This article was last updated on Feb. 14, 2020.
Jan. 24, 2020 -- News about the coronavirus outbreak that started in Wuhan, China, is changing rapidly. The respiratory infection, recently named COVID-19 by the World Health Organization (WHO), is closely related to SARS and MERS. While the vast majority of cases are in China, the disease has been diagnosed in more than two dozen other countries, including the United States. We’ll provide the latest updates on cases, deaths, travel restrictions, and more here.
What is the latest news?
More than 1,700 health care workers in China have been diagnosed with COVID-19, and six of them have died, according to media reports. Most of the cases were in Hubei, the province at the center of the outbreak.
Also, Japan recorded its first death from the virus. It’s only the second death reported outside of China.
Worldwide the number of cases has passed 64,000, the majority of them in China, and the number of deaths is now 1,383, according to the European Center for Disease Prevention and Control.
In the U.S., two more people have been diagnosed with COVID-19, bringing the number to 15.
Both cases are in people under a quarantine who recently returned to the country from China on State Department-chartered flights. The latest was housed in Texas at JBSA-Lackland. The patient is in isolation at a nearby hospital.
The 14th case was at a base in California. The CDC says it’s the second person at this base who has tested positive for the disease. The agency said there’s no connection between the two in California as they came on different planes and were staying in separate facilities.
The agency said while there is no evidence that the virus is spreading among the more than 600 people still in under federally-ordered quarantine who had recently returned from China, “there will likely be additional cases in the coming days and weeks.”
More than 600 people are still under federally-ordered quarantine who had recently returned from China. On Tuesday, close to 200 Americans who had been quarantined at a military base after being evacuated from China on an earlier flight were released.
Public health officials kept the 195 evacuees at March Air Reserve Base for 14 days to monitor them for symptoms of the coronarvirus. None of them tested positive for the virus in that time, officials said, and they pose no health risk to the public.
On Wednesday, the CDC said some coronavirus testing kits sent to state laboratories across the country are flawed and don't provide accurate results. The CDC sent the kits so states could do their own testing for faster results.
The problem appears to be with one ingredient involved in the test, said Nancy Messonnier, MD, director of the CDC’s National Center for Immunization and Respiratory Diseases.
The CDC will make a new supply of that ingredient and send it to all of the state laboratories with the kits as soon as possible, Messonnier said.
At least 24 Americans are among the 221 people infected with the coronavirus on board the cruise ship Diamond Princess. It's the largest concentration of infection outside China. The ship has been quarantined off the coast of Japan since Tuesday.
Last week, the U.S. government said that foreigners who had traveled to China in the past two weeks will be barred from entering the the country, as the White House declared a national public health emergency over the new coronavirus.
As part of that proclamation, any citizen returning to the U.S. who has been to Hubei province in China in the past 14 days will be under mandatory quarantine for 14 days, which is thought to be the incubation period for the virus. Any citizen who’s been to the rest of China within the past 2 weeks will get a health screening when they get back to the U.S. They’ll then be asked to self-quarantine for 14 days. Their movements will be monitored.
These restrictions took effect Sunday. At least two planes carrying Americans out of China landed in the U.S. on Wednesday, with more on the way. Federal officials said they did not yet have an accurate count of the number of passengers who have made it out. All of the planes are bound for one of three Air Force bases: Travis Air Force Base in Fairfield, CA, southwest of Sacramento, Marine Corps Air Station Miramar in San Diego, Lackland Air Force Base in San Antonio, TX, and Eppley Airfield in Omaha, NE. The CDC is coordinating the quarantines.
“The actions we have taken and continue to take compliment the work of China and the World Health Organization to contain the outbreak within China," Health and Human Services Secretary Alex Azar said.
“This is a significant global situation, but I want to emphasize at this time that the risk to the American public is low,” said CDC Director Robert Redfield, MD.
These are the first federal quarantine orders issued in 50 years, the last coming in the 1960s for smallpox evaluations, CDC officials said.
How many people have been diagnosed with the virus, and how many have died?
According to European CDC, the majority of the confirmed cases -- more than 64,000 – are in China. More than 500 are confirmed outside of China in 25 countries. These include: Thailand, Japan, Singapore, Taiwan, Malaysia, South Korea, United Arab Emirates, Vietnam, Cambodia, Nepal, the Philippines, India, Sri Lanka, Germany, France, Italy, United Kingdom, Russia, Finland, Spain, Sweden, United States, Canada, Australia, Belgium and Macau. Singapore, Thailand and Japan are the countries with the most cases outside of China.
