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day0one · 4 years

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As coronavirus testing expands, a new problem arises: Not enough people to test

Four months into the U.S. coronavirus outbreak, tests for the virus finally are becoming widely available, a crucial step toward lifting stay-at-home orders and safely returning to normal life. But while many states no longer report crippling supply shortages, a new problem has emerged: too few people lining up to get tested.

A Washington Post survey of governors’ offices and state health departments found at least a dozen states where testing capacity outstrips the supply of patients. Many have scrambled to make testing more convenient, especially for vulnerable communities, by setting up pop-up sites and developing apps that help assess symptoms, find free test sites and deliver quick results.

But the numbers, while rising, are well short of capacity — and far short of targets set by independent experts. Utah, for example, is conducting about 3,500 tests a day, a little more than a third of its 9,000-test maximum capacity, and health officials have erected highway billboards begging drivers to “GET TESTED FOR COVID-19.”

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Why aren’t more people showing up? “Well, that’s the million-dollar question,” said Utah Health Department spokesman Tom Hudachko. “It could be simply that people don’t want to be tested. It could be that people feel like they don’t need to be tested. It could be that people are so mildly symptomatic that they’re just not concerned that having a positive lab result would actually change their course in any meaningful way.”

Experts say several factors may be preventing more people from seeking tests, including a lingering sense of scarcity, a lack of access in rural and underserved communities, concerns about cost, and skepticism about testing operations.

“We know there’s a lack of trust in the African American community with the medical profession,” said Ala Stanford, a pediatric surgeon in Philadelphia who started a group to provide free testing in low-income and minority communities, which have been hit particularly hard by the virus. The effort, which offers testing in church parking lots, has serviced more than 3,000 people in recent weeks.

“You’ve got to meet people where they are,” Stanford said.

Another major hurdle: lingering confusion about who qualifies. In the earliest days of the outbreak, Americans were told that only the sickest and most vulnerable should get tested while others should stay home. Last month, the Centers for Disease Control and Prevention relaxed its guidelines to offer tests to people without symptoms who are referred by local health departments or clinicians.

Some states have since relaxed their testing criteria dramatically. Georgia Gov. Brian Kemp (R) has encouraged “all Georgians, even if they are not experiencing symptoms, to schedule an appointment.” And Oklahoma Gov. Kevin Stitt (R) urged residents earlier this month to “call 2-1-1 and find a location close to you, even if you don’t have symptoms and you’re just curious.”

Elsewhere, officials scarred by shortages have been hesitant to follow suit.

“A lot of states put in very, very restrictive testing policies . . . because they didn’t have any tests. And they’ve either not relaxed those, or the word is not getting out,” said Ashish Jha, who directs the Harvard Global Health Institute. “We want to be at a point where everybody who has mild symptoms is tested. That is critical. That is still not happening in a lot of places.”

Last week, Jha and other Harvard researchers estimated that the United States should be testing at least 900,000 people a day, or about 8 percent of the population per month. At that rate, they say, local officials would get a clear sense of the spread of the virus, would be able to detect clusters of infection in the early stages and could move to isolate people who test positive or have been exposed, a process known as contact tracing.

A White House estimate, obtained by The Post, shows the nation has sufficient lab capacity to process at least 400,000 tests per day, and potentially many more. But in surveying the states, The Post found that few are testing at full capacity. In 20 states that provided detailed information, the number of tests performed was roughly 235,000 per day lower than their technical capacity, with the biggest gaps in California and New Jersey.

Lab capacity remains untapped for many reasons, including lingering supply shortages. While most states say they are now able to test people in hospitals, nursing homes, prisons and other front-line settings, many continue to be hampered by a lack of personal protective equipment (PPE), nasal swabs and reagents, the chemicals necessary to process tests.

California, for example, has sufficient lab capacity to conduct nearly 100,000 tests a day, but is averaging fewer than 40,000. At a news conference last week, Gov. Gavin Newsom (D) cited continuing “supply-chain constraints.”

And in Chicago, a major chain of urgent-care clinics temporarily halted mobile testing last week when it ran out of test kits. “[W]e are currently unable to test for COVID-19 in Illinois,” said a message posted Sunday on the website of Physicians Immediate Care, adding that the chain hopes to resume testing Monday.

As states trying to encourage people to return to normal life ramp up testing, experts worry that widespread shortages could return.

“Right now, in some locations in this country, they don’t have adequate testing to test all symptomatic patients,” said Angela M. Caliendo, a board member of the Infectious Diseases Society of America and vice chair in the Department of Medicine at Alpert Medical School of Brown University. “So when you open up and you start testing people that are asymptomatic, you’re going to put a lot of pressure on the supply chain.”

The federal government is working to remedy the problem, including by investing $75.5 million through the Defense Production Act to increase swab production. The Food and Drug Administration has eased regulations to permit use of swabs made from polyester in addition to nylon and foam, and the Trump administration has pledged to supply 12.9 million swabs directly to states this month, a promise many governors are banking on.

Last week, President Trump announced that the federal government will distribute $11 billion to help states get additional supplies, part of a $25 billion testing budget approved by Congress.

“I said from the beginning that the federal government would back up the states and help them build their testing capability and capacities, and that’s exactly what’s happened,” he said.

But reagents remain a problem. In the District, health officials have access to a public health lab, a research lab and six hospital labs, which together have the capacity to process at least 3,700 tests per day, said LaQuandra Nesbitt, director of the D.C. Department of Health. But reagents must match the labs’ testing machines; in recent weeks, the labs have managed to purchase only enough to conduct 1,500 tests per day.

Still, even that supply has outstripped demand, with only about 1,000 D.C. residents seeking tests each day. In late April, the city expanded its guidelines to permit grocery store clerks and other critical workers to get tested regardless of whether they have symptoms. Further changes prioritized people over 65 and with underlying health conditions. Meanwhile, former first lady Michelle Obama has urged people in robocalls to take advantage of the free service.

Testing has been similarly slow to ramp up in Virginia, where guidelines posted on the state’s website limited testing mostly to people with symptoms who were hospitalized, living in communal settings or working as health-care providers.

Hilary Adams, a 28-year-old Web coordinator for the American Society of Clinical Oncology, said her doctor refused to order a test in late April even though she had a sore throat and headache, suffers from asthma and lives with her father, who had tested positive. She was told to stay home and quarantine.

“Just living with that level of uncertainty and anxiety was really, really stressful,” Adams said.

After being criticized for low testing rates, Virginia officials posted relaxed guidelines on May 5. That day, Adams’s doctor finally ordered a test — which came back negative. Virginia has since reported an increase in testing from about 4,000 per day to nearly 7,000.

