The spread of a deadly new virus is accelerating, Chinese President Xi Jinping warned, after holding a special government meeting on the Lunar New Year public holiday.The country is facing a "grave situation" Mr Xi told senior officials.The coronavirus has killed at least 56 people and infected almost 2,000 since its discovery in the city of Wuhan.The US has announced that staff at the Wuhan consulate will be evacuated on a special flight on Tuesday.
The State Department said that private Americans most at risk will also be able to board the flight to San Francisco.Meanwhile, UK-based researchers have warned of a real possibility that China will not be able to contain the virus.Travel restrictions have come in place in several affected cities. From Sunday, private vehicles will be banned from central districts of Wuhan, the source of the outbreak.A second emergency hospital is to be built there within weeks to handle 1,300 new patients, and will be finished in half a month, state newspaper the People's Daily said. It is the second such rapid construction project: work on another 1,000-bed hospital has already begun.Specialist military medical teams have also been flown into Hubei province, where Wuhan is located.
The urgency reflects concern both within China and elsewhere about the virus which first appeared in December.
Lunar New Year celebrations for the year of the rat, which began on Saturday, have been cancelled in many Chinese cities.Across mainland China, travellers are having their temperatures checked for signs of fever, and train stations have been shut in several cities.In Hong Kong, the highest level of emergency has been declared and school holidays extended.Several other nations are each dealing with a handful of cases, with patients being treated in isolation.
A coronavirus is a family of viruses which include the common cold.But this virus has never been seen before, so it's been called 2019-nCov, for "novel coronavirus".New viruses can become common in humans after jumping across the species barrier from animals.The Sars [Severe Acute Respiratory Syndrome] outbreak of 2003 started in bats and transferred to the civet cat which passed it on to humans.Queues have been growing at hospitals in Wuhan
This new virus also causes severe acute respiratory infection.Symptoms seem to start with a fever, followed by a dry cough and then, after a week, lead to shortness of breath and some patients needing hospital treatment.
Based on early information, it is believed that only a quarter of infected cases are "severe", and the dead are mostly - though not exclusively - older people, some of whom have pre-existing conditions.The Chinese authorities suspect a seafood market that "conducted illegal transactions of wild animals" was the source of the outbreak.
Why is there concern about containing the virus? Scientists at the respected MRC Centre for Global Infectious Disease Analysis in the UK have warned that it may not be possible to contain the virus to China.They say self-sustaining human-to-human transmission of the coronavirus is the "only plausible explanation" for the scale of the epidemic.Their calculations estimate each infected person is passing it onto, on average, 2.5 other people.The centre praised the efforts of the Chinese authorities, but said transmission of the virus needed to be cut by 60% in order to get on top of the outbreak.
The coronavirus has killed at least 56 people
This is a massive challenge, the scientists suggest, which will require finding and isolating even patients with only mild symptoms that could easily be confused with other diseases.

Elsewhere, a team at Lancaster University have published their estimates of the number of cases suggesting 11,000 have been infected this year. If true, that would be more than Sars.

Where has it spread?
There are now 1,372 confirmed cases across China, though most are concentrated in those provinces closest to Hubei.

But it has also spread abroad - in isolated cases affecting small numbers of patients.

On Saturday, Australia confirmed its first four cases - first in Melbourne, and then three more in Sydney.

It has also spread to Europe, with three cases confirmed in France. Tests in the UK on 31 people have come back negative, the government has said. Officials are trying to trace around 2,000 people who have recently flown to the UK from Hubei province.

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The cases largely involve people who had recently travelled from the affected region in China.

China's neighbours in the Asia region are on high alert, however, with cases reported in Thailand, Singapore, Japan, Taiwan, Malaysia, Vietnam, South Korea and Nepal.

There are also two cases in the United States, including a woman in her 60s who had returned home to Chicago from Wuhan on 13 January.

Canada has a "presumptive case" of the virus, but the condition of the person suffering from it is deemed stable, according to a government statement.

What's happening at the source?
The city of Wuhan is effectively on lockdown, with heavy restrictions on travel in and out, and public transport options from buses to planes cancelled.

It is a major population centre with up to 11 million inhabitants - comparable in size to London.

