New Unexplained Cases Reported in Oregon and California

Here’s what you need to know:

Credit…Max Whittaker for The New York Times

Two new and unexplained cases of coronavirus emerged in Northern California and in Oregon on Friday, and health officials in both states quickly moved to contact people who might have been exposed. Experts warned that the cases could indicate signs of spread within the United States.

Oregon health officials said they had identified a school employee in the Portland area who appears to have contracted the coronavirus more than a week ago. The patient, who had not recently traveled to China, has had symptoms since Feb. 19 and may have exposed students and staff at a school in Clackamas County, officials said.

Oregon’s announcement followed one earlier Friday in Santa Clara County, Calif., where officials said a patient with no known risk factors had tested positive for the virus.

The findings hint that the coronavirus may already be circulating locally in the United States, passing from person to person.

Earlier this week, a woman who had no known risk factors tested positive for the virus in Solano County, between San Francisco and Sacramento. Hundreds of Americans who were potentially exposed to the virus in Asia have been quarantined at military bases in California, including Travis Air Force Base in Solano County.

A whistle-blower complaint made public on Thursday alleged that federal health officials were sent into quarantine areas at the bases without proper training or protective gear, and then were allowed to roam around, on and off the bases.

From eastern Asia, Europe, the Middle East, the Americas and Africa, a steady stream of new cases on Friday fueled fears that the new coronavirus epidemic may be turning into a global pandemic, with some health officials saying it may be inevitable.

In South Korea, Italy and Iran — the countries with the biggest outbreaks outside China — the governments reported more than 3,500 infections on Friday, about twice as many as two days earlier, and South Korea reported almost 600 more on Saturday. South Korean officials were rushing to test thousands of members of a church at the center of that country’s outbreak.

Africa has long been a source of concern, and a case in Nigeria raised fears that more infections might lurk there undetected.

In Europe, caseloads soared as Belarus, Estonia, Lithuania, Wales and Northern Ireland reported their first confirmed infections.

About 84,000 people in at least 56 countries have been infected, and about 2,900 have died.

Unnerved by the rapid spread of the virus and the growing threat it poses to economies, financial markets around the world continued their slide on Friday, with U.S. stocks recording their worst week since the 2008 financial crisis.

Even as countries prepared for the likelihood of significant outbreaks, early missteps raised troubling questions about how nations — even those with robust health care systems — will handle a flood of cases.

A whistle-blower complaint in the United States outlined how federal health care workers had interacted with quarantined Americans without proper training or safety equipment.

South Korea, which has the largest coronavirus outbreak outside China, reported 594 new cases on Saturday morning, bringing its total to 2,931. In North Korea, Kim Jong-un ordered all-out efforts to fight the virus at a high-level meeting, state media reported.

South Korean officials have warned that confirmed cases would rise sharply as they aggressively tested thousands of people, particularly in the southeastern city of Daegu. More than 86 percent of patients have been in Daegu and nearby towns; many have been associated with a church called Shincheonji, which has a strong presence in Daegu.

The United States military, which has more than 28,000 personnel in South Korea, said on Saturday that the spouse of an American soldier infected with the virus had also tested positive for it. She had been in self-quarantine since Wednesday, following her husband’s diagnosis, and was being transported to a military hospital, the military said.

Also on Saturday, Mr. Kim, North Korea’s leader, convened the Politburo of his ruling party to order an all-out campaign to prevent an outbreak, state media reported. The North has not reported any coronavirus cases, but there has been concern that the secretive, totalitarian country could be hiding an outbreak.

“In case the infectious disease spreading beyond control finds its way into our country, it will entail serious consequences,” the North’s official Korean Central News Agency quoted Mr. Kim as saying. It said that officials had discussed “measures to deter the influx and spread of the infectious disease in a scientific, preemptive and lockdown way.”

  • Answers to your most common questions:

    Updated Feb. 26, 2020

    • What is a coronavirus?
      It is a novel virus named for the crownlike spikes that protrude from its surface. The coronavirus can infect both animals and people and can cause a range of respiratory illnesses from the common cold to more dangerous conditions like Severe Acute Respiratory Syndrome, or SARS.
    • How do I keep myself and others safe?
      Washing your hands frequently is the most important thing you can do, along with staying at home when you’re sick.
    • What if I’m traveling?
      The C.D.C. haswarned older and at-risk travelers to avoid Japan, Italy and Iran. The agency also has advised against all nonessential travel to South Korea and China.
    • Where has the virus spread?
      The virus, which originated in Wuhan, China, has sickened more than 80,000 people in at least 33 countries, including Italy, Iran and South Korea.
    • How contagious is the virus?
      According to preliminary research, it seems moderately infectious, similar to SARS, and is probably transmitted through sneezes, coughs and contaminated surfaces. Scientists have estimated that each infected person could spread it to somewhere between 1.5 and 3.5 people without effective containment measures.
    • Who is working to contain the virus?
      World Health Organization officials have been working with officials in China, where growth has slowed. But this week, as confirmed cases spiked on two continents, experts warned that the world was not ready for a major outbreak.

