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    Coronavirus: Hong Kong to slash border travel as virus spreads

    January 28, 2020

    Hong Kong has announced plans to slash cross-border travel between the city and mainland China as the new coronavirus continues to spread.More than 100 people have now died in China, with confirmed infections surging to more than 4,500.High-speed trains and ferries that cross the border will be suspended from Thursday, Hong Kong leader Carrie Lam announced. She wore a face mask.The virus has spread across China and to at least 16 countries globally.Several foreign governments with large numbers of citizens in Wuhan, the epicentre of the outbreak, are considering evacuations. Japan is sending a plane later on Tuesday.Wuhan, as well as the wider Hubei province, are already effectively in a lockdown with strict transport restrictions in and out of the area. Wearing masks in public is now mandatory in some Chinese cities.
    On Monday, authorities in Beijing confirmed that a 50-year-old man had died - the first fatality in the Chinese capital from the virus.Hours later, Ms Lam announced Hong Kong's new strategy to tackle the virus. In addition to suspending train and ferry services, flights to mainland China will be halved. People will also no longer be able to receive permits to visit Hong Kong from the mainland.The city of seven million - a major financial centre - is part of China but retains significant autonomy.
    Tens of millions of people visit from mainland China every year but numbers were down in 2019 because of the pro-democracy protests that rocked the city.

    "The flow of people between the two places needs to be drastically reduced" amid the outbreak, Ms Lam was quoted as saying by the South China Morning Post newspaper.
    The number of total cases confirmed by China rose to 4,515 as of 27 January, up from 2,835 a day earlier.

    The virus causes severe acute respiratory infection and there is no specific cure or vaccine.

    Most of the deaths have been in Hubei province. The initial victims were mostly elderly people or those with pre-existing respiratory problems, but few details have been released about the dozens of deaths confirmed in recent days.

    A total of 60 people had been discharged from hospital after recovery, according to Chinese state media.

    The new coronavirus causes severe acute respiratory infection
    Efforts to stem the spread of the new coronavirus have coincided with the Lunar New Year celebration, which usually sees millions travel across the country to visit relatives and friends.

    Many festivities have been suspended and the holiday period has been extended by three days to Sunday.

    Chinese authorities have also imposed several other measures in recent days:

    Beijing and Shanghai introduced a 14-day observation period for people arriving from Hubei
    Authorities postponed the new semester for schools and universities nationwide, without giving a resumption date
    China Railway Group suspended hundreds of train lines throughout the country
    The immigration administration encouraged citizens to reconsider the timing of overseas travel

    Media captionRoad blocks and ghost towns: Inside the province where the virus originated
    In Wuhan, travel from the city of 11 million has been severely restricted and non-essential vehicles have been banned from the roads.

    The city's mayor though said about five million people had already left the city ahead of the holidays and before the lockdown.

    How is the virus spreading?
    The new coronavirus is thought to have emerged from illegally traded wildlife at a seafood market in Wuhan and can now spread between people.

    Chinese authorities over the weekend said the virus was - like a normal flu - able to spread during its incubation period and before any symptoms appeared.

    This would set it apart from cases like Sars and Ebola and make it much harder to contain.

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    The incubation period can range from two to 10 days, according to the World Health Organization (WHO).

    However unlike China, it says it remains unclear whether the virus is contagious before symptoms appear.

    What is the situation internationally?
    According to the WHO and national authorities, there have been at least more than 50 confirmed cases outside China.

    The latest case to be confirmed is in the German state of Bavaria, only the fourth so far in Europe.

    Eight cases: Thailand
    Five: USA, Australia, Singapore, Taiwan
    Four: Malaysia, South Korea, Japan
    Three: France
    Two: Vietnam
    One: Nepal, Canada, Cambodia, Sri Lanka, Germany
    So far, there have been no deaths outside China.

    Like many countries, the United States has urged its nationals to "reconsider travel" to China and is advising against visiting Hubei. The country plans to fly consular staff and US citizens out of Wuhan in the coming days.

    Japan is expecting to evacuate about 200 nationals on a chartered plane on Wednesday morning, with health workers on board to monitor passengers. The evacuees will be asked to look out for any symptoms of coronavirus for two weeks after their return.


    Media captionWhat are viruses? And how do they spread?
    France, India and South Korea have also said they plans to airlift citizens out of Wuhan.

    The UK is yet to make a similar decision but has urged Britons to leave the area if they can - however this has upset some living in Hubei who complain they are trapped.