Among those who died last week is a Chinese doctor who was silenced by authorities when he was one of the first to sound the alarm about the coronavirus, according to the Wuhan City Central Hospital, The New York Times reported.
"We deeply regret and mourn this," the hospital said on the Chinese social media site Weibo.
In a Feb. 1 story, the Times described Li's efforts to raise concerns about a cluster of illnesses that were similar to Severe Acute Respiratory Syndrome (SARS), which ravaged China and spread to other countries nearly two decades ago.
The article also revealed Li's summons by upset health officials.
"If the officials had disclosed information about the epidemic earlier," Li told The Times. "I think it would have been a lot better. There should be more openness and transparency."
Over the weekend, the first U.S. citizen died of coronavirus in China. Media reports say the 60-year-old died in Wuhan.
A Chinese man visiting the Philippines died Feb. 1, becoming the first coronavirus patient to die outside China.
What do we know about cases in the United States?
The 15 U.S. cases are in Wisconsin, Illinois, Washington, California, Arizona, Massachusetts and Texas. The CDC in total has 427 persons under investigation for coronavirus from 41 states and territories. In addition to the 15 confirmed positive, 347 have tested negative.
As with the 14th and 15th case, the 13th patient in the U.S. had recently returned from Wuhan and was under a federal quarantine order in San Diego.
According to UC San Diego Health, this patient and three others were in the hospital for testing until Sunday, when the CDC cleared all four had tested negative for the virus. On Monday, however, according to the hospital, the CDC said further testing showed one of the four patients had in fact tested positive. That patient was returned to the hospital.
The 12th case of COVID-19 is in a man in Wisconsin.
Health officials there say the man has a history of travel to Beijing and was recently exposed to other known coronavirus patients while in China. The patient is isolated at home, and is doing well, Wisconsin officials say.
In California, a husband and wife diagnosed with coronavirus in San Benito County have experienced “worsening symptoms” and were admitted to a hospital outside the county “equipped for a higher level of care,” county officials said. They were originally being isolated at home. The husband had recently traveled from Wuhan, China, although the wife did not. She caught the virus from him, county officials said. They are both 57.
The ninth case involves a woman who had recently traveled to Wuhan and then to Santa Clara, CA. She is being quarantined but never required hospitalization, Reuters reported.
The eighth case is a man in his 20s from Boston who had just returned from Wuhan, according to the Massachusetts Department of Public Health. He will remain in isolation until cleared by health officials.
The seventh is also a man from Santa Clara County. He had recently returned from Wuhan and was never sick enough to need hospitalization, health officials said. He is in stable condition and is “self-isolating” at home. His case is not related to the other one in Santa Clara County.
On Thursday, a man in Illinois became the first case of person-to-person transmission of the virus in the U.S, the CDC said. He is the husband of a Chicago woman diagnosed with the virus after returning from Wuhan. He is hospitalized in isolation and is stable. His wife, who is in her 60s, is also in isolation and in good condition. The Chicago Department of Public Health reported that she had visited China in December and returned to Chicago earlier this month.
California has three others: one in Los Angeles County, one in Orange County and the most recent case in San Diego. The patient from Orange County is a man in his 50s. He is in a local hospital in isolation and is in good condition, according to the Orange County Health Care Agency. Los Angeles County officials did not provide additional details about the patient there.
Arizona's Department of Health Services said its patient is a Maricopa County resident and member of the Arizona State University community who did not live in student housing. The patient is not severely ill and is being kept in isolation.
The first man diagnosed with coronavirus in the U.S. has been released from the hospital, according to news reports. The Washington state resident, who had recently traveled to Wuhan, said he was continuing to recover at home. He was released from Providence Regional Medical Center in Everett.
The CDC is prioritizing the testing based on a person’s risk.
What are public officials doing to contain the virus?
The WHO declared on Jan. 30 that the 2019-nCoV outbreak is a Public Health Emergency of International Concern, or PHEIC.
WHO Director General Tedros Adhanom Ghebreysus said the agency had already released $9 million in reserve funding to help poorer countries prepare for a pandemic. The agency is also sending hundreds of thousands of masks, gloves and respirators to areas in need.
