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backlinkci · 2 years

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Coronavirüs Nedir? COVID-19 Hastalığının Belirtileri Nelerdir?

Coronavirüs Nedir? COVID-19 Hastalığının Belirtileri Nelerdir? Coronavirüs (koronavirüs) nedir? Coronavirüsler, hayvanlarda veya insanlarda hastalığa neden olabilecek büyük bir virüs ailesidir. Daha önce rastlanan birkaç coronavirüsün soğuk algınlığından Orta Doğu Solunum Sendromu (MERS) ve Şiddetli Akut Solunum Sendromu (SARS) gibi daha şiddetli hastalıklara kadar neden olduğu bilinmektedir. En son keşfedilen coronavirüs, COVID-19 hastalığına neden olur. Bu yeni virüs ve hastalık, salgının Aralık 2019'da Çin'in Wuhan kentinde başlamasından önce bilinmiyordu.

Coronavirüs (COVID-19) belirtileri nelerdir? COVID-19'un en yaygın semptomları ateş, yorgunluk ve kuru öksürüktür. Bazı hastalarda burun tıkanıklığı, burun akıntısı, boğaz ağrısı veya ishal olabilir. Bu semptomlar genellikle hafiftir ve yavaş yavaş başlar. Bazı insanlar enfekte olduğu halde herhangi bir semptom geliştirmeyebilirler. Çoğu insan (yaklaşık %80) özel tedaviye ihtiyaç duymadan hastalıktan iyileşir. COVID-19 alan her 6 kişiden yaklaşık 1'i ağır hastalanmakta ve nefes almakta güçlük çekmektedir. Yaşlı insanlar ve yüksek tansiyon, kalp problemleri veya diyabet gibi altta yatan tıbbi sorunları olanların ciddi hastalık geliştirme olasılığı daha yüksektir. Ateş, öksürük ve nefes almada zorluk çeken insanlar tıbbi yardım almalıdır.

Coronavirüs (koronavirüs) tanısı nasıl konulur? SARS-CoV-2 virüsünün neden olduğu COVID-19 tanısı, direkt olarak virüsü saptamaya yönelik olarak yapılabildiği gibi, konak organizmanın virüse karşı oluşturduğu spesifik antikorların gösterilmesi ile de yapılabilir. Bu doğrultuda laboratuvarlarda kullanılan iki test kategorisi vardır. Bunlar virüsün kendisini tespit eden PCR testi ve konakçının virüse verdiği yanıtı tespit eden antikor testidir. Ayrıca hastalığın tanısında akciğer tomografisi ve bazı kan tetkikleri de kullanılmaktadır.

Coronavirus (koronavirüs) antikor testi nedir? Antikorlar, bağışıklık sisteminin tehditleri tanımlamasına ve ortadan kaldırmasına yardımcı olan proteinlerdir. Ayrıca vücudun gelecekteki enfeksiyonları aynı tehditten korumasına yardımcı olmaktadır. Serolojik testler, kişinin SARS-CoV-2 virüsüne karşı yanıt olarak oluşturduğu proteinleri tespit etmektedir. Antikor testleri, COVID-19'dan iyileşen veya virüsü fark etmeden taşıyabilen hastalarda, virüs artık mevcut olmasa bile antikorları kimin taşıdığını gösterebilmektedir. Detaylı bilgi için içeriğimizi okuyabilirsiniz.

Coronavirüsler nasıl bulaşır? Hastalık, kişiden kişiye, COVID-19'lu bir kişi öksürdüğünde veya nefes verdiğinde ortama yayılan küçük damlacıklardan veya ağızdan yayılabilir. Bu damlacıklar kişinin etrafındaki nesnelere ve yüzeylere düşer. Diğer insanlar bu nesnelere veya yüzeylere temas ettikten sonra gözlerine, burnuna veya ağzına dokunduğunda viruse yakalanırlar. İnsanlar ayrıca, COVID-19'lu damlacıkları öksüren veya nefes veren bir kişiden damlacıklar halinde nefes alırlarsa COVID-19 hastalığına yakalanabilirler. Bu yüzden hasta olan bir kişiden 1.5 metreden daha uzak mesafede durmak önemlidir. Bugüne kadar yapılan çalışmalar, COVID-19'a neden olan virüsün, esas olarak hava vasıtasından çok temas yoluyla bulaştığını göstermektedir.

COVID-19, şikayeti olmayan kişilerden bulaşabilir mi? COVID-19 olan birçok insan sadece hafif semptomlar yaşar. Bu özellikle hastalığın erken evrelerinde geçerlidir. Bu nedenle, COVID-19'u örneğin hafif bir öksürüğü olan ve hasta hissetmeyen birinden yakalamak mümkündür.

COVID-19’un grip ya da soğuk algınlığından farkı nasıl anlaşılır? 2019-nCoV enfeksiyonunda, grip veya soğuk algınlığında olduğu gibi genellikle ateş, öksürük ve burun akıntısı gibi solunum şikayetleri görülür. Birçok yakınma benzer olsa da, bu hastalıklar farklı virüslerden kaynaklanır. Benzerlikleri nedeniyle, hastalığı sadece şikayetlere dayanarak tanımlamak zor olabilir. Bu yüzden birinin 2019-nCoV olup olmadığını doğrulamak için laboratuvar testleri gereklidir.

