Coronavirus prompts CDC to expand travel warning to all of China; top U.S. health official urges Beijing to admit disease experts

Even as China takes more stringent measures to limit the movement of the vast country’s population during the biggest travel period of the year, and as the United States and other countries move ahead with evacuation plans, there are increasing fears that a quarantine will not be enough to stop the spread of the new coronavirus, which so far has infected at least 4,428 people in China and killed at least 106. Here’s what we know:
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● With at least 106 dead so far, Beijing has broadened the extraordinary quarantine to more than 50 million people, but the mayor of Wuhan, the outbreak’s epicenter, said 5 million people have already left his city.
● China’s health minister said the coronavirus is increasing in virulence and now could be contagious even before people exhibit symptoms, making apparently healthy people possible carriers.
● A scientific assessment of the spread of the disease, assuming an optimistic 90 percent quarantine, still predicted more than 59,000 infections and 1,500 deaths — twice the toll of the 2002-2003 SARS outbreak.
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● In the United States, health officials confirmed five cases of the pneumonia-like illness, while infections also have been confirmed in France, South Korea, Japan, Nepal, Thailand, Cambodia, Singapore, Vietnam, Taiwan, Canada, Sri Lanka and Germany. We’re mapping the spread here.
What we know about the coronavirus
9:30 PM: Germany records first confirmed case of coronavirus
Officials in Germany confirmed the country’s first case of coronavirus late Monday, the Bavarian Health Ministry announced.
A man from southern Bavaria, roughly 20 miles south of Munich, is in an isolation ward, where doctors are monitoring him but say he’s in good condition, according to a statement from the agency.
The first confirmed case comes as Germany’s leaders urged residents to avoid all unnecessary travel to China and discussed evacuating its citizens from the country.
“We are checking and preparing for all options; that means we are also considering a possible evacuation of all those willing to leave,” Foreign Minister Heiko Maas said at a press conference, according to the German outlet Deutsche Welle.
By: Reis Thebault
9:00 PM: Death toll in China rises to more than 100
WASHINGTON — Early Tuesday Beijing time, Chinese health agencies announced the country’s death toll had risen overnight to 106 people. The total number of infections also climbed to 4,428 across more than 30 provinces, according to a tally from national and local health commissions. Country-wide, roughly 60 people have recovered from the coronavirus.
Major metropolitan areas, including Beijing and Shanghai, recorded their first deaths late Monday local time. In Hubei province, the disease’s epicenter, there have been more than 2,700 confirmed cases and 100 deaths, state media reported.
By: Reis Thebault
8:15 P.M.: U.S. will send more staff for passenger screening to 20 airports
WASHINGTON — The U.S. government is increasing staff to conduct screenings at 20 airports that handle almost all passengers traveling into the country from China, where a novel coronavirus continues to spread, according to the U.S. Centers for Disease Control and Prevention. Details of the expanded surveillance are still being formulated. The CDC already has quarantine facilities in place at 20 ports of entry, including Los Angeles, San Francisco, San Diego, Seattle, Anchorage, Honolulu, Boston, New York, Philadelphia, Washington, Atlanta, Miami and Houston.
Vice President Mike Pence alluded to the expanded screening in public remarks Monday afternoon. He said the 20 airports involved are “the airports that receive 90 percent of all passengers from China. Any passengers who are ill will receive additional screening.”
“Here in our country, we’re taking strong steps to see to the health and the wellbeing of the American people,” Pence said. “But as President Trump made clear today, the United States of America stands ready to assist the people of China and around the world as they deal with this virus.”
Read more about the staffing surge here.
By: Joel Achenbach
6:00 PM: Canada urges citizens to ‘avoid all travel’ to China’s Hubei province
TORONTO — The Canadian government raised its travel warning Monday for China’s Hubei province to its highest risk level, advising citizens to “avoid all travel” to the area, including the cities of Wuhan, Huanggang and Ezhou.
The warning does not cite the coronavirus itself as the reason for the change, but the “imposition of heavy travel restrictions” in the area to prevent the spread of the illness.
By: Amanda Coletta
5:30 PM: Top U.S. health official criticizes China for not admitting outside experts
WASHINGTON — Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said that China has been more transparent in the outbreak of the novel coronavirus outbreak than it was in the 2003 SARS outbreak but that U.S. officials are still getting their information through Chinese press briefings rather than from shared scientific data.
He noted that China’s health minister, Ma Xiaowei, said Sunday that the virus could be transmitted by an infected person even before symptoms appear. Fauci said he wished China would allow U.S. and international research teams to travel to China to see what’s happening directly.
“We really need to know what is the scientific basis of saying the virus is spread by someone who doesn’t have any symptoms,” Fauci told The Washington Post. “That was a major potential game-changer that gets spoken to us in a press briefing. We should have seen the data.”
It matters, he said, because the United States is actively screening people who travel from China.
“If people can be transmitting and infecting without any symptoms, that has a major impact on how you screen people,” he added.
By: Joel Achenbach
4:40 PM: CDC issues highest travel warning, urges U.S. citizens to avoid nonessential travel to China
WASHINGTON — The Centers for Disease Control and Prevention raised its travel warning Monday to a level 3, its highest alert level, urging U.S. citizens to avoid all nonessential travel to China because of the coronavirus outbreak. The warning says those who travel should avoid all contact with sick people, animal markets and products that come from animals. It advises travelers to wash hands often with soap and water for at least 20 seconds. Older adults and travelers with underlying health issues may be at risk for more severe effects of the disease and should discuss travel with their health-care provider, the agency said.
The warning also advises people who have traveled to China in the last 14 days and feel sick with fever, cough, or have difficulty breathing to seek medical care right away. Before going to a doctor’s office or emergency room, those people are advised to call ahead and tell them about recent travel and symptoms.
By: Lena H. Sun
4:15 PM: State Department urges U.S. citizens to ‘reconsider travel’ to China and avoid Hubei province
WASHINGTON — The State Department raised its China travel warning to a level 3 Monday, urging U.S. citizens to reconsider travel to the country due to the coronavirus outbreak. It also raised the travel warning for Hubei province to level 4, advising against any travel there and noting that U.S. officials have “limited ability to provide emergency services to U.S. citizens” in the province.
“Travelers should be aware that the Chinese government could prevent them from entering or exiting parts of Hubei province,” the warning said, adding that restrictions could “be put into effect with little or no advance notice.”
The warning stated that those who must travel to China should avoid all contact with sick people, animals and animal products.
By: Siobhán O’Grady
4:05 PM: U.S. stock markets close sharply lower over fears about coronavirus
WASHINGTON — Global markets took a steep drop Monday as investors grew increasingly anxious about the swift spread of the coronavirus beyond China’s borders.
The Dow Jones industrial average fell 454 points, or 1.6 percent. The Standard & Poor’s 500 and Nasdaq also slid significantly, 1.6 percent and 1.9 percent, respectively.
Travel-related companies were hit particularly hard. Shares of American Airlines lost 5.5 percent and Delta fell 3.4 percent. Wynn Resorts, which has a large footprint in Macao, fell 8.1 percent. Las Vegas Sands fell 6.7 percent. Luckin Coffee, a company based in China that manages more than 4,000 locations, saw its stock price fall 9 percent.
“If the current outbreak turns into a pandemic that significantly disrupts global commerce, the impact would be bad news for the global economy and corporate earnings,” said Ed Yardeni, president of Yardeni Research.
Read more about the global stock market shudder here.
By: Rachel Siegel
4:00 PM: Washington officials track more than five dozen contacts of first confirmed U.S. case of novel coronavirus
SEATTLE — Washington state health authorities are tracking a growing number of people — the total has expanded to 64 — who had contact with the Washington state man who was the first confirmed U.S. case of the novel coronavirus. That patient, a man in his 30s, is still in “satisfactory” condition and is being monitored at Providence Regional Medical Center in Everett, Wash., authorities said. He had reached out to health authorities more than a week ago upon feeling sick after his return from Wuhan.
Two of the man’s contacts are considered “people under investigation,” said Heather Thomas, a spokeswoman for the Snohomish County Health District. Their specimens are being delivered to the CDC today. In the meantime, they are isolated at home, she said.
As to why the contact list keeps expanding, Thomas noted that “sometimes, we find one contact that adds on a couple more. For example, if one person was listed, but they had others with them, that initial contact now becomes two or three.”
“In a complex case like this one, it is to be expected that we identify others who need to be tested. That is why our disease investigators are doing daily monitoring for potential symptoms,” said Thomas.
Hospital officials said they are working with the CDC and the Washington state health department to treat and monitor the patient, said hospital spokesman Casey Calamusa.
“We are working with them on determining when to discharge, but that hasn’t been determined yet,” he said.
By: Bonnie Rochman
3:40 PM: U.S. tech giants battling against disinformation
WASHINGTON — The rapid spread of the coronavirus in China and around the world has sent Facebook, Google and Twitter scrambling to prevent a different sort of malady — a surge of half-truths and outright falsehoods about the deadly outbreak.
Already, Facebook and its peers have tried to battle back pervasive conspiracy theories, including a hoax that wrongly claims U.S. government officials secretly created or obtained a patent for the illness. Some of the misinformation has circulated through private Facebook groups — channels that are hard for researchers to monitor in real time — that came into existence after news first broke about the coronavirus.
