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In U.S. and Germany, Community Transmission Is Now Suspected
Three cases have emerged that suggest the possible beginning of a worrisome trend.
[This briefing has ended. Read the latest updates on the coronavirus epidemic here.]
Trump puts Pence in charge of coronavirus response. ‘We’re very, very ready for this.’
President Trump named Vice President Mike Pence his point person to coordinate the government’s response to the coronavirus, expressing confidence that the United States would prevent a widespread domestic outbreak.
Mr. Trump’s announcement, at a White House news conference, came after two days of contradictory messages from government officials about the dangers posed to Americans by the virus, which first emerged in China and has infected more than 81,000 people globally, killing nearly 3,000. He also expressed confidence that scientists would develop a vaccine, but he provided no details.
“We’re very, very ready for this,” he said.
Earlier in the day, the president condemned the news media, accusing journalists of making the situation “look as bad as possible” even as government health experts warned that the coronavirus threat in the United States was only beginning. Alex M. Azar II, the health and human services secretary, confirmed another American case of the virus on Wednesday, bringing to 60 the total number of infections in the United States.
First potential case of community transmission is reported in U.S.
A person in California who was not exposed to anyone known to have been infected with the coronavirus, and who had not traveled to countries where it is circulating, has tested positive for the infection, the Centers for Disease Control and Prevention said Wednesday night. The case may be the first instance of community transmission in the United States
“The case was detected through the U.S. public health system and picked up by astute clinicians,” a C.D.C. statement said.
It brings the number of infections in the country to 60, including the 45 cases among Americans repatriated from Wuhan, China — the epicenter of the outbreak — and the Diamond Princess cruise ship, which was overwhelmed by the virus after it docked in Japan.
The potential transmission in the new case is a source of concern.
“That would suggest there are other undetected cases out there, and we have already started some low-grade transmission,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University.
Coronavirus pushes across Europe and Middle East.
New coronavirus clusters across Europe and the Middle East. More infections in Iran stoking fears about an uncontrolled spread. Global market jitters. A toxic political climate in Washington complicating the public health challenge.
That worrying drumbeat frayed nerves across the world on Wednesday even as the pace of the outbreak seemed to be slowing in China, where most cases have been.
[Read: 10 Chinese readers share their stories of the coronavirus crisis.]
For the first time, more new cases were reported outside China than inside, according to the World Health Organization. Chinese officials on Tuesday reported 411 new infections; in the rest of the world, the number was 427. The total number of cases globally has now topped 81,000 and nearly 3,000 have died.
South Korea, with nearly 1,600 cases, has seen the largest outbreak outside China.
In the European Union, new cases were recorded in Austria, Croatia, France, Germany, Greece and Spain. Most were tied to Italy, where the authorities have been struggling to contain an outbreak that has infected at least 400 people, most of them in the north near Milan.
Hotels in Austria, France and the Canary Islands of Spain were locked down this week after guests tested positive for the virus or were suspected of having it.
As the American health authorities braced for an outbreak in the United States, the Trump administration came under criticism from both Democratic and Republican lawmakers for contradictory statements on the severity of the crisis, a lack of transparency and seemingly lax preparations.
South Korea and U.S. call off joint military exercises.
The fast-growing coronavirus outbreak forced South Korea and the United States on Thursday to postpone “until further notice” their joint spring military exercise, originally scheduled to take place next month.
The decision came as South Korea reported 334 new cases of the coronavirus on Thursday, bringing the total number there to 1,595, the largest outbreak outside of China. Nearly 84 percent of the patients were from Daegu, a city in southeast South Korea, and in nearby towns.
On Wednesday, the United States military reported the first case of a soldier being infected. The soldier was stationed at a base near Daegu.
South Korea has placed itself on the highest possible alert to deal with the outbreak, suspending nonessential military training and placing more than 9,500 troops under quarantine. It has also banned most of its enlisted soldiers from taking a leave.
Saudis halt religious visits to Mecca and Medina.
Saudi Arabia on Wednesday temporarily barred Muslim pilgrims from entering the country to visit the holy cities of Mecca and Medina, as it tries to slow the spread of the coronavirus, a stark illustration of the fear the epidemic has stirred.
The Saudi royal family derives much of its stature in the Islamic world from its status as guardians of the holy sites, and it very rarely closes them off. The Saudi response contrasts with that of Iran, which has kept its pilgrimage sites open, despite a significant coronavirus outbreak there, and evidence that people who visited Iran have spread the virus to many other countries.
Each year, millions of Muslims make a pilgrimage to Mecca, or Umrah, which can take place at any time of year; the Hajj, the pilgrimage to Mecca that all Muslims are expected to make at least once, takes place in a specific part of the lunar year, which this year falls in midsummer.
Many Muslims also visit the mosque in Medina that was established by the prophet Mohammed.