“We’ve said from the very beginning that we needed more PPE. We have that now. Then we said we needed more testing supplies. We have that now,” said former Virginia health commissioner Karen Remley, who co-directs a testing task force appointed by Gov. Ralph Northam (D). “Now we’re working on education and bringing people to the table.”

A national strategy could make that effort more effective, said Danielle Allen, director of Harvard’s Edmond J. Safra Center for Ethics, which last week published a $74 billion road map that calls for 24-hour contact tracing and isolation facilities for people who test positive. Although many states are building those services, the patchwork approach means scarce resources may not be efficiently deployed.

For example, inviting anyone to get tested, rather than focusing on hot spots or areas of high vulnerability, is “not going to be that valuable,” said Jan Malcolm, the health commissioner in Minnesota, where policymakers are building toward 20,000 tests per day and considering hiring more than 4,000 contact tracers.

Kentucky illustrates the transition many states are making. In the first few months of the pandemic, the state had major shortages of testing materials and had to send many samples out of state for processing. Then in March, Gov. Andy Beshear (D) tapped a pair of local lab companies to scale up operations.

Gravity Diagnostics, a 140-person firm in Covington, blew out a wall to expand its main lab and hired 15 more people. It has processed nearly 40 percent of all tests in the state, as well as tests conducted at Kroger mobile health clinics across the nation.

By last week, Beshear said Kentucky had secured all the components needed to further ramp up testing, including a significant supply of swabs from the federal government. With businesses starting to reopen, Beshear is urging everyone to get tested. The state recorded an average of 5,700 tests a day over the past week, a sharp uptick.

“We can provide all the capacity in the world,” Beshear said. “You’ve got to show up and take a test.”

The story is similar elsewhere. In Wisconsin, officials last week listed a daily capacity of 13,400 tests, spread across 52 labs. But daily reported tests have averaged only about 4,800. To bump up the numbers, Gov. Tony Evers (D) has ordered the National Guard to set up mobile testing sites and told doctors to test anyone with symptoms.

In Florida, tests are averaging about half the statewide capacity of 30,000 per day. Jared Moskowitz, director of Florida’s Division of Emergency Management, said the state has opened sites to improve access, including one outside Hard Rock Stadium in Miami Gardens, where he spoke at a news conference this month. Still, Moskowitz acknowledged that “less and less people are coming to these sites, and we’ve seen that decline in the numbers.”

And in Arizona, 5,400 people turned out for a Saturday “testing blitz” held May 2 in dozens of community locations for people with symptoms or who think they have had contact with the virus. Health officials had been hoping for 10,000, and have since extended the blitz to every Saturday in May.

Although Massachusetts has tested nearly 6 percent of its population — one of the highest rates in the nation — even Gov. Charlie Baker (R) has been frustrated by a lack of interest in testing. Earlier this month, Baker chastised Bay State residents for refusing tests even in highly vulnerable settings such as nursing homes.

“There’s some people who, for whatever reason, don’t want to be tested,” Baker told reporters. “And we’re just going to have to find a way to work through that.”

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vsplusonline · 4 years

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Coronavirus: Celebrities face backlash after getting tested while others face delays

New Post has been published on https://apzweb.com/coronavirus-celebrities-face-backlash-after-getting-tested-while-others-face-delays/

Coronavirus: Celebrities face backlash after getting tested while others face delays

Celebrities, politicians and professional athletes faced a backlash this week as many revealed that they had been tested for the coronavirus, even when they didn’t have a fever or other tell-tale symptoms.

That’s fueling a perception that the wealthy and famous have been able to jump to the head of the line to get tested while others have been turned away or met with long delays.

The concerns over preferential treatment underscores a fundamental truth about inequalities baked into the American health care system — those with the financial means can often receive a different level of service.

READ MORE: Kevin Durant among 4 Brooklyn Nets players who tested positive for coronavirus

Asked about the issue Wednesday, President Donald Trump said the well-to-do and well-connected shouldn’t get priority for coronavirus tests. But the wealthy former reality star conceded that the rich and famous sometimes get perks.

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“Perhaps that’s been the story of life,” Trump said during a briefing at the White House. “That does happen on occasion. And I’ve noticed where some people have been tested fairly quickly.”

On Wednesday, the Brooklyn Nets professional basketball team announced the entire team was tested last week upon returning from San Francisco after a game against the Golden State Warriors. The team found a private lab to do the work, and on Tuesday announced that four of its players were positive for the virus, including perennial All-Star Kevin Durant.

2:17 Coronavirus outbreak: Trump signs COVID-19 relief package into law

Coronavirus outbreak: Trump signs COVID-19 relief package into law

Even though public health resources were not used, it raised the ire of many including New York Mayor Bill de Blasio, who turned to Twitter to voice his objections.

“We wish them a speedy recovery,” the mayor wrote. “But, with all due respect, an entire NBA team should NOT get tested for COVID-19 while there are critically ill patients waiting to be tested. Tests should not be for the wealthy, but for the sick.”

Like Robin Fraser.

READ MORE: Coronavirus: Trump to invoke emergency powers to marshal medical supplies amid pandemic

The 30-year-old has fibromyalgia and an autoimmune disorder that put her at high risk for complications if she contracts the virus. She’s been running a fever and coughing since last week. Her doctor recommended she get tested at the emergency room, but there she was told there weren’t enough tests, so she can’t get one.

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“That’s just not fair,” said Fraser, who lives in Victor, New York, near Rochester.

Fraser has seen celebrities and politicians getting tests, and that upsets her.

“Why are they getting in front of the line? People like me, average Joes, we get pushed to the back of the line. Why can Congress get it and we can’t?” she asked.

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2:41 Coronavirus outbreak: WHO says key to stopping COVID-19 spread is ‘test and isolate’

Coronavirus outbreak: WHO says key to stopping COVID-19 spread is ‘test and isolate’

Public frustrations over the difficulties getting tested for the new virus have been building since the first U.S. case was confirmed Jan. 20. Early missteps with test kits developed by the Centers for Disease Control and Prevention, coupled with strict government criteria about who qualified for screening, have led to widespread reports of people struggling to get tested. Even those who manage to get successfully swabbed often report long delays in getting the results back amid lengthy backlogs at government-run labs.

Seeking to break the logjam, the federal Food and Drug Administration announced earlier this month it would allow major private diagnostic lab companies to begin rolling out new COVID-19 tests and relaxed regulations typically required before new tests can be brought to market.

Over the last two weeks, that has led to a surge in testing available from private doctors and labs not bound by CDC’s criteria for which patients should be prioritized for testing, such as those with fever and difficulty breathing who have recently traveled to affected countries overseas, or those who have had close contact with someone confirmed to have had the virus.

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READ MORE: Trump shifts tone as U.S. struggles to contain coronavirus outbreak

Quest Diagnostics, a major lab testing company, began providing COVID-19 test on March 9. LabCorp, another major national provider, followed suit on March 13.

