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→‎Origin: the confusion here needs a sentence divide or three, expand from that as needed
→‎Spread: I think this is clearer called transmission, how one case is given to others. This is as opposed to geographic spread
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An ongoing outbreak of [[coronavirus disease 2019]] (COVID-19), caused by [[SARS-CoV-2]], started in December 2019. It was first identified in [[Wuhan]], the capital of [[Hubei]], China.<ref name=":2">{{Cite journal|title=[The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19) in China]|date=17 February 2020|pmid=32064853|author1=Novel Coronavirus Pneumonia Emergency Response Epidemiology Team|journal=Zhonghua Liu Xing Bing Xue Za Zhi = Zhonghua Liuxingbingxue Zazhi|volume=41|issue=2|pages=145–151|doi=10.3760/cma.j.issn.0254-6450.2020.02.003}}</ref> As of 25 February 2020, around 80,153 cases have been confirmed, including in all [[provinces of China]] and more than two dozen other countries.<ref>{{cite web|url=https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6|title=Coronavirus COVID-19 Global Cases|website=gisanddata.maps.arcgis.com|publisher=Johns Hopkins CSSE|url-status=live|access-date=17 February 2020}}</ref> Of these, 11,569 cases were classified as serious.<ref name="auto82">{{cite web|url=https://www.worldometers.info/coronavirus/|title=Coronavirus Update (Live):69,268 Cases and 1,665 Deaths from the Wuhan China Virus Outbreak – Worldometer|website=worldometers.info|url-status=live|access-date=8 February 2020}}</ref> There have been 2,701 deaths attributable to the disease, including 38 outside mainland China,<ref name="bno1" /> surpassing that of the 2003 [[Severe acute respiratory syndrome|SARS]] outbreak.<ref>{{cite news|url=https://www.nytimes.com/2020/02/09/world/asia/coronavirus-china.html|title=Deaths in China Surpass Toll From SARS|date=9 February 2020|work=[[The New York Times]]|url-status=live|archive-url=https://web.archive.org/web/20200209052034/https://www.nytimes.com/2020/02/09/world/asia/coronavirus-china.html|archive-date=9 February 2020|access-date=21 February 2020}}</ref> More than 27,000 people have since recovered.<ref name=bno1 />
An ongoing outbreak of [[coronavirus disease 2019]] (COVID-19), caused by [[SARS-CoV-2]], started in December 2019. It was first identified in [[Wuhan]], the capital of [[Hubei]], China.<ref name=":2">{{Cite journal|title=[The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19) in China]|date=17 February 2020|pmid=32064853|author1=Novel Coronavirus Pneumonia Emergency Response Epidemiology Team|journal=Zhonghua Liu Xing Bing Xue Za Zhi = Zhonghua Liuxingbingxue Zazhi|volume=41|issue=2|pages=145–151|doi=10.3760/cma.j.issn.0254-6450.2020.02.003}}</ref> As of 25 February 2020, around 80,153 cases have been confirmed, including in all [[provinces of China]] and more than two dozen other countries.<ref>{{cite web|url=https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6|title=Coronavirus COVID-19 Global Cases|website=gisanddata.maps.arcgis.com|publisher=Johns Hopkins CSSE|url-status=live|access-date=17 February 2020}}</ref> Of these, 11,569 cases were classified as serious.<ref name="auto82">{{cite web|url=https://www.worldometers.info/coronavirus/|title=Coronavirus Update (Live):69,268 Cases and 1,665 Deaths from the Wuhan China Virus Outbreak – Worldometer|website=worldometers.info|url-status=live|access-date=8 February 2020}}</ref> There have been 2,701 deaths attributable to the disease, including 38 outside mainland China,<ref name="bno1" /> surpassing that of the 2003 [[Severe acute respiratory syndrome|SARS]] outbreak.<ref>{{cite news|url=https://www.nytimes.com/2020/02/09/world/asia/coronavirus-china.html|title=Deaths in China Surpass Toll From SARS|date=9 February 2020|work=[[The New York Times]]|url-status=live|archive-url=https://web.archive.org/web/20200209052034/https://www.nytimes.com/2020/02/09/world/asia/coronavirus-china.html|archive-date=9 February 2020|access-date=21 February 2020}}</ref> More than 27,000 people have since recovered.<ref name=bno1 />


Infection is primarily through human-to-human transmission via respiratory droplets that people exhale (such as sneeze or [[coughing|cough]]). The incubation period is typically two to fourteen days.Symptoms may include [[fever]], [[cough]], and [[shortness of breath]]. Complications may include [[pneumonia]] and [[acute respiratory distress syndrome]]. There are no vaccines or specific [[antiviral treatment|antiviral treatments]], with efforts typically aiming at managing symptoms and [[supportive therapy]]. Anyone who is suspected of carrying the virus is advised to monitor their health for two weeks, wear a [[surgical mask]] to limit the spread, and seek medical advice by calling a doctor before visiting a clinic.<ref name=":8" /><ref name=WHO2020QA>{{Citeweb|url=https://www.who.int/news-room/q-a-detail/q-a-coronaviruses|title=Q&A on coronaviruses|website=[[World Health Organization]] (WHO)|date=11 February 2020|access-date=24 February 2020}}</ref>
Infection is primarily through human-to-human transmission via respiratory droplets that people exhale (such as sneeze or [[coughing|cough]]). The incubation period is typically two to fourteen days. Symptoms may include [[fever]], [[cough]], and [[shortness of breath]]. Complications may include [[pneumonia]] and [[acute respiratory distress syndrome]]. There are no vaccines or specific [[antiviral treatment|antiviral treatments]], with efforts typically aiming at managing symptoms and [[supportive therapy]]. Anyone who is suspected of carrying the virus is advised to monitor their health for two weeks, wear a [[surgical mask]] to limit the spread, and seek medical advice by calling a doctor before visiting a clinic.<ref name=":8" /><ref name=WHO2020QA>{{Citeweb|url=https://www.who.int/news-room/q-a-detail/q-a-coronaviruses|title=Q&A on coronaviruses|website=[[World Health Organization]] (WHO)|date=11 February 2020|access-date=24 February 2020}}</ref>


A large response, both in China and globally, followed an increase in cases in mid-January 2020, bringing [[2020 Hubei lockdowns|travel restrictions]], [[quarantine]]s, and curfews. Examples include the quarantine of the British cruise ship ''[[Diamond Princess (ship)|Diamond Princess]]'' in Japanese waters, the curfew of over 780 million in China, a voluntary curfew in [[Daegu]], South Korea, and the curfew of a dozen towns with over 50,000 people in the [[Lombardy]] and [[Veneto]] regions of Italy.<ref name="SCMP 20200206">{{cite web|url=https://www.scmp.com/news/china/society/article/3049298/coronavirus-zhejiang-adopts-draconian-quarantine-measures-fight|title=Zhejiang province next to Shanghai adopts draconian quarantine measures|date=6 February 2020|website=South China Morning Post|url-status=live|archive-url=https://web.archive.org/web/20200206112642/https://www.scmp.com/news/china/society/article/3049298/coronavirus-zhejiang-adopts-draconian-quarantine-measures-fight|archive-date=6 February 2020|access-date=8 February 2020}}</ref><ref>{{Cite news|last=Marsh|first=Sarah|url=https://www.theguardian.com/world/live/2020/feb/23/coronavirus-outbreak-woman-tests-positive-after-disembarking-diamond-princess-live-news|title=Coronavirus outbreak: four cruise ship passengers test positive in UK – live news|date=23 February 2020|work=[[The Guardian]]|access-date=23 February 2020|issn=0261-3077}}</ref><ref>{{Cite web | url=https://www.cnn.co.jp/world/35149546.html |script-title=ja:新型肺炎流行の中国、7億8000万人に「移動制限」 |work=CNN Japan |language=ja}}</ref> The outbreak has been declared a [[Public Health Emergency of International Concern]] (PHEIC) by the [[World Health Organization]] (WHO).<ref name=":3" /><ref name="The Hill 20200130">{{cite web|url=https://thehill.com/changing-america/respect/diversity-inclusion/480749-the-coronavirus-is-causing-an-outbreak-in-anti|title=The coronavirus is causing an outbreak in America—of anti-Asian racism|last=Somvichian-Clausen|first=Austa|date=30 January 2020|website=[[The Hill (newspaper)|The Hill]]|url-status=live|archive-url=https://web.archive.org/web/20200201181522/https://thehill.com/changing-america/respect/diversity-inclusion/480749-the-coronavirus-is-causing-an-outbreak-in-anti|archive-date=1 February 2020|access-date=4 February 2020}}</ref> Airports and train stations have implemented [[Human body temperature|body temperature]] checks, health declarations, and information signage in an attempt to identify carriers of the virus.<ref>{{cite web|url=https://knpr.org/npr/2020-01/coronavirus-update-masks-and-temperature-checks-hong-kong|title=Coronavirus Update: Masks And Temperature Checks In Hong Kong|website=Nevada Public Radio|access-date=26 January 2020}}</ref> A number of countries have issued warnings against travel to Wuhan, Hubei, or China generally.<ref name="CDC Travel">{{cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html|title=Coronavirus Disease 2019 Information for Travel |date=3 February 2020|website=U.S. [[Centers for Disease Control and Prevention]] (CDC)|url-status=live|archive-url=https://web.archive.org/web/20200130163513/https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html|archive-date=30 January 2020|access-date=6 February 2020}}</ref><ref name=":6">{{cite news|url=https://www.usatoday.com/story/travel/news/2020/01/24/coronavirus-outbreak-leads-state-department-issue-level-4-advisory/4562349002/|title=Coronavirus: US says 'do not travel' to Wuhan, China, as airlines issue waivers, add safeguards|last=Deerwester|first=Jayme|last2=Gilbertson|first2=Dawn|website=USA Today|url-status=live|archive-url=https://web.archive.org/web/20200127063342/https://www.usatoday.com/story/travel/news/2020/01/24/coronavirus-outbreak-leads-state-department-issue-level-4-advisory/4562349002/|archive-date=27 January 2020|access-date=26 January 2020}}</ref>
A large response, both in China and globally, followed an increase in cases in mid-January 2020, bringing [[2020 Hubei lockdowns|travel restrictions]], [[quarantine]]s, and curfews. Examples include the quarantine of the British cruise ship ''[[Diamond Princess (ship)|Diamond Princess]]'' in Japanese waters, the curfew of over 780 million in China, a voluntary curfew in [[Daegu]], South Korea, and the curfew of a dozen towns with over 50,000 people in the [[Lombardy]] and [[Veneto]] regions of Italy.<ref name="SCMP 20200206">{{cite web|url=https://www.scmp.com/news/china/society/article/3049298/coronavirus-zhejiang-adopts-draconian-quarantine-measures-fight|title=Zhejiang province next to Shanghai adopts draconian quarantine measures|date=6 February 2020|website=South China Morning Post|url-status=live|archive-url=https://web.archive.org/web/20200206112642/https://www.scmp.com/news/china/society/article/3049298/coronavirus-zhejiang-adopts-draconian-quarantine-measures-fight|archive-date=6 February 2020|access-date=8 February 2020}}</ref><ref>{{Cite news|last=Marsh|first=Sarah|url=https://www.theguardian.com/world/live/2020/feb/23/coronavirus-outbreak-woman-tests-positive-after-disembarking-diamond-princess-live-news|title=Coronavirus outbreak: four cruise ship passengers test positive in UK – live news|date=23 February 2020|work=[[The Guardian]]|access-date=23 February 2020|issn=0261-3077}}</ref><ref>{{Cite web | url=https://www.cnn.co.jp/world/35149546.html |script-title=ja:新型肺炎流行の中国、7億8000万人に「移動制限」 |work=CNN Japan |language=ja}}</ref> The outbreak has been declared a [[Public Health Emergency of International Concern]] (PHEIC) by the [[World Health Organization]] (WHO).<ref name=":3" /><ref name="The Hill 20200130">{{cite web|url=https://thehill.com/changing-america/respect/diversity-inclusion/480749-the-coronavirus-is-causing-an-outbreak-in-anti|title=The coronavirus is causing an outbreak in America—of anti-Asian racism|last=Somvichian-Clausen|first=Austa|date=30 January 2020|website=[[The Hill (newspaper)|The Hill]]|url-status=live|archive-url=https://web.archive.org/web/20200201181522/https://thehill.com/changing-america/respect/diversity-inclusion/480749-the-coronavirus-is-causing-an-outbreak-in-anti|archive-date=1 February 2020|access-date=4 February 2020}}</ref> Airports and train stations have implemented [[Human body temperature|body temperature]] checks, health declarations, and information signage in an attempt to identify carriers of the virus.<ref>{{cite web|url=https://knpr.org/npr/2020-01/coronavirus-update-masks-and-temperature-checks-hong-kong|title=Coronavirus Update: Masks And Temperature Checks In Hong Kong|website=Nevada Public Radio|access-date=26 January 2020}}</ref> A number of countries have issued warnings against travel to Wuhan, Hubei, or China generally.<ref name="CDC Travel">{{cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html|title=Coronavirus Disease 2019 Information for Travel |date=3 February 2020|website=U.S. [[Centers for Disease Control and Prevention]] (CDC)|url-status=live|archive-url=https://web.archive.org/web/20200130163513/https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html|archive-date=30 January 2020|access-date=6 February 2020}}</ref><ref name=":6">{{cite news|url=https://www.usatoday.com/story/travel/news/2020/01/24/coronavirus-outbreak-leads-state-department-issue-level-4-advisory/4562349002/|title=Coronavirus: US says 'do not travel' to Wuhan, China, as airlines issue waivers, add safeguards|last=Deerwester|first=Jayme|last2=Gilbertson|first2=Dawn|website=USA Today|url-status=live|archive-url=https://web.archive.org/web/20200127063342/https://www.usatoday.com/story/travel/news/2020/01/24/coronavirus-outbreak-leads-state-department-issue-level-4-advisory/4562349002/|archive-date=27 January 2020|access-date=26 January 2020}}</ref>
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==Origin==
==Origin==
In late December, a cluster of pneumonia cases of unknown aetiology was reported by health authorities in Wuhan, Hubei Province, People's Republic of China. The initial cases mostly had epidemiological links to the [[Huanan Seafood Wholesale Market]] and consequently the virus is thought to have a zoonotic origin.<ref name=":2" /> The China '''CDC''' reported in early January that the causative agent was a novel coronavirus (now called SARS-CoV-2), which is closely related to bat coronaviruses, [[pangolin]] coronaviruses and SARS-CoV-1. Evidence shows that the transmissibility of the coronavirus is sufficient for sustained community transmission. Locally acquired cases have been reported in several countries. Most deaths have so far been in China.<ref name=":14">{{Cite web|url=http://www.ecdc.europa.eu/sites/default/files/documents/SARS-CoV-2-risk-assessment-14-february-2020.pdf.pdf|title=European Center for Disease Control|website=|url-status=live}}</ref>
In late December, a cluster of pneumonia cases of unknown aetiology was reported by health authorities in Wuhan, Hubei Province, People's Republic of China. The initial cases mostly had epidemiological links to the [[Huanan Seafood Wholesale Market]] and consequently the virus is thought to have a zoonotic origin.<ref name=":2" /> The virus that caused the outbreak is known as SARS-CoV-2, a new virus which is closely related to bat coronaviruses, [[pangolin]] coronaviruses and SARS-CoV-1.<ref name=":14">{{Cite web|url=http://www.ecdc.europa.eu/sites/default/files/documents/SARS-CoV-2-risk-assessment-14-february-2020.pdf.pdf|title=European Center for Disease Control|website=|url-status=live}}</ref>

The earliest reported symptoms occurred on 1 December 2019, in a person who had not had any exposure to the [[Huanan Seafood Wholesale Market]] or to the remaining 40 of the first cluster detected with the new virus.<ref name="Huang24Jan2020">{{Cite journal|display-authors=3|vauthors=Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B|date=February 2020|title=Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China|journal=Lancet|volume=395|issue=10223|pages=497–506|doi=10.1016/S0140-6736(20)30183-5|issn=0140-6736|pmid=31986264}} {{free access}}</ref><ref name="Wang24Jan2020">{{Cite journal|last=Wang|first=Chen|last2=Horby|first2=Peter W.|last3=Hayden|first3=Frederick G.|last4=Gao|first4=George F.|date=24 January 2020|title=A novel coronavirus outbreak of global health concern|url=https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30185-9/abstract|journal=The Lancet|volume=395|issue=10223|pages=470–473|doi=10.1016/S0140-6736(20)30185-9|issn=0140-6736|pmid=31986257}} {{free access}}</ref> Of this first cluster, two-thirds were found to have a link with the market, which also sold live animals.<ref name="Huang24Jan2020" /><ref name="Joseph24Jan2020">{{Cite news|last=Joseph|first=Andrew|url=https://www.statnews.com/2020/01/24/coronavirus-infections-no-symptoms-lancet-studies/|title=New coronavirus can cause infections with no symptoms and sicken otherwise healthy people, studies show|date=24 January 2020|work=STAT|access-date=27 January 2020|url-status=live|archive-url=https://web.archive.org/web/20200124204338/https://www.statnews.com/2020/01/24/coronavirus-infections-no-symptoms-lancet-studies/|archive-date=24 January 2020}}</ref><ref name="han24Jan2020">{{Cite journal|last=Chan|first=Jasper Fuk-Woo|last2=Yuan|first2=Shuofeng|last3=Kok|first3=Kin-Hang|last4=To|first4=Kelvin Kai-Wang|last5=Chu|first5=Hin|last6=Yang|first6=Jin|last7=Xing|first7=Fanfan|last8=Liu|first8=Jieling|last9=Yip|first9=Cyril Chik-Yan|last10=Poon|first10=Rosana Wing-Shan|last11=Tsoi|first11=Hoi-Wah|date=24 January 2020|title=A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster|journal=The Lancet|volume=0|issue=10223|pages=514–523|doi=10.1016/S0140-6736(20)30154-9|issn=0140-6736|pmid=31986261}} {{free access}}</ref><ref name="Schnirring25Jan2020">{{cite web|url=http://www.cidrap.umn.edu/news-perspective/2020/01/doubts-rise-about-chinas-ability-contain-new-coronavirus|title=Doubts rise about China's ability to contain new coronavirus|last=Schnirring|first=Lisa|date=25 January 2020|website=CIDRAP|url-status=live|archive-url=https://web.archive.org/web/20200126102242/http://www.cidrap.umn.edu/news-perspective/2020/01/doubts-rise-about-chinas-ability-contain-new-coronavirus|archive-date=26 January 2020|access-date=26 January 2020}}</ref>


== Epidemiology ==
== Epidemiology ==
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{{2019–20 coronavirus outbreak data}}
{{2019–20 coronavirus outbreak data}}
{{2019–20 coronavirus outbreak data/China medical cases chart}}
{{2019–20 coronavirus outbreak data/China medical cases chart}}
[[Epidemic curve|Epidemiological analysis]] of the outbreak has shown a probable pattern of a "mixed outbreak" – there was likely a continuous common source outbreak at the seafood market in December 2019, potentially from several [[zoonotic]] events.<ref name=":2" /> Following this, the epidemiologists found that the outbreak likely became a propagated source (transmitted from person to person), potentially due to the virus' ability to mutate.<ref name=":2" /> The earliest reported symptoms occurred on 1 December 2019, in a person who had not had any exposure to the [[Huanan Seafood Wholesale Market]] or to the remaining 40 of the first cluster detected with the new virus.<ref name="Huang24Jan2020">{{Cite journal|vauthors=Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B | display-authors=3 |date=February 2020|title=Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China|journal=Lancet|volume=395|issue=10223|pages=497–506|doi=10.1016/S0140-6736(20)30183-5|issn=0140-6736|pmid=31986264}} {{free access}}</ref><ref name="Wang24Jan2020">{{Cite journal|last=Wang|first=Chen|last2=Horby|first2=Peter W.|last3=Hayden|first3=Frederick G.|last4=Gao|first4=George F.|date=24 January 2020|title=A novel coronavirus outbreak of global health concern|url=https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30185-9/abstract|journal=The Lancet|volume=395|issue=10223|pages=470–473|doi=10.1016/S0140-6736(20)30185-9|issn=0140-6736|pmid=31986257}} {{free access}}</ref> Of this first cluster, two-thirds were found to have a link with the market, which also sold live animals.<ref name="Huang24Jan2020" /><ref name="Joseph24Jan2020">{{Cite news|last=Joseph|first=Andrew|url=https://www.statnews.com/2020/01/24/coronavirus-infections-no-symptoms-lancet-studies/|title=New coronavirus can cause infections with no symptoms and sicken otherwise healthy people, studies show|date=24 January 2020|work=STAT|access-date=27 January 2020|url-status=live|archive-url=https://web.archive.org/web/20200124204338/https://www.statnews.com/2020/01/24/coronavirus-infections-no-symptoms-lancet-studies/|archive-date=24 January 2020}}</ref><ref name="han24Jan2020">{{Cite journal|last=Chan|first=Jasper Fuk-Woo|last2=Yuan|first2=Shuofeng|last3=Kok|first3=Kin-Hang|last4=To|first4=Kelvin Kai-Wang|last5=Chu|first5=Hin|last6=Yang|first6=Jin|last7=Xing|first7=Fanfan|last8=Liu|first8=Jieling|last9=Yip|first9=Cyril Chik-Yan|last10=Poon|first10=Rosana Wing-Shan|last11=Tsoi|first11=Hoi-Wah|date=24 January 2020|title=A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster|journal=The Lancet|volume=0|issue=10223|pages=514–523|doi=10.1016/S0140-6736(20)30154-9|issn=0140-6736|pmid=31986261}} {{free access}}</ref><ref name="Schnirring25Jan2020">{{cite web|url=http://www.cidrap.umn.edu/news-perspective/2020/01/doubts-rise-about-chinas-ability-contain-new-coronavirus|title=Doubts rise about China's ability to contain new coronavirus|last=Schnirring|first=Lisa|date=25 January 2020|website=CIDRAP|url-status=live|archive-url=https://web.archive.org/web/20200126102242/http://www.cidrap.umn.edu/news-perspective/2020/01/doubts-rise-about-chinas-ability-contain-new-coronavirus|archive-date=26 January 2020|access-date=26 January 2020}}</ref> Of cases that began before 1 January 2020, 55% were linked to the market. By 22 January this figure was reported to have dropped to 8.6%.<ref name="Qun29Jan2020">{{Cite journal|last=Li|first=Qun|last2=Guan|first2=Xuhua|last3=Wu|first3=Peng|last4=Wang|first4=Xiaoye|last5=Zhou|first5=Lei|last6=Tong|first6=Yeqing|last7=Ren|first7=Ruiqi|last8=Leung|first8=Kathy S. M.|last9=Lau|first9=Eric H. Y.|last10=Wong|first10=Jessica Y.|last11=Xing|first11=Xuesen|date=29 January 2020|title=Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia|journal=The New England Journal of Medicine|doi=10.1056/NEJMoa2001316|issn=1533-4406|pmid=31995857}} {{free access}}</ref> Hence, as the number of cases has increased, the significance of the market has lessened.<ref name="Huang24Jan2020" /><ref name="Wang24Jan2020" /><ref name=Qun29Jan2020/>
[[Epidemic curve|Epidemiological analysis]] of the outbreak has shown a probable pattern of a "mixed outbreak" – there was likely a continuous common source outbreak at the seafood market in December 2019, potentially from several [[zoonotic]] events.<ref name=":2" /> Following this, the epidemiologists found that the outbreak likely became a propagated source (transmitted from person to person), potentially due to the virus' ability to mutate.<ref name=":2" /> Hence, as the number of cases has increased, the significance of the market has lessened.<ref name="Huang24Jan2020" /><ref name="Wang24Jan2020" /><ref name="Qun29Jan2020">{{Cite journal|last=Li|first=Qun|last2=Guan|first2=Xuhua|last3=Wu|first3=Peng|last4=Wang|first4=Xiaoye|last5=Zhou|first5=Lei|last6=Tong|first6=Yeqing|last7=Ren|first7=Ruiqi|last8=Leung|first8=Kathy S. M.|last9=Lau|first9=Eric H. Y.|last10=Wong|first10=Jessica Y.|last11=Xing|first11=Xuesen|date=29 January 2020|title=Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia|journal=The New England Journal of Medicine|doi=10.1056/NEJMoa2001316|issn=1533-4406|pmid=31995857}} {{free access}}</ref>


During the early stages, the number of cases doubled approximately every seven and a half days.<ref name=Qun29Jan2020/> In early and mid-January 2020, the virus spread to other [[Provinces of China|Chinese provinces]], helped by the [[Chunyun|Chinese new year migration]]. On 20 January, China reported nearly 140 new patients in a day, including two people in Beijing and one in [[Shenzhen]].<ref name="france2420200120">{{Cite news |url=https://www.france24.com/en/20200120-china-confirms-sharp-rise-in-cases-of-sars-like-virus-across-the-country |title=China confirms sharp rise in cases of SARS-like virus across the country |date=20 January 2020 |access-date=20 January 2020 |url-status=live |archive-url=https://web.archive.org/web/20200120055618/https://www.france24.com/en/20200120-china-confirms-sharp-rise-in-cases-of-sars-like-virus-across-the-country |archive-date=20 January 2020}}</ref> Later official data shows that 6,174 SARS-CoV-2-infected patients had already developed symptoms by 20 January 2020.<ref>{{Cite web|url=http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9a9b-fea8db1a8f51|title=The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19) — China, 2020}}</ref>
During the early stages, the number of cases doubled approximately every seven and a half days.<ref name="Qun29Jan2020" /> In early and mid-January 2020, the virus spread to other [[Provinces of China|Chinese provinces]], helped by the [[Chunyun|Chinese new year migration]]. On 20 January, China reported nearly 140 new patients in a day, including two people in Beijing and one in [[Shenzhen]].<ref name="france2420200120">{{Cite news|url=https://www.france24.com/en/20200120-china-confirms-sharp-rise-in-cases-of-sars-like-virus-across-the-country|title=China confirms sharp rise in cases of SARS-like virus across the country|date=20 January 2020|access-date=20 January 2020|url-status=live|archive-url=https://web.archive.org/web/20200120055618/https://www.france24.com/en/20200120-china-confirms-sharp-rise-in-cases-of-sars-like-virus-across-the-country|archive-date=20 January 2020}}</ref> Later official data shows that 6,174 SARS-CoV-2-infected patients had already developed symptoms by 20 January 2020.<ref>{{Cite web|url=http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9a9b-fea8db1a8f51|title=The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19) — China, 2020}}</ref>


