BEIJING - One nation after another is closing its doors to most Chinese travelers as the death toll from the novel coronavirus continues to rise with no sign that the virus can be contained before it becomes a full-blown planetary health crisis. China's increasing isolation threatens to turn this new epidemic into a geopolitical conflict, intensifying pre-existing tensions between China and the United States and having potentially significant impacts on the global economy.
At 5 p.m. Sunday, the United States put into effect stringent new travel restrictions on people coming from China. But the official edict of the Trump administration, announced Friday, led to confusion late Sunday about where, exactly, travelers from China deemed in need of quarantining would be screened and housed at or near the airports where they would be arriving.
The U.S travel restrictions came in the wake of a new report released late last week showing that the virus can be transmitted by someone who has not yet shown any symptoms of an infection. At least a dozen countries have put travel restrictions on people coming from China. That list includes some neighboring countries that have closed their border with China.
Such travel restrictions are contrary to public health recommendations and have riled Chinese government officials. The Foreign Ministry's combative spokeswoman, Hua Chunying, singled out the United States, saying the World Health Organization has said such restrictions are not necessary.
A "certain country has turned a blind eye to WHO recommendations and imposed sweeping travel restrictions against China," Hua tweeted Saturday. "This kind of overreaction could only make things even worse. It's not the right way to deal with the pandemic."
Hua said many countries have offered China support, but in contrast, "certain U.S. officials' words and actions are neither factual nor appropriate." That appeared to be a reference to U.S. Commerce Secretary Wilbur Ross, who last week said the coronavirus could "help" to bring jobs to the United States as companies moved operations away from China. Hua said these "unfriendly U.S. comments" were "certainly not a gesture of goodwill."
The coronavirus, which causes pneumonia-like symptoms, and for which there is no vaccine, was first identified in late December in the Hubei provincial capital of Wuhan. An early cluster of cases was found among people who had visited a seafood market where live animals were sold for consumption. Bats and the catlike civets have been linked to previous mutations in viruses that have jumped from animals to humans, including severe acute respiratory syndrome (SARS), which began in southern China in 2002.
The National Health Commission in China reported Sunday that there have been 17,205 confirmed cases of illness caused by the coronavirus. The WHO reported 146 confirmed cases in 23 countries outside China. The U.S. Centers for Disease Control and Prevention on Sunday confirmed an additional case in California, involving a patient who had recently returned to the United States from Wuhan. That brings the U.S. case number to nine, with no deaths.
Scientists suspect that the true number of infections may be many times higher than the official count. So far, 361 people have died, all but one in China.
The most serious illnesses appear to be in the elderly and people with pre-existing medical problems. The ratio of infections to deaths strongly suggests that this virus is not as deadly as, for example, the coronavirus that caused SARS. But it is very contagious. Unless contained soon, it could become a pandemic - a disease that becomes intercontinental, and potentially travels almost everywhere on the planet in the same manner as influenza.
The WHO on Sunday warned that the coronavirus is spreading not only disease but also rumors, myths and misinformation.
"The 2019-nCoV outbreak and response has been accompanied by a massive 'infodemic' - an over-abundance of information - some accurate and some not - that makes it hard for people to find trustworthy sources and reliable guidance when they need it," the WHO wrote.
A report published Friday in the New England Journal of Medicine documented a cluster of cases in Germany linked to a Chinese business traveler who showed no symptoms of disease when she was in Germany and only became sick when she returned home. The WHO, however, said this weekend that such transmission by an asymptomatic person is rare with coronaviruses. "Persons who are symptomatic will spread the virus more readily through coughing and sneezing," the WHO wrote.
The Trump administration announced Friday that non-U.S. citizens who had been in China recently - and not just in Wuhan or in surrounding Hubei province - will be temporarily barred from entering the United States, with a few exemptions. American citizens who had been in Hubei province in the previous 14 days would be allowed to return but would be quarantined. U.S. citizens who had been elsewhere in China would be required to self-quarantine at home and report any symptoms to health officials.
Meanwhile, the Philippines has blocked entry to travelers from China, including from Hong Kong and Macao, after a man from Wuhan died in Manila of the coronavirus, the first person outside China to succumb to the illness.
New Zealand's government announced that starting Monday, it would deny entry to foreign travelers arriving from China and order returning New Zealanders to isolate themselves for 14 days. Indonesia said it would immediately bar visitors who have been in China for 14 days, the maximum incubation period, from entering or transiting. Iraq's Interior Ministry said it would ban all foreign nationals coming from China.
With authorities slow to recognize this latest outbreak as a new virus and even slower to warn people of it, the number of infections has continued to rise rapidly, passing the total infected by SARS. The People's Liberation Army sent 1,400 medical staff members from the armed forces to Wuhan on Sunday to treat patients at the new 1,000-bed Huoshenshan Hospital, which was built in 10 days and is due to start operation Monday.
In trying to contain the outbreak, Hubei officials continue to speak in terms of an epic battle against what Chinese President Xi Jinping has called a "devil" virus.
"Cadres at all levels should truly show a wartime spirit," the Hubei state newspaper exhorted Sunday after a meeting at the provincial pneumonia prevention headquarters.
China's stock markets will reopen Monday after the Lunar New Year holiday, the first trading day since the extent of the outbreak became clear. Anticipating a sharp sell-off, China's central bank and other financial regulators said Sunday that they had prepared an emergency package totaling an astronomical $173 billion to support companies and markets during the coronavirus crisis.
Medical advice over the past two weeks has emphasized the need to wear masks to stop transmission through respiratory droplets from the mouth and nose. Rearchers from the Renmin Hospital of Wuhan University and the Wuhan Institute of Virology of the Chinese Academy of Sciences reported this weekend that there is also a danger of fecal-oral transmission. It warned medical workers to "protect themselves against vomit and feces of patients."
Anger is mounting about the lack of access to protective equipment, especially face masks. With stores and online shopping sites sold out, many cities across the country have launched an online booking system or lottery system for masks.
Basic protective items including goggles and gloves are in such short supply that Hubei hospitals have been openly appealing for donations on social media. One Wuhan doctor said his hospital had not received a single mask from the Red Cross, one of the few officially recognized organizations permitted to handle civic donations.
In a post on social media, since deleted by censors, the doctor said his hospital had only 300 N95 masks left, barely enough for a day. "Fortunately we got a batch of donations from America, 500 U.S. FDA standard N95 masks. It made us so happy because we could last one more day!"
One netizen even called the Wuhan Charity Federation and other such groups "pixiu," a mythical winged animal that eats but never defecates, accusing them of receiving more than $80 million in donations but spending none of that amount on the public. That post has also been deleted by China's zealous Internet police, who try to swiftly stamp out any criticism of the ruling Communist Party.
In apparent recognition of this growing discontent, Premier Li Keqiang, who is leading the party's efforts to control the coronavirus outbreak, went to the national hub for medical supplies in Beijing over the weekend.
Echoing the military language of the state media, Li said medical supply manufacturers were "like military contractors producing for the 'arsenal' in this battle against the epidemic."
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Achenbach reported from Washington. The Washington Post’s Alex Horton in Washington, Liu Yang in Beijing and Stefano Pitrelli in Rome contributed to this report.