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Seoul’s handling of the outbreak emphasises transparency and relies heavily on public cooperation in place of hardline measures such as lockdowns
While uncertainties remain, it is increasingly viewed by public health experts as a model to emulate for authorities desperate to keep Covid-19 in check
A woman wearing a face mask walks along the Han river at a park in Seoul, South Korea. Photo: AP
After announcing 600 new cases for March 3, the authorities reported 131 new infections a week later. On Friday, officials reported just 110, the lowest daily toll since February 21. The same day, the number of recovered patients, 177, exceeded new infections for the first time.President Moon Jae-in, while cautioning against premature optimism, has expressed hope that South Korea could soon enter a “phase of stability” if the trend holds firm.
With about 8,000 confirmed cases and more than 65 deaths, it was until recently the country with the most confirmed cases outside China – but South Korea has since emerged as a source of inspiration and hope for authorities around the world as they scramble to fight the pandemic.
South Korea’s infection rate falls without citywide lockdowns like China, Italy
11 Mar 2020
As countries ranging from the United States to Italy and Iran struggle to manage the virus, Seoul’s handling of the outbreak – involving a highly coordinated government response that has emphasised transparency and relied heavily on public cooperation in place of hardline measures such as lockdowns – is increasingly viewed by public health experts as a model to emulate for authorities desperate to keep the virus under control.
Whereas China, where the virus originated, and more recently Italy have placed millions of their citizens on lockdown, South Korea has not restricted people’s movements – not even in Daegu, the southeastern city at the centre of the country’s outbreak.
Instead, authorities have focused mandatory quarantine on infected patients and those with whom they have come into close contact, while advising the public to stay indoors, avoid public events, wear masks and practise good hygiene.
South Korean President Moon Jae-in visits the Korea Centres for Disease Control and Prevention on March 11. Photo: EPA
And while numerous countries have imposed sweeping travel bans – including the US, which has introduced dramatic restrictions on travel from Europe – Seoul has instead introduced “special immigration procedures” for heavily affected countries such as China, requiring travellers to undergo temperature checks, provide verified contact information and fill out health questionnaires.
[South Korea’s] approach seems less dramatic and more usable by other countries, compared with that used in mainland China – Ian MacKay, virologist at the University of Queensland
“More than a week of downward-trending case counts shows that the approach in South Korea has turned around an epidemic,” said Ian Mackay, a virologist at the University of Queensland, Australia. “This approach seems less dramatic and more usable by other countries, compared with that used in mainland China. If these trends continue, they will have managed to stop the growth of their epidemic.”
‘A SPECTACULAR FEAT’
The linchpin of South Korea’s response has been a testing programme that has screened more people per capita for the virus than any other country by far. By carrying out up to 15,000 tests per day, health officials have been able to screen some 250,000 people – about one in every 200 South Koreans – since January.
To encourage participation, testing is free for anyone referred by a doctor or displaying symptoms after recent contact with a confirmed case or travel to China. For anyone simply concerned about the risk of infection, the cost is a relatively affordable 160,000 won (US$135). Testing is available at hundreds of clinics, as well as some 50 drive-through testing stations that took their inspiration from past counterterrorism drills and can screen suspected patients in minutes.
“This country has a universal health-coverage system for the whole population and the economic burden for testing is very low,” said Kim Dong-hyun, president of the Korean Society of Epidemiology. “Tests are conducted for free if you have proper symptoms.”
The massive volume of data collected has enabled the authorities to pinpoint clusters of infection to better target their quarantine and disinfection efforts, and send members of the public text-message alerts to inform them of the past movements of infected patients in their area – even down to the names of shops and restaurants they visited.
This country has a universal health coverage system for the whole population and the economic burden for testing is very low – Kim Dong-hyun, president of the Korean Society of Epidemiology
“South Korea’s capability to test for early detection of viruses has developed greatly as it went through the 2009 new influenza outbreak and 2015 Mers [Middle East respiratory syndrome] outbreak,” said Kim Woo-joo, a professor of medicine at Korea University’s College of Medicine. “It ranks among the world’s top countries in this field.”
South Korea’s ‘drive-through’ coronavirus testing stations
Collecting this amount of data has also allowed the South Korean authorities to glean a clearer indication of the potential lethality of the virus, the fatality rate of which has diverged significantly from about 5 per cent in Italy to about 0.8 per cent in South Korea. Although factors including quality of health care, patient age and public awareness can affect the fatality rate of a virus, the scale of testing is among the most influential.
By comparison, in neighbouring Japan – which has confirmed more than 600 cases, not including the virus-stricken Diamond Princess cruise ship – the authorities had as of Friday tested over 10,000 people.
In the United States, where the authorities are unable to confirm the number of tests since they are being carried out by a patchwork of federal, state and private laboratories, the total was estimated to be fewer than 5,000 in a survey of available data by The Atlantic.
William Schaffner, a professor of preventive medicine and infectious diseases at Vanderbilt University School of Medicine in the US, said South Korea had pulled off a “spectacular” feat that was allowing health officials to track the virus and assess its intensity.
“We are unsure where our infection is and how intensely it is being transmitted in the US and we are only now starting to test,” he said.
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South Korea is not unique in claiming some success in its fight against the virus. Singapore, Taiwan and Hong Kong, informed by past outbreaks such as severe acute respiratory syndrome (Sars) and Mers, have managed to keep confirmed cases low while eschewing the sort of draconian measures implemented in mainland China.
Early on, Hong Kong took some of the most comprehensive steps to implement “social distancing” – in which events are cancelled and venues closed to minimise contact between people – by shutting schools in late January, while the authorities produced a digital map of confirmed cases to allow people to avoid potentially infected areas.
In Taiwan, officials have pooled information from immigration and health insurance databases to track people’s travel histories and symptoms, and used phone tracking to ensure compliance with quarantine. Singapore has similarly tracked infected patients and traced their contacts, with stiff penalties for those who disobey quarantine or mislead the authorities about where they have travelled.
