Four Iranians have died after contracting the coronavirus, with health authorities warning it has spread to multiple cities, while Israel and Lebanon declared their first domestic cases as the deadly epidemic spreads across the Middle East.
Asked on Friday if the new cases put the crisis at a tipping point, the World Health Organization director general, Tedros Adhanom Ghebreyesus, said the “window of opportunity is narrowing, so we need to act quickly before it closes completely”.
The World Health Organization is recommending that people take simple precautions to reduce exposure to and transmission of the Wuhan coronavirus, for which there is no specific cure or vaccine.
The UN agency advises people to:
- Frequently wash their hands with an alcohol-based hand rub or warm water and soap
- Cover their mouth and nose with a flexed elbow or tissue when sneezing or coughing
- Avoid close contact with anyone who has a fever or cough
- Seek early medical help if they have a fever, cough and difficulty breathing, and share their travel history with healthcare providers
- Avoid direct, unprotected contact with live animals and surfaces in contact with animals when visiting live markets in affected areas
- Avoid eating raw or undercooked animal products and exercise care when handling raw meat, milk or animal organs to avoid cross-contamination with uncooked foods.
Despite a surge in sales of face masks in the aftermath of the outbreak of the coronavirus outbreak, experts are divided over whether they can prevent transmission and infection. There is some evidence to suggest that masks can help prevent hand-to-mouth transmissions, given the large number of times people touch their faces. The consensus appears to be that wearing a mask can limit – but not eliminate – the risks, provided they are used correctly.
The Foreign and Commonwealth Office has advised UK nationals to leave China where possible. It is also warning that travellers from Hong Kong, Japan, Macau, Malaysia, Republic of Korea, Singapore, Taiwan and Thailand who develop symptoms of cough or fever or shortness of breath within 14 days of returning the UK should contact the NHS by phone.
“This outbreak could go in any direction,” Tedros said. “If we do well, we can avert any serious crisis, but if we squander the opportunity then we will have a serious problem on our hands.”
The increase in Middle East cases came as Italy reported its first death – a 78-year-old man in Padova in the Veneto region. Earlier the country had identified 16 new cases, with authorities in the north ordering the closure of schools, bars and other public spaces in 10 towns. More than 50,000 people have been asked to stay at home, while all public activities such as church masses and sporting events have been banned for up to a week.
Iranian health authorities reported two fatalities on Friday, according to Mehr news agency, adding to the two elderly patients who died on Wednesday. A further 14 people tested positive for the virus.
The outbreak in Iran began in the city of Qom, an often-visited religious destination. The health ministry official Minou Mohrez warned it had since spread to several cities, including the capital, Tehran, according to the official IRNA news agency.
“It’s possible that it exists in all cities in Iran,” she said, adding the source of the virus was likely a Chinese worker in Qom.
As the country held a parliamentary election on Friday, state television showed voters in Qom wearing surgical masks. Earlier this week, authorities closed all schools in the city as a precaution and called for the suspension of religious gatherings.
The threat posed is especially concerning in Iran after several years of tightening US sanctions by the Trump administration that have dangerously undermined the domestic health care system. In addition, the sharp devaluation of the Iranian rial makes it extremely unlikely its government would be able to throw the resources at an epidemic as witnessed in China.
To prevent infections, neighbouring Iraq shut its land crossings with Iran. However, the virus already appears to have leaked out of the country and across international borders.
In Lebanon, the health minister, Hamad Hassan, reported the country’s first case of the virus on Friday, stating the patient was a 45-year-old woman who arrived on Thursday on a flight from Qom.
At a news conference in Beirut, he said the ministry was also following up on the cases of two other suspected cases.
The new coronavirus, which causes the illness recently named by the WHO as Covid-19, has infected more than 76,000 people in 27 countries and led to more than 2,200 deaths since December.
There have been only a few cases in the Middle East so far. Nine have been confirmed in the United Arab Emirates, seven of whom are Chinese nationals, and one in Egypt.
In Israel, the health ministry announced the country’s first case, saying the patient was an Israeli woman who had been quarantined on the Diamond Princess cruise ship in Japan.
The ship was carrying more than 3,700 people in early February, when 10 passengers were diagnosed with Covid-19. Since it was docked and quarantined in the port of Yokohama, a total of 634 passengers and crew have been infected, with two people dying.
Eleven Israelis who initially tested negative were flown home by chartered plane overnight on Thursday. However, on arrival, a woman failed a breath sample check, the ministry said, and was immediately moved to a special isolation unit at a hospital near Tel Aviv.
The repatriation of people from the Diamond Princess, as well as parts of China and other countries affected by the coronavirus, has caused fears of outbreaks on their return.
In Ukraine, protesters on Thursday attacked buses carrying 45 Ukrainians and 27 other evacuees from the Chinese province of Wuhan, the virus’ centre, to the small town of Novi Sanzhary, fearing they would be a health hazard.
Videos showed dozens of protesters lighting tires ablaze and hurling rocks at the buses carrying the evacuees. Riot police broke up the crowds and detained 24 people.
The Ukrainian government has planned to quarantine the people at a sanatorium there for two weeks. In an attempt to calm the demonstrators, the health minister, Zoryana Skaletska, pledged to spend the next two weeks in the same sanatorium.
A selfie she posted from her room in quarantine was followed by the hashtags calling on Ukrainians “not to fear our own” and “I am not afraid of the virus, I am with you”.
In Italy, as well as the death of the 78-year-old man, 15 other coronavirus cases have been confirmed. Several towns in the northern Lombardy region, where 14 of the cases were detected, are under lockdown after officials warned residents to stay home and avoid social contact.
The fatality and the other case are in the Veneto region.
The first locally transmitted case in Italy was that of a 38-year-old Italian man, who contracted the disease after meeting a colleague who had recently returned from China. He is in intensive care. His pregnant wife is also infected, as is a person who played sport with the man. Italian media reported that three other cases were in elderly people who frequented a bar in the Lombardy town of Codogno, near Lodi, that is owned by the father of the man who played sport with the 38-year-old.
Giulio Gallera, Lombardy’s welfare councillor, said the other eight cases included five health workers and three patients at Codogno hospital.
“There have already been clusters of the virus in Germany and France,” said Roberto Speranza, the health minister.
“Italy is ready. We had already prepared a plan because it was evident that what has happened could happen. Now it’s a question of applying the plan. Clearly this plan features immediate decisions for the areas of the outbreak in order to limit it.