“Oregano Oil Proves Effective Against Coronavirus,” read one post that had been shared at least 2,000 times across multiple groups by Monday. The original post is a decade old, originating on a holistic care website — and scientists have said there is no such cure for coronavirus.
Nine organizations that partner with Facebook on fact-checking have rated multiple coronavirus claims as false, including those peddling fake treatments, the company said Monday. Facebook said it has labeled the inaccuracies and lowered their rank in users’ daily feeds.
Read more about how U.S. tech giants are responding here.
By: Tony Romm
3:38 PM: Canadian officials not sure how second case was contracted
WASHINGTON — As the infections mount in China, officials in countries with confirmed travel-related cases are trying to better understand how easily the virus spreads and how deadly it is.
Officials in Canada said Monday during a news conference in Toronto that they do not know how their presumptive second case, the wife of a man who is Canada’s first confirmed case, was infected. It could have been from human to human spread from her husband, or from exposure in Wuhan, the central Chinese city where the outbreak began.
“This individual has been in close proximity to her husband and, having also arrived in Toronto from the area of Wuhan, could also have been exposed to the virus in China,” said David Williams, Ontario’s chief medical officer.
The couple, both in their 50s, arrived in Toronto from Wuhan on Jan. 22. Both wore masks on the flight. The man is in isolation in Toronto’s Sunnybrook Hospital, and in stable condition. The wife is not showing symptoms, and is in isolation at home. There are no other family members living in the same household.
“She’s not been in need of the same acute hospital care as her husband,” Williams said. Her case shows that the virus causes a range of illness. “Not all people who contract this experience the same severe symptoms,” he said.
By: Lena H. Sun
3:13 PM: Wuhan residents shout message of encouragement
BERLIN — In Wuhan, residents sought to encourage one another from their apartments on Monday by chanting a message of support, according to footage that has emerged from the epicenter of the coronavirus outbreak.
In videos uploaded to social media on Monday and authenticated by Storyful, a social media verification agency, residents of high-rise buildings could be heard repeatedly shouting the words “Wuhan, jiayou” — the latter being a versatile Chinese term that can be translated as “Hang in there” or “Do your best” in an encouraging sense. (Literally translated, “jiayou” means “add oil.”)
Wuhan has been under a travel lockdown since Jan. 23. Of its around 11 million residents, 5 million have already left Wuhan, according to the city’s mayor. Many residents who are still in the city have tried to stay at home as a precautionary measure.
By: Rick Noack
2:47 PM: Companies and research institutes entering race for a vaccine
BERLIN — U.S. pharmaceutical corporation Johnson & Johnson announced on Monday that its researchers are joining the race to develop a vaccine for the coronavirus.
“Multiple efforts are needed to make sure that at the end, one vaccine or two or three make it — because we are not sure at all” what will succeed, Paul Stoffels, the corporation’s chief scientific officer, said in an interview.
He added that the work began two weeks ago and it would likely take eight to 12 months before the first tests on people.
The corporation’s announcement followed a number of similar recent initiatives by international companies, as well as private and governmental research institutes. The National Institutes of Health expects to have a vaccine in human safety tests in three months.
Last week, the Norway-headquartered Coalition for Epidemic Preparedness Innovations (CEPI) announced that it had initiated several new programs to advance “vaccine candidates into clinical testing as quickly as possible.” Other efforts are testing existing and experimental antiviral drugs to see if they could help patients in the short term.
Johnson & Johnson sent 100 boxes of an HIV drug, Prezcobix, to the Shanghai Public Health Clinical Center so that researchers can test whether it has any effect against coronavirus.
By: Rick Noack and Carolyn Johnson
2:11 PM: Turkey and Ukraine join list of countries to issue China travel advisories
Turkey and Ukraine on Monday recommended against traveling to China’s Hubei province as the new coronavirus continued to spread.
“It is highly recommended that our citizens do not travel to China unless it is necessary and if they travel there, they should stay away from the regions where the [coronavirus] cases are seen, especially in Hubei province,” Turkey’s Foreign Ministry said in a statement, according to Anadolu, the country’s state-run news agency.
Ukraine warned its citizens against nonessential travel as well, Reuters reported.
By: Benjamin Soloway
2:03 PM: U.S. epidemiologist says it is still too soon to make predictions
A U.S. epidemiologist who helped China respond to the 2003 SARS virus plans to return there Tuesday to assist his Chinese counterparts with their response to the novel coronavirus. W. Ian Lipkin, director of Columbia University’s Center for Infection and Immunity, said that information about this new virus remains preliminary and that it’s still too soon to predict how widespread or deadly the outbreak will turn out to be.
Among the unanswered questions, he said, are how long the virus incubates before becoming symptomatic, whether it can be spread before symptoms emerging, how exactly the virus is spread, how likely it is to cause a severe illness and what other factors might contribute to that.
“Until we have a handle on all of these issues, it’s very difficult to make predictions about the outbreak,” he said.
He added: “It’s fair to say that every year, there are 30,000 to 40,000 people who die of flu in the United States. It is very unlikely that this will ever reach the level that we annually lose to flu.”
Lipkin said that it will take time to develop drugs and vaccines for the new virus, and that in the meantime officials have to focus on containment — of halting the spread of the virus.
“Given the time frame of developing drugs and vaccines for treatment and prevention of infection, what we have at present is containment. We have to do our best to use what we have. The first step, of course, is to get as much information as we can about transmission,” he said.
By: Joel Achenbach
1:49 PM: China allocates nearly $9 billion to stop outbreak
WASHINGTON — China’s Finance Ministry and National Health Commission announced Monday that they had allocated $8.74 billion to help contain the coronavirus outbreak.
The 60.33 billion yuan fund, a 10 billion-yuan increase from 50.38 billion already allocated, was announced on the ministry’s website on Monday.
According to the official Xinhua News Agency, the statement said that “any actions related to withholding, diversion, misappropriation and changing the use of the money will not be tolerated.”
By: Adam Taylor
1:29 PM: If Chinese officials control outbreak, it could ‘beef up their legitimacy,’ expert says
WASHINGTON — As Chinese officials widened a travel ban in recent days in an effort to control the virus, concerns emerged that the quarantine may not be effective. Yanzhong Huang, senior fellow for global health at the Council on Foreign Relations, said China’s ability to implement such a dramatic ban on movement “might be an example of resilience of the authoritarian state, especially in a crisis setting, but there is no strong evidence supporting that the approach will be effective.”
Although Chinese leader Xi Jinping said over the weekend that officials “can win the battle of controlling the epidemic,” Huang cautioned that extreme measures can lead to serious consequences, such as the medical supply shortages now being reported in Hubei province.
Despite concerns over the efficacy and ethics of a travel ban, Huang said that if China does ultimately control the virus, some officials there may actually see the outbreak as “an opportunity to beef up their legitimacy when they portray themselves as being decisive and as being wise.”
If the outbreak doesn’t last long, he said, “they would claim to be the winners.”
Read more here.
By: Siobhán O’Grady
11:59 AM: Sri Lanka confirms first case
NEW DELHI — Sri Lanka has reported its first confirmed case of the coronavirus that is sweeping China, making it the latest country to grapple with the rapid spread of the illness.
A Chinese tourist who was visiting the island nation tested positive for the virus, Anil Jasinghe, the country’s director general of health services, told The Washington Post. He said the woman arrived in Sri Lanka about six days ago.
An official Facebook page for Sri Lanka’s Health Promotion Bureau said authorities were working to prevent the spread of the disease and said it was a time for vigilance, not panic. It added that patients would be treated at a hospital in Colombo, Sri Lanka’s capital.
By: Joanna Slater and Nina Masih
11:58 AM: CDC says no new confirmed cases of coronavirus
WASHINGTON — The U.S. Centers for Disease Control and Prevention said Monday there were no new confirmed cases of coronavirus overnight.
The United States has five confirmed cases of coronavirus in Southern California, Chicago, Arizona and Washington state. The CDC said it is investigating 110 people in 26 states but added that the virus is not spreading within communities in the United States and that the immediate health risk to the general public is low.
Nancy Messonnier, director of CDC’s National Center for Immunization and Respiratory Diseases, said the agency screened about 2,400 travelers over the weekend as the United States began screening at five airports. She said she expected travel recommendations to change in the coming days.
By: Yasmeen Abutaleb
11:20 AM: Governments introduce restrictions on cross-border travel
BERLIN — Malaysia joined several other countries and territories on Monday to restrict travel to prevent the spreading of the coronavirus.
Malaysian officials halted the issuance of visas to visitors from China’s Wuhan city and the surrounding Hubei province. Four cases of the virus that spread from there had been reported in Malaysia by Saturday.
The Chinese semiautonomous region of Macao also announced new travel restrictions Monday. Any visitors who have been to Hubei province less than two weeks before arrival in Macao will be refused access unless they can provide documentation that they are virus-free, officials said.
Hong Kong introduced a similar ban on Sunday.
Meanwhile, Mongolia planned to “restrict movements of autos and pedestrians at border crossings with China” starting on Tuesday, according to the state media outlet Montsame.