A worker disinfects a Seoul subway station as a precaution against the new coronavirus. Photo: AP
OPENNESS AND TRANSPARENCY
But where South Korea has stood apart is seemingly turning the tide against a major outbreak while maintaining openness and transparency. The largest cluster of cases in the country is linked to a secretive religious sect, Shincheonji, members of which have been accused of negligently spreading the virus as well as evading medical follow-ups and testing.
In addressing the Covid-19 outbreak, sound decision-making should not be about making a choice between maximised protection or minimal disruption – Yanzhong Huang, Council on Foreign Relations
“South Korea’s experience suggests that a country can contain the spread of the virus in a relatively short period of time without relying on draconian, at-all-costs containment measures,” said Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations in New York.
“For countries like the US, the Korean experience offers an acceptable, likely more viable, alternative to addressing the outbreak. In addressing the Covid-19 outbreak, sound decision-making should not be about making a choice between maximised protection and minimal disruption.”
China effectively barred 60 million people in Wuhan – ground zero of the outbreak – and the rest of the province of Hubei from leaving their homes, while restricting the movements of hundreds of millions of others across the country by shutting down public transport, banning private cars and setting up roadblocks.
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The country claims to have effectively halted the spread of the virus after recording more than 80,000 cases and 3,100 deaths, and its daily updates have in recent weeks fallen from thousands of new cases to dozens. However, scepticism lingers over official figures after local and provincial officials in Hubei initially tried to hide the extent of the outbreak.
In a move widely seen to be aimed at touting the success of Beijing’s hardline measures, Chinese President Xi Jinping on Tuesday made his first visit to Wuhan, during which he called for businesses and factories to return to work as normal and for the country to refocus on economic growth.
“While China has been able to control Covid-19, I don’t think its draconian methods are worth copying in liberal democracies,” said Lawrence Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown University Law Centre in Washington. “Most democracies value human rights and freedoms … [not] the degree of social control we’ve seen in China. South Korea offers a better model.”
A nearly empty customer call centre in the Gocheok-dong neighbourhood of Seoul as workers isolate or work from home. Photo: EPA
But in a striking indication that Beijing’s harsh tactics could inform even liberal democratic societies, Italy on Monday announced a nationwide quarantine after a massive spike in cases caught the authorities off guard. Shops, restaurants and bars have been closed, while public gatherings and most travel have been banned in the European country, which has confirmed more than 15,000 cases and 1,000 deaths as of Friday – making it the site of the biggest outbreak outside China.
In the Philippines, President Rodrigo Duterte on Thursday announced a lockdown of the entire Metro Manila region and its 12.8 million people.
David Hui Shu-cheong, an expert in respiratory medicine at the Chinese University of Hong Kong, said Italy had responded “very slowly” to the outbreak, in contrast to South Korea.
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Even as Beijing touted its success at fighting the virus, with state media recently insisting the “world owes China a ‘thank you’”, South Korea – which democratised in the late 1980s following decades of military dictatorship – has made no secret of its desire to promote a more liberal alternative.
At a press conference with foreign media this week, vice-health minister Kim Gang-lip said that while drastic measures such as locking down affected areas had demonstrated “modest effectiveness”, they suffered from being “coercive and inflexible”.
“Korea, as a democratic country, values globalisation and a pluralistic society,” he said.
“Therefore we believe we must transcend the limitations of the conventional approach to fighting infectious disease.”
Kim stressed that public trust was crucial to the government’s strategy. “The more transparently and quickly accurate information is provided, the more the people will trust the government,” he said. “They will act rationally for the good of the community at large.”
South Korean ministers listen to Prime Minister Chung Sye-kyun (on screen) during a meeting to discuss measures to deal with the spread of the new coronavirus. Photo: EPA
UNKNOWN FACTORS
Although the authorities have shut down schools nationwide, South Koreans have largely embraced self-isolation and social distancing of their own accord.
In the past fortnight, more than 12,000 businesses have applied for subsidies to pay the wages of employees while they temporarily close their doors due to the outbreak, according to the country’s labour ministry. Many shops in Daegu, the site of more than three-quarters of the country’s cases, have shut their doors, while shopping malls and cinemas across the country have become largely deserted as people stay at home. Catholic churches and Buddhist temples nationwide have suspended mass and prayer services.
“To an outsider, South Korea has handled an enormous surge in cases very well and seemed to mitigate further spread through forms of … passive social isolation,” said Howard P. Forman, a professor of public health policy at Yale School of Management.
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Some experts suggest South Korean society’s emphasis on discipline and community may have given it room to avoid implementing more draconian measures.
“This measure appears to have been very successful but is reliant on the local population working with the response,” said Jeremy Rossman, an honorary senior lecturer in virology at the University of Kent. “It is not clear how effective this approach would be in other cultures and it does require effective communication with the local population.”
How a secretive church in South Korea became a coronavirus ‘super spreader’
However, South Korea’s response has not been without missteps or critics.
In mid-February, before it emerged that the virus had spread rapidly among Shincheonji followers, Moon made the ill-fated prediction that the outbreak would “disappear before long”.
The Korean Medical Association – the country’s largest association of doctors – and conservative media have criticised the president for not outright banning travel from China.
Nearly 1.5 million South Koreans have signed an online petition calling for Moon’s impeachment over his handling of the outbreak, and his approval rating this week dropped to just under 45 per cent – although, in a sign of reviving fortunes, an opinion poll released on Friday saw the president’s response rated favourably.
Medical workers attend to a woman who was feeling unwell upon her arrival at the Keimyung University hospital in Daegu. Photo: AFP
It is still too early to say whether the response is working – Kim Dong-hyun, president of the Korean Society of Epidemiology
Some experts caution that it is too early to tell if South Korea truly has the virus under control. The discovery of a new cluster of about 100 infections at a call centre in densely populated Seoul prompted a sudden uptick in cases on Wednesday, raising fears the virus could be on the verge of spreading uncontrollably nationwide.
