The Pandemic Informer

TOKYO (AP) — The coronavirus has claimed its first victim in the United States as the number of cases shot up in Iran, Italy and South Korea and the spreading outbreak shook the global economy. Governments stepped up efforts to contain the disease. Saudi Arabia closed Islam’s holiest sites to foreign pilgrims. In Japan, professional baseball teams played in deserted stadiums. The French government advised the public to forgo customary greeting kisses. Ireland and Ecuador among the countries reporting their first cases Saturday. More than 85,000 people worldwide have contracted the virus, with deaths topping 2,900. China recorded 573 new virus cases and 35 more deaths in the 24 hours through midnight Saturday, according to the National Health Commission. That raised the total for the country where the disease emerged in December to 2,870 deaths and 79,834 cases. In the United States, a man in his 50s in suburban Seattle became the first coronavirus death on U.S. soil. Officials say they aren’t sure how the man acquired the virus because he had not traveled to any affected areas. “Additional cases in the United States are likely, but healthy individuals should be able to fully recover,” President Donald Trump said. Officials announced heightened warnings about travel to certain regions of Italy and South Korea as well as a ban on travel to Iran. Many cases of the virus have been relatively mild, and some of those infected are believed to show no symptoms at all. But that can allow for easier spread, and concern is mounting that prolonged quarantines, supply chain disruptions and a sharp reduction in tourism and business travel could weaken the global economy or even cause a recession. South Korea, the second hardest hit country after China, reported 376 new cases on Sunday morning, raising its total to 3,526. Most of the cases in South Korea have been reported in the southeastern city of Daegu and nearby towns. Italian authorities say the country now has more than 1,100 coronavirus cases, with 29 deaths so far. Iran is preparing for the possibility of “tens of thousands” of people getting tested for the virus as the number of confirmed cases spiked again Saturday, an official said. So far, the virus and the COVID-19 illness it causes have killed 43 people out of 593 confirmed cases in Iran.

Researchers reported the death rate may be lower than initially feared as more mild cases are counted.

A study by Chinese researchers published Friday in the New England Journal of Medicine analyzing 1,099 patients at more than 500 hospitals throughout China calculated a death rate of 1.4%, substantially lower than earlier studies that focused on patients in the central city of Wuhan, where it started and has been most severe.

Assuming there are many more cases with no or very mild symptoms, “the case fatality rate may be considerably less than 1%,” U.S. health officials wrote in an editorial in the journal.

That would make the new virus more like a severe seasonal flu than a disease similar to its genetic cousins SARS, severe acute respiratory syndrome, or MERS, Middle East respiratory syndrome.

Also Saturday, a survey of Chinese manufacturers showed activity plunged in February by a wider margin than anticipated, adding to the virus’s mounting economic toll.

The monthly purchasing managers’ index issued by the Chinese statistics agency and an industry group fell to 35.7 from January’s 50 on a 100-point scale on which numbers below 50 indicate activity contracting.

Japanese Prime Minister Shinzo Abe announced a 270 billion yen ($2.5 billion) emergency economic package to help fight the virus. Abe said at a news conference that Japan is at critical juncture to determine whether the country can keep the outbreak under control ahead of the Tokyo summer Olympics.

Abe, who earlier announced plans to close all schools for more than a month through the end of the Japanese academic year sparked public criticism, said the package includes financial support for families and their employers affected by the closures.

“Frankly speaking, this battle cannot be won solely by the efforts of the government,” Abe said. “We cannot do it without understanding and cooperation from every one of you, including medical institutions, families, companies and local governments.”

Even in isolated, sanctions-hit North Korea, leader Kim Jong Un called for stronger anti-virus efforts to guard against COVID-19, saying there will be “serious consequences” if the illness spreads to the country.

In other areas caught up in the outbreak, eerie scenes met those who ventured outside.

Streets were deserted in the city of Sapporo on Japan’s northernmost main island of Hokkaido, where a state of emergency was issued until mid-March. Tokyo Disneyland and Universal Studios Japan announced they would close, and big events were canceled, including a concert series by the K-pop group BTS.

In France, the archbishop of Paris advised parish priests not to administer communion by placing the sacramental bread in worshippers’ mouths. Instead, priests were told to place the bread in their hands. The French government cancelled large indoor events.

Saudi Arabia closed off Islam’s holiest sites in Mecca and Medina to foreign pilgrims, disrupting travel for thousands of Muslims already headed to the kingdom and potentially affecting plans later this year for millions more ahead of the fasting month of Ramadan and the annual hajj pilgrimage.

Tourist arrivals in Thailand are down 50% compared with a year ago. In Italy, which has the most reported cases of any country outside of Asia, hotel bookings are falling. Premier Giuseppe Conte raised the specter of recession.

The head of the World Health Organization on Friday announced that the risk of the virus spreading worldwide was “very high.” U.N. Secretary-General Antonio Guterres said the “window of opportunity” for containing the virus was narrowing.

Economists have forecast global growth will slip to 2.4% this year, the slowest since the Great Recession in 2009, and down from earlier expectations closer to 3%. For the United States, estimates are falling to as low as 1.7% growth this year, down from 2.3% in 2019.

Despite anxieties about a wider outbreak in the U.S., Trump has defended measures taken and lashed out at Democrats who have questioned his handling of the threat.

