TOKYO — Borders are closing and flights are being canceled as coronavirus rapidly takes root in China and spreads around the world, with approximately 14,500 people diagnosed globally, according to the most recently released official figures.

Inside China, business and the economy have ground to a halt, as hundreds of millions of people hunkered down in their homes. The virus-hit central province of Hubei is desperately short of medical supplies and hospitals are overwhelmed.

As concern and anger mounts, Chinese President Xi Jinping is keeping a low profile.

The Philippines on Sunday reported the first death of a coronavirus patient outside of China — a 44-year-old man who died Saturday. The man and a previously diagnosed patient in the Philippines were “close contacts,” according to the World Health Organization’s Philippines branch.

The man who died was a resident of Wuhan, the Chinese city of 11 million people where the outbreak began, officials said. He had a fever, cough and sore throat before he was admitted to a hospital.

The United States confirmed its eighth case on Saturday, after a man connected to the University of Massachusetts at Boston who recently traveled to Wuhan was diagnosed with the virus. Massachusetts’s Department of Public Health said in a statement that the patient, who is in his 20s, has been in isolation since shortly after his return and that his close contacts are being monitored.


On Friday, the United States imposed unprecedented travel restrictions on movements to and from China, denying entry to foreign nationals who had recently visited the country — apart from permanent residents and relatives of U.S. citizens — and imposing a 14-day quarantine on returning American citizens.

The Department of Defense said that it would provide housing support for 1,000 people who might need to be quarantined when they arrive in the United States from overseas. Military installations in Colorado, California and Texas were chosen to potentially provide housing.

The State Department told Americans not to travel to China, and dozens of countries followed suit. Australia imposed similar restrictions, while Russia said that its armed forces would start evacuating citizens Saturday.

Japan has imposed less stringent but nevertheless remarkable measures, barring any foreigners who had visited the virus-hit city of Wuhan in the past two weeks and any Chinese person whose passport was issued by the provincial government of Hubei. Concerns were also mounting in Japan that the virus could disrupt the Summer Olympics set to take place in Tokyo in July and August.

In Hong Kong, however, the government hasn’t closed its border or halted transport links with mainland China — one of the only territories bordering China that has not taken such a step. On Saturday, a pro-democracy union representing thousands of medical workers in Hong Kong voted overwhelmingly in favor of a strike starting Monday, hoping to pressure the Hong Kong government to completely closing the border with mainland China. More than 3,100 members voted in favor of the strike and only 10 voted against.

North Korean leader Kim Jong Un — in a rare move for a country that has generally been on the receiving end of foreign aid — on Saturday sent a consolation letter to Xi in support of the country’s fight against the coronavirus outbreak.


The official Korea Central News Agency, or KCNA, said Kim conveyed in the letter sincere wishes to “share the suffering and trial of the fraternal Chinese people” and had sent aid to China. The isolationist country has also sealed its border with China as scores of virus cases have been confirmed in provinces along the Sino-North Korea border.

A growing list of airlines have already canceled flights to China, while the union representing flight attendants in the United States asked the Trump administration to halt all flights to China. Nearly 10,000 flights have been canceled since the start of the outbreak, travel data analytics firm Cirium said.

But as governments battened down the hatches, the virus continued to spread around the globe, with more than a dozen cases each in Thailand, Singapore, Japan and South Korea, as well as everywhere from Finland to Australia. The United Kingdom confirmed two cases Saturday.

The spread around China is also a major concern, experts said, with more than 150 cases in Shanghai and nearly 140 in Beijing. And recent analyses suggest that Chinese officials potentially could have controlled the virus sooner if they had been more transparent about the potential severity of the outbreak.

In a study published by the Lancet medical journal Friday, three experts from the University of Hong Kong warned that the epidemic may already be “growing exponentially” in multiple cities around China with a time lag behind the Wuhan outbreak of one to two weeks.

“Large cities overseas with close transport links to China could also become outbreak epicenters, unless substantial public health interventions at both the population and personal levels are implemented immediately,” the study warned.


“Independent self-sustaining outbreaks in major cities globally could become inevitable because of substantial exportation of presymptomatic cases and in the absence of large-scale public health interventions.”

The Chinese government effectively closed down the entire province of Hubei on Jan. 23, but not before an estimated 5 million people had already left Wuhan, the provincial capital. Evidence that people who have caught the virus may be infectious before symptoms are obvious has added to concerns.

Meanwhile, the pain for the Chinese economy is mounting, with Beijing, Shanghai and many other provinces telling nonessential businesses to remain closed until Feb. 9 and major international hotels empty.

The streets of Beijing, typically quiet during the Lunar New Year holiday, would normally have returned to life by now. Instead, they remain largely deserted, with few people taking public transport, restaurants and stores closed, and reminders for returning workers to register and quarantine themselves at the entrance to every residential compound.

The start of the spring semester at universities and schools has been postponed indefinitely, while national railway traffic on Friday and Saturday was down nearly 80% from a year earlier, official figures published by Chinese media showed.