In a statement, LabCorp said its COVID-19 test is available on the order of any physician or other authorized healthcare provider anywhere in the United States. The company said it expects to be performing more than 10,000 tests per day by the end of this week, ramping up to 20,000 tests per day by the end of this month.

By comparison, the CDC and other public health labs conducted about 30,000 tests in the eight weeks since the pandemic arrived in the U.S., according to data compiled by researchers at Johns Hopkins University.

The NBA suspended its season on March 11 after a Utah Jazz player tested positive for the coronavirus just before a game — eventually canceled — with the Oklahoma City Thunder. Oklahoma’s state epidemiologist confirmed last week that the Jazz, their traveling party and a number of Utah beat writers — 58 people in all — were tested after the cancellation of the game in Oklahoma City once it became known that All-Star center Rudy Gobert tested positive for the virus.

0:48 Coronavirus outbreak: Tom Hanks and Rita Wilson test positive for COVID-19

Coronavirus outbreak: Tom Hanks and Rita Wilson test positive for COVID-19

League officials have said that since its players have direct contact with each other and often interact very closely with fans, both physicians who work for teams and public health officials were concerned that they could accelerate the spread of the virus. NBA spokesman Mike Bass said that players getting tested — and in some cases, revealing their positive status — may have ultimately “drawn attention to the critical need for young people to follow CDC recommendations.”

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Hollywood actor Idris Elba said he didn’t have any symptoms when he announced his positive test on Monday, prompting questions and criticism on social media about why he got a test when he was not symptomatic.

On Tuesday, Elba explained further in a follow-up video. He said it was because he learned on Friday that a person he was in contact with had tested positive. He said he was on location, about to start a film. It was not clear what country he was in or where he was tested.

READ MORE: Idris Elba reveals he’s tested positive for coronavirus

“I was around a lot of people. And quite honestly, my job made me test immediately,” said Elba, an Englishman best known for his roles on the HBO series “The Wire” and as a detective on the BBC One series “Luther.”

“I had to test anyway, because it meant putting a lot of people at risk if I had been exposed, then the people I would be working with would also be exposed. So, we got a test immediately. We were really lucky to take the test very quickly, because of the shortages of tests.”

But Elba’s work situation isn’t unusual. Businesses across the country are shutting down to prevent employees from exposing themselves to the virus at work. Several cities, including New York, San Francisco and Washington, have ordered bars, restaurants, gyms, movie theaters and other businesses to close to slow the virus’ spread.

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1:43 Coronavirus outbreak: Jazz, Thunder fans express concern after Rudy Gobert tests positive

Coronavirus outbreak: Jazz, Thunder fans express concern after Rudy Gobert tests positive

Ali Fedotowsky-Manno, former star of ABC’s “The Bachelorette,” found herself on the defensive after announcing in a post on Instagram Sunday that she had been tested at a clinic in Los Angeles after she said she had shortness of breath and an X-ray that showed white spots on her lungs, and what she said were “all the symptoms of the virus, except for a fever.”

She said she went to a clinic called Mend, which she said was “one of the only places that will do the test if you don’t have a fever.”

Fedotowsky-Manno said Wednesday in an interview with The Associated Press that she had seen commentary accusing her of special treatment. She denied the accusation, saying she chose the clinic closest to her house, She checked in under her married name and only heard the clinic would give tests to people without a fever from someone else in the waiting room, after she was already there.

“Nobody knew who I was at that urgent care. I went to urgent care like anybody could,” she said.

READ MORE: Coronavirus: Celebrities including Tom Hanks, Naomi Campbell react to outbreak

The CEO of Mend did not return emails seeking comment, but the clinic’s websitesays it charges $195 for a home visit to collect swabs for COVID-19 tests, with Quest then billing a patient’s insurance to process the samples.

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“We would expect physicians to follow CDC clinical criteria,” said Wendy Bost, a spokeswoman for Quest. “Our materials about the test are clear on this point.”

The company declined to provide a figure for what it charges for its COVID-19 test.

Fedotowsky-Manno on Wednesday was still waiting for her results, five days after getting tested. She said she understands why people are upset over testing.

“I think it’s crazy that everybody can’t get tested,” she said. “It’s absolutely absurd.”

Smith reported from Providence, Rhode Island, and Reynolds from Miami.

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bountyofbeads · 4 years

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CORONAVIRUS-INFECTED AMERICANS FLOWN HOME AGAINST CDC’s ADVICE

By Lena H. Sun, Lenny Bernstein, Shibani Mahtani and Joel Achenbach | Published February 20 at 7:50 PM EST | Washington Post | Posted Feb 21, 2020

In the wee hours of a rainy Monday, more than a dozen buses sat on the tarmac at Tokyo’s Haneda Airport. Inside, 328 weary Americans wearing surgical masks and gloves waited anxiously to fly home after weeks in quarantine aboard the Diamond Princess, the luxury liner where the novel coronavirus had exploded into a shipwide epidemic.

But as the buses idled, U.S. officials wrestled with troubling news. New test results showed that 14 passengers were infected with the virus. The U.S. State Department had promised that no one with the infection would be allowed to board the planes.

A decision had to be made. Let them all fly? Or leave them behind in Japanese hospitals?

In Washington, where it was still Sunday afternoon, a fierce debate broke out: The State Department and a top Trump administration health official wanted to forge ahead. The infected passengers had no symptoms and could be segregated on the plane in a plastic-lined enclosure. But officials at the Centers for Disease Control and Prevention disagreed, contending they could still spread the virus. The CDC believed the 14 should not be flown back with uninfected passengers.

“It was like the worst nightmare,” said a senior U.S. official involved in the decision, speaking on the condition of anonymity to describe private conversations. “Quite frankly, the alternative could have been pulling grandma out in the pouring rain, and that would have been bad, too.”

The State Department won the argument. But unhappy CDC officials demanded to be left out of the news release that explained that infected people were being flown back to the United States — a move that would nearly double the number of known coronavirus cases in this country.

The tarmac decision was a pivotal moment for U.S. officials improvising their response to a crisis with few precedents and extraordinarily high stakes. Efforts to prevent the new pathogen from spreading have revealed the limits of the world’s readiness for an unprecedented public health emergency. In the worst-case scenario, covid-19, a flulike respiratory infection, could become a full-blown global pandemic.

Navigating the crisis has required delicate medical and political judgments. The decision to evacuate the Americans from the Diamond Princess came only after infections on the cruise ship spiked and passengers revealed their grim living conditions.

One lesson from that debacle is that cruise ships are like petri dishes. Thousands live in close quarters on a vessel never designed for quarantines. The crew continued to deliver food, and health workers moved throughout the ship. More than 600 of the 3,700 passengers and crew members have now tested positive for the virus and two older Japanese passengers have died.