    What is the new coronavirus?
    The virus causes severe acute respiratory infection and symptoms seem to start with a fever, followed by a dry cough. After a week, some people can experience shortness of breath and need hospital treatment.

    The virus itself is a new, or "novel" coronavirus - a family that normally affects animals.

    The effect of the coronavirus family on humans has long been observed mainly in the form of the common cold. In recent decades though, more serious coronaviruses - like Sars or Mers - have proven potentially deadly to humans.

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    Yet even in the cases of severe viruses most people infected were likely to fully recover just as they would from a normal flu.On Tuesday, an expert at China's National Health Commission (NHC) said one week was sufficient for a recovery from mild coronavirus symp

    Tales of solidarity from China's virus-hit Wuhan
    3 hours ago
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    Image copyrightGETTY IMAGES
    Image caption
    Keeping spirits up in virus-hit Wuhan
    As the number of coronavirus infections continues to grow, millions of people have gone into lockdown in Wuhan - the centre of the outbreak - to try to stop the virus spreading. But in this time of isolation some people are determined to raise each others' spirits.

    The neighbours who spread cheer
    The deadly outbreak comes as China celebrates one of the most important dates in its calendar - Lunar New Year.

    Imagine Christmas and Thanksgiving all rolled into one - typically a time filled with lots of cheer. For many, it's the only chance in a year they have to meet up with their family and exchange gifts of food and money.

    In Wuhan people have been encouraged to stay home to minimise the spread of the virus. But residents in a block of flats found a small way to cheer each other up.

    Videos circulating on social media show people shouting "Wuhan jiayou" out of their windows- roughly translated to "Stay strong Wuhan" or "Keep on going Wuhan".


    Media caption"Wuhan, add oil!": Watch residents shouting to boost morale in quarantined city
    The phrase is echoed across the block and residents can be heard cheering in the background.

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    It's also a cheer that's being repeated online.

    On social media site Weibo, the phrase "Wuhan jiayou" has been trending.

    Many across different parts of the country are posting the phrase in solidarity with Wuhan - where the majority of deaths as a result of the virus have occurred.

    "We will get through this. Wuhan jiayou, the whole country is supporting you," said one comment on Weibo.

    More than one hundred people - mostly in Wuhan - have now died as a result of the outbreak which has spread across China and internationally.

    Though there is plenty of fear and anger at the authorities on social media in China, state media has been highlighting kind acts and stories of residents banding together in Wuhan.

    The restaurant owner who packed 200 lunch boxes
    One new restaurant owner in Wuhan spent the Lunar New Year festival packing food for medical workers in the city, according to state news outlet Changjiang Daily.

    Li Bo had opened a restaurant in the city just a month ago. He sold his car and borrowed money in order to raise the funds for it.

    But before the 36-year-old could properly get his business started, the outbreak kicked in - leaving the streets of the city empty and his restaurant deserted.

    "I panicked. I lay at home worrying about how I was going to repay the loan," he told Changjiang Daily.

    "But then I saw [news] about how the medical staff in hospitals were struggling and I felt like it was time for me act. I wanted to do my part, no matter how insignificant."

    According to a report by news site Beijing News, some hospitals in Wuhan have experienced food shortages. Two residents living in Wuhan had previously told the BBC that people in the city have been trying to stockpile food.

    Image copyrightCHANGJIANG DAILY
    Image caption
    Li Bo is packing 200 lunch boxes for medical workers at a local hospital
    Li Bo along with his chef spent days buying ingredients and cooking enough food to fit into 200 boxes. He told the news outlet on 26 January that he was in the process of finding enough boxes to pack the food into, adding that the meals would eventually be delivered to medical staff in Wuhan's Xiehe Hospital.

    "I wanted to do my best to [make sure] the medical staff eat hot meals. I hope they get the nutrition they need and that will boost their immunity," he told the paper, adding that he plans to continue the food deliveries for as long as he can.

    "I hope the city we love gets better soon."

    The villager who donated 15,000 masks
    Fears of the coronavirus have seen thousands across the country flocking to buy face masks - triggering a mask shortage in some places.

    Masks have become such a valuable commodity that many on Weibo have joked that they would rather receive face masks instead of the typical monetary gifts given out during Lunar New Year.

    One villager in Changde, a neighbouring province of Hubei where Wuhan is located, decided he would donate almost 15,000 face masks, according to news outlet the Xiaoxiang Morning Herald.