Some travelers will be exempt from the restrictions, Montsame specified Monday.
Mongolian schools, universities and other educational institutions will also be closed until the beginning of March, according to the official news outlet.
By: Rick Noack
11:01 AM: Evacuation plans move forward for U.S. citizens and others
BERLIN — A number of countries moved forward with plans to evacuate their citizens from the coronavirus epicenter Wuhan on Monday, including Japan, France, Sri Lanka and the United States. Others are weighing their options.
U.S. officials are organizing a plane to fly American citizens out of Wuhan to California as early as Monday night, though some cautioned that the timing of the flight was still fluid. The plane will stop in Anchorage for refueling.
The evacuated U.S. citizens will be evaluated before they get on the plane, during the flight and after they arrive in the United States, the official said. Once they arrive in California, they will be monitored for an additional 72 hours. Even after they return to the United States, they will not be able to return home immediately because they are expected to undergo additional monitoring and evaluation.
In a statement, the U.S. Embassy in Beijing cautioned that it expects “there will be limited capacity to transport private U.S. citizens” and said that “priority will be given to individuals at greater risk from coronavirus.”
France has scheduled a similar flight for midweek, according to French Health Minister Agnès Buzyn, while Sri Lankan officials said Monday that they have a plan for their own citizens. Japan also said it would charter at least one plane this week to bring citizens out of Wuhan, which serves as a hub for many Japanese corporations. The German government said Monday it was still “considering” an evacuation.
The British government is facing mounting pressure to enact an evacuation plan. Emily Thornberry of the opposition Labour Party said Prime Minister Boris Johnson was “not doing whatever it takes to protect our citizens from harm. They need to get this evacuation sorted now,” according to the Evening Standard newspaper.
On Twitter, the British Embassy in Beijing wrote that its officials “are working to make available an option for British nationals to leave Hubei province.”
By: Rick Noack and Lena H. Sun
10:50 AM: First death from virus in Beijing announced
WASHINGTON — There are eight new confirmed coronavirus cases in Beijing, including the capital’s first death from the outbreak, city authorities announced Monday.
The unnamed victim was a 50-year-old man who had visited Wuhan on Jan. 8 and developed a fever after he returned to Beijing seven days later, according to a Weibo post by Beijing’s city health commission.
The man had visited a hospital on Jan. 21, was diagnosed the next day and died on Monday of respiratory failure, the commission announced.
By: Adam Taylor
10:37 AM: Indian students in Wuhan describe ‘ghost town’ atmosphere
NEW DELHI — Monika Sethuraman, a PhD student from India, described Wuhan as a “ghost town” when she stepped out of her university dormitory for the first time in four days Monday to stock up on supplies.
She bought vegetables to last for three weeks, since it was not clear how long the lockdown would last in the central Chinese city. She said the university has asked students to remain confined to their rooms and distributed thermometers.
“Every day before noon, we have to check our temperature and register it on a university portal,” she said.
Debesh Mitra, a postdoctoral scientist at another university in the city, said more than 200 Indians were “stuck” in Wuhan. He described the situation as “grim.”
He said he had avoided leaving the campus for fear of contracting the virus.
“We really want to come back [to India] at the earliest,” he said. “All our families are very worried.”
By: Niha Masih
10:27 AM: Outbreak hitting Chinese tourism market
BERLIN — Several Russian tourism operators have halted the sale of package trips to China, following advice from Russia’s federal tourism agency, Rosturizm.
The vice president of the Association of Russian Tour Operators, Dmitry Gorin, told Reuters that sales ceased Friday and that customers who had already purchased trips would be reimbursed.
The measure came as China announced its own steps to curb tourism, aimed at slowing the spread of the new coronavirus outbreak there. Beijing halted inter-province bus traffic into the capital over the weekend, followed by a nationwide ban on tour groups traveling abroad that took effect on Monday.
Hotel and restaurant owners in destinations that rely heavily on Chinese visitors fear the ban could remain in place for months.
In China, Shanghai’s Disneyland and Beijing’s Palace Museum will remain closed until further notice.
Meanwhile, corporations around the globe moved to restrict business travel to China as a precautionary measure. German manufacturer Schaeffler — which employs around 90,000 people internationally — was among the biggest European companies to prohibit business trips to China last week.
By: Rick Noack
10:15 AM: Dow falls on fears the outbreak will turn into a pandemic
WASHINGTON — Global markets took a sharp downturn Monday as investors grew increasingly anxious about the swift spread of the coronavirus beyond China.
The Dow plunged 450 points, or about 1.5 percent. Standard & Poor’s 500 and Nasdaq futures were also down significantly, 1.5 percent and 2 percent, respectively.
“Stock markets are selling off this morning on fears that the coronavirus might be harder to contain than previous viral outbreaks,” said Ed Yardeni, president of Yardeni Research. “If the current outbreak turns into a pandemic that significantly disrupts global commerce, the impact would be bad news for the global economy and corporate earnings.”
Read more here.
By: Rachel Siegel
10:13 AM: Canada confirms second ‘presumptive positive’ case of the coronavirus
TORONTO — Canadian public health officials said Monday that the wife of the man who was declared the country’s first “presumptive positive” case of the coronavirus has also tested positive for the virus at Ontario’s public health laboratory.
The woman has been in “self-isolation,” David Williams, Ontario’s chief medical officer of health, said in a statement. He added that the risk to Ontarians of contracting the virus remains low.
The husband and wife returned to Toronto from Wuhan, China, the epicenter of the outbreak, via Guangzhou on a China Southern Airlines flight that arrived on Jan. 22, authorities said. He was admitted the next day to Toronto’s Sunnybrook Hospital, where he is now in isolation and in stable condition.
Theresa Tam, Canada’s chief medical officer, said the man had “mild symptoms” of the virus on the plane, although he was not flagged to public health officials upon his arrival. Authorities are contacting passengers who sat within about six feet of him and any flight attendants who might have assisted him.
Both cases are considered “presumptive positive” because officials are awaiting confirmation from the National Microbiology Laboratory in Winnipeg.
By: Amanda Coletta
10:10AM: Trump says he is ‘strongly on watch’ despite few cases in U.S.
WASHINGTON — President Trump tweeted Monday that the United States is “in very close communication with China concerning the virus.”
“Very few cases reported in USA, but strongly on watch,” he wrote. “We have offered China and President Xi any help that is necessary. Our experts are extraordinary!”
The tweet was his second mention of the virus on social media in recent days. On Friday, he praised China’s response to the outbreak, thanking Xi and saying Chinese officials have “been working very hard” to contain the virus and that the United States “greatly appreciates their efforts and transparency.”
“It will all work out well,” he wrote.
By: Siobhán O’Grady
9:00 AM: Wuhan mayor says 5 million people left city in recent days
BEIJING — The mayor of Wuhan, the Chinese city at the center of the coronavirus outbreak, announced several stark numbers at a late-night news conference on Sunday, with most focusing on his prediction that there would be at least 1,000 new infections.
But Mayor Zhou Xianwang revealed another number that underscored the metastasizing challenge of the accelerating epidemic: 5 million.
That was the number of people who had emptied out of Wuhan in recent days — and scattered all over the world — as China’s Lunar New Year holiday period approached and authorities announced a lockdown in an urgent bid to contain the outbreak.
As of Monday, the virus has infected 2,835 people in China and killed 81, according to data provided by the National Health Commission.
By: Gerry Shih and Simon Denyer
8:40 AM: Experts unsure if Chinese attempts to contain virus can work
BEIJING — The effectiveness of an unprecedented quarantine around the viral epicenter in central China’s Hubei province has become a key question, as Chinese and international authorities ponder how to rein in the disease — and, at this point, whether it could be contained at all.
“Radical times call for radical measures,” said Dong-Yan Jin, a professor of molecular virology and oncology at Hong Kong University’s School of Biomedical Sciences. “A lot of cities have followed Wuhan in announcing a lockdown, but don’t forget that many potential patients are already out there before such an administrative order. Are we going to shut down the whole country?”
Jin said Chinese authorities had missed the critical moment to control the epidemic: before the New Year’s travel rush began a week ago.
“There was a lack of transparency in Hubei and an unwillingness by local governments to face the music; now, they tend to overcompensate,” he said. “You cannot expect that to work miracles and stop the outbreak.”
Widespread suspicions on Chinese social media that government officials mishandled the early stages of the crisis were fanned dramatically on Monday by an unlikely player: the Wuhan mayor, Zhou Xianwang.
In a remarkable interview with Chinese state broadcaster CCTV, Zhou acknowledged that his city did not release “timely and satisfactory” information at the start of the epidemic, and he appeared to blame higher-ups in his chain of command.
“I hope everyone can understand that this is an infectious disease, and infectious diseases must be disclosed according to law,” he said. “We can only disclose information after we receive authorization.”
By: Gerry Shih and Simon Denyer
8:30AM: Number of cases may be higher than reported, experts say
BEIJING — Some medical experts warn that the number of cases may be higher than the authorities know or acknowledge. They also say that the mass lockdown and efforts to quarantine patients are too late due to the missteps in December, when reports of a novel virus in Wuhan began to emerge without prompting a response.