With Japanese authorities isolating the passengers for weeks off the coast, the ship, operated by Princess Cruises, quickly developed the second-largest number of coronavirus cases on the planet outside of China — more than in Japan, Singapore, Thailand, the United States or all of Europe. Avoiding “another China” has been the goal of the World Health Organization for weeks, and then it happened anyway, in Yokohama harbor.

The treatment of the Diamond Princess passengers stands in stark contrast to what happened to those on another cruise ship, the Westerdam, who were greeted by the Cambodian prime minister with handshakes and flowers, and who later traveled widely. Only later did news come that one of the Westerdam passengers had tested positive for the virus.

That situation spurred fears that Westerdam passengers would spread the virus around the world. But no additional passengers have tested positive, and so far, no evidence has emerged they have widely seeded the virus.

The coronavirus (officially, SARS-CoV-2) is extremely contagious. Experts estimate that without protective measures, every infected person will spread it to an average of slightly more than two additional people. The disease has been fatal in roughly two out of 100 confirmed cases.

Travelers have already spread it to more than two dozen countries, where it has infected more than 75,000 people and killed more than 2,000.

'THE KNOCK OF DOOM'

The Diamond Princess left Yokohama for a 15-day cruise on Jan. 20. One man from Hong Kong left the ship when it docked there five days later, and checked into a hospital. On Feb. 1, officials confirmed he was infected with the coronavirus.

Spencer Fehrenbacher, 29, an American studying for his master’s degree in China, signed up for the cruise with friends as a break between semesters. Just a couple of days in, they became alarmed about reports of the virus spreading in China.

In Vietnam, he came down with a fever. It lasted only 24 hours, but he feared he might have the virus. He decided not to get off at the next two stops, in Taipei and Okinawa, because he was afraid he’d wind up quarantined.

The ship sped back to Yokohama and docked Feb. 3. Japanese authorities told passengers they could not leave.

The next day, they mingled onboard. Many ate a buffet dinner, but the casino was closed and the evening show canceled. That night, the captain ordered passengers to return to their cabins and stay there until quarantine officers came to see them.

Over the next several days, test results trickled in: Dozens had become infected. Fehrenbacher kept fearing the worst.

“I was sitting there all day waiting for what I call the knock of doom on the door,” he said.

Fehrenbacher stayed in his room — every day, all day. He had a balcony and that was good enough. He started using the word “optimistic” when he spoke to friends and family, because “positive” carried a bad connotation.

He recorded a video and sent it to his brother to share with his family in case he was hospitalized and unable to communicate, or even died. “Mom, Dad, I love you, I miss you. I’m sure everything will be okay,” he recalled saying.

Five days after the ship reached port, the CDC wrote a letter to the American passengers saying that “remaining in your room is the safest option to minimize your risk of infection,” and adding, “We acknowledge that this situation is difficult.”

For nearly two weeks, the only way off the Diamond Princess was through illness, and a ride by ambulance to further isolation in a hospital.

'COMPLAINT TO A CONGRESSMAN TIPS THE BALANCE'

For some, the difficult situation became dire. By the score, people tested positive. Some 200 passengers were over the age of 80, at much higher risk of complications from the virus. The crew members, meanwhile, were forced to stay at their jobs.

“Obviously, the situation on the ground changed, and clearly there’s been more transmission than expected on the ship,” said Michael Ryan, a WHO executive director for health emergencies. “It’s very easy in retrospect to make judgments on public health decisions made at a certain point.”

On Feb. 12, U.S. officials briefed members of Congress in a closed-door hearing. Rep. Phil Roe (R-Tenn.), a doctor, had also heard from a friend and fellow doctor, Arnold Hopland, of Elizabethton, Tenn., who was on the ship with his wife, Jeanie. Hopland told Roe about the deteriorating conditions.

“That tipped the balance,” said the senior administration official.

By Friday afternoon in Washington, there was agreement among all the agencies in the U.S. coronavirus task force to evacuate the Americans.

The State Department, through the U.S. Embassy in Tokyo, posted an urgent notice to U.S. citizens: Americans who wanted to leave needed to let the embassy know by 10 a.m. Saturday local time in Tokyo.

In all, 328 Americans disembarked from the ship in the early hours of Monday, Tokyo time. They boarded buses — and then were forced to wait, in the port, for more than two hours, according to two passengers. They couldn’t see out of the buses — the windows were covered.

Some began crying because they needed to use the bathroom, said Vana Mendizabal, 69, of Crystal River, Fla. The retired nurse had taken the cruise with her husband, Mario, 75, a physician.

“We just couldn’t understand why we were sitting there, loaded, and not going anywhere,” she said. “And we couldn’t get any answers.”

Eventually the buses arrived at the airport, and once again, everyone waited while top officials in Washington argued about the test results, according to a senior administration official.

“Nobody anticipated getting these results,” said another U.S. official involved in the evacuation.

During one call, the CDC’s principal deputy director, Anne Schuchat, argued against taking the infected Americans on the plane, according to two participants. She noted the U.S. government had already told passengers they would not be evacuated with anyone who was infected or who showed symptoms. She was also concerned about infection control.

Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, who was also on the calls, recalled saying her points were valid and should be considered.

But Robert Kadlec, assistant secretary for preparedness and response for the Department of Health and Human Services and a member of the coronavirus task force, pushed back: Officials had already prepared the plane to handle passengers who might develop symptoms on the long flight, he argued. The two Boeing 747s had 18 seats cordoned off with 10-foot-high plastic on all four sides. Infectious disease doctors would also be onboard.

“We felt like we had very experienced hands in evaluating and caring for these patients,” Kadlec said at a news briefing Monday.

The State Department made the call. The 14 people were already in the evacuation pipeline and protocol dictated they be brought home, said William Walters, director of operational medicine for the State Department.

As the State Department drafted its news release, the CDC’s top officials insisted that any mention of the agency be removed.

“CDC did weigh in on this and explicitly recommended against it,” Schuchat wrote on behalf of the officials, according to an HHS official who saw the email and shared the language. “We should not be mentioned as having been consulted as it begs the question of what was our advice.”

She wrote that the infected passengers could pose “an increased risk to the other passengers.”

Schuchat declined to comment.

About an hour before the planes landed in California and Texas, the State Department revealed that the 14 evacuees had tested positive and did not mention the CDC.

Mendizabal, the retired nurse, said she learned about the infections only when she landed at Travis Air Force Base in California and talked to one of her five children, who had seen a news report.

“We were upset that people were knowingly put on the plane who were positive,” she said Wednesday in an interview from the military base. She said she and her husband had already completed 12 days of quarantine on the ship and both were healthy.

“I think those people should not have been allowed on the plane,” Mendizabal said. “They should have been transferred to medical facilities in Japan. We feel we were re-exposed. We were very upset about that.”