Pharmacies in the city have begun to run out of supplies and hospitals have been filled with nervous members of the public.

Officials have urged people to avoid crowds and gatherings.

"The whole transport system has been shut down," Kathleen Bell, who is is originally from the UK and works in Wuhan, told the BBC. "From midnight tonight private cars are not allowed on the road. And taxis aren't running."
ajor Western brands such as McDonald's and Starbucks have closed in the city and in others nearby.The US, France and Russia are among several countries trying to evacuate their nationals from Wuhan, reports say.
Media captionThe WHO's regional director gives some measured advice on the outbreakChina is also suspending from Monday all foreign trips by Chinese holiday tour groups, state media reported.The outbreak has severely restricted Lunar New Year celebrations in China, when millions of people normally travel home. Major public events have been cancelled and tourist sites shut.
China's travel industry counts cost of coronavirus
24 January 2020
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As public health concerns rise over a new virus, the impact is being felt by China's travel and tourism sector.

More than 400m Chinese were expected to travel over the Lunar New Year which starts today, normally one of the busiest periods for airlines, hotels and tourist attractions.

Instead, flights and hotels are being cancelled as people face travel restrictions or choose to stay home.

The virus has already taken 25 lives, with more than 800 cases globally.

Many airlines have agreed to refund fares or let passengers rebook free of charge if affected, while major hotel chains are now following suit as more travel restrictions are announced.

After the Civil Aviation Administration of China announced that airlines should give refunds for cancelled flights, the country's three major airlines, China Southern Airlines, China Eastern Airlines and China Air all saw their share prices take a dive. China Eastern Airlines has seen its value fall about 13% this week.

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Hong Kong's national carrier Cathay Pacific was among the first airlines to allow passengers scheduled to fly to or from Wuhan to reschedule for free while, at the same time, allowing cabin crew to wear surgical masks on flights.

Wuhan is where the first cases in the outbreak were reported. The flu-like virus has since spread to several our parts of China and internationally with cases being confirmed in Singapore, Thailand and the US among others countries.

China's biggest online travel agency, Trip.com, is also waiving cancellation fees on all hotels, car rentals and tickets for tourist attractions to Wuhan and is ''actively monitoring the situation to ensure the safety of all travellers''.

Hotels and casinos hit
Hotel groups are also paying out refunds to tourists who want to cancel trips to Wuhan and other parts of China.

Both InterContinental Hotels Group (IHG) and Hyatt will allow guests to change or cancel stays at the majority of their Chinese hotels over the Lunar New Year holiday. IHG has 443 hotels in China, Hong Kong, Macau and Taiwan under different brands, with four in Wuhan.

Casino operators have also seen shares fall, particularly those with businesses in Macau. The city is home to casinos owned by Las Vegas Sands and Wynn Resorts.

The release of seven movies over the Lunar New Year has also been postponed.

Blow to economy
Tourism has become an increasingly important part of the Chinese economy and is estimated to contribute about 11% of China's economic growth and employ about 28 million people.

In 2018, 62.9 million tourists visited China, ranking it the fourth most popular tourist destination behind France, Spain and the US, according to the UN's World Tourism Rankings.

Outside of China, luxury goods brands are also likely to take a battering as Chinese tourists stay at home rather than travel overseas for shopping sprees. LVMH, which owns the Burberry, Louis Vuitton and Hermes brands, saw its value slide this week.
How is the Chinese city at the centre of the outbreak coping?
By Reality Check team
BBC News
24 January 2020
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Outbound trains in Wuhan have been stopped
There have been widely-shared reports on social media and some state-run services that healthcare services in Wuhan - one of China's largest cities - are under strain following the outbreak of coronavirus.

Hu Xijin, the editor of state-run newspaper Global Times, said there had been a "failure" to contain the virus, and videos of patients queuing to get seen in hospitals.

However, other Communist-party outlets have praised the response to the outbreak.

Wuhan is a major transit hub with a population of about 11 million people, and has effectively been put on lockdown, along with other major cities in the region, in an unprecedented move to stop the spread of the virus.

Can healthcare in Wuhan cope?
The city serves as the main economic hub for the wider province, Hubei, and has the most advanced healthcare facilities in the region.

The metropolitan area has seven major hospitals - considered some of the best in China, with Tong Ji Hospital ranked third nationally - treating patients.