Coronavirüsten (koronavirüs) nasıl korunurum? Dünya Sağlık Örgütü'nün enfeksiyonun yayılmasını önlemek için standart önerileri arasında düzenli el yıkama, öksürme ve hapşırma sırasında ağız ve burnu tek kullanımlık bir mendil ya da dirsek içi ile kapatmak, ellerin göz, burun ve ağıza temasından kaçınmak yer alır. Virüsten korunmak için belirlenen standart önerilerin en başında el hijyeni gelir.

Öksürme ve hapşırma gibi solunum yolu rahatsızlığı belirtileri gösteren kişiler ile yakın temastan kaçınmak gerekir. Ateş, öksürük ve nefes darlığı olan kişiler erken tıbbi yardım almalı ve önceki seyahat geçmişi sağlık uzmanıyla paylaşılmalıdır. Yerel sağlık kurumunun talimatları izlenmelidir. COVID-19'un yaygın olarak yayıldığı şehirler veya yerel bölgelerden haberdar olunmalıdır. Mümkünse bu yerlere seyahat etmekten kaçınılmalıdır.

Tıbbi maske takmak, bazı solunum yolu hastalıklarının yayılmasını sınırlamaya yardımcı olabilir. Bununla birlikte, tek başına maske kullanmak enfeksiyondan korunmayı garantilemez. El hijyeni dahil olmak üzere diğer önleme tedbirleri ile birleştirilmeli ve şüpheli ya da kesin tanı almış kişiler ile en az 1 metre mesafe olmalıdır.

Coronavirüs (koronavirüs) tedavisi nasıl yapılır? Yeni tip Coronavirüs enfeksiyonu için spesifik tedavi mevcut değildir, antibiyotiklerin hastalığın önlenmesinde ya da tedavisinde yeri yoktur. Tedavi hastanın şikayetlerine yönelik olan destek tedavisidir.

Coronavirüs (koronavirüs) aşısı bulundu mu? Yeni tip Coronavirüs enfeksiyonu için aşı henüz mevcut değildir.

COVID-19 hastalığına karşı nasıl beslenilmedir? Pandemi döneminde, bağışıklık sistemini güçlendirici şekilde beslenme düzeninde değişiklik yapılmalıdır. Dünya Sağlık Örgütü günde ortalama 5 ile 8 porsiyon arasında meyve ve sebze tüketimini önermektedir. Bağışıklık sisteminin özellikle güçlü tutulması gereken bu dönemde, bahsedilen bu miktarı biraz daha artırmanızı öneriyoruz.

Coronavirus (koronavirüs) kuluçka süresi ne kadardır? Kuluçka dönemi, virüsü yakalama ile hastalığın belirtilerini göstermeye başlama arasındaki zaman anlamına gelir. COVID-19 için kuluçka döneminin çoğu tahmini 1-14 gün arasında, en yaygın olarak 5 gündür.

COVID-19 evcil hayvanlardan bulaşır mı? Yeni tip coronavirüsün hayvan kaynağı henüz tanımlanmadı. Ancak bu, herhangi bir hayvandan veya evcil hayvanlardan 2019-nCoV bulaşabileceği anlamına gelmez. Kediler ve köpekler gibi evcil hayvanların 2019-nCoV ile enfekte olduğuna veya virüsün bu hayvanlar arasında yayıldığına dair hiçbir kanıt yoktur.

COVID-19 hastalığına neden olan virüs, cansız yüzeylerde ne kadar süre yaşayabilir? COVID-19'a neden olan virüsün yüzeylerde ne kadar süre hayatta kaldığı kesin değildir, ancak diğer coronavirüsler gibi davranmaktadır. Çalışmalar, coronavirüslerin yüzeylerde birkaç saat veya birkaç güne kadar devam edebileceğini göstermektedir. Bu, farklı koşullar altında değişebilir (örn. yüzey tipi, ortam sıcaklığı veya nemi).

COVID-19 hastalığı kargo paketleri ile bulaşır mı? Diğer coronavirüslerle olan deneyimlerden, bu tür virüslerin zarf veya paket gibi nesnelerde uzun süre hayatta kalamadığı tespit edilmiştir.

COVID-19 döneminde zatürre ve grip aşısını kimler yaptırmalıdır? Özellikle yaşlılık döneminde yapılması önerilen iki aşı pnömokok (zatürre) ve influenza (grip) aşılarıdır. Ayrıca yaşlıların aşıyla önlenebilir hastalıklar ve komplikasyonlarından korunabilmesi için çevrelerindeki bireylerin de mutlaka aşılanmaları önerilmektedir. Toplumda aşılanma yüzdesi arttıkça, hastalıkların görülme ve yayılma oranları da göreceli olarak düşer.

Bu iki aşı SARS virüslerinden korumasa da, SARS virüsünden etkilenenlerin yaşayacakları karışıklıkları engellemek için kullanılacak bir koruma faktörü olarak öne çıkmaktadır. Özellikle influenza virüsü, bizleri SARS nedeniyle şaşırtacak ve ikisinin ayrımını yapmak zor olacaktır. Bu nedenle aşılamanın yaygın yapılması büyük önem taşımaktadır.

Koronavirüs hastalığının (COVID-19) hamileler üzerindeki etkileri nelerdir? Tüm dünyayı etkisi altına alan COVID-19 virüsünün yeni bir enfeksiyon olması sebebiyle gebelik ve bebek üzerindeki etkileri bilinmiyor. Daha önceki SARS ve MERS enfeksiyonlarından elde edilen bilgiler, coronavirüs enfeksiyonunun gebeliğin ilk altı ayında bebek üzerinde olumsuz bir etki yaratmadığını gösteriyor. Ancak gebeliğin son 3 ayında, anne COVID-19 enfeksiyonu geçirirse birtakım riskler oluşabileceği hakkında çalışmalar yayınlanıyor.