North Korea has already closed its 930-mile border with China, where the coronavirus emerged, and its border with Russia. But the Chinese border has long been porous for smugglers, who ferry goods across the shallow river that separates the countries. The North has also suspended all flights and trains to and from China and asked all foreign diplomats not to leave their compounds.

The state media report Saturday also said that Mr. Kim had fired one of his top aides, Ri Man-gon, and another official for corruption, but it was unclear whether the dismissals were connected to the antivirus campaign.

President Trump could use a Korean War-era law to require manufacturers to speed up production of emergency supplies needed to fight the new coronavirus, Alex M. Azar II, the health and human services secretary, said on Friday.

The Defense Production Act, enacted in 1950, allows the president to exert control over parts of the civilian economy when it is necessary for national defense — forcing industries to step up production, reallocating basic resources and imposing price controls.

Mr. Azar, at a White House press briefing, said there was no need to invoke the law so far, but it could be used, for instance, to help stockpile face masks and other supplies.

“I don’t have any procurements I need it for now, but if I need it, we’ll use it,” Mr. Azar told reporters.

President Harry Truman made extensive use of the law during the Korean War, and it has been invoked occasionally in the decades since then.

Stocks tumbled for a seventh consecutive day on Friday, recording the market’s worst week since the 2008 financial crisis.

The S&P 500 index fell about 0.8 percent, and the Dow Jones industrial average fell more than 1 percent. The S&P index lost more than 11 percent in the week, and almost 13 percent since its peak on Feb. 19.

The sell-off was fueled mostly by worry that measures to contain the coronavirus would hamper corporate profits and economic growth, and fears that the outbreak could get worse. The selling has in a matter of days dragged stock benchmarks around the world into a correction — a drop of 10 percent or more that is taken as a measure of extreme pessimism.

In Europe, the Britain’s FTSE 100 fell more than 3 percent and the Dax in Germany fell more than 4 percent. In Asia, the Nikkei 225 in Japan closed down 3.7 percent, the KOSPI in South Korea dropped 3.3 percent and the Shanghai Composite in China dropped 3.7 percent

A summit of the U.S.-Association of Southeast Asian Nations Business Council that was set for March 14 in Las Vegas has been postponed by the Trump administration over the coronavirus outbreak, a senior administration official said on Friday.

“As the international community works together to defeat the novel coronavirus, the United States, in consultation with ASEAN partners, has made the difficult decision to postpone the ASEAN leaders meeting previously scheduled for mid-March,” the official said. “The United States values our relationships with the nations of this critical region, and looks forward to future meetings.”

The association, a 10-member bloc, addresses trade, security and economics, among other issues, in the region. The United States was the first non-ASEAN country to establish a resident ambassador to the organization and began to hold annual summits in 2012, according to the association.

The World Health Organization on Friday raised its assessment of the global coronavirus risk from “high” to “very high,” the most serious assessment in its new four-stage alert system.

“This is a reality check for every government on the planet,” said Dr. Michael J. Ryan, deputy director of W.H.O.’s health emergency program. “Wake up. Get ready. This virus may be on its way.”

The assessment addresses the risks of both uncontrolled spread of the virus and the resulting impacts.

United States health officials have given similarly alarming assessments, though President Trump has played down the threat.

The W.H.O. does not officially use the word “pandemic,” often defined as the worldwide spread of a new disease, but many health experts say the coronavirus epidemic is one, or soon will be.

In a new report, the organization praised the aggressive quarantine approach used by China, where the epidemic began and the majority of cases have occurred. After initially downplaying the outbreak in the city of Wuhan, the government closed off entire cities, shut down transportation networks and schools, and isolated many people who might have been exposed.

“China’s bold approach to contain the rapid spread of this new respiratory pathogen has changed the course of a rapidly escalating and deadly epidemic,” the report said, noting that new, confirmed infections had fallen from more than 2,000 per day to a few hundred.