“It is still too early to say whether the response is working,” said Kim, the president of the Korean Society of Epidemiology. “There is an optical illusion involved in the figures. The daily numbers of new cases appear to be decreasing as the screening of Shincheonji followers is coming to an end, but it must be noted that there are new clusters emerging in Seoul and other areas. We can’t lower vigilance.”
Like elsewhere, the country is facing unknown factors such as warming temperatures in the coming weeks and the arrival of travellers from new and emerging infection hotspots overseas. “We are seeing that in South Korea, large epidemics can be slowed,” said Mackay from the University of Queensland. “Can they be prevented? That will be the challenge for countries who have yet to see widespread community transmission.”
In the face of uncertainty, South Korea appears determined to hold firm to its strategy. During a visit to the Korea Centres for Disease Control and Prevention on Wednesday, Moon said the country’s response had received international recognition and allowed it to avoid the “extreme choice” of sweeping travel bans.
The next day, responding to the World Health Organisation’s decision to declare the virus a global pandemic, the president called on South Koreans to maintain hope that the virus would be overcome.
“It might take more time than we thought,” Moon said. “Everyone, please don’t become fatigued.”
SEOUL (Reuters) – Makers of soju, South Korea’s national drink and one of the world’s best selling spirits, are jumping into the fight on the largest outbreak of coronavirus outside China by sharing their stockpiles of alcohol with makers of sanitisers.
Disinfectants, such as hand sanitisers, are flying off the shelves, along with medical-grade masks, as infections in South Korea have surged past 5,000 in just over a month since its first patient was diagnosed.
South Korean soju makers have responded to soaring ethanol demand for sanitisers by donating the alcohol that goes into the drink, a distilled spirit with 17% to 20% alcohol by volume traditionally based on rice, but now often wheat or potatoes.
“Ethanol demand for disinfection has grown while supply is limited…we have decided to provide it,” an official of Daesun Distilling, based in the southeastern city of Busan, told Reuters.
To banish the virus, the company has pledged to donate 32 tonnes of ethanol for use in disinfecting buildings and public places in Busan and southeastern Daegu, the city at the centre of South Korea’s outbreak.
“We plan to keep donating until the coronavirus outbreak is stabilised and to donate 50 tonnes more,” added the official, who sought anonymity as he was not authorised to speak to media.
South Koreans drink an average of about 12 shots of soju each week, media say, citing industry figures. Ethanol for alcoholic drinks can be produced by fermentation or distillation, typically from grains and plants.
The chemical can also be made from petrochemical feedstock.
Whether used for liquor or disinfection, both have the same chemical structure and can break apart the virus particle, said Lee Duckhwan, a chemistry professor at Sogang University in Seoul, the capital.
“If there’s any difference, that is the liquor tax imposed on ethanol produced by liquor makers,” Lee said.
The virus fears boosted February sales of soaps and hand sanitisers, including those with an alcohol base, to four times the level a year ago, data from a major retailer Lotte Mart shows. Shares of ethanol producers also jumped.
Following Daesun Distilling, Hallasan Soju, based on the resort island of Jeju, also provided 5 tonnes of ethanol to authorities on Tuesday, a company official said.
Image copyright EPAImage caption Lee Man-hee is the founder of the Shincheonji Church
The head of the religious sect that has been at the centre of the coronavirus outbreak in South Korea has apologised to the nation for the disease’s spread.
Lee Man-hee, the leader of the Shincheonji Church of Jesus, got on his knees and bowed at a news conference.
About 60% of the country’s more than 4,000 confirmed cases are sect members.
On Monday, South Korea – the biggest hotspot outside China – reported 476 new cases, bringing the total number to 4,212. It has recorded 26 deaths.
Prosecutors have been asked to investigate Mr Lee on possible charges of gross negligence.
“Although it was not intentional, many people have been infected,” said the 88-year-old leader. “We put our utmost efforts, but were unable to prevent it all.”
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Of the confirmed cases, 3,081 are from the southern city of Daegu and 73% of these cases have been linked to the Shincheonji Church near there.
In the capital Seoul, the mayor urged the city’s 10 million residents to work from home and to avoid crowded places.
But church spokesman Kim Shin-chang told the BBC they had provided a list of members, students, and buildings to authorities.
“We were worried about releasing this information because of the safety of our members,” Mr Kim said.
Media caption ‘We’re often persecuted’: Spokesman for virus-hit S Korean church defends secrecy
Mr Lee claims he is the second coming of Jesus Christ and identifies as “the promised pastor” mentioned in the Bible who will take 144,000 people to heaven with him.
The Shincheonji Church is labelled as a cult within South Korea and also in the Christian community, which results in the group often being discriminated against, persecuted or criticised, Mr Kim told the BBC.
What’s the global situation?
The number of people killed worldwide by the coronavirus has exceeded 3,000, as China reported 42 more deaths. More than 90% of the total deaths are in Hubei, the Chinese province where the virus emerged late last year.
But there have also been deaths in 10 other countries, including more than 50 in Iran and more than 30 in Italy.
Worldwide, there have been almost 90,000 confirmed cases, with the numbers outside China now growing faster than inside China.
In other developments:
In the UK, where there are 36 confirmed cases, Prime Minister Boris Johnson has called a meeting of the emergency Cobra committee on Monday
Indonesia – one of the world’s most populous countries – has announced its first confirmed cases of coronavirus, a 64-year-old woman and her 31-year-old daughter, currently being treated at a Jakarta hospital
Iceland and Andorra also reported their first confirmed cases on Monday
Share prices in Asia and in Europe rose after central banks pledged to intervene to help protect markets from the impact of the coronavirus. Concerns about the outbreak last week wiped more than $5tn (£3.9tn) from global stocks
US sportswear giant Nike has closed its European headquarters in Hilversum city in the Netherlands after an employee tested positive for the virus
In the European hotspot of Italy, the number of infections doubled in 48 hours, the head of the country’s civil protection body said on Sunday.
There have been at least 34 deaths and 1,694 confirmed cases. Amazon said two of its employees in Italy have the virus and are under quarantine.