COVID-19 kalp hastalarını nasıl etkiler? Kalp ve damar hastaları virüsün kalbe bindirdiği yükten dolayı ciddi risk altındadır. COVID-19’a karşı kalp ve hipertansiyon hastalarının, kalp damar hastalığı olanların hijyen koşullarına dikkat etmeleri gerekirken, mümkün olduğunca kendilerini evde izole etmeleri gerekiyor. Hastaların ilaçlarını aksatmadan kullanmaları gerekmektedir. Tansiyonlarını ve şekerlerini kontrol altında tutmalılar.

Pandemi sürecinde psikolojimizi korumak için nelere dikkat etmeliyiz? Her insan stresli durumlara kişisel özellikleri, travmatik deneyimleri ve içinde bulunduğu şartlar dahilinde farklı tepkiler verebilir. Belirsizlik herkes için ciddi bir problem. Her şeyi kontrol edemeyiz. Öncelikle kontrol edebileceğimiz noktalardaki tüm önlemleri aldığımıza emin olmalıyız. Unutmamamız gereken en önemli şey kaygı ve paniğin virüsten daha bulaşıcı olduğudur.

Evde çokça vakit geçirilen pandemi döneminde hareketlilik nasıl artırılabilir? Evde yapılabilecek kişiye özel egzersiz önerileri için videomuzu izleyebilirsiniz.

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bountyofbeads · 4 years

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Coronavirus Live Updates: South Korean Cases Spike, and Fear Builds https://nyti.ms/38NmL2w

Coronavirus Live Updates: South Korean Cases Spike, and Fear Builds

A major city is locked down and 28 countries outside of China have reported a total of 1,500 cases.

RIGHT NOW

Iran reports a sixth death, and Israel is barring travelers from South Korea.

Here’s what you need to know:

READ UPDATES IN CHINESE: 新冠病毒疫情最新消息汇总

THE COUNT: 28 COUNTRIES AND A SPIKE IN SOUTH KOREA.

South Korea reported 229 new coronavirus cases on Saturday, doubling its total in a single day and adding to concerns that another Asian country is losing control of the spread and that the window to avert a pandemic was closing.

As of Saturday, the virus had spread to 28 countries. Some 1,500 cases have been confirmed outside China; multiple infections in the United States, Italy, Iran and the United Arab Emirates; and one in Egypt, the first to be confirmed on the African continent. The highest death toll outside of China is in Iran, with six as of Saturday.

Panic is spreading in Israel, where a woman, who was aboard the Diamond Princess cruise ship in Japan tested positive after returning home, health officials said.

Many African countries are bracing for the disease. The World Health Organization has identified 13 as priorities because of their direct links to China or their high volume of travel to it.

SOUTH KOREA’S FOURTH-LARGEST CITY IS ON LOCKDOWN.

South Korea added 229 new coronavirus cases on Saturday, driving its total to 433. Prime Minister Chung Sye-kyun called the situation “grave.”

“We will deal sternly with any acts that interfere with the government’s quarantine efforts and add to anxiety among the people,” Mr. Chung said in a nationally televised statement. He urged citizens not to hoard facial masks or other hygiene products.

More than half of the cases are among members of a secretive religious sect, the Shincheonji Church of Jesus, and their relatives or contacts. Between Daegu, the country’s fourth largest city, and a nearby province where the sect’s members often do volunteer work, 352 people have tested positive.

More than 1,250 members of the sect have reported potential symptoms, and officials are still trying to locate 700 members so they can be screened.

The neighborhood around the sect’s church in Daegu has turned into a ghost town. Banks, coffee shops, restaurants and convenience stores have all shut down.

Across the city of 2.4 million, department stores, shopping alleys and outdoor marketplaces are drained of shoppers.

The only places more crowded than usual are government-run health centers, where citizens lined up to find out whether they were infected.

In Busan, South Korea’s second largest city, public libraries, a horse racetrack and facilities for senior citizens closed when the city reported its first coronavirus case on Friday.

Many churches have shuttered, instead offering prayer services online. Others stayed open, but skipped hymns or “Amens” to limit congregants’ exposure.

The national news agency Yonhap reported people emptying shelves of rice, instant noodle, eggs and other essential food items in some supermarkets in Chuncheon and Ulsan, as both cities reported their first cases on Saturday.

Samsung, the world’s smartphone maker, shut down a factory about an hour north of Cheongdo after a worker tested positive. The factory is expected to resume operations on Monday morning, Samsung said. But the floor of the factory where the patient has worked will be closed until Tuesday morning, it said.

PRESIDENT TRUMP WAS FURIOUS OVER THE REPATRIATION OF INFECTED AMERICANS.

The news that 14 American citizens from the Diamond Princess who had tested positive for the coronavirus were being flown to the United States this week surprised and infuriated President Trump, two senior American officials said.

The Washington Post first reported Mr. Trump’s anger on Friday. The president is a self-declared “germophobe.”

Mr. Trump conveyed his anger to Alex M. Azar II, the health and human services secretary overseeing the White House interagency task force on the coronavirus, and other top officials. The task force’s top State Department official is Stephen E. Biegun, the deputy secretary of state.