Gabriel Leung, an epidemiologist who is chair of public health medicine at Hong Kong University, told reporters in Hong Kong on Monday that his model showed the true number of coronavirus patients to be as high as 44,000.
He warned that the epidemic could become global and reach a peak in China in April or May, when 150,000 new cases could be confirmed every day in one Chinese city — Chongqing — alone.
By: Gerry Shih and Simon Denyer
8:20AM: Still unclear if patients can infect others without showing symptoms
Escalating worldwide concerns, Chinese Health Minister Ma Xiaowei said Sunday that people carrying the new coronavirus could infect others even while they do not show any symptoms for as long as 14 days, a period known as incubation. That implies that, unlike SARS, seemingly healthy travelers could have unwittingly infected others.
But international experts, including at the U.S. Centers for Disease Control and Prevention, say they are still seeking to confirm Ma’s statement. Australia’s chief medical officer, Brendan Murphy, told reporters on Monday that expert panels were not yet convinced that the virus could be spread by people who were still symptom-free.
Some researchers say that even a small degree of porousness in the quarantine effort could have magnified implications for the epidemic’s toll.
In a study published Saturday, Yu Xiaohua, a professor at the University of Göttingen in Germany, concluded that the epidemic cannot be controlled if the quarantine rate of the infectious population falls below 90 percent.
If 90 percent of patients are quarantined, his modeling suggested, the final number of cases might reach 59,000, with 1,500 deaths. But if only half the infected patients are quarantined, the final number of infected people could approach 5 million, with more than 100,000 deaths.
At the same time, experts say they are heartened so far by the low number of reports so far of human-to-human transmission outside of central China.
In its update Sunday, the U.S. CDC said it considered the coronavirus to pose a low health risk to the general American public “at this time,” but warned that person-to-person infection will likely occur at some point in the United States.
By: Gerry Shih and Simon Denyer


How has foreign travel been affected by the COVID-19 pandemic?

Due to the COVID-19 pandemic, foreign travel is being severely restricted in an attempt to prevent further spread of the disease.  Travel bans are in place for Americans traveling to certain foreign countries, as well as for foreigners who want to travel to the U.S.  According to research, over 93% of the world's population live in countries with sudden new border restrictions.  It is estimated that at least 140 countries have closed their borders to some or all foreign travelers.  Information about current rules and regulations, as well as indications as to what factors influence those decisions, are relevant.

Due to the COVID-19 pandemic, foreign travel is being severely restricted in an attempt to prevent further spread of the disease.  Travel bans are in place for Americans traveling to certain foreign countries, as well as for foreigners who want to travel to the U.S.  According to research, over 93% of the world's population live in countries with sudden new border restrictions.  It is estimated that at least 140 countries have closed their borders to some or all foreign travelers.  Information about current rules and regulations, as well as indications as to what factors influence those decisions, are relevant but anything about air travel is not.

Find current travel restriction information relevant to this question.

Coronavirus pandemic tests clout of cruise industry and its long-standing ties to Trump

Huddled with donors at his private Mar-a-Lago Club on Friday, President Trump told supporters that he was intent on protecting the cruise industry from the fallout of the coronavirus crisis — even as top health officials and other key advisers were privately pushing him to keep the public off the ships.
Two days later, the State Department and the Centers for Disease Control and Prevention (CDC) warned U.S. citizens, particularly those with medical issues, not to travel by cruise ship, sending the industry into a panic, according to people familiar with the situation, who spoke on the condition of anonymity to describe private discussions.
The administration’s whipsawing posture has led to an intensive behind-the-scenes lobbying effort by cruise executives to mitigate the financial fallout from the virus, which has infected passengers and crew members on at least two Carnival-owned Princess Cruise ships.
The coming days will test the clout of the industry, which has long-standing connections to Trump, including through Carnival Corp. chairman Micky Arison, a friend whose company helped sponsor Trump’s reality show franchise “The Apprentice” over the years.
The cruise lines have raced to get ahead of further government action, voluntarily suspending a small number of voyages this week and pitching to the White House a plan to safeguard passengers.
But stock value of cruise companies has plummeted as the industry struggled to deal with the infections on the two ships and warnings from health experts about the risks of such travel.
Trump appears sympathetic and has said he wants to help the cruise lines. At the donor event Friday, the president brought up the industry and said he did not want it to shut it down or for it to suffer job losses, according to three people familiar with his remarks, who spoke on the condition of anonymity to describe the closed-door event.
A White House spokesman declined to comment.
Trump echoed that sentiment publicly Monday, saying at a White House news conference that he was concerned that cruise lines and airlines “will be hit.”
“We’re working with them very, very strongly,” he said. “We want them to travel.”
Treasury Secretary Steven Mnuchin said Wednesday that the administration was considering emergency assistance for affected industries. “This is not a bailout. This is considering providing certain things for certain industries. Airlines, hotels, cruise lines,” he said.
But at the same time, several top health officials and members of the administration’s coronavirus task force have been pushing for a tougher stance and wanted to impose a temporary ban on Americans going on cruise ships, according to people familiar with the conversations.
They included Health and Human Services Secretary Alex Azar, Centers for Medicare and Medicaid Services Administrator Seema Verma and Surgeon General Jerome Adams, the people said.
The advisories from the State Department and the CDC were recommended by the White House coronavirus task force, according to an administration official who said Trump and Vice President Pence knew about them in advance.
There has been mounting frustration with the cruise industry’s handling of the crisis among top administration officials, including in the office of Pence, according to people with knowledge of their thinking.
The lack of a clear mitigation plan for ships with outbreaks has forced the government to handle the expensive and complicated logistics of evacuating and quarantining thousands of potentially infected passengers this week aboard the Grand Princess in Oakland, an operation that has drawn in the National Guard and the Defense Department, among other agencies.
On Thursday, Princess Cruises announced that it was voluntarily canceling trips on its 18 ships worldwide through May 10, following a similar temporary suspension by Viking. Carnival, which owns Princess Cruises as well as Carnival Cruise Line, Holland America Line and several other lines, has not announced whether others will follow suit.
In its proposal, the industry said it plans to deny boarding to anyone older than 70 unless they have a doctor’s note, said people familiar with the plan. People who are obviously ill won’t be allowed to board. The plan also addresses testing passengers for the virus while they are on ships and how cruise lines will pay for the care of sick passengers or crew members.
However, some administration officials do not think the proposal goes far enough to screen passengers or deal with an outbreak, the people said.
Bari Golin-Blaugrund, a spokeswoman for the Cruise Lines International Association (CLIA), the industry’s trade group, said the industry is focused on the health and safety of its guests and crew.
“CLIA has participated as-invited in briefings with policymakers since the emergence of the crisis which culminated with a meeting with Vice President Pence,” she said in a statement. “We have submitted an industry-funded plan to the government consistent with input from government officials that doesn’t come with a price tag for taxpayers. Some plan details include more stringent boarding procedures, additional onboard medical protocols, monitoring capabilities, quarantine arrangements and shoreside care for guests and crew in the event of detection of COVID-19.”
Carnival spokesman Roger Frizzell declined to comment on any discussions executives may have had with the White House, but said the company is not seeking a bailout.
“We are working as part of an industry-wide group of cruise line leaders with Vice President Pence to develop proactive initiatives from the cruise industry to enhance our health and safety measures,” he said.
Two Princess ships became central characters in the global spread of the disease when they were found to be carrying infected people and forced to quarantine passengers before they were allowed to disembark.
Trump was infuriated when he learned last month that U.S. authorities had brought coronavirus-infected Americans home from a ship in Japan, as The Washington Post previously reported. He said last week that he would have preferred to leave Americans aboard the second ship docked in California because he did not want the coronavirus numbers to rise in the United States.
About 700 people aboard the Diamond Princess became infected while the ship was moored for weeks off the coast of Japan. Of 3,500 people on a second ship, the Grand Princess, at least 21 have tested positive, and the vessel remains docked in Oakland as tests continue.
Passengers who have been permitted to leave the ship have been sent to military bases in California, Georgia and Texas for quarantine.
Before leaving the Grand Princess, two passengers from Florida filed a lawsuit in federal court seeking more than $1 million in damages for being put at “serious risk of imminent harm.” The company said it is committed to the well-being of its passengers and declined to comment on pending litigation.
A third ship, the Caribbean Princess, was forced to cut short a voyage Sunday and head back to U.S. waters from Costa Rica to test two crew members for the coronavirus. Their tests came back negative.
As the pandemic has grown, health experts have warned that cruise ships could facilitate infections.
“Cruises inherently have conditions that can promote infectious disease spread,” said Henry Wu, assistant professor of infectious diseases at Emory University School of Medicine and director of the Emory TravelWell Center. “Shared facilities, such as common bathrooms, cafeterias, are of particular concern. Infected crew members or incomplete environmental cleaning can also lead to continuation of outbreaks on subsequent voyages.”
Some lawmakers are pushing for an industry shutdown.
Cruise companies should immediately stop launching new voyages, said Sen. Richard Blumenthal (D-Conn.), adding that “if they won’t do it voluntarily, we should look at mandatory measures.”
