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First coronavirus death in Hong Kong as four cities are locked down

<span>Photograph: Anadolu Agency/Anadolu Agency via Getty Images</span>
Photograph: Anadolu Agency/Anadolu Agency via Getty Images

Hong Kong reported its first death from the coronavirus and four major Chinese cities hundreds of miles from the centre ordered lockdowns as concerns about the spread of the disease mounted.

The country’s leadership admitted “shortcomings” in its handling of the outbreak, with the number of infections and deaths still mounting daily. The death toll inside China has passed 420 and Britain has advised its citizens to leave the country.

A 39-year-old man with an underlying health condition died in Hong Kong on Tuesday morning, according to the public broadcaster RTHK.

His death is the second outside the mainland after a Chinese national from Wuhan was confirmed on Sunday to have died in the Philippines.

China announced 64 more deaths on Tuesday – surpassing Monday’s record to confirm the biggest daily increase since the virus was detected late last year in the central province of Hubei.

What is the virus causing illness in Wuhan?

It is a member of the coronavirus family that has never been encountered before. Like other coronaviruses, it has come from animals, or possibly seafood. New and troubling viruses usually originate in animal hosts. Ebola and flu are examples.

What other coronaviruses have there been?

Severe acute respiratory syndrome (Sars) and Middle Eastern respiratory syndrome (Mers) are both caused by coronaviruses that came from animals.

What are the symptoms of the Wuhan coronavirus?

The virus causes pneumonia. Those who have fallen ill are reported to suffer coughs, fever and breathing difficulties. In severe cases there can be organ failure. As this is viral pneumonia, antibiotics are of no use. The antiviral drugs we have against flu will not work. If people are admitted to hospital, they may get support for their lungs and other organs as well as fluids. Recovery will depend on the strength of their immune system. Many of those who have died are known to have been already in poor health.

Is the virus being transmitted from one person to another?

Human to human transmission has been confirmed by China’s national health commission. As of 3 February, 361 people have died in China, and one in the Philippines. Confirmed infections in China are 17,238, and the official Chinese figures include Taiwan, Hong Kong and Macau. Outside of China, infections stand at more than 150.

Two members of one family have been confirmed to have the virus in the UK, after more than 160 were tested and found negative. The actual number to have contracted the virus could be far higher as people with mild symptoms may not have been detected. Modelling by World Health Organization (WHO) experts at Imperial College London suggests there could be as many as 100,000 cases, with uncertainty putting the margins between 30,000 and 200,000.

How worried are the experts?

There were fears that the coronavirus might spread more widely during the week-long lunar new year holidays, which start on 24 January, when millions of Chinese travel home to celebrate, but the festivities have largely been cancelled and Wuhan and other Chinese cities are in lockdown.

At what point should you go to the doctor if you have a cough, say?

Unless you have recently travelled to China or been in contact with someone infected with the virus, then you should treat any cough or cold symptoms as normal. The NHS advises that there is generally no need to visit a doctor for a cough unless it is persistent or you are having other symptoms such as chest pain, difficulty breathing or you feel very unwell.

Should we panic?

No. The spread of the virus outside China is worrying but not an unexpected development. It increases the likelihood that the World Health Organization will declare the outbreak to be a public health emergency of international concern on Thursday evening. The key concerns are how transmissible this new coronavirus is between people and what proportion become severely ill and end up in hospital.

Sarah Boseley Health editor and Hannah Devlin

The virus has killed at least 426 people, exceeding the 349 mainland deaths from the severe acute respiratory syndrome (Sars) outbreak of 2002-03, which killed nearly 800 globally.

The total number of infections in China also rose, to more than 20,000. The World Health Organization (WHO) has declared the crisis a global health emergency, with at least 151 cases in 23 other countries and regions.

The vast majority of cases are still concentrated in and around Wuhan, the Hubei provincial capital, which has been on lockdown for nearly two weeks. But with increasing numbers of infections registered in other parts of China, some of the worst-hit areas are also bringing in radical measures.

Several cities in Zhejiang, a coastal province with a strong trade and manufacturing heritage, have shut schools, businesses, markets and shopping centres, cut off most public transport and barred residents from leaving their homes except to buy necessities or seek medical treatment.

The coastal city of Wenzhou, hundreds of miles east of Wuhan, was the first to bring in “special measures”, Reuters reported. On Sunday it had 291 confirmed cases of coronavirus, the highest number of any city outside Hubei.

Since then the city of Taizhou, and several districts in the cities of Ningbo and historic Hangzhou have also been locked down. They include the base of the Chinese tech giant Alibaba, city officials said.

The virus is taking an increasing economic toll, shutting businesses, curbing international travel and affecting production lines of global brands.

China’s currency and stock markets steadied in choppy trade after anxiety over the virus hit the yuan on Monday and erased about £308bn in market value from Shanghai’s benchmark index. Macau, the world’s biggest gambling hub, said it had asked all casino operators to suspend operations for two weeks to help curb the spread of the virus.

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Wuhan, a bustling industrial hub where the virus first infected humans, has been turned into a near ghost town as a de facto quarantine continues.

Residents say they are unable to find hospitals to care for their sick relatives. Several hospitals require patients to first get a referral from local community health centres, many of which are also overwhelmed. As the city remains under lockdown, with public transport and roads shut, people are also struggling to get to health facilities.

Authorities have been racing to build two hospitals to treat the infected. The first of those – a 1,000-bed facility – began to receive patients on Monday, the People’s Daily reported, only 10 days after construction began. A second hospital is due to open this week.

Authorities in Wuhan have also started converting a gymnasium, exhibition centre and cultural complex into makeshift hospitals with more than 3,400 beds for patients with mild infections, the official Changjiang Daily said.

As the crisis has developed, people from Wuhan and Hubei have faced increasing discrimination in other parts of the country. Many say they have been kicked out or turned away from hotels.

Passengers on a flight from Japan to Shanghai in late January reportedly refused to board a flight that had passengers from Wuhan on it. Neighbourhood committees have placed signs on the doors of those recently returned from the province advising other residents not to visit them.

Experts say much is still unknown about the pathogen. The mortality rate for the new coronavirus is lower than the 9.6% rate for Sars, but it appears to be more contagious. Reports of deaths not counted in official statistics have also cast doubt on the mortality rate.

Such uncertainties have spurred extreme measures by some countries to stem the spread. On Tuesday the UK urged all its citizens to leave China if they can, while Australia sent hundreds of evacuees to a remote island in the Indian Ocean, and Japan ordered the quarantine of a cruise ship with more than 3,000 onboard after a Hong Kong man who sailed on it last month tested positive for the virus.

There have been 15 confirmed cases in Hong Kong, where authorities announced new border closures after hundreds of medical workers went on strike on Monday over the government’s refusal to stop travellers from mainland China.

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Late on Monday, China’s elite Politburo Standing Committee called for improvements to the “national emergency management system” following “shortcoming and difficulties exposed in the response to the epidemic”.

The Chinese president, Xi Jinping, who led the meeting, said the outbreak was a “major test” of China’s system and ability to govern.