Countries began evacuating their citizens Wednesday from Wuhan, the Chinese city hardest-hit by a new virus that has now infected more people in China than were sickened in the country by SARS.
The number of confirmed cases jumped to 5,974, surpassing the 5,327 in mainland China during the SARS outbreak in 2002-2003.
The death toll rose to 132, which is still lower than the 348 people who were killed in China by SARS, or severe acute respiratory syndrome. Scientists say there are still many questions to be answered about the new virus, including just how transmissible and severe it is.
Chartered planes carrying about 200 evacuees each arrived in Japan and the United States early Wednesday as other countries planned similar evacuations from the city of Wuhan, which authorities have shut down to try to contain the virus.
The first cases in the Middle East were confirmed Wednesday, a family of four from Wuhan that was visiting the United Arab Emirates. Airlines around the world announced they were cutting flights to China, and Hong Kong was suspending rail travel to and from the mainland at midnight.
The number of cases in China rose 1,459 from the previous day, a smaller increase than the 1,771 new cases reported Tuesday. Australia and Singapore were among those reporting new cases, as the number outside China topped 70. The vast majority are people who came from Wuhan.
Four passengers on the evacuation flight to Japan had coughs and fevers, and two were diagnosed with pneumonia.
It wasn't clear whether they were infected with the new virus, which first appeared in Wuhan in December. Its symptoms, including cough and fever and in severe cases pneumonia, are similar to many other illnesses.
Takeo Aoyama, an employee at Nippon Steel Corp.’s subsidiary in Wuhan, told reporters he was relieved to be able to return home.
“We were feeling increasingly uneasy as the situation developed so rapidly and we were still in the city,” Aoyama said, his voice muffled by a white surgical mask.
The US plane was headed to California after a refueling stop in Alaska. All 201 passengers, who included diplomats from the US Consulate in Wuhan, passed health screenings in China and Anchorage.
Australia, New Zealand and Britain were among the latest countries to announce they are planning evacuations.
British Airways said it was suspending all flights to and from mainland China after the UK government warned against unnecessary travel to the country. The airline has daily flights from London to Shanghai and Beijing.
British Health Secretary Matt Hancock tweeted that “anyone who returns from Wuhan will be safely isolated for 14 days, with all necessary medical attention.” The measures are a step up from those during the devastating 2014-16 Ebola outbreak, when returning travelers from West Africa were asked to monitor themselves for symptoms.
Mark Woolhouse, a professor of infectious disease epidemiology at the University of Edinburgh, said the steps are justified to prevent the introduction of the virus and its spread.
“There's always a balance between the draconian measures of public health and what people might want to do, and obviously it's regrettable if people who turn out not to have the virus are quarantined unnecessarily," he said.
The outbreak has affected international sporting events. The International Hockey Federation postponed Pro League games in China, and football, basketball and boxing qualifiers for the Tokyo Olympics in February have been moved outside of the country.
In Australia, health officials said the Chinese women's national soccer team was quarantined in the city of Brisbane because it had passed through Wuhan a week ago.
The team will be kept in isolation in a hotel until January 5. None of the 32 players and staff has shown symptoms.
In China's Hubei province, 17 cities including Wuhan have been locked down, trapping more than 50 million people in the most far-reaching disease control measures ever imposed.
Sara Platto, an Italian animal behaviour researcher and veterinarian, said there were 25 Italians stuck in Wuhan, who stay in touch online for material and emotional support.
“My son turned 12 on January 23, the first day of the lockdown in Wuhan. So he couldn’t invite his friends over. We had a remote birthday celebration, with people ‘visiting’ him over WeChat,” Platto said, referring to a Chinese messaging app. “We called it the epidemic birthday.”
As much as panic, people spending most of their times indoors have to deal with boredom.
Her son Matteo usually has a very busy agenda between his school, sports, and volunteer work, but now “it’s like suddenly everything has slowed down,” Platto said. As with other international schools, classes are moving online until the all-clear is sounded.
The new virus is from the coronavirus family, which includes those that can cause the common cold as well as more serious illnesses such as SARS and MERS. As of December, MERS had sickened nearly 2,500 people since its identification in 2012.
The source of the new virus and the full extent of its spread are still unknown. However, the World Health Organization said most cases reported to date “have been milder, with around 20% of those infected experiencing severe illness.”
Scientists expect many crucial questions about the virus' behavior will be answered in the coming weeks as the outbreak evolves and it becomes clearer how people are infected.
Although the Chinese health minister and others have suggested that the virus is spreading before people get symptoms, data to confirm that has not yet been shared widely beyond China.
“It’s still unclear whether that takes place,” said Malik Peiris, chair in virology at the University of Hong Kong.
If it does, that might explain why China has already exceeded the case numbers for SARS.
“The fortunate thing about SARS, if there was anything fortunate, was that transmission did not take place before symptoms,” he said. Peiris said that if it turns out that the new coronavirus can indeed be spread by people who don’t show any symptoms, “a pandemic is a scenario that we have to consider.”