Japan and the US have airlifted hundreds of their citizens from Wuhan, the centre of the coronavirus outbreak, as officials in China said the death toll from the disease had risen sharply overnight to 132, with nearly 1,500 new cases in the country, bringing the total number of people diagnosed to nearly 6,000.
A government-chartered plane carrying 206 Japanese nationals arrived in Tokyo from Wuhan on Wednesday morning. Two showed symptoms of pneumonia following scans, but a coronavirus diagnosis has not been confirmed, hospital representatives said. Two more have been admitted to hospital. Seven others with symptoms such as coughs and fever will undergo tests.
The rest of the passengers were sent home with instructions to stay in and not mix with people for 14 days. The Japanese authorities have dispatched a second plane to Wuhan to collect more of the 450 nationals awaiting evacuation.
Pressure is mounting on China to control the spread of the disease. The country’s national health commission said on Wednesday that the total number of deaths from the flu-like virus rose by 26 on Tuesday, with almost all of the new cases in Hubei province. The governor of Hubei said the city of Huanggang, one of more than a dozen in the province under virtual lockdown, was suffering an especially severe outbreak, with 324 cases and five deaths.
Unicef said it had shipped six tonnes of respiratory masks and protective suits to Shanghai to protect health workers. “This coronavirus is spreading at a breakneck speed and it is important to put all the necessary resources into halting it,” said Unicef’s executive director, Henrietta Fore. “We may not know enough about the virus’s impact on children or how many may be affected – but we do know that close monitoring and prevention are key. Time is not on our side.”
The total number of confirmed cases rose to 5,974 – overtaking the 5,327 confirmed cases in mainland China during the severe acute respiratory syndrome (Sars) epidemic. The Sars outbreak killed more than 770 people globally, including 349 in mainland China. The death rate from Sars, caused by a more virulent member of the coronavirus family than the Wuhan strain appears to be, was more than 10%. So far, the death rate among confirmed cases of coronavirus is 2%, and may be less if there are many mild cases that do not end up in hospital, as experts believe.
What is the virus causing illness in Wuhan?
It is a member of the coronavirus family that has never been encountered before. Like other coronaviruses, it has come from animals, or possibly seafood. New and troubling viruses usually originate in animal hosts. Ebola and flu are examples.
What other coronaviruses have there been?
Severe acute respiratory syndrome (Sars) and Middle Eastern respiratory syndrome (Mers) are both caused by coronaviruses that came from animals.
What are the symptoms of the Wuhan coronavirus?
The virus causes pneumonia. Those who have fallen ill are reported to suffer coughs, fever and breathing difficulties. In severe cases there can be organ failure. As this is viral pneumonia, antibiotics are of no use. The antiviral drugs we have against flu will not work. If people are admitted to hospital, they may get support for their lungs and other organs as well as fluids. Recovery will depend on the strength of their immune system. Many of those who have died are known to have been already in poor health.
Is the virus being transmitted from one person to another?
Human to human transmission has been confirmed by China’s national health commission. As of 27 January, the Chinese authorities had acknowledged more than 2,700 cases and 56 deaths. In the past week, the number of confirmed infections has more than tripled and cases have been found in 13 provinces, as well as the municipalities of Beijing, Shanghai, Chongqing and Tianjin. The virus has also been confirmed outside China, in Hong Kong, Macau, Japan, Nepal, Singapore, South Korea, Taiwan, Thailand, the US, and Vietnam. There have not been any confirmed cases in the UK at present, with the more than 70 people tested for the virus all proving negative. The actual number to have contracted the virus could be far higher as people with mild symptoms may not have been detected. Modelling by WHO experts at Imperial College London suggests there could be as many as 100,000 cases, with uncertainty putting the margins between 30,000 and 200,000.
How worried are the experts?
There were fears that the coronavirus might spread more widely during the week-long lunar new year holidays, which start on 24 January, when millions of Chinese travel home to celebrate, but the festivities have largely been cancelled and Wuhan and other Chinese cities are in lockdown.
At what point should you go to the doctor if you have a cough, say?
Unless you have recently travelled to China or been in contact with someone infected with the virus, then you should treat any cough or cold symptoms as normal. The NHS advises that there is generally no need to visit a doctor for a cough unless it is persistent or you are having other symptoms such as chest pain, difficulty breathing or you feel very unwell.
