A coronavirus pandemic looked ever more likely on Monday as multiple countries around the world raced to stem outbreaks of “untraceable” cases of the virus.

Clusters of cases arising in South Korea, Italy and Iran with no clear ties to outbreak’s epicenter in China have heightened concerns about local, self-sustaining epidemics and a global pandemic. In a pandemic, outbreaks occur on more than one continent. As of Monday, there were more than 79,000 cases of COVID-19 and 2,600 deaths globally.

“We are worried about the situation in the Islamic Republic of Iran and in Italy,” Tedros Adhanom Ghebreyesus, director of the World Health Organization, said Monday.

“It is an incredible time. Less than two months ago, the coronavirus was completely unknown to us,” Ghebreyesus said. “The past few weeks have demonstrated just how quickly a new virus can spread around the world and cause widespread fear and disruption.”

As reported Monday by Associated Press, the list of countries with burgeoning case counts includes:

• South Korea. Total cases of COVID-19 have risen from just 28 last week to 833 by Monday. Seven people have died. South Korea now has the most cases behind China and Japan. Most of the South Korean cases are centered in the southern city of Daegu, and more than half are concentrated among members of the Shingeongji religious group. The president of South Korea put the country on its highest alert Sunday, ordering officials to take “unprecedented and powerful” actions to curb the spread of coronavirus. These actions can include closing schools and public transportation temporarily. Officials said the re-opening of schools following a spring break will be delayed until March 9.
• Italy. Officials announced Monday that the number of new cases reported jumped to 219, with five deaths. Most of the cases have been reported in the northern Lombardy region of Italy, an area that includes Milan. Local officials have set up roadblocks in 10 towns where cases have been reported. Meanwhile, officials in Venice halted its annual Carnival, an international gathering that draws people from all over the world, after three cases of coronavirus were reported there. Italy now has the largest number of cases outside Asia.
• Iran. So far, Iranian officials say 61 cases have been identified and 12 people have died. There are also 900 suspected cases that are being investigated. It’s thought that a Chinese worker who’d returned to the Iranian city of Qom may have been the source for the Iranian cases there, although cases are arising elsewhere.

  Minnou Mohraz, a member of the National Committee for Infectious Diseases at Iran’s Ministry of Health, said the outbreak “started in Qom and has reached other cities in the country like Tehran, Babol, Arak, Isfahan, Rasht and other cities due to people traveling. There is a possibility that it exists in all cities across the country.”

• Singapore. Five coronavirus case clusters have also emerged in that country, bringing the total number of cases to 89 on Monday.

Speaking to the AP, one expert said that the mild nature of most cases of COVID-19 is making the virus tough to spot and contain. People with symptoms that might simply be taken for cold or flu may be transmitting the virus to others, explained Dr. Amesh Adalja of the Johns Hopkins Center for Health Security in Baltimore.

“If that’s the case, all of these containment methods are not going to work,” Adalja told the AP. “It’s likely mixed in the cold and flu season all over the place, in multiple countries.

By Monday, the total number of cases within mainland China had reached more than 77,150, CNN reported, with 2,592 deaths. The rate of new cases is slowing in China, suggesting that draconian efforts to contain the outbreak there are working.

Cruise ship cases spur uptick in U.S. numbers

In the meantime, the number of coronavirus cases among Americans jumped to 35 on Friday, as U.S. health officials reported that more repatriated passengers evacuated from a quarantined cruise ship in Japan have tested positive for the virus.

“The repatriated cases include 18 passengers from the Diamond Princess [cruise ship] and three from the Wuhan repatriation flights,” Dr. Nancy Messonnier, director of the U.S. National Center for Immunization and Respiratory Diseases, said during a media briefing Friday.

However, nearly everyone else evacuated in the special flights from Wuhan have finished their 14-day quarantine, Messonnier added.

Of the Diamond Princess patients who are now in the United States, 11 are receiving care at the University of Nebraska Medical Center, five are receiving care around Travis Air Force Base in northern California and two are being cared for around Lackland Air Force Base in Texas, Messonnier said.

“Because the passengers on the Diamond Princess were in a close setting where there has been a significant spread of COVID-19, they are considered at high risk for infection and we do expect to see additional confirmed cases,” she noted.

Ten more passengers from the Diamond Princess tested positive for coronavirus in Japan, but they are not being counted among the infected yet because the tests have not been confirmed by the U.S. Centers for Disease Control and Prevention, Messonnier said.

“We never expected that we would catch every single traveler with novel coronavirus returning from China, given the nature of this virus and how it’s spreading,” Messonnier said during the briefing. “That would be simply impossible.”

Buying time

Instead, the measures being taken are buying health officials time for a response before the virus gains a foothold in the United States, she explained.

Among the 400 Americans who were on board the Diamond Princess cruise ship, roughly 300 were evacuated a week ago and are under quarantine in the United States.

For the patients who have been sent to the University of Nebraska Medical Center, the facility has a biocontainment unit and is specially designated to treat highly infectious diseases, CNN reported. The unit successfully treated three patients for Ebola in 2004.

More than 100 American passengers remain in Japan, and U.S. health officials have said that they will not be allowed to return home for at least two more weeks.

Earlier this month, the United States began to bar entry to any foreigners who have recently traveled to China. U.S. citizens who have recently traveled to the Hubei province of China, where Wuhan is located, will be quarantined for up to 14 days, U.S. health officials said. U.S. citizens who have recently traveled to other parts of China will face health screenings and voluntary quarantines of up to 14 days.

The temporary entry ban applies to foreign nationals, with the exception of relatives of citizens and permanent residents.

More information

The U.S. Centers for Disease Control and Prevention has more on the new coronavirus.

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