After the planes landed, the infected passengers were retested. On Thursday, the CDC confirmed that 11 were indeed positive and two tested negative. One passenger is still awaiting results.

Scientists are still trying to understand the virus. Some of its features, such as how long it can live on surfaces, are unknown. But experts say it is mainly spread by respiratory droplets produced by coughs and sneezes from an infected person. That person must be in close contact, usually defined as six feet.

“We still don’t have a good understanding of the risk posed by people who are infected but without symptoms,” said Jeffrey Duchin, an infectious disease specialist at the University of Washington.

'ANOTHER SHIP GETS A WARM RECEPTION '

Thousands of miles away, a different scene was playing out in Cambodia.

The Westerdam, a luxurious Holland America Line ship with 2,257 passengers and crew, spent days searching for a port amid fears that it might have infected passengers aboard — even though there was no evidence of it. The ship was turned away from five ports, including Guam.

The Westerdam finally was embraced Feb. 13 by Cambodia, a nation with close ties to China and whose authoritarian prime minister, Hun Sen, has used the coronavirus crisis to advance his country’s political interests.

Having lost a preferential trade arrangement with the European Union over human rights abuses, Hun Sen used the Westerdam as a vehicle to alter headlines and potentially improve relations with the West.

When the ship sailed into Sihanoukville last Thursday, he rolled out the red carpet. Without any protective gear — not even a mask or gloves — he greeted passengers as they disembarked, shaking their hands as he passed out bouquets of flowers.

U.S. Ambassador W. Patrick Murphy also went to the dock with his family to welcome passengers. Murphy wore no face mask or gloves, and maintained little distance between himself and jubilant, relieved passengers.

They filed off and dispersed to hotels, hundreds to the luxury Sokha in Phnom Penh, a little more than 100 miles away. There, some went out to dinner, assured by Cambodia and cruise ship officials that among the 20 people who were tested for the virus, none was positive. Others took a bus tour.

More than 700 headed for the airport and flights to homes around the world.

Then came startling news. On Saturday night, an 83-year-old American woman, as yet unidentified, tested positive for coronavirus in Malaysia. Her husband, who also has symptoms of the respiratory illness, tested negative.

Suddenly, as if flash-frozen, the exodus from the Westerdam halted. Hundreds of passengers and crew were ordered to remain onboard. Others retreated to the Sokha hotel, where they were asked to stay in their rooms — a request some ignored, said Christina Kerby, 41, of Alameda, Calif., who had taken the cruise with her mother.

Kerby had spent Saturday relaxing at the hotel. She went for a swim, then out to dinner, publishing photos of her meal on Twitter for followers who had been tracking her ordeal over the previous two weeks.

“It was my afternoon to relax before a long trip home,” she said.

Kerby has received blowback on Twitter for going out in Phnom Penh. Back home in Alameda, her children’s preschool asked whether she might endanger other kids when she returns. The stigma of the virus is a new feeling, she said.

On Sunday, she awoke to find a note slipped under her door asking that she stay in her room.

“That, for me, was the moment I lost it,” said Kerby, who had been relentlessly optimistic during her cruise ship confinement. “As Americans, we’re very used to having agency over our own bodies and being able to come and go as we pleased.”

Now, health experts say, there is little to do but wait and see whether the Westerdam passengers spread the virus around the world. Some are skeptical they will see that, suggesting the single positive test result may have been erroneous.

“You would assume if one person got infected on any cruise, you would have a mini-outbreak,” said one U.S. official involved in the response. “Maybe she wasn’t positive.”

Based on what is known so far, Cambodia’s approach is preferable to quarantining people aboard a ship where the virus is spreading, said Saskia V. Popescu, senior infection prevention epidemiologist for HonorHealth, a hospital system in Phoenix.

But that requires educating passengers about reporting symptoms and self-isolating if necessary, and having public health authorities in home countries closely monitor those who have returned. It includes quickly tracing the contacts of anyone who develops the infection.

“I think we can say if you’re going to quarantine people, doing it on a cruise ship is not the best place,” Popescu said.

In an interview with The Washington Post, Phay Siphan, the Cambodian government spokesman, expressed no regrets on the handling of the Westerdam and its passengers.

“The ship was abandoned by the Earth,” he said. “We understood their predicament, and we knew we had to help them.”

'A STRUGGLE TO GET HOME'

Christina Kerby initially struggled to find a flight home from Cambodia.

“It literally is minute by minute over here,” she said Wednesday. “One minute, they think they have an agreement with a country to let us through and the next, people are being held at the airport.” She arrived in San Francisco on Thursday.

Fehrenbacher, the graduate student, described his room at Travis Air Force Base as surprisingly spacious. He was told that for 48 hours, he could not leave the room. To receive a meal from uniformed personnel, he must first put on a mask. He has never tested positive for the virus.

“I’m just trying to stay hydrated and optimistic about what the next 12 days are going to look like,” he said.

In Japan, meanwhile, the Diamond Princess is finally being vacated. On Wednesday, Japan released 443 people from the ship, saying they had completed their 14-day quarantines. Scores of its passengers, about 40 of them Americans, remain hospitalized with the infection.

On Thursday, the State Department urged U.S. citizens to reconsider cruise ship travel to or within East Asia and the Asia-Pacific region.

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Mahtani reported from Hong Kong. Simon Denyer in Tokyo, Meta Kong in Phnom Penh and William Wan and Alex Horton in Washington contributed to this report.

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LIVE UPDATES: CHINA AGAIN CHANGES CORONAVIRUS REPORTING CRITERIA, AS PRISON OUTBREAK RAISES ALARM; CASES SOAR IN SOUTH KOREA

By Gerry Shih, Simon Denyer, Teo Armus and Miriam Berger | Published

Feb 21 at 9:44 AM EST | Washington Post | Posted February 21, 2020 |

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For the third time in eight days & the second time in 24 HOURS Chinese public health officials made changes Friday to their criteria for counting coronavirus cases, once again sowing confusion over the widely fluctuating figures. In a further sign of potential inconsistencies, an official in China’s Hubei Health Commission suggested that agencies were not being transparent and accurate in their reported case numbers.

Another death amid a surge in coronavirus cases in South Korea — many traced to a church — also provoked fresh alarm Friday, after Chinese authorities reported hundreds of new infections at prisons, undercutting Beijing’s effort to show progress in containing the deadly epidemic.

Meanwhile, Lebanon and Israel reported their first coronavirus cases, as infection numbers rose in Iran and Italy.

South Korea’s caseload surged to 204, prompting officials to ramp up control measures, as worries mounted that the country is becoming a new hot spot for infection.

Earlier, a handful of Chinese prisons reported nearly 500 new cases, a significant portion of the more than 1,100 new cases reported in mainland China on Friday — and a marked increase after several days of declines.