The virus was soon carried to other countries by [[international travel]]lers: Thailand (13 January); Japan (15 January); Macau (19 January);<ref>{{cite web |url=https://www.gov.mo/en/news/122165/ |title=Macao sparing no effort to prevent the spread locally of a new coronavirus |publisher=Government Information Bureau |url-status=live |archive-url=https://web.archive.org/web/20200205204527/https://www.gov.mo/en/news/122165/ |archive-date=5 February 2020 |access-date=14 February 2020}}</ref> South Korea (20 January); Taiwan and the United States (21 January); Hong Kong (22 January); Singapore (23 January); France, Nepal, and Vietnam (24 January); Australia and Malaysia (25 January); Canada (26 January); Cambodia (27 January); Germany (28 January); Finland, Sri Lanka, and the United Arab Emirates (29 January); India, Italy, and the Philippines (30 January); the United Kingdom, Russia, Sweden, and Spain (31 January); Belgium (4 February); Egypt (14 February); Iran (19 February); Israel and Lebanon (21 February); Afghanistan, Bahrain, Kuwait, Iraq, and Oman (24 February).<ref name="auto2" /><ref name="APviruswhere" />
The virus was soon carried to other countries by [[international travel]]lers: Thailand (13 January); Japan (15 January); Macau (19 January);<ref>{{cite web|url=https://www.gov.mo/en/news/122165/|title=Macao sparing no effort to prevent the spread locally of a new coronavirus|publisher=Government Information Bureau|url-status=live|archive-url=https://web.archive.org/web/20200205204527/https://www.gov.mo/en/news/122165/|archive-date=5 February 2020|access-date=14 February 2020}}</ref> South Korea (20 January); Taiwan and the United States (21 January); Hong Kong (22 January); Singapore (23 January); France, Nepal, and Vietnam (24 January); Australia and Malaysia (25 January); Canada (26 January); Cambodia (27 January); Germany (28 January); Finland, Sri Lanka, and the United Arab Emirates (29 January); India, Italy, and the Philippines (30 January); the United Kingdom, Russia, Sweden, and Spain (31 January); Belgium (4 February); Egypt (14 February); Iran (19 February); Israel and Lebanon (21 February); Afghanistan, Bahrain, Kuwait, Iraq, and Oman (24 February).<ref name="auto2">{{Cite news|last=Frejdeman|first=Hannah|url=https://www.svd.se/bekraftat-fall-i-jonkoping-av-nya-coronaviruset|title=Coronaviruset har upptäckts i Jönköping|date=31 January 2020|work=Svenska Dagbladet|access-date=31 January 2020|url-status=live|archive-url=https://web.archive.org/web/20200131163041/https://www.svd.se/bekraftat-fall-i-jonkoping-av-nya-coronaviruset|archive-date=31 January 2020|language=Swedish|issn=1101-2412}}</ref><ref name="APviruswhere">{{cite news|last=Holm|first=Phil|url=https://apnews.com/VirusOutbreak|title=Where the virus has spread|access-date=29 January 2020|url-status=live|archive-url=https://web.archive.org/web/20200130191856/https://apnews.com/VirusOutbreak|archive-date=30 January 2020|agency=Associated Press|last2=Moritsugu|first2=Ken}}</ref>


By 25 January, the number of laboratory-confirmed cases had stood at 2,062, including 2,016 in Mainland China, seven in Thailand, six in Hong Kong, five in Macau, five in Australia, four in Malaysia, four in Singapore, three in France, three in Japan, three in South Korea, three in Taiwan, three in the United States, two in Vietnam, one in Nepal, and one in Sweden.<ref name="auto2">{{Cite news |last=Frejdeman |first=Hannah |url=https://www.svd.se/bekraftat-fall-i-jonkoping-av-nya-coronaviruset |title=Coronaviruset har upptäckts i Jönköping |date=31 January 2020 |work=Svenska Dagbladet |access-date=31 January 2020 |language=Swedish |issn=1101-2412 |archive-url=https://web.archive.org/web/20200131163041/https://www.svd.se/bekraftat-fall-i-jonkoping-av-nya-coronaviruset |archive-date=31 January 2020 |url-status=live}}</ref><ref name="aljazeera2001250709">{{cite web |url=https://www.aljazeera.com/amp/news/2020/01/countries-confirmed-cases-coronavirus-200125070959786.html |title=Which countries have confirmed cases of new coronavirus? |publisher=Al Jazeera |url-status=live |archive-url=https://web.archive.org/web/20200127035129/https://www.aljazeera.com/amp/news/2020/01/countries-confirmed-cases-coronavirus-200125070959786.html |archive-date=27 January 2020 |access-date=26 January 2020}}</ref><ref name="scmp3047663">{{Cite news |url=https://www.scmp.com/news/asia/southeast-asia/article/3047663/china-coronavirus-singapore-and-malaysia-both-report |title=Singapore, Malaysia both report fourth confirmed coronavirus cases |date=26 January 2020 |access-date=26 January 2020 |url-status=live |archive-url=https://web.archive.org/web/20200125235133/https://www.scmp.com/news/asia/southeast-asia/article/3047663/china-coronavirus-singapore-and-malaysia-both-report |archive-date=25 January 2020 |website=South China Morning Post}}</ref>
By 25 January, the number of laboratory-confirmed cases had stood at 2,062, including 2,016 in Mainland China, seven in Thailand, six in Hong Kong, five in Macau, five in Australia, four in Malaysia, four in Singapore, three in France, three in Japan, three in South Korea, three in Taiwan, three in the United States, two in Vietnam, one in Nepal, and one in Sweden.<ref name="auto2" /><ref name="aljazeera2001250709">{{cite web|url=https://www.aljazeera.com/amp/news/2020/01/countries-confirmed-cases-coronavirus-200125070959786.html|title=Which countries have confirmed cases of new coronavirus?|publisher=Al Jazeera|url-status=live|archive-url=https://web.archive.org/web/20200127035129/https://www.aljazeera.com/amp/news/2020/01/countries-confirmed-cases-coronavirus-200125070959786.html|archive-date=27 January 2020|access-date=26 January 2020}}</ref><ref name="scmp3047663">{{Cite news|url=https://www.scmp.com/news/asia/southeast-asia/article/3047663/china-coronavirus-singapore-and-malaysia-both-report|title=Singapore, Malaysia both report fourth confirmed coronavirus cases|date=26 January 2020|access-date=26 January 2020|url-status=live|archive-url=https://web.archive.org/web/20200125235133/https://www.scmp.com/news/asia/southeast-asia/article/3047663/china-coronavirus-singapore-and-malaysia-both-report|archive-date=25 January 2020|website=South China Morning Post}}</ref>


Citing 7,711 cases essentially in China and 83 cases abroad across 18 countries as of 29 January, WHO declared the outbreak to be a [[Public Health Emergency of International Concern]] on 30 January.<ref name="WHO_PHEIC_decl2" /> As of 25 February, 80,153 cases have been confirmed worldwide, over 96.9% in mainland China.<ref name="APviruswhere">{{cite news |last=Holm |first=Phil |url=https://apnews.com/VirusOutbreak |title=Where the virus has spread |access-date=29 January 2020 |url-status=live |archive-url=https://web.archive.org/web/20200130191856/https://apnews.com/VirusOutbreak |archive-date=30 January 2020 |agency=Associated Press |last2=Moritsugu |first2=Ken}}</ref>
Citing 7,711 cases essentially in China and 83 cases abroad across 18 countries as of 29 January, WHO declared the outbreak to be a [[Public Health Emergency of International Concern]] on 30 January.<ref name="WHO_PHEIC_decl2" /> As of 25 February, 80,153 cases have been confirmed worldwide, over 96.9% in mainland China.<ref name="APviruswhere" />


On 6 February 2020, the Chinese [[National Health Commission]] (NHC) started to change how cases were reported [[asymptomatic]] carriers, who tested positive for the virus but did not show clinical symptoms, would no longer be included in the number of confirmed cases. This had the effect of reducing the total number of cases reported, but also meant that potentially contagious individuals were ignored in reports.<ref name="asymptomatic">{{cite news|title=China changes counting scheme to lower Wuhan virus numbers|url=https://www.taiwannews.com.tw/en/news/3874490|newspaper=Taiwan News|date=11 February 2020|access-date=11 February 2020}}</ref><ref>{{Cite news|url=https://www.nytimes.com/2020/02/12/world/asia/china-coronavirus-cases.html|website=[[The New York Times]]|title=How Many Coronavirus Cases in China? Officials Tweak the Answer|first=Vivian |last=Wang | date=12 February 2020 | access-date=12 February 2020}}</ref>
On 12 February 2020, the Hubei government adopted a broader definition of confirmed cases, which now includes [[Medical diagnosis#Related concepts|clinically diagnosed]] patients diagnosed by their symptoms and [[CT scans]] but without [[nucleic acid test]], which can take days to process and delay treatment. "Using CT scans that reveal lung infection would help patients receive treatment as soon as possible and improve their chances of recovery," the provincial health commission said.<ref>{{Cite news|url=https://www.abc.net.au/news/2020-02-13/coronavirus-chinas-hubei-province-reports-242-new-deaths/11961602|title=China's Hubei province reports 242 new coronavirus deaths and 14,840 new cases|date=13 February 2020|access-date=13 February 2020|publisher=ABC News}}</ref> This new methodology accounts for the sharp increase in Hubei's daily confirmed cases: 13,332 of the 14,840 newly confirmed cases in the province on 12 February were diagnosed clinically under the new definition.<ref>{{Cite news|url=https://www.bbc.com/news/world-asia-china-51482994|title=Coronavirus: Sharp increase in coronavrius deaths and cases in Hubei|date=13 February 2020|access-date=13 February 2020|publisher=[[BBC News Online]]}}</ref>


On 12 February 2020, the Hubei government adopted a broader definition of confirmed cases, which now includes [[Medical diagnosis#Related concepts|clinically diagnosed]] patients diagnosed by their symptoms and [[CT scans]] but without [[nucleic acid test]], which can take days to process and delay treatment. "Using CT scans that reveal lung infection would help patients receive treatment as soon as possible and improve their chances of recovery," the provincial health commission said.<ref>{{Cite news|url=https://www.abc.net.au/news/2020-02-13/coronavirus-chinas-hubei-province-reports-242-new-deaths/11961602|publisher=ABC News|title=China's Hubei province reports 242 new coronavirus deaths and 14,840 new cases|date=13 February 2020|access-date=13 February 2020}}</ref> This new methodology accounts for the sharp increase in Hubei's daily confirmed cases: 13,332 of the 14,840 newly confirmed cases in the province on 12 February were diagnosed clinically under the new definition.<ref>{{Cite news|url=https://www.bbc.com/news/world-asia-china-51482994|publisher=[[BBC News Online]]|title=Coronavirus: Sharp increase in coronavrius deaths and cases in Hubei|date=13 February 2020|access-date=13 February 2020}}</ref>
On 20 February, the Chinese [[National Health Commission]] (NHC) changed how cases are counted again by counting only cases showing positive results through laboratory tests. The change is done as the backlog of patients who needed to be treated has since cleared.<ref>{{cite web|url=https://www.channelnewsasia.com/news/asia/coronavirus-covid19-china-changed-method-counting-infected-12455084|title=China changes method of counting COVID-19 patients again|date=20 February 2020|website=CNA|access-date=20 February 2020}}</ref> Other sources interpreted the new NHC guidelines as cancelling the previous change in how Hubei (alone) was counting confirmed cases without laboratory tests, and said NHC now distinguished counting of confirmed cases from suspected cases, requiring RT-PCR or gene sequencing for confirmation of infection, whereas suspicion of infection is based on two levels of epidemiological history and clinical symptoms.<ref>{{cite web|url=https://myemail.constantcontact.com/COVID-19-Updates---Feb-19.html?soid=1107826135286&aid=LRRozAzFNPQ|title=New Case Definitions, Therapeutics, Discharge Criteria From China|date=19 February 2020|publisher=Johns Hopkins Center for Health Security|access-date=23 February 2020|quote=Daily updates on the emerging novel coronavirus from the Johns Hopkins Center for Health Security. ... Additional resources are now available on our website.}}</ref>



On 20 February, the Chinese [[National Health Commission]] (NHC) changed how cases are counted again by counting only cases showing positive results through laboratory tests. The change is done as the backlog of patients who needed to be treated has since cleared.<ref>{{cite web |url=https://www.channelnewsasia.com/news/asia/coronavirus-covid19-china-changed-method-counting-infected-12455084 |title=China changes method of counting COVID-19 patients again |date=20 February 2020 |website=CNA |access-date=20 February 2020}}</ref> Other sources interpreted the new NHC guidelines as cancelling the previous change in how Hubei (alone) was counting confirmed cases without laboratory tests, and said NHC now distinguished counting of confirmed cases from suspected cases, requiring RT-PCR or gene sequencing for confirmation of infection, whereas suspicion of infection is based on two levels of epidemiological history and clinical symptoms.<ref>{{cite web |title=New Case Definitions, Therapeutics, Discharge Criteria From China |url=https://myemail.constantcontact.com/COVID-19-Updates---Feb-19.html?soid=1107826135286&aid=LRRozAzFNPQ |publisher=Johns Hopkins Center for Health Security |access-date=23 February 2020 |date=19 February 2020 |quote=Daily updates on the emerging novel coronavirus from the Johns Hopkins Center for Health Security. ... Additional resources are now available on our website.}}</ref>

<br />


=== Deaths ===
=== Deaths ===
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Case and death counts in China are influenced by changes in [[clinical case definition]].<ref>{{cite web|url=https://www.npr.org/2020/02/13/805566551/officials-report-huge-jump-in-coronavirus-cases-in-1-chinese-province|title=Officials Report Huge Jump in Coronavirus Cases in 1 Chinese Province|publisher=NPR|url-status=live|access-date=20 February 2020}}</ref><ref>{{cite news|url=https://www.nytimes.com/reuters/2020/02/19/world/asia/19reuters-china-health-hubei.html|title=China's Hubei Reports 349 New Coronavirus Cases, Lowest Since Jan. 25|work=[[The New York Times]]|url-status=live|access-date=20 February 2020}}</ref> A paper submitted to [[Eurosurveillance]] modelling China's official death rate statistics reported that "In the popular press, there are also speculations about a large number of unreported cases, casting doubt on the usefulness of the reported numbers. Although this is justified in view of the length of the incubation period of about six days in this case, it affects all data uniformly."<ref>{{cite arXiv |last=Brandenburg |first=A. |eprint=2002.03638 |title=Quadratic growth during the 2019 novel coronavirus epidemic |date=14 February 2020 |class=q-bio.PE }}</ref>
Case and death counts in China are influenced by changes in [[clinical case definition]].<ref>{{cite web|url=https://www.npr.org/2020/02/13/805566551/officials-report-huge-jump-in-coronavirus-cases-in-1-chinese-province|title=Officials Report Huge Jump in Coronavirus Cases in 1 Chinese Province|publisher=NPR|url-status=live|access-date=20 February 2020}}</ref><ref>{{cite news|url=https://www.nytimes.com/reuters/2020/02/19/world/asia/19reuters-china-health-hubei.html|title=China's Hubei Reports 349 New Coronavirus Cases, Lowest Since Jan. 25|work=[[The New York Times]]|url-status=live|access-date=20 February 2020}}</ref> A paper submitted to [[Eurosurveillance]] modelling China's official death rate statistics reported that "In the popular press, there are also speculations about a large number of unreported cases, casting doubt on the usefulness of the reported numbers. Although this is justified in view of the length of the incubation period of about six days in this case, it affects all data uniformly."<ref>{{cite arXiv |last=Brandenburg |first=A. |eprint=2002.03638 |title=Quadratic growth during the 2019 novel coronavirus epidemic |date=14 February 2020 |class=q-bio.PE }}</ref>

== Transmission ==
The transmissibility of the coronavirus is sufficient for sustained community transmission. Locally acquired cases have been reported in several countries. Most deaths have so far been in China.<ref name=":14" />

On 6 February 2020, the Chinese [[National Health Commission]] (NHC) started to change how cases were reported – [[asymptomatic]] carriers, who tested positive for the virus but did not show clinical symptoms, would no longer be included in the number of confirmed cases. This had the effect of reducing the total number of cases reported, but also meant that potentially contagious individuals were ignored in reports.<ref name="asymptomatic">{{cite news|url=https://www.taiwannews.com.tw/en/news/3874490|title=China changes counting scheme to lower Wuhan virus numbers|date=11 February 2020|newspaper=Taiwan News|access-date=11 February 2020}}</ref><ref>{{Cite news|last=Wang|first=Vivian|url=https://www.nytimes.com/2020/02/12/world/asia/china-coronavirus-cases.html|title=How Many Coronavirus Cases in China? Officials Tweak the Answer|date=12 February 2020|access-date=12 February 2020|website=[[The New York Times]]}}</ref> On 13 February 2020, the director of the [[Centers for Disease Control and Prevention]] of the United States confirmed asymptomatic transmission.<ref>{{cite news|last=Salo|first=Jackie|url=https://nypost.com/2020/02/13/coronavirus-can-be-spread-by-people-who-dont-show-symptoms-cdc-warns/|title=CDC says coronavirus can spread through people who aren't showing symptoms|date=13 February 2020|access-date=13 February 2020|url-status=live|archive-url=https://web.archive.org/web/20200214054214/https://nypost.com/2020/02/13/coronavirus-can-be-spread-by-people-who-dont-show-symptoms-cdc-warns/|archive-date=14 February 2020|website=[[New York Post]]}}</ref> However, as of 27 February 2019, the extent to which asymptomatic transmission can occur remains unclear.<ref>{{Cite journal|last=Burki|first=Talha|date=17 February 2020|title=Outbreak of coronavirus disease 2019|url=https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30076-1/abstract|journal=The Lancet Infectious Diseases|volume=0|doi=10.1016/S1473-3099(20)30076-1|issn=1473-3099|pmid=32078809}}</ref>

COVID-19 is primarily spread between people via respiratory droplets produced when an infected person [[cough]]s or [[sneeze]]s.<ref>{{Cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html|title=Coronavirus Disease 2019 (COVID-19)|last=CDC|date=2020-02-11|website=Centers for Disease Control and Prevention|access-date=2020-02-25}}</ref> However, the virus can also be spread by people who do not show symptoms.<ref name="cnn-asymptomatic-spread">{{Cite news|last=Cohen|first=Elizabeth|url=https://www.cnn.com/2020/01/31/health/coronavirus-asymptomatic-spread-study/index.html|title='There's no doubt': Top US infectious disease doctor says Wuhan coronavirus can spread even when people have no symptoms|date=31 January 2020|access-date=2 February 2020|url-status=live|publisher=CNN|last2=Bonifield|first2=John}}</ref> Coronavirus droplets only stay suspended in the air for a short time, but can stay viable and contagious on a metal, glass or plastic surface for up to nine days.<ref name="GunterTPS_9days_persistence">{{cite journal|last1=Kampf|first1=Günter|last2=Todt|first2=Daniel|last3=Pfaender|first3=Stephanie|last4=Steinmann|first4=Eike|date=6 February 2020|title=Persistence of coronaviruses on inanimate surfaces and its inactivation with biocidal agents|url=https://www.sciencedirect.com/science/article/pii/S0195670120300463/|journal=[[Journal of Hospital Infection]]|publisher=Elsevier|biorxiv=|doi=10.1016/j.jhin.2020.01.022|pmid=32035997|access-date=15 February 2020}} {{free access}}</ref> Disinfection of surfaces is possible with cheap substances such as 62–71% [[ethanol]] applied for one minute.<ref name="GunterTPS_9days_persistence" /> Chinese public health officials suggest extra caution for aerosol transmission in closed rooms and recommend regularly exchanging air.<ref>{{cite web|url=http://www.eeo.com.cn/2020/0208/375915.shtml|title=新冠肺炎可通过气溶胶传播意味着什么|date=8 February 2020|publisher=Economic Observation Network|language=chinese|access-date=10 February 2020}}</ref>

Viral RNA was detected in stool specimens collected from the first confirmed case in the United States, though it was unclear if enough of the infectious virus was present to suggest [[Fecal–oral route|fecal-oral transmission.]]<ref name=":15">{{Cite journal|last=Holshue|first=Michelle L.|last2=DeBolt|first2=Chas|last3=Lindquist|first3=Scott|last4=Lofy|first4=Kathy H.|last5=Wiesman|first5=John|last6=Bruce|first6=Hollianne|last7=Spitters|first7=Christopher|last8=Ericson|first8=Keith|last9=Wilkerson|first9=Sara|last10=Tural|first10=Ahmet|last11=Diaz|first11=George|date=31 January 2020|title=First Case of 2019 Novel Coronavirus in the United States|journal=New England Journal of Medicine|pages=NEJMoa2001191|doi=10.1056/NEJMoa2001191|issn=0028-4793|pmid=32004427}}</ref>

Of the initial 41 cases, two-thirds had a history of exposure to the Huanan Seafood Wholesale Market.<ref name="Huang24Jan2020" />

There have been estimates for the [[basic reproduction number]] (the average number of people an infected person is likely to infect), ranging from 2.13<ref name="Leung27Jan2020">{{cite web|url=https://www.med.hku.hk/f/news/3549/7418/Wuhan-coronavirus-outbreak_AN-UPDATE_20200127.pdf|title=Real-time nowcast and forecast on the extent of the Wuhan CoV outbreak, domestic and international spread|last=Leung|first=Gabriel|last2=Wu|first2=Joseph|date=27 January 2020|website=Wuhan-coronavirus-outbreak AN UPDATE|access-date=29 January 2020}}</ref> to 4.82.<ref>{{Cite web|url=https://news.163.com/20/0213/18/F59LVB3P00018AOR.html|title=中疾控分析九千新冠患者:老年男性风险大 R0为3.77|date=13 February 2020|website=news.163.com}}</ref><ref>{{Cite journal|last1=Yang|first1=Yang|last2=Lu|first2=Qingbin|last3=Liu|first3=Mingjin|last4=Wang|first4=Yixing|last5=Zhang|first5=Anran|last6=Jalali|first6=Neda|last7=Dean|first7=Natalie|last8=Longini|first8=Ira|last9=Halloran|first9=M. Elizabeth|last10=Xu|first10=Bo|last11=Zhang|first11=Xiaoai|date=21 February 2020|title=Epidemiological and clinical features of the 2019 novel coronavirus outbreak in China|url=https://www.medrxiv.org/content/10.1101/2020.02.10.20021675v2|journal=MedRxiv|pages=2020.02.10.20021675|doi=10.1101/2020.02.10.20021675|via=www.medrxiv.org|last12=Wang|first13=Wei|last13=Liu|first14=Liqun|last14=Fang|first12=Liping}}</ref> The virus has reportedly been able to transmit down a chain of up to four people so far{{when|date=February 2020}}.<ref name="Saey24Jan2020">{{cite web|url=https://www.sciencenews.org/article/how-new-wuhan-coronavirus-stacks-up-against-sars-mers|title=How the new coronavirus stacks up against SARS and MERS|last=Saey|first=Tina Hesman|date=24 January 2020|url-status=live|archive-url=https://web.archive.org/web/20200125064423/https://www.sciencenews.org/article/how-new-wuhan-coronavirus-stacks-up-against-sars-mers|archive-date=25 January 2020|access-date=25 January 2020}}</ref> This is similar to [[severe acute respiratory syndrome-related coronavirus]] (SARS-CoV).<ref>Julien Riou & Christian L. Althaus, [https://www.biorxiv.org/content/10.1101/2020.01.23.917351v1.full.pdf Pattern of early human-to-human transmission of Wuhan 2019-NCoV], Preprint, [[bioRxiv]], 23 January 2020.</ref> There are disputed reports that some of the infected may be [[super-spreader]]s.<ref name="xinhuanet138733483">{{Cite news|url=http://www.xinhuanet.com/english/2020-01/25/c_138733483.htm|title=China CDC head dismisses super-spreader media report|date=25 January 2020|access-date=25 January 2020|url-status=live|archive-url=https://web.archive.org/web/20200125191047/http://www.xinhuanet.com/english/2020-01/25/c_138733483.htm|archive-date=25 January 2020|agency=Xinhua News Agency}}</ref><ref name="qq2020012500">{{Cite news|url=https://new.qq.com/rain/a/TWF2020012500903100|date=25 January 2020|work=China Newsweek|access-date=25 January 2020|url-status=live|archive-url=https://web.archive.org/web/20200125200018/https://new.qq.com/rain/a/TWF2020012500903100|archive-date=25 January 2020|publisher=[[qq.com]]|language=Chinese|script-title=zh:还原"超级传播者"传染路径 武汉医生:疫情刚开始"整个不让说"|trans-title=Restore the infection route for "super-spreader"s; "'Not allowed to speak anything' at the beginning of the outbreak," said Wuhan doctors}}</ref>


== Signs and symptoms ==
== Signs and symptoms ==
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Tracking genetic and using mathematics it was estimated patient zero likely had been infect between 15th November and 15th December. Based on the data provided by the worldwide Nextstrain collaboration, Dr. Bedford refuted claims of its origin being from a laboratory.<ref name="20200214BioWorld">{{cite document|url=https://www.bioworld.com/articles/433087-article-headline |title=Researchers trace COVID-19's family tree to battle outbreak and 'infodemic'|author=Nuala Moran|work=BioWorld|date=14 February 2020}}</ref><ref name="20200214NatPst">{{cite document|url=https://nationalpost.com/news/world/no-the-coronavirus-was-not-genetically-engineered-in-a-wuhan-lab
Tracking genetic and using mathematics it was estimated patient zero likely had been infect between 15th November and 15th December. Based on the data provided by the worldwide Nextstrain collaboration, Dr. Bedford refuted claims of its origin being from a laboratory.<ref name="20200214BioWorld">{{cite document|url=https://www.bioworld.com/articles/433087-article-headline |title=Researchers trace COVID-19's family tree to battle outbreak and 'infodemic'|author=Nuala Moran|work=BioWorld|date=14 February 2020}}</ref><ref name="20200214NatPst">{{cite document|url=https://nationalpost.com/news/world/no-the-coronavirus-was-not-genetically-engineered-in-a-wuhan-lab
|title=No, the coronavirus was not genetically engineered in a Wuhan lab, expert says|work=National Post|date=14 February 2020}}</ref><ref name="20200211NxtStr">{{cite document|url=https://nextstrain.org/ncov |title=Genomic epidemiology of novel coronavirus (nCoV)|date=11 February 2020}}</ref>
|title=No, the coronavirus was not genetically engineered in a Wuhan lab, expert says|work=National Post|date=14 February 2020}}</ref><ref name="20200211NxtStr">{{cite document|url=https://nextstrain.org/ncov |title=Genomic epidemiology of novel coronavirus (nCoV)|date=11 February 2020}}</ref>

=== Spread ===
COVID-19 is primarily spread between people via respiratory droplets produced when an infected person [[cough]]s or [[sneeze]]s.<ref>{{Cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html|title=Coronavirus Disease 2019 (COVID-19)|last=CDC|date=2020-02-11|website=Centers for Disease Control and Prevention|access-date=2020-02-25}}</ref> However, the virus can also be spread by people who do not show symptoms.<ref name="cnn-asymptomatic-spread">{{Cite news | last=Cohen | first=Elizabeth | last2=Bonifield | first2=John |url=https://www.cnn.com/2020/01/31/health/coronavirus-asymptomatic-spread-study/index.html |title='There's no doubt': Top US infectious disease doctor says Wuhan coronavirus can spread even when people have no symptoms |publisher=CNN |url-status=live | date=31 January 2020 |access-date=2 February 2020}}</ref> Coronavirus droplets only stay suspended in the air for a short time, but can stay viable and contagious on a metal, glass or plastic surface for up to nine days.<ref name="GunterTPS_9days_persistence">{{cite journal | last1 = Kampf | first1 = Günter | last2 = Todt | first2 = Daniel |last3=Pfaender |first3=Stephanie |last4=Steinmann |first4=Eike | title = Persistence of coronaviruses on inanimate surfaces and its inactivation with biocidal agents | journal = [[Journal of Hospital Infection]] | publisher = Elsevier | date = 6 February 2020 | url = https://www.sciencedirect.com/science/article/pii/S0195670120300463/ | doi = 10.1016/j.jhin.2020.01.022 | pmid = 32035997 | biorxiv= | access-date = 15 February 2020 }} {{free access}}</ref> Disinfection of surfaces is possible with cheap substances such as 62–71% [[ethanol]] applied for one minute.<ref name="GunterTPS_9days_persistence" /> Chinese public health officials suggest extra caution for aerosol transmission in closed rooms and recommend regularly exchanging air.<ref>{{cite web |url=http://www.eeo.com.cn/2020/0208/375915.shtml |title=新冠肺炎可通过气溶胶传播意味着什么 |publisher=Economic Observation Network |language=chinese |date=8 February 2020|access-date=10 February 2020}}</ref>

