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Coronavirus Live Updates: New Fears Over Virus’s Spread in Washington State – The New York Times

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LIVE UPDATES

Coronavirus Live Updates: New Fears Over Virus’s Spread in Washington State

New findings, based on analysis of two infections, suggest that the coronavirus may have been in the state for weeks, and that hundreds may already have been infected.

Right Now

China’s leader, Xi Jinping, says the country must strengthen its defenses against outbreaks.

Credit…David Ryder/Getty Images

Researchers who have examined the genomes of two coronavirus infections in Washington State say the similarities between the cases suggest the virus may have been spreading in the state for weeks.

Washington State had the first confirmed coronavirus case in the United States last month, in a patient from which health officials took a sample on Jan. 19. But another case that surfaced in the region this week probably descended from it, based on an analysis of the virus’s genetic sequence.

The findings suggest that the virus has been spreading in the community for close to six weeks, according to one of the scientists who compared the sequences, Trevor Bedford, an associate professor at the Fred Hutchinson Cancer Research Center and the University of Washington.

If that is true, it could mean that anywhere from 150 to 1,500 people “have either been infected and recovered or currently are infected now,” said Mike Famulare, a principal research scientist at the Institute for Disease Modeling in Bellevue, Wash., who performed the analysis. Those cases, if they exist, have thus far been undetected.

[Do you know anyone who lives or works at Life Care Center in Kirkland, Wash.? If so, please email our reporter, Mike Baker, at mike.baker@nytimes.com.]

Many of those people would be in the early stages of incubating the virus and might not yet be contagious, Dr. Famulare said.

Dr. Famulare’s estimation was based on a simulation using what scientists have learned about the incubation period and transmissibility of the virus. He characterized his estimate of community cases as a “best guess, with broad uncertainty.” Another method, based on census data and estimated sampling, produced similar results, he said.

The scientists immediately reported the genomic sequence and their findings to state and federal health officials. According to a statement by the Snohomish Health District, the patient whose case emerged more recently, a teenager, was unaware he was being tested for the novel coronavirus. His case came to light because he went to a clinic to be tested for the flu, and his sample was shared with the Seattle Flu Study, which tested it for a variety of pathogens, including the new coronavirus.

“I do think as more community cases start popping up in the United States, this approach and technique could prove very useful to figuring out the extent of community transmission we currently are having,” Dr. Bedford said.

Dr. Bedford said it was also possible that the genetic similarities between the viruses could be explained by separate introductions into the United States. He said that was less likely, however, because both contain a marker that is rare among samples collected in Wuhan, China, where the virus originated, and because the two U.S. patients live near each other.

“As a virus passes from person to person, there will be errors that occur” as copies of the virus are made, he said. He compared the tiny mutations in the genetic sequence to a game of telephone: “Those can link up.”

Similar analyses have helped public health officials trace cases and fight outbreaks of Ebola in West Africa and the Democratic Republic of Congo.

President Trump sought on Saturday to more aggressively address the coronavirus after weeks of confusion over his administration’s response, urging public calm and issuing new foreign travel warnings and restrictions.

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The Coronavirus Outbreak

  • 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.

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At a White House news conference, Mr. Trump acknowledged the first death recorded in the United States, in Washington State. Vice President Mike Pence said the administration was issuing its highest-level warning, known as a “do not travel” warning, to areas of Italy and South Korea most affected by the virus.

The United States is also barring all travel to Iran, and barring entry to any foreign citizen who has visited Iran in the last 14 days. There will also be screenings of travelers coming from Italy and South Korea.

Speaking later Saturday at the Conservative Political Action Conference, Mr. Trump also suggested the United States was ready to help Iranians amid an outbreak there.

“If we can help the Iranians, we have the greatest health care professionals in the world,” he said, adding that “we would love to be able to help them.”

“All they have to do is ask,” he said.

Aiming to calm the public after the worst week for the stock market since 2008, the president, flanked by top federal public health officials, appealed to “the media and politicians and everybody else involved not do anything to incite a panic, because there’s no reason to panic at all.”

Of the nearly 87,000 coronavirus cases recorded globally as of Sunday, fewer than 7,200 were outside of mainland China.

The Chinese authorities reported 573 new cases. That brings the country’s total to 79,824 since the outbreak began, a figure that includes people who have recovered or died. China also reported 35 new deaths on Sunday, a drop from the previous day’s toll of 47.

The virus has now been detected in at least 60 countries. Qatar confirmed its first case on Saturday, a 36-year-old Qatari citizen who had been in quarantine since recently returning from Iran, the country’s health ministry said.

Iran, which has been at the center of the virus’s spread in the region, confirmed an additional 205 cases on Saturday, bringing its official total to 593. The death toll rose by nine, to 43 — a number many public health experts say indicates a wider spread than officials have acknowledged.

South Korea, which has the largest coronavirus outbreak outside China, reported 586 new cases on Sunday, bringing its total to 3,736.

Italy, the center of the outbreak in Europe, now has a total of 1,128 confirmed cases and 29 deaths. France has reported 100 cases and two deaths. Australia, which has 25 confirmed cases, reported its first death from the virus on Sunday.

China’s initial response to the coronavirus epidemic was marred by policy stumbles that fueled public anger, the nation’s leader, Xi Jinping, said in published speech excerpts that laid out his ideas for strengthening the country’s defenses against such outbreaks.