The prison outbreaks underscored the high transmissibility of the virus, officially called SARS-CoV-2, in confined spaces after the disease it causes, covid-19, ravaged the Diamond Princess cruise ship docked in Japan.

China’s government has sought to encourage companies to resume work after an extended Lunar New Year closure aimed at containing the virus, but some factories have been forced to shut down soon after reopening as infections surface.

HERE ARE THE LATEST DEVELOPMENTS:

●A second person died from covid-19 and cases in South Korea soared, with investigators focusing on a church and hospital in the southern city of Daegu as clusters of infection.

● Hundreds of passengers were disembarking from the Diamond Princess, but the massive case load left questions about the rigor of quarantine and testing procedures on board.

●In Iran, authorities reported two deaths among 13 new coronavirus infections, raising the tally there to 18 cases so far.

● Italy confirmed its first three cases of local transmission of the coronavirus. Israel anounced its first coronavirus case — a Diamond Princess passenger — while Lebanon reported its first infection — someone who had just traveled from Iran.

● Beijing braced for a potential explosion of infection numbers in the capital after two hospitals were put under quarantine. The discovery of hundreds of new coronavirus cases in Chinese prisons underlined fears about the virus’s ability to spread rapidly in confined areas.

● World Health Organization Director General Tedros Adhanom Ghebreyesus said that Friday’s “significant decrease in confirmed cases.

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9:40 AM: BRITISH EVACUATION FLIGHT FROM DIAMOND PRINCESS IS DELAYED

A British repatriation flight scheduled to carry more than 70 Britons quarantined on the Diamond Princess cruise liner has been delayed, according to the British Embassy in Japan.

The flight, initially scheduled for Friday night, will now leave early Saturday. Organizing the flight was “logistically complicated,” according to an embassy comment to the BBC. The departing passengers will be allowed to leave the quarantined ship on Friday instead.

The Diamond Princess, carrying more than 3,700 passengers and crew members, has been among the most dramatic plot lines in the coronavirus saga.

Ten people on board were initially diagnosed with the disease in early February. Since then, while the ship has remained under quarantine in Japan’s Yokohama harbor, 634 on board have tested positive for the virus.

That total includes four Britons, but Saturday’s repatriation flight will carry only those who have tested negative.

When it departs Japan Saturday morning, the United Kingdom-bound flight will land at Boscombe Down military base. The arriving passengers will then be quarantined for an additional 14 days at Arrowe Park Hospital.

Nine people in the U.K. have currently tested positive for coronavirus.

By: James McAuley

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8:55 AM: LEBANON REPORTS FIRST CORONAVIRUS CASE, WITH LINK TO IRAN

Lebanon confirmed its first case of coronavirus on Friday, Health Minister Hamad Hassan said in a news conference, adding that the patient was a 45-year-old woman who arrived in Lebanon from Iran on Thursday.

Hassan said the Lebanese patient, who flew to the capital, Beirut, from Qom, Iran, was placed in quarantine. He also confirmed two other suspected cases and designated a hospital in Beirut as an isolation center for those who show symptoms.

Hassan also requested that any Iranian visitors self-impose quarantine in their residences for 14 days, until they confirm they have not contracted the virus. Iran has confirmed a total of 18 cases so far, including four deaths from covid-19, centered in Qom, a Shiite holy city south of Tehran.

The health minister and the head of the Lebanese Red Cross warned against the spread of hysteria after voice notes and false news circulated via messaging services and on social media in Lebanon, including a rumor that two dead bodies were on the plane – which the minister denied.

Hassan emphasized the importance of preventative treatment at this stage. “Do not mix with those infected with respiratory diseases who are isolated at home,” Hassan said during the news conference. “Leave your neighbors in their houses: now is not the time for visits.”

By: SARAH DADOUCH

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8:30 AM: UKRAINIAN MODEL WON’T LEAVE WUHAN WITHOUT HER POMERANIAN PUP

MOSCOW — Ukrainian model Anastasiya Zinchenko refused to be evacuated from Wuhan, the epicenter of the coronavirus outbreak, because she was not allowed to take her dog with her, she wrote Thursday on Instagram.

Still in Wuhan with Misha, her Pomeranian pup, Zinchenko received a phone call Friday from Ukrainian President Volodymyr Zelensky, posting video of the exchange on Instagram. Zelensky’s office confirmed that he called Zinchenko, according to the BBC’s Jonah Fisher.

“We won’t leave you there,” Zelensky says to Zinchenko in the video, adding that he only recently heard of her situation.

Zinchenko said the Ukrainian Embassy initially told her she would not be allowed to evacuate with the dog but later relented on the condition that “everything meets the sanitary standards.” She said she got veterinary approval but was then told by the Ukrainian Embassy that Chinese authorities refused to let the dog evacuate with her.

“I wanted to call you personally because I find it very important,” Zelensky told Zinchenko. “We will surely find means and ways.”

By: ISABELLE KHURSHUDYAN

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8:10 AM: SOUTH KOREAN HOSPITAL RECORDS SECOND PATIENT TO DIE FROM CORONAVIRUS

SEOUL — South Korea on Friday reported its second death from the new coronavirus, according to the Korea Centers for Disease Control and Prevention (KCDC).

The woman in her 50s died after being diagnosed with the virus at Daenam hospital in Cheongdo, in the southern North Gyeongsang province.

The hospital has recorded 16 coronavirus cases, including South Korea’s first death from the virus on Thursday, according to the KCDC. Of the 16, five were doctors and staff members at the hospital.

The woman had been hospitalized at Daenam and was transferred to a bigger hospital in nearby Busan after contracting the virus. She died around 6.p.m.

KCDC Director Jung Eun-kyeong told reporters Friday that the confined environment at Daenam hospital’s locked psychiatric ward could have given rise to transmissions there. It was not immediately clear if the woman had been hospitalized at the psychiatric ward.

The KCDC is investigating the hospital’s link to a bigger cluster of coronavirus infections at a church in the nearby city of Daegu.

More than two-thirds of South Korea’s 204 coronavirus cases are traced to the Daegu church, according to the KCDC.

By: MIN JOO KIM

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8:00 AM: TWO DIE IN IRAN FROM CORONAVIRUS, AMONG 13 NEW REPORTED CASES

Iran raised its coronavirus count Friday, reporting two deaths among overall 13 new confirmed cases, the state-run Mehr News Agency reported.

On Wednesday, two elderly Iranians were the first in the country reported to both have and then die from covid-19. So far, there have been 18 cases in total, according to Iran’s health ministry.

The outbreak has centered in the Shiite holy city of Qom, where authorities have closed all schools and seminaries and requested the suspension of religious gatherings.

Kianoush Jahanpour, a Health Ministry spokesman, said the latest cases all involved people either from Qom or who had recently visited there, Mehr reported.