    Hao Jin had last year worked in a mask production factory. He eventually resigned from the job but the company could not afford to pay him his salary. He was instead given 15,000 masks - worth 20,000 yuan (£2,207; $2,883) as a form of compensation.

    He brought the masks home and forgot about them until he heard news of the mask shortage.

    "I thought I would donate the masks I have to those in need, I hope they can be of more use and value to others," he said.

    He kept a handful of the masks for his family, and distributed some to those in his village before donating the rest to people in his county.

    How worried should we be?
    By James Gallagher
    Health and science correspondent
    27 January 2020
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    Related TopicsCoronavirus outbreak
    Image copyrightGETTY IMAGES
    Image caption
    The outbreak occurred in the city of Wuhan, south of Beijing
    A virus - previously unknown to science - is causing severe lung disease in China and has also been detected in other countries.

    More than 100 people are known to have died from the virus, which appeared in the Chinese city of Wuhan in December.

    There are already more than 4,500 confirmed cases, and experts expect the number will keep rising.

    A new virus arriving on the scene, leaving patients with pneumonia, is always a worry and health officials around the world are on high alert.

    Can this outbreak be contained or is this something far more dangerous?

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    What is this virus?
    Officials in China have confirmed the cases are caused by a coronavirus.

    These are a broad family of viruses, but only six (the new one would make it seven) are known to infect people.

    Severe acute respiratory syndrome (Sars), which is caused by a coronavirus, killed 774 of the 8,098 people infected in an outbreak that started in China in 2002.

    "There is a strong memory of Sars, that's where a lot of fear comes from, but we're a lot more prepared to deal with those types of diseases," says Dr Josie Golding, from the Wellcome Trust.

    How severe are the symptoms?
    It seems to start with a fever, followed by a dry cough and then, after a week, leads to shortness of breath and some patients needing hospital treatment.

    Around one-in-four cases are thought to be severe.

    Notably, the infection rarely seems to cause a runny nose or sneezing.

    The coronavirus family itself can cause symptoms ranging from a mild cold all the way through to death.

    "When we see a new coronavirus, we want to know how severe are the symptoms. This is more than cold-like symptoms and that is a concern but it is not as severe as Sars," says Prof Mark Woolhouse, from the University of Edinburgh.

    The World Health Organization (WHO) says it is an emergency in China, but decided not to declare an international public health emergency - as it did with swine flu and Ebola.

    How deadly is it?
    More than 100 people are known to have died from the virus - but while the ratio of deaths to known cases appears low, the figures are unreliable.

    But the infection seems to take a while to kill, so more of those patients may yet die.

    And it is unclear how many unreported cases there are.

    Where has it come from?
    New viruses are detected all the time.

    They jump from one species, where they went unnoticed, into humans.

    "If we think about outbreaks in the past, if it is a new coronavirus, it will have come from an animal reservoir," says Prof Jonathan Ball, a virologist at the University of Nottingham.

    Many of the early coronavirus cases were linked to the South China Seafood Wholesale Market, in Wuhan.

    But the earliest documented case, which has been traced back to 1 December, had no connection to the market.

    Sars started off in bats and then infected the civet cat, which in turn passed it on to humans.

    And Middle East respiratory syndrome (Mers), which has killed 858 out of the 2,494 recorded cases since it emerged in 2012, regularly makes the jump from the dromedary camel.

    Which animal?
    Once the animal reservoir (where the virus normally camps out) is detected, then the problem becomes much easier to deal with.

    While some sea-going mammals can carry coronaviruses (such as the Beluga whale), the South China Seafood Wholesale Market also has live wild animals, including chickens, bats, rabbits, snakes, which are more likely to be the source.

    Researchers say the new virus is closely related to one found in Chinese horseshoe bats.

    However, this does not mean wild bats are the source of the outbreak - they could have passed the virus onto another species sold at the market.

    Why China?
    Prof Woolhouse says it is because of the size and density of the population and close contact with animals harbouring viruses.

    "No-one is surprised the next outbreak is in China or that part of the world," he says.

    How easily does it spread between people?
    At the beginning of the outbreak, the Chinese authorities said the virus was not spreading between people - but now, such cases have been identified.

    Scientists have now revealed each infected person is passing the virus on to between 1.4 and 2.5 people.

    This figure is called the virus' basic reproduction number - anything higher than 1 means it's self-sustaining.

