Cases Soar in Italy, Iran and South Korea as Alarm Grows

Japan closed its colleges for no less than a month. Iran canceled Friday Prayers in main cities. Saudi Arabia barred pilgrims from its holiest websites. Stock markets tumbled. U.S. officers referred to as for a lot of extra individuals to be examined.

As circumstances of the brand new coronavirus soared in Europe and the Middle East, and infections cropped up in a number of further international locations — cumulatively no less than 48 thus far — the indicators have been in all places on Thursday that the epidemic shaking a lot of the world was being seen with rising alarm.

South Korea, with the largest outbreak outside of China, reported 256 new cases Friday, bringing its total to 2,022, and officials made plans to test an estimated 200,000 members of a church that has become one of the epidemic’s hot zones.

Federal government health workers were not given proper medical training or protective gear when they were sent to assist Americans who had been quarantined for possible exposure to the coronavirus, according to a whistle-blower complaint.

Staff members entered quarantine areas at Travis Air Force Base and March Air Reserve Base in California, interacted with the people who were in isolation and then moved freely around and off the bases, the complaint said.

The whistle-blower, described as a senior leader at the Department of Health and Human Services, said at least one worker stayed in a nearby hotel and left California on a commercial flight.

Many of the health workers were unaware of the need to test their temperatures three times a day, the person said. The complaint was submitted to the Office of the Special Counsel, and a portion was obtained by The New York Times.

The employees were not given training in safety protocols until five days after they were ordered into quarantined areas, including a hangar where evacuees from coronavirus hot zones in China and elsewhere were being received, the whistle-blower said.

President Trump has sought to play down the danger of a domestic outbreak, amid bipartisan concerns about a sluggish and disjointed administration response to an epidemic that public health officials say is likely to spread in the United States.

The first U.S. case of coronavirus infection in a patient with no known risk factors — travel to a hot zone or contact with another person known to be infected — emerged this week near Travis Air Force Base.

In a statement on Thursday, the Department of Health and Human Services acknowledged the complaint, saying, “We take all whistle-blower complaints very seriously.”

Global markets tumbled for a sixth consecutive day on Thursday, dragging the S&P 500 down more than 10 percent in just over a week, reflecting rising fears over the coronavirus spreading quickly around the world.

The benchmark index fell 4.4 percent on Thursday, the worst single-day slide for the market since August 2011. It is on pace for its worst weekly performance since the 2008 financial crisis. Stocks in Europe and Asia were also hard hit on Thursday.

New York City has had no confirmed cases of the virus so far. Seven patients had previously been deemed potential cases, only to be ruled out after testing.

Federal health officials on Thursday approved coronavirus testing of significantly more people, a day after a California patient who had no known risk factors tested positive for the virus.

Testing for the infection — which is now done almost entirely by the Centers for Disease Control and Prevention in Atlanta — has been administered only to patients who had been to China recently or who were in touch with a person who had a confirmed case of the illness, though exceptions could be made.

Credit…Centers for Disease Control and Prevention

The C.D.C. expanded the criteria to include people with symptoms of illness who had traveled to Iran, Italy, Japan and South Korea. They will also cover severely ill patients with acute lower respiratory sickness who are hospitalized, even if no source of coronavirus exposure has been identified, when there is no alternative diagnosis.

The California patient had to wait days to be tested because of restrictive federal criteria, despite doctors’ suggestions. Public health officials said the person was a resident of Solano County, in Northern California, but they have not disclosed any other information to protect the patient’s privacy.

Doctors at the University of California, Davis Medical Center considered the novel pathogen a possible diagnosis when the patient was first admitted last week.

The patient in California and one in Germany had not traveled to any country with an outbreak, or been in contact with anyone known to be infected, suggesting that the virus had spread within their communities.

“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.

The number of coronavirus cases in Italy soared on Thursday, and the count of European countries reporting infections rose to 15.

Leaders are struggling to find a balance between slowing the epidemic and avoiding panic or economic disruption — debating, for example, the wisdom of holding major events that draw from across the continent.

The Netherlands, Denmark, Estonia, Norway and Romania all reported infections for the first time, joining Italy, Austria, Croatia, France, Germany, Greece, North Macedonia, Spain, Sweden and Britain.