In response to the outbreak, neighboring Iraq and nearby Kuwait banned travelers from Iran. The two countries both have citizens who frequently travel to Iran for pilgrimages, as well as strong business and trade ties.

By: MIRIAM BERGER

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7:15 AM: FIRST ISRAELI FROM DIAMOND PRINCESS CRUISE SHIP TESTS POSITIVE FOR CORONAVIRUS

Israel’s Health Ministry confirmed Friday the first case of an Israeli citizen having contracted covid-19 while aboard the Diamond Princess cruise ship, currently docked in a port in Japan. The female patient is under supervision and in isolation, the ministry said, according to Israeli media.

Officials stressed that the patient did not contract the virus in Israel.

Eleven Israeli citizens were among the more than 3,000 passengers and crew quarantined on the cruise liner after a coronavirus outbreak on board. In total, 634 of the ship’s occupants have tested positive for the virus and two have died from covid-19, according to Japanese health authorities.

The 11 Israelis were flown out of Japan and sent directly Friday into isolation at Sheba Tel Hashomer Hospital, where they will remain for a quarantine period.

In an effort to prevent the entry of the virus into Israel, Israel’s government on Monday announced a temporary travel ban on all foreign nationals who in the past 14 days had traveled to Thailand, Singapore, Hong Kong and Macao.

Thailand has asked Israel to reconsider including it on the ban, which affects about 25,000 Thai workers employed largely in agriculture in Israel.

By: MIRIAM BERGER

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6:33 PM: A RELIGIOUS FRINGE IN SOUTH KOREA FEARED AS HOTBED OF CORONAVIRUS TRANSMISSIONS

SEOUL — The leader of a South Korean religious sect identified as a hotbed of the coronavirus called the outbreak “a devil’s deed” on Friday.

More than two-thirds of the country’s 204 coronavirus cases are traced to a local branch of the Shincheonji Church of Jesus the Temple of the Tabernacle of the Testimony.

The church’s branch in the southern city of Daegu is linked to 144 cases of the virus, according to Korea Centers for Disease Control and Prevention (KCDC).

Leader Lee Man-hee, who founded the church in 1984, said the mass infection is “a devil’s deed to curb the rapid growth of Shincheonji,” according to an internal message carried by South Korea’s Yonhap News Agency on Friday.

Shincheonji said in a public statement Friday that it has shut and disinfected all its 74 churches nationwide. All gatherings and evangelical practices have been suspended, the church said.

KCDC director Jung Eun-kyeong told reporters on Friday that Shincheonji services that gather many churchgoers in a crowded space possibly led to mass transmissions.

South Korean President Moon Jae-in called for a thorough investigation of transmission clusters at the Daegu church and a funeral service at a nearby hospital in Cheongdo County.

Since members of the church attended the funeral, the Cheongdo hospital reported 15 coronavirus cases, including South Korea’s first death from the virus.

Daegu authorities said 544 out of 4,475 Shincheonji churchgoers are identified as symptomatic.

The church is believed to have more than 200,000 adherents across the country. Followers of Shincheonji founder Lee equate him with the second coming of Jesus who will deliver salvation from an impending apocalypse.

By: MIN JOO KIM

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6:12 AM: TWO BEIJING HOSPITALS QUARANTINED AMID FEARS CORONAVIRUS INFECTIONS WILL SPIKE IN THE CAPITAL

BEIJING – Two Beijing hospitals have been put under quarantine amid fears of a coronavirus outbreak in the capital, with one district in the city having an “infection density” second only to Wuhan, the epicenter of the epidemic.

The sudden rise in cases in Beijing this week has people worried both about a potential explosion of infection numbers in the capital and about what may happen as millions of Chinese return to work after weeks of relative isolation.

Even the Global Times, a nationalist newspaper affiliated with the ruling Communist Party, described the increase in cases in Beijing this week as a “whopping” rise.

There are 396 confirmed cases of coronavirus in Beijing, a city of 22 million people. Haidian district has the most, with 61, while the much smaller area of Xicheng has 53, according to Beijing government figures.

The central Beijing district of Xicheng — which is home to the Zhongnanhai compound and the offices of the Communist Party’s leaders, as well as many government offices and the central bank — is next after Wuhan in the number of confirmed cases per square kilometer, the Global Times reported.

The party is all but certain to decide on Monday to postpone the important annual National People’s Congress meeting due to begin on March 5 in the Great Hall of the People, across the road from Zhongnanhai.

With migrant workers set to return to Beijing in droves after the coronavirus-related extension of the Lunar New Year holiday, officials are clearly worried about the prospect that the returnees could bring the infection. A new rule stipulates that all people entering Beijing must quarantine themselves at home for 14 days before going out in the city.

Now, two hospitals are monitoring hundreds of people for potential infection after a sudden spike in cases.

Fuxing Hospital in the Xicheng district, and only a block away from an apartment complex known as home to many senior government officials, is now under a total lockdown.

It reported 36 novel coronavirus cases Thursday, with eight medical workers and nine cleaning staff infected, as well as 19 patients or their relatives. A total of 668 people who had been in contact with the infected patients were placed under observation.

Six security officers, some of them in People’s Liberation Army-style coats and surgical face masks, came out to stop two Washington Post reporters from approaching.

Three patients at nearby Peking University People’s Hospital in Beijing have been confirmed as infected with coronavirus. A total of 164 people who had close contact with them, including medical staff who treated them, are now under observation.

Medical workers in full protective gear were guarding the gate on Friday, where a sign read that all visitors were banned.

By: ANNA FIFIELD, LYRIC LI and LIU YANG

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6:05 AM: DISQUIET GROWS AS CHINA APPEARS TO MASSAGE VIRUS STATISTICS

BEIJING — Reporting of case statistics at the epidemic epicenter in China appeared to descend into disarray Friday as public health officials said they had been ordered to change how they count cases for the third time in eight days — and the second time in 24 hours.

In remarks to the state news agency Xinhua, a Hubei Health Commission official suggested that agencies were not being transparent and accurate with their reported case numbers at a time when statistics have fluctuated wildly and inconsistencies have emerged in Chinese official data.

Tu Yuanchao, deputy director of Hubei’s health commission, told Xinhua on Friday that the newly installed Communist Party chief of Hubei province, Ying Yong, reversed an earlier decision to deduct coronavirus cases that were not confirmed by genetic tests from the total case number, which included diagnoses made by physicians.

The order from Ying, the former Shanghai mayor brought in by the Communist Party leadership to take charge in Hubei, reversed an earlier move that allowed the province to report sharply lower numbers as the Chinese government looks to present an image of normalcy slowly returning across the country this week. As a result, Hubei announced a sharp surge in new cases again on Friday to more than 1,000 — as well as the startling revelation that the coronavirus was spreading inside prisons and has infected hundreds of inmates without being disclosed to the public.

