centers are being set up at the country’s borders, ports and airports where anyone believed to have been exposed to the illness will be isolated.
The Ebola-related restrictions were kept in place for four months.
By: Simon Denyer
3:30 AM: Thailand fears $1.6 billion loss in tourism revenue from China
HONG KONG — Thailand is facing a $1.6 billion loss in tourism revenue with the shutdown of Chinese cities and banning of tour groups, an official said Tuesday.
Tourism and Sports Minister Pipat Ratchakitprakarn told local media that China’s decision to restrict tour groups would have a deep impact on the tourism industry, which relies heavily on Chinese visitors.
Thailand also confirmed six more infections on Tuesday, taking its tally up to 14, the most in the region outside China. All of the new cases were travelers from China.
“Now we will expand screening to all Chinese from China and prepare equipment to screen 100 percent,” said Sukhum Kanchanapimai, the permanent secretary of the Public Health Ministry, said according to Reuters.
By: Shibani Mahtani
3:20 AM: Kazakhstan toughening up visa requirements for Chinese
DUBAI — Kazakhstan will now require medical certificates from Chinese visitors and has stopped issuing electronic visas in effort to prevent the spread of the coronavirus outbreak into the country, an official said Tuesday.
Deputy Foreign Minister Shukhrat Nuryshev also said there were no plans to close the border, and the country was seeking to repatriate 98 of its citizens stuck inside the outbreak’s epicenter in Wuhan, Reuters reported.
By: Paul Schemm
3:00 AM: Number of Chinese on lockdown rises to 54 million
TOKYO — The number of Chinese citizens on travel lockdown has increased to 54 million with the addition of Shiyan.
China is attempting to seal off the epicenter of the coronavirus outbreak, centered around Wuhan in Hubei province and cutting all travel links.
Shiyan, the “Detroit of the East,” is an industrial city of over 3.4 million known for its auto sector.
By: Simon Denyer
2:45 AM: Growing calls in Hong Kong to close border with mainland China
HONG KONG — Even some pro-establishment politicians here are backing calls for the government to close the border with mainland China, regardless of the economic impact and the potential political fallout from the decision.
Beijing has sovereignty over Hong Kong, but under the “one country, two systems” arrangement, Hong Kong maintains its own immigration system.
James Tien, a prominent businessman and honorary chairman of the pro-business and pro-Beijing Liberal Party, urged the government to consider starting by closing the mainland border for a period of a month.
Though it is a “very painful” suggestion for someone who’s advocated for a business-friendly environment, “special times call for special measures,” Tien wrote in a Facebook post.
The territory is already reeling from the impact of eight months of political unrest over fears that Hong Kong’s autonomy is being eroded by Beijing.
Tourism has been hit particularly hard, with a pronounced drop in visitors from mainland China. Some unions even in this sector, however, are similarly advocating for the border closure, arguing that the government must prioritize public health over short-term economic gain.
“If everyone is unwell, economics won’t be important anymore,” said Alex Tsui, chairman of the pro-democracy Hong Kong Hotel Employees Union, noting that the 2003 SARS epidemic that hit the territory particularly hard spread through hotels.
“Our industry is very high risk, and hotels are a dangerous place for a virus to spread,” he said. “The safety of the Hong Kong people and our hotel workers have to be the priority.”
The Hong Kong government has encouraged civil servants, other than those delivering health care and other essential public services, to work from home after the Lunar New Year holiday, which ends on Tuesday.
Sports facilities and museums have been closed indefinitely, and major banks, financial institutions and law firms have also asked workers to self-quarantine. Trading however will return to normal on Wednesday.
By: Shibani Mahtani


Before the new coronavirus, travel aided the spread of other diseases. Here’s a look back at 5 notable cases.

The world has been on edge in the early days of 2020 after a new, deadly strain of coronavirus was reported in China late last year. This coronavirus strain originated in the Wuhan province of China and has killed more than 100 people and infected over 8,100 there.
In the United States, six cases of the pneumonia-like illness have been confirmed, and it has quickly spread to countries including France, Japan, Nepal, Cambodia, Singapore, the United Arab Emirates, Vietnam, Canada and Sri Lanka, plus Hong Kong and the island of Taiwan.