One official said that Mr. Trump views keeping infected people from entering the country as critical to keeping the country safe and that the president wants to be seen as managing a proper response.

The decision to fly back the infected passengers was made over the objections of officials at the Centers for Disease Control.

On Monday, after two planes carrying more than 300 evacuated passengers had landed at military bases in Texas and California, William Walters, a top medical official at the State Department, told reporters that the decision to keep the 14 infected Americans in the group had been made by the State Department in consultation with Robert Kadlec, an assistant secretary at the Department of Health and Human Services.

Dr. Walters said that the evacuation had already begun when Japanese officials informed their American counterparts of the laboratory test results. Dr. Walters said that he had spoken with Dr. Kadlec to go over the options after learning of the test results.

Since the passengers returned, Japanese officials have informed American officials that several more of them had also tested positive for coronavirus.

On Friday, American officials said at least 34 people inside the United States have the virus — 18 of them from the Diamond Princess. All of the 34 cases have been linked to overseas travel. There has been no sign yet of the virus spreading among communities in the United States.

[ U.S. MOBILIZATION: Local health departments around the country are scrambling to monitor the thousands of people returning from travel in China and elsewhere. READ BELOW]

THE W.H.O. HEADS TO WUHAN, AND SAYS IT FEARS FOR AFRICA.

A team of experts from the World Health Organization were traveling on Saturday to the Chinese city of Wuhan, the center of the coronavirus epidemic, the agency’s director general, Tedros Adhanom Ghebreyesus, said.

Health professionals from the U.N. agency have worked on the outbreak in three Chinese provinces — Beijing, Sichuan and Guangdong — but had not yet been to the city at its heart.

Dr. Tedros confirmed the trip during an address on Saturday morning to African officials from Geneva, where he spoke of the virus’s increasing global spread and urged them to prepare for possible cases on their continent.

“We have to take advantage of the window of opportunity we have, to attack the virus outbreak with a sense of urgency,” Dr. Tedros told the leaders, who had gathered for an emergency meeting on the response to the coronavirus in the continent.

With only one confirmed case on the continent, Africa has so far been mostly spared, but health officials have warned that the spread could be deadly in countries with already-strained health systems. The W.H.O. has provided online training on the coronavirus to 11,000 African health workers.

China and Africa have become intertwined in the last two decades as China has expanded its political, economic, and military ties to Africa, funding large infrastructure projects and pledging tens of billions of dollars in investments and loans.

Now, Africa has large numbers of Chinese workers and more than 81,000 Africans were studying in mainland China in 2018. About 4,600 African citizens and students were living in Wuhan.

While some African countries, including Morocco, Mauritius and Egypt, have evacuated their citizens from China, Kenya has not. On Friday, the Kenyan government explained its rationale on Twitter, saying “the safest place for the students to be is Wuhan.”

[CORONAVIRUS IN AFRICA: Experts worry that the steady traffic between China and Africa could spread the epidemic and overrun the continent’s already-strained health systems

ISRAEL BARS SOUTH KOREAN TOURISTS.

Nine South Korean tourists who spent a week visiting some of Israel’s most popular religious sites have tested positive for the coronavirus after returning home. Within hours, Israel began closing the country to South Korean travelers altogether.

Korean passengers flying on a Korean Air flight scheduled to land at Ben Gurion Airport at 7:30 p.m. Saturday would be barred entry into the country, Ynet reported late Saturday afternoon. Kan radio said that, on Sunday, the government would discuss whether to allow the other South-Korea-to-Tel Aviv flights to continue.

Israel’s health ministry ordered the immediate suspension of all tours by South Korean tourists who are currently in Israel, according to Kan radio. Health officials were working with the tourism ministry and travel agencies to book flights back to South Korea for the 1,700 South Korea tourists in Israel.

Israel suspended all flights from China on Jan. 30 in response to the outbreak of coronavirus.

The nine South Korean tourists were among a Roman Catholic tour group of 77 people, Haaretz reported. The health ministry said the pilgrims visited Israel from Feb. 8 to Feb. 15, touring Christian sites and other attractions in Netanya, Caesaria, Nazareth, the Sea of Galilee, the Dead Sea, Beersheva, Hebron and Jerusalem.

Among the often-crowded sites the group visited were the Cave of the Patriarchs in Hebron and the Church of the Holy Sepulcher in Jerusalem.

The health ministry said it was conducting an epidemiological investigation to identify anyone who came in contact with the group.

Twenty Israel Nature and Parks Authority employees and two Dead Sea hotel housekeeping employees who were in contact with the South Korea tourists have already been placed in quarantine, according to local reports.

RUSSIAN DISINFORMATION BLAMES U.S. FOR CORONAVIRUS.

State Department officials say that thousands of Russia-linked social media accounts are spreading disinformation about the coronavirus, including a conspiracy theory that the United States is behind the Covid-19 outbreak.

American monitors identified the campaign in mid-January. Agence-France Presse first reported on the assessment on Saturday.

“Russia’s intent is to sow discord and undermine U.S. institutions and alliances from within, including through covert and coercive malign influence campaigns,” said Philip Reeker, the acting assistant secretary of state for Europe and Eurasia.

“By spreading disinformation about coronavirus, Russian malign actors are once again choosing to threaten public safety by distracting from the global health response.”

The effort was described as being carried out by several thousand Russia-linked accounts on Instagram, Facebook and Twitter, which post similar messages at similar times in English, Spanish, French, German and Italian.