    We now know this is not a virus that will burn out on its own and disappear.

    Only the decisions being made in China - including shutting down cities - can stop it spreading.

    While those figures are early estimates, they put coronavirus in roughly the same league as Sars.

    When are people infectious?
    Chinese scientists say people are infectious even before their symptoms appear.

    The time between infection and symptoms - known as the incubation period - lasts between one and 14 days.

    Sars and Ebola are contagious only when symptoms appear. Such outbreaks are relatively easy to stop: identify and isolate people who are sick and monitor anyone they came into contact with.

    Flu, however, is the most famous example of a virus that you spread before you even know you're ill.

    Prof Wendy Barclay from the department of infectious disease at Imperial College London said it was common for lung infectious to spread without symptoms.

    The virus is "carried into the air during normal breathing and talking by the infected person," she explained.

    "It would not be too surprising if the new coronavirus also does this."

    We are not at the stage where people are saying this could be a global pandemic like swine flu.

    But the problems of stopping such "symptomless spreaders" will make the job of the Chinese authorities much harder.

    What is not known is how infectious people are during the incubation period.

    How fast is it spreading?
    It might appear as though cases have soared. But this is somewhat misleading.

    Many of these seeming new cases will have come to light as a result of China improving its ability to find infected people.

    There is actually very little information on the "growth rate" of the outbreak.

    But experts say the number of people becoming sick is likely to be far higher than the reported figures.

    A report last week by the MRC Centre for Global Infectious Disease Analysis at Imperial College London said: "It is likely that the Wuhan outbreak of a novel coronavirus has caused substantially more cases of moderate or severe respiratory illness than currently reported."

    And over the weekend, researchers at Lancaster University estimated the number of cases suggesting 11,000 have been infected this year. If true, that would be more than Sars.

    Could the virus mutate?
    Yes, you would expect viruses to mutate and evolve all the time. But what this means is harder to tell.

    China's National Health Commission has warned the coronavirus's transmission ability is getting stronger, but they were unclear on the risks posed by mutations of the virus.

    This is something scientists will be watching closely.

    How can the virus be stopped?
    We now know the virus will not stop on its own; only the actions of the Chinese authorities can bring this epidemic to an end.

    There is also no vaccine to give people immunity to the virus.

    The only option is to prevent people who have become infected from spreading the virus to others.

    That means:

    Limiting people's movement
    Encouraging hand-washing
    Treating patients in isolation with healthcare workers wearing protective gear
    A massive feat of detective work will also be needed to identify people whom patients have come into contact with to see if they have the virus.

    How have Chinese authorities responded so far?
    Image copyrightGETTY IMAGES
    Image caption
    Temperature screening can help identify people who have been infected
    China has done something unprecedented anywhere in the world - by effectively putting Wuhan into quarantine.

    Travel restrictions have also been imposed on a dozen other cities with 36 million people affected.

    Some mass gatherings have been banned and tourists sites, including part of the Great Wall, have been closed.

    And a ban on the sale of wildlife, a possible source of the infection, has been imposed.

    Wuhan - the centre of the outbreak - is building a two new hospitals with beds for a total of 2,300 people.

    How is the world responding?
    Most Asian countries have stepped up screenings of travellers from Wuhan and the WHO has warned hospitals worldwide a wider outbreak is possible.

    Singapore and Hong Kong have been screening air passengers from Wuhan and authorities in the US and the UK have announced similar measures.

    However, questions remain about the effectiveness of such measures.

    If it takes up to two weeks for symptoms to appear, then someone could easily be halfway round the world and have passed through any screening checks before starting to feel ill.

    How worried are the experts?
    Dr Golding says: "At the moment, until we have more information, it's really hard to know how worried we should be.

    "Until we have confirmation of the source, that's always going to make us uneasy."

    Prof Ball says: "We should be worried about any virus that explores humans for the first time, because it's overcome the first major barrier.

    "Once inside a [human] cell and replicating, it can start to generate mutations that could allow it to spread more efficiently and become more dangerous.

    "You don't want to give the virus the opportunity."

    Are there any vaccines or treatments?

    However, the work to develop them is already under way. It is hoped that research into developing a vaccine for Mers, which is also a coronavirus, will make this an easier job.

    And hospitals are testing anti-viral drugs to see if they have an impact.

    A combination of two drugs - lopinavir and ritonavir - was successful in the Sars epidemic and are being tested in China.



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