It has seven more hospitals supporting the efforts, and 61 clinics around the city which are testing patients for symptoms of the virus.

A local government report from 2014 included Wuhan among the top six cities for medical treatment in the country - although it ranks behind Beijing and Shanghai.

In terms of capacity, the report said Wuhan had 6.51 hospital beds and 3.08 doctors per 1,000 people - this isn't a straightforward indication of healthcare capacity (more doctors doesn't always mean better healthcare), but it does rank Wuhan among the more developed places in the world. The UK and US have 2.8 and 2.6 doctors per 1,000 heads, respectively.

GETTY
Wuhan in numbers
6.51
Hospital beds per 1,000 people

3.08
Doctors per 1,000 people

Source: Local Chinese government report 2014
So - is is this enough for a such a large city undergoing a mass shutdown?

The lockdown in Wuhan has caused panic in the city - the World Health Organization (WHO) has said that containing a large city like this is "new to science".

Image Copyright @xinyanyu@XINYANYU<br< a="">>Report
Hubei as a province has a lower number of doctors per 1,000 people, at 2.55 according to the latest government statistics.

"It's yet to be seen whether the costs associated with this kind of mass quarantine measure (not just financially, but with respect to personal liberty too) will translate into effective infection control," said Dr. Maia Majumder, an expert at Harvard Medical School in the US, who is tracking the virus.

Hubei has declared a "Grade 1 public health emergency", the most severe level - that means the response is led centrally from Beijing by the State Council, the government's cabinet.

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Image caption
A hospital under construction in Wuhan
Beijing has tried to allay concerns by sending more healthcare professionals, and constructing a hospital.

Reports from state-run media say there are 405 medical staff from Shanghai and 205 staff from Guangdong travelling to the region, and officials are building one new healthcare centre with 1,000 beds from scratch over the weekend. They're also expanding existing capacity in other facilities.

The government has also assigned 21 centres in Hubei province to help co-ordinate treatment, and train local health officials.

Professor Shenglan Tang, an expert in global health at Duke University in the US, says there are concerns that rural areas will struggle to cope.

"I'm confident that the health centres in Wuhan will be able to handle the outbreak, but I am a bit worried about Hubei province - rural workers have gone back home from Wuhan to celebrate Chinese New Year, and in these areas the hospital capacity is weak," said Professor Tang.

Was Beijing slow to act?
Despite resilient rhetoric from the government, people are expressing concern about the city's ability to cope with the outbreak.

The BBC spoke to a number of people in the region who said that getting test results was taking longer than officials are claiming.

We were told that in some cases medical staff lack equipment and doctors are overstretched. There are also claims that local government, which was apparently made aware of the outbreak in mid-December, ignored initial warning signs.

We haven't been able to independently verify these claims.

The government has called for people to report poor medical responses to an online "inspection" platform.

The regional government has issued a statement appealing for donations to help with the response, including asking for facemasks.

How do you quarantine a city - and does it work?
By Owen Amos
BBC News
23 January 2020
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Workers disinfect the Hankou Railway Station in Wuhan, a day before the shutdown
With two days until the Chinese New Year, the railway station in Wuhan should be buzzing.

Across the country, millions of people are heading home to see loved ones. But in China's seventh biggest city - home of the coronavirus - most platforms are deserted.

As of 10:00 on Thursday (02:00 GMT), buses, trains, subways and ferries were stopped from leaving the city.

Flights were also suspended. Roads are not officially closed, but roadblocks have been reported, and residents have been told not to leave.

So the question is - can you quarantine an entire city? And if you can - does it work?

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Image caption
Thermal scanners that detect temperatures of passengers inside the Hankou station in Tuesday
Wuhan is a huge place - the 42nd biggest city in the world, according to UN data - and cannot easily be turned into an isolation ward.

More than 20 major roads come into Wuhan, plus dozens of smaller ones. Even with public transport closed, sealing the city would require a massive military effort.

"The only way you could do it, realistically, would be to ring-fence the city with the PLA [Chinese military]," says Professor Adam Kamradt-Scott, a health security expert from the University of Sydney.

But even if they do it, where - literally - would they draw the line? Like most modern cities, Wuhan sprawls into smaller towns and villages.