Fringe theories of uncertain origin have accused China of engineering the virus, including suggesting that it is an escaped bioweapon.

Misinformation about the virus — whether shared purposefully or unwittingly — is so rife that the World Health Organization has called it an “infodemic.” The W.H.O. has been working with big tech companies to try to quell the flood of rumors and falsehoods.

IRAN’S DEATH TOLL FROM THE VIRUS REACHES SIX, THE HIGHEST OUTSIDE CHINA.

Iran, which insisted as recently as Tuesday that it had no coronavirus cases, confirmed 28 cases and six deaths on Saturday, according to Iranian state media, making it the country with the highest death toll outside of China, where the number climbed to 2,345 on Saturday.

On Saturday, Dr. Tedros Adhanom Ghebreyesus, the World Health Organization’s director, said the organization was “especially concerned about the increase in cases in the Islamic Republic of Iran.”

Iran was the first country in the Middle East to declare deaths related to the virus. The head of public relations at the country’s health ministry, Kianush Jahanpur, wrote in a tweet that most of the infections came from Qom, 80 miles south of the capital, Tehran. Officials also confirmed cases in Tehran, and in the northern city of Rasht.

The number of deaths suggest the virus is being transmitted far more widely than Iranian officials have acknowledged. Infectious health experts note that, if, as Chinese doctors have reported, the virus kills about 2 percent of known victims, multiplying the number of deaths by 50 offers a rough case estimate. On that logic, Iran could have 300 cases.

Already, cases of travelers from Iran testing positive for the virus have turned up in Canada and Lebanon, and on Saturday, the United Arab Emirates said two Iranian travelers had the virus, raising that country’s total cases to 13.

State media in Iran reported that universities and institutions of higher education were closed for a week in 10 provinces and schools were closed for three days in Tehran because of the virus. Seminaries in Qom were also closed.

Concerts, movies and other cultural events were canceled across the country for a week, state media said. And spectators were barred from soccer games countrywide.

Kuwait Airways announced Saturday that it would evacuate more than 700 Kuwaiti nationals from Mashhad, Iran.

As Iran holds parliamentary elections this weekend, many voters in Qom lined up in front of voting stations wearing masks, according to videos from Iranian news agencies.

Conflicting news reports emerged on Saturday about the mayor of a district of Tehran, who was said to have been hospitalized with coronavirus symptoms on Friday. But the semiofficial news agency Fars later denied that the mayor, Morteza Rahmanzadeh, had been hospitalized, saying he was in good health.

[ FEARS OF A PANDEMIC RISE: Health officials warn that the number of cases outside of China may be greater than previously acknowledged. READ BELOW]

THE C.D.C. LIFTS RESTRICTIONS ON WESTERDAM CRUISE SHIP PASSENGERS.

The U.S. Centers for Disease Control and Prevention has advised American passengers of the Westerdam cruise ship that they do not need to self-quarantine and are no longer subject to travel restrictions after their lives were upended when a fellow passenger was found to have the coronavirus.

No other infections have been found among passengers on the Westerdam, a C.D.C. spokesman said on Saturday, adding that the organization had sent an advisory to state and local health departments this past week.

An American woman, 83, who had disembarked from the Westerdam in Cambodia along with more than 2,000 other passengers and crew members, had tested positive for the coronavirus after arriving at the airport in Kuala Lumpur, Malaysia, on a subsequent layover, Malaysian officials said on Feb. 15. Only a small number of passengers had been tested before they were allowed to disembark.

The American passenger’s diagnosis, which Malaysian officials said was confirmed in a second test, had raised fears that another vector of transmission was going global. Cambodia has called the Malaysian diagnosis flawed.

That no other Westerdam passengers have become ill is not proof in itself that the American woman’s diagnosis was flawed, said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center.

But Dr. Schaffner said the C.D.C. has been “very meticulous about implementing a containment policy in the U.S. and has been assiduous about finding and monitoring people who’ve had contact or previous exposure.”

On Saturday, the Malaysian health director general, Noor Hisham Abdullah, said that the American passenger was now clear of the coronavirus and was being monitored in the hospital with a “slight cough,” after an antiretroviral treatment.

People who have recovered from the infection will test negative as their bodies clear the virus.

Cambodia’s prime minister, Hun Sen, who had personally welcomed the ship’s passengers after they had been turned away from several other ports, called Malaysia’s diagnosis into question again on Saturday. The woman never had coronavirus at all, he said.

Mr. Hun Sen is a close ally of China and his claims have cast doubts on the seriousness of the coronavirus outbreak.

JAPAN ADMITS RELEASING SOME UNTESTED CRUISE SHIP PASSENGERS BY MISTAKE.

Just days after releasing nearly 1,000 passengers from the cruise ship quarantined for two weeks in the port of Yokohama that has been a coronavirus hot spot, Japan’s health minister admitted that 23 passengers had been mistakenly cleared to leave without taking a valid recent test.

In a news briefing on Saturday night, the health minister, Katsunobu Kato, apologized for the error that allowed the passengers, who had not been tested since before the ship went into lockdown on Feb. 5, to leave the Diamond Princess.

The Japanese Health Ministry said it had tested them and checked for symptoms, and certified that they posed “no risk of infection.”

Mr. Kato said that all 23 mistakenly cleared passengers had boarded some form of public transportation after disembarking. He said none of them had reported any symptoms so far and 20 had already agreed to be retested, with three negative tests so far.

