The World Health Organization admitted Monday it underestimated the risks posed by the deadly coronavirus last week as the death toll from the outbreak in China soared to 106, with nearly 1,300 new cases confirmed Tuesday.
The health commission in central Hubei province, the epicenter of the epidemic, said 24 more people had died from the virus and 1,291 more people were infected, raising the total number of confirmed cases to more than 4,000 nationwide.
The global risk was now “high” rather than moderate, WHO said, noting that it remained unclear if the coronavirus spreading in China and beyond is contagious during its incubation period before symptoms appear.
The virus, which can cause a pneumonia-like acute respiratory infection, has in a matter of weeks killed more than 100 people and infected some 4,000 in China, while cases have been identified in more than a dozen other countries.
In a fresh report on the new virus, known as 2019nCoV, the UN health agency said current estimates put the incubation period for the virus at between two and 10 days.
“Understanding the time when infected patients may transmit the virus to others is critical for control efforts,” WHO said.
It did not immediately confirm assertions made by Chinese authorities that people who are infected can spread the disease before they show any symptoms of fever or respiratory difficulties.
“Detailed epidemiological information from more people infected is needed to determine the infectious period of 2019nCoV, in particular, whether transmission can occur from asymptomatic individuals or during the incubation period,” it said.
WHO last week stopped short of declaring the outbreak a public health emergency of international concern—a rare designation used only for the worst outbreaks that would trigger more concerted global action.
The virus has caused global concern because of its similarity to Severe Acute Respiratory Syndrome (SARS), which killed hundreds across China and Hong Kong in 2002-2003 and was also traced to the wild game trade.
The new virus is believed to have jumped to people from animals in a Wuhan market, but it has since begun spreading between humans, although the exact mode of transmission has yet to be confirmed.
As with SARS and another deadly coronavirus known as Middle-East Respiratory Syndrome, or MERS, WHO suggested that the new virus could be spreading through droplets, for instance when people sneeze or cough, or through direct contact with infected people or with objects they have touched.
To reduce the risk of infection, WHO stressed the need to avoid close contact with people suffering from acute respiratory infections, frequently wash one’s hands, and avoid unprotected contact with farm or wild animals.
The agency also stressed the importance of practicing so-called cough etiquette, including maintaining distance and covering coughs and sneezes with tissues.
WHO has not recommended any international travel or trade restrictions, but does call for high levels of vigilance, including encouraging airport exit and entry screening for passengers leaving affected areas to check for fever and coughs.
The deadly new coronavirus will afflict a minimum of tens of thousands of people and will last at least several months, researchers estimate based on the first available data.
“The best-case scenario, you would have something… where we go through the spring into the summer, and then it dies down,” David Fisman, a professor at the University of Toronto who wrote an analysis of the virus for the International Society for Infectious Diseases, said.
“It’s not something that’s going to end the next week or the next month,” said Alessandro Vespignani, a professor at Northeastern University. He is part of a group of researchers that manages an online dashboard about the outbreak.
The official number of cases is more than 4,000 in China, with more than 100 deaths, and some 50 confirmed infections outside the country.
But the actual number of Chinese cases, including those not yet detected, is likely to be more than 25,000, said Vespignani, according to the analysis of the group coordinated by Northeastern.
And researchers at the University of Hong Kong estimate that the number of actual cases has currently passed 40,000.
“It’s easy to get to twice or three times as much, even just in the city of Wuhan,” the virus’ epicenter, said Vespignani. “If we start to have other larger areas affected, then those numbers are going to be much, much bigger.”
China has quarantined millions of people and urged its citizens to delay overseas travel as it scrambles to stop the deadly coronavirus epidemic from spreading further.
Authorities also ordered schools and universities to remain closed on Tuesday after extending a national holiday by a week in a bid to contain an outbreak that has already killed more than 100 people and spread to a dozen countries.
Earlier, the government shuttered major tourist attractions from Disneyland to a stretch of the Great Wall and rolled out draconian transport restrictions in areas worst affected by the virus.
More than 56 million people are subject to travel curbs in Hubei province, where the virus was first detected.
Public transport has been stopped in 18 cities there, with train stations shut, events canceled and theaters, libraries, and karaoke bars closed in some locations.
The epicenter of the outbreak is provincial capital Wuhan, the biggest city on lockdown, where the government has halted all travel out of the Yangtze River metropolis of 11 million.
Wuhan residents have been told to stay home and authorities have restricted car traffic in the city center.
Similar quarantine measures are being taken in nearby cities, with strict controls on weddings and funerals, temperature screenings for new arrivals, and the suspension of online taxi services.
Beijing, Shanghai and other megacities have suspended the entry and departure of long-distance bus services.
More than 400 inter-province train services were canceled—most until Feb. 8-9 but some for weeks.
China’s immigration agency has also asked citizens to delay international travel to stop the virus from spreading elsewhere overseas.
Authorities had already suspended both domestic and overseas Chinese group tours over the weekend.
Tourists from Hubei in Haikou, capital of the island province of Hainan, were told by the city government they had to spend 14 days in a hotel for centralized medical observation, and were forbidden to leave.
Hundreds of millions of people criss-crossed the country last week return to their families for the Lunar New Year holiday, in what is typically a joyous time of gatherings and public celebration.
Instead, public health officials asked China’s 1.4 billion citizens to confine themselves at home until all is clear.
Schools and universities across the country were ordered not to reopen until further notice on Tuesday, a day after the holiday break was extended to try and reduce the spread of the virus.
Wuhan and Beijing had earlier canceled public events that usually attract hundreds of thousands of people to temples during the New Year holiday.
The historic Forbidden City—a sprawling imperial palace in Beijing and one of the country’s most revered cultural sites—was closed from Saturday.
Other famous landmarks including a section of the Great Wall, the Ming Tombs, and Yinshan Pagoda are also not open to visitors. Tibet’s Potala Palace was shut down on Monday.
Disneyland theme parks in Shanghai and Hong Kong have closed down indefinitely.
Women’s Olympics football qualifiers scheduled for next week in Wuhan have been moved out of the country and will now be held in Sydney.
China’s film box-office earnings for Lunar New Year’s Eve on Friday were just one-tenth of last year as people shunned crowds.
US coffee chain Starbucks said it had shut all its stores in Hubei during the holiday break.
China has ordered sterilization and ventilation at airports and bus stations, as well as inside planes and trains, while travelers are being screened for fever.
Temperature screening checkpoints have been set up in hundreds of Chinese railway stations, according to state news agency Xinhua.
Authorities have asked people to wash their hands regularly, avoid crowded places, get plenty of fresh air and wear protective face masks.
City authorities in Wuhan have gone further and made it mandatory to wear masks in public places. A similar order was issued in southern Guangdong province, which has more than 110 million people.
With people rushing to get masks at pharmacies and on popular websites, China’s industry and information technology ministry vowed to increase supply.
Authorities in Wuhan are rushing to build two field hospitals by next week to ease pressure on medical facilities in the city that are struggling to handle a growing caseload.
The first facility is expected to be operational by next Monday and will have a capacity of 1,000 beds spread over 25,000 square meters, according to state media. The second is slated to open two days later with 1,300 beds.
Xinhua said the two new hospitals in Wuhan would be similar in size to the temporary facility built to tackle SARS in Beijing in 2003 when 650 people died from the disease in the mainland and Hong Kong.