Countries including Qatar, Ecuador, Luxembourg and Ireland all confirmed their first cases over the weekend. On Monday, Ecuador reported five new cases of the disease, bringing the total number of infected patients in the country to six.
The US state of New York has also confirmed its first case. The patient is a woman in her 30s who contracted the virus during a recent trip to Iran. Two people have died in the US, both in the state of Washington.
A spokesman from China’s National Health Commission said the next stop would be to “focus on the risks brought by the resumption of work”.
China’s economy has taken a hit – with factory activity falling at a record rate.
On Monday, a man was sentenced to death by a Chinese court for fatally stabbing two officials at a virus checkpoint, news agency AFP reported.
Ma Jianguo, 23, refused to co-operate with officials – though it is not clear what he was told to do – and stabbed two checkpoint officials.
What has the WHO said?
On Sunday, the World Health Organization (WHO) said the virus appears to particularly affect those over 60, and people already ill.
It urged countries to stock up on ventilators, saying “oxygen therapy is a major treatment intervention for patients with severe Covid-19”.
In the first large analysis of more than 44,000 cases from China, the death rate was 10 times higher in the very elderly compared to the middle-aged.
But most patients have only mild symptoms and the death rate appears to be between 2% and 5%, the WHO said.
By comparison, the seasonal flu has an average mortality rate of about 0.1%, but is highly infectious – with up to 400,000 people dying from it each year.
Other strains of coronavirus, such as Severe Acute Respiratory Syndrome (Sars) and Middle East Respiratory Syndrome (Mers), have much higher death rates than Covid-19.
Around 200 Shincheonji Church of Jesus members continued to meet in the Chinese city amid rumours of virus, but ‘no one took [claims] seriously’ at first
Around half the Covid-19 cases in South Korea have been linked to members of the religious group
The Shincheonji church in Daegu has been linked to a cluster of infections. Photo: Yonhap via AP
Members of the Christian sect linked to a cluster of coronavirus cases in South Korea held meetings in Wuhan until December, only stopping when they realised that their community had been hit by Covid-19, the previously unknown disease caused by the virus.
The South China Morning Post has learned that the Shincheonji Church of Jesus in Wuhan, the Chinese city at the centre of the epidemic, has around 200 members, most of whom are currently under quarantine outside the city.
“Rumours about a virus began to circulate in November but no one took them seriously,” said one member, a 28-year-old kindergarten teacher.
“I was in Wuhan in December when our church suspended all gatherings as soon as we learned about [the coronavirus],” said the woman, who declined to be named because of the sensitivity of the matter.
She said the group was continuing to share sermons and teachings online, but most members had returned home at the start of the Lunar New Year holiday in late January.
The 250,000-member Shincheonji Church of Jesus is regarded by mainstream Christian groups as a secretive and unorthodox sect. Its founder, Lee Man-hee, has claimed that he is the second coming of Jesus Christ.
Around half the Covid-19 infections in South Korea have been linked to a branch of the church in Daegu.
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According to the Korea Centres for Disease Control and Prevention, there were 977 confirmed cases as of Tuesday – the second highest number outside China – and 11 deaths.
Of the 84 new cases reported on Tuesday, over half were recorded in Daegu city.
Coronavirus: Churches on high alert as South Korea confirms huge rise in infections
A member of the church from Daegu reportedly visited China in January, and health officials in South Korea are investigating whether a cluster of infections in Cheongdo city is linked to a three-day funeral ceremony held at a local hospital.
Chinese sources said that the Shincheonji church has about 20,000 members in China – most of whom live in major cities such as Beijing, Shanghai, Dalian, Changchun and Shenyang.
One Christian pastor in Hubei province, who declined to be named, said that Shincheonji church members were hard-working and some continued to proselytise even during the outbreak.
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The Wuhan kindergarten teacher said she was confident that the recent mass outbreaks in South Korea were not linked to Shincheonji church members from the city.
“I don’t think the virus came from us because none of our brothers and sisters in Wuhan have been infected. I don’t know about members in other places but at least we are clean. None of us have reported sick,” she said.
“There are so many Chinese travelling to South Korea, it’s quite unfair to pin [the disease] on us.”
Coronavirus: China reports 508 new Covid-19 cases, with only nine outside outbreak epicentre
She sidestepped questions on whether church members had travelled from Wuhan to South Korea after the outbreak.
The teacher said that in 2018 the Wuhan group’s “holy temple” in Hankou district had been raided by police “who branded us a cult”, but members continued to worship in small groups.
“We are aware of all the negative reporting out there after the outbreak in South Korea, but we do not want to defend ourselves in public because that will create trouble with the government,” she said. “We just want to get through the crisis first.”
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Bill Zhang, a 33-year-old Shanghai resident and a former missionary with Shincheonji, said the group’s secretive nature made it hard for the authorities to effectively crackdown on its activities.
He said the Shanghai branch held its main meetings on Wednesdays and Saturdays, attracting 300 to 400 people at a time.
“The Shincheonji church in Shanghai has been raided many times and police spoke to church leaders regularly.
“But the church members simply continued their meetings in smaller groups of eight-to-10 people and regrouped when the surveillance was relaxed.”
Zhang continued: “Shincheonji holds that it is the only real church that upholds the biblical truth and all other churches – mainstream or cults – are evil.”
SHANGHAI/SEOUL (Reuters) – Asia reported hundreds of new coronavirus cases on Wednesday, including a U.S. soldier stationed in South Korea, as the United States warned of an inevitable pandemic and outbreaks in Italy and Iran spread to other countries.
World stocks tumbled for the fifth day on fears of prolonged disruption to global supply chains, while safe-haven gold rose back toward seven-year highs and U.S. bond yields held near record lows.
Stock markets globally have wiped out $3.3 trillion of value in the past four trading sessions, as measured by the MSCI all-country index.
The disease is believed to have originated in a market selling wildlife in the central Chinese city of Wuhan late last year and has infected about 80,000 people and killed more than 2,700, the vast majority in China.