On 13 February 2020, the director of the [[Centers for Disease Control and Prevention]] of the United States confirmed asymptomatic transmission.<ref>{{cite news | first=Jackie | last=Salo | title=CDC says coronavirus can spread through people who aren't showing symptoms | website=[[New York Post]] | date=13 February 2020 | url=https://nypost.com/2020/02/13/coronavirus-can-be-spread-by-people-who-dont-show-symptoms-cdc-warns/ | archive-url=https://web.archive.org/web/20200214054214/https://nypost.com/2020/02/13/coronavirus-can-be-spread-by-people-who-dont-show-symptoms-cdc-warns/ | archive-date=14 February 2020 | url-status=live | access-date=13 February 2020}}</ref> However, as of 27 February 2019, the extent to which asymptomatic transmission can occur remains unclear.<ref>{{Cite journal|last=Burki|first=Talha|date=17 February 2020|title=Outbreak of coronavirus disease 2019|url=https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30076-1/abstract|journal=The Lancet Infectious Diseases|volume=0|doi=10.1016/S1473-3099(20)30076-1|issn=1473-3099|pmid=32078809}}</ref> Viral RNA was detected in stool specimens collected from the first confirmed case in the United States, though it was unclear if enough of the infectious virus was present to suggest [[Fecal–oral route|fecal-oral transmission.]]<ref name=":15">{{Cite journal |last=Holshue |first=Michelle L. |last2=DeBolt |first2=Chas |last3=Lindquist |first3=Scott |last4=Lofy |first4=Kathy H. |last5=Wiesman |first5=John |last6=Bruce |first6=Hollianne |last7=Spitters |first7=Christopher |last8=Ericson |first8=Keith |last9=Wilkerson |first9=Sara |last10=Tural |first10=Ahmet |last11=Diaz |first11=George |date=31 January 2020 |title=First Case of 2019 Novel Coronavirus in the United States |journal=New England Journal of Medicine |pages=NEJMoa2001191 |doi=10.1056/NEJMoa2001191 |issn=0028-4793 |pmid=32004427}}</ref>

Of the initial 41 cases, two-thirds had a history of exposure to the Huanan Seafood Wholesale Market.<ref name= Huang24Jan2020 />

There have been estimates for the [[basic reproduction number]] (the average number of people an infected person is likely to infect), ranging from 2.13<ref name="Leung27Jan2020">{{cite web |url=https://www.med.hku.hk/f/news/3549/7418/Wuhan-coronavirus-outbreak_AN-UPDATE_20200127.pdf |title=Real-time nowcast and forecast on the extent of the Wuhan CoV outbreak, domestic and international spread |last=Leung |first=Gabriel |last2=Wu |first2=Joseph |date=27 January 2020 |website=Wuhan-coronavirus-outbreak AN UPDATE |access-date=29 January 2020}}</ref> to 4.82.<ref>{{Cite web|url=https://news.163.com/20/0213/18/F59LVB3P00018AOR.html|title=中疾控分析九千新冠患者:老年男性风险大 R0为3.77|date=13 February 2020|website=news.163.com}}</ref><ref>{{Cite journal|url=https://www.medrxiv.org/content/10.1101/2020.02.10.20021675v2|title=Epidemiological and clinical features of the 2019 novel coronavirus outbreak in China|first1=Yang|last1=Yang|first2=Qingbin|last2=Lu|first3=Mingjin|last3=Liu|first4=Yixing|last4=Wang|first5=Anran|last5=Zhang|first6=Neda|last6=Jalali|first7=Natalie|last7=Dean|first8=Ira|last8=Longini|first9=M. Elizabeth|last9=Halloran|first10=Bo|last10=Xu|first11=Xiaoai|last11=Zhang|first12=Liping|last12=Wang|first13=Wei|last13=Liu|first14=Liqun|last14=Fang|date=21 February 2020|journal=MedRxiv|pages=2020.02.10.20021675|via=www.medrxiv.org|doi=10.1101/2020.02.10.20021675}}</ref> The virus has reportedly been able to transmit down a chain of up to four people so far{{when|date=February 2020}}.<ref name="Saey24Jan2020">{{cite web |url=https://www.sciencenews.org/article/how-new-wuhan-coronavirus-stacks-up-against-sars-mers |title=How the new coronavirus stacks up against SARS and MERS |last=Saey |first=Tina Hesman |date=24 January 2020 |url-status=live |archive-url=https://web.archive.org/web/20200125064423/https://www.sciencenews.org/article/how-new-wuhan-coronavirus-stacks-up-against-sars-mers |archive-date=25 January 2020 |access-date=25 January 2020}}</ref> This is similar to [[severe acute respiratory syndrome-related coronavirus]] (SARS-CoV).<ref>Julien Riou & Christian L. Althaus, [https://www.biorxiv.org/content/10.1101/2020.01.23.917351v1.full.pdf Pattern of early human-to-human transmission of Wuhan 2019-NCoV], Preprint, [[bioRxiv]], 23 January 2020.</ref> There are disputed reports that some of the infected may be [[super-spreader]]s.<ref name="xinhuanet138733483">{{Cite news |url=http://www.xinhuanet.com/english/2020-01/25/c_138733483.htm |title=China CDC head dismisses super-spreader media report |date=25 January 2020 |access-date=25 January 2020 |url-status=live |archive-url=https://web.archive.org/web/20200125191047/http://www.xinhuanet.com/english/2020-01/25/c_138733483.htm |archive-date=25 January 2020 |agency=Xinhua News Agency}}</ref><ref name="qq2020012500">{{Cite news |url=https://new.qq.com/rain/a/TWF2020012500903100 |date=25 January 2020 |work=China Newsweek |access-date=25 January 2020 |url-status=live |archive-url=https://web.archive.org/web/20200125200018/https://new.qq.com/rain/a/TWF2020012500903100 |archive-date=25 January 2020 |publisher=[[qq.com]] |language=Chinese |script-title=zh:还原"超级传播者"传染路径 武汉医生:疫情刚开始"整个不让说" |trans-title=Restore the infection route for "super-spreader"s; "'Not allowed to speak anything' at the beginning of the outbreak," said Wuhan doctors}}</ref>


== Diagnosis ==
== Diagnosis ==
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== Prevention ==
== Prevention ==
[[File:A_doctor_wearing_special_protective_suit_for_the_Wuhan_coronavirus_outbreak_treat_patient_in_Hubei_TCM_Hospital,_Wuhan.jpg|alt=|thumb|A medical worker wearing a [[Cleanroom suit|bunny suit]] sees a patient in a Wuhan hospital]]
[[File:A_doctor_wearing_special_protective_suit_for_the_Wuhan_coronavirus_outbreak_treat_patient_in_Hubei_TCM_Hospital,_Wuhan.jpg|alt=|thumb|A medical worker wearing a [[Personal Protective Equipment|PPE suit]] sees a patient in a Wuhan hospital]]
To reduce the chances of infection, health organizations recommend avoiding close contact with sick individuals; frequently washing hands with soap and water; not touching the eyes, nose, or mouth with unwashed hands; and practicing good respiratory hygiene.<ref>{{Cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/about/prevention-treatment.html|title=COVID-19 Prevention & Treatment|last=CDC|first=|date=2020-02-11|website=Centers for Disease Control and Prevention|language=en-us|url-status=live|archive-url=|archive-date=|access-date=2020-02-25}}</ref><ref>{{Cite web|url=https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public|title=Advice for public|website=www.who.int|language=en|access-date=2020-02-10|archive-url=https://web.archive.org/web/20200126025750/https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public|archive-date=26 January 2020|url-status=live}}</ref>
There are no vaccines against SARS-CoV-2 as of 22 February 2020. Infection is primarily through human-to-human transmission, via respiratory droplets that people exhale (such as sneeze and cough). The [[Ministry of Health (Singapore)|Ministry of Health]] in Singapore advises people that "those who are unwell should wear a mask and see a doctor immediately [...] but there is no need to wear a mask if you are well". It has advised against all non-essential travel to Mainland China, especially Hubei province and the city of Wuhan. In addition, it lists several precautions under its health advisory:<ref>{{Cite web|url=https://www.moh.gov.sg/covid-19|title=MOH {{!}} Updates on COVID-19 (Coronavirus Disease 2019) Local Situation|website=www.moh.gov.sg|access-date=2020-02-25}}</ref>


Those who may be infected are advised to stay at home except to get medical care, call ahead before visiting a healthcare provider, wear a facemask (especially in public), cover coughs and sneezes with a tissue, regularly wash hands with soap and water, and avoid sharing personal household items.<ref>{{Cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/about/steps-when-sick.html|title=What to do if you are sick with 2019 Novel Coronavirus (2019-nCoV)|last=CDC|date=2020-02-11|website=Centers for Disease Control and Prevention|language=en-us|url-status=live|archive-url=|archive-date=|access-date=2020-02-13}}</ref>
* Stay clear of crowded places and avoid close contact with people who are sick (something known as ''social distancing'');
* Maintain good hygiene and frequently wash hands when appropriate;
* Cough or sneeze into a tissue and directly dispose of the tissue into a garbage can;
* Wear a surgical face mask if you are coughing, sneezing or have other respiratory symptoms;
* Seek prompt medical attention if you are feeling unwell;
*Do not eat raw or undercooked meats.


No vaccine currently exists.<ref>{{Cite web|url=https://www.coronavirus.gov.hk/eng/covid19.html|title=COVID-19 Thematic Website, Together, We Fight the Virus, COVID-19|website=www.coronavirus.gov.hk|language=en|access-date=2020-02-22}}</ref>
If a person is suspected to be infected, to prevent transmission, health authorities recommend that the infected individual stay at home except to get medical care; call ahead before visiting a healthcare provider; wear a surgical face mask (especially in public); cover coughs and sneezes with a tissue; regularly wash hands with soap and water; and avoid sharing personal household items.<ref name="CDC Sick">{{Cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/about/steps-when-sick.html|title=What to Do If You Are Sick With Coronavirus Disease 2019 (COVID-19)|date=11 February 2020|website=U.S. [[Centers for Disease Control and Prevention]] (CDC)|url-status=live|access-date=13 February 2020}}</ref><br />Though the virus is thought to have a zoonotic origin, there is no evidence that pets such as dogs and cats can be infected. The [[Government of Hong Kong]] warned anyone travelling outside the city to not touch animals; to not eat [[Game (hunting)|game]] meat; and to avoid visiting [[Wet market|wet markets]], live poultry markets, and farms.<ref>{{Cite web|url=https://www.coronavirus.gov.hk/eng/index.html|title=COVID-19 Thematic Website, Together, We Fight the Virus, Home|website=www.coronavirus.gov.hk|access-date=2020-02-25}}</ref>

A number of governments advise against all non-essential travel to Mainland China.<ref>{{Cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html|title=COVID-19 Information for Travel|last=CDC|first=|date=2020-02-11|website=Centers for Disease Control and Prevention|language=en-us|url-status=live|archive-url=|archive-date=|access-date=2020-02-25}}</ref> The [[Government of Hong Kong]] warned anyone travelling outside the city to not touch animals; to not eat [[Game (hunting)|game]] meat; and to avoid visiting [[wet market]]s, live poultry markets, and farms.<ref name=":7" /> There is no evidence that pets such as dogs and cats can be infected.<ref name="WHO2020Myth">{{cite web|url=https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters|title=Myth busters|website=www.who.int|accessdate=8 February 2020}}</ref>

For health care providers taking care of someone who may be infected [[standard precautions]], contact precautions, and airborne precautions with eye protection are recommended.<ref>{{cite web |title=Coronavirus Disease 2019 (COVID-19) |url=https://www.cdc.gov/coronavirus/2019-ncov/hcp/caring-for-patients.html |website=Centers for Disease Control and Prevention |accessdate=25 February 2020 |language=en-us |date=11 February 2020}}</ref>


=== Hand washing ===
=== Hand washing ===
Line 164: Line 171:
Healthcare professionals interacting directly with people who have the disease are advised to use [[respirator]]s at least as protective as [[National Institute for Occupational Safety and Health|NIOSH]]-certified [[NIOSH air filtration rating|N95]], EU standard FFP2, or equivalent, in addition to other [[personal protective equipment]].<ref name="who-mask-advices" /><ref>{{cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control.html|title=Interim Infection Prevention and Control Recommendations for Patients with Confirmed Coronavirus Disease 2019 (COVID-19) or Persons Under Investigation for COVID-19 in Healthcare Settings |date=6 February 2020|website=U.S. [[Centers for Disease Control and Prevention]] (CDC)|access-date=8 February 2020}}</ref>
Healthcare professionals interacting directly with people who have the disease are advised to use [[respirator]]s at least as protective as [[National Institute for Occupational Safety and Health|NIOSH]]-certified [[NIOSH air filtration rating|N95]], EU standard FFP2, or equivalent, in addition to other [[personal protective equipment]].<ref name="who-mask-advices" /><ref>{{cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control.html|title=Interim Infection Prevention and Control Recommendations for Patients with Confirmed Coronavirus Disease 2019 (COVID-19) or Persons Under Investigation for COVID-19 in Healthcare Settings |date=6 February 2020|website=U.S. [[Centers for Disease Control and Prevention]] (CDC)|access-date=8 February 2020}}</ref>


There is no evidence to show that masks protect uninfected persons at low risk and wearing them may create a false sense of security.<ref name="who-mask-advices" /> Surgical masks are widely used by healthy people in Hong Kong,<ref name="scmp3048492">{{cite web|url=https://www.scmp.com/news/hong-kong/law-and-crime/article/3048492/residents-clamour-surgical-masks-coronavirus-hit-hong|title=As Hongkongers clamour for surgical masks, 25,000 stolen from warehouse|date=31 January 2020|website=South China Morning Post|access-date=1 February 2020}}</ref> Japan,<ref>{{Cite news|last=Takahashi|first=Ryusei|url=https://www.japantimes.co.jp/news/2020/01/31/national/coronavirus-japan-surgical-masks/|title=Amid virus outbreak, Japan stores scramble to meet demand for face masks|work=Japan Times|access-date=1 February 2020}}</ref> Singapore<ref name="20200131straitstimes">{{cite web|url=https://www.straitstimes.com/askst/wuhan-virus-who-needs-to-wear-a-mask-and-whats-the-proper-way-to-wear-it|title=Wuhan virus: Who needs to wear a mask and what's the proper way to wear it?|last=munsan|date=31 January 2020|website=The Straits Times|access-date=1 February 2020}}</ref><ref>{{cite web|url=https://www.businessinsider.sg/photos-and-videos-show-insane-queues-for-masks-in-singapore-shanghai-and-hong-kong-which-netizens-say-are-all-sold-out/|title=These 12 Twitter posts show the insane queues for masks in Singapore, Shanghai and Hong Kong, which are all sold out, Business Insider – Business Insider Singapore|last=Chia|first=Rachel Genevieve|website=businessinsider.sg|access-date=1 February 2020}}</ref> and Malaysia.<ref name="nst561250">{{Cite news|last=Harun|first=Hana Naz|url=https://www.nst.com.my/news/nation/2020/01/561250/demand-face-masks-hand-sanitisers-soars|title=Demand for face masks, hand sanitisers soars|date=31 January 2020|work=New Straits Times|access-date=1 February 2020|last2=Teh|first2=Athira Yusof|last3=Solhi|first3=Farah}}</ref> Surgical masks are not recommended by the CDC as a preventive measure for the American general public.<ref name="nCoV: What the Public Should Do" /> The use of masks by healthy members of the public is not recommended outside of China.<ref>{{Cite web|url=https://www.health.gov.au/health-topics/novel-coronavirus-2019-ncov|title=Coronavirus (COVID-19)|last=Health|first=Australian Government Department of|date=2020-01-21|website=Australian Government Department of Health|access-date=2020-02-15}}</ref><ref name="autogenerated1" /><ref name=":1" />
There is no evidence to show that masks protect uninfected persons at low risk, and wearing them may create a false sense of security.<ref name="who-mask-advices" /> Surgical masks are widely used by healthy people in Hong Kong,<ref name="scmp3048492">{{cite web|url=https://www.scmp.com/news/hong-kong/law-and-crime/article/3048492/residents-clamour-surgical-masks-coronavirus-hit-hong|title=As Hongkongers clamour for surgical masks, 25,000 stolen from warehouse|date=31 January 2020|website=South China Morning Post|access-date=1 February 2020}}</ref> Japan,<ref>{{Cite news|last=Takahashi|first=Ryusei|url=https://www.japantimes.co.jp/news/2020/01/31/national/coronavirus-japan-surgical-masks/|title=Amid virus outbreak, Japan stores scramble to meet demand for face masks|work=Japan Times|access-date=1 February 2020}}</ref> Singapore,<ref name="20200131straitstimes">{{cite web|url=https://www.straitstimes.com/askst/wuhan-virus-who-needs-to-wear-a-mask-and-whats-the-proper-way-to-wear-it|title=Wuhan virus: Who needs to wear a mask and what's the proper way to wear it?|last=munsan|date=31 January 2020|website=The Straits Times|access-date=1 February 2020}}</ref><ref>{{cite web|url=https://www.businessinsider.sg/photos-and-videos-show-insane-queues-for-masks-in-singapore-shanghai-and-hong-kong-which-netizens-say-are-all-sold-out/|title=These 12 Twitter posts show the insane queues for masks in Singapore, Shanghai and Hong Kong, which are all sold out, Business Insider – Business Insider Singapore|last=Chia|first=Rachel Genevieve|website=businessinsider.sg|access-date=1 February 2020}}</ref> and Malaysia.<ref name="nst561250">{{Cite news|last=Harun|first=Hana Naz|url=https://www.nst.com.my/news/nation/2020/01/561250/demand-face-masks-hand-sanitisers-soars|title=Demand for face masks, hand sanitisers soars|date=31 January 2020|work=New Straits Times|access-date=1 February 2020|last2=Teh|first2=Athira Yusof|last3=Solhi|first3=Farah}}</ref> Surgical masks are not recommended by the CDC as a preventive measure for the American general public.<ref name="nCoV: What the Public Should Do" /> The use of masks by healthy members of the public is not recommended outside of China.<ref name="autogenerated1" /><ref name=":1" /><ref>{{Cite web|url=https://www.health.gov.au/health-topics/novel-coronavirus-2019-ncov|title=Coronavirus (COVID-19)|last=Health|first=Australian Government Department of|date=2020-01-21|website=Australian Government Department of Health|access-date=2020-02-15}}</ref>


=== Vaccine and therapy research ===
=== Vaccine and therapy research ===
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On 18 February 2020, the Chinese [[National Medical Products Administration]] approved the antiviral drug [[favipiravir]] for use COVID-19. The drug, previously approved for treatment of influenza, had shown early efficacy against COVID-19 in human trials in China.<ref>{{Cite web|url=https://www.pharmaceutical-technology.com/news/china-approves-favilavir-covid-19/|title=China approves first anti-viral drug against coronavirus Covid-19}}</ref>
On 18 February 2020, the Chinese [[National Medical Products Administration]] approved the antiviral drug [[favipiravir]] for use COVID-19. The drug, previously approved for treatment of influenza, had shown early efficacy against COVID-19 in human trials in China.<ref>{{Cite web|url=https://www.pharmaceutical-technology.com/news/china-approves-favilavir-covid-19/|title=China approves first anti-viral drug against coronavirus Covid-19}}</ref>


Bruce Aylward, an assistant director-general of the World Health Organization (WHO), has stated "there is only one drug right now that we think may have real efficacy and that's [[remdesivir]]." Clinical trials for this drug are in progress, and results could be available within weeks of February 24.<ref>{{Cite web|url=https://www.cnn.com/2020/02/24/investing/gilead-sciences-coronavirus-who-remdesivir/index.html|title=Gilead Sciences drug may help treat coronavirus symptoms, according to WHO|last=Business|first=Paul R. La Monica, CNN|website=CNN|access-date=2020-02-25}}</ref>
=== Domestic responses ===

==Public health responses==

=== China ===
[[File:航拍武汉中心城区机动车禁行后道路:少有车辆踪影-Wg-8rMZAsY0.webm|thumb|right|'Aerial photography of roads after motor vehicles are banned in central urban areas of Wuhan: few vehicle traces' – Video news from [[China News Service]]]]
[[File:航拍武汉中心城区机动车禁行后道路:少有车辆踪影-Wg-8rMZAsY0.webm|thumb|right|'Aerial photography of roads after motor vehicles are banned in central urban areas of Wuhan: few vehicle traces' – Video news from [[China News Service]]]]
[[File:Changchun Longjia Airport Terminal 2 Security Check (20200126) (cropped).jpg|thumb|right|Passengers wearing masks going through an extra body temperature check as part of airport security. Captured on 26 January in NE China's [[Changchun Longjia International Airport|Changchun Longjia Airport]]]]
[[File:Changchun Longjia Airport Terminal 2 Security Check (20200126) (cropped).jpg|thumb|right|Passengers wearing masks going through an extra body temperature check as part of airport security. Captured on 26 January in NE China's [[Changchun Longjia International Airport|Changchun Longjia Airport]]]]
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In Wuhan, authorities have seized dormitories, offices and hospitals to create more beds for patients.<ref>{{cite web|url=https://www.ft.com/content/cf24d4b2-4d5a-11ea-95a0-43d18ec715f5|title=China seizes hotels, hospitals and cars to fight coronavirus | work=[[Financial Times]]|date=12 February 2020|first1=Sun |last1=Yu |first2=Ryan |last2=McMorrow |url-access=subscription}}</ref>
In Wuhan, authorities have seized dormitories, offices and hospitals to create more beds for patients.<ref>{{cite web|url=https://www.ft.com/content/cf24d4b2-4d5a-11ea-95a0-43d18ec715f5|title=China seizes hotels, hospitals and cars to fight coronavirus | work=[[Financial Times]]|date=12 February 2020|first1=Sun |last1=Yu |first2=Ryan |last2=McMorrow |url-access=subscription}}</ref>


== Reactions to prevention efforts ==
=== Reactions to public health responses ===
{{Main|Controversies related to the 2019–20 coronavirus outbreak}}
{{Main|Controversies related to the 2019–20 coronavirus outbreak}}


=== WHO response measures ===
==== WHO response measures ====
{{See also|World Health Organization#Reactions to WHO response in 2019-20 novel coronavirus outbreak (COVID19)}}
{{See also|World Health Organization#Reactions to WHO response in 2019-20 novel coronavirus outbreak (COVID19)}}
The [[World Health Organization]] (WHO) has commended the efforts of Chinese authorities in managing and containing the epidemic, with Director-General [[Tedros Adhanom Ghebreyesus]] expressing "confidence in China's approach to controlling the epidemic" and calling for the public to "remain calm".<ref name="wsj1158022764">{{Cite news |last=Yang |first=Stephanie |url=https://www.wsj.com/articles/who-chief-praises-beijings-coronavirus-response-as-travel-barriers-rise-11580227640 |title=WHO Chief Praises Beijing's Coronavirus Response as Travel Barriers Rise |date=28 January 2020 |work=[[The Wall Street Journal]] |access-date=28 January 2020 |url-status=live |archive-url=https://web.archive.org/web/20200128201740/https://www.wsj.com/articles/who-chief-praises-beijings-coronavirus-response-as-travel-barriers-rise-11580227640 |archive-date=28 January 2020 |issn=0099-9660 |url-access=subscription}}</ref> The WHO noted the contrast between the [[2003 SARS outbreak|2003 epidemic]], where Chinese authorities were accused of secrecy that impeded prevention and containment efforts, and the current crisis where the central government "has provided regular updates to avoid panic ahead of Lunar New Year holidays".<ref name="auto">{{Cite news |url=https://www.reuters.com/article/us-china-health-who-idUSKBN1ZM1G9 |title=Wuhan lockdown 'unprecedented', shows commitment to contain virus: WHO representative in China |author=Gabriel Crossley, Alison Williams|date=23 January 2020 |access-date=28 January 2020 |url-status=live |archive-url=https://web.archive.org/web/20200124203401/https://www.reuters.com/article/us-china-health-who-idUSKBN1ZM1G9 |archive-date=24 January 2020 |agency=Reuters}}</ref>
The [[World Health Organization]] (WHO) has commended the efforts of Chinese authorities in managing and containing the epidemic, with Director-General [[Tedros Adhanom Ghebreyesus]] expressing "confidence in China's approach to controlling the epidemic" and calling for the public to "remain calm".<ref name="wsj1158022764">{{Cite news |last=Yang |first=Stephanie |url=https://www.wsj.com/articles/who-chief-praises-beijings-coronavirus-response-as-travel-barriers-rise-11580227640 |title=WHO Chief Praises Beijing's Coronavirus Response as Travel Barriers Rise |date=28 January 2020 |work=[[The Wall Street Journal]] |access-date=28 January 2020 |url-status=live |archive-url=https://web.archive.org/web/20200128201740/https://www.wsj.com/articles/who-chief-praises-beijings-coronavirus-response-as-travel-barriers-rise-11580227640 |archive-date=28 January 2020 |issn=0099-9660 |url-access=subscription}}</ref> The WHO noted the contrast between the [[2003 SARS outbreak|2003 epidemic]], where Chinese authorities were accused of secrecy that impeded prevention and containment efforts, and the current crisis where the central government "has provided regular updates to avoid panic ahead of Lunar New Year holidays".<ref name="auto">{{Cite news |url=https://www.reuters.com/article/us-china-health-who-idUSKBN1ZM1G9 |title=Wuhan lockdown 'unprecedented', shows commitment to contain virus: WHO representative in China |author=Gabriel Crossley, Alison Williams|date=23 January 2020 |access-date=28 January 2020 |url-status=live |archive-url=https://web.archive.org/web/20200124203401/https://www.reuters.com/article/us-china-health-who-idUSKBN1ZM1G9 |archive-date=24 January 2020 |agency=Reuters}}</ref>
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On 25 February, the WHO declared that "the world should do more to prepare for a possible coronavirus pandemic," stating that while it was still too early to call it a pandemic, countries should nonetheless be "in a phase of preparedness."<ref>{{Cite news|url=https://www.bbc.com/news/world-51611422|title=World must prepare for pandemic, says WHO|date=2020-02-25|publisher=[[BBC News Online]]|access-date=2020-02-25}}</ref>
On 25 February, the WHO declared that "the world should do more to prepare for a possible coronavirus pandemic," stating that while it was still too early to call it a pandemic, countries should nonetheless be "in a phase of preparedness."<ref>{{Cite news|url=https://www.bbc.com/news/world-51611422|title=World must prepare for pandemic, says WHO|date=2020-02-25|publisher=[[BBC News Online]]|access-date=2020-02-25}}</ref>