"Cities are shaped in unorthodox ways," says Professor Mikhail Prokopenko, a pandemics expert also from the University of Sydney,

"You can't really block every road and every connection. It may be possible to an extent... but it's not a foolproof measure."

Gauden Galea, the World Health Organization's representative in China, puts it more bluntly.

"To my knowledge, trying to contain a city of 11 million people is new to science," he told the Associated Press. "We cannot at this stage say it will or it will not work."

And - even if it proves possible to shut the stable door on Wuhan - the horse may already have bolted.

Media captionBritish passenger Thomas Crosby describes journey from virus-hit Wuhan
The Wuhan virus was reported to the WHO on 31 December. It wasn't until 20 January that officials in China confirmed it could be passed human-to-human.

By that time, tens of thousands of people had been and gone from the city. The virus has since been reported across China and Asia, and even in the US - all in people who had recently been in Wuhan.

But, even though the virus is spreading worldwide, Prof Kamradt-Scott says the domestic situation is more worrying.

"In each of the [other] countries where we've seen cases emerge, it's only been one or two, or four in Thailand," says Prof Kamradt-Scott.

"They're very small numbers of cases. It appears they have effectively been caught in time to prevent further transmission locally. So the bigger concern is within China."

Of the 571 cases reported by Thursday, 375 were in Hubei province, where Wuhan is the capital. But there were another 26 in Guangdong, 10 in Beijing, plus 38 possible cases in Hong Kong.

"If the virus is already there, and there's already local community transmission, then the measures in Wuhan are too late," says Prof Kamradt-Scott.

Prof Prokopenko agrees that the international response has been good. Passengers on the last plane from Wuhan to Sydney, for example, were greeted by biosecurity officials.

The problem, the professor says, is many people could have the virus and not even know it.

"There is a difference between infected and infectious," he warns.

"Infected people have a virus in their organism, but they are not yet infectious. They don't show symptoms. They look totally normal until they have already been in contact with other people."

The normal incubation period for flu, he says, is two or three days. But for a coronavirus, it could be five to six days, a week, or even longer.

That is - someone could have caught the virus last week, taken it across the world, infected others, and still not know they are ill.

"And when they do start showing symptoms, it may be confused with common cold or flu," says Prof Prokopenko. "That's the difficulty."

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None of this means China is wrong to try to contain the virus. The WHO has praised their efforts, and there are some precedents for what experts call "social distancing".

In April 2009, Mexico City shut down bars, cinemas, theatres, football grounds, and even churches in an attempt to stop swine flu. Restaurants were only allowed to serve takeaway food.

"It did apparently slow the transmission of the virus in Mexico City, and helped authorities get a handle on the situation," says Prof Kamradt-Scott. "Did it stop it completely? No."

So overall, is the Wuhan shutdown worthwhile?

"China has only been reporting confirmed cases," says Prof Kamradt-Scott.

"On the basis of those numbers [571 cases, with 17 dead], if it was me, I probably wouldn't do it. But if there are thousands of suspected cases, then that would considerably change the equation."

Death toll rises as more cities restrict travel
24 January 2020
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Media captionWhat's life like in quarantined Wuhan?
China has widened its travel restrictions in Hubei province - the centre of the coronavirus outbreak - as the death toll climbed to 26.

The restrictions will affect at least 20 million people across 10 cities, including the capital, Wuhan, where the virus emerged.

On Thursday, a coronavirus patient died in northern Hebei province - making it the first death outside Hubei.

Another death was later confirmed in north-east Heilongjiang province.

The province borders Russia and is more than 2,000 kilometres (1,200 miles) from Wuhan.

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Nationally, there are currently 830 confirmed cases of patients infected with the virus.

A small number of confirmed cases have also been found outside China, including in Thailand, the US, Taiwan, South Korea, Japan, Vietnam and Singapore.

The growing list of restrictions comes on the eve of Lunar New Year - one of the most important dates in the Chinese calendar, when millions of people travel home.

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Millions of people across China are making their way home for Lunar New Year
Travel restrictions vary from city to city.

Wuhan is effectively on lockdown: all bus, subway and ferry services have been suspended and all outbound planes and trains cancelled.