Although several governments that evacuated citizens from the ship — including those in the United States, Australia, Hong Kong and South Korea — confined them for an additional 14 days at home, Japan said that passengers who had tested negative for coronavirus and showed no symptoms could leave starting this week.

On the subject of the passengers released untested, Mr. Kato said that public health officers who had been conducting the tests missed the 23 passengers as they went door to door.

“While they made their multiple rounds to take samples, some passengers left their rooms to go outside and do exercise or something,” he said, “so they were unavailable.”

A total of 634 people tested positive on board the cruise ship, and two passengers infected with the coronavirus have died.

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Reporting and research were contributed by Hannah Beech, Liz Alderman, Vivian Wang, Choe Sang-Hun, Elian Peltier, Donald G. McNeil Jr., Farnaz Fassihi, Amy Harmon, Steven Lee Myers, Elaine Yu, Marc Santora, Matt Philips, Niraj Chokshi, Amie Tsang, Keith Bradsher, Amber Wang, Yiwei Wang, Ed Wong, David Halbfinger and Derrick Bryson Taylor.

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‘All Hands on Deck’: Health Workers Race to Track Thousands of Americans Amid Coronavirus

Local health departments around the United States are scrambling to monitor thousands of people returning from travel in China and elsewhere. Among the tasks: daily calls, emails, texts.

By Amy Harmon and Farah Stockman | Published Feb. 22, 2020 Updated 11:13 a.m. ET | New York Times | Posted February 22, 2020 |

After a long journey at sea on the Westerdam cruise ship, which was denied entry at ports across Asia over fears of the coronavirus, Holley Rauen finally returned home to Florida on Wednesday night. Moments later, she discovered that she had joined a cast of thousands who are being meticulously tracked by local health officials across the United States.

As Ms. Rauen’s plane from overseas touched down, one message was already waiting on her phone, from a nurse at the local public health department in her Florida county. Should she develop a fever or cough over the next 14 days, she should report it immediately, the nurse explained when Ms. Rauen called back.

“I was so impressed,” said Ms. Rauen, who is herself a retired public health nurse from the same health department in Lee County. “We are really truly in uncharted waters.”

Preventing the spread of infectious disease is the essence of public health work, but the scale of efforts by state and local health departments across the country to contain the virus known as COVID-19, experts said, has rarely been seen. Since early February, thousands of people returning to the United States from mainland China, the center of the outbreak, have been asked to isolate themselves at home for 14 days.

Local health officials check in daily by email, phone or text. They arrange tests for people who come down with symptoms, and in some cases, groceries and isolated housing. There is no centralized tally in the United States of people being monitored or asked to remain in isolation, and they are scattered across the nation’s nearly 3,000 local health jurisdictions.

People arriving from mainland China are added each day, while those who have completed 14-day “self-quarantine” periods are released from oversight. In California alone, the department of public health has been monitoring more than 6,700 returning travelers from China, while health officials in Washington State have tracked about 800, and officials in Illinois more than 200.

The nationwide mobilization is taking a financial toll, health officials say. The cost to local health departments is unknown, but some experts say it has reached into the tens of millions. Even as the first of 34 confirmed coronavirus patients in the United States have recovered in recent days, health officials say they are preparing for what some fear could still be a much wider outbreak. Worldwide, the virus, which is known to be highly contagious, has infected 75,000 people and killed more than 2,000.

“All hands on deck are being pulled into this,’’ said Dr. Marcus Plescia, the chief medical officer for the Association of State and Territorial Health Officials, a nonprofit organization that represents public health agencies across the country. “If it really blows up, at some point, it could overwhelm state and local health departments.”

So far, officials say, the containment effort in this country has been largely orderly. The only known transmission of the virus in the United States has involved people in the same household. But no matter how effective health workers are in monitoring their charges, “there will always be some leakage,’’ said Dr. John Wiesman, the Secretary of Health in Washington State.

In Washington, where the first coronavirus patient in the United States was confirmed on Jan. 21, health officials tracked down and monitored 69 individuals with whom the man had come in contact, including work colleagues, health workers and other patients present in a clinic he visited when he first felt sick. Still, there have been issues. One person the man had been in contact with and who had developed symptoms of illness flew on a plane to Wisconsin during the 14-day period when she was supposed to be isolated at home.

“There is no way, with something this large, that you can make it seal-proof,’’ said Dr. Wiesman, who has started twice-weekly conference calls with the chief health officers in every state and territory to share tips and seek advice on how to manage the shifting challenges of the coronavirus response. While enforcing total compliance with isolation orders may not be possible, Dr. Wiesman said, “We have to try for 80 to 85 percent, and hopefully that will work.’’

Federal authorities are in charge of setting guidelines to manage the danger, such as deciding how much risk a returning traveler poses and who should be tested for the coronavirus. But the day-to-day work putting those policies in place and tracking thousands of people falls to the vast, decentralized network of local health departments across the country. Travelers’ data, culled from federal customs officials, is passed on to state health agencies, who farm out lists of people returning from China to local health departments.

In the Chicago area, public health officials are using an electronic monitoring system originally developed to track the measles to monitor more than 200 travelers. Each day, they receive a link asking their temperature and symptoms.

The costs associated with containing the virus have reached more than $150,000 a week for the Chicago public health department alone, according to its commissioner, Dr. Allison Arwady. Among the costs: $17,000 for a quarantine facility at an undisclosed location for people who can’t isolate themselves at home. So far, fewer than five people have used it, she said.

“If you are quarantining them under a legal order, you have to think about food, their medications, their communication needs and their mental health,” she said.