=== International reactions ===
==== International reactions ====
[[File:President Trump Addresses a Briefing on the Coronavirus (49463760243).jpg|thumb|On 29 January, US president [[Donald Trump]] received a briefing on the coronavirus in China.]]
[[File:President Trump Addresses a Briefing on the Coronavirus (49463760243).jpg|thumb|On 29 January, US president [[Donald Trump]] received a briefing on the coronavirus in China.]]
China's response to the virus, in comparison to the [[2003 SARS outbreak]], has been praised by some foreign leaders.<ref name="20200125business-standard">{{Cite news |last=AFP |url=https://www.business-standard.com/article/pti-stories/trump-praises-china-efforts-and-transparency-on-virus-120012500107_1.html |title=Trump praises China 'efforts and transparency' on virus |date=25 January 2020 |work=Business Standard India |access-date=28 January 2020 |url-status=live |archive-url=https://web.archive.org/web/20200125151634/https://www.business-standard.com/article/pti-stories/trump-praises-china-efforts-and-transparency-on-virus-120012500107_1.html |archive-date=25 January 2020}}</ref> US president [[Donald Trump]] thanked [[Paramount leader|Chinese President]] Xi Jinping "on behalf of the American People" on 24 January 2020 on Twitter, stating that "China has been working very hard to contain the Coronavirus. The United States greatly appreciates their efforts and transparency" and declaring that "It will all work out well."<ref name="20200125straitstimes">{{cite web |url=https://www.straitstimes.com/world/united-states/trump-praises-china-efforts-and-transparency-on-wuhan-virus |title=Trump praises China 'efforts and transparency' on Wuhan virus |last=hermesauto |date=25 January 2020 |website=The Straits Times |url-status=live |archive-url=https://web.archive.org/web/20200127163253/https://www.straitstimes.com/world/united-states/trump-praises-china-efforts-and-transparency-on-wuhan-virus |archive-date=27 January 2020 |access-date=28 January 2020}}</ref> Germany's health minister [[Jens Spahn]], in an interview on [[Bloomberg Television|Bloomberg TV]], said with comparison to the Chinese response to SARS in 2003: "There's a big difference to SARS. We have a much more transparent China. The action of China is much more effective in the first days already." He also praised the international co-operation and communication in dealing with the virus.<ref name="dw52145333">{{cite web |url=https://www.dw.com/en/coronavirus-reaches-europe-as-france-confirms-3-cases/a-52145333 |title=Coronavirus reaches Europe as France confirms 3 cases |date=24 January 2020 |website=DW.COM |access-date=28 January 2020}}</ref><ref>{{cite web |url=https://webcache.googleusercontent.com/search?q=cache:tThjZC8ZDxsJ:https://www.bloomberg.com/news/articles/2020-01-24/china-doing-good-job-in-combating-virus-german-minister-says+&cd=1&hl=en&ct=clnk&gl=ca |title=China Doing Good Job in Combating Virus, German Minister Says – Bloomberg |website=webcache.googleusercontent.com |access-date=28 January 2020}}</ref> In a letter to Xi, Singapore President [[Halimah Yacob]] applauded China's "swift, decisive and comprehensive measures" in safeguarding the health of the Chinese people, while Singapore Prime Minister [[Lee Hsien Loong]] remarked of "China's firm and decisive response" in communities affected by the virus.<ref>{{cite web |url=https://www.channelnewsasia.com/news/singapore/covid19-coronavirus-singapore-china-solidarity-12465678 |title=Singapore leaders stand in solidarity with China over COVID-19 outbreak |access-date=24 February 2020}}</ref> Similar sentiments were expressed by Russian President [[Vladimir Putin]].<ref>{{cite web |url=https://www.scmp.com/news/china/diplomacy/article/3050782/russia-and-china-pledge-maintain-special-relationship-despite |title=Russia and China pledge to maintain special relationship despite Moscow's slow response to coronavirus |access-date=24 February 2020}}</ref>
China's response to the virus, in comparison to the [[2003 SARS outbreak]], has been praised by some foreign leaders.<ref name="20200125business-standard">{{Cite news |last=AFP |url=https://www.business-standard.com/article/pti-stories/trump-praises-china-efforts-and-transparency-on-virus-120012500107_1.html |title=Trump praises China 'efforts and transparency' on virus |date=25 January 2020 |work=Business Standard India |access-date=28 January 2020 |url-status=live |archive-url=https://web.archive.org/web/20200125151634/https://www.business-standard.com/article/pti-stories/trump-praises-china-efforts-and-transparency-on-virus-120012500107_1.html |archive-date=25 January 2020}}</ref> US president [[Donald Trump]] thanked [[Paramount leader|Chinese President]] Xi Jinping "on behalf of the American People" on 24 January 2020 on Twitter, stating that "China has been working very hard to contain the Coronavirus. The United States greatly appreciates their efforts and transparency" and declaring that "It will all work out well."<ref name="20200125straitstimes">{{cite web |url=https://www.straitstimes.com/world/united-states/trump-praises-china-efforts-and-transparency-on-wuhan-virus |title=Trump praises China 'efforts and transparency' on Wuhan virus |last=hermesauto |date=25 January 2020 |website=The Straits Times |url-status=live |archive-url=https://web.archive.org/web/20200127163253/https://www.straitstimes.com/world/united-states/trump-praises-china-efforts-and-transparency-on-wuhan-virus |archive-date=27 January 2020 |access-date=28 January 2020}}</ref> Germany's health minister [[Jens Spahn]], in an interview on [[Bloomberg Television|Bloomberg TV]], said with comparison to the Chinese response to SARS in 2003: "There's a big difference to SARS. We have a much more transparent China. The action of China is much more effective in the first days already." He also praised the international co-operation and communication in dealing with the virus.<ref name="dw52145333">{{cite web |url=https://www.dw.com/en/coronavirus-reaches-europe-as-france-confirms-3-cases/a-52145333 |title=Coronavirus reaches Europe as France confirms 3 cases |date=24 January 2020 |website=DW.COM |access-date=28 January 2020}}</ref><ref>{{cite web |url=https://webcache.googleusercontent.com/search?q=cache:tThjZC8ZDxsJ:https://www.bloomberg.com/news/articles/2020-01-24/china-doing-good-job-in-combating-virus-german-minister-says+&cd=1&hl=en&ct=clnk&gl=ca |title=China Doing Good Job in Combating Virus, German Minister Says – Bloomberg |website=webcache.googleusercontent.com |access-date=28 January 2020}}</ref> In a letter to Xi, Singapore President [[Halimah Yacob]] applauded China's "swift, decisive and comprehensive measures" in safeguarding the health of the Chinese people, while Singapore Prime Minister [[Lee Hsien Loong]] remarked of "China's firm and decisive response" in communities affected by the virus.<ref>{{cite web |url=https://www.channelnewsasia.com/news/singapore/covid19-coronavirus-singapore-china-solidarity-12465678 |title=Singapore leaders stand in solidarity with China over COVID-19 outbreak |access-date=24 February 2020}}</ref> Similar sentiments were expressed by Russian President [[Vladimir Putin]].<ref>{{cite web |url=https://www.scmp.com/news/china/diplomacy/article/3050782/russia-and-china-pledge-maintain-special-relationship-despite |title=Russia and China pledge to maintain special relationship despite Moscow's slow response to coronavirus |access-date=24 February 2020}}</ref>

Revision as of 10:06, 25 February 2020

2019–20 coronavirus outbreak
Animated map of confirmed COVID-19 cases from 12 January to 23 February 2020
DiseaseCoronavirus disease 2019 (COVID-19)
Virus strainSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
First outbreakWuhan, Hubei, China[1]
Index case1 December 2019[2][3]
Confirmed cases80,153[4]
Deaths
2,701[4]

An ongoing outbreak of coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, started in December 2019. It was first identified in Wuhan, the capital of Hubei, China.[5] As of 25 February 2020, around 80,153 cases have been confirmed, including in all provinces of China and more than two dozen other countries.[6] Of these, 11,569 cases were classified as serious.[7] There have been 2,701 deaths attributable to the disease, including 38 outside mainland China,[4] surpassing that of the 2003 SARS outbreak.[8] More than 27,000 people have since recovered.[4]

Infection is primarily through human-to-human transmission via respiratory droplets that people exhale (such as sneeze or cough). The incubation period is typically two to fourteen days. Symptoms may include fever, cough, and shortness of breath. Complications may include pneumonia and acute respiratory distress syndrome. There are no vaccines or specific antiviral treatments, with efforts typically aiming at managing symptoms and supportive therapy. Anyone who is suspected of carrying the virus is advised to monitor their health for two weeks, wear a surgical mask to limit the spread, and seek medical advice by calling a doctor before visiting a clinic.[9][10]

A large response, both in China and globally, followed an increase in cases in mid-January 2020, bringing travel restrictions, quarantines, and curfews. Examples include the quarantine of the British cruise ship Diamond Princess in Japanese waters, the curfew of over 780 million in China, a voluntary curfew in Daegu, South Korea, and the curfew of a dozen towns with over 50,000 people in the Lombardy and Veneto regions of Italy.[11][12][13] The outbreak has been declared a Public Health Emergency of International Concern (PHEIC) by the World Health Organization (WHO).[14][15] Airports and train stations have implemented body temperature checks, health declarations, and information signage in an attempt to identify carriers of the virus.[16] A number of countries have issued warnings against travel to Wuhan, Hubei, or China generally.[17][18]

Among the wider consequences of the outbreak are concerns about potential economic instability and political fallout such as the firing of several local leaders of the Chinese Communist Party for their poor response to the outbreak.[19] Outbreak-related incidents of xenophobia and racism against people of Chinese and East Asian descent have been reported in several countries.[20][21][22][23] The spread of misinformation and disinformation about the virus, primarily online, has been described as an "infodemic" by the WHO.[24]

Origin

In late December, a cluster of pneumonia cases of unknown aetiology was reported by health authorities in Wuhan, Hubei Province, People's Republic of China. The initial cases mostly had epidemiological links to the Huanan Seafood Wholesale Market and consequently the virus is thought to have a zoonotic origin.[5] The virus that caused the outbreak is known as SARS-CoV-2, a new virus which is closely related to bat coronaviruses, pangolin coronaviruses and SARS-CoV-1.[25]

The earliest reported symptoms occurred on 1 December 2019, in a person who had not had any exposure to the Huanan Seafood Wholesale Market or to the remaining 40 of the first cluster detected with the new virus.[26][27] Of this first cluster, two-thirds were found to have a link with the market, which also sold live animals.[26][28][29][30]

Epidemiology

Updated August 17, 2024.
COVID-19 pandemic by location[31]
Location Cases Deaths
World[a] 775,866,783 7,057,132
European Union European Union[b] 185,822,587 1,262,988
United States United States 103,436,829 1,193,165
China China[c] 99,373,219 122,304
India India 45,041,748 533,623
France France 38,997,490 168,091
Germany Germany 38,437,756 174,979
Brazil Brazil 37,511,921 702,116
South Korea South Korea 34,571,873 35,934
Japan Japan 33,803,572 74,694
Italy Italy 26,781,078 197,307
United Kingdom United Kingdom 24,974,629 232,112
Russia Russia 24,268,728 403,188
Turkey Turkey 17,004,718 101,419
Spain Spain 13,980,340 121,852
Australia Australia 11,861,161 25,236
Vietnam Vietnam 11,624,000 43,206
Argentina Argentina 10,101,218 130,663
Taiwan Taiwan 9,970,937 17,672
Netherlands Netherlands 8,640,008 22,986
Iran Iran 7,627,863 146,837
Mexico Mexico 7,619,458 334,551
Indonesia Indonesia 6,829,399 162,059
Poland Poland 6,670,799 120,726
Colombia Colombia 6,391,876 142,727
Austria Austria 6,082,444 22,534
Greece Greece 5,673,681 39,258
Portugal Portugal 5,664,109 28,809
Ukraine Ukraine 5,532,777 109,920
Chile Chile 5,401,126 62,730
Malaysia Malaysia 5,309,410 37,351
Belgium Belgium 4,872,829 34,339
Israel Israel 4,841,558 12,707
Canada Canada 4,819,055 55,282
Thailand Thailand 4,799,180 34,715
Czech Republic Czech Republic 4,761,919 43,509
Peru Peru 4,526,977 220,975
Switzerland Switzerland 4,457,868 14,170
Philippines Philippines 4,140,383 66,864
South Africa South Africa 4,072,765 102,595
Romania Romania 3,541,619 68,825
Denmark Denmark 3,435,679 9,693
Singapore Singapore 3,006,155 2,024
Hong Kong Hong Kong 2,876,106 13,466
Sweden Sweden 2,755,181 27,399
New Zealand New Zealand 2,639,048 4,284
Serbia Serbia 2,583,470 18,057
Iraq Iraq 2,465,545 25,375
Hungary Hungary 2,230,800 49,053
Bangladesh Bangladesh 2,051,348 29,499
Slovakia Slovakia 1,878,002 21,227
Georgia (country) Georgia 1,863,615 17,150
Jordan Jordan 1,746,997 14,122
Republic of Ireland Republic of Ireland 1,745,088 9,744
Pakistan Pakistan 1,580,631 30,656
Norway Norway 1,512,647 5,732
Kazakhstan Kazakhstan 1,504,370 19,072
Finland Finland 1,499,712 11,466
Lithuania Lithuania 1,369,355 9,810
Slovenia Slovenia 1,356,582 10,083
Bulgaria Bulgaria 1,329,988 38,700
Croatia Croatia 1,317,144 18,752
Morocco Morocco 1,279,115 16,305
Puerto Rico Puerto Rico 1,252,713 5,938
Guatemala Guatemala 1,250,371 20,203
Lebanon Lebanon 1,239,904 10,947
Costa Rica Costa Rica 1,234,701 9,372
Bolivia Bolivia 1,212,147 22,387
Tunisia Tunisia 1,153,361 29,423
Cuba Cuba 1,113,662 8,530
Ecuador Ecuador 1,077,445 36,050
United Arab Emirates United Arab Emirates 1,067,030 2,349
Panama Panama 1,044,821 8,748
Uruguay Uruguay 1,041,346 7,682
Mongolia Mongolia 1,011,489 2,136
Nepal Nepal 1,003,450 12,031
Belarus Belarus 994,037 7,118
Latvia Latvia 977,765 7,475
Saudi Arabia Saudi Arabia 841,469 9,646
Azerbaijan Azerbaijan 835,757 10,353
Paraguay Paraguay 735,759 19,880
State of Palestine Palestine 703,228 5,708
Bahrain Bahrain 696,614 1,536
Cyprus Cyprus 696,410 1,451
Sri Lanka Sri Lanka 672,798 16,907
Kuwait Kuwait 667,290 2,570
Dominican Republic Dominican Republic 661,103 4,384
Myanmar Myanmar 642,885 19,494
Moldova Moldova 637,520 12,245
Estonia Estonia 610,471 2,998
Venezuela Venezuela 552,695 5,856
Egypt Egypt 516,023 24,830
Qatar Qatar 514,524 690
Libya Libya 507,269 6,437
Ethiopia Ethiopia 501,193 7,574
Réunion Réunion 494,595 921
Honduras Honduras 472,896 11,114
Armenia Armenia 452,273 8,777
Bosnia and Herzegovina Bosnia and Herzegovina 403,666 16,392
Oman Oman 399,449 4,628
Luxembourg Luxembourg 393,542 1,000
North Macedonia North Macedonia 350,924 9,978
Zambia Zambia 349,842 4,077
Brunei Brunei 347,723 179
Kenya Kenya 344,106 5,689
Albania Albania 335,047 3,605
Botswana Botswana 330,696 2,801
Mauritius Mauritius 328,167 1,073
Kosovo Kosovo 274,279 3,212
Algeria Algeria 272,139 6,881
Nigeria Nigeria 267,188 3,155
Zimbabwe Zimbabwe 266,386 5,740
Montenegro Montenegro 251,280 2,654
Afghanistan Afghanistan 235,214 7,998
Mozambique Mozambique 233,843 2,252
Martinique Martinique 230,354 1,104
Laos Laos 219,060 671
Iceland Iceland 210,374 186
Guadeloupe Guadeloupe 203,235 1,021
El Salvador El Salvador 201,920 4,230
Trinidad and Tobago Trinidad and Tobago 191,496 4,390
Maldives Maldives 186,694 316
Uzbekistan Uzbekistan 175,081 1,016
Namibia Namibia 172,533 4,108
Uganda Uganda 172,154 3,632
Ghana Ghana 172,062 1,462
Jamaica Jamaica 157,181 3,611
Cambodia Cambodia 139,319 3,056
Rwanda Rwanda 133,264 1,468
Cameroon Cameroon 125,246 1,974
Malta Malta 122,796 922
Barbados Barbados 108,582 593
Angola Angola 107,481 1,937
Democratic Republic of the Congo Democratic Republic of the Congo 101,009 1,474
French Guiana French Guiana 98,041 413
Senegal Senegal 89,485 1,971
Malawi Malawi 89,168 2,686
Kyrgyzstan Kyrgyzstan 88,953 1,024
Ivory Coast Ivory Coast 88,434 835
Suriname Suriname 82,501 1,406
New Caledonia New Caledonia 80,163 314
French Polynesia French Polynesia 79,387 650
Eswatini Eswatini 75,356 1,427
Guyana Guyana 74,443 1,302
Belize Belize 71,414 688
Fiji Fiji 69,047 885
Madagascar Madagascar 68,567 1,428
Jersey Jersey 66,391 161
Cape Verde Cabo Verde 64,474 417
Sudan Sudan 63,993 5,046
Mauritania Mauritania 63,872 997
Bhutan Bhutan 62,697 21
Syria Syria 57,423 3,163
Burundi Burundi 54,569 15
Guam Guam 52,287 419
Seychelles Seychelles 51,886 172
Gabon Gabon 49,051 307
Andorra Andorra 48,015 159
Papua New Guinea Papua New Guinea 46,864 670
Curaçao Curaçao 45,883 305
Aruba Aruba 44,224 292
Tanzania Tanzania 43,230 846
Mayotte Mayotte 42,027 187
Togo Togo 39,530 290
The Bahamas Bahamas 39,127 849
Guinea Guinea 38,572 468
Isle of Man Isle of Man 38,008 116
Lesotho Lesotho 36,138 709
Guernsey Guernsey 35,326 67
Faroe Islands Faroe Islands 34,658 28
Haiti Haiti 34,456 860
Mali Mali 33,166 743
Federated States of Micronesia Federated States of Micronesia 31,765 65
Cayman Islands Cayman Islands 31,472 37
Saint Lucia Saint Lucia 30,282 410
Benin Benin 28,036 163
Somalia Somalia 27,334 1,361
Solomon Islands Solomon Islands 25,954 199
United States Virgin Islands United States Virgin Islands 25,389 132
San Marino San Marino 25,292 126
Republic of the Congo Republic of the Congo 25,227 389
East Timor Timor-Leste 23,460 138
Burkina Faso Burkina Faso 22,139 400
Liechtenstein Liechtenstein 21,588 89
Gibraltar Gibraltar 20,550 113
Grenada Grenada 19,693 238
Bermuda Bermuda 18,860 165
South Sudan South Sudan 18,823 147
Tajikistan Tajikistan 17,786 125
Monaco Monaco 17,181 67
Equatorial Guinea Equatorial Guinea 17,130 183
Samoa Samoa 17,057 31
Tonga Tonga 16,976 12
Marshall Islands Marshall Islands 16,297 17
Nicaragua Nicaragua 16,185 245
Dominica Dominica 16,047 74
Djibouti Djibouti 15,690 189
Central African Republic Central African Republic 15,441 113
Northern Mariana Islands Northern Mariana Islands 14,912 41
The Gambia Gambia 12,627 372
Collectivity of Saint Martin Collectivity of Saint Martin 12,324 46
Vanuatu Vanuatu 12,019 14
Greenland Greenland 11,971 21
Yemen Yemen 11,945 2,159
Caribbean Netherlands Caribbean Netherlands 11,922 41
Sint Maarten Sint Maarten 11,051 92
Eritrea Eritrea 10,189 103
Saint Vincent and the Grenadines Saint Vincent and the Grenadines 9,674 124
Guinea-Bissau Guinea-Bissau 9,614 177
Niger Niger 9,518 315
Comoros Comoros 9,109 160
Antigua and Barbuda Antigua and Barbuda 9,106 146
American Samoa American Samoa 8,359 34
Sierra Leone Sierra Leone 7,979 125
Liberia Liberia 7,930 294
Chad Chad 7,702 194
British Virgin Islands British Virgin Islands 7,557 64
Cook Islands Cook Islands 7,345 2
Turks and Caicos Islands Turks and Caicos Islands 6,805 40
São Tomé and Príncipe Sao Tome and Principe 6,771 80
Saint Kitts and Nevis Saint Kitts and Nevis 6,607 46
Palau Palau 6,372 10
Saint Barthélemy Saint Barthélemy 5,507 5
Nauru Nauru 5,393 1
Kiribati Kiribati 5,085 24
Anguilla Anguilla 3,904 12
Wallis and Futuna Wallis and Futuna 3,760 9
Macau Macau 3,514 121
Saint Pierre and Miquelon Saint Pierre and Miquelon 3,426 2
Tuvalu Tuvalu 2,943 1
Saint Helena, Ascension and Tristan da Cunha Saint Helena, Ascension and Tristan da Cunha 2,166
Falkland Islands Falkland Islands 1,923
Montserrat Montserrat 1,403 8
Niue Niue 1,074
Tokelau Tokelau 80 0
Vatican City Vatican City 26 0
Pitcairn Islands Pitcairn Islands 4
North Korea North Korea 1 6
Turkmenistan Turkmenistan 0 0
  1. ^ Countries which do not report data for a column are not included in that column's world total.
  2. ^ Data on member states of the European Union are individually listed, but are also summed here for convenience. They are not double-counted in world totals.
  3. ^ Does not include special administrative regions (Hong Kong and Macau) or Taiwan.