Mr. Xi’s comments, drawn from two internal speeches that he made in February, were published on Saturday in Qiushi, or “Seeking Truth,” the ruling Communist Party’s leading journal. They seemed intended to highlight the policy and legal changes that Mr. Xi intends to push to confront the epidemic.

Those include banning the trade in wildlife that scientists believe may have let the coronavirus jump from animals into the human population; more effective monitoring of potential epidemics; and stronger coordination to direct emergency medical supplies when an outbreak happens.

While praising the Chinese government’s response to the crisis, Mr. Xi also acknowledged problems, using blunter language than he has in previous public comments on the epidemic.

“Some localities and departments were at a loss in how to react to this sudden epidemic,” Mr. Xi said. “Some protective measures went through abrupt changes, and in some areas there was even lawless and criminal conduct that seriously impeded containing the epidemic, and there was public dissatisfaction about this.”

Mr. Xi did not elaborate on what he meant by criminal conduct. Chinese news media have reported cases of officials neglecting stricken families, as well as crude, unhygienic efforts to transfer patients.

After more than a month of emergency measures that have locked down cities, towns and villages, and shut down much transportation, commerce and industry, China appears to be taming the new coronavirus, labeled Covid-19, that emerged late last year in Wuhan, a city in the country’s center. On Saturday, China officially recorded 573 new infections, and another 35 deaths, from the virus.

In his latest comments, Mr. Xi tried to look beyond the immediate crisis, laying out areas where he wants changed policy. These included:

Improved health services. China has been building a safety net of medical insurance for citizens, but the expense and inadequacies of basic health care remain a source of public ire — and a problem highlighted by the epidemic. Mr. Xi signaled that the government would try to channel more spending to ease those problems. “Don’t let small ailments brew into major epidemics,” he said.

That would entail more spending on medical training, especially for general practitioners, he suggested. Chinese hospitals often refer patients to specialists, even for common illnesses that general practitioners could easily treat.

Cracking down on the illegal trade in wildlife. Scientists generally believe that the coronavirus may have spread from a wholesale market in Wuhan, the capital of Hubei Province, where some vendors sold wildlife. They say the pathogen may have jumped from bats to other animals, possibly pangolins, and to humans.

“Resolutely ban and harshly attack the illegal market and trade in wildlife,” he said in the comments published Saturday. “Contain major public health hazards at their source.”

Improved emergency preparations. The Chinese government has touted its vast mobilization of officials, doctors and medical resources to fight the epidemic. In his latest comments, Mr. Xi said that even so, China could do better. He called for clear lines of command in response to public health emergencies.

As Mr. Xi often does, he emphasized the potential of new, data-driven technology to improve the government’s response. “We must encourage the application of big data, artificial intelligence, cloud computing and other digital technology to play a better supporting role in monitoring and analyzing outbreaks, tracing viruses, prevention and treatment, and allocating resources,” he said.

No signs of liberalization. One notable thing was what Mr. Xi did not say. Many Chinese people, including health experts, have said that the epidemic illustrated the risks to public health created by official censorship, which early in the epidemic led to doctors being silenced by the authorities after they discussed the outbreak with colleagues. One of those doctors, Li Wenliang, himself died from the virus, making him into a martyr-like symbol of the costs of speaking out.

But Mr. Xi gave no indication that loosening censorship was on his agenda. The government, he said, would continue to crack down on “concocting and spreading rumors” — the accusation that the police in Wuhan leveled against Dr. Li.

A 78-year-old man died of the coronavirus early Sunday at a hospital in Perth, Australia, the first known death from the illness in that country, officials said. He had been a passenger on the Diamond Princess cruise ship, where a large concentration of coronavirus infections emerged last month as it was docked in Japan.

The man’s death was announced by Andrew Robertson, chief health officer at the Western Australia Department of Health. The man’s wife, who had also been on the cruise ship and was later diagnosed with the virus, was in stable condition, Mr. Robertson said.

Australia has so far reported 25 confirmed cases of the new virus, nine of which were associated with the Diamond Princess. Fifteen of these patients have recovered.

“We still need to make the point very clear that there isn’t community spread within Australia,” Mr. Robertson said. “This very tragic case is still related to the Diamond Princess.”

“The public shouldn’t be panicking at this stage,” he said.

Some members of a church at the center of South Korea’s coronavirus outbreak visited the Chinese city of Wuhan in January, officials said on Sunday. The global outbreak is believed to have begun in a seafood and poultry market in Wuhan.

Nearly 60 percent of the 3,736 people confirmed to have been infected in South Korea are members of Shincheonji Church of Jesus in the southeastern city of Daegu or came into contact with them, officials said.

Disease-control officials in South Korea have been trying to figure out when and how the virus reached the congregation. The Shincheonji church has acknowledged having members in Wuhan, but it said none of them had visited South Korea since December.

On Sunday, Kwon Jun-wook, a leader of the government’s efforts to fight the virus, said that some Shincheonji members had visited Wuhan in January. He did not say when in the month they had gone there, and he said “not many” had made the trip. China imposed a lockdown on Wuhan and other cities in Hubei Province on Jan. 23.

South Korea banned visitors from Wuhan and other Hubei cities on Feb. 4, but it still allows visitors from elsewhere in China.

Reporting was contributed by Sheri Fink, Mike Baker, Michael Crowley, Keith Bradsher, Raymond Zhong and Choe Sang-hun.

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