Trump has accused Democrats of “politicizing” the coronavirus threat and boasted about preventive steps he’s ordered in an attempt to keep the virus from spreading across the United States.

— Klepper reported from Providence, R.I. Associated Press writers Joe McDonald in Beijing, Jon Gambrell in Dubai, United Arab Emirates, John Leicester in Paris, Deb Riechmann and Darlene Superville in Washington, Adam Geller, Joseph Pisani and Edith M. Lederer in New York, Hyung-jin Kim and Tong-hyung Kim in Seoul, South Korea, Renata Brito and Giada Zampano in Venice, Italy, Frances D’Emilio in Rome, Paul Wiseman, Christopher Rugaber in Washington, Marilynn Marchione in Milwuakee and Frank Jordans in Berlin contributed to this report.

Amy Reynolds of the Washington state health department said in a brief telephone interview: “We are dealing with an emergency evolving situation.” Health officials in California, Oregon and Washington state worried about the novel coronavirus spreading through West Coast communities after confirming at least three patients were infected by unknown means. They had not visited an area where there was an outbreak, nor apparently been in contact with anyone who had. The number of coronavirus cases in the United States is considered small. Worldwide, the number of people sickened by the virus hovered Friday around 83,000, and there were more than 2,800 deaths, most of them in China. Most infections result in mild symptoms, including coughing and fever, though some can become more serious and lead to pneumonia. Older people, especially those with chronic illnesses such as heart or lung disease, are especially vulnerable. Health officials think it spreads mainly from droplets when an infected person coughs or sneezes, similar to how the flu spreads. The patients — an older Northern California woman with chronic health conditions, a high school student in Everett, Washington, and an employee at a Portland, Oregon-area school — hadn’t recently traveled overseas or had any known close contact with a traveler or an infected person, authorities said. Earlier U.S. cases include three people who were evacuated from the central China city of Wuhan, epicenter of the outbreak; 14 people who returned from China, or their spouses; and 42 American passengers on the Diamond Princess cruise ship, who were flown to U.S. military bases in California and Texas for quarantining. Convinced that the number of cases will grow but determined to keep them from exploding, health agencies were ramping up efforts to identify patients. The California Department of Public Health said Friday that the state will receive enough kits from the U.S. Centers for Disease Control to test up to 1,200 people a day for the COVID-19 virus — a day after Gov. Gavin Newsom complained to federal health officials that the state had already exhausted its initial 200 test kits. Santa Clara County in the San Francisco Bay Area reported two cases where the source of infection wasn’t known. The older woman was hospitalized for a respiratory illness, and rapid local testing confirmed in one day that she had the virus, health officials said. “This case represents some degree of community spread, some degree of circulation,” said Dr. Sara Cody, health officer for Santa Clara County and director of the County of Santa Clara Public Health Department. “But we don’t know to what extent,” Cody said. “It could be a little, it could be a lot.” “We need to begin taking important additional measures to at least slow it down as much as possible,” she said.Cody said the newly confirmed case in Santa Clara County is not linked to two previous cases in that county, nor to others in the state. The Santa Clara County resident was treated at a local hospital and is not known to have traveled to Solano County, where another woman was identified Wednesday as having contracted the virus from an unknown source. Dozens of people had close contact with the Solano County woman. They were urged to quarantine themselves at home, while a few who showed symptoms of illness were in isolation, officials said. At UC Davis Medical Center at least 124 registered nurses and other health care workers were sent home for “self-quarantine” after the Solano County woman with the virus was admitted, National Nurses United, a nationwide union representing RNs, said Friday. The case “highlights the vulnerability of the nation’s hospitals to this virus,” the union said. Earlier Friday, Oregon confirmed its first coronavirus case, a person who works at an elementary school in the Portland area, which will be temporarily closed. The Lake Oswego School District sent a robocall to parents saying that Forest Hills Elementary will be closed until Wednesday so it can be deep-cleaned by maintenance workers. Washington state health officials announced two new coronavirus cases Friday night, including a high school student who attends Jackson High School in Everett, said Dr. Chris Spitters of the Snohomish County Health District. The other case in Washington was a woman in in King County in her 50s who had recently traveled to South Korea, authorities said.

Both patients weren’t seriously ill.

But health officials aren’t taking any chances. Some communities, including San Francisco, already have declared local emergencies in case they need to obtain government funding. In Southern California’s Orange County, the city of Costa Mesa went to court to prevent state and federal health officials from transferring dozens of people exposed to the virus aboard a cruise ship in Japan to a state-owned facility in the city. The passengers, including some who tested positive for the virus and underwent hospital care, had been staying at Travis Air Force Base in Northern California. On Friday, state officials said the federal decided it no longer had a crucial need to move those people to the Fairview Developmental Center in Costa Mesa. That’s because of the imminent end of the isolation period for those passengers and the relatively small number of persons who ended up testing positive, officials said. The new coronavirus cases of unknown origin marks an escalation of the worldwide outbreak in the U.S. because it means the virus could spread beyond the reach of preventative measures like quarantines, though state health officials said that was inevitable and that the risk of widespread transmission remains low. Federal officials think the coronavirus is spread only through “close contact, being within 6 feet of somebody for what they’re calling a prolonged period of time,” said Dr. James Watt, interim state epidemiologist at the California Department of Public Health. Peter Beilenson, Sacramento County’s health services director, said he expects even those who test positive to become only mildly ill.