“Next, we will further strengthen discipline and tighten management to ensure the openness and transparency, timeliness and accuracy of epidemic statistics,” Tu was quoted by Xinhua as saying.

A senior-ranking official in the Communist Party’s political and legal apparatus also warned cadres on Friday in a widely disseminated speech that “hiding” cases or manipulating numbers will no longer be tolerated.

Inconsistencies in China’s epidemic data, particularly in Hubei, have presented frustrations for biostatisticians trying to gain a crucial understanding of how the outbreak is progressing.

Statistics in China are politically sensitive, and Communist Party officials at every level are rewarded or punished based on their performance against certain numerical benchmarks.

In one particularly glaring moment that drew ridicule this week, Wuhan, a city with one-sixth the population of Hubei, reported twice the number of new coronavirus cases as the entire province.

By: GERRY SHIH

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5:50 AM: FIRST CASES OF LOCAL TRANSMISSION OF CORONAVIRUS CONFIRMED IN ITALY

Six people in a city near Milan have tested positive for coronavirus, marking the first cases of local transmission of the virus in Italy, the country’s ANSA news agency reported.

Officials say the first to locally contract the virus was a 38-year-old man in the northern region of Lombardy, who became sick after having dinner with a friend who recently returned from China.

He then passed the virus on to his wife and another close friend, according to Reuters.

ANSA reported that the man is in serious condition, including respiratory insufficiency, and has been admitted to the intensive care unit at a hospital in Codogno, about 35 miles southeast of Milan. Both other patients have also been hospitalized.

After initially reporting three cases, Italian officials raised the count Friday to six.

Local police have since tried to retrace the couple’s steps over the past four days, including where they went to work, exercised and had contact with other people, ANSA reported. The 38-year-old man’s family and the friend who came from China have all been placed in isolation.

As of Tuesday, about 40 cases of the novel coronavirus had been confirmed elsewhere in Europe.

Correction: An earlier version of this post reported incorrectly that the three new cases were Italy’s first coronavirus infections. They were the first cases of local transmission.

By: TEO ARMUS

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5:13 AM: LEFT BEHIND IN JAPAN, U.S. VIRUS PATIENTS HAVE MORE QUESTIONS THAN ANSWERS

YOKOHAMA, Japan — When Wayne and Susan Hidalgo heard that a fellow passenger on the Diamond Princess had been diagnosed with the new coronavirus, he was not too worried.

When he discovered that one of the people he regularly dined with on board had shared a bus with the infected passenger on a shore excursion, he didn’t think too much about it, at first.

“But as time went on, after a day or so, I wondered, why are we eating dinner with these people? Why is everybody out dancing? Why are they having these shows going on?” the 77-year-old from Kansas City said by telephone from his hospital bed in Tokyo.

Japan’s Health Ministry says 88 Americans on board the ship have been diagnosed with covid-19, with most taken to hospitals. Some 14 people with the virus were controversially allowed to board charter flights bound for California and Texas, after their test results came back just before they were due to take off.

That left many Americans behind in Japan searching for answers.

The Hidalgos’ children want them to be brought home, arguing that it’s “not fair” they’ve been left behind in Japan while other Americans have been brought home.

Susan, 76, says they just want to get back to Kansas City, but Wayne says he knows that isn’t going to happen until they are given the all-clear by Japanese doctors, for which they each need two successive negative tests.

Wayne says he is suffering from mild pneumonia, and has been put on oxygen, but only had a fleeting fever. He’s taking antibiotics, but doctors haven’t felt it necessary to put him on anti-retroviral tablets that are being given to the most severely ill patients. Susan doesn’t have any symptoms.

An official from the U.S. Embassy has paid a visit, bringing them some clothes and some local currency, while Princess Cruises, the owner of the ship, has been in regular contact, with their Tokyo representative calling every day.

But he does wonder if the cruise liner operator “dropped the ball” by allowing passengers to continue to mingle freely with each other for two to three days, after news broke that the passenger from Hong Kong had been infected.

By: SIMON DENYER

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4:56 AM: FALSE INFORMATION ON CORONAVIRUS SETS OFF UGLY SCENES IN UKRAINE

MOSCOW — Ukrainians evacuated from the Chinese city of Wuhan, the epicenter of the coronavirus outbreak, were met with protests and violence Thursday upon arriving back in Ukraine.

Residents fearful of potentially infected people in the town of Novi Sanzhary threw stones at the 45 Ukrainian and 27 foreign evacuees and clashed with police, according to local media reports. The stones smashed a window of the bus carrying the evacuees. It was not immediately clear whether anyone was injured. Videos posted on social media showed scores of police dragging protesters away.

The incident appeared to have been sparked by the circulation of a fraudulent email that Ukrainian intelligence officials said originated outside the country. The email, which coincided with the arrival of Wuhan evacuees, purported to be from Ukraine’s Health Ministry and was sent to the ministry’s entire contact list. It falsely said there were five cases of coronavirus in the country.

Just two Ukrainians have been infected — both were quarantined in Japan on the Diamond Princess cruise ship — and they have since recovered.

“Those events that took place yesterday, in my opinion, are the result of, among other things, the information war that is ongoing against our country, both from the inside and the outside,” Ukrainian Prime Minister Oleksiy Honcharuk said Friday in an address to parliament.

“I suppose that the provocations will continue,” he added. “I think that the information field will continue to swing, to create a panic, to sow distrust and discord among us.”

By: ISABELLE KHURSHUDYAN

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4:36 AM: ANGOLA RELEASES 50 FROM QUARANTINE, HIGHLIGHTING CORONAVIRUS CHALLENGES IN AFRICA

Angola has released 50 travelers who arrived from China, ending what may be one of the first quarantines in Africa meant to stop the possible spread of coronavirus.

The group of travelers held in the capital, Luanda, included 13 people from Angola, 36 from China and one from Brazil, according to the country’s official ANGOP news agency.

While there are no confirmed cases of coronavirus in Africa, global health officials have expressed concerns that some countries on the continent may be especially ill-equipped to handle the virus in the event of an outbreak.

The World Health Organization has identified 13 countries across the continent, including Angola, as “vulnerable” because of high volumes of travel or their direct links to China. About 10,000 Chinese firms operate in Africa, and the continent’s largest airline, Ethiopian Airlines, has continued its flights to China despite intense public pressure.

WHO has sent kits to 29 labs on the continent to equip them to handle the virus, the BBC reported, with the ultimate goal of ensuring that 36 African countries are prepared.

Outside of Angola, more than 100 people were quarantined earlier this month after arriving in Uganda. Botswana, Ethiopia, Ghana, Ivory Coast and Kenya have all also dealt with suspected cases, though only Egypt has confirmed a case so far.

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