China’s strategy “has averted or at least delayed hundreds of thousands” of cases, and “played a significant role in protecting the global community.”

Mick Mulvaney, the acting White House chief of staff, on Friday blamed the media for exaggerating the seriousness of coronavirus because “they think this will bring down the president, that’s what this is all about.”

Speaking at the Conservative Political Action Conference, an annual gathering of conservative activists, Mr. Mulvaney played down concerns about the virus that is spreading around the globe and panicking investors.

Mr. Mulvaney said the administration took “extraordinary steps four or five weeks ago,” to prevent the spread of the virus when it declared a rare public health emergency and barred entry by most foreign citizens who had recently visited China.

“Why didn’t you hear about it?” Mr. Mulvaney said of travel restrictions that were widely covered in the news media. “What was still going on four or five weeks ago? Impeachment, that’s all the press wanted to talk about.”

The news media has been covering the global spread of coronavirus since early January.

As the coronavirus spreads, early research is drawing a clearer picture of how the pathogen behaves and the key factors that will determine how it can be contained.

Here are the considerations: The virus spreads easily, making it hard to contain. The fatality rate may be more than 1 percent, much higher than the flu. The incubation period is between two and 14 days, allowing the illness to go undetected. And the virus has spread rapidly because it started in a transportation hub.

In terms of response, the World Health Organization has praised China’s efforts, but critics fear a pandemic. A few drugs are being tested in clinical trials, but a vaccine is still at least year away.

The State Department on Friday issued an advisory telling Americans to “reconsider travel” to Italy because of the coronavirus.

The department set the new advisory at Level 3. The highest alert, Level 4, is reserved for the most perilous situations.

“Many cases of COVID-19 have been associated with travel to or from mainland China or close contact with a travel-related case, but sustained community spread has been reported in Italy,” the department said in its alert. “Sustained community spread means that people have been infected with the virus, but how or where they became infected is not known, and the spread is ongoing.”

Italy reported more than 800 infections on Friday — 531 of them in Lombardy, which includes the city of Milan. Eighty-five patients in Lombardy are in intensive care.

The U.S. Navy on Friday ordered all ships that have made stops in the Pacific, about 30 to 40 vessels holding several thousand sailors and Marines, to self-quarantine at sea for 14 days and said that all sailors who had traveled to high-risk areas should be closely monitored.

“At this time, there are no indications that any U.S. Navy personnel have contracted coronavirus,” the Navy said in a statement. “The health and welfare of our sailors, civilians and their families is paramount, and our efforts are directed at detection and, if required, prevention of the spread of this illness.”

“Operational impact is minimal, if at all,” said a senior Navy officer with experience in the Pacific. “Most deployed ships in 7th Fleet already stay out to sea for that long, if not longer, and there is no better place for a ship operationally than at sea. I would expect some schedule impact to ships that do have port visits within two weeks, but no cancellations.”

The American military has already confirmed one coronavirus case: A 23-year-old soldier based near Daegu, South Korea, has tested positive for the virus, the military said on Wednesday. He has been quarantined in his off-base residence, the military said.

South Korea is experiencing the largest coronavirus outbreak outside China.

The United States and South Korea have also postponed their joint military drills.

The official count of cases in Iran, the center of the Middle East’s coronavirus spread, continued to rise at an alarming rate, from 139 on Wednesday to 245 on Thursday to 388 on Friday, with 34 deaths.

And that, an independent count claimed, was a gross underestimate.

BBC Persia reported that it had asked Iranian hospitals one by one, and found 210 fatalities, suggesting that there were several thousand infections either undetected or unacknowledged.

The authorities in Iran denied the report, but the health minister warned of a “pretty difficult week” ahead.

The conflicting information punctuated the mixed messages and confusion that have been emanating from Iran since it disclosed its first coronavirus deaths a little over a week ago.

Senior government officials and clerics have played down the outbreak and predicted it would soon be under control.

But the authorities have closed schools and canceled Friday Prayers in major cities, and several other countries have reported coronavirus cases in people who had recently been to Iran. And at least seven government officials have been infected, including a member of the president’s cabinet.

Two men in Mexico who had recently visited Italy have tested positive for the coronavirus, Mexican officials said on Friday, confirming the first known cases in the nation.

The discovery makes Mexico the second country in Latin America, after Brazil, to confirm the presence of the virus.

