Virus Epidemic Enters New Phase as Cases Outside China Climb
A voter, wearing a protective face mask to protect against the coronavirus, waits to cast her ballot during the general election in Tehran, Iran, on Feb. 21, 2020. (Photographer: Ali Mohammadi/Bloomberg)

Virus Epidemic Enters New Phase as Cases Outside China Climb

(Bloomberg) -- South Korea’s cases have climbed past 200. The tallies for Singapore and Japan have topped 85. There are the 600-plus from a quarantined cruise ship in Japan, and new cases are popping up in the Middle East and Italy.

While China still accounts for the vast majority of coronavirus cases and deaths, there are now signs infections are spreading more rapidly within other Asian countries. Anxiety is creeping into financial markets, as investors weigh the impact of a wider regional outbreak on economic growth and corporate earnings.

“The sudden jump in infections in other parts of Asia, notably in Japan and South Korea, has sparked renewed concerns,” said Khoon Goh, Singapore-based head of Asia research at Australia & New Zealand Banking Group Ltd. “This points to a new phase in the outbreak, and one which will see continued disruption and more economic impact than previously thought.”

Virus Epidemic Enters New Phase as Cases Outside China Climb

The epidemic that emerged in December and infected more than 75,000 people in China has yet to become a pandemic -- defined as a situation where the virus is spreading across multiple continents. So far, the numbers outside China remain comparatively small: of 2,247 deaths, only 11 have occurred in other regions. Yet there’s been a marked uptick in non-China cases this week.

Outside Asia, new cases have been spotted in Iran, the United Arab Emirates, Lebanon and Italy. Four people in Iran have died and at least 18 have been infected. Health authorities are worried about the development of local transmission there.

“The cases that we see that are not linked to China are very worrisome,” Tedros Adhanom Ghebreyesus, the head of the World Health Organization, told reporters at a press briefing in Geneva. The window of opportunity to stop the spread in countries outside China is “really narrowing,” he said. “This outbreak could go in any direction.”

A new study published Friday estimated that about two-thirds of coronavirus cases exported from mainland China have gone undetected worldwide, potentially leaving sources of human-to-human transmission unchecked. The analysis, led by researchers at Imperial College London, used air-travel data to estimate what case counts should be in countries outside China.

“Undoubtedly, the exported cases vary in the severity of their clinical symptoms, making some cases more difficult to detect than others,” the researchers said in the analysis. “However, some countries have detected significantly fewer than would have been expected based on the volume of flight passengers arriving from Wuhan City, China.”

Virus Epidemic Enters New Phase as Cases Outside China Climb

In Asia, South Korea saw infections double in 24 hours, with the surge tied to a cluster from a religious sect in Daegu. Most of the patients are among those who may have attended church services with a person who was confirmed with the virus earlier this week.

South Korean Health Minister Park Neung-hoo said authorities are aware of transmission channels and the current situation is “manageable.” Daegu has shut down public facilities and advised residents to stay indoors to try to contain the disease.

Even more alarming is the situation in Japan, which has emerged as one of the riskiest places outside China for the spread of the coronavirus. Health Minister Katsunobu Kato said on Sunday that Japan had lost track of the route of some of the infections, which tripled in the past week to more than 90.

Virus Epidemic Enters New Phase as Cases Outside China Climb

Japan, slated to host the summer Olympics starting in July, is seeing cases in multiple, unconnected areas across the country and authorities have been struggling to figure out where they’re coming from. The government is being faulted for being too slow to bar visitors from China and too lax in its 14-day quarantine of the Diamond Princess cruise ship, the vessel with 3,700 passengers and crew that’s been under the global spotlight.

At least 636 of those passengers have been infected by the virus and two have died.

The situation has the potential to escalate given the presence of high-risk factors like Japan’s elderly population and a societal work ethic that often frowns on taking a sick day. The U.S. Centers for Disease Control and Prevention has issued a Level 1 alert for Japan, which doesn’t discourage travel to the country but urges caution.

Virus Epidemic Enters New Phase as Cases Outside China Climb

To be sure, Japan’s advanced health-care system puts it in a better position to fight the outbreak than poorer states with fewer resources like China’s neighbor North Korea, and countries in sub-Saharan Africa.

There’s also progress being made in Asian cities where strict containment measures have been put into place. The Chinese-controlled territory of Macau, the world’s biggest gambling hub, hasn’t reported a new infection in more than two weeks, as casinos were shut and travel to mainland China was restricted.

While Singapore has more than 80 cases, the rate of new infections has been steady, and 37 patients have so far recovered.

Hong Kong similarly hasn’t seen a surge. That could change, however, with the case of a police officer infected with the virus. He had a meal with 59 other officers, who are now in quarantine.

Powder Keg

Some say the Diamond Princess could be a potential powder keg as more than 1,000 quarantined passengers leave the ship by the end of Friday. With people aboard hailing from more than 50 nations and now returning home, their travels could spawn a fresh wave of global infections. On Friday, two people evacuated to Australia tested positive for the virus.

“It’s entirely possible to get tested, be negative and get on an airplane and be positive once you land,” said Keiji Fukuda, the director of the School of Public Health at Hong Kong University and a former World Health Organization official who has led responses to outbreaks. “That’s just how infections work.”

Tedros said Thursday that the world has a chance to contain the virus because the number of cases outside of China have been relatively limited. The risk is that if countries aren’t aggressive enough now to stop the spread, a second epicenter of the outbreak could emerge.

“We need to use the window of opportunity we have to hammer the outbreak in every country,” the director-general said at a briefing in Geneva. He added that it’s surprising that donations have been limited after his call for $675 million in funding.

©2020 Bloomberg L.P.

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