COVID-19 cases in Mainland China  ()
     Deaths        Recoveries        Tested        Clinically diagnosed (C.D.)        Tested or C.D.
20192019202020202021202120222022
DecDec
JanJanFebFebMarMarAprAprMayMayJunJunJulJulAugAugSepSepOctOctNovNovDecDec
JanJanFebFebMarMarAprAprMayMayJunJunJulJulAugAugSepSepOctOctNovNovDecDec
JanJan
Last 15 daysLast 15 days
Date
Number of cases
(excluding C.D.)
Number of cases
(including C.D.)
2019-12-31
27(n.a.)
27(=)
2020-01-03
44(+63%)
2020-01-04
44(=)
2020-01-05
59(+34%)
59(=)
2020-01-10
41(n.a.)
2020-01-11
41(=)
2020-01-12
41(=)
41(=)
2020-01-15
41(=)
2020-01-16
45(+9.8%)
2020-01-17
62(+38%)
2020-01-18
121(+95%)
2020-01-19
198(+64%)
2020-01-20
291(+47%)
2020-01-21
440(+51%)
2020-01-22
571(+30%)
2020-01-23
830(+45%)
2020-01-24
1,287(+55%)
2020-01-25
1,975(+53%)
2020-01-26
2,744(+39%)
2020-01-27
4,515(+65%)
2020-01-28
5,974(+32%)
2020-01-29
7,711(+29%)
2020-01-30
9,692(+26%)
2020-01-31
11,791(+22%)
2020-02-01
14,380(+22%)
2020-02-02
17,205(+20%)
2020-02-03
20,438(+19%)
2020-02-04
24,324(+19%)
2020-02-05
28,018(+15%)
2020-02-06
31,161(+11%)
2020-02-07
34,546(+11%)
2020-02-08
37,198(+7.7%)
2020-02-09
40,171(+8%)
2020-02-10[i]
42,638(+6.1%) 48,315(n.a.)
2020-02-11
44,653(+4.7%) 55,220(+14%)
2020-02-12[ii]
46,472(+4.1%) 58,761(+6.4%)
2020-02-13
48,467(+4.3%) 63,851(+8.7%)
2020-02-14
49,970(+3.1%) 66,492(+4.1%)
2020-02-15
51,091(+2.2%) 68,500(+3.0%)
2020-02-16
70,548(+3.0%)
2020-02-17
72,436(+2.7%)
2020-02-18[iii]
74,185(+2.4%)
2020-02-19[iv]
75,002(+1.1%)
2020-02-20
75,891(+1.2%)
2020-02-21
76,288(+0.52%)
2020-02-22
76,936(+0.85%)
2020-02-23
77,150(+0.28%)
2020-02-24
77,658(+0.66%)
2020-02-25
78,064(+0.52%)
2020-02-26
78,497(+0.55%)
2020-02-27
78,824(+0.42%)
2020-02-28
79,251(+0.54%)
2020-02-29
79,824(+0.72%)
2020-03-01
80,026(+0.25%)
2020-03-02
80,151(+0.16%)
2020-03-03
80,270(+0.15%)
2020-03-04
80,409(+0.17%)
2020-03-05
80,552(+0.18%)
2020-03-06
80,651(+0.12%)
2020-03-07
80,695(+0.05%)
2020-03-08
80,735(+0.05%)
2020-03-09
80,754(+0.02%)
2020-03-10
80,778(+0.03%)
2020-03-11
80,793(+0.02%)
2020-03-12
80,813(+0.02%)
2020-03-13
80,824(+0.01%)
2020-03-14
80,844(+0.02%)
2020-03-15
80,860(+0.02%)
2020-03-16
80,881(+0.03%)
2020-03-17
80,894(+0.02%)
2020-03-18
80,928(+0.04%)
2020-03-19
80,967(+0.05%)
2020-03-20
81,008(+0.05%)
2020-03-21
81,054(+0.06%)
2020-03-22
81,093(+0.05%)
2020-03-23
81,171(+0.1%)
2020-03-24
81,218(+0.06%)
2020-03-25
81,285(+0.08%)
2020-03-26
81,340(+0.07%)
2020-03-27
81,394(+0.07%)
2020-03-28
81,439(+0.06%)
2020-03-29
81,470(+0.04%)
2020-03-30
81,518(+0.06%)
2020-03-31
81,554(+0.04%)
2020-04-01
81,589(+0.04%)
2020-04-02
81,620(+0.04%)
2020-04-03
81,639(+0.02%)
2020-04-04
81,669(+0.04%)
2020-04-05
81,708(+0.05%)
2020-04-06
81,740(+0.04%)
2020-04-07
81,802(+0.08%)
2020-04-08
81,865(+0.08%)
2020-04-09
81,907(+0.05%)
2020-04-10
81,953(+0.06%)
2020-04-11
82,052(+0.12%)
2020-04-12
82,160(+0.13%)
2020-04-13
82,249(+0.11%)
2020-04-14
82,295(+0.06%)
2020-04-15
82,341(+0.06%)
2020-04-16
82,692(+0.43%)
2020-04-17
82,719(+0.03%)
2020-04-18
82,735(+0.02%)
2020-04-19
82,747(+0.01%)
2020-04-20
82,758(+0.01%)
2020-04-21
82,788(+0.04%)
2020-04-22
82,798(+0.01%)
2020-04-23
82,804(+0.01%)
2020-04-24
82,816(+0.01%)
2020-04-25
82,827(+0.01%)
2020-04-26
82,830(=)
2020-04-27
82,836(+0.01%)
2020-04-28
82,858(+0.03%)
2020-04-29
82,862(=)
2020-04-30
82,874(+0.01%)
2020-05-01
82,875(=)
2020-05-02
82,877(=)
2020-05-03
82,880(=)
2020-05-04
82,881(=)
2020-05-05
82,883(=)
2020-05-06
82,885(=)
2020-05-07
82,886(=)
2020-05-08
82,887(=)
2020-05-09
82,901(+0.02%)
2020-05-10
82,918(+0.02%)
2020-05-11
82,919(=)
2020-05-12
82,926(+0.01%)
2020-05-13
82,929(=)
2020-05-14
82,933(=)
2020-05-15
82,941(+0.01%)
2020-05-16
82,947(+0.01%)
2020-05-17
82,954(+0.01%)
2020-05-18
82,960(+0.01%)
2020-05-19
82,965(+0.01%)
2020-05-20
82,967(=)
2020-05-21
82,971(=)
2020-05-22
82,971(=)
2020-05-23
82,974(=)
2020-05-24
82,985(+0.01%)
2020-05-25
82,992(+0.01%)
2020-05-26
82,993(=)
2020-05-27
82,995(=)
2020-05-28
82,995(=)
2020-05-29
82,999(=)
2020-05-30
83,001(=)
2020-05-31
83,017(+0.02%)
2020-06-01
83,022(+0.01%)
2020-06-02
83,021(=)
2020-06-03
83,022(=)
2020-06-04
83,027(+0.01%)
2020-06-05
83,030(=)
2020-06-06
83,036(+0.01%)
2020-06-07
83,040(=)
2020-06-08
83,043(=)
2020-06-09
83,046(=)
2020-06-10
83,057(+0.01%)
2020-06-11
83,064(+0.01%)
2020-06-12
83,075(+0.01%)
2020-06-13
83,132(+0.07%)
2020-06-14
83,181(+0.06%)
2020-06-15
83,221(+0.05%)
2020-06-16
83,265(+0.05%)
2020-06-17
83,293(+0.03%)
2020-06-18
83,325(+0.04%)
2020-06-19
83,352(+0.03%)
2020-06-20
83,378(+0.03%)
2020-06-21
83,396(+0.02%)
2020-06-22
83,418(+0.03%)
2020-06-23
83,430(+0.01%)
2020-06-24
83,449(+0.02%)
2020-06-25
83,462(+0.02%)
2020-06-26
83,483(+0.03%)
2020-06-27
83,500(+0.02%)
2020-06-28
83,512(+0.01%)
2020-06-29
83,531(+0.02%)
2020-06-30
83,534(=)
2020-07-01
83,537(=)
2020-07-02
83,542(+0.01%)
2020-07-03
83,545(=)
2020-07-04
83,553(+0.01%)
2020-07-05
83,557(=)
2020-07-06
83,565(+0.01%)
2020-07-07
83,572(+0.01%)
2020-07-08
83,581(+0.01%)
2020-07-09
83,585(=)
2020-07-10
83,587(=)
2020-07-11
83,594(+0.01%)
2020-07-12
83,602(+0.01%)
2020-07-13
83,605(=)
2020-07-14
83,611(+0.01%)
2020-07-15
83,612(=)
2020-07-16
83,622(+0.01%)
2020-07-17
83,644(+0.03%)
2020-07-18
83,660(+0.02%)
2020-07-19
83,682(+0.03%)
2020-07-20
83,693(+0.01%)
2020-07-21
83,707(+0.02%)
2020-07-22
83,729(+0.03%)
2020-07-23
83,750(+0.03%)
2020-07-24
83,784(+0.04%)
2020-07-25
83,830(+0.05%)
2020-07-26
83,891(+0.07%)
2020-07-27
83,959(+0.08%)
2020-07-28
84,060(+0.12%)
2020-07-29
84,165(+0.12%)
2020-07-30
84,292(+0.15%)
2020-07-31
84,337(+0.05%)
2020-08-01
84,385(+0.06%)
2020-08-02
84,428(+0.05%)
2020-08-03
84,464(+0.04%)
2020-08-04
84,491(+0.03%)
2020-08-05
84,528(+0.04%)
2020-08-06
84,565(+0.04%)
2020-08-07
84,596(+0.04%)
2020-08-08
84,619(+0.03%)
2020-08-09
84,668(+0.06%)
2020-08-10
84,712(+0.05%)
2020-08-11
84,737(+0.03%)
2020-08-12
84,756(+0.02%)
2020-08-13
84,786(+0.04%)
2020-08-14
84,808(+0.03%)
2020-08-15
84,827(+0.02%)
2020-08-16
84,849(+0.03%)
2020-08-17
84,871(+0.03%)
2020-08-18
84,888(+0.02%)
2020-08-19
84,895(+0.01%)
2020-08-20
84,917(+0.03%)
2020-08-21
84,939(+0.03%)
2020-08-22
84,951(+0.01%)
2020-08-23
84,967(+0.02%)
2020-08-24
84,981(+0.02%)
2020-08-25
84,996(+0.02%)
2020-08-26
85,004(+0.01%)
2020-08-27
85,013(+0.01%)
2020-08-28
85,022(+0.01%)
2020-08-29
85,031(+0.01%)
2020-08-30
85,048(+0.02%)
2020-08-31
85,058(+0.01%)
2020-09-01
85,066(+0.01%)
2020-09-02
85,077(+0.01%)
2020-09-03
85,102(+0.03%)
2020-09-04
85,112(+0.01%)
2020-09-05
85,122(+0.01%)
2020-09-06
85,134(+0.01%)
2020-09-07
85,144(+0.01%)
2020-09-08
85,146(=)
2020-09-09
85,153(+0.01%)
2020-09-10
85,168(+0.02%)
2020-09-11
85,174(+0.01%)
2020-09-12
85,184(+0.01%)
2020-09-13
85,194(+0.01%)
2020-09-14
85,202(+0.01%)
2020-09-15
85,214(+0.01%)
2020-09-16
85,223(+0.01%)
2020-09-17
85,255(+0.04%)
2020-09-18
85,269(+0.02%)
2020-09-19
85,279(+0.01%)
2020-09-20
85,291(+0.01%)
2020-09-21
85,297(+0.01%)
2020-09-22
85,307(+0.01%)
2020-09-23
85,314(+0.01%)
2020-09-24
85,322(+0.01%)
2020-09-25
85,337(+0.02%)
2020-09-26
85,351(+0.02%)
2020-09-27
85,372(+0.02%)
2020-09-28
85,384(+0.01%)
2020-09-29
85,403(+0.02%)
2020-09-30
85,414(+0.01%)
2020-10-01
85,424(+0.01%)
2020-10-02
85,434(+0.01%)
2020-10-03
85,450(+0.02%)
2020-10-04
85,470(+0.02%)
2020-10-05
85,482(+0.01%)
2020-10-06
85,489(+0.01%)
2020-10-07
85,500(+0.01%)
2020-10-08
85,521(+0.02%)
2020-10-09
85,536(+0.02%)
2020-10-10
85,557(+0.02%)
2020-10-11
85,578(+0.02%)
2020-10-12
85,591(+0.02%)
2020-10-13
85,611(+0.02%)
2020-10-14
85,622(+0.01%)
2020-10-15
85,646(+0.03%)
2020-10-16
85,659(+0.02%)
2020-10-17
85,672(+0.02%)
2020-10-18
85,685(+0.02%)
2020-10-19
85,704(+0.02%)
2020-10-20
85,715(+0.01%)
2020-10-21
85,729(+0.02%)
2020-10-22
85,747(+0.02%)
2020-10-23
85,775(+0.03%)
2020-10-24
85,790(+0.02%)
2020-10-25
85,810(+0.02%)
2020-10-26
85,826(+0.02%)
2020-10-27
85,868(+0.05%)
2020-10-28
85,915(+0.05%)
2020-10-29
85,940(+0.03%)
2020-10-30
85,973(+0.04%)
2020-10-31
85,997(+0.03%)
2020-11-01
86,021(+0.03%)
2020-11-02
86,070(+0.06%)
2020-11-03
86,087(+0.02%)
2020-11-04
86,115(+0.03%)
2020-11-05
86,151(+0.04%)
2020-11-06
86,184(+0.04%)
2020-11-07
86,212(+0.03%)
2020-11-08
86,245(+0.04%)
2020-11-09
86,267(+0.03%)
2020-11-10
86,284(+0.02%)
2020-11-11
86,299(+0.02%)
2020-11-12
86,307(+0.01%)
2020-11-13
86,325(+0.02%)
2020-11-14
86,338(+0.02%)
2020-11-15
86,346(+0.01%)
2020-11-16
86,361(+0.02%)
2020-11-17
86,369(+0.01%)
2020-11-18
86,381(+0.01%)
2020-11-19
86,398(+0.02%)
2020-11-20
86,414(+0.02%)
2020-11-21
86,431(+0.02%)
2020-11-22
86,442(+0.01%)
2020-11-23
86,464(+0.03%)
2020-11-24
86,469(+0.01%)
2020-11-25
86,490(+0.02%)
2020-11-26
86,495(+0.01%)
2020-11-27
86,501(+0.01%)
2020-11-28
86,512(+0.01%)
2020-11-29
86,530(+0.02%)
2020-11-30
86,542(+0.01%)
2020-12-01
86,551(+0.01%)
2020-12-02
86,567(+0.02%)
2020-12-03
86,584(+0.02%)
2020-12-04
86,601(+0.02%)
2020-12-05
86,619(+0.02%)
2020-12-06
86,634(+0.02%)
2020-12-07
86,646(+0.01%)
2020-12-08
86,661(+0.02%)
2020-12-09
86,673(+0.01%)
2020-12-10
86,688(+0.02%)
2020-12-11
86,701(+0.01%)
2020-12-12
86,725(+0.03%)
2020-12-13
86,741(+0.02%)
2020-12-14
86,758(+0.02%)
2020-12-15
86,770(+0.01%)
2020-12-16
86,777(+0.01%)
2020-12-17
86,789(+0.01%)
2020-12-18
86,806(+0.02%)
2020-12-19
86,829(+0.03%)
2020-12-20
86,852(+0.03%)
2020-12-21
86,867(+0.02%)
2020-12-22
86,882(+0.02%)
2020-12-23
86,899(+0.02%)
2020-12-24
86,913(+0.02%)
2020-12-25
86,933(+0.02%)
2020-12-26
86,955(+0.03%)
2020-12-27
86,976(+0.02%)
2020-12-28
87,003(+0.03%)
2020-12-29
87,027(+0.03%)
2020-12-30
87,052(+0.03%)
2020-12-31
87,071(+0.02%)
2021-01-01
87,093(+0.03%)
2021-01-02
87,117(+0.03%)
2021-01-03
87,150(+0.04%)
2021-01-04
87,183(+0.04%)
2021-01-05
87,215(+0.04%)
2021-01-06
87,278(+0.07%)
2021-01-07
87,331(+0.06%)
2021-01-08
87,364(+0.04%)
2021-01-09
87,433(+0.08%)
2021-01-10
87,536(+0.12%)
2021-01-11
87,591(+0.06%)
2021-01-12
87,706(+0.13%)
2021-01-13
87,844(+0.16%)
2021-01-14
87,988(+0.16%)
2021-01-15
88,118(+0.15%)
2021-01-16
88,227(+0.12%)
2021-01-17
88,336(+0.12%)
2021-01-18
88,454(+0.13%)
2021-01-19
88,557(+0.12%)
2021-01-20
88,701(+0.16%)
2021-01-21
88,804(+0.12%)
2021-01-22
88,911(+0.12%)
2021-01-23
88,991(+0.09%)
2021-01-24
89,115(+0.14%)
2021-01-25
89,197(+0.09%)
2021-01-26
89,272(+0.08%)
2021-01-27
89,326(+0.06%)
2021-01-28
89,378(+0.06%)
2021-01-29
89,430(+0.06%)
2021-01-30
89,522(+0.1%)
2021-01-31
89,564(+0.05%)
2021-02-01
89,594(+0.03%)
2021-02-02
89,619(+0.03%)
2021-02-03
89,649(+0.03%)
2021-02-04
89,669(+0.02%)
2021-02-05
89,681(+0.01%)
2021-02-06
89,692(+0.01%)
2021-02-07
89,706(+0.02%)
2021-02-08
89,720(+0.02%)
2021-02-09
89,734(+0.02%)
2021-02-10
89,736(=)
2021-02-11
89,748(+0.01%)
2021-02-12
89,756(+0.01%)
2021-02-13
89,763(+0.01%)
2021-02-14
89,772(+0.01%)
2021-02-15
89,788(+0.02%)
2021-02-16
89,795(+0.01%)
2021-02-17
89,806(+0.01%)
2021-02-18
89,816(+0.01%)
2021-02-19
89,824(+0.01%)
2021-02-20
89,831(+0.01%)
2021-02-21
89,842(+0.01%)
2021-02-22
89,852(+0.01%)
2021-02-23
89,864(+0.01%)
2021-02-24
89,871(+0.01%)
2021-02-25
89,877(+0.01%)
2021-02-26
89,887(+0.01%)
2021-02-27
89,893(+0.01%)
2021-02-28
89,912(+0.02%)
2021-03-01
89,923(+0.01%)
2021-03-02
89,933(+0.01%)
2021-03-03
89,943(+0.01%)
2021-03-04
89,952(+0.01%)
2021-03-05
89,962(+0.01%)
2021-03-06
89,975(+0.01%)
2021-03-07
89,994(+0.02%)
2021-03-08
90,002(+0.01%)
2021-03-09
90,007(+0.01%)
2021-03-10
90,018(+0.01%)
2021-03-11
90,027(+0.01%)
2021-03-12
90,034(+0.01%)
2021-03-13
90,044(+0.01%)
2021-03-14
90,049(+0.01%)
2021-03-15
90,062(+0.01%)
2021-03-16
90,066(=)
2021-03-17
90,072(+0.01%)
2021-03-18
90,083(+0.01%)
2021-03-19
90,087(=)
2021-03-20
90,099(+0.01%)
2021-03-21
90,106(+0.01%)
2021-03-22
90,115(+0.01%)
2021-03-23
90,125(+0.01%)
2021-03-24
90,136(+0.01%)
2021-03-25
90,147(+0.01%)
2021-03-26
90,159(+0.01%)
2021-03-27
90,167(+0.01%)
2021-03-28
90,182(+0.02%)
2021-03-29
90,190(+0.01%)
2021-03-30
90,201(+0.01%)
2021-03-31
90,217(+0.02%)
2021-04-01
90,226(+0.01%)
2021-04-02
90,252(+0.03%)
2021-04-03
90,273(+0.02%)
2021-04-04
90,305(+0.04%)
2021-04-05
90,329(+0.03%)
2021-04-06
90,341(+0.01%)
2021-04-07
90,365(+0.03%)
2021-04-08
90,386(+0.02%)
2021-04-09
90,400(+0.02%)
2021-04-10
90,410(+0.01%)
2021-04-11
90,426(+0.02%)
2021-04-12
90,435(+0.01%)
2021-04-13
90,447(+0.01%)
2021-04-14
90,457(+0.01%)
2021-04-15
90,468(+0.01%)
2021-04-16
90,483(+0.02%)
2021-04-17
90,499(+0.02%)
2021-04-18
90,510(+0.01%)
2021-04-19
90,520(+0.01%)
2021-04-20
90,541(+0.02%)
2021-04-21
90,547(+0.01%)
2021-04-22
90,566(+0.02%)
2021-04-23
90,575(+0.01%)
2021-04-24
90,588(+0.01%)
2021-04-25
90,599(+0.01%)
2021-04-26
90,610(+0.01%)
2021-04-27
90,622(+0.01%)
2021-04-28
90,642(+0.02%)
2021-04-29
90,655(+0.01%)
2021-04-30
90,671(+0.02%)
2021-05-01
90,686(+0.02%)
2021-05-02
90,697(+0.01%)
2021-05-03
90,714(+0.02%)
2021-05-04
90,721(+0.01%)
2021-05-05
90,726(+0.01%)
2021-05-06
90,739(+0.01%)
2021-05-07
90,746(+0.01%)
2021-05-08
90,758(+0.01%)
2021-05-09
90,769(+0.01%)
2021-05-10
90,783(+0.02%)
2021-05-11
90,799(+0.02%)
2021-05-12
90,808(+0.01%)
2021-05-13
90,815(+0.01%)
2021-05-14
90,829(+0.02%)
2021-05-15
90,847(+0.02%)
2021-05-16
90,872(+0.03%)
2021-05-17
90,894(+0.02%)
2021-05-18
90,908(+0.02%)
2021-05-19
90,920(+0.01%)
2021-05-20
90,944(+0.03%)
2021-05-21
90,954(+0.01%)
2021-05-22
90,973(+0.02%)
2021-05-23
90,991(+0.02%)
2021-05-24
91,006(+0.02%)
2021-05-25
91,019(+0.01%)
2021-05-26
91,038(+0.02%)
2021-05-27
91,045(+0.01%)
2021-05-28
91,061(+0.02%)
2021-05-29
91,072(+0.01%)
2021-05-30
91,099(+0.03%)
2021-05-31
91,122(+0.03%)
2021-06-01
91,146(+0.03%)
2021-06-02
91,170(+0.03%)
2021-06-03
91,194(+0.03%)
2021-06-04
91,218(+0.03%)
2021-06-05
91,248(+0.03%)
2021-06-06
91,267(+0.02%)
2021-06-07
91,300(+0.04%)
2021-06-08
91,316(+0.02%)
2021-06-09
91,337(+0.02%)
2021-06-10
91,359(+0.02%)
2021-06-11
91,394(+0.04%)
2021-06-12
91,428(+0.04%)
2021-06-13
91,451(+0.03%)
2021-06-14
91,471(+0.02%)
2021-06-15
91,492(+0.02%)
2021-06-16
91,511(+0.02%)
2021-06-17
91,534(+0.03%)
2021-06-18
91,564(+0.03%)
2021-06-19
91,587(+0.03%)
2021-06-20
91,604(+0.02%)
2021-06-21
91,629(+0.03%)
2021-06-22
91,653(+0.03%)
2021-06-23
91,669(+0.02%)
2021-06-24
91,693(+0.03%)
2021-06-25
91,718(+0.03%)
2021-06-26
91,732(+0.02%)
2021-06-27
91,753(+0.02%)
2021-06-28
91,771(+0.02%)
2021-06-29
91,780(+0.01%)
2021-06-30
91,792(+0.01%)
2021-07-01
91,810(+0.02%)
2021-07-02
91,833(+0.03%)
2021-07-03
91,847(+0.02%)
2021-07-04
91,869(+0.02%)
2021-07-05
91,892(+0.03%)
2021-07-06
91,949(+0.06%)
2021-07-07
91,966(+0.02%)
2021-07-08
91,989(+0.03%)
2021-07-09
92,015(+0.03%)
2021-07-10
92,039(+0.03%)
2021-07-11
92,066(+0.03%)
2021-07-12
92,095(+0.03%)
2021-07-13
92,119(+0.03%)
2021-07-14
92,147(+0.03%)
2021-07-15
92,183(+0.04%)
2021-07-16
92,213(+0.03%)
2021-07-17
92,246(+0.04%)
2021-07-18
92,277(+0.03%)
2021-07-19
92,342(+0.07%)
2021-07-20
92,364(+0.02%)
2021-07-21
92,414(+0.05%)
2021-07-22
92,462(+0.05%)
2021-07-23
92,497(+0.04%)
2021-07-24
92,529(+0.03%)
2021-07-25
92,605(+0.08%)
2021-07-26
92,676(+0.08%)
2021-07-27
92,762(+0.09%)
2021-07-28
92,811(+0.05%)
2021-07-29
92,875(+0.07%)
2021-07-30
92,930(+0.06%)
2021-07-31
93,005(+0.08%)
2021-08-01
93,103(+0.11%)
2021-08-02
93,193(+0.1%)
2021-08-03
93,289(+0.1%)
2021-08-04
93,374(+0.09%)
2021-08-05
93,498(+0.13%)
2021-08-06
93,605(+0.11%)
2021-08-07
93,701(+0.1%)
2021-08-08
93,826(+0.13%)
2021-08-09
93,969(+0.15%)
2021-08-10
94,080(+0.12%)
2021-08-11
94,161(+0.09%)
2021-08-12
94,260(+0.11%)
2021-08-13
94,326(+0.07%)
2021-08-14
94,379(+0.06%)
2021-08-15
94,430(+0.05%)
2021-08-16
94,472(+0.04%)
2021-08-17
94,500(+0.03%)
2021-08-18
94,546(+0.05%)
2021-08-19
94,579(+0.03%)
2021-08-20
94,599(+0.02%)
2021-08-21
94,631(+0.03%)
2021-08-22
94,652(+0.02%)
2021-08-23
94,687(+0.04%)
2021-08-24
94,707(+0.02%)
2021-08-25
94,733(+0.03%)
2021-08-26
94,765(+0.03%)
2021-08-27
94,786(+0.02%)
2021-08-28
94,819(+0.03%)
2021-08-29
94,842(+0.02%)
2021-08-30
94,879(+0.04%)
2021-08-31
94,898(+0.02%)
2021-09-01
94,926(+0.03%)
2021-09-02
94,954(+0.03%)
2021-09-03
94,982(+0.03%)
2021-09-04
95,010(+0.03%)
2021-09-05
95,028(+0.02%)
2021-09-06
95,064(+0.04%)
2021-09-07
95,083(+0.02%)
2021-09-08
95,111(+0.03%)
2021-09-09
95,128(+0.02%)
2021-09-10
95,153(+0.03%)
2021-09-11
95,199(+0.05%)
2021-09-12
95,248(+0.05%)
2021-09-13
95,340(+0.1%)
2021-09-14
95,413(+0.08%)
2021-09-15
95,493(+0.08%)
2021-09-16
95,577(+0.09%)
2021-09-17
95,623(+0.05%)
2021-09-18
95,689(+0.07%)
2021-09-19
95,738(+0.05%)
2021-09-20
95,810(+0.08%)
2021-09-21
95,851(+0.04%)
2021-09-22
95,894(+0.04%)
2021-09-23
95,948(+0.06%)
2021-09-24
95,986(+0.04%)
2021-09-25
96,015(+0.03%)
2021-09-26
96,050(+0.04%)
2021-09-27
96,081(+0.03%)
2021-09-28
96,106(+0.03%)
2021-09-29
96,128(+0.02%)
2021-09-30
96,162(+0.04%)
2021-10-01
96,203(+0.04%)
2021-10-02
96,231(+0.03%)
2021-10-03
96,258(+0.03%)
2021-10-04
96,284(+0.03%)
2021-10-05
96,310(+0.03%)
2021-10-06
96,335(+0.03%)
2021-10-07
96,357(+0.02%)
2021-10-08
96,374(+0.02%)
2021-10-09
96,398(+0.02%)
2021-10-10
96,423(+0.03%)
2021-10-11
96,435(+0.01%)
2021-10-12
96,457(+0.02%)
2021-10-13
96,478(+0.02%)
2021-10-14
96,488(+0.01%)
2021-10-15
96,502(+0.01%)
2021-10-16
96,522(+0.02%)
2021-10-17
96,546(+0.02%)
2021-10-18
96,571(+0.03%)
2021-10-19
96,601(+0.03%)
2021-10-20
96,622(+0.02%)
2021-10-21
96,665(+0.04%)
2021-10-22
96,715(+0.05%)
2021-10-23
96,758(+0.04%)
2021-10-24
96,797(+0.04%)
2021-10-25
96,840(+0.04%)
2021-10-26
96,899(+0.06%)
2021-10-27
96,938(+0.04%)
2021-10-28
97,002(+0.07%)
2021-10-29
97,080(+0.08%)
2021-10-30
97,151(+0.07%)
2021-10-31
97,243(+0.09%)
2021-11-01
97,314(+0.07%)
2021-11-02
97,423(+0.11%)
2021-11-03
97,527(+0.11%)
2021-11-04
97,605(+0.08%)
2021-11-05
97,660(+0.06%)
2021-11-06
97,734(+0.08%)
2021-11-07
97,823(+0.09%)
2021-11-08
97,885(+0.06%)
2021-11-09
97,939(+0.06%)
2021-11-10
98,001(+0.06%)
2021-11-11
98,099(+0.1%)
2021-11-12
98,174(+0.08%)
2021-11-13
98,263(+0.09%)
2021-11-14
98,315(+0.05%)
2021-11-15
98,337(+0.02%)
2021-11-16
98,368(+0.03%)
2021-11-17
98,403(+0.04%)
2021-11-18
98,427(+0.02%)
2021-11-19
98,450(+0.02%)
2021-11-20
98,467(+0.02%)
2021-11-21
98,505(+0.04%)
2021-11-22
98,524(+0.02%)
2021-11-23
98,546(+0.02%)
2021-11-24
98,570(+0.02%)
2021-11-25
98,583(+0.01%)
2021-11-26
98,608(+0.03%)
2021-11-27
98,631(+0.02%)
2021-11-28
98,672(+0.04%)
2021-11-29
98,711(+0.04%)
2021-11-30
98,824(+0.11%)
2021-12-01
98,897(+0.07%)
2021-12-02
98,993(+0.1%)
2021-12-03
99,083(+0.09%)
2021-12-04
99,142(+0.06%)
2021-12-05
99,203(+0.06%)
2021-12-06
99,297(+0.09%)
2021-12-07
99,371(+0.07%)
2021-12-08
99,454(+0.08%)
2021-12-09
99,517(+0.06%)
2021-12-10
99,604(+0.09%)
2021-12-11
99,679(+0.08%)
2021-12-12
99,780(+0.1%)
2021-12-13
99,856(+0.08%)
2021-12-14
99,923(+0.07%)
2021-12-15
100,000(+0.08%)
2021-12-16
100,076(+0.08%)
2021-12-17
100,201(+0.12%)
2021-12-18
100,284(+0.08%)
2021-12-19
100,386(+0.1%)
2021-12-20
100,467(+0.08%)
2021-12-21
100,544(+0.08%)
2021-12-22
100,644(+0.1%)
2021-12-23
100,731(+0.09%)
2021-12-24
100,871(+0.14%)
2021-12-25
101,077(+0.2%)
2021-12-26
101,277(+0.2%)
2021-12-27
101,486(+0.21%)
2021-12-28
101,683(+0.19%)
2021-12-29
101,890(+0.2%)
2021-12-30
102,083(+0.19%)
2021-12-31
102,314(+0.23%)
2022-01-01
102,505(+0.19%)
2022-01-02
102,666(+0.16%)
2022-01-03
102,841(+0.17%)
2022-01-04
102,932(+0.09%)
2022-01-05
103,121(+0.18%)
2022-01-06
103,295(+0.17%)
2022-01-07
103,454(+0.15%)
2022-01-08
103,619(+0.16%)
2022-01-09
103,776(+0.15%)
2022-01-10
103,968(+0.19%)
2022-01-11
104,189(+0.21%)
2022-01-12
104,379(+0.18%)
2022-01-13
104,580(+0.19%)
2022-01-14
104,745(+0.16%)
2022-01-15
104,864(+0.11%)
2022-01-16
105,087(+0.21%)
2022-01-17
105,258(+0.16%)
2022-01-18
105,345(+0.08%)
2022-01-19
105,411(+0.06%)
2022-01-20
105,484(+0.07%)
2022-01-21
105,547(+0.06%)
2022-01-22
105,603(+0.05%)
2022-01-23
105,660(+0.05%)
2022-01-24
105,705(+0.04%)
2022-01-25
105,749(+0.04%)
2022-01-26
105,811(+0.06%)
2022-01-27
105,875(+0.06%)
2022-01-28
105,934(+0.06%)
2022-01-29
106,015(+0.08%)
2022-01-30
106,073(+0.05%)
2022-01-31
106,139(+0.06%)
From 10 February 2020 onwards, the data includes the cases in Hubei that were not tested for the virus but clinically diagnosed based on medical imaging showing signs of pneumonia.[32]
The lab-tested data was also separately available for 10–15 February 2020.[33]
Data from 16 February 2020 onwards did not include a separate number of lab-tested cases.
From 19 February 2020 onwards, only new lab-tested cases were counted towards the total (but clinically diagnosed cases counted earlier were not discarded).[34]
On 17 April 2020, following the Wuhan government's issuance of a report on accounting for COVID-19 deaths that occurred at home that went previously unreported, as well as the subtraction of deaths that were previously double-counted by different hospitals, the NHC revised their cumulative totals dating to 16 April, adding 325 cumulative cases and 1,290 deaths.[35]
Data sourced from NHC daily reports. (In another link before January 25, on Wuhan MHC website before January 10)
  1. ^ The 02-10 and 02-11 clinically diagnosed data has been based on appendix in the 02-11 Hubei WJW data, with 02-10's data obtained from deducting the number of new C.D. cases on that day from the total.
  2. ^ The 02-12 data has been corrected based on the 02-13 NHC subtraction data and corresponding 02-13 Hubei data.
  3. ^ The 02-18 number of tested cases is calculated based on the 02-19 subtraction data.
  4. ^ Data from 02-19 excludes clinical diagnoses, so the calculation is made provisionally for ease of understanding the progression of the situation.