The first case in the United States appeared after a man from Washington state brought the virus back from Wuhan via plane in mid-January, and another traveler — a woman from Chicago — was confirmed to have brought the disease back from Wuhan as well. That woman passed the virus to her husband in the first case of person-to-person transmission within the States.
In the weeks since, the Centers for Disease Control and Prevention has raised its travel warning to a Level 3 (of three), its highest. The World Health Organization has issued a public health emergency as the number of people infected on mainland China rose above the SARS epidemic of 2003.
American Airlines has suspended routes to China in February and March. Following their lead, British Airways and Lufthansa have also suspended flights there, as well as airlines based in India and Kazakhstan.
With a travel ban in full effect out of Wuhan, it’s worth a look back in recent decades at the global response and subsequent mobilization of resources. Here are a few that prompted global action from scientists and governments alike in the 21st century.
China faced the skepticism of the international health community when it was discovered that the country had initially covered up the SARS outbreak from 2002 to 2003. When a whistleblower told the world about the severity of the disease, China relented in letting the WHO help contain the highly infectious virus, which led to widespread changes in global health policy and an overhaul of China’s public health system. The WHO warned travelers away from visiting Beijing and Toronto, the first time in its history to issue such a sweeping alert.
China’s secrecy during the outbreak circumvented the WHO’s ability to declare a public health emergency, which is a useful tool in coordinating countries’ response to the spread of an infectious disease. When it was finally contained, SARS had infected more than 8,000 people in 30 countries across the world and killed 774 people worldwide, according to the CDC.
When the worst Ebola outbreak in history began in West Africa in 2014, the disease had no treatment or vaccine. Those affected faced a fatality rate of up to 90 percent. By that summer, Ebola had caused the deaths of more than 700 people, and when the first patient infected with the hemorrhagic fever came to the United States, panic set in.
The WHO declared a “public health emergency of international concern” just days after a case was discovered near Rwanda. The Obama administration responded to the outbreak in an unprecedented way, ordering thousands of soldiers to West Africa to assist in treatment. The WHO argued that a travel ban would negatively affect the countries of West Africa. From 2014 to 2016, 11 Americans who contracted the disease were treated, while 11,000 people across that region and the Congo died due to the epidemic.
Flaring up in Brazil in 2015, the Zika outbreak quickly spread across Central and South America through transmission from mosquitoes. The symptoms of the disease are mild, but the virus caused a scare in the United States due to its effects on pregnant women. In 2016, the WHO issued a travel advisory for Zika-impacted countries where the disease was linked to miscarriages, stillbirths and a birth defect called microcephaly. The outcomes of microcephaly in infants include intellectual disabilities, serious speech problems and motor problems, which led the WHO to declare a global health emergency to prevent the spread of the virus. The United States has seen about 20 cases of the Zika virus, and in the 88 countries where the disease has been reported, hundreds of thousands have been infected, with nearly 2,200 babies born with microcephaly.
Another disease that warranted the WHO’s highest level of alert was the H1N1 swine flu epidemic in 2009 that is reported to have infected as many as 200 million people across the world. The swine flu pandemic, which originated as a respiratory illness in pigs, killed 358 children in the United States. It prompted travel restrictions in nearly a quarter of the countries in the world, and many imposed pork bans targeting NAFTA-affiliated countries.
At the height of the outbreak, a number of countries imposed travel restrictions on flights in and out of Mexico, which resulted in a 40 percent decrease in traffic volume. A vaccine has been developed for H1N1, but due to the cyclical nature of flu season, new strains pop up — e.g., H7N9 — which has caused a spike in flu-related deaths as recently as 2018.
The spread of inaccurate information became a central conflict amid the outbreak of Middle East respiratory syndrome that was identified in 2012 in Saudi Arabia. Worries over MERS (a strain of the coronavirus) began after the world’s slow response to the Ebola outbreak had the international community questioning the leaders of Saudi Arabia about the effects of the disease and the adequacy of Saudi health facilities. MERS killed at least 13 people, infected more than 100 and was brought to South Korea by a passenger who had traveled from Saudi Arabia in 2015, which tested the WHO’s rapid-response apparatus in controlling the disease’s spread. MERS led to two deaths in South Korea, the closing of 500 schools and more than 1,300 people quarantined.