The government is “suspending entry into the kingdom for the purpose of Umrah and visiting the Prophet’s Mosque temporarily,” the government-run Saudi Press Agency said.
Syracuse shuts Italy program, joining other colleges in suspending studies abroad.
Syracuse University moved on Wednesday to shut down a study abroad program in Florence, Italy, as the coronavirus continues to spread, bringing to at least six the number of universities and colleges that have taken such steps.
“Yesterday, on very short notice, we made the difficult decision to suspend our academic program in Florence, Italy, based on Italy’s very aggressive stance toward virus containment and travel restrictions,” Kent Syverud, the Syracuse chancellor said in a statement.
New York University’s president, Andrew Hamilton, said in a statement on Wednesday that “out of an abundance of caution,” classes in Florence were being canceled for the rest of the week and students there were to “promptly travel home or to another appropriate location.”
Other colleges that have suspended study abroad programs include Elon University, Fairfield University, Florida International University and the University of Tennessee.
The Times begins a newsletter on the crisis.
The Times is beginning a coronavirus newsletter, an informed guide to the outbreak with the latest developments from our reporting and expert advice about prevention and treatment.
Every day at 6 p.m. Eastern, we’ll tell you what to know about this far-reaching and fast-moving story.
Brazil confirms coronavirus infection, the first in Latin America.
Brazil’s health ministry said on Wednesday that a 61-year-old man who had recently traveled to São Paulo from Italy had contracted the coronavirus.
The first known case in Latin America, it comes as Brazil is in the midst of Carnival, a hugely popular festival that draws large crowds into close quarters for raucous street celebrations.
Officials were scrambling to track down other passengers on the flight the man took to Brazil and to find others who had come into contact with him in recent days.
The patient, who lives in São Paulo, had recently traveled for work to northern Italy, where an outbreak has infected at least 325 people. He sought medical help after experiencing a fever, cough and sore throat, according to health officials.
Iran downplays outbreak spreading quickly there and in neighboring countries.
Iran’s leaders continued to downplay the seriousness of the outbreak there on Wednesday, even as the number of cases in Iran or linked to it kept climbing quickly.
The health ministry reported 139 cases and 19 deaths, up from 95 and 15 on Tuesday, and the government ordered a weeklong closure of schools and cultural sites in 10 provinces. Experts say Iran’s high apparent death rate suggests that it has far more infections than it has discovered or acknowledged.
[Update: Japan shocks parents by moving to close all schools in response to coronavirus.]
But President Hassan Rouhani said the virus was coming under control, and he predicted a return to normalcy by Saturday, Iranian state media reported. He added that Iran’s enemies were using the epidemic to further isolate the country.
Bahrain on Wednesday raised its case total to 26, and said all three new patients had just arrived from Iran — as had some of the previous ones. Bahrain is one of several countries reporting infections in people who had recently traveled to Iran.
Pakistan’s health minister, Dr. Zafar Mirza, on Wednesday confirmed the first two cases of the coronavirus in that country, and said that one of them was a 22-year-old student who had recently returned from Iran. Pakistan closed its border with Iran on Sunday.
Georgia reported its first case on Wednesday, also a traveler returning from Iran, who had entered the country through Azerbaijan.
And in Iraq, movie theaters, coffee shops and other public gathering places were ordered to close until March 7. The Education Ministry said that schools and universities, which have been on a winter break, would also remain closed until then.
Some dos and don’ts to avoid the virus.
transcript
Wash Your Hands. No, Like This.
Scientists say that a common technique for applying hand sanitizer, one recommended by the Centers for Disease Control and Prevention, is inferior to an alternative method with twice as many steps.