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The U.S. Centers for Disease Control and Prevention urged Americans to prepare, saying that while the immediate risk there was low the global situation suggested a pandemic was likely.
“It’s not a question of if. It’s a question of when and how many people will be infected,” the CDC’s principal deputy director, Anne Schuchat, said on Tuesday.
World Health Organization (WHO) chief Tedros Adhanom Ghebreyesus, however, advised against referring to a pandemic.
“We should not be too eager to declare a pandemic without a careful and clear-minded analysis of the facts,” Tedros said in remarks to Geneva-based diplomats.
“Using the word pandemic carelessly has no tangible benefit, but it does have significant risk in terms of amplifying unnecessary and unjustified fear and stigma, and paralyzing systems. It may also signal that we can no longer contain the virus, which is not true.”
‘DON’T WAIT’
The United States has reported 57 cases of the virus. U.S. President Donald Trump, back in Washington after a visit to India, said on Twitter that he would meet U.S. officials for a briefing on the coronavirus on Wednesday.
Dr Bruce Aylward, head of a joint WHO-Chinese mission on the outbreak, told reporters on his return to Geneva that countries’ preparations should not wait.
“Think the virus is going to show up tomorrow. If you don’t think that way, you’re not going to be ready,” he said. “This a rapidly escalating epidemic in different places that we have got to tackle super-fast to prevent a pandemic.”
Aylward said China’s “extraordinary mobilization” showed how an aggressive public health policy could curb its spread.
The WHO says the outbreak peaked in China around Feb. 2, after authorities isolated Hubei province and imposed other containment measures.
China’s National Health Commission reported another 406 new infections on Wednesday, down from 508 a day earlier and bringing the total number of confirmed cases in mainland China to 78,064. Its death toll rose by 52 to 2,715.
The WHO said only 10 new cases were reported in China on Tuesday outside Hubei.
South Korea, which with 1,261 cases has the most outside China, reported 284 new ones including a U.S. soldier, as authorities readied an ambitious plan to test more than 200,000 members of a church at the center of the outbreak.
Of the new cases, 134 were from Daegu city, where the virus is believed to have been passed among members of the Shincheonji Church of Jesus, the Korea Centers for Disease Control and Prevention said.
The U.S. military said a 23-year-old soldier based in Camp Carroll, about 20 km (12 miles) from Daegu, had been infected and was in self-quarantine at home.
OLYMPIC WORRIES
In Japan, Prime Minister Shinzo Abe called for sports and cultural events to be scrapped or curtailed for two weeks to stem the virus as concern mounted for the 2020 Tokyo Olympics.
Japan’s professional baseball teams would play matches without spectators until March 15 due to virus concerns, Kyodo news agency reported.
Japan has nearly 170 virus cases, besides the 691 linked to a cruise ship that was quarantined of its coast this month. Six people have died in Japan, including four from the ship.
There have been nearly 50 deaths outside China, including 11 in Italy and 19 in Iran, the most outside China, according to a Reuters tally.
Iran’s deputy health minister – seen mopping his brow at a televised news conference – was among its 139 coronavirus infections. Cases linked to Iran have been reported across the region.
Kuwait said six new coronavirus cases, all linked to travel to Iran, took its tally to 18, while Bahrain said its infections had risen to 26 after three new ones on a flight from Iran.
The United Arab Emirates, which has reported 13 coronavirus cases, is prepared for “worst case scenarios” as it spreads in the Middle East, a government official said.
In Europe, Italy has become a front line in the global outbreak with 322 cases. Italians or people who had recently visited the country, have tested positive in Algeria, Austria, Croatia, Romania, Spain and Switzerland.
Two hotels, one in Austria and one in Spain’s Canary Islands, were also locked down after cases emerged linked to Italy. Spain also reported its first three cases on the mainland.
BEIJING/SEOUL (Reuters) – Italy, South Korea and Iran reported sharp rises in coronavirus infections on Monday, triggering concern from the World Health Organization (WHO), but China relaxed some curbs on movement, including in Beijing, as the rate of new infections there eased.
The virus has put Chinese cities into lockdown, disrupted air traffic to the workshop of the world and blocked global supply chains for everything from cars and car parts to smartphones.
The surge of cases outside mainland China triggered steep falls in global share markets and Wall Street stock futures as investors fled to safe havens. Gold soared to a seven-year high, oil tumbled nearly 4% and the Korean won KRW= fell to its lowest level since August.[MKTS/GLOB]
But U.S. Treasury Secretary Steven Mnuchin cautioned against jumping to conclusions about the impact on the global economy or supply chains, saying it was simply too soon to know.
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The World Health Organization (WHO) said it no longer had a process for declaring a pandemic, but that the coronavirus outbreak remained an international emergency.
“We are specially concerned about the rapid increase in cases in … Iran, Italy and the Republic of Korea,” WHO head Tedros Adhanom Ghebreyesus told a news conference in Sweden via video link from Geneva.
South Korea reported 231 new cases, taking its total to 833. Many are in its fourth-largest city, Daegu, which became more isolated with Asiana Airlines (020560.KS) and Korean Air (003490.KS) suspending flights there until next month.
Iran, which announced its first two cases last Wednesday, said it had confirmed 43 cases and eight deaths. Most of the infections were in the Shi’ite Muslim holy city of Qom.
Elsewhere in the Middle East, Bahrain and Iraq reported their first cases and Kuwait reported three cases involving people who had been in Iran.
Saudi Arabia, Kuwait, Iraq, Turkey, Pakistan and Afghanistan imposed restrictions on travel and immigration from Iran. Afghanistan also reported its first case, officials said.
The WHO has been saying for weeks that it dreads the disease reaching countries with weak health systems.
Europe’s biggest outbreak is in Italy, with some 150 infections – compared with just three before Friday – and a fifth death.
‘SEVERE AND COMPLEX’
Scientists around the world are scrambling to analyze the virus, but a vaccine is probably more than a year away.