Lauren Tierney, Tim Meko, Joe Fox, Simon Denyer, Lena H. Sun, Miriam Berger, Adam Taylor, Elanah Uretsky, Ishaan Tharoor, Lenny Bernstein, Bonnie Berkowitz, Laris Karklis, Shelly Tan, Denise Lu, Patterson Clark, Lena H. Sun and Anna Fifield contributed to this report.
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Coronavirus vaccine research is moving at record speed

In a suburb south of Boston, robots have already started manufacturing a potential vaccine against the fast-spreading coronavirus. Another candidate vaccine — developed when a similar virus terrified the world — sits in deep freeze in a repository in Houston, ready to be thawed and formulated into thousands of vials for further testing. Yet another is being put together at facilities in San Diego and Houston, with projections that it could be tested in people by summer.
To scientists, the work to create a vaccine against the new coronavirus is advancing with a speed they could barely have imagined a decade ago. At the same time, it’s not even close to quick enough to contain the spreading infection — and in many ways, the outbreak will test the capacity of science to react in real time to a new and unknown “pathogen X” that takes the world by surprise.
“Traditional vaccine development efforts have usually taken decades, not months,” said Barney Graham, deputy director of the Vaccine Research Center at the National Institutes of Health, which hopes to have a vaccine in human testing by April. “This is, first, a response to this new virus, but it’s also a drill for pathogen X … [to] press the system, to see how rapidly we can go.”
When a mysterious new illness emerges and public alarm is at its peak, there’s a race to develop a way to prevent or treat the disease. But by the time a promising candidate is ready, it’s often too late to be helpful against the outbreak that triggered the rush. Public interest, funding and the urgency that drove the early vaccine development can quickly taper.
“We were getting candidate vaccines, the epidemics would die down, and they’d get put back on the shelf,” said Jacqueline Shea, chief scientific officer of Inovio, a biotech company that has been developing vaccines for Zika, Ebola and Middle East respiratory syndrome.
That’s what happened with severe acute respiratory syndrome (SARS), to the dismay of Peter Jay Hotez, co-director of the Texas Children’s Hospital Center for Vaccine Development. Eight years ago, he and his co-director, Maria Elena Bottazzi, won federal funding to create a vaccine against SARS, a coronavirus that emerged in 2002 and infected 8,000 people and killed nearly 800. By 2016, they had manufactured enough of the potential vaccine to get through toxicology tests and human safety trials.
But the team tried and failed to win various grants to bring their experimental vaccine through further testing. They say about $2 million could have funded essential and time-consuming toxicology studies and ready it for phase 1 trials — the technical term for the first-in-humans studies that typically determine the dosing and safety of a drug. Although the threat of SARS has receded, it was becoming increasingly clear that coronaviruses, long thought to cause mild illness, were able to cause serious pandemics.
When the new coronavirus genome sequence was posted to an online genetic databank in early January, Hotez immediately saw the close similarity to SARS and realized the samples sitting in storage had the potential to defend against the new virus.
“Had we been able to secure the investment, we could have done all the phase 1 trials. We could have potentially been ready to vaccinate in China, now,” Hotez said. “This is the problem with the whole vaccine infrastructure — it’s reactive, not anticipatory enough. ‘Oh, SARS is gone now, let’s move on.’”
What the scientific response to the new coronavirus has shown so far is how the first step in the process — designing and even beginning to manufacture the vaccine — can happen nearly overnight, thanks to the emergence of new technologies.
Scientists at the National Institutes of Health were strategizing with a Massachusetts biotech company, Moderna, over the winter holiday break about collaborating to build a vaccine for the virus. As soon as the genome of the virus was posted online, NIH designed the piece of the vaccine that should trigger the immune system to recognize and disable the virus. NIH sent its design to Moderna, which could integrate it into its virus platform and rapidly scale up manufacturing. NIH hopes to have the vaccine in the first safety trials by April.
At Inovio, a biotech company headquartered outside Philadelphia, a team began working on designing a vaccine hours after the sequence appeared, Shea said. The company farmed out production of one piece of its vaccine to a contract laboratory in Houston and is making the other component at its facility in San Diego. The company is gearing up for the lab and animal tests that will be necessary before safety trials in people.