Some jurisdictions have negotiated with hotels to host people who may harbor the virus. Washington State has RV’s.

Ruth Jones, public health commissioner in Quincy, Mass., a town of about 100,000 people south of Boston, says that her department has been receiving lists of between three and 10 people each day who are returning from China and are being asked to stay isolated from other people. Quincy’s two public health nurses and two translators have been working long hours to call them and make sure they understand how to monitor and report any symptoms.

“It’s overtime for our nurses,’’ Ms. Jones said. “It’s been extremely busy,”

Local officials in places that have had confirmed cases have been under particular strain. In Madison and Dane County, Wis., a local health staff of 160 has been forced to rearrange its operation to focus on monitoring anyone who may have been exposed to a resident who tested positive for the virus after falling ill and remains in self-isolation.

“We’re in this new normal, but it’s not normal,” said Janel Heinrich, the county’s director of public health.

Along with monitoring individuals who are seen as at risk of having been exposed to the virus, state and local health officials have been scrambling to prepare for worst case scenarios in the months ahead. State officials in Washington said they will hold a webinar next week to brief school superintendents on best practices for cleaning and planning for home schooling should schools need to shut down.

“People are doing contingency planning,’’ said Julie Sullivan-Springhetti, spokeswoman for the Multnomah County Health Department in Oregon, which has devoted resources to preparing a regional hospital system for a potential case. “Just like we plan for the Cascadia earthquake, which may or may not happen in our lifetime.”

As for the returning passengers from the Westerdam, the cruise ship, passengers at first thought they had no reason to worry about the coronavirus because no one on the ship had traveled through mainland China during the outbreak. But after passengers began leaving the ship to head home, an 83-year-old woman was reported to have tested positive on a layover in Malaysia, creating confusion and chaos.

Erin Carney, 70, a retired nurse and midwife from Mendocino County, Calif., flew out on the same flight as the woman who was reported to have tested positive, though questions have been raised about that finding and the C.D.C. has since said that other passengers do not need to isolate themselves.

Given the initial reports of a positive test, Ms. Carney called hospitals to figure out what she and her partner should do.

“The person that we spoke to read the C.D.C. guidelines and thought that everything seemed fine and we didn’t have to self-quarantine,” Ms. Carney said. “They said, ‘If you have symptoms, go see your doctor.’”

But then a nurse from the Mendocino County Health and Human Services Department called Ms. Carney. She recommended that they quarantine themselves at home, and offered to supply groceries.

“We had kind of talked about doing that anyway,” Ms. Carney said. “They’ve called every day since.”

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Nicholas Bogel-Burroughs contributed reporting.

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With 4 Deaths in Iran and More Cases on 3 Continents, Fears of Coronavirus Pandemic Rise

Health officials called the surge in reported infections “very worrisome,” as cases soared in South Korea. Europe and North America reported a big uptick in infections.

By Vivian Wang, Donald G. McNeil Jr., Farnaz Fassihi and Steven Lee Myers| Published Feb. 21, 2020 Updated Feb. 22, 2020, 12:52 a.m. ET | New York Times |

HONG KONG — An alarming surge of new coronavirus cases outside China, with fears of a major outbreak in Iran, is threatening to transform the contagion into a global pandemic, as countries around the Middle East scrambled to close their borders and continents so far largely spared reported big upticks in the illness.

In Iran, which had insisted as recently as Tuesday that it had no cases, the virus may now have reached most major cities, including Tehran, and has killed at least four people, according to health officials. Already, cases of travelers from Iran testing positive for the virus have turned up in Canada and Lebanon.

The number of cases also soared in South Korea, with the sudden spread tied to a secretive church where hundreds of congregants attended services with numerous people infected with the virus.

The United States now has 34 cases, with more expected, and Italy experienced a spike from three cases to 17 and ordered mandatory quarantine measures.

“The cases that we see in the rest of the world, although the numbers are small, but not linked to Wuhan or China, it’s very worrisome,” Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, said Friday at a news conference at the agency’s headquarters in Geneva. “These dots are actually very concerning.”

As uneasiness about the breadth and duration of the outbreak grew, stocks fell for the second straight day on Friday amid worries the virus would drag down global demand and hurt the world economy.

The disturbing reports out of Tehran suggested the virus was being transmitted far more widely there than officials had previously acknowledged. While the country’s health officials confirmed only 18 cases by Friday, the number of deaths indicates the total is likely to be far higher.

Four reported deaths probably mean at least 200 cases, said Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. If the virus kills about 2 percent of known victims, as Chinese doctors have reported, then the number of deaths can be multiplied by 50 to get a rough case estimate, he explained.

“People don’t die right away of this virus — it usually takes two or three weeks after cases start to spread for the first death,” Mr. Osterholm said. “So there may be a lot more cases, and a lot more deaths on the way. And we didn’t even know there was a problem in Iran before yesterday.”

Minou Mohrez, who is on the infectious disease committee of the Iranian Health Ministry, told the official IRNA news agency on Friday that it was clear the virus was spreading across Iran’s cities.

“A coronavirus epidemic has started in the country,” she said. “It’s possible that it exists in all cities in Iran.”

A spokesman for the Health Ministry, Kianush Jahanpur, said on Friday there were more than 735 people hospitalized with flulike symptoms who were being tested for the virus.

Kuwait’s civil aviation authority on Friday stopped all flights to and from Iran, which shares a long border with both Afghanistan and Iraq, where health officials have a limited capacity to stop the spread of the virus should it find its way to those countries.