China's travel industry counts cost of coronavirus
Residents have been advised not to leave, and roadblocks have been reported.

Ezhou, a smaller city in Hubei, shut its railway station. The city of Enshi has suspended all bus services.

City officials in the capital, Beijing, and Shanghai have also asked residents who return from affected areas to stay at home for 14 days to prevent the spread of the virus, local media report.

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Analysis - Can the coronavirus be stopped?
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.

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

It is known as the virus's basic reproduction number - anything higher than 1.0 means it's self-sustaining.

Those figures are early estimates, but put coronavirus in roughly the same league as Sars. There are two crucial outstanding questions - who is infectious and when are they infectious.

The fact only 25% of reported cases are severe is a mixed blessing.

Yes, that is less dangerous than Sars, but if those hard-to-detect mild or maybe symptomless cases are contagious too, then it is much harder to contain.

And we still don't know when people are contagious. Is it before symptoms appear, or only after severe symptoms emerge? One is significantly harder to stop spreading than the other.

The impact of the coronavirus is not limited to Hubei province. Authorities have also shut major tourist sites including the Forbidden City in Beijing and a section of the Great Wall and cancelled major public events in other parts of the country, including:

Traditional temple fairs in Beijing
An international carnival in Hong Kong
Hong Kong's annual football tournament
All public Lunar New Year celebrations in Macau
Shanghai's Disney Resort is temporarily closing, as are McDonald's in five cities.

 

Media captionWHO regional director says China now has "stronger capacity" to deal with infectious outbreaks
Earlier, information from China's National Health Commission, when the death toll was 17, said the youngest person who died from the virus was 48 and the oldest was 89.

Most victims were elderly and suffered from other chronic diseases including Parkinson's and diabetes.

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Coronavirus: How worried should we be?
Wuhan - home to around 11 million people - is now rapidly building a new 1,000-bed hospital to deal with the increasing number of victims.

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Image caption
This photo was taken at the construction site on Friday
The project will "solve the shortage of existing medical resources" and would be "built fast [and] not cost much... because it will be prefabricated buildings".

 

Media captionWhat are viruses? And how do they spread?
Videos have been circulating on social media, reportedly taken by Wuhan residents, showing long queues at local hospitals.

In one video on Twitter taken from Chinese social media, a man can be heard complaining, saying patients could be queuing for as long as 10 hours. The video could not be independently verified by the BBC.

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Xinyan Yu
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I’m not on the #WuhanCoronavirus story as a journalist this time. I’m a very concerned 武汉人 posting videos I see in chat groups. Here is a another one - the man in the video speaks with a Wuhan accent: “I’m at the Hankou Hospital... (1/2)

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The World Health Organization has not classed the virus as an "international emergency", partly because of the low number of overseas cases.

"It may yet become one," said the WHO's director-general, Dr Tedros Adhanom Ghebreyesus.

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Fourteen people in UK tested for new strain
How are people coping in the lockdown?
One doctor, who requested anonymity, describes the conditions at a hospital in Wuhan.

"In the last two weeks, there has been an alarming rate of spread," she told the BBC. "The hospitals have been flooding with patients, there are thousands, I haven't seen so many before."

One woman, Jane, flew back to Wuhan from Beijing just before the lockdown.

"I feel very uneasy," she said. "But for me, because my child, my husband and family… are in the Wuhan area, I have to go back."

Daniel Pekarek, a software engineering student at Wuhan University, told the BBC he and his friends were all staying in their rooms.

"I was planning to stay in my apartment because I'm scared to go to the gym, and I'm scared to go to out in public, and not many people are willing to go out."

Read more: Life as a foreigner in Wuhan
What's the global situation?
Vietnam and Singapore were on Thursday added to the nations recording confirmed cases, joining Thailand, the US, Taiwan and South Korea.

Japan and South Korea have both confirmed their second cases.

On Friday, Singapore confirmed its third case - who is known to be the son of another patient. Thailand has five.

Other nations are investigating suspected cases, including the UK, US, and Canada.

Many authorities have announced screening measures for passengers from China, including on Thursday the major airport hubs of Dubai and Abu Dhabi.

Taiwan has banned people arriving from Wuhan and the US state department warned American travellers to exercise increased caution in China.