“Worryingly, it seems that the virus can pass from person to person without symptoms, making it extremely difficult to track, regardless of what health authorities do,” said Simon Clarke, an expert in cellular microbiology at the University of Reading in Britain.
China postponed the annual meeting of its parliament in Beijing.
But there was a measure of relief for the world’s second-largest economy as more than 20 province-level jurisdictions, including Beijing and Shanghai, reported zero new infections, the best showing since the outbreak began.
President Xi Jinping urged businesses to get back to work, though he said the epidemic was still “severe and complex, and prevention and control work is in the most difficult and critical stage”.
Excluding the central Hubei province, center of the outbreak, mainland China reported 11 new cases, the lowest since the national health authority started publishing nationwide daily figures on Jan. 20.
The coronavirus has infected nearly 77,000 people and killed more than 2,500 in China, most in Hubei.
Overall, China reported 409 new cases on the mainland, down from 648 a day earlier, taking the total number of infections to 77,150 cases as of Feb. 23. The death toll rose by 150 to 2,592.
Outside mainland China, the outbreak has spread to about 29 countries and territories, with a death toll of about two dozen, according to a Reuters tally.
Xi said on Sunday the outbreak would have a relatively big, but short-term, impact on the economy and the government would step up policy adjustments to help cushion the blow.
Mnuchin, speaking to Reuters in the Saudi city of Riyadh, said he did not expect the coronavirus to have a material impact on the Phase 1 U.S.-China trade deal.
“Obviously that could change as the situation develops,” he added.
In northern Italy, authorities sealed off the worst-affected towns and banned public gatherings across a wide area, halting the carnival in Venice, where there were two cases.
Austria briefly suspended train services over the Alps from Italy after two travelers coming from Italy showed symptoms of fever.
Both tested negative for the new coronavirus but Austrian Interior Minister Karl Nehammer said a task force would meet on Monday to discuss whether to introduce border controls.
Japan had 773 cases as of late Sunday, mostly on a cruise ship quarantined near Tokyo. A third passenger, a Japanese man in his 80s, died on Sunday.
In South Korea, authorities reported a seventh death and dozens more cases on Monday. Of the new cases, 115 were linked to a church in the city of Daegu.
Drone footage showed what appeared to be hundreds of people queuing in a neat line outside a Daegu supermarket under the winter sunshine to buy face masks. ( tmsnrt.rs/37WP6lA )
SEOUL/SHANGHAI (Reuters) – South Korea raised its disease alert to the highest level on Sunday after a surge in coronavirus infections and two more deaths, while China state media warned the outbreak there had yet to reach a turning point despite some signs of easing.
South Korea’s president said he was putting the country on “red alert” due to the rapid rise in new cases, which are largely being traced back to church services. Health officials reported 169 new infections, bringing the total to 602, having doubled from Friday to Saturday.
The escalation in the alert level allows the government to send extra resources to Daegu city and Cheongdo county, which were designated “special care zones” on Friday.
South Korea’s Yonhap News Agency said it also enables the government to forcibly prevent public activities and order the temporary closure of schools, though the government gave no immediate details on what steps could be taken.
In China, the health commission confirmed 648 new infections – higher than a day earlier – but only 18 were outside of Hubei province, the lowest number outside of the epicenter since authorities started publishing data a month ago and locked down large parts of the country.
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But the number of cases continued to climb elsewhere.
Japanese Prime Minister Shinzo Abe instructed government agencies on Sunday to urgently prepare medical provisions and draft a comprehensive plan to curb the spread of the virus, after it reported 27 more cases a day earlier.
The U.S. State Department raised its travel advisory level one notch for South Korea and Japan to Level 2 on a scale of 1 to 4.
Concern about the reach and rapid spread of coronavirus also grew in Europe and the Middle East.
Cases in Italy, Europe’s worst hit country, more than quadrupled to 79 on Saturday, with two deaths.
Iran reported a total of 43 infections, with eight deaths – all since Tuesday – forcing some of its neighbors to announce travel and immigration curbs.
The World Health Organization on Saturday stressed that the number of cases outside of China was still relatively few, but it was worried by the detection of infections without a clear link to China.
The disease has spread to some 26 countries and territories outside China, killing more than a dozen people, according to a Reuters tally. It has been fatal in 2% of reported cases, with the elderly and ill the most vulnerable, according to the WHO.
The potential economic impact of coronavirus was prominent at a meeting of G20 finance ministers in Riyadh, at which the International Monetary Fund chief said China’s 2020 growth would likely be lower at 5.6%, down 0.4 percentage points from its January outlook, with 0.1 percentage points shaved from global growth.
The last time South Korea raised the alert to the highest was 11 years ago during the Influenza A or H1N1 outbreak.
Many of South Korea’s new cases were linked to the Shincheonji Church of Jesus congregation in Daegu after a 61-year-old woman known as “Patient 31” tested positive for the virus last week. The woman had no recent record of overseas travel.
Catholic churches in Daegu and Gwangju have suspended mass and other gatherings, while churches elsewhere saw declines in attendance on Sunday, especially among the elderly.
“If the situation gets worse, I think we’ll need to take more measures. Currently, we’re limiting personal gatherings within the church except for Mass,” said Song Gi-young, 53, wearing a face mask at church.
Heo Young-moo, 88, expressed frustration.
“Devotees shouldn’t go to any risky places … Hasn’t it become so widespread because those people didn’t get checked?”,” he said.
Outside of the church was a sign that said: “All Shincheonji followers are strictly prohibited from entering”.
The foreign ministry said South Koreans aboard a plane to Israel had been denied entry there on Saturday due to concerns about the virus spread.
China said the number of new deaths on Saturday from COVID-19, as the disease caused by the virus is known, was 97, all but one of which were in Hubei.
Eighty-two of those were in the provincial capital Wuhan, where Xinhua news agency said nucleic tests were being carried out on the backlog of cases to try to contain the spread.
In total, China has reported 76,936 cases, and 2,442 deaths. The WHO says the virus is severe or critical in only a fifth of infected patients, and mild in the rest.