Dr. Sylvie Briand, the director of infectious hazards management for the W.H.O., said the rapid increase in cases in Iran was disquieting.

“We are wondering what the extent of the outbreak in Iran is,” she told reporters on Friday. “We are wondering about the potential for more cases to be exported in the coming days. We want all countries to be aware of this and to put in place detailed measures to pick up these cases as early as possible.”

As concern grew that Iran was emerging as an important new vector of transmission, the country where the coronavirus originated was also responding to significant negative developments.

Officials in China, already straining to deal with an outbreak that has infected more than 76,000 people and resulted in 2,300 deaths, announced a new front in its war on the virus on Friday as officials reported clusters of infections in at least four prisons in three provinces.

The outbreaks, affecting at least 512 prisoners and guards, raised the specter of the disease spreading through the country’s extensive prison system.

More than 200 of the infections occurred in one prison in the city of Jining, 450 miles east of Wuhan, the capital of Hubei Province and the center of the outbreak; officials there suggested that the cluster may have been tied to a prison guard.

In South Korea, the total number of cases surpassed 340 on Saturday morning, and the authorities were racing to trace all the people who had come in contact with members of the Shincheonji Church of Jesus. Members of that church, along with their relatives and others who got the virus from them, account for more than half of the country’s confirmed infections.

More than 1,250 other church members have reported potential symptoms, health officials said, raising the possibility that the nation’s caseload could skyrocket.

As of Saturday, more than 700 members of Shincheonji, which mainstream South Korean churches consider a cult, still could not be reached, according to health officials, who were hoping to screen them for signs of infection.

In response, the government is shutting thousands of day-care facilities and community centers, even banning the outdoor political rallies that are a feature of life in downtown Seoul.

All four virus-related deaths in Iran occurred in Qom, a holy city popular with Shiite pilgrims across the Middle East.

People have already tested positive in Qom, Tehran and Gilan, near the Caspian Sea, said Mr. Jahanpur, the Health Ministry spokesman.

“Most of these people were residents of Qom or they had traveled to Qom in the past days or weeks,” he said.

In Qom, schools and religious seminaries were shut down on Thursday as officials urged people to avoid gathering in large groups. But on Friday, as Iranians went to vote in parliamentary elections, polling stations were open and the communal pools of ink for people to dip their fingers proving they voted were in wide use.

With rumors spreading across the country on instant messaging services like Telegram, a confused and increasingly worried public watched as Tehran’s largest metro station was suddenly closed. Workers wearing protective gear descended on the station, apparently responding to reports of sick commuters. It remained closed Friday night.

There was growing skepticism over the government’s handling of the outbreak. Mahmoud Sadeghi, an outspoken member of Parliament from Tehran, accused the government of “covering up the spread of an epidemic.”

While the source of the outbreak in Iran could not be pinned down, officials speculated that it began in the large population of Chinese workers in the country.

Critics accused the government of playing down the disease, and failing to take strict precautions to prevent its arrival in the country, in order to avoid provoking China, a key trading partner and a lifeline for Iran’s economy in the face of U.S. sanctions.

The sanctions against Iran could hamper its ability to contain the spread of the virus and diminish the country’s ability to mobilize international support.

“Iran does have problems accessing specialized medication for rare and special diseases because of sanctions — either private companies or banks refuse to work with Iran in fear of U.S. secondary sanctions,” said Tara Sepehri Far, an Iran researcher at Human Rights Watch.

The new global clusters showed, again, the difficulty in judging the true number of infections, amid concerns about underreporting and rapidly shifting definitions of confirmed cases.

Further bolstering the idea that the virus is spreading widely, an epidemiological modeling team from Imperial College in London estimated Friday that two-thirds of the people infected with coronavirus who left mainland China before restrictions were imposed had traveled throughout the world without being detected.

The team, one of several modeling groups regularly consulted by the W.H.O., calculated how many cases were detected in different countries and how many should have been detected based on flights that left Wuhan just before most air travel out of China ended.

Detection failures “potentially resulted in multiple chains of as-yet-undetected human-to-human transmission,” the modeling team’s study concluded.

The virus is spreading even in places that might be expected to have the closest monitoring and prevention. In Beijing, a spike in cases at two hospitals raised fears that the epidemic could be growing in a city so far largely exempt from extensive infections.

The infections — and in some cases, deaths — of medical workers have become a potent symbol of the epidemic’s toll for many Chinese. On Thursday, another doctor in Wuhan died. The doctor, Peng Yinhua, 29, had postponed his wedding to continue treating patients, according to local news reports.

Earlier this week, a high-profile doctor, Liu Zhiming, the director of the Wuchang Hospital in Wuhan, died.

The almost random nature of new reports and new deaths is an indication the virus is moving much faster than countries are reporting to the W.H.O., Dr. Osterholm said.

“How many of these clusters and travel cases and prison outbreaks do we have to see before we realize that we’re just seeing the tip of the iceberg?” he said. “Testing is just getting set up around the world. There’s barely any in Africa right now. Even in the U.S., we’re testing travel cases — but we’re not testing in any meaningful way that will pick up cases that we didn’t suspect were there.”

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Vivian Wang reported from Hong Kong, Donald G. McNeil Jr. and Farnaz Fassihi from New York, and Steven Lee Myers from Beijing. Marc Santora contributed reporting from London and Choe Sang-Hun from Seoul, South Korea.

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