Italian officials reported 650 cases as of Thursday night — up from 400 a day earlier — with 17 deaths. The number of infections had doubled in just two days, as Italy grapples with the largest outbreak outside of Asia, centered in the northern region of Lombardy.

Whole towns have been isolated, and Lombardy’s governor, Attilio Fontana, started a period of self-isolation after a co-worker tested positive.

Most other affected European nations have just a handful of cases, but national leaders say that these early days will prove crucial.

“We have before us a crisis, an epidemic that is coming, we know that certain countries are already much more affected than us,” President Emmanuel Macron of France said during a visit to the Paris hospital where a coronavirus patient died this week. “We are going to have to confront it as best we can, even as life goes on.”

Hours later, officials in France reported that the number of cases there had jumped to 38, from 18 a day earlier.

In Spain, where there are 17 cases, the latest patient, announced Thursday, was a soccer fan from Valencia — one of thousands who had traveled to Milan, the capital of Lombardy, earlier this month to watch a Champions League match.

Hadi Khosroshahi, 81, a prominent cleric and former ambassador to the Vatican, was sickened by the coronavirus and died in a hospital, Iran’s official media have reported. The outbreak has also killed Elham Sheikhi, 22, a member of the women’s national soccer team.

But three people have now been designated as the administration’s primary coronavirus official.

In announcing Mr. Pence’s coronavirus responsibilities, Mr. Trump said, “Mike is going to be in charge, and Mike will report back to me.” Mr. Pence says it will be Ms. Birx. Meanwhile, Alex M. Azar II, the health and human services secretary, remains the chairman of the government’s coronavirus task force — whose meeting Thursday Mr. Pence is scheduled to lead.

The insertion of Mr. Pence and then Dr. Birx into the government’s response further erodes Mr. Azar’s traditional role. Mr. Trump has told people that he considers Mr. Azar to be too “alarmist” about the virus.

Health officials in Germany reacted aggressively on Thursday after a man with no known connection to anyone infected with the coronavirus tested positive for the illness.

In addition to closing schools in the community where he lived, they reached out to hundreds of people who took part in a carnival celebration over the weekend where the man was also present, urging them to stay home for 14 days.

Karl-Josef Laumann, the health minister for the state of North Rhine-Westphalia, where the man lives, said that the authorities were still trying to figure out how the man had contracted the virus.

He remains critically ill and cannot provide information about his recent travels, including the period of time when he was infected and contagious but not showing symptoms.

Still, German officials said they would resist taking measures like those seen in China and, to a lesser extent, in Italy, where entire towns and cities have been locked down.

They cautioned against panic, pointing to success in preventing the spread of the virus last month through simply encouraging people to stay home.

Federal officials warned this week that a coronavirus outbreak could force schools to close for a long period.

The U.S. announcement caught educators and parents off guard, leaving them asking how to manage such a crisis.

Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, suggested that a temporary system of “internet-based teleschooling” could replace traditional schools.

But most schools have no experience in providing online instruction on a large scale, and American families have uneven access to computers and broadband internet.

Parents would be forced to juggle their own work responsibilities with what could amount to “a vast, unplanned experiment in mass home-schooling,” said Kevin Carey, vice president for education policy at New America, a think tank.

Even as they struggled to absorb the federal warning, schools were busy making their own plans.

Many districts have already sent home letters about the coronavirus, asking parents to keep sick children away from school and to remember basic prevention measures like hand washing, cough covering and flu vaccination.

Reporting and research was contributed by Sheri Fink, Melissa Eddy, Salman Masood, Marc Santora, Russell Goldman, Carlos Tejada, Kevin Granville, Geneva Abdul, Choe Sang-Hun, Zoe Mou, Daniel Victor, Roni Caryn Rabin, Denise Grady, David Yaffe-Bellany, Ed Shanahan, Andrew Keh, Ben Dooley, Motoko Rich, Vivian Yee, Michael D. Shear, Emily Cochrane, Aurelien Breeden, Raphael Minder, Matina Stevis-Gridneff, Elaine Yu, Richard Pérez-Peña, Emma Bubola, Dana Goldstein, Julie Bosman and Matt Phillips.

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