One of the patients, a 35-year-old man, was being treated at a hospital in Mexico City, the authorities said. The other, a 41-year-old man from the state of Hidalgo, was being kept in isolation in a hotel in the state of Sinaloa, in northwestern Mexico, officials said.

Both men had direct contact with an infected man in Italy and with each other during a conference this month in Bergamo, Italy, they said.

In addition to the two infected people in Mexico, two other men who had been in direct contact with those patients are under observation, the deputy health minister for prevention and health promotion, Hugo López-Gatell Ramírez, said at a news conference.

Italy, with the worst outbreak in Europe, continued to pose problems for the rest of the continent on Friday. Cases in 14 other countries can be traced back to Italy, the W.H.O. said, including the first infections in Northern Ireland and Wales, diagnosed on Friday.

Nations that only had a handful of cases at the start of the week reported dozens on Friday. Germany had nearly 60 cases by Friday afternoon, the government said — twice as many as a day earlier.

France reported 57 infections on Friday, more than triple the number it had counted on Wednesday.

“A new stage of the epidemic has been reached and we are now moving on to stage two,” said Olivier Véran, the health minister.

In Italy, officials extended the quarantine of ten towns in the Lombardy region by a week and warned that hospitals in the area were stretched to their limits.

All non-emergency surgery and routine medical exams have been postponed in the “Red Zone” encompassing the quarantined towns, but if the caseload continues to rise at the same rate, hospitals “will go into grave crisis,” the Lombardy government said in a statement.

Italy reported more than 800 infections on Friday — 531 of them in Lombardy, which includes the city of Milan. Eighty-five patients in Lombardy are in intensive care.

Nurses and doctors are getting ill, protective supplies are in short supply and treatment for other serious conditions may be compromised, officials said.

Switzerland reported nine new cases, bringing its total to 15, and said it was banning all gatherings of more than 1,000 people until March 15. The Geneva International Motor Show, an important annual automotive trade event, was among the gatherings that were abruptly canceled.

England reported two additional cases on Friday, both contracted in Iran, bringing the total in Britain to 19, health officials said.

Three countries in Eastern Europe — Belarus, Estonia and Lithuania — reported their first cases, all apparently linked to travel to either Iran or Italy.

Nigeria on Friday confirmed its first case of coronavirus, raising fears of how an outbreak could wreak havoc in Africa’s most populous nation and across the continent.

The case, confirmed by the Nigerian Health Ministry, is the first known infection in sub-Saharan Africa. The ministry said the patient was an Italian citizen who had returned to Lagos, the country’s largest city, from Milan on Tuesday.

The Nigerian government said in a statement that the patient was stable, did not have “serious symptoms” and was being treated at the Infectious Disease Hospital in Yaba, a suburb of Lagos.

Despite the steady number of flights and the growing relationship between China and African countries, the only previously confirmed infections on the continent had been in Egypt and Algeria.

Dr. Osagie Ehanire, Nigeria’s minister of health, said in a statement that the country had been shoring up its preparedness since the virus started spreading in China and that it would respond with all available resources.

Africa has very few confirmed cases, but experts have already expressed concerns about how the continent would cope with a wide-scale outbreak.

The Africa Centers for Disease Control and the W.H.O. have worked with African nations to improve surveillance and testing.

Currently, 26 laboratories on the continent are able to test for the coronavirus, up from two in early February.

Dr. Ngozi Erondu, an associate fellow in the Global Health Program at Chatham House, an international research group in London, said it would be crucial to enhance scrutiny of all travelers, especially those coming from countries with documented outbreaks.

“Staff at points of entry must realize that Covid-19 has no ethnicity or nationality, so personal biases must be checked,” she said, using the name of the disease caused by the coronavirus.

Reporting and research was contributed by Eric Schmitt, Rick Rojas, Marc Santora, Megan Specia, Katie Thomas, Russell Goldman, Melissa Eddy, Aurelien Breeden, Elian Peltier, Andrew Higgins, Abdi Latif Dahir, Jack Ewing, Choe Sang-Hun, Keith Bradsher, Alexandra Stevenson, Elaine Yu, Tiffany May, Karen Zraick, Wang Yiwei, Andrew Das, Jamal Jordan, Heather Casey, Joseph Goldstein, Jesse McKinley, Ian Austen, Kirk Semple, Richard Pérez-Peña, Josh Keller, Rick Gladstone, Farnaz Fassihi, Knvul Sheikh, Elisabetta Povoledo, Noah Weiland and Constant Méheut.

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