“Cruise ships are small cities at sea, isolated from professional medical facilities. They compel people to be in very crowded situations,” he told The Post. “They seem to bring together people in almost exactly the way we are trying to avoid at the moment.”
CLIA said that cruise lines work diligently to sanitize ships, screen passengers and train crew members in safety procedures. Ships also undergo inspections by the Centers for Disease Control and Prevention.
The cruise sector supports about 422,000 jobs in the United States, more than a third of which are in the key political battleground state of Florida, the trade group said.
But the major cruise lines are incorporated overseas and pay virtually no federal taxes. A patchwork of weak international laws governs the industry, critics say.
In 2016, Princess Cruise Lines agreed to plead guilty to seven felony charges and pay a $40 million penalty for polluting the ocean and then trying to cover it up — the largest criminal penalty involving deliberate pollution by a ship at sea. Princess Cruises was ordered to pay an additional $20 million criminal penalty last year for violating the terms of its probation and deliberately discharging plastic in Bahamian waters. At that time, Arison pledged that his company was “totally committed” to curbing pollution.
Trump’s personal connections to the industry date back more than a decade.
Arison, a billionaire and donor to both political parties, has known Trump for years. The two were photographed in 2005 at a game of Arison’s Miami Heat basketball team with their wives, and Trump sent Arison a congratulatory tweet in 2012 when the team won the NBA championship. Arison returned the favor by congratulating Trump on renovations and new steakhouse at the Trump National Doral golf club in Miami, near Carnival’s own headquarters. (One of Arison’s tweets about Trump was deleted Wednesday after a Post reporter highlighted it.)
Their franchises joined forces at times. In 2005, Trump presided over the launch of a Carnival “Apprentice Legend Cruise” from New York to the Caribbean featuring cast members from “The Apprentice,” his NBC reality show. And in 2017, shortly after his inauguration, Carnival sponsored the two-part finale of “The New Celebrity Apprentice” in which the company’s chief executive appeared in one episode.
Trump has other ties to the cruise industry. His wife, Melania Trump, christened one of the Norwegian Cruise Line’s newest ships in 2005 and was dubbed the vessel’s “godmother.” The company made a $100,000 donation to Trump’s charitable foundation that year.
At a 2017 conference in South Florida, Norwegian Cruise Lines Holdings chief executive Frank Del Rio was widely quoted as crediting what he called “the Trump effect” for a booming stock market, and he said the administration’s pro-business, anti-regulatory posture was good for business.
And some of the president’s top allies have represented the industry, which spent $3.6 million last year on federal lobbying, according to the Center for Responsive Politics.
Brian Ballard, a major Trump fundraiser, and former Florida attorney general Pam Bondi, who helped defend Trump during his impeachment trial, were registered federal lobbyists for Carnival North American from February to August last year, lobbying records show.
Tandy Bondi, Bondi’s sister-in-law, remains registered as a federal lobbyist for Carnival North America, records show, and has tried to help the company deal with the virus fallout, according to a person familiar with her role. Tandy Bondi declined to comment.
As the coronavirus crisis unfolded, the industry began a public-relations campaign aimed at reassuring people that cruises are safe and sanitary.
Executives scrambled to convince the administration that it could handle the situation. On Saturday, Pence met with corporate leaders at Port Everglades in Fort Lauderdale, including Del Rio of Norwegian, Carnival chief executive Arnold Donald and Royal Caribbean Cruises chief executive Richard Fain.
A day earlier, two Floridians tested positive for the coronavirus, including one who worked as a guide for cruise companies.
“We made it very clear that we needed cruise lines to be safer; to establish and to embrace new protocols; screening onboard, screening off; new medical protocols; shipboard processes for evacuating people that may contract coronavirus or a serious illness,” Pence later told reporters.
The stern message came after a number of government agencies have been deployed to help those stuck on the cruise ships, officials said.
The Health and Human Services Department has provided health screenings for anyone on the Grand Princess with medical concerns, going door to door on the ship, and is delivering any needed medication to those in quarantine. The Defense Department worked to arrange housing for passengers on four military bases, providing private rooms and bathrooms for the cruise patrons for two weeks while they self-isolated, while also keeping the U.S. military forces separate and protected. In addition, officials are helping to coordinate meals, weather-appropriate clothing and children’s activities.
The State Department’s advisory that Americans should not travel by cruise ship a day after the Pence meeting stunned and angered industry executives, according to people familiar with their responses.
By Tuesday night, the industry had delivered its proposal, hoping to get the administration’s backing and a green light to keep cruising.
But some members of the White House task force are concerned that the cruise lines have not done enough to prepare for more infections, and think the public would be safer staying off the ships, said a senior administration official familiar with the conversations.
How the administration responds will be crucial for an industry that considers its future on the line.
In the past, the industry has batted down attempts by Congress to better protect the passengers’ health and safety, including proposals that would have required that more crew members be trained in emergency procedures.
Rep. Doris Matsui (D-Calif.) is co-sponsoring legislation that she said would strengthen requirements for crime reporting and video surveillance on cruise ships, raise medical standards and hold cruise lines responsible for crimes at sea. The bill builds on a 2010 law that mandates that cruise vessels that visit U.S. ports meet certain security and safety requirements, including rail heights of at least 42 inches and reporting certain criminal allegations to the FBI.
But Matsui said the industry has largely managed to avoid such strict regulation because most ships are flagged overseas.
“We didn’t know how tough it was going to be to fight the cruise lines,” she said. “The industry has been very successful.”
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Much of life comes to a standstill as countries shut themselves off from the rest of the world

European truck drivers stuck in miles-long backups. Asylum seekers stranded in Mexico. Cities and states within countries — from Rio de Janeiro to Tasmania — sealing themselves off from the rest of their nations.
In a world where the once-steady march of globalization hit strong head winds in recent years from nationalist governments, the novel coronavirus pandemic has done more to suddenly halt and reverse the notion of open — and easily crossed — borders than perhaps any other event in modern history.
The impact to the global economy will be severe. Yet the larger question arising from empty international airports and backed-up land borders may be the long-haul effect of the pandemic on everything from freedom of movement to asylum claims to trade.
“The question is, when the health crisis recedes, be that six months, one year, or two years from now, are we going to see the protectionist measures related to the health crisis recede too?” said Stephanie Segal, a former senior economist at the International Monetary Fund and a senior fellow at the Washington-based Center for Strategic and International Studies. “Certainly they will, but will they ever go back to precrisis levels?”
In the meantime,  the pandemic is stranding travelers and upending everything from refugee flows to wedding rites.
In South America, still less impacted than other regions, many nations are striving to keep it that way by imposing some of the strictest border controls in the world. Peru and Bolivia have suspended international flights, restricted crossings at land borders, and deployed police and the military on the streets.
As concerns mount about the ability of crisis-plagued Venezuela to control the pandemic, its neighbors have sealed its borders.  The closures have raised fears of a bottleneck that could force migrants — as well  as Venezuelans who flocked to Colombia to buy or sell food and other supplies to live — to risk dangerous trips across illegal crossing controlled by armed gangs and guerrilla groups.
Vianney Durán, an unemployed 22-year-old law student living in the Venezuelan border city of La Fría, is one of the many who crossed regularly into Colombia to buy food and medicine. He has also survived off remittances from relatives working abroad that he only was able to collect on the other side of the border.
Now, that lifeline is closed.
“If we are not killed by the coronavirus, people will starve to death if they don’t do something,” Durán said.
The U.S. announcement that it would close its borders with Mexico, as well as Canada, sparked an immediate outcry over the fate of thousands of asylum seekers being held south of the border.
“I’ve been preparing for my hearing, but now I don’t know if it will happen,” said Daniel, a 20-year-old Venezuelan asylum seeker with HIV who declined to give his full name for fear of repercussions from authorities. Daniel, who was stuck in Piedras Negras, Mexico, has a U.S. asylum hearing scheduled for March 31. “With my immune system, I need to be very careful.”
In continental Europe, leaders rushed guards to reoccupy long-disused border posts to start turning away nonresidents.
Trucks backed up for dozens of miles on either side of Poland, which imposed a particularly stringent quarantine on anyone entering the country, leading to fears that other parts of Eastern Europe would soon run out of supplies.
“Right now there are two very strong feelings,” said Latvian Foreign Minister Edgars Rinkevics, whose country was caught on the isolated side of the Polish blockade. “One, ‘Let’s close down everything.’ Another is, ‘Wait a minute, we have seen we are too interconnected.’ ”
Live updates: Illinois, California, New York and Florida increase restrictions because of coronavirus
E.U. leaders in Brussels moved quickly to allow truck transportation to continue, fearing that shortages of medical supplies could worsen the pandemic. But by week’s end, there were still pileups at borders across the continent.
In sub-Saharan Africa, sweeping travel restrictions have gone into effect despite only 353 confirmed cases across its 48 countries as of Friday, according to the Africa Centers for Disease Control and Prevention. Nearly every country has imposed total or near-total entry restrictions on nonresident foreigners and suspended issuance of new visas. More than a dozen have closed airports to international flights.
Karen Mwalo, 34, was planning a marital ceremony with her husband known as an “itara” on April 18, in which Mwalo’s family would visit the homestead of her husband’s parents in western Kenya. Some family members were coming from as far as Denmark and the Netherlands.