Graphic: Reuters graphics on the new coronavirus here
NOT OVER YET
Beijing, Zhejiang, Sichuan had no new infections on Feb. 22 for the first time since the outbreak was detected. There were signs of street life in Shanghai, with some cafes serving take-out food and families wearing masks walking their dogs.
State run television on Sunday urged people to avoid complacency, drawing attention to people gathering in public areas and tourist spots without wearing masks.
Analysts have been closely watching out for any signs of a secondary wave of infections as transport restrictions are eased and many migrant workers return to factories and offices. Business activity in the world’s second-biggest economy is only gradually returning to normal after widespread disruptions.
Japan’s health minister apologized on Saturday after a woman who was allowed to leave the coronavirus-struck Diamond Princess cruise ship tested positive despite having underwent quarantine.
At least 623 cases have been reported on the vessel, the biggest outbreak outside China, involving more than a dozen nationalities.
In Italy, schools and universities were closed and some soccer matches postponed in Lombardy and Veneto, the country’s industrial heartland.
Saudi Arabia, Kuwait, Iraq have travel and immigration curbs on Iran, while Oman on Sunday urged its citizens to steer clear of countries with high infection rates and said arrivals from those nations would be quarantined.
Image copyright GETTY IMAGESImage caption Cases of coronavirus have risen sharply in South Korea, where the outbreak is worsening
The head of the World Health Organization (WHO) has expressed concern at the number of coronavirus cases with no clear link to China or other confirmed cases.
Dr Tedros Adhanom Ghebreyesus said the window of opportunity to contain the virus was “narrowing”.
Chinese health authorities reported a decrease in deaths and new cases of the coronavirus on Saturday.
But cases are on the rise in South Korea, Italy, Iran and other countries.
Outside China, more than 1,200 cases of the virus have been confirmed in 26 countries and there have been eight deaths, the WHO says.
They include two deaths in South Korea, which has the biggest cluster of confirmed cases apart from China and a cruise ship quarantined in Japan.
On Saturday, South Korea reported 142 new confirmed cases of the coronavirus, bringing the national tally to 346.
On Friday, doctors in Italy said a 78-year-old man became the first person in the country to die from the new coronavirus, Ansa news agency reported.
Earlier Italy had announced 16 more cases and its health minister said schools and offices would be closed and sports events cancelled in the affected regions.
China has reported 76,288 cases including 2,345 deaths. The new virus, which originated last year in Hubei province in China, causes a respiratory disease called Covid-19.
What did the WHO chief say?
Dr Tedros said the number of coronavirus cases outside China was “relatively small” but the pattern of infection was worrying.
“We are concerned about the number of cases with no clear epidemiological link, such as travel history to or contact with a confirmed case,” he said.
The new deaths and infections in Iran were “very concerning”, he said.
Image copyright AFPImage caption Iraq has been checking people at its border with Iran
But he insisted that the measures China and other countries had put in place meant there was still a “fighting chance” of stopping further spread and called on countries to put more resources into preparing for possible outbreaks.
What is the latest in South Korea?
Prime Minister Chung Sye-kyun declared a public health emergency as the total number of cases surpassed 300 on Saturday.
The southern cities of Daegu and Cheongdo have been declared “special care zones”. The streets of Daegu are now largely abandoned.
The nation’s capital, Seoul, banned demonstrations in central areas.
Two cases were also reported in Busan, South Korea’s second-largest city, and one on the Island of Jeju on Saturday – the first in both places.
Media caption People in Daegu have voiced concern over the spread of the virus
All military bases are in lockdown after three soldiers tested positive.
The authorities suspect the current outbreak in South Korea originated in Cheongdo, pointing out that a large number of sect followers attended the funeral of the founder’s brother from 31 January to 2 February.
The sect – known as Shincheonji – which has been accused of being a cult, said it had now shut down its Daegu branch and that services in other regions would be held online or individually at home.
As of Friday, more than 400 members of the church were showing symptoms of the disease, though tests were still ongoing, the city mayor said.
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Hand sanitizers and warning signs
By Hyung Eun Kim, BBC Korean Service, Seoul
Many people in South Korea are wearing masks on a daily basis.
Hand sanitizers have been placed at public transport stops and building entrances.
Warning government signs are everywhere. They say: “Three ways to prevent further infection: wear a mask at all times; wash your hands properly with soap for more than 30 seconds; and cover yourself when coughing.”
Image copyright EPAImage caption New norm: Mask-wearing crowd in Seoul
Koreans have also developed several apps and websites that tell you how much risk you face where you are. They show where the infected people are within a 10km radius.
“I can’t miss work, what I can do is minimise contact with others and stay at home during the weekend,” Seung-hye Lim, a Seoul resident, told the BBC.
“I do wonder if we reacted too laxly initially or if it really is because of the specific service practices of the Shincheonji sect.”
So-young Sung, a mother of two in Seoul, told the BBC: “It feels like my daily life is collapsing.”
She said she was struggling to find pharmacies that had masks.
She added that checking coronavirus-related alarms from her children’s schools and kindergartens was now a daily routine for her.
What about the Iran cases?
In Iran the outbreak is centred on the holy city of Qom, south of the capital Tehran, which is a popular destination for Shia Muslims in the region.
Iran reported two more deaths in Qom on Friday, adding to the two deaths it reported on Thursday. A total of 18 cases have been confirmed in the country.
Lebanon has reported its first confirmed case – a 45-year-old woman who was detected as she arrived in Beirut from Qom. The UAE, Israel and Egypt have also reported cases.
Image copyright EPAImage caption Lebanon has confirmed its first case – a woman returning from the Iranian city of Qom
Meanwhile Canadian officials said one of the nine cases there was a woman who had recently returned from Iran.
WHO officials said both Iran and Lebanon had the basic capacity to detect the virus and the WHO was contacting them to offer further assistance.
But Dr Tedros said the organisation was concerned about the virus’s possible spread in countries with weaker health systems.
What about China and elsewhere?
The virus has now hit the country’s prison system, with more than 500 inmates confirmed infected.