<i>The best way to clean your skin</i> <i>is still the old-fashioned use</i> <i>of soap, hot water and plenty of elbow grease.</i> What if we told you that you’ve probably been cleaning your hands wrong and that science tells you so? It turns out there’s not one but two common internationally accepted ways to clean your hands: One from our very own C.D.C., and another by the World Health Organization. So which of these two methods is better? Researchers now know. They enlisted doctors and nurses in a Glasgow hospital in an experiment. And what they found in a study published this month was that the W.H.O.’s method was microbiologically more effective than the C.D.C.’s. So the W.H.O. won. But here’s the rub. The C.D.C.’s method for cleaning hands goes something like this: The W.H.O.’s method is like so: Rub palms together. Rub each palm front to back over the back of the other hand, interlacing fingers. Twist palms with fingers interlaced. Interlock your fingers and twist again, this time backs of fingers against palms. Clasp your left thumb in your right hand and move thumb in circular motion. Still with us? Press your right fingers together and rub them in a circular motion on your left palm. Then switch. All right — you’re done! Don’t take it hard if it doesn’t seem worth it. Although the W.H.O. method got cleaner hands, only about two-thirds of the study’s doctors and nurses completed the whole thing, which took about 42 seconds to do. The simpler C.D.C. method? Only 35. And this is important. Because, you see, in hospitals ... <i>(Training video)</i> <i>♪ Hand hygiene is dope. ♪</i> <i>♪ Now sing the alphabet</i> <i>from A to Z, ♪</i> <i>♪ get between all the nooks and tiny crannies ♪ </i> <i>♪ </i> According to the C.D.C., some two million patients get hospital-related infections a year. And the C.D.C. estimates that doctors and nurses clean their hands correctly only half the time they should. So follow-through might be just as important as “microbiological effectiveness.” While this study focused only on alcohol-based hand sanitizers, its author says that the W.H.O. way applies equally well to washing your hands with plain old soap and water — something you can practice at home. <i>♪ Wait! Don’t go near that patient ♪</i> <i>♪ What’s the matter with you? You didn’t clean your hands, ♪</i> <i>♪ and they’re covered with goo ♪</i> <i>Wash your hands all the time, in front of everyone ♪</i> <i>♪ That goes for everybody, yo, get it done ♪</i> <i>♪ Clean your hands. If you just wiped a rear or did enemas ♪</i> <i>♪ ’til clear, clean your hands, Clean your hands ♪</i>
If the coronavirus appears in your community, what can you do to protect yourself and your family?
Much of the advice from experts involves common sense, not very different from what you would do to dodge the flu or any other respiratory virus.
Because Americans often disregard colds and flus, continuing about their ordinary business, there are people with symptoms in public places. Without apology, you should put distance between you and them. Six feet would be good, but even a little distancing is helpful.
And do your colleagues a favor if you aren’t feeling well: Stay home from work.
Another obvious way to reduce the odds of infection: wash your hands often. “It’s not super sexy, but it works,” said Dr. Trish Perl, an infectious disease specialist at the University of Texas Southwestern Medical Center.
During the SARS epidemic — also caused by a coronavirus, but one that was much deadlier — hand-washing reduced the risk of transmission by 30 to 50 percent, she said.
If it is not feasible to wash your hands with water, you can use a hand sanitizer, but check the label to be sure it contains at least 60 percent alcohol.
The trademark of coronavirus outbreaks abroad is those ubiquitous face masks. But if you are healthy, the Centers for Disease Control and Prevention and infectious disease specialists do not recommend face masks. Most surgical masks are too loose to prevent inhalation of the virus.
If you are infected, however, a mask can help prevent the spread of a virus.
The most effective are so-called N95 masks, which block 95 percent of very small particles.
In suburban New York, 83 people agree to be isolated after potential exposure.
Health officials in Nassau County, N.Y., said on Wednesday that they were monitoring 83 people in voluntary isolation for potential coronavirus exposure, but that there were no confirmed cases in the county or the state.
Many of the people had recently been in China, while others had been in contact with such people, the county health commissioner, Dr. Lawrence Eisenstein, said in a news conference.
About 175 people in Nassau County, which borders New York City, have been asked to self-quarantine for some period of time since the authorities started taking that precaution several weeks ago, he said.
People in other parts of the country have also agreed to isolate themselves after traveling from places with coronavirus outbreaks.
“As of today, there are 83 people who are on our list of being removed from contacting other people,” Dr. Eisenstein said. Officials are in communication with them every day, he said, and all have complied with the quarantine request.
Five of the people have tested negative for the virus, and a sixth person’s test results are pending.
Andy Simone, the county’s director for emergency preparedness, said that hospitals were prepared in the event that someone tests positive. But she added, “There is no fear right now, we do not have a case in Nassau County.”
Germany’s health minister says source of some new infections cannot be traced.
Germany’s health minister, Jens Spahn, said Wednesday that new cases were confirmed in the country that cannot be traced to the virus’s original source in China.
This raised the troubling possibility that the virus might have been transmitted within the country itself.
The disease is moving to a new phase in Germany, Mr. Spahn said at a news conference. “The infection chains are partially no longer trackable,” he said.
About 20 cases of the coronavirus have been identified in the country, he said, but until now health officials had been able to trace those who became infected back to the virus’s origins in central China or to hot spots in Italy.
The authorities in Germany’s most populous state, North Rhine-Westphalia, were trying on Wednesday to retrace the steps of a couple who contracted the coronavirus from a source they could not immediately identify.
The couple had spent the previous two weeks — the estimated incubation period for the virus — “taking part in normal, public life,” said Karl-Josef Laumann, the state health minister.
That included attending a large carnival party and taking a brief trip to the Netherlands, he said. Dutch authorities and the hotel where the couple stayed have been informed.
As global markets continue to slide, Wall Street shows some signs of stabilizing.