“We can’t go ahead,” said Mwalo, who said they have postponed their plans until at least July.  It is “not good to be risking people. You never know. It’s already a breeding ground here.”
Brazil, which has at least 700 confirmed cases of the novel coronavirus, by far Latin America’s most, is taking a more relaxed approach that has led local governments to act.  Beginning Saturday, the state of Rio de Janeiro will effectively seal itself off from the rest of the country, and the city of Rio will seal itself off from the rest of the state.
“It is a painful process to interfere in this way with people’s lives, but it’s necessary,” said Wilson Witzel, the governor of Rio de Janeiro state.
In the Middle East,  Jordan, Iraq, Lebanon and Saudi Arabia halted international flights over the past week and sealed their land borders. Other countries in the region have sharply curtailed the flights, and the United Arab Emirates is allowing entry only to the small number of people who are UAE citizens.
After initially only restricting travel from the most infected parts of the world — China’s Hubei province and regions in South Korea, Iran and Italy — Japan suddenly switched gears.
Earlier this month, Japan canceled 3 million visas issued to Chinese and South Korean visitors, and it said anyone arriving from those countries would be subjected to a 14-day quarantine. On Wednesday, Prime Minister Shinzo Abe said travelers from Europe, Egypt and Iran would have to self-quarantine for 14 days and refrain from using public transport.
The coronavirus makes inroads into the highest echelons of the world
India, the world’s second-most populous nation, has progressively sealed itself off from the world as the crisis has intensified. On Thursday, it became the largest country to announce a one-week total ban, starting March 22, on all arriving commercial flights from abroad.
For people such as Rupa Subramanya, 40, the virtual walls coming up around the world have rendered her life unrecognizable. For the past decade, Subramanya and her husband, both economists, have split their time between India and Canada, traveling back and forth about four times a year. But when she attempted to fly from Mumbai to Ottawa on March 19, she encountered a maze of obstacles, including gate agents telling her that she did not meet Canada’s new restrictions on entry, even though she did.
Mumbai’s normally bustling airport was “desolate,” she said. Standing in a near-empty terminal “was like being in a zombie movie,” she said. She missed her flight to Canada, but she will try again at the end of March if India does not extend its ban. “Who’s to say [the ban] is not going to last longer?” she asked. “It sounds ludicrous, but everything that I thought was ludicrous is happening.”
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Chinese citizens abroad seek refuge from the coronavirus pandemic — at home

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As the coronavirus started spreading across the United States last week, New York University student Jane Zhang knew what she needed to do. She needed to seek shelter from the outbreak. At home. In China.
“China has already contained the situation, and there are no new domestic cases in Beijing,” the 19-year-old sophomore said, “but I think the number of people with the virus in the United States is going to rise exponentially.”
So on Friday, the day the number of cases in New York state rose 30 percent overnight, she boarded a flight home to the Chinese capital. It just feels safer, she said, because authorities there have made more of an effort to ensure public health.
“The Chinese government basically pays for a patient’s recovery, so we don’t have to worry about how much treatment is going to cost,” she said, making a contrast with the U.S. health-care system.
Plus, she said, Americans didn’t seem to be taking the outbreak seriously enough.
In a matter of weeks, China has gone from being the epicenter of the virus to almost the only refuge from it, prompting hundreds of thousands of Chinese citizens abroad to flock home. About 20,000 people a day are arriving on flights into China, while five times as many arrive by land or sea, state media reported.
With many flights to China canceled amid the outbreak, seats were already relatively scarce. But the sudden spike in demand means prices have skyrocketed, with the few remaining economy-class seats from U.S. airports going for four or five times the usual rate.
Xiangyuan Li, a freshman at Franklin & Marshall College in Pennsylvania, had already decided to return home to Chengdu after being told on Thursday that his classes would move online. It would be boring with everyone gone from his college town, and he was worried about not being able to get into China for his summer internship.
But the growing outbreak in the United States cemented his decision.
“Certainly, China is indeed very safe now,” Li said, while the United States is becoming more dangerous.
“The U.S. can’t test everyone, like in China. Testing an entire planeload of passengers and providing results the next day is impossible in the U.S.,” he said, referring to the entry procedures he went through on arrival in his home country.
There has also been a rush of returns from Britain since a government adviser there advocated a “herd immunity” strategy, suggesting that it could be helpful if 60 percent of the population was infected.
Tickets from Britain are eye-wateringly expensive, if they can be found at all. A business-class charter flight from London via Geneva, operated by China Eastern Airlines, was selling seats for more than $25,000 over the weekend, according to the Yicai Global news site.
But this mass influx of people has created a problem for Chinese authorities as they trumpet their achievements in containing the coronavirus and reducing infection rates to negligible levels: People are arriving with the disease.
For the fourth day in a row, China’s National Health Commission on Tuesday reported that the number of imported cases exceeded domestic transmissions. It said 21 infections had been diagnosed the previous day — 20 of which came from abroad. A total of 143 people have arrived in the country with the coronavirus, many of them from hot spots such as Iran and Italy.
“Preventing imported cases has become a key task of China’s epidemic prevention and control work,” Wang Jun, an official with the General Administration of Customs, told reporters in Beijing this week. “We must resolutely curb the spread across the border.”
Nine of the cases reported Tuesday were detected in Beijing, explaining why authorities in the capital are going to extreme measures to prevent the virus from spreading in the city that is home to the Communist Party’s top officials.
Beijing’s municipal government on Sunday introduced rules requiring all people arriving in the capital to go into “centralized quarantine” at hotels for 14 days upon arrival, at their own expense.
The rules came into effect while one American, Jacob Gunter, was in the air on his way to Beijing. He live-tweeted his journey through various checks at the airport and intermediate staging posts before finally arriving at his quarantine hotel a full 12 hours later.
Other videos posted on social media showed huge crowds at Beijing Capital International Airport after weeks of it being empty, as multiple packed planes landed.
Areas across the country, from Inner Mongolia in the north to Sanya on the island of Hainan in the south, have instituted similar measures, requiring stays in quarantine centers rather than trusting people to isolate themselves at home. More local authorities are expected to follow suit.
All manner of methods are being employed to track down and punish those caught violating the rules.
Beijing police have made an example of a 37-year-old Chinese woman who works at Massachusetts biotechnology company Biogen and attended the Boston conference that has been linked to other infections, according to local media reports.
She failed to report that she was feeling sick before boarding her flight, took painkillers to suppress her fever and then lied to flight attendants about her condition, local police said.
Upon arrival, the suspicious attendants reported her to police authorities, who quarantined her and had her tested for the virus. It came back positive. She is under criminal investigation on charges of obstructing infectious-disease prevention.
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White House suspends travel from most of Europe to the United States beginning Friday

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Nearly all travel from Europe to the United States will be suspended for 30 days in an effort to slow the spread of the coronavirus, President Trump said in an address to the nation Wednesday night.
The ban, which takes effect at midnight Friday, will not include Britain.
“I am confident that by counting and continuing to take these tough measures, we will significantly reduce the threat to our citizens and we will ultimately and expeditiously defeat this virus,” Trump said.
Trump also criticized Europe for not acting to quickly enact travel restrictions for China, as the United States did, saying virus clusters here were “seeded by travel from Europe.”
The announcement came on the same day the World Health Organization declared the coronavirus a pandemic, reflecting alarm that countries aren’t working quickly and aggressively enough to fight covid-19, the disease caused by the virus. WHO officials said countries should take a “blended” approach — focusing on containment to slow the spread, in hopes of buying time for mitigation strategies.
Worldwide, there are now more than 121,000 cases of the coronavirus in 114 countries. More than 4,300 people have died. In the United States, there are more than 1,000 cases, and more than 30 people have died.
[Live updates: WHO declares coronavirus a pandemic]
Earlier in the day, the administration had signaled that the growing number of infections in Europe was prompting it to reexamine its strategy for containing the virus, but Trump had not been expected to announce a ban.
At a hearing before the House Oversight and Reform Committee on Wednesday, Robert Redfield, director of the Centers for Disease Control and Prevention, confirmed that the administration was shifting its focus to Europe.
“A real threat right now is Europe,” he told committee members. “That’s where the cases are coming in. Europe is the new China.”
However, some experts question whether Trump’s strategy is the right approach.
Such bans can cause people to keep their travel surreptitious, making it harder to do crucial contact tracing of those who are infected. They can also disrupt the movement of health workers, experts and medical supplies. The bans, experts also point out, can cause friction, hampering information-sharing and international efforts — as has happened between the United States and China — at a time when coordination and transparency have been crucial to fighting the virus.
In Italy, where the number of infections has grown exponentially, more than 10,000 cases have been reported and there have been more than 600 deaths. This week, the country’s leader took the drastic steps of imposing a nationwide lockdown that will limit the movement of 60 million people in hopes of containing the spread of the virus. On Wednesday, the country announced even more drastic measures, saying it will stop almost all commercial activity aside from supermarkets and pharmacies.
In the United States, Trump’s  announcement could also further hobble the airline industry, which is already facing enormous, potentially crippling financial pressures.