Epidemiological analysis of the outbreak has shown a probable pattern of a "mixed outbreak" – there was likely a continuous common source outbreak at the seafood market in December 2019, potentially from several zoonotic events.[5] Following this, the epidemiologists found that the outbreak likely became a propagated source (transmitted from person to person), potentially due to the virus' ability to mutate.[5] Hence, as the number of cases has increased, the significance of the market has lessened.[26][27][36]

During the early stages, the number of cases doubled approximately every seven and a half days.[36] In early and mid-January 2020, the virus spread to other Chinese provinces, helped by the Chinese new year migration. On 20 January, China reported nearly 140 new patients in a day, including two people in Beijing and one in Shenzhen.[37] Later official data shows that 6,174 SARS-CoV-2-infected patients had already developed symptoms by 20 January 2020.[38]

The virus was soon carried to other countries by international travellers: Thailand (13 January); Japan (15 January); Macau (19 January);[39] South Korea (20 January); Taiwan and the United States (21 January); Hong Kong (22 January); Singapore (23 January); France, Nepal, and Vietnam (24 January); Australia and Malaysia (25 January); Canada (26 January); Cambodia (27 January); Germany (28 January); Finland, Sri Lanka, and the United Arab Emirates (29 January); India, Italy, and the Philippines (30 January); the United Kingdom, Russia, Sweden, and Spain (31 January); Belgium (4 February); Egypt (14 February); Iran (19 February); Israel and Lebanon (21 February); Afghanistan, Bahrain, Kuwait, Iraq, and Oman (24 February).[40][41]

By 25 January, the number of laboratory-confirmed cases had stood at 2,062, including 2,016 in Mainland China, seven in Thailand, six in Hong Kong, five in Macau, five in Australia, four in Malaysia, four in Singapore, three in France, three in Japan, three in South Korea, three in Taiwan, three in the United States, two in Vietnam, one in Nepal, and one in Sweden.[40][42][43]

Citing 7,711 cases essentially in China and 83 cases abroad across 18 countries as of 29 January, WHO declared the outbreak to be a Public Health Emergency of International Concern on 30 January.[44] As of 25 February, 80,153 cases have been confirmed worldwide, over 96.9% in mainland China.[41]

On 12 February 2020, the Hubei government adopted a broader definition of confirmed cases, which now includes clinically diagnosed patients diagnosed by their symptoms and CT scans but without nucleic acid test, which can take days to process and delay treatment. "Using CT scans that reveal lung infection would help patients receive treatment as soon as possible and improve their chances of recovery," the provincial health commission said.[45] This new methodology accounts for the sharp increase in Hubei's daily confirmed cases: 13,332 of the 14,840 newly confirmed cases in the province on 12 February were diagnosed clinically under the new definition.[46]

On 20 February, the Chinese National Health Commission (NHC) changed how cases are counted again by counting only cases showing positive results through laboratory tests. The change is done as the backlog of patients who needed to be treated has since cleared.[47] Other sources interpreted the new NHC guidelines as cancelling the previous change in how Hubei (alone) was counting confirmed cases without laboratory tests, and said NHC now distinguished counting of confirmed cases from suspected cases, requiring RT-PCR or gene sequencing for confirmation of infection, whereas suspicion of infection is based on two levels of epidemiological history and clinical symptoms.[48]



Deaths

As of 25 February, 2,701 deaths have been attributed to COVID-19. According to China's NHC, most of those who died were older patients – about 80% of deaths recorded were from those over the age of 60, and 75% had pre-existing health conditions including cardiovascular diseases and diabetes.[49] The case fatality rate has been estimated at around 2–3%.[50]

The first confirmed death was a 61-year-old man on 9 January 2020, who was first admitted to a Wuhan hospital on 27 December 2019.[51] The first death outside China occurred in the Philippines,[52][41] when a 44-year-old Chinese male citizen developed severe pneumonia and died on 1 February. His companion, a 38-year-old Chinese female citizen was also confirmed to have contracted the virus, but eventually recovered. She stayed in the same hospital in Manila as her companion until her discharge on 8 February.[53] On 8 February 2020, it was announced that a Japanese and an American died from the virus in Wuhan. They were the first non-Chinese killed by the virus.[54] The first death outside Asia was confirmed in Paris, France, on 15 February 2020, when an 80-year-old Chinese tourist from Hubei died after being in hospital since 25 January.[55] On 19 February 2020, two elderly Japanese citizens who had been on the Diamond Princess died after being hospitalised for a week after they had tested positive for the virus,[56][57] while a third elderly Japanese citizen died on 23 February 2020.[58]

As of 24 February 2020, the highest COVID-19 death counts outside of mainland China were 12 in Iran according to the Iranian Ministry of Health and Medical Education or 50 in Qom alone according to member of the Iranian parliament Ahmad Amirabadi Farahani;[59] seven in South Korea;[60] and seven in Italy.[61]

Estimates

On 17 January, a research group from the Imperial College London in the United Kingdom published a report giving an estimate of 1,723 cases (95% confidence interval, 427–4,471) with onset of symptoms by 12 January. This was based on the pattern of the initial spread to Thailand and Japan. They also concluded that "self-sustaining human-to-human transmission should not be ruled out",[62][63] which has since been confirmed. As further cases came to light, they later recalculated that there may be 4,000 symptomatic cases in Wuhan City by 18 January (uncertainty range of 1,000 to 9,700).[64][65][63] A Hong Kong University group has reached a similar conclusion as the earlier study, with additional detail on transport within China.[66]

Based on cases reported and assuming a ten-day delay between infection and detection, researchers at Northeastern University estimated that the number of actual infections may be much higher than those confirmed at the time of reporting. Northeastern University estimated 21,300 infections by 26 January, increasing to 31,200 infections by 29 January (95% confidence interval 23,400–40,400).[67] On 31 January 2020, an article in The Lancet estimated that 75,815 individuals (95% confidence interval 37,304–130,330) had been infected in Wuhan as of 25 January, with an estimated doubling time of 6.4 days in the period of study.[68]

There are concerns about whether adequate medical personnel and equipment are available in regions affected by the outbreak for hospitals to correctly identify coronavirus cases instead of misdiagnosing suspected cases as "severe pneumonia".[69][70][71] Many of those experiencing symptoms were told to self-quarantine at home instead of going to a hospital to avoid close contact with other patients with different levels of symptoms.[72] After two repatriation flights were conducted from Wuhan to Japan in late January, five out of approximately 400 persons repatriated were diagnosed with the virus, of whom one was symptomatic, and four were not.[73]

On 4 February 2020, the University of Southampton's WorldPop research group used mobile phone data and airline flight records to create a risk map for the likely spread of the disease.[74][75]





Case and death counts in China are influenced by changes in clinical case definition.[80][81] A paper submitted to Eurosurveillance modelling China's official death rate statistics reported that "In the popular press, there are also speculations about a large number of unreported cases, casting doubt on the usefulness of the reported numbers. Although this is justified in view of the length of the incubation period of about six days in this case, it affects all data uniformly."[82]

Transmission

The transmissibility of the coronavirus is sufficient for sustained community transmission. Locally acquired cases have been reported in several countries. Most deaths have so far been in China.[25]

On 6 February 2020, the Chinese National Health Commission (NHC) started to change how cases were reported – asymptomatic carriers, who tested positive for the virus but did not show clinical symptoms, would no longer be included in the number of confirmed cases. This had the effect of reducing the total number of cases reported, but also meant that potentially contagious individuals were ignored in reports.[83][84] On 13 February 2020, the director of the Centers for Disease Control and Prevention of the United States confirmed asymptomatic transmission.[85] However, as of 27 February 2019, the extent to which asymptomatic transmission can occur remains unclear.[86]

COVID-19 is primarily spread between people via respiratory droplets produced when an infected person coughs or sneezes.[87] However, the virus can also be spread by people who do not show symptoms.[88] Coronavirus droplets only stay suspended in the air for a short time, but can stay viable and contagious on a metal, glass or plastic surface for up to nine days.[89] Disinfection of surfaces is possible with cheap substances such as 62–71% ethanol applied for one minute.[89] Chinese public health officials suggest extra caution for aerosol transmission in closed rooms and recommend regularly exchanging air.[90]

Viral RNA was detected in stool specimens collected from the first confirmed case in the United States, though it was unclear if enough of the infectious virus was present to suggest fecal-oral transmission.[91]

Of the initial 41 cases, two-thirds had a history of exposure to the Huanan Seafood Wholesale Market.[26]

There have been estimates for the basic reproduction number (the average number of people an infected person is likely to infect), ranging from 2.13[92] to 4.82.[93][94] The virus has reportedly been able to transmit down a chain of up to four people so far[when?].[95] This is similar to severe acute respiratory syndrome-related coronavirus (SARS-CoV).[96] There are disputed reports that some of the infected may be super-spreaders.[97][98]

Signs and symptoms

Symptoms of coronavirus disease 2019

Most infected people will initially show clinical symptoms, often described as flu-like symptoms, such as fever, coughing, breathing difficulties, fatigue, and myalgia. Further development can lead to severe pneumonia, acute respiratory distress syndrome, sepsis, septic shock and death. Upper respiratory symptoms, such as sneezing, a runny nose and sore throat, are less frequent.[26] Some of those infected may be asymptomatic, returning test results that confirm infection but show no clinical symptoms, so researches have issued advice that individuals with close contact to confirmed infected patients should be closely monitored and examined to rule out infection.[99]

The incubation period is estimated at between two to 14 days.[100] One study found that the usual incubation time was three days but may be as long as 24 days.[101]

Cause

SARS-CoV-2, a novel severe acute respiratory syndrome coronavirus first isolated from three people with pneumonia connected to the cluster of acute respiratory illness cases reported in Wuhan, is the cause of Coronavirus disease 2019 (COVID-19).[25]

Virology

SARS-CoV-2 is closely related to SARS-CoV-1 (75% to 80% identical).[102] It is thought to have a zoonotic origin based on probable epidemiological links to the Huanan Seafood Market. Genetic analysis has revealed that the coronavirus genetically clusters with the genus Betacoronavirus, in lineage B of the subgenus Sarbecovirus together with two bat-derived strains. It is 96% identical at the whole genome level to other bat coronavirus samples.[103] In February 2020, researchers from South China Agricultural University announced that there is a 99% similarity in genome sequences between the viruses found in pangolins and those from human patients, suggesting that the animal may be an intermediary host for the virus, but did not release evidence.[104] At least five genomes of the novel coronavirus have been isolated and reported.[105][106][107]

The coronavirus enters human cells through a receptor called angiotensin-converting enzyme 2 (ACE 2), a membrane exopeptidase.[25]

Bayesian analysis by Benvenuto et al. of the genome sequences of SARS-CoV-2 and related coronaviruses, shows that the nucleocapsid and the spike glycoprotein have some sites under positive selective pressure. Homology modelling indicated certain molecular and structural differences among the viruses. The phylogenetic tree showed that SARS-CoV-2 significantly clustered with a bat SARS-like coronavirus sequence, whereas structural analysis revealed mutations in spike glycoprotein and nucleocapsid protein. The authors conclude SARS-CoV-2 is a coronavirus distinct from SARS virus that probably was transmitted from bats or another host that provided the ability to infect humans.[108]

Tracking genetic and using mathematics it was estimated patient zero likely had been infect between 15th November and 15th December. Based on the data provided by the worldwide Nextstrain collaboration, Dr. Bedford refuted claims of its origin being from a laboratory.[109][110][111]

Diagnosis

The WHO has published several testing protocols for SARS-CoV-2.[112][113] Testing uses real time reverse transcription polymerase chain reaction (rRT-PCR).[1] The test can be done on respiratory or blood samples.[114] Results are generally available within a few hours to days.[115][116] However, Chinese pulmonologist Wang Chen reported that this method of RT-PCR testing would give false positive in 50-70% times.[117]

Chinese scientists were able to isolate a strain of the coronavirus and publish the genetic sequence so that laboratories across the world could independently develop PCR tests to detect infection by the virus.[118][119][120][121]

Prevention

A medical worker wearing a PPE suit sees a patient in a Wuhan hospital

To reduce the chances of infection, health organizations recommend avoiding close contact with sick individuals; frequently washing hands with soap and water; not touching the eyes, nose, or mouth with unwashed hands; and practicing good respiratory hygiene.[122][123]

Those who may be infected are advised to stay at home except to get medical care, call ahead before visiting a healthcare provider, wear a facemask (especially in public), cover coughs and sneezes with a tissue, regularly wash hands with soap and water, and avoid sharing personal household items.[124]

No vaccine currently exists.[125]

A number of governments advise against all non-essential travel to Mainland China.[126] The Government of Hong Kong warned anyone travelling outside the city to not touch animals; to not eat game meat; and to avoid visiting wet markets, live poultry markets, and farms.[127] There is no evidence that pets such as dogs and cats can be infected.[128]

For health care providers taking care of someone who may be infected standard precautions, contact precautions, and airborne precautions with eye protection are recommended.[129]

Hand washing

Hand washing is recommended to prevent the spread of coronavirus. The CDC recommends that individuals:[130]

Wash hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing
If soap and water are not readily available, use an alcohol-based hand sanitiser with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.

The CDC, the National Health Service (NHS), and the WHO also advise individuals to avoid touching the eyes, nose, or mouth with unwashed hands.[130][131][132]

Coronaviruses can survive and remain contagious on a metal, glass or plastic surface for up to nine days.[89] Methods to remove the virus from surfaces include chlorine-based disinfectants, 75% ethanol, peracetic acid, and chloroform.[128]

Respiratory hygiene

Surgical masks used by people in Guangzhou. Masks are not recommended for people at low risk of infection.

Those who suspect they are infected should wear a surgical mask (especially when in public) and call a doctor for medical advice.[127][9][133] By limiting the volume and travel distance of expiratory droplets dispersed when talking, sneezing, and coughing, masks can serve a public health benefit in reducing transmission by those unknowingly infected.[134]

If a mask is not available, anyone experiencing respiratory symptoms should cover a cough or sneeze with a tissue, promptly discard it in the trash, and wash their hands. If a tissue is unavailable, individuals can cover their mouth or nose with a flexed elbow.[131]

Masks are also recommended for those taking care of someone who may have the disease.[133] Rinsing the nose, gargling with mouthwash, and eating garlic are not effective.[128]

The WHO advises the following best practices for mask usage:[133]

  • Place mask carefully to cover mouth and nose and tie securely to minimise any gaps between the face and the mask; while in use, avoid touching the mask;
  • Remove the mask by using appropriate technique (i.e., do not touch the front but remove the lace from behind);
  • After removal or whenever you inadvertently touch a used mask, clean hands by using an alcohol-based hand rub or soap and water if visibly soiled;
  • Replace masks with a new clean, dry mask as soon as they become damp/humid;
  • Do not re-use single-use masks; discard single-use masks after each use and dispose of them immediately upon removal

Healthcare professionals interacting directly with people who have the disease are advised to use respirators at least as protective as NIOSH-certified N95, EU standard FFP2, or equivalent, in addition to other personal protective equipment.[133][135]

There is no evidence to show that masks protect uninfected persons at low risk, and wearing them may create a false sense of security.[133] Surgical masks are widely used by healthy people in Hong Kong,[136] Japan,[137] Singapore,[138][139] and Malaysia.[140] Surgical masks are not recommended by the CDC as a preventive measure for the American general public.[134] The use of masks by healthy members of the public is not recommended outside of China.[76][105][141]

Vaccine and therapy research

Several organisations around the world are developing vaccines or testing antiviral medicine. In China, the Chinese Center for Disease Control and Prevention (CCDC) has started developing vaccines against the novel coronavirus and is testing existing drug effectiveness for pneumonia.[142][143] Also, a team at the University of Hong Kong announced that a new vaccine is developed, but needs to be tested on animals before conducting clinical tests on humans.[144]

In Western countries, the United States' National Institutes of Health (NIH) is hoping for human trials of a vaccine by April 2020;[145][146] the Norwegian Coalition for Epidemic Preparedness Innovations (CEPI) is funding three vaccine projects and hopes to have a vaccine in trials by June 2020, and approved and ready in a year.[147] These projects are an mRNA vaccine developed by Cambridge, Massachusetts–based Moderna,[148][149] a "molecular clamp" vaccine platform the University of Queensland in Australia is developing after receiving AU$10.6 million in funding from CEPI,[150][151][152] and a vaccine Inovio Pharmaceuticals designed in two hours after receiving the gene sequence of the virus.[153] The latter vaccine is being manufactured so that it can be first tested on animals.[153] By February 2020, United States Department of Health and Human Services' Biomedical Advanced Research and Development Authority announced partnerships with Johnson & Johnson's Janssen Pharmaceutica and Sanofi Pasteur to develop vaccines and to screen for potential drugs in collaboration with the Belgium-based Rega Institute for Medical Research.[154]

Management

Wuhan Metro System Map before Wuhan lockdown, in which the daily ridership in January 2020 is recorded.
Infrared cameras were installed in Wuhan railway station to check passengers' body temperature before they board the trains.

There are no specific medications for SARS-CoV-2, though development efforts are underway. Attempts to relieve the symptoms include taking regular (over-the-counter) flu medications,[155] drinking fluids, and resting.[130] Depending on the severity, oxygen therapy, intravenous fluids, and breathing support may be required.[156] Some countries require people to report flu-like symptoms to their doctor, especially if they have visited mainland China.[157]

On 18 February 2020, the Chinese National Medical Products Administration approved the antiviral drug favipiravir for use COVID-19. The drug, previously approved for treatment of influenza, had shown early efficacy against COVID-19 in human trials in China.[158]

Bruce Aylward, an assistant director-general of the World Health Organization (WHO), has stated "there is only one drug right now that we think may have real efficacy and that's remdesivir." Clinical trials for this drug are in progress, and results could be available within weeks of February 24.[159]

Public health responses

China

'Aerial photography of roads after motor vehicles are banned in central urban areas of Wuhan: few vehicle traces' – Video news from China News Service
Passengers wearing masks going through an extra body temperature check as part of airport security. Captured on 26 January in NE China's Changchun Longjia Airport
Hong Kong residents queueing to refund their bullet train tickets to the mainland in West Kowloon railway station

The first person known to have fallen ill due to the new virus was in Wuhan on 1 December 2019.[160] A public notice on the outbreak was released 30 days later by Wuhan health authority on 31 December 2019; the initial notice informed Wuhan residents that there was no clear evidence of human-to-human transmission of the virus, that the disease is preventable and controllable, and that people can wear masks when going out.[161] WHO was informed of the outbreak on the same day.[162]

On 7 January 2020, Chinese Communist Party general secretary Xi Jinping, chaired the meeting of Party Politburo Standing Committee to discuss novel coronavirus prevention and control.[163][164]

On 20 January, Zhong Nanshan, a scientist at China's National Health Commission who played a prominent role in the SARS epidemic, declared its potential for human-to-human transmission, after two cases emerged in Guangdong of infection by family members who had visited Wuhan.[165] This was later confirmed by the Wuhan government, which announced a number of new measures such as cancelling the Chinese New Year celebrations, in addition to measures such as checking the temperature of passengers at transport terminals first introduced on 14 January.[166] A quarantine was announced on 23 January 2020 stopping travel in and out of Wuhan.[167]

On 25 January, Politburo of the Communist Party of China met to discuss novel coronavirus prevention and control. Chinese Communist Party general secretary Xi Jinping stated that the country is facing a "grave situation" as the number of infected people is accelerating.[168] In the evening, the authorities banned the use of private vehicles in Wuhan. Only vehicles that are transporting critical supplies or emergency response vehicles are allowed to move within the city.[169]

On 26 January, a leading group tasked with the prevention and control of the novel coronavirus outbreak was established, led by Chinese Premier Li Keqiang. Premier Li visited Wuhan to direct the epidemic prevention work on 27 January.[170][171] The leading group has decided to extend Spring Festival holiday to contain coronavirus outbreak.[172]

China Customs started requiring that all passengers entering and exiting China fill in an extra health declaration form from 26 January. The health declaration form was mentioned in China's Frontier Health and Quarantine Law, granting the customs rights to require it if needed. The customs said it will "restart this system" as it was not a requirement before.[173][174][175]

On 27 January, the General Office of the State Council of China, one of the top governing bodies of the People's Republic, officially declared a nation-wide extension on the New Year holiday and the postponement of the coming spring semester. The Office extended the previously scheduled public holiday from 30 January, to 2 February, while it said school openings for the spring semester will be announced in the future.[176] Some universities with open campuses also banned the public from visiting.[177] On 23 January, the education department in Hunan, which neighbours the centre of the outbreak Hubei province, stated it will strictly ban off-school tutors and restrict student gatherings.[178] Education departments in Shanghai and Shenzhen also imposed bans on off-school tutoring and requested that schools track and report students who had been to Wuhan or Hubei province during the winter break.[179][180] The semi-autonomous regions of Hong Kong and Macau also announced adjustments on schooling schedules. Hong Kong's Chief Executive Carrie Lam declared an emergency at a press conference on 25 January, saying the government will close primary and secondary schools for two more weeks on top of the previously scheduled New Year holiday, pushing the date for school reopening to 17 February.[181][182] Macau closed several museums and libraries, and prolonged the New Year holiday break to 11 February for higher education institutions and 10 February for others.[183] The University of Macau said they would track the physical conditions of students who have been to Wuhan during the New Year break.[184]

After the Chinese New Year on 25 January, there would be another peak of people travelling back from their hometowns to workplaces as a part of Chunyun. Several provinces and cities encouraged people to stay in their hometowns and not travel back. Eastern China's Suzhou also encouraged remote working via the Internet and further prolonged the spring festival break.[185]

The Civil Aviation Administration of China and the China State Railway Group, which regulates China's civil aviation and operates rail services, announced on 24 January that passengers could have full refunds for their plane and train tickets without any additional surcharges, regardless of whether their flight or train will go through Wuhan or not. Some hotel chains and online travel agencies also allowed more flexibility in cancellations and changes.[186][187] China's Ministry of Culture and Tourism ordered travel agencies and online tourism firms to suspend package tours and stop offering "flight+hotel" bundles.[188][185]

Additional provinces and cities outside Hubei imposed travel restrictions. Beijing suspended all intercity bus services on 25 January,[189] with several others following suit. Shanghai, Tianjin, Shandong, Xi'an, and Sanya all announced suspension of intercity or inter-province bus services on 26 January.[185]

A screen display in Hefei showing "early detection, early report, early quarantine, early diagnosis, early treatment" during the coronavirus outbreak.

On 1 February 2020, Xinhua News reported that China's Supreme People's Procuratorate (SPP) has "asked procuratorates nationwide to fully play their role to create a favourable judicial environment in the fight against the novel coronavirus outbreak." This includes severe punishments for those found guilty of dereliction of duty and the withholding of information for officials. Tougher charges were proscribed for commercial criminal activities such as "the pushing up of prices, profiteering and severely disturbing market order" along with the "production and sale of fake and shoddy protective equipment and medicines." Prosecuting actions against patients who deliberately spread the infection or refuse examination or compulsory isolation along with threats of violence against medical personnel were also urged. The statement also included urging to prosecute those found "fabricating coronavirus-related information that may lead to panic among the public, making up and spreading rumors about the virus, sabotaging the implementation of the law and endangering public security" and also stressed "harshly punishing the illegal hunting of wildlife under state protection, as well as improving inspection and quarantine measures for fresh food and meat products."[190]

Museums throughout China are temporarily closed.[191][192] To provide cultural and heritage seekers some form of service, the Chinese National Cultural Heritage Administration (NCHA) has asked museums around the country to move their exhibits and galleries temporarily online.[193] This is done via a specific program that the NCHA is launching.[191][194] Some museums are also putting the content on their own website, social media, or even social chat apps and rooms like WeChat.[195] The majority of the content will be available on a NCHA website web page, however it is only accessible inside of China.[191][194] However, there are a few excerpts from the main created exhibition website that are on the NCHA general information page that are linked too, that are accessible outside of China.[191]

Quarantines

Place Province Start date End date City level Population Cases Deaths Recoveries Active
Wuhan Hubei 2020-01-23 2020-04-08[196][197][198] Sub-provincial 11,081,000 50,340 3,869 46,471 0
Xiaogan Hubei 2020-01-24 2020-03-25[199] Prefectural 4,920,000 3,518 129 3,389 0
Huanggang Hubei 2020-01-23 2020-03-25[199] Prefectural 6,330,000 2,907 125 2,782 0
Jingzhou Hubei 2020-01-24 2020-03-17[200] Prefectural 5,590,200 1,580 52 1,528 0
Ezhou Hubei 2020-01-23 2020-03-25[199] Prefectural 1,077,700 1,394 59 1,335 0
Suizhou Hubei 2020-01-24 2020-03-25[199] Prefectural 2,216,700 1,307 45 1,262 0
Xiangyang Hubei 2020-01-28[201] 2020-03-25[199] Prefectural 5,669,000 1,175 40 1,135 0
Huangshi Hubei 2020-01-24 2020-03-13[202] Prefectural 2,470,700 1,015 39 976 0
Yichang Hubei 2020-01-24 2020-03-25[199] Prefectural 4,135,850 931 37 894 0
Jingmen Hubei 2020-01-24 2020-03-25[199] Prefectural 2,896,500 928 41 887 0
Xianning Hubei 2020-01-24 2020-03-25[199] Prefectural 2,543,300 836 15 821 0
Shiyan Hubei 2020-01-24 2020-03-25[199] Prefectural 3,406,000 672 8 664 0
Xiantao Hubei 2020-01-24 2020-03-25[199] Sub-prefectural 1,140,500 575 22 553 0
Tianmen Hubei 2020-01-24 2020-03-25[199] Sub-prefectural 1,272,300 496 15 481 0
Enshi Hubei 2020-01-24 2020-03-25[199] Prefectural 3,378,000 252 7 245 0
Qianjiang Hubei 2020-01-24 2020-03-13[203] Sub-prefectural 966,000 198 9 189 0
Shennongjia Hubei 2020-01-27 2020-03-25[199] Sub-prefectural 78,912 11 0 11 0
Wenzhou Zhejiang 2020-02-02 2020-02-20[204] Prefectural 9,190,000 507 1 503 3
Ürümqi Xinjiang 2020-07-18 2020-08-26[205] Prefectural 3,519,600 845 0 845 0
Shijiazhuang Hebei 2021-01-07 2021-01-31[206] Prefectural 11,031,200 977 1 962 14
Xi'an Shaanxi 2021-12-22[207] 2022-01-16[208] Sub-provincial 8,467,838 2,265 3 2,185 77
Yuzhou Henan 2022-01-04[209] 2022-01-31[210] County 1,167,000 - - - -
Anyang Henan 2022-01-10[211] 2022-02-03[212] Prefectural 5,477,614 522 0 522 0
Shenzhen Guangdong 2022-03-14[213][214] 2022-03-21[215][216] Sub-provincial 17,560,000 982 3 428 551
Shanghai Shanghai 2022-04-01[217] 2022-06-01[218] Direct-administered municipality 24,870,895
Lockdown total 101,602,895 68,135 4,512 63,623 0
Outbreak ongoing: Infection and fatality data as of 24:00 (UTC+8) 4 June 2020.[219][220] Totals will evolve.