Nervousness about the spread of the coronavirus gripped Wall Street again on Wednesday, with an early rise in stock prices giving way to a third day of selling. The S & P 500 was down 0.4 percent at the end of trading, bringing its losses for the week to more than 6 percent.
The day began with the S & P 500 increasing by more than 1.5 percent before giving up those gains. Market observers attributed the change in sentiment to comments from Germany’s health minister that the outbreak had entered a more serious phase, because the coronavirus had been transmitted there.
Bonds rallied, pushing the yield on the 10-year Treasury note to a record low for a second day. The price of oil also fell.
Major markets around the world continued to drop, with investors reacting to reports of the coronavirus spreading across the globe. European markets fell more by than 1 percent on Wednesday, and Asian markets ended the trading day lower.
A potential casualty of the virus is Europe’s open borders.
The coronavirus epidemic poses a new and serious threat to Europe’s already diminished system of free movement across borders.
For generations, Europe Union leaders have pursued — and, to a great degree, realized — a vision of a continent where not only would trade be seamless, so would travel.
Eventually, 26 European countries — including four that are not in the bloc — signed on, allowing people to travel from country to country in what is known as the Schengen area without showing passports, or even being stopped at border crossings.
But the idea has never been universally loved; right-wing and nationalist politicians in particular have opposed it. Ireland joined the European Union in 1973, but has never joined Schengen; neither did Britain, a member of the bloc for 47 years until it left in January.
Opposition to free movement surged with the migrant crisis of 2015. Many countries erected what were supposed to be temporary border controls, but five years later, some are still in place.
As coronavirus outbreaks grow and multiply, calls for closing borders have grown louder. So far no country has taken that drastic step, but privately European officials have warned that could change quickly.
On Wednesday, the European Union’s top official for communicable diseases said that Europe needed to prepare more broadly for the kind of crisis that has hit northern Italy.
“Our current assessment is that we will likely see a similar situation in other countries in Europe, and that the picture may vary from country to country,” said the official, Andrea Ammon, director of the European Center for Disease Prevention and Control.
Two European hotels remain locked down as new cases spread across the Continent.
Two European hotels were on lockdown on Wednesday as coronavirus infections spread on the Continent, and a third was quarantined for several hours.
The authorities in Innsbruck, an Austrian ski town in the Alps, sealed off the 108-room Grand Hotel after an Italian employee there tested positive for the virus. The cordon was the second at a European hotel in two days, after Spain on Tuesday cordoned off the H10 Costa Adeje Palace on the resort island of Tenerife after a guest, also from Italy, tested positive.
Each of the infected Italians had recently visited the Lombardy region of the country.
Spain, Austria, Croatia, Switzerland and France all reported cases linked to Lombardy on Tuesday.
In central France, the Ibis Center hotel in Beaune was closed after a client from Hong Kong died during the night. The health authorities ordered that all 30 members of the guest’s group remain in isolation while tests were conducted.
[Read: For a Hong Kong restaurateur in the time of coronavirus, resilience is on the menu.]
But the tests results on Wednesday afternoon did not show coronavirus, and the lockdown was lifted.
Cuomo to set aside $40 million to prepare for possible infections.
Gov. Andrew M. Cuomo of New York said Wednesday that the state would set aside $40 million in the expectation that the coronavirus would eventually spread to New York. He also said the state had begun planning for possible quarantines at homes, hotels and hospitals.
While there have been no confirmed cases of the virus in New York, the governor and the state health commissioner, Dr. Howard Zucker, warned that its spread to the state was inevitable.
“It is highly probable that we will have people in New York State who test positive,” said Mr. Cuomo, noting that New York City is “the front door internationally” for many travelers. “No one should be surprised when we have positive cases.”
The governor also said he would ask federal health authorities for permission to test patient samples in a laboratory in New York, rather than waiting several days for results from the C.D.C. in Atlanta.
State officials have already been taking precautions against the disease, asking about 700 recent visitors to China to voluntarily quarantine themselves, even as Customs and Border Protection agents continue to screen passengers at area airports.
Reporting was contributed by Russell Goldman, Choe Sang-Hun, Roni Caryn Rabin, Keith Bradsher, Austin Ramzy, Elaine Yu, Ben Dooley, Alexandra Stevenson, Ed Shanahan, Kevin Granville, Marc Santora, Melissa Eddy, Christopher F. Schuetze, Matina Stevis-Gridneff, Alan Yuhas, Andrew Kramer, Anton Troianovski, Richard Pérez-Peña, Alan Finder, Gina Kolata, Ernesto Londoño, Noah Weiland, Maggie Haberman Emily Cochrane, Alissa J. Rubin and Falih Hassan.
An earlier version of this article incorrectly referred to Switzerland's relationship to the European Union. Although Switzerland is within Europe's Schengen zone of passport-free travel, it is not an E.U. member.
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