Pharmaceutical giant Johnson & Johnson has also jumped into the vaccine effort and estimates it will be eight to 12 months before its candidate is ready for testing in people. Many countries are also working on different approaches, in parallel.
“The actual technical feat of making a vaccine against this virus is probably not going to be that hard,” Hotez said. “The problem is you can’t avoid or even compress the timelines very much for safety testing.”
That means scientists are flooded with public interest in their vaccine efforts right now and must temper their excitement with the reality that there will be a months-long wait, at minimum, for a vaccine that’s ready for its first tests in people.
“What is the value of a vaccine if development takes a year in the context of the current situation, which seems to be moving very rapidly? The value of a vaccine is we don’t actually know what the trajectory of the epidemic could be,” said Richard Hatchett, chief executive of the Coalition for Epidemic Preparedness Innovations, a global alliance that is funding the Inovio and Moderna efforts and another vaccine being created by researchers at the University of Queensland in Australia.
For example, if the outbreak is still raging after initial safety tests, it is possible experimental vaccines could be used to protect people on the front lines of treating the disease or in emergency situations before they are approved for the general population, as happened with Ebola. When Ebola devastated West Africa in 2014, a vaccine was not ready. But when the virus resurfaced in 2019 in Congo, more than 200,000 people were vaccinated.
If the infections have begun to subside by the time vaccines are through the first round of safety testing, getting a vaccine approved would still be useful in case the virus flares again — but showing it is safe for healthy people in the general population will take time and continued effort.
In the meantime, researchers are also looking at ways of quickly repurposing existing antiviral drugs to see whether any might work against the coronavirus. Paul Stoffels, chief scientific officer of Johnson & Johnson, said the company has donated 100 boxes of an HIV medication, Prezcobix, to clinicians in Shanghai to see whether it showed any efficacy against the illness. Purdue University researchers hope to test experimental drugs that were initially developed to fight SARS. At the University of North Carolina at Chapel Hill, researchers have been gearing up to test remdesivir, an experimental antiviral drug that has shown promise against other coronaviruses but failed against Ebola.
But every step takes time. Even having the right laboratory tests, ingredients and animal models of the disease are crucial and time-consuming steps. Laboratories have been waiting for the viral genome to be synthesized by companies and are anxious to get samples of the actual virus.
A decade after SARS, another coronavirus emerged that caused Middle East respiratory syndrome (MERS). Many say the coronavirus in China is a lesson that this family of viruses will continue to cross from animals into humans and cause potential pandemics. That means scientists would like to be prepared, with vaccine platforms that can be readily adapted to new infections and antiviral drugs that work broadly for multiple diseases.
“Emerging viruses, they’re a moving target. They come, and they go, and sometimes they come and they don’t go. But it’s impossible to predict the trajectory of an emerging virus,” said Timothy Sheahan, assistant professor at the Gillings School of Global Public Health at the University of North Carolina. “So one way we’re trying to maximize the utility of a given antiviral drug is to develop broad-spectrum antivirals. Rather than have one drug for one bug, we want one drug for many bugs.”
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South Korea quarantines more than 1,300 in race against MERS

home. Education authorities have left it to principals to decide whether to shut their schools, and 200 kindergartens and schools closed their doors on Wednesday while more than 500 planned to shut on Thursday. Almost all of them are in Gyeonggi province, the area around Seoul, where the first patient with the viral illness sought treatment, although six elementary schools and a middle school in Seoul will also close until Friday at parents’ request. Drugstores reported a run on surgical masks and hand sanitizer as fear about a wider outbreak spread. MERS arrived in South Korea in a 68-year-old “index patient” who had traveled to four countries in the Middle East and showed no symptoms when he returned home on May 4. But a week later, he sought treatment at two outpatient clinics and then two hospitals, potentially exposing a large number of health-care workers and other patients to the virus. South Korea’s Ministry of Health and Welfare is scrambling to contain the spread of Middle East Respiratory Syndrome (MERS), which has killed two people. The two patients who died, a 58-year-old woman and a 71-year-old man, had both been in contact with the index patient in the hospital, and both had other health problems that could have weakened their ability to fight the infection. The exposure times could have been as short as five minutes to a few hours, the WHO said. The South Korean government has been criticized for refusing to disclose the names of the clinics and hospitals where the index patient sought treatment. But three doctors at the emergency meeting Wednesday rejected demands for greater openness, Yonhap News Agency reported. Twenty-five out of the 30 people confirmed to have contracted the disease were infected at a single hospital, which has since closed to new patients. Meanwhile, Chinese authorities quarantined 88 people, including 14 South Koreans, after a 44-year-old South Korean man, the son of one of the people who has contracted the viral illness, defied medical advice and flew to Hong Kong on May 26 while he had symptoms of the illness. He then traveled to the southern Chinese province of Guangdong by bus. China informed the WHO on May 29 that the man had tested positive for the virus and had been isolated at a hospital in Huizhou, Guangdong, while Chinese authorities try to track down other people who might have been exposed. Yoonjung Seo

Seoul’s mayor says the 35th identified case of MERS in the country is a doctor who had contact with another MERS patient. The country has at least 41 infections, the highest of anywhere outside the Middle East.