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This week, Delta Air Lines, for example, announced it may cut as much as a quarter of its international flights and reduce domestic routes by as much as 15 percent due to decreased demand. The carrier has instituted a hiring freeze and is suspending its stock repurchase program. American and United are also cutting back some routes, while Southwest Airlines chief executive Gary Kelly has said he will take a 10 percent pay cut.
Carriers, including United, American and Southwest, are already dealing with fallout from the grounding of Boeing’s 737 Max following two fatal crashes that killed 346 people.
“We are in contact with the federal government to understand and comply with this directive,” American said in a statement. “The health and safety of our customers and team members remains our highest priority.”
Even if they are in place for only 30 days, the travel restrictions could cause additional damage not just to airlines but also to airports and other businesses that depend on the aviation sector.
In the early days of the coronavirus outbreak, Trump credited sweeping travel restrictions imposed on China by his administration for helping slow the spread of the virus in the United States. In that instance, all flights from China were funneled through one of 11 U.S. airports. Once there, U.S. citizens who had been in China in the past 14 days were required to undergo enhanced screening and were subject to quarantine if they showed signs of the virus; most non-U. S. citizens were barred from entering the country.
“The European Union failed to take the same precautions and restrict travel from China and other hotspots. As a result, a large number of new clusters in the United States were seeded by travelers from Europe,” Trump said.
The president also offered cautions for older Americans, who are most vulnerable to the virus, urging them to “avoid nonessential travel in crowded areas.”
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CDC drops 14-day self-quarantine recommendation for international and out-of-state travelers

Since March, the Centers for Disease Control and Prevention has advised travelers to self-quarantine for 14 days after all international travel, and after domestic travel to states seeing a high rate of coronavirus cases. But the CDC has changed that stance, removing the directions for two-week quarantines from the “After You Travel” section of its coronavirus travel guidance.
Instead, they share “after-travel” recommendations based on individual countries. A map of country-specific health information can be found on the CDC website, and includes a map of reported cases in the United States.
In an email, CDC spokesman Scott Pauley told The Washington Post: “This updated guidance is based on risk of exposure during travel, asking travelers to think about what they did, where they were, and who they came into contact with to evaluate their risk of exposure to covid-19.”
The CDC’s updated travel guidance states that all returning travelers should social distance, wear a cloth face covering, wash their hands often and watch for symptoms. Notably, those are all basic measures the CDC has highlighted to Americans to follow since the beginning of the pandemic, regardless of whether traveling is involved.
Doctors say that quarantines can still be a good idea after traveling to a coronavirus-impacted area, and that quarantines are especially useful in the absence of testing. Plus, if you’re from a state that requires a two-week quarantine, you’ll likely still need to complete one.
“Broadly speaking, if someone travels to an area with an active outbreak, it’s reasonable upon return for them to be required to either get tested or to quarantine, a measure that many states now have in place,” Boston University epidemiologist Sandro Galea told The Washington Post. “We’re all trying to adapt to shifting realities and shifting facts all the time,” he says, but the advice to distance, frequently sanitize and wear a mask in public “are guidelines we should all be following all the time, regardless of whether we’ve traveled or not.”
The CDC’s travel guidance does still note that travel and being in crowds increases the chance of contracting the virus, and that infected people can be asymptomatic and spread the disease. But CDC quarantine guidelines also now narrowly define those who should isolate for two weeks as “people who have been in close contact with someone who has COVID-19 — excluding people who have had COVID-19 within the past three months.”
Galea calls the new CDC travel guidance a “direct contradiction” of what many states are doing — requiring quarantines. “In general, the U.S. could have benefited from having specific guidelines at a federal level from the beginning of this pandemic,” he says.
Wondering if you should self-quarantine after travel even if you’re visiting a lower-risk destinations and your state doesn’t require it? Lawrence Mayer, an epidemiologist and visiting fellow at Harvard University, says quarantines can be useful in returning from a high-risk area if you aren’t able to acquire a test and will be around some higher-risk individuals.
“If arriving from a high-transmission area, I think testing and quarantining on return would be helpful,” Mayer says. “Without a test, a 14-day quarantine seems reasonable” to prevent the spread of the virus. Like Galea, Mayer notes that the updated travel guidelines simply restate the standard advice that the CDC has urged everyone in the United States to follow, regardless of travel, since the pandemic began.
States mandating two-week quarantines for arrivals in some cases include Alaska, Connecticut, Hawaii, Maine, Massachusetts, New York and New Jersey. The CDC’s bottom line that travel elevates the risk of contracting the coronavirus hasn’t changed, even as the quarantine-after-travel advice disappeared.
“Don’t travel if you are sick or if you have been around someone with COVID-19 in the past 14 days. Don’t travel with someone who is sick,” the CDC’s travel guidance states. “Travel increases your chance of getting and spreading COVID-19. Staying home is the best way to protect yourself and others from COVID-19.”
Read more:
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Has your travel bucket list changed during the pandemic? You’re not alone.
Traveling may not be safe, but leaving vacation days behind isn’t healthy, either


U.S. expands coronavirus travel restrictions to include U.K. and Ireland

The White House announced Saturday that its sweeping travel restrictions will be expanded to include the United Kingdom and Ireland, as countries around the globe struggled to intensify efforts to combat the spread of the deadly coronavirus.
The United States is limiting travel from 28 nations across Europe, though U.S. citizens and legal permanent residents are exempted. The announcement came as other countries sought to lock down their borders to contain the pandemic that surged across Asia and now claims Europe as the latest epicenter.
The number of confirmed cases climbed past 2,200 in the United States, with more than 50 dead, and health officials scrambled to ramp up testing that they expect will yield thousands of more infections. A day after he declared a national emergency, a designation that could free up $50 billion to fight the outbreak, President Trump said the administration is considering limiting domestic travel.
“If you don’t have to travel, I wouldn’t do it,” said Trump, who made a surprise announcement that he was tested for the novel coronavirus Friday night. On Saturday evening, his physician said the test came back negative.
Health officials continued to warn Saturday that the worst is yet to come and urged hospitals to prepare for waves of sick patients that could overwhelm the nation’s health-care system.
“We have not reached a peak,” Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, said during a news conference. “We will see more cases, and we will see more suffering and death, predominantly … among the vulnerables in our society.”
One stunning new projection from the Kaiser Family Foundation is that 41 percent of U.S. adults — more than 105 million people — have a “higher risk of developing serious illness” if infected with the coronavirus because of their age or underlying health conditions.
As cases decline in China, the origin of the outbreak, countries in Europe are emerging as the world’s new hot spots, especially Italy and Spain.
Italy announced that health officials confirmed nearly 3,500 new cases in 24 hours, a 20 percent increase from Friday and that nation’s largest daily increase yet. Italy has more than 21,000 confirmed cases, despite the fact that the country has been in a lockdown since Monday.
Spain announced 1,500 new cases Saturday, and the government ordered all 47 million residents to stay in their homes except to buy essential goods or go to work, medical appointments and banks. Prime Minister Pedro Sánchez told the nation in a televised address that the restrictions will remain in place for an initial 15-day period but could be extended. The move was so abrupt that several airplanes en route from England turned around midflight to avoid landing in the country.
In Russia, Prime Minister Mikhail Mishustin said the nation had closed its land border with Poland and Norway after already closing its border with China. Poland, Denmark and the Czech Republic also sought to seal off their borders, and France ordered all nonessential businesses to close, including restaurants and cafes.
The U.K. and Ireland were not included in the initial travel restrictions from Europe that Trump announced Wednesday. But since then, both have seen an increase of cases, and Britian’s death toll nearly doubled Saturday, to 21. The White House said the travel restrictions will go into place at midnight Monday. They do not cover cargo shipments.
The effectiveness of such measures continues to be debated, however, and they run counter to the World Health Organization’s recommendations. Critics say they can cause some people to travel more surreptitiously, divert vital resources and hamper the international cooperation needed to fight the virus.
“Travel restrictions can cause more harm than good,” World Health Organization Director General Tedros Adhanom Ghebreyesus has stressed.
Additional travel restrictions will further hit the airline industry, which is facing enormous losses because of the pandemic. White House officials are considering offering low-interest loans or tax deferrals to airlines to help them survive the downturn.
In yet another sign that virtually no facet of society — from museums to sporting events  to religious services — will go unscathed, restaurants across France braced for their last meals and customers as part of the government’s closure order. For a country that thrives on food, wine and leisurely afternoons spent alfresco at sidewalk cafes, the government acknowledged it was an extreme measure. But officials said they had no choice because too many people appeared to be ignoring earlier advice about social distancing and staying home.
Israel banned all gatherings of more than 10 people. The United Arab Emirates said it will stop issuing visas to all foreigners except diplomats. And amid the season of Lent, one of the most significant holy seasons for Christians, the Catholic Archdiocese of New York announced it was canceling all Masses beginning Sunday.
Across the United States, health officials  moved to limit visits to nursing homes because of their extremely vulnerable population. During the news conference Saturday, Vice President Pence urged people to “look after seniors with serious underlying health conditions and make sure that every American around them is practicing the best kind of hygiene, the best kind of measures to ensure that they’re not exposed.”