It’s increasingly clear that life will not return to normal soon.


Even if the outbreak is quickly contained, economic growth “will show sharply in early 2020,” the PNC Financial Services Group wrote in a report. “The crisis will most directly hit China’s economy by reducing discretionary consumer spending, and secondarily through government restrictions on economic activity.”

PNC predicts a sharp recovery in the economy if the government gets the crisis under control in the second quarter and unleashes a new round of stimulus spending. But Bill Bishop, a longtime observer of China, warned that there is a lot more debt in the Chinese economy than in 2002, when it was hit by an outbreak of SARS, or severe acute respiratory syndrome, but bounced back.

“The financial system is likely to come under extreme pressure in the coming weeks and if the Party cannot get the outbreak under control and restore confidence quickly there is a small but greater than zero chance we could see an economic heart attack alongside this virus,” he warned in his Sinocism newsletter.

Xibei, a Chinese restaurant chain with over 400 stores in some 60 cities, says most of its restaurants remain closed, with only around 100 open to take online orders. Director Jia Guolong told the China Venture website that the company still has to pay over 20,000 employees, half of whom are staying in dormitories and the rest are having an extended holiday at home, and probably only had enough cash flow to cover another three months.

“We are among the better performing ones in this industry. So what about the worse off?” he asked. “We can ask for loans and … take care of another three months of payrolls, but what can other brands and companies do? They might just give up, stop making payments, or even shut down. And the last option would be firing all those workers.”

Apple announced Saturday it would close all of its stores, offices and contact centers in mainland China until at least Feb. 9, “based on the latest advice from leading health experts.”


In Hubei, the information that is trickling out suggests the crisis remained extremely severe, with patients being turned away from hospitals because of a shortage of beds or staying home and avoiding hospitals even when they do fall sick.

“The majority of people are now confined to their homes,” citizen journalist Chen Qiushi said in a video posted on YouTube.

“If there’s no transportation, how are you going to get to the hospital? And when you get there, you don’t get admitted. So what’s the point of going to the hospital if you can’t get diagnosed?”

Other Wuhan residents said the same thing: that people were reluctant to go to hospital even if they fall sick, because they felt the chances of treatment were low and the risk of contracting the virus was high.

Chinese authorities are racing against time to build two new hospitals on the outskirts of Wuhan, which were expected to open within the next week and provide an additional 2,500 beds. Other cities around China including Beijing were following suit.

But the shortage of medical supplies in Hubei remains acute, with the city of Erzhou issuing an “urgent appeal” on its social media account.


“Designated hospitals in our city are in urgent need of medical suits, N95 masks, surgical masks, goggles, protective masks and protective suits,” it wrote. “Now we appeal to the society and citizens for love donations. Urgent need! Urgent need! Urgent need!”

A doctor in Wuhan was quoted as complaining that his hospital had not received anything from the Chinese Red Cross and was quickly running out of supplies.

“Fortunately we got a batch of donations from America, 500 U.S. (FDA) standard N95 masks,” he was quoted as saying in a report. “It made us so happy because we could last one more day!”

Chen, the citizen journalist who traveled to Wuhan, said there was a shortage of masks, protective clothing and most importantly virus test kits, while every hospital he visited said it did not have enough beds.

“There were people lying on benches, there were extra beds in the corridor, extra beds at the door of the bathroom, 60 to 70% of the people were on oxygen,” he said.

“Some were lying on benches getting their drip, people in a better condition would park their cars in the parking lot and hang a drip from a nearby branch. Those who don’t have a car would sit outside in the open air on the steps with a drip in such cold weather.”


Chen said he had spoken to people who had visited five or six hospitals but had not been able to get tested.

“There’s no point in lying there with all those other people if you can’t get seen by a doctor. That’s why so many people are just ‘suspected cases’ at home,” he said.

Even outside Wuhan, getting a quality face mask is becoming increasingly tough to source in many parts of China, local media reported.

The coastal city of Xiamen launched an online lottery for masks on Friday while Shanghai is rationing masks to a limit of five per household, with buyers required to register with local neighborhood authorities and buy from specified pharmacies.

The Communist Party has launched an extraordinary call for its members to step up to the front lines and relieve overworked medical staff. On Saturday, the Global Times, a party-controlled newspaper, tweeted that 337 officials in the city of Huanggang have been punished “for slacking off from their duty” in the fight against the outbreak. Six of them lost their jobs, the English-language outlet reported.

Bishop noted that Xi has been keeping a relatively low profile as anger mounts, not appearing on the front page of the Thursday, Friday or Saturday People’s Daily, nor on the Thursday or Friday CCTV Evening News broadcasts on state China Central Television, apart from an unrelated report on an article he has written on protecting Chinese culture.

“Now is not the time for the people’s leader to disappear from the view of the people,” he said.

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O’Grady and Iati reported from Washington. The Washington Post’s Lyric Li, Liu Yang and Wang Yuan in Beijing, Shibani Mahtani in Hong Kong and Min Joo Kim in Seoul contributed to this report.