TOKYO —
Amid criticism it has been too slow to respond to the viral illness, which has no vaccine or cure, President Park Geun-hye ordered the establishment of a task force to try to contain the infection and to be more transparent along the way.
“There are a lot people worried about this situation,” Park told an emergency meeting of officials and health experts Wednesday. “We must make the utmost effort to stop MERS from spreading.”
The outbreak brings back memories of severe acute respiratory syndrome, or SARS, that began in Asia in 2003, spreading to Europe and the Americas and leading to 774 deaths worldwide, according to the Centers for Disease Control and Prevention.
Fearful that MERS has already spread, China is also taking measures to contain it.

Two people have died from MERS in South Korea, while 28 others have been confirmed as having the viral illness, five of them on Wednesday alone. This makes the outbreak the largest outside Saudi Arabia, where MERS began in 2012, the World Health Organization said, warning that “further cases can be expected.”
Suspected cases in South Korea total 398, and at least 1,364 people have been quarantined, the vast majority of them at home.
Education authorities have left it to principals to decide whether to shut their schools, and 200 kindergartens and schools closed their doors on Wednesday while more than 500 planned to shut on Thursday. Almost all of them are in Gyeonggi province, the area around Seoul, where the first patient with the viral illness sought treatment, although six elementary schools and a middle school in Seoul will also close until Friday at parents’ request.
Drugstores reported a run on surgical masks and hand sanitizer as fear about a wider outbreak spread.
MERS arrived in South Korea in a 68-year-old “index patient” who had traveled to four countries in the Middle East and showed no symptoms when he returned home on May 4.
But a week later, he sought treatment at two outpatient clinics and then two hospitals, potentially exposing a large number of health-care workers and other patients to the virus.
South Korea’s Ministry of Health and Welfare is scrambling to contain the spread of Middle East Respiratory Syndrome (MERS), which has killed two people.
“Given the number of clinics and hospitals that cared for the index case, further cases can be expected,” the World Health Organization said in a statement.
The two patients who died, a 58-year-old woman and a 71-year-old man, had both been in contact with the index patient in the hospital, and both had other health problems that could have weakened their ability to fight the infection. The exposure times could have been as short as five minutes to a few hours, the WHO said.
The South Korean government has been criticized for refusing to disclose the names of the clinics and hospitals where the index patient sought treatment. But three doctors at the emergency meeting Wednesday rejected demands for greater openness, Yonhap News Agency reported. Twenty-five out of the 30 people confirmed to have contracted the disease were infected at a single hospital, which has since closed to new patients.
Meanwhile, Chinese authorities quarantined 88 people, including 14 South Koreans, after a 44-year-old South Korean man, the son of one of the people who has contracted the viral illness, defied medical advice and flew to Hong Kong on May 26 while he had symptoms of the illness. He then traveled to the southern Chinese province of Guangdong by bus.
China informed the WHO on May 29 that the man had tested positive for the virus and had been isolated at a hospital in Huizhou, Guangdong, while Chinese authorities try to track down other people who might have been exposed.
Yoonjung Seo contributed reporting from Seoul.


MERS crisis: Do we need a NATO-type war strategy for potential epidemics?