On 23 January 2020, a quarantine on travel in and out of Wuhan was imposed in an effort to stop the spread of the virus out of Wuhan. Flights, trains, public buses, the metro system, and long-distance coaches were suspended indefinitely. Large-scale gatherings and group tours were also suspended.[167] By 24 January 2020, a total of 15 cities in Hubei, including Wuhan, were placed under similar quarantine measures.[221] On 27 and 28 January 2020, Xiangyang closed its railway stations and suspended all ferry operations, after shutting down its airport and intercity bus services earlier. Thus, the entire Hubei province entered a city-by-city quarantine, save for the Shennongjia Forestry District.[citation needed]

Before the quarantine began, some in Wuhan questioned the reliability of the figures from the Chinese government as well as the government response, with some calling for quarantine,[222] and a post also showed sick people and three dead bodies covered in white sheets on the floor of a hospital on 24 January, although many such posts in Weibo about the epidemic have since been deleted.[223][224]

Due to quarantine measures, Wuhan residents rushed to stockpile essential goods, food, and fuel; prices rose significantly.[225][226] 5,000,000 people left Wuhan, with 9,000,000 left in the city.[227]

On 26 January, the city of Shantou in Guangdong declared a partial lockdown,[228] though this was reversed two hours later.[229] Residents had rushed to supermarkets to stock food as soon as the lockdown was declared, until the authorities reversed their decision. Caixin said, that the wording of Shantou's initial declaration was "unprecedentedly strict" and will severely affect residents' lives, if implemented as-is. Shantou's Department for Outbreak Control later clarified, that they will not restrict travelling, and all they would do, is to sterilise vehicles used for transportation.[230]

Local authorities in Beijing and several other major cities, including Hangzhou, Guangzhou, Shanghai, and Shenzhen, announced on 26 January, that these cities will not impose a lockdown similar to those in Hubei province. Rumours of these potential lockdowns had spread widely prior to the official announcements.[231] A spokesperson of Beijing's Municipal Transportation Commission claimed, that the expressways and highways, as well as subways and buses were operating normally. To ease the residents' panic, the Hangzhou city government stressed that the city would not be locked down from the outside world, and both cities said that they would introduce precautions against potential risks.[232]

On 2 February 2020, the city of Wenzhou in Zhejiang also implemented a partial lockdown, closing 46 of the 54 highway checkpoints.[233]

On 4 February 2020, two more cities in Zhejiang province restricted the movement of residents. The city of Taizhou, three Hangzhou districts, and some in Ningbo began to only allow one person per household to go outside every two days to buy necessities, city officials said. More than 12 million people are affected by the new restrictions.[234]

By 6 February 2020, a total of four Zhejiang cities—Wenzhou, Hangzhou, Ningbo, and Taizhou—were under the "passport" system, allowing only one person per household to leave their home every two days. These restrictions apply to over 30 million people.[11]

Outside Mainland China, some cruise ships were quarantined after passengers developed symptoms or tested positive for SARS-CoV-2. The Costa Smeralda was quarantined on 30 January off Civitavecchia in Italy, after passengers developed flu-like symptoms – the quarantine was lifted when tests for the virus came back negative.[235] Two further ships were quarantined on 5 February: Diamond Princess in the Port of Yokohama, Japan and World Dream, which returned to Hong Kong after being refused entry to Kaohsiung, Taiwan. In both cases, passengers and crew tested positive.[236][237][238][239] On 10 February passengers were allowed to disembark the World Dream "without the need to self-quarantine after leaving."[240] The Diamond Princess remains quarantined with 136 confirmed cases as of 10 February.[241] Although the quarantine has not been completely lifted, around 500 passengers that were not diagnosed with the virus were allowed to leave on 19 February 2020.[242]In addition, although not quarantined the MS Westerdam has been refused entry by several ports after departing Hong Kong on 1 February.

Outdoor restrictions

On 1 February, Huanggang, Hubei implemented a measure whereby only one person from each household is permitted to go outside for provisions once every two days, except for medical reasons or to work at shops or pharmacies.[243] Many cities, districts, and counties across mainland China implemented similar measures in the days following, including Wenzhou, Hangzhou, Fuzhou, Harbin, and the whole of Jiangxi.

Interprovincial medical aid

As of 16 February 2020, 217 teams of a total of 25,633 medical workers from across China went to Wuhan and other cities in Hubei to help open up more facilities and treat patients.[277]

Censorship and police responses

Document issued by the Wuhan Police ordering Li Wenliang to stop "spreading rumours" about a possible 'SARS virus' dated 3 January.

The first known infection by a new virus was reported in Wuhan on 1 December 2019. The early response by city authorities was accused of prioritising a control of information on the outbreak. A group of eight medical personnel, including Li Wenliang, an ophthalmologist from Wuhan Central Hospital, who in late December posted warnings on a new coronavirus strain akin to SARS, were warned by Wuhan police for "spreading rumours" for likening it to SARS.[302][303]

By the time China had informed the World Health Organization of the new coronavirus on 31 December 2019, The New York Times reported that the government was still keeping "its own citizens in the dark".[304][305][306] While by a number of measures, China's initial handling of the crisis was an improvement in relation to the SARS response in 2003, China has been criticised for cover-ups and downplaying the initial discovery and severity of the outbreak. This has been attributed to the censorship institutional structure of the country's press and internet, with Nicholas Kristof of The New York Times and Jude Blanchette of the Center for Strategic and International Studies suggesting that it was exacerbated by China's paramount leader Xi Jinping's crackdown on independent oversight such as journalism and social media that left senior officials with inaccurate information on the outbreak and "contributed to a prolonged period of inaction that allowed the virus to spread".[307][306][304]

On 20 January, General Secretary Xi Jinping made his first public remark on the outbreak and spoke of "the need for the timely release of information".[168][308] Chinese premier Li Keqiang also urged efforts to prevent and control the epidemic.[309] One day later, the CPC Central Political and Legal Affairs Commission, the most powerful political organ in China overseeing legal enforcement and the police, wrote "self-deception will only make the epidemic worse and turn a natural disaster that was controllable into a man-made disaster at great cost," and "only openness can minimise panic to the greatest extent." The commission then added, "anyone who deliberately delays and hides the reporting of cases out of self-interest will be nailed on a pillar of shame for eternity."[310][311] Also on the same day, Xi Jinping instructed authorities "to strengthen the guidance of public opinions", language which some view as a call for censorship after commentators on social media became increasingly pointedly critical and angry at the government due to the epidemic. Some view this as contradictory to the calls for "openness" that the central government had already declared.[312]

Statements issued by Xi Jinping on 3 February declared the need for an emphasis by state media on "telling the moving stories of how [people] on the front line are preventing and fighting the virus" as a priority of coverage, while top official Zhang Xiaoguo said that his department would "treat propaganda regarding the control and prevention measures of the virus as its top priority".[313][314] The Cyberspace Administration (CAC) declared its intent to foster an "good online atmosphere," with CAC notices sent to video platforms encouraging them to "not to push any negative story, and not to conduct non-official live-streaming on the virus."[315]

Censorship has been observed being applied on news articles and social media posts deemed to hold negative tones about the coronavirus and the governmental response, including posts mocking Xi Jinping for not visiting areas of the epidemic,[316] an article that predicted negative effects of the epidemic on the economy, and calls to remove local government officials.[307][317][318][314] Chinese citizens have reportedly used innovative methods to avoid censorship to express anger about how government officials have handled the initial outbreak response, such as using the word 'Trump' to refer to Xi Jinping, or 'Chernobyl' to refer to the outbreak as a whole.[313] While censorship had been briefly relaxed giving a "window of about two weeks in which Chinese journalists were able to publish hard-hitting stories exposing the mishandling of the novel coronavirus by officials", since then private news outlets were reportedly required to use "planned and controlled publicity" with the authorities' consent.[319][313][314]

On 30 January, China's Supreme Court, delivered a rare rebuke against the country's police forces, calling the "unreasonably harsh crackdown on online rumours" as undermining public trust. In what has been called a "highly unusual criticism" by observers, supreme court judge Tang Xinghua said that if police had been lenient against rumours and allowed the public to have taken heed of them, an earlier adoption of "measures like wearing masks, strictly disinfecting and avoiding wildlife markets" might have been useful in countering the spread of the epidemic.[320] The Human Rights Watch reported that "there is considerable misinformation on Chinese social media and authorities have legitimate reasons to counter false information that can cause public panic," but also noted censorship by the authorities on social media posted by families of infected people who were potentially seeking help as well as by people living in cordoned cities who were documenting their daily lives amidst the lockdown.[321]

After the death of Li Wenliang, who was widely hailed as a whistleblower in China on 7 February, some of the trending hashtags on Weibo such as "Wuhan government owes Dr Li Wenliang an apology" and "We want freedom of speech" were blocked.[322][323][314] While media outlets were allowed to report his death, the nature of the doctor's censorship which produced widespread public anger in the aftermath, in what has been described as "one of the biggest outpourings of online criticism of the government in years," was not a topic that was permitted for coverage.[324] One such media outlet even sending notices to editors, and leaked to reporters, asking them to refrain from "commenting or speculating" and giving instructions to "not hashtag and let the topic gradually die out from the hot search list, and guard against harmful information."[325] After attempts to discourage the discussion on Dr. Li's death further escalated online anger, the central government has reportedly attempted to reshape the narrative by "cast[ing] Dr. Li's death as the nation's sacrifice – meaning, the Chinese Communist Party's own".[326] A group of Chinese academics including Xu Zhangrun of Tsinghua University signed an open letter calling for the central government to issue an apology to Dr. Li and to protect freedom of speech.[327] Professor Zhou Lian of Renmin University has observed that the epidemic has "allowed more people to see the institutional factors behind the outbreak and the importance of freedom of speech".[328]

International responses

Countries/regions with imposed travel restrictions in response as of 9 February 2020. These include entry bans on Chinese citizens or recent visitors to China, halted issuing of visas to Chinese citizens or reimposed visa requirements on Chinese citizens and also countries that have responded with border closures with China.
Announcement on a television screen at Delft University of Technology in the Netherlands, advising students not to travel to China

Since 31 December 2019, some regions and countries near China tightened their screening of selected travellers.[121] The Centers for Disease Control and Prevention (CDC) of the United States later issued a Level 1 travel watch.[329][330] Guidances and risk assessments were shortly posted by others including the European Centre for Disease Prevention and Control and Public Health England.[331] In China, airports, railway stations and coach stations installed infrared thermometers. Travellers with a measured fever are taken to medical institutions after being registered and given masks.[332] Real time Reverse Transcription-Polymerase Chain Reaction (rRT-PCR) test was used to confirm new cases of coronavirus infection.[333]

An analysis of air travel patterns was used to map out and predict patterns of spread and was published in the Journal of Travel Medicine in mid-January 2020. Based on information from the International Air Transport Association (2018), Bangkok, Hong Kong, Tokyo, and Taipei had the largest volume of travellers from Wuhan. Dubai, Sydney and Melbourne were also reported as popular destinations for people travelling from Wuhan. Using the validated tool, the Infectious Disease Vulnerability Index (IDVI), to assess the ability to manage a disease threat, Bali was reported as least able in preparedness, while cities in Australia were considered most able.[334][335]

As a result of the outbreak many countries including most of the Schengen area,[336] Armenia,[337] Australia,[338] India,[339] Iraq,[340][341] Indonesia,[342] Kazakhstan,[343] Kuwait,[344] Malaysia, Maldives, Mongolia, New Zealand, Philippines, Singapore, Sri Lanka, Taiwan,[345] Vietnam,[346] and the United States[347] have imposed temporary entry bans on Chinese citizens or recent visitors to China, or have ceased issuing visas and reimposed visa requirements on Chinese citizens.[348] Samoa even started refusing entry to its own citizens who had previously been to China, attracting widespread condemnation over the legality of such decision.[349][350]

In Asia, Hong Kong, Mongolia, Nepal, North Korea, Russia, and Vietnam have also responded with border tightening/closures with mainland China.[351] On 22 January 2020, North Korea closed its borders to international tourists to prevent the spread of the virus into the country. Chinese visitors make up the bulk of foreign tourists to North Korea.[352]

Also on 22 January, the Asian Football Confederation (AFC) announced that it would be moving the matches in the third round of the 2020 AFC Women's Olympic Qualifying Tournament from Wuhan to Nanjing, affecting the women's national team squads from Australia, China PR, Chinese Taipei, and Thailand.[353] A few days later, the AFC announced that together with Football Federation Australia they would be moving the matches to Sydney.[354] The Asia-Pacific Olympic boxing qualifiers, which were originally set to be held in Wuhan from 3–14 February, were also cancelled and moved to Amman, Jordan to be held between 3–11 March.[355][356]

On 27 January 2020, the United States CDC issued updated travel guidance for China, recommending that travellers avoid all nonessential travel to all of the country. The CDC has directed US Customs and Border Protection to check individuals for symptoms of the coronavirus.[1]

On 29 January 2020, British Airways, Lufthansa, Lion Air, and Air Seoul cancelled all their flights to mainland China in reaction to the spread of the virus.[357][358][359] The same day, the Czech Republic stopped issuing Schengen visas to Chinese citizens.[360]

On 30 January 2020, Belgium, Greece and Italy closed all Schengen Visa application centres in China.[361][362][363] The same day, Egyptair announced suspension of flights between Egypt and Hangzhou starting 1 February 2020 while those to Beijing and Guangzhou will be suspended starting 4 February 2020 until further notice.[364]

On 31 January 2020, Italy suspended all passenger air traffic to Italy from Mainland China, Hong Kong, Macau, and Taiwan. The Italian Civil Aviation Authority NOTAM says that effective 31 January, all passenger flights from China, including the special administrative regions of Hong Kong and Macau, and Taiwan are suspended until further notice, on request of the Italian health authorities. Aircraft that were flying to Italy when the NOTAM was published, were cleared to land.[363][365]

As of 1 February 2020, France was the only remaining Schengen country still issuing visas to Chinese citizens.[336]

Qatar Airways took the decision to suspend flights to mainland China from 3 February until further notice, due to significant operational challenges caused by entry restrictions imposed by several countries.[366] Qatar Airways is the first carrier in the Middle East to do so. An ongoing review of operations will be conducted weekly with the intention to reinstate flights as soon as the restrictions are lifted.[366]

Though some of the airlines cancelled flights to Hong Kong as well, British Airways, Finnair and Lufthansa have not, and American Airlines continues operating a limited service to the area. Hong Kong's four airlines halved the flights to mainland China.[367] A large number of airlines have reduced or cancelled flights to and from China.[368] On 31 January 2020, the United States declared the virus a public health emergency. Starting 2 February, all inbound passengers who have been to Hubei in the previous 14 days will be put under quarantine for up to 14 days. Any US citizen who has travelled to the rest of mainland China will be allowed to continue their travel home if they are asymptomatic, but will be monitored by local health departments.[369]

On 2 February 2020, India issued a travel advisory that warned all people residing in India to not travel to China, suspended E-visas from China, and further stated anyone who has travelled to China starting 15 January (to an indefinite point in the future) could be quarantined.[370] New Zealand announced that it will deny entry to all travellers from China and that it will order its citizens to self-isolate for 14 days if they are returning from China.[371] Indonesia and Iraq followed by also banning all travellers that visited China within the past 14 days.[371]

On 3 February 2020, Indonesia announced it would ban passenger flights and also sea freight from and to China starting on 5 February and until further notice. Live animal imports and other products were banned as well. Minister of Trade Agus Suparmanto "We will obviously stop live animals imports from China and are still considering banning other products"[372][373][374] Turkey announced it would suspend all flights from China till the end of February and begin scanning passengers coming from South Asian countries at airports.[375][376]

Australia released its Australian Health Sector Emergency Response Plan for Novel Coronavirus (COVID-19) in 7 February 2020. It states that, although much is yet to be known about COVID-19, "Australia has taken a precautionary approach in line with preparedness and response guidance for a pandemic, working collaboratively with state and territory and whole of government partners to implement strategies to minimise disease transmission through strong border measures and widespread communication activities."[377]

Evacuation of foreign citizens

Owing to the effective lockdown of public transport in Wuhan and Hubei, several countries have planned to evacuate their citizens and diplomatic staff from the area, primarily through chartered flights of the home nation that have been provided clearance by Chinese authorities. Canada, the United States, Japan, India, France, Australia, Sri Lanka, Germany and Thailand were among the first to plan the evacuation of their citizens.[378] Pakistan has said that it will not be evacuating any citizens from China.[379] On 7 February, Brazil evacuated 34 Brazilians or family members in addition to four Poles, a Chinese and an Indian citizen. The citizens of Poland, China and India got off the plane in Poland, where the Brazilian plane made a stopover before following its route to Brazil. Brazilian citizens who went to Brazil were quarantined at a military base near Brasilia.[380][381][382] On 7 February 215 Canadians (176 from the first plane, and 39 from a second plane chartered by the U.S. government) were evacuated from Wuhan, China, to CFB Trenton to be quarantined for two weeks. On 11 February, another plane of Canadians (185) from Wuhan landed at CFB Trenton. Australian authorities evacuated 277 citizens on 3 and 4 February to the Christmas Island Detention Centre which had been "repurposed" as a quarantine facility, where they remained for 14 days.[383][384][385] United States announced that it will evacuate Americans currently aboard the cruise ship Diamond Princess.[386] On 21 February, a plane carrying 129 Canadian passengers evacuated from the Diamond Princess landed in Trenton, Ontario.[387]

International aid

On 5 February, the Chinese foreign ministry stated that 21 countries (including Belarus, Pakistan, Trinidad and Tobago, Egypt, and Iran) had sent aid to China.[388]

File:Digital billboard in Shibuya expressing support against coronavirus.jpg
Digital billboard conveying support with the words "Be Strong China" in various languages at Shibuya in Tokyo, Japan on 10 February.

The United States city of Pittsburgh announced plans to promptly send aid to Wuhan, with mayor Bill Peduto stating that "Our office has reached out to the mayor of Wuhan, which is our sister city" and promising that "over the next two days we should be able to have a care package that has been put together." He speculated that the contents of such a package will be coordinated with the consultation of medical experts, but that it will likely consist of "face masks, rubber gloves and other material that could be hard to find in the future".[389] Additionally, the University of Pittsburgh Medical Center (UPMC) announced plans to provide help, with UPMC spokesman Paul Wood stating that "UPMC has a significant presence in China and has been in contact with our partners there", also declaring that "we stand ready to assist them and others in China with their unmet humanitarian needs."[390] Some Chinese students at other American universities have also joined together to help send aid to virus-stricken parts of China, with a joint group in the Greater Chicago Area reportedly managing to send 50,000 N95 masks and 1,500 protection suits to hospitals in the Hubei province on 30 January.[391]

The humanitarian aid organisation Direct Relief, in co-ordination with FedEx transportation and logistics support, sent 200,000 face masks along with other personal protective equipment, including gloves and gowns, by emergency airlift to arrive in Wuhan Union Hospital, who requested the supplies by 30 January.[392] The Gates Foundation stated on 26 January that it would donate US$5 million in aid to support the response in China that will be aimed at assisting "emergency funds and corresponding technical support to help front-line responders".[393] On 5 February, Bill and Melinda further announced a $100 million donation to the World Health Organization, who made an appeal for funding contributions to the international community the same day. The donation will be used to fund vaccine research and treatment efforts along with protecting "at-risk populations in Africa and South Asia."[394]

Japan, in the process of co-ordinating a plane flight to Wuhan to pick up Japanese nationals in the city, has promised that the plane will first carry into Wuhan aid supplies that Japanese foreign minister Toshimitsu Motegi stated will consist of "masks and protective suits for Chinese people as well as for Japanese nationals".[395] On 26 January, the plane arrived in Wuhan, donating its supply of one million face masks to the city.[396] Also among the aid supplies were 20,000 protective suits for medical staff across Hubei donated by the Tokyo Metropolitan Government.[397]

Support efforts have sprung across Japan to help aid residents in Wuhan. On 27 January, the city of Ōita, a sister city to Wuhan for 40 years, sent 30,000 masks from its own disaster relief stockpile to its sister city through the Red Cross network with boxes labelled "Wuhan Jiayou!", meaning "Hang in there, Wuhan!" in Chinese. Its International Affairs Office division head, Soichiro Hayashi, said that "The people of Wuhan are like family" and expressed hopes that "people can return to their ordinary lives as quickly as possible".

File:Azadi Tower lights in support of China against coronavirus 2.jpg
Tehran's Azadi Tower lights in colours of China flag in support of them against coronavirus.

On 28 January, the city of Mito donated 50,000 masks to its sister-city of Chongqing, and on 6 February, the city of Okayama sent 22,000 masks to Luoyang, its own sister-city. The ruling Liberal Democratic Party on 10 February made a symbolic deduction of 5,000 yen from the March salary of every LDP parliamentarian, a total of 2 million yen, to donate to China, with the party's secretary-general, Toshihiro Nikai, stating that "For Japan, when it sees a virus outbreak in China, it is like seeing a relative or neighbour suffering. Japanese people are willing to help China and hope the outbreak will pass as soon as possible."[398]

Peace Winds Japan has declared it will send a staff member to China to help distribute the face masks and other goods that the NGO will send to the country.[397]

A number of other countries have also announced aid efforts. Malaysia announced a donation of 18 million medical gloves to China,[399] The Philippine Red Cross also donated $1.4 million worth of Philippine-made face masks, which were shipped to Wuhan.[400] Turkey dispatched medical equipment,[401] and Germany delivered various medical supplies including 10,000 Hazmat suits.[402] On 19 February, Singapore Red Cross announced that they will send $2.26 million worth of aid to China, which they declared would consist of "purchasing and distributing protective equipment like surgical masks for hospital staff and other healthcare workers." It will also be used to "buy and distribute hygiene items and conduct health education in seven welfare homes in Tianjin and Nanning."[403]

Speciality hospitals

File:Wuhan Jinyintan Hospital (retouched).jpg
Jinyintan Hospital had initially been tasked with treating those with the coronavirus.
Construction site of Huoshenshan Hospital as it appeared on 24 January.

A speciality hospital named Huoshenshan Hospital has been constructed as a countermeasure against the outbreak and to better quarantine the patients. Wuhan City government had demanded that a state-owned enterprise construct such a hospital "at the fastest speed" comparable to that of the SARS outbreak in 2003.[404] On 24 January, Wuhan authorities specified its planning, saying they planned to have Huoshenshan Hospital built within six days of the announcement and it will be ready to use on 3 February. Upon opening, the speciality hospital has 1,000 beds[405] and takes up 30,000 square metres. The hospital is modelled after the Xiaotangshan Hospital [zh], which was fabricated for the SARS outbreak of 2003, itself built in only seven days.[406][407] State media reported that there were 7,000 workers and nearly 300 units of construction machinery on the site at peak.[408]

On 25 January authorities announced plans for Leishenshan Hospital, a second speciality hospital, with a capacity of 1,600 beds;[409] operations are scheduled to start by 6 February.[410][411] Some people voiced their concerns through social media services, saying the authorities' decision to build yet another hospital in such little time showed the severity of the outbreak could be a lot worse than expected.[412]

On 24 January 2020, the authority announced that they would convert an empty building in Huangzhou District, Huanggang to a 1,000-bed hospital named Dabie Mountain Regional Medical Centre. Works began the next day by 500 personnel and the building began accepting patients on 28 January 2020 at 10:30 pm.[413]

In Wuhan, authorities have seized dormitories, offices and hospitals to create more beds for patients.[414]

Reactions to public health responses

WHO response measures

The World Health Organization (WHO) has commended the efforts of Chinese authorities in managing and containing the epidemic, with Director-General Tedros Adhanom Ghebreyesus expressing "confidence in China's approach to controlling the epidemic" and calling for the public to "remain calm".[415] The WHO noted the contrast between the 2003 epidemic, where Chinese authorities were accused of secrecy that impeded prevention and containment efforts, and the current crisis where the central government "has provided regular updates to avoid panic ahead of Lunar New Year holidays".[416]

The WHO and Chinese authorities have also received criticism for their delayed reporting and handling of the epidemic, leading to scrutiny of the relationship between the two entities amid allegations of a cover-up. The WHO relies upon data provided and filtered by member states, with China have a "historical aversion to transparency and sensitivity to international criticism".[417] John Mackenzie of the WHO's emergency committee and Anne Schuchat of the Centers for Disease Control and Prevention in the Unites States suggested that China's official tally of cases and deaths was an underestimation. Others noted that China lumped Taiwan with the semi-autonomous regions of Hong Kong and Macao when reporting outbreak data, resulting in Taiwan receiving the same WHO "very high" risk rating as the mainland despite only a small number of cases on the self-governing island.[418] Insiders at the US Centres for Disease Control and Prevention complained that China would not agree to on-site visits, while it took two weeks for Chinese authorities to approve an international mission team led by Dr. Bruce Aylward but the team composition and scope of work was still yet to be determined.[419] Taiwan, which has long been excluded from the WHO for refusing to adhere to the "One China" policy, was only granted participation for this outbreak after "lobbying by countries including the U.S."[420]

In response to the criticisms, Tedros stated that China "doesn't need to be asked to be praised. China has done many good things to slow down the virus. The whole world can judge. There is no spinning here." Some attacked Tedros for his apparent appeasement to avoid "antagoniz[ing] the notoriously touchy Chinese government even though it is clear the country has been less than fully transparent about the outbreak's early stages, and perhaps still is". Others including Dr. David Nabarro have defended this strategy in order "to ensure Beijing's co-operation in mounting an effective global response to the outbreak".[421]

In reaction to the central authorities' decision to implement a transportation ban in Wuhan, WHO representative Gauden Galea remarked that while it was "certainly not a recommendation the WHO has made", it was also "a very important indication of the commitment to contain the epidemic in the place where it is most concentrated" and called it "unprecedented in public health history".[416] Unlike the recommendations of other agencies,[156] Tedros stated that "there is no reason for measures that unnecessarily interfere with international travel and trade" and that "WHO doesn't recommend limiting trade and movement".[422]

On 30 January 2020, following confirmation of human-to-human transmission outside China and the increase in number of cases in other countries, the WHO declared the outbreak a Public Health Emergency of International Concern (PHEIC), the sixth PHEIC since the measure was first invoked during the 2009 swine flu pandemic. Tedros clarified that the PHEIC, in this case, was "not a vote of no confidence in China", but because of the risk of global spread, especially to low- and middle-income countries without robust health systems.[44][423]

On 5 February, the WHO appealed to the global community for a $675 million contribution to fund strategic preparedness in low-income countries, citing the urgency to develop those countries which "do not have the systems in place to detect people who have contracted the virus, even if it were to emerge." Tedros further made statements declaring that "We are only as strong as our weakest link" and urged the international community to "invest today or pay more later."[424][425]

On 11 February, the WHO in a press conference established COVID-19 as the name of the disease. In a further statement on the same day, Tedros stated that he had briefed with UN Secretary General Antonio Guterres who agreed to provide the "power of the entire UN system in the response." A UN Crisis Management Team was activated as a result, allowing co-ordination of the entire United Nations response, which the WHO states will allow them to "focus on the health response while the other agencies can bring their expertise to bear on the wider social, economic and developmental implications of the outbreak"[426]

On 14 February, a WHO-led Joint Mission Team with China was activated to provide international and WHO experts to touch ground in China to assist in the domestic management and evaluate "the severity and the transmissibility of the disease" by hosting workshops and meetings with key national-level institutions to conduct field visits to assess the "impact of response activities at provincial and county levels, including urban and rural settings."[427]

On 25 February, the WHO declared that "the world should do more to prepare for a possible coronavirus pandemic," stating that while it was still too early to call it a pandemic, countries should nonetheless be "in a phase of preparedness."[428]

International reactions

On 29 January, US president Donald Trump received a briefing on the coronavirus in China.