Should we panic?
No. The spread of the virus outside China is worrying but not an unexpected development. It increases the likelihood that the World Health Organization will declare the outbreak to be a public health emergency of international concern on Thursday evening. The key concerns are how transmissible this new coronavirus is between people and what proportion become severely ill and end up in hospital.
Sarah Boseley Health editor and Hannah Devlin
The first cases in the Middle East were reported in the United Arab Emirates. Four members of a Chinese family who had been in Wuhan and arrived in the UAE on 16 January for a visit were confirmed to have the virus. One member of the family sought medical help, reporting feeling unwell, a week after their arrival.
Officials in the US, meanwhile, said a chartered plane had landed in Anchorage, Alaska, with about 240 US citizens onboard, including staff from the US consulate in Wuhan.
The plane was to make a refuelling stop in Alaska before flying on to southern California, but passengers were to be re-screened in Anchorage for the virus, and hospitals were prepared to treat or quarantine people who may be infected.
British Airways said it had suspended all direct flights to and from mainland China after British authorities warned against “all but essential” travel to the country. The airline’s website shows no direct flights to China were available in January and February.
“We apologise to customers for the inconvenience, but the safety of our customers and crew is always our priority,” BA said in an statement.
The World Health Organization is recommending that people take simple precautions to reduce exposure to and transmission of the Wuhan coronavirus, for which there is no specific cure or vaccine.
The UN agency advises people to:
- Frequently wash their hands with an alcohol-based hand rub or warm water and soap
- Cover their mouth and nose with a flexed elbow or tissue when sneezing or coughing
- Avoid close contact with anyone who has a fever or cough
- Seek early medical help if they have a fever, cough and difficulty breathing, and share their travel history with healthcare providers
- Avoid direct, unprotected contact with live animals and surfaces in contact with animals when visiting live markets in affected areas
- Avoid eating raw or undercooked animal products and exercise care when handling raw meat, milk or animal organs to avoid cross-contamination with uncooked foods.
Despite a surge in sales of face masks in the aftermath of the outbreak of the coronavirus outbreak, experts are divided over whether they can prevent transmission and infection. There is some evidence to suggest that masks can help prevent hand-to-mouth transmissions, given the large number of times people touch their faces. The consensus appears to be that wearing a mask can limit – but not eliminate – the risks, provided they are used correctly.
Air France suspended its three weekly flights to Wuhan last week, but as of Wednesday morning said it was maintaining its 23 weekly flights to Beijing and Shanghai.
Cathay Pacific, which is based in Hong Kong, said it would gradually reduce capacity by 50% or more on its routes to mainland China from Thursday through to the end of March, while Indonesia’s Lion Air said it was halting all its flights to and from China. Other airlines said they were reducing their China services.
Australia said on Wednesday it would help “vulnerable or isolated” citizens leave Hubei province, where Wuhan is located, and quarantine them on Christmas Island, an Australian territory in the Indian Ocean that is home to a detention centre for asylum seekers.
Britain is finalising plans to repatriate citizens from in and around Wuhan. The Department of Health has said it will quarantine those who return for 14 days, possibly at a military facility. That is a change in the line from the health secretary, Matt Hancock, who said on Monday in the House of Commons that returnees would be asked to stay at home and “self-isolate” for two weeks.
The change may come in response to protests by Britons in Wuhan, who said the advice was confusing and objected that they were being asked to make their own way back from the airport, which would mean coming into contact with many other people. Other countries are believed to be putting in quarantine measures, including Germany and France.
The European Union will fly out its citizens on two French planes this week, and South Korea was also due to evacuate. Several other countries were assessing their options.
The World Health Organization has not called for evacuation of other nationals from China. It has said it is for individual governments to decide and has suggested there may be other ways to keep them safe within China itself.
One of the Japanese evacuees, Takeo Aoyama, said he was relieved to be home. “We were feeling increasingly uneasy as the situation developed so rapidly and we were still in the city,” Aoyama, wearing a surgical mask, said at Haneda airport in Tokyo.
“We were not able to move freely, so we only had partial information. The restrictions on the flow of goods and transport were extremely strict.”
Wire agencies contributed to this report