The new report by the Kaiser Family Foundation found that although “the majority of people who become infected are expected to be asymptomatic or recover without needing special treatment,” there is an “increasing concern for adults who have a higher risk of developing serious illness if they are infected.” Prime among them: individuals 60 or older as well as those with underlying health conditions such as heart and lung disease, cancer and diabetes.
U.S. Surgeon General Jerome M. Adams on Saturday urged hospitals to “PLEASE CONSIDER STOPPING ELECTIVE SURGERIES,” which he said could bring potential cases of the virus into health-care facilities while occupying precious resources and space needed to treat people with the crisis.
The day began with a rare showing of bipartisanship in Congress, when House Republicans and Democrats overwhelmingly passed a bill that would allocate billions of dollars for paid sick leave, unemployment insurance, free testing and other steps to help the country grapple with the virus.
Hours after the bill passed the House, 363 to 40, Trump, who on Friday had criticized congressional Democrats for not doing enough on the bill, praised the uncommon demonstration of unity.
“Good teamwork between Republicans & Democrats as the House passes the big CoronaVirus Relief Bill,” he tweeted. “People really pulled together. Nice to see!”
The bill now moves to the Senate, which is expected to pass it in coming days.
The pandemic’s toll continues to reverberate.
New York, which has been hit particularly hard by the virus, reported its first death, as did Virginia and Louisiana. The Pentagon announced that 10 servicemembers had tested positive for the virus along with one Defense Department civilian and two contractors.
Georgia became the second state, after Louisiana, to delay its presidential primary for at least two months. Supermarket chains shortened their hours to allow them to sanitize their stores and restock inventories: Harris Teeter said it will close its stores at 9 every night; Publix said it will close its stores daily at 8 p.m.
Apple said it will close stores globally, including more than 250 in the United States, while simultaneously reopening stores in China that had been shuttered for weeks.
“I think it’s fine if they do it, and I think it’s frankly, it’s good that they do it. I think what Apple did is fine,” Trump said. “And we want to keep people away for just a little while, just keep them away.”
That appeared to mark a shift from Trump’s tone earlier in the crisis, when he batted away questions about broad economic disruption by saying that the U.S. economy is the world’s mightiest.
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Advice for pregnant women, older people and others about travel during coronavirus outbreak

This story has been updated.
International travel has slowed to a crawl thanks to the coronavirus — which is responsible for cancellations across the globe. Airlines are cutting service and furloughing staff. Businesses are restricting trips by their employees, and families are reconsidering spring break plans.
The International Air Transport Association, in an analysis released March 5, predicted 2020 global losses involving passengers to reach between $63 billion and $113 billion, depending on the virus’ spread.
The Centers for Disease Control and Prevention recommends that all travelers avoid nonessential travel to China, Iran, South Korea and Italy and that older adults or those who have chronic medical conditions consider postponing trips to Japan. But should other people cancel, postpone or abstain from travel?
Not necessarily, said Larry Burchett, an ER doctor and board-certified family physician based in Sonoma, Bakersfield and Los Angeles. “This may be an opportunity for young, healthy people to take advantage of cheap vacations,” Burchett said.
According to CDC guidelines, areas in Watch Level 1 (essentially every spot that shouldn’t specifically be avoided) can be visited as long as getting there doesn’t require a layover in an infected area. In fact, the CDC doesn’t recommend canceling or postponing travel to those areas, because the risk of becoming infected with covid-19 there is believed to be low.
Contrary to popular perception, the risk of getting covid-19 on an airplane also is low, as long as one is not seated within six feet of an infected passenger, according to the CDC.  “Because of how air circulates and is filtered on airplanes, most viruses and other germs do not spread easily on airplanes,” it says on its website. Cruises, on the other hand, “put large numbers of people, often from countries around the world, in frequent and close contact with each other,” which can spread respiratory viruses.
As potential travelers weigh the pros and cons of going ahead with travel plans, here are specific suggestions based on different health statuses.
According to the American College of Obstetricians and Gynecologists, pregnant women are not at higher risk than the general population of falling victim to coronavirus. But it should be noted that very little is known about the coronavirus as it relates to pregnant women, the developing fetus or infants, said Kecia Gaither, director of perinatal services at NYC Health + Hospitals/Lincoln in New York City.
What is currently known — and this information is continually evolving — is based on knowledge about previous coronavirus outbreaks (MERS-CoV and SARS-CoV) and the small number of covid-19 cases involving pregnant women.
Since this is so new and unstudied, Gaither said that it’s still not completely known whether pregnant women may be more susceptible to the risk of disease acquisition (despite what the ACOG said) and associated death. It’s also unclear whether transmission to the fetus occurs, either via the placenta or through breast milk, Gaither said.
“From the few case reports out of China, the virus may have adverse effects on the newborns, causing issues such as preterm labor, fetal distress, respiratory distress, low platelets, abnormal liver function tests and thrombocytopenia,” she said.
Daniel Roshan, director of Rosh Maternal & Fetal Medicine in New York City, personally advises pregnant women not to fly.
“However, if one must fly, I recommend precautions,” Roshan said, suggesting hand washing frequently, hydrating, taking prenatal vitamins and vitamin C, and wearing a mask during the flight.
In general, older adults are more susceptible to viral illnesses, including the flu and coronavirus, because their ability to fight off infection is diminished, said Steven Reisman, a cardiologist with New York Cardiac Diagnostic Center. In addition, he said, older adults may also have other underlying health issues such as lung or heart disease, which will result in a more severe outcome with a viral illness.
Before traveling, anyone 65 or older should receive a pneumonia vaccination. While coronavirus is only a viral lower respiratory infection, one complication is pneumonia or bacterial infection in the lungs, Burchett said.
In case of quarantine, older adults should travel with an extra two weeks’ worth of essential medicine.
It’s also essential that older adults (and anyone with a medical condition) travel with their health records, said Reuben Elovitz, internal medicine physician with Private Health Dallas. These will be needed in case you get sick or require medical care. Providing the local medical team with your health information is essential for obtaining optimal treatment and avoiding adverse effects and complications, Elovitz said.
“Your records are even more crucial if you are not able to communicate with your health care providers due to the severity of your illness,” he said.
The CDC is advising those at higher risk of complications from COVID-19 — older people and those with underlying health conditions -- to avoid crowds and, if they are in an area with an outbreak, to stay at home as much as possible. Vice President Mike Pence has recommended that older people with underlying health conditions not take cruises, and Health and Human Services Secretary Alez Azar advised both older people and those with serious health problems to avoid crowds “especially in poorly ventilated spaces.” On March 8, the State Department advised U.S. citizens, particularly those with health issues, not to travel by cruise ship.
As a rule, young kids touch everything around them with hands that frequently make their way to their mouths, as well as to the faces of their adult companions. This alone makes it easier for them to get infected and to pass along any illnesses — and it also makes it less safe for them to travel, said Chad Sanborn, pediatric infectious disease specialist at Palm Beach Children’s Hospital. If you do plan on traveling with young children, make sure their vaccines are up to date, and take at least an extra two weeks’ worth of any essential medications with them should they need to be quarantined.
Children who are immune-compromised should not get on a plane or go to an airport unless it’s truly necessary, Sanborn said. “Young children who may be immune-suppressed or with chronic illness, in particular, may not be good travel candidates because they don’t wash their hands as well, they touch their face more often, they do not cover their cough and sneezes as well, and they pick their noses and wipe their nasal secretions more often,” he said.
If kids need to travel to a high-risk area (as designated by the CDC), Sanborn recommends that they avoid contact with immune-suppressed friends for two weeks post-travel, especially if they were in direct contact with someone subsequently found to be infected.
“If a child traveling internationally becomes sick upon return, it may not be coronavirus, but I would still recommend 14 days of school avoidance if they are coming from an area with covid-19 activity,” he said.
Those who have compromised immune systems, perhaps because they are undergoing chemotherapy or are on immunosuppressant medication for a disorder such as Crohn’s disease, are at higher risk of having complications from viral diseases such as coronavirus, Burchett said. The same applies to those with significant poor health, especially chronic lung disease or severe heart failure. “Saying ‘no travel across the board’ is extreme in my opinion, but I would certainly recommend avoiding places with high incidences of corona,” Burchett said.
It’s not uncommon to become sick after traveling. In fact, up to 79 percent of those traveling to low- and middle-income countries experience a travel-related health problem, according to the CDC. Fortunately, most illnesses aren’t serious. But depending on where you were traveling, your risk of infection from the coronavirus could limit your movement back home.
The CDC is not allowing foreign nationals who have visited China or Iran within the past two weeks to enter the United States (those returning from other highly affected countries including Iran, South Korea and Italy will be heavily screened and may face quarantine measures). American citizens, permanent residents and their families will be allowed to enter, but will have to undergo a health screening that includes being checked for fever, coughing and trouble breathing. They will also have restrictions on their movement for up to 14 days. Travelers returning from Italy and South Korea are undergoing exit screenings in those countries.
If you are returning from any area with an outbreak, avoid close contact with anyone in a nursing home or anyone sick just in case: Even if you don’t have symptoms, you could still potentially be contagious if you were exposed to the virus, Elovitz said.
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