"We are only as strong as the weakest link,” Tedros said.
He also stressed, though, that much more money would be needed to fund a global response — an estimated $675 million for just the next 3 months.
“It’s a lot of money, but it’s much less than the bill we will face if we don’t invest in preparedness now,” he said.
The Bill and Melinda Gates Foundation has already donated $100 million to the effort.
The U.S. has also declared the crisis a public health emergency.
The U.S. is banning any foreign visitors who have come from China from entering the country. All U.S. citizens who have visited China’s Hubei province in the past 14 days will face mandatory quarantine for 14 days. Other visitors returning from China will be screened and asked to self-quarantine for 14 days.
The State Department has issued a level 4 travel advisory telling people not to travel to China because of the outbreak.
Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, said the strict precautions are warranted because of “the issue now with this is that there are a lot of unknowns.”
He pointed out that the number of cases “has steeply inclined each and every day.”
We now know for certain that a person without symptoms can transmit the disease, Fauci said.
Health officials also clarified the distinctions between isolation and quarantine. Isolation is used to keep a person who’s already sick from infecting others. Quarantines restrict the movement of someone who is exposed, but not yet sick.
In the U.S., the number of airports that will screen passengers from China for symptoms has expanded to 20.
Chinese officials have shut down all public transportation to many of the affected cities, affecting millions of people. The first was Wuhan, which has a population of about 11 million. In Wuhan, that includes buses, subways, trains, and the airport.
When did the outbreak start?
China first reported the outbreak in Wuhan on Dec. 30, 2019.
Is the virus seasonal, like the flu?
Will the coronavirus die out once warmer weather hits? It’s possible, but we don’t know enough about the virus yet to know for sure, said Messonnier.
Messonnier urged caution with that hypothesis during a CDC press briefing Wednesday. Most respiratory viruses, like flu, are seasonal. Coronavirus may behave like flu and we’ll see cases go down in spring and summer, she said. “But it’s premature to assume that,” Messonnier said. The agency continues to take aggressive action because it can’t count on that.
What are the symptoms, and how is the virus diagnosed?
China created a test for the virus and shared that information with other countries. The CDC has developed its own test.
Symptoms include a fever, coughing, and shortness of breath. They may appear 2 to 14 days after you’re exposed to the virus.
What is the source of the virus, and how is it spread?
Health officials are not sure of the source of the virus yet or how easily it can spread.
The virus can spread from person to person. A new case report published in the New England Journal of Medicine, describes how a woman from China infected 4 co-workers at a German company before she showed any symptoms of the disease herself.
The CDC believes that severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), two other types of coronavirus, are spread through droplets when someone coughs or sneezes.
Coronaviruses are found in many different animals, including camels, cattle, cats, and bats. One research paper also suggested snakes as a possible source. The new virus may be linked to a seafood and live animal market in Wuhan that has since been closed.
Is there a vaccine?
There is no vaccine, but the National Institutes of Health is working on one and hopes to begin testing in several months. That testing would be for safety. If it’s safe, there would be testing to see how well it works.
How is it treated?
There is no specific treatment for the virus. Patients are generally given supportive care for their symptoms, such a fluids and pain relievers. Hospitalized patients may need support with breathing.
HealthDay contributed to this report. Correction: An earlier version of this story included the wrong location for Travis Air Force Base. It is in Fairfield, CA., not Sacremento.
Is travel to China safe?
The U.S. State Department issued a level 4 travel advisory telling people not to travel to China because of the outbreak. Some cities in China, such as Wuhan, are closed to travelers.
Several airlines, including Delta, United and American, have announced they are ending service to China until the outbreak wanes.
But, commercial flights continue to come and go between the U.S. and China, and the CDC said it was currently evaluating whether or not to restrict the movement of passengers coming in on those flights.
“At this point we’re evaluating the appropriate strategy in light of the new information. There’s really nothing new to share at this point,” said Martin Cetron, MD, Director for the Division of Global Migration and Quarantine at CDC.
Travelers who do go should:
- Avoid contact with sick people.
- Avoid animals, animal markets, and products that come from animals.
- Wash their hands often with soap and water, or use an alcohol-based sanitizer if that’s not available.
- Seek medical care right away for a fever, cough, or difficulty breathing. Tell a health care professional about any travel.