China's response to the virus, in comparison to the 2003 SARS outbreak, has been praised by some foreign leaders.[429] US president Donald Trump thanked Chinese President Xi Jinping "on behalf of the American People" on 24 January 2020 on Twitter, stating that "China has been working very hard to contain the Coronavirus. The United States greatly appreciates their efforts and transparency" and declaring that "It will all work out well."[430] Germany's health minister Jens Spahn, in an interview on Bloomberg TV, said with comparison to the Chinese response to SARS in 2003: "There's a big difference to SARS. We have a much more transparent China. The action of China is much more effective in the first days already." He also praised the international co-operation and communication in dealing with the virus.[431][432] In a letter to Xi, Singapore President Halimah Yacob applauded China's "swift, decisive and comprehensive measures" in safeguarding the health of the Chinese people, while Singapore Prime Minister Lee Hsien Loong remarked of "China's firm and decisive response" in communities affected by the virus.[433] Similar sentiments were expressed by Russian President Vladimir Putin.[434]

At a Sunday mass at St. Peter's Square in Vatican City on 26 January 2020, Pope Francis praised "the great commitment by the Chinese community that has already been put in place to combat the epidemic" and commenced a closing prayer for "the people who are sick because of the virus that has spread through China".[435]

File:2020 coronavirus task force.jpg
Prime Minister Giuseppe Conte and the Italian task force to face the coronavirus outbreak

On 22 February, the Italian Council of Ministers announced a new decree law to contain the outbreak, including quarantining more than 50,000 people from 11 different municipalities in Northern Italy.[436] Prime Minister Giuseppe Conte said "In the outbreak areas, entry and exit will not be provided. Suspension of work activities and sport events has already been ordered in those areas."[437][438] Punishments for violating of the lockdown range from a fine of 206 euros to 3 months imprisonment.[439] Italian military and law enforcement agencies were instructed to secure and implement the lockdown.[440]

Criticism of responses

Hubei and Wuhan government

Local officials in Wuhan and the province of Hubei have faced criticism, both domestically and internationally, for mishandling the initial outbreak.[441] Allegations included insufficient medical supplies, lack of transparency to the press and censorship of social media during the initial weeks of the outbreak.[442][443] On 1 January 2020, the Wuhan police interviewed eight residents for "spreading false information" (characterising the new infection as SARS-like).[444][224] The Wuhan police had originally stated through a post on its official Weibo account that "eight people had been dealt with according to the law",[445][446] later clarifying through Weibo that they had only given out "education and criticism" and refrained from harsher punishments such as "warnings, fines, or detention".[307] One of the eight, a doctor named Li Wenliang who informed his former medical school classmates of the coronavirus in a WeChat group after examining a patient's medical report with symptoms of the illness, was warned by the police on 3 January for "making untrue comments" that had "severely disturbed the social order" and made to sign a statement of acknowledgment.[447][448][449] It was reported on 7 February 2020 Li had died after contracting the disease from a patient in January 2020.[450] His death triggered grief and anger on the social media, which became extended to demands for freedom of speech in China.[451][452] China's anti-corruption body, the National Supervisory Commission, has initiated an investigation into the issues involving Li.[453]

Local officials were criticised for hiding evidence of human-to-human transmission in early January, and suppressing reports about the disease during People's Congress meetings for political reasons.[454] Criticism was directed at Hubei Governor Wang Xiaodong after he twice claimed at a press conference that 10.8 billion face masks were produced each year in the province, rather than the accurate number of 1.8 million.[455]

Wuhan Police detained several Hong Kong media correspondents for over an hour when they were conducting interviews at Wuhan's Jinyintan Hospital on 14 January. Reports said the police brought the correspondents to a police station, where the police checked their travel documents and belongings, then asked them to delete video footage taken in the hospital before releasing them.[456][457]

Authorities in Wuhan and Hubei provinces have been criticised for downplaying the severity of the outbreak and responding more slowly than they could have. The Beijing-based media journal, Caixin noted that Hubei did not roll out the first level of "public health emergency response mechanism" until 24 January, while several other provinces and cities outside the centre of the outbreak have already done so the day before.[458] John Mackenzie, a senior expert at WHO, accused them of keeping "the figures quiet for a while because of some major meeting they had in Wuhan", alleging that there was a "period of very poor reporting, or very poor communication" in early January.[459]

On 19 January, four days before the city's lockdown, a wan jia yan (Chinese: 万家宴; lit. 'ten-thousand family banquet') was held in Wuhan, with over 40,000 families turning out; this attracted retrospective criticism. The domestic The Beijing News argued that the local authorities should not have held such a public assembly while attempting to control the outbreak. The paper also stated that when their journalists visited the Huanan Seafood Wholesale Market where the coronavirus likely originated, most residents and merchants there were not wearing face masks.[460] Zhou Xianwang, the mayor of Wuhan, later spoke to China Central Television, explaining that the banquet was held annually, that it is a "sample of the people's self-autonomy", and that the decision was made based on the fact that scientists then wrongly believed that the virus's ability to spread between humans was limited.[461][462] Meanwhile, on 20 January, Wuhan's municipal department for culture and tourism gave out 200,000 tickets valid for visiting all tourist attractions in Wuhan to its citizens for free. The department was later criticised for disregarding the outbreak.[460]

Tang Zhihong, the chief of the health department in Huanggang, was fired hours after she was unable to answer questions on how many people in her city were being treated.[320]

Central government of China

In contrast to the widespread criticism of the local response, the central government has been praised by international experts and state media for its handling of the crisis.[463][464] This has led to suggestions, in particular by the international media, that it is an attempt by the official press to shift public anger away from the central government and towards local authorities.[465] It has been noted historically that the tendency of provincial governments to minimise reporting local incidents have been because of the central government directing a large proportion of the blame onto them.[466] Critics, such as Wu Qiang, a former professor at Tsinghua University, and Steve Tsang, director of the China Institute at the University of London, have further argued the same point, with the latter suggesting that it was also exacerbated through local officials being "apprehensive about taking sensible preventive measures without knowing what Xi and other top leaders wanted as they feared that any missteps would have serious political consequences", a sentiment that Tsang argued was difficult to avoid when "power is concentrated in the hands of one top leader who is punitive to those who make mistakes".[467][468][465]

Wuhan mayor Zhou Xianwang defended himself, referring to those suggestions by publicly blaming regulatory requirements that require local governments to first seek Beijing's approval, which delayed disclosure of the epidemic. He stated in an interview that "as a local government, we may disclose information only after we are given permission to do so. That is something that many people do not understand."[469][470] The Chinese government has also been accused of rejecting help from the CDC and the WHO.[471]

Japanese government

The Japanese government has been criticised for its quarantine measures on the cruise Diamond Princess after the ship proved a fertile breeding ground for the virus.[472][473] Kentaro Iwata, a infectious disease professor at Kobe University Hospital, said that the condition aboard was "completely chaotic" and "violating all infection control principles".[474] A preliminary report by Japan's National Institute of Infectious Diseases (NIID) estimated that most of the transmission on the ship had occurred before the quarantine, although it was based on the first 184 cases.[475]

On 22 February, the Ministry of Health, Labour and Welfare admitted that 23 passengers were disembarked without being properly tested for the virus.[476] On 23 February, a Japanese woman who tested negative before disembarking from the cruise ship later tested positive after returning to her home in Tochigi Prefecture.[477] However, she was not among the 23 passengers.[478]

South Korean government

The Ministry of Health and Welfare has been critized for unilaterally implementing telephone consultation and prescription without discussing with the Korea Medical Association, and for not restricting traffic from China despite several warnings from the association and a petition proposed by the society.[479][480]

On 22 February, the South Korean government apologised for calling the virus "Daegu Corona 19" in an offical report. The term has been widespread on social medias and rises concerns about discrimination.[481]

Iranian Government

Despite an announcement by Iran's vice president on 31 January of the Iran's willingness to stop flights from China, reports on the 24th of February indicated that Mahan Airline, a company related to the IRGC, has kept operating its flights between China, Iran and Turkey.[482]

Iranians have criticized the regime for proceeding with elections while the disease was spreading and closing secular spaces while keeping shrines open, especially in the Shia holy city of Qom.[483] Others, including Qom MP Ahmad Amirabadi Farahani, have claimed the number of infections and deaths have been understated.[483]

Misinformation

After the initial outbreak, conspiracy theories and misinformation spread online regarding the origin and scale of the Wuhan coronavirus.[484] Various social media posts claimed the virus was a bio-weapon, a population control scheme, or the result of a spy operation.[485][486][487] Google, Facebook, and Twitter announced they will crack down on possible misinformation.[488] In a blogpost, Facebook stated they would remove content flagged by leading global health organisations and local authorities that violate its content policy on misinformation leading to "physical harm".[489]

On 2 February, the WHO declared there was a "massive infodemic" accompanying the outbreak and response, citing an over-abundance of reported information, accurate and false, about the virus that "makes it hard for people to find trustworthy sources and reliable guidance when they need it." The WHO stated that the high demand for timely and trustworthy information has incentivised the creation of a direct WHO 24/7 myth-busting hotline where its communication and social media teams have been monitoring and responding to misinformation through its website and social media pages.[14][490] A group of scientists from outside China have released a statement to "strongly condemn" rumours and conspiracy theories about the origin of outbreak.[491]

On 22 February, US officials said that Russia is behind disinformation campaign, using thousands of social media accounts to deliberately promote unfounded conspiracy theories, claiming that "the virus is a biological weapon manufactured by the CIA" and US is "waging economic war on China" using the virus.[492] The acting assistant secretary of state for Europe and Eurasia, Philip Reeker, said that "Russia’s intent is to sow discord and undermine US institutions and alliances from within" and "by spreading disinformation about coronavirus, Russian malign actors are once again choosing to threaten public safety by distracting from the global health response".[492] Russia denies the allegation, "this is a deliberately false story".[493]

Xenophobia and racism

Since the outbreak of COVID-19, heightened prejudice, xenophobia and racism against peoples of Chinese and East Asian descent has arisen as a result, with incidents of fear, suspicion and hostility being noted across various countries.[494][495][15][496] Although there has been support from Chinese both on and offline towards those in virus-stricken areas,[497][498][499][500] many residents of Wuhan and Hubei have reported experiencing discrimination based on their regional origin.[501][502][503]

On 30 January, WHO's Emergency Committee issued a statement advising all countries to be mindful of the "principles of Article 3 of the IHR," which cautions against "actions that promote stigma or discrimination," when conducting national response measures to the outbreak.[44]

Open access science

Due to the urgency of the epidemic, many scientific publishers have made scientific papers related to the outbreak open access.[504] Some scientists have chosen to share their results quickly on preprint servers such as BioRxiv,[505] while archivists have created an illegal open access database of over 5,000 papers.[506]

Socio-economic impact

The epidemic coincided with the Chunyun, a major travel season associated with the Chinese New Year holiday. A number of events involving large crowds were cancelled by national and regional governments, including annual New Year festivals, with private companies also independently closing their shops and tourist attractions such as Hong Kong Disneyland and Shanghai Disneyland.[507][508] Many Lunar New Year events and tourist attractions have been closed to prevent mass gatherings, including the Forbidden City in Beijing and traditional temple fairs.[509] In 24 of China's 31 provinces, municipalities and regions, authorities extended the New Year's holiday to 10 February, instructing most workplaces not to re-open until that date.[510][511] These regions represented 80% of the country's GDP and 90% of exports.[511] Hong Kong raised its infectious disease response level to the highest and declared an emergency, closing schools until March and cancelling its New Year celebrations.[512][513]

As Mainland China is a major economy and a manufacturing hub, the viral outbreak has been seen to pose a major destabilising threat to the global economy. Agathe Demarais of the Economist Intelligence Unit has forecast that markets will remain volatile until a clearer image emerges on potential outcomes. Some analysts have estimated that the economic fallout of the epidemic on global growth could surpass that of the SARS outbreak.[514] Dr. Panos Kouvelis, director of "The Boeing Center" at Washington University in St. Louis, estimates a $300+ billion impact on world's supply chain that could last up to two years.[515] Organization of the Petroleum Exporting Countries reportedly "scrambled" after a steep decline in oil prices due to lower demand from China.[516] Global stock markets fell on 24 February 2020 due to a significant rise in the number of COVID-19 cases outside Mainland China.[517][518]

The demand for personal protection equipment has risen 100-fold, according to WHO director-general Tedros Adhanom. This demand has lead to the increase in prices of up to twenty times the normal price and also induced delays on the supply of medical items for four to six months.[519][520]

Asia

East Asia

Mainland China

Morgan Stanley expects the economy of China to grow by between 5.6% (worst case scenario) to 5.9% for 2020.[521] Though cautioning that the economic impact would be short-term, NDRC Party Secretary Cong Liang views small and medium businesses encountering more difficulties in their operations. Human Resources and Social Security Assistant Minister You Jun specified that agricultural workers and college graduates would have difficulties.[522]

Animated map showing confirmed 2019-nCoV cases spreading from 22 January. (high resolution)

Tourism in China has been hit hard by travel restrictions and fears of contagion, including a ban on both domestic and international tour groups.[523] Many airlines have either cancelled or greatly reduced flights to China and several travel advisories now warn against travel to China. Many countries, including France, Japan, Australia, New Zealand, the United Kingdom and the United States, have evacuated their nationals from the Wuhan and Hubei provinces.[524]

The majority of schools and universities have extended their annual holidays to mid-February.[525] Overseas students enrolled at Chinese universities have been returning home over fears of being infected—the first cases to be reported by Nepal and Kerala, a southern state of India, were both of students who had returned home.[526][526][527]

The Finance Ministry of China announced it would fully subsidise personal medical cost incurred by patients.[528]

CNN reported that some people from Wuhan "have become outcasts in their own country, shunned by hotels, neighbors and – in some areas – placed under controversial quarantine measures."[529]

The sale of new cars in China has been impacted due to the outbreak. There was a 92% reduction on the volume of cars sold during the first two weeks of February 2020.[530]

On 24 February, China's Standing Committee declared an "immediate and "comprehensive" ban on its $74 billion USD wildlife trade industry, citing the "prominent problem of excessive consumption of wild animals, and the huge hidden dangers to public health and safety" that has been revealed by the outbreak. This permanently extends the temporary ban already in place since the end of January.[531][532]

Japan
Shelves in a pharmacy in Japan sold out of masks on 3 February 2020

Prime Minister Shinzō Abe has said that "the new coronavirus is having a major impact on tourism, the economy and our society as a whole".[533][534] Face masks have sold out across the nation and stocks of face masks are depleted within a day of new arrivals.[535] There has been pressure placed on the healthcare system as demands for medical checkups increase.[536] Chinese people have reported increasing discrimination.[537] The health minister has pointed out that the situation has not reached a point where mass gatherings must be called off.[538]

Aviation, retail and tourism sectors have reported decreased sales and some manufactures have complained about disruption to Chinese factories, logistics and supply chains.[539] Prime Minister Abe has considered using emergency funds to mitigate the outbreak's impact on tourism, of which Chinese nationals account for 40%.[540] S&P Global noted that the worst hit shares were from companies spanning travel, cosmetics and retail sectors which are most exposed to Chinese tourism.[541] Nintendo announced that they would delay shipment of the Nintendo Switch, which is manufactured in China, to Japan.[542]

The outbreak itself has been a concern for the 2020 Summer Olympics which is scheduled to take place in Tokyo starting at the end of July. The national government has thus been taking extra precautions to help minimise the outbreak's impact.[543][544] The Tokyo organising committee and the International Olympic Committee have been monitoring the outbreak's impact in Japan.[543]

Hong Kong

Hong Kong has seen high-profile protests that saw tourist arrivals from Mainland China plummet over an eight-month period. The viral epidemic put additional pressure on the travel sector to withstand a prolonged period of downturn.[545] A drop in arrivals from third countries more resilient during the previous months has also been cited as a concern.[524] The city is already in recession[545] and Moody has lowered the city's credit rating.[546][547] The worst economic effects from the outbreak are expected for Australia, Hong Kong and China.[548]

There has also been a renewed increase in protest activity as hostile sentiment against Mainland Chinese strengthened over fears of viral transmission from Mainland China, with many calling for the border ports to be closed and for all Mainland Chinese travellers to be refused entry. Incidents have included a number of petrol bombs being thrown at police stations,[549] a homemade bomb exploding in a toilet,[550] and foreign objects being thrown onto transit rail tracks between Hong Kong and the Mainland Chinese border.[551] Political issues raised have included concerns that Mainland Chinese may prefer to travel to Hong Kong to seek free medical help (which has since been addressed by the Hong Kong government).[552][553]

Since the outbreak of the virus, a significant number of products have been sold out across the city, including face masks and disinfectant products (such as alcohol and bleach).[554] An ongoing period of panic buying has also caused many stores to be cleared of non-medical products such as bottled water, vegetables and rice.[555] The Government of Hong Kong had its imports of face masks cancelled as global face mask stockpiles decline.[556]

In view of the coronavirus outbreak, the Education Bureau closed all kindergartens, primary schools, secondary schools and special schools until 17 February.[557] This was later extended to 1 March due to further development of the epidemic.[558] The disruption has raised concerns over the situation of students who are due to take examinations at the end of the year, especially in light of the protest-related disruption that happened in 2019.[559]

On 5 February, flag carrier Cathay Pacific requested its 27,000 employees to voluntarily take three weeks of unpaid leave by the end of June. The airline had previously reduced flights to mainland China by 90% and to overall flights by 30%.[560]

Macau

On 4 February 2020, all casinos in Macau were ordered to shut down for 15 days.[561][562] All casinos reopened on 20 February 2020.[563]

South Korea

South Korea has been reporting increasing human-to-human community transmission of SARS-CoV-2 since 19 February 2020, traced to a church of Shincheonji, located near the city of Daegu. Apart from the city of Daegu and the church community involved, most of South Korea is operating close to normality, although nine planned festivals have been closed and tax-free retailers are closing.[564] South Korean military manpower agency made an announcement that conscription from the Daegu will temporarily be suspended.[565] The Daegu Office of Education decided to postpone the start of every school in the region by one week.[566]

Numerous educational institutes have temporarily shut down, including dozens of kindergartens in Daegu and several elementary schools in Seoul.[567] As of 18 February, most universities in South Korea had announced plans to postpone the start of the spring semester. This included 155 universities planning to delay the semester start by 2 weeks to 16 and 22 March universities planning to delay the semester start by 1 week to 9 March.[568] Also, on 23 February 2020, all kindergartens, elementary schools, middle schools, and high schools were announced to delay the semester start from 2 to 9 March.[569]

The economy of South Korea is forecast to grow 1.9%, which is down from 2.1%. The government has provided 136.7 billion won for local governments as support.[564] The government has also organised the procurement of masks and other hygiene equipment.[564]

Taiwan
Surgical masks used by people in Taiwan
Surgical masks and other medical equipments sold out in Taiwan

On 24 January, the Taiwanese government announced a temporary ban on the export of face masks for a month, to secure a supply of masks for its own citizens.[570][571] On 2 February 2020, Taiwan's Central Epidemic Command Center postponed the opening of primary and secondary schools until 25 February.[572][573] Taiwan has also announced a ban of cruise ships from entering all Taiwanese ports.[574] In January, Italy has banned flights from Mainland China, Hong Kong, Macau, and Taiwan. On 10 February, the Philippines announced it will ban the entry of Taiwanese citizens due to the One-China Policy.[575] Later on 14 February, Presidential Spokesperson of Philippines, Salvador Panelo, announced the lifting of the temporary ban on Taiwan.[576] In early February 2020 Taiwan's Central Epidemic Command Center requested the mobilisation of the Taiwanese Armed Forces to contain the spread of the virus and to build up the defences against it. Soldiers were dispatched to the factory floors of major mask manufacturers to help staff the 62 additional mask production lines being set up at the time.[577]

In the aviation industry, Taiwanese carrier China Airlines's direct flights to Rome have been rejected and cancelled since Italy has announced the ban on Taiwanese flights.[578] On the other hand, the second-largest Taiwanese carrier, Eva Air, has also postponed the launch of Milan and Phuket flights.[579] Both Taiwanese airlines have cut numerous cross-strait destinations, leaving just three Chinese cities still served.[580]

South Asia

In India, economists expect the near-term impact of the outbreak to be limited to the supply chains of major conglomerates, especially pharmaceuticals, fertilisers, automobiles, textiles and electronics. A severe impact on global trade logistics is also expected due to disruption of logistics in Mainland China, but due to the combined risk with regional geopolitical tensions, wider trade wars and Brexit.[581]

In Sri Lanka, research houses expect the economic impact to be limited to a short term impact on the tourism and transport sectors.[582]

Southeast Asia

Among Association of Southeast Asian Nations countries, the city-state of Singapore was forecast to be one of the worst hit countries by Maybank.[583] The tourism sector was considered to be an "immediate concern" along with the effects on production lines due to disruption to factories and logistics in mainland China.[584] Singapore has witnessed panic buying of essential groceries,[585] and of masks, thermometers and sanitation products despite being advised against doing so by the government.[586][587] Prime Minister Lee Hsien Loong said that a recession in the country is a possibility, and that the country's economy "would definitely take a hit".[588]

Maybank economists rated Thailand as being most at risk, with the threat of the viral outbreak's impact on tourism causing the Thai baht to fall to a seven-month low.[589]

In Malaysia, economists predicted that the outbreak would affect the country's GDP, trade and investment flows, commodity prices and tourist arrivals.[590] Initially, the cycling race event Le Tour de Langkawi was rumoured to be cancelled, but the organiser stated that it would continue to be held as usual. Despite this, two cycling teams, the Hengxiang Cycling Team and the Giant Cycling Team, both from China, were pulled from participating in this race due to fear of the coronavirus outbreak.[591] As the outbreak situation has worsened, some of the upcoming concerts held in Kuala Lumpur, such as Kenny G, Jay Chou, The Wynners, Super Junior, Rockaway Festival and Miriam Yeung, were postponed to a future date, and the upcoming Seventeen concert was cancelled.[592]

In Indonesia, over 10,000 Chinese tourists cancelled trips and flights to major destinations such as Bali, Jakarta, Bandung, etc., over coronavirus fears. Many existing Chinese visitors are queuing up with the Indonesian authority appealing for extended stay.[593]

Prime Minister Hun Sen of Cambodia made a special visit to China with an aim to showcase Cambodia's support to China in fighting the outbreak of the epidemic.[594]

Europe

Civil Protection volunteers carrying out health checks at the Guglielmo Marconi Airport in Bologna

In the United Kingdom, digger manufacturer JCB announced that it plans to reduce working hours and production due to shortages in their supply chain caused by the outbreak.[595]

In Spain, a large number of exhibitors (including Chinese firms Huawei and Vivo) announced plans to pull out of or reduce their presence at Mobile World Congress, a wireless industry trade show in Barcelona, Spain, due to concerns over coronavirus.[596][597][598] On 12 February 2020, GSMA CEO John Hoffman announced that the event had been cancelled, as the concerns had made it "impossible" to host.[599]

In Germany, according to the Deutsche Bank the outbreak of the novel coronavirus may contribute to a recession in Germany.[600]

Owing to an increase in the demand for masks,[601] on 1 February most masks were sold out in Portuguese pharmacies.[602] On 4 February, President Marcelo Rebelo de Sousa admitted that the epidemic of the new coronavirus in China "affects the economic activity of a very powerful economy and thus affects the world's economic activity or could affect". He also admitted the possibility of economic upheavals due to the break in production."[603]

Italy

On 21 February, at least ten towns in the Lombardy and Veneto regions of Italy, with a total population of 50,000, were locked down in quarantine procedure following an outbreak in the town of Codogno in Lombardy, with Italian police mandating a curfew closing all public buildings and controlling access through police checkpoints to the so-called 'red zone' which is enforced under penalty by fines against trespassers who are not health or supply workers.[604] Italian Prime Minister Giuseppe Conte vowing that sending in the armed forces to enforce the lockdown was within possibility.[605] Schools and universities have been closed throughout Northern Italy along with museums, and various festivities, concerts, sporting events and church masses have been cancelled as of February 23.[606]

Sustained panic buying of groceries has reportedly cleared out supermarkets and several major events were cancelled such as the annual Carnival of Venice along with the cancellation of Serie A soccer matches on 23 February by the Sports Ministry.[607] Concerns about the Milan Fashion Week has led to several fashion houses declaring that they will only hold broadcasted closed door shows with no spectators. As of 24 February 2020, there have been 229 confirmed coronavirus cases in Italy, with the country currently holding the third highest infection count in the world.[608]

Austria temporarily reintroduced border control for 4 hours to inspect an outgoing Italian train with two suspected cases of coronavirus, that ultimately turned out to be false alarms. The threat of Italy becoming another hotspot for the epidemic has led to discussions on a suspension of Schengen, although has rebuked those suggestions saying "There's no ground for an initiative of this kind, at the moment," who added that "a temporary reintroduction of border control will have a devastating impact on the country's economy." The EU Health Commission has also reiterated those sentiments, saying that "Right now, our advice does not include border controls."[609] Austria has issued a travel advisory for its citizens on visiting the affected regions in northern Italy on 24 February, which Greece's Education Ministry has cancelled all educational excursions the country.[610]

North America

United States

The viral outbreak was cited by many companies in their briefings to shareholders, but several maintained confidence that they would not be too adversely affected by short-term disruption due to "limited" exposure to the Chinese consumer market. Those with manufacturing lines in mainland China warned about possible exposure to supply shortages.[611]

Silicon Valley representatives expressed worries about serious disruption to production lines, as much of the technology sector relies on factories in Mainland China. Since there had been a scheduled holiday over Lunar New Year, the full effects of the outbreak on the tech sector were considered to be unknown as of 31 January 2020, according to The Wall Street Journal.[612]

Cities with high populations of Chinese residents have seen an increase in demand for face masks to protect against the virus;[613] many are purchasing masks to mail to relatives in Mainland China, Hong Kong, and Macau, where there is a shortage of masks.[614]

As of February 2020, many stores in the United States had sold out of masks.[614] This mask shortage has caused an increase in prices.[615]

Universities in the United States have warned about a significant impact to their income due to the large number of Chinese international students potentially unable to attend classes.[616]

Oceania

Australia

Australia is expected to be one of three economies worst affected by the epidemic, along with Mainland China, and Hong Kong.[548] Early estimations have GDP contracting by 0.2% to 0.5%[617][618] and more than 20,000 Australian jobs being lost.[619] The Australian Treasurer, Josh Frydenberg said that the country would no longer be able to promise a budget surplus due to the outbreak.[620] The Australian dollar dropped to its lowest value since the Great Recession.[621]

The Australasian College for Emergency Medicine called for a calm and a fact-based response to the epidemic, asking people to avoid racism, "panic and division" and the spread of misinformation.[622] A large amount of protective face masks were purchased by foreign and domestic buyers, which has sparked a nationwide face masks shortage.[623] In response to price increases of nearly 2000%, the Pharmaceutical Society of Australia has called on these "unethical suppliers" to keep supplies affordable.[623]

Tourism bodies have suggested that the total economic cost to the sector, as of 11 February 2020, would be A$4.5bn. Casino earnings are expected to fall.[624] At least two localities in Australia, Cairns and the Gold Coast, have reported already lost earnings of more that $600 million.[625] The Australian Tourism Industry Council (ATIC) called on the Government of Australia for financial support especially in light of the large number of small businesses affected.[626]

Mining companies are thought to be highly exposed to the outbreak, since sales to China constitute 93% of the sales of Fortescue Metals, 55% of the sales of BHP, and 45% of the sales of Rio Tinto.[624] The iron ore shipping gauge dropped 99.9% as a result of the outbreak,[627] and the virus has made shipping and logistic operations of mining companies more complicated.[628]

Agriculture is also experiencing negative effects from the outbreak,[629] including the Australian dairy industry,[630] fishing industry,[631] wine producers,[632] and meat producers.[618] On 13 February 2020 Rabobank, which specialises in agricultural banking, warned that the agricultural sector had eight weeks for the coronavirus to be contained before facing major losses.[633]

The education sector is expected to suffer a US$5 billion loss according to an early government estimate,[634][635] including costs due to "tuition fee refunds, free deferral of study, realignment of teaching calendars and student accommodation costs."[636] The taxpayer is likely to be required to cover the shortfall in education budgets.[637] An estimated 100,000 students were not able to enroll at the start of the semester.[638] Nearly two-thirds of Chinese students were forced to remain overseas due to visa restrictions on travellers from Mainland China.[639] Salvatore Babones, associate professor at the University of Sydney, stated that "Australia will remain an attractive study destination for Chinese students, but it may take several years for Chinese student numbers to recover".[636]

South America

Brazil

Two Brazilian banks predicted the deceleration of economic growth in China. UBS has reviewed its estimations from 6% to 5.4%, while Itaú stated a reduction to 5.8%.[640]

A representative of some of the bigger Brazilian companies of the electronics sector, Eletros, stated that the current stock for the supply of components is enough for around 10 to 15 days.[640]

The prices of soy-beans, oil and iron ore have been falling. These three goods represent 30%, 24%, and 21% of the Brazilian exports to China, respectively.[640][641][642]

See also

References

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