They include 230 patients in a women’s prison in Wuhan. More cases have been found in a prison in the eastern province of Shandong and the south-eastern province of Zhejiang.
Some 36 people at a hospital in Beijing have also tested positive.
Senior officials have been sacked for mishandling management of the outbreak.
Passengers of the Diamond Princess cruise ship who have tested negative continue to disembark the ship in Yokohama after more than 14 days quarantined on board.
However, 18 American evacuees from the ship tested positive after arriving in the US, officials said. More than 300 other US nationals have arrived back in the US after disembarking.
Media caption Coronavirus: Quarantined passengers released from Japan ship
More than 150 Australian passengers have been evacuated from the ship and have already arrived in Darwin, where they will begin two more weeks of quarantine.
Australian officials said on Friday that six people had reported feeling unwell on arrival in Darwin and were immediately tested. Two of those people tested positive despite having received negative tests before leaving Japan.
The first batch of people from Hong Kong have also flown back to the city, where they will similarly be quarantined.
The authorities suspect the current outbreak in South Korea originated in Cheongdo, pointing out that a large number of sect followers attended a funeral of the founder’s brother from 31 January to 2 February.
On Friday, a second person who contracted the coronavirus died.
The victim was a woman in her 50s. She died in the south-western city of Busan after being transferred there from a hospital in a nearby country, according to Yonhap news agency.
Reports say she had earlier been a patient at the same mental hospital in Cheongdo as the country’s first victim – an elderly man. Another 15 patients there have also tested positive.
On Thursday, 53 new cases were reported. South Korea now has a total of 204 cases making it the largest cluster outside mainland China and the cruise ship docked off Japan.
The new virus, which originated last year in Hubei province in China, causes a respiratory disease called Covid-19.
What measures are being taken?
From the 100 new cases reported on Friday, 86 were in Daegu, a city 300km (186 miles) south-east of the capital Seoul, and nearly all of those were from a cluster involving the religious sect.
Image copyright AFPImage caption South Korea is trying hard to stop the local spread of the new coronavirus
Reacting to the quickly deteriorating situation, the government promised swift measures to prevent further spread of the virus.
“It is urgent to find people who have contacted infected people and cure patients,” PM Chung said, according to Yonhap.
He said the government was readying resources like sickbeds, medical equipment and health workers and warned the virus was now spreading locally.
“The government has so far focused on curbing infections coming from outside the country. From now on, the government will further prioritise preventing the virus from spreading locally.”
Health Minister Park Neung-hoo said authorities would allow hospitals to isolate respiratory patients from others in an effort to prevent any spread within medical institutions.
He also said that all pneumonia patients in Daegu hospitals would be checked for the virus.
What happened in Daegu?
The city’s biggest cluster appears to be at a branch of a religious sect which calls itself the Shincheonji Church of Jesus, Temple of the Tabernacle of the Testimony.
South Korean health officials believe these infections are linked to a 61-year-old woman who tested positive for the virus earlier this week.
Image copyright AFP/GETTY IMAGESImage caption Workers have been disinfecting the streets of Daegu, South Korea’s fourth-largest city
The Shincheonji, which has been accused of being a cult, said it had now shut down its Daegu branch and that services in other regions would be held online or individually at home.
As of Friday, more than 400 members of the church were showing symptoms of the disease, though tests were still ongoing, the city mayor said.
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Once you’ve had coronavirus, will you be immune?
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Daegu is the country’s fourth-largest city, with a population of 2.5 million people.
Residents are now being asked to remain at home after authorities described the church cluster as “super-spreading event”.
Hand sanitizers and warning signs
By Hyung Eun Kim, BBC Korean Service, Seoul
Many people in South Korea are wearing masks on a daily basis.
Hand sanitizers have been placed at public transport stops and building entrances.
Warning government signs are everywhere. They say: “Three ways to prevent further infection: wear a mask at all times; wash your hands properly with soap for more than 30 seconds; and cover yourself when coughing.”
Image copyright EPAImage caption New norm: Mask-wearing crowd in Seoul
Koreans have also developed several apps and websites that tell you how much risk you face where you are. They show where the infected people are within a 10km radius.
“I can’t miss work, what I can do is minimise contact with others and stay at home during the weekend,” Seung-hye Lim, a Seoul resident, told the BBC.
“I do wonder if we reacted too laxly initially or if it really is because of the specific service practices of the Shincheonji sect.”
So-young Sung, a mother of two in Seoul, told the BBC: “It feels like my daily life is collapsing.”
She said she was struggling to find pharmacies that had masks.
She added that checking coronavirus-related alarms from her children’s schools and kindergartens was now a daily routine for her.
What about China and elsewhere?
The latest figures from China put the death toll from the disease at 2,236 people and total infections at more than 75,000.
The virus has now hit the country’s prison system, with more than 500 inmates confirmed infected.
Senior officials have already been sacked for mishandling management of the outbreak.
The virus has also spread around the globe with more than 1,000 cases and several deaths in the rest of Asia, in Europe, the Middle East, the US and Africa.
On Friday, Iran confirmed 13 new cases, saying that two of those infected had died.
Health ministry official Minou Mohrez was quoted by the state-run Iran news agency as saying the coronavirus has spread to several cities, including the capital Tehran.
South Korea is now the worst affected country after mainland China and the more than 600 infections on a cruise ship docked in Japan.
Media caption Coronavirus: Quarantined passengers released from Japan ship
Passengers of the Diamond Princess who have tested negative continue to disembark the ship in Yokohama after more than 14 days quarantined on board.
More than 150 Australian passengers have been evacuated from the ship and have already arrived in Darwin, where they will begin two more weeks of quarantine.
Australian officials said on Friday that six people had reported feeling unwell on arrival in Darwin and were immediately tested.
Two of those people tested positive despite having received negative tests before leaving Japan.
The first batch of people from Hong Kong have also flown back to the city, where they will similarly be quarantined.
CHINDIA ALERT: You'll be living in their world, very soon 