Bill and Melinda Gates speak with parents whose children are participating in a malaria vaccine trial at the Bagamoyo District Hospital in Tanzania on June 28, 2011. (Photo courtesy Bill & Melinda Gates Foundation) At the top of many researchers' lists are a more structured way to prioritize, fund and work on vaccines for such pathogens. MERS was first discovered in 2012, and while scientists understand its molecular structure, there has been little progress toward a vaccine due to lack of interest from pharmaceutical companies. [Why MERS spread so far, so fast in South Korea] “There's nothing standing in our way from pushing this forward other than the money and the will to do it,” he said to the IBT. With the MERS death toll climbing higher in South Korea, here's what scientists know about the virus, how it spreads, and whether it poses a global threat. During the Ebola crisis, billionaire philanthropist Bill Gates described the need for a way for governments to join together in manner similar to the North Atlantic Treaty Organization (NATO). [Ebola’s lessons, painfully learned at great cost in dollars and human lives] Warning that there is a significant chance that an epidemic of a substantially more infectious disease will occur sometime in the next 20 years, Gates said Ebola is far from the most infectious disease we know. "Although the system is not perfect, NATO countries participate in joint exercises in which they work out logistics such as how fuel and food will be provided, what language they will speak, and what radio frequencies will be used," he wrote. "Few, if any, such measures are in place for response to an epidemic," Gates added. "Because there was so little preparation, the world lost time in the current epidemic trying to answer basic questions about combating Ebola. In the next epidemic, such delays could result in a global disaster." READ MORE: Good news, chocolate lovers: The more you eat the lower your risk of heart disease Common heartburn medications linked to greater risk of heart attack 5 things about trans fats and the FDA’s proposed phase out DDT's breast cancer legacy: Daughters of those exposed have 4x higher risk of breast cancer

Bill and Melinda Gates speak with parents whose children are participating in a malaria vaccine trial at the Bagamoyo District Hospital in Tanzania on June 28, 2011. (Photo courtesy Bill & Melinda Gates Foundation)
Health officials in Thailand on Friday confirmed the country's first case of Middle East Respiratory Syndrome (MERS) in a 75-year-old businessman from Oman. With the death of a MERS patient in Germany and the "superspreading event" in South Korea that has claimed 24 lives, the crisis has prompted calls for a better early warning and response process to stop the spread of infectious diseases that threaten the planet.
At the top of many researchers' lists are a more structured way to prioritize, fund and work on vaccines for such pathogens. MERS was first discovered in 2012, and while scientists understand its molecular structure, there has been little progress toward a vaccine due to lack of interest from pharmaceutical companies.
[Why MERS spread so far, so fast in South Korea]
"The question is: How long are we going to wait around and just follow these outbreaks before we get serious about making vaccines?" Adrian Hill, a professor and director at the Jenner Institute at Britain's Oxford University, told Reuters.
Matthew Frieman, an immunologist at University of Maryland School of Medicine, has been working on such a vaccine since 2013, according to the International Business Times. He said he's still looking for partner to begin clinical trials.
“There's nothing standing in our way from pushing this forward other than the money and the will to do it,” he said to the IBT.
With the MERS death toll climbing higher in South Korea, here's what scientists know about the virus, how it spreads, and whether it poses a global threat.
During the Ebola crisis, billionaire philanthropist Bill Gates described the need for a way for governments to join together in manner similar to the North Atlantic Treaty Organization (NATO).
“It’s instructive to compare our preparations for epidemics with our preparations for another sort of global threat -- war,” Gates wrote in the The New England Journal of Medicine in April.
[Ebola’s lessons, painfully learned at great cost in dollars and human lives]
Warning that there is a significant chance that an epidemic of a substantially more infectious disease will occur sometime in the next 20 years, Gates said Ebola is far from the most infectious disease we know.
"Although the system is not perfect, NATO countries participate in joint exercises in which they work out logistics such as how fuel and food will be provided, what language they will speak, and what radio frequencies will be used," he wrote.
"Few, if any, such measures are in place for response to an epidemic," Gates added. "Because there was so little preparation, the world lost time in the current epidemic trying to answer basic questions about combating Ebola. In the next epidemic, such delays could result in a global disaster."
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Common heartburn medications linked to greater risk of heart attack
5 things about trans fats and the FDA’s proposed phase out
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