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The death toll of the coronavirus outbreak has surpassed 3,300, with nearly 98,000 people infected. China has seen a drop-off in its rate of new cases, but the virus has gained momentum in other parts of the globe.
As of Thursday, the coronavirus — which causes a disease known as COVID-19 — has spread to every province and region in China as well at least 86 other countries. At least 335 people have died outside of mainland China.
The US has reported at least 224 cases, including 46 passengers who were on the Diamond Princess cruise ship that was quarantined in Japan. The country has confirmed 12 coronavirus deaths: 11 in Washington state and one in California.
The World Health Organization considers the outbreak an international public-health emergency and warned that the window of opportunity to contain it is narrowing.
Here's everything we know.
SEE ALSO: The US has reported 12 coronavirus deaths among at least 224 cases. Here's what we know about the US patients.
DON'T MISS: Here are the symptoms of the deadly Wuhan coronavirus and when you should be worried
The coronavirus has killed 3,348 people.
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"The people who are likely to die first will have other illnesses," Adrian Hyzler, the chief medical officer at Healix International, which offers risk-management solutions for global travelers, told Business Insider.
Indeed, most patients who have died were elderly or otherwise unwell, according to Chinese officials.
It had infected at least 97,886 people as of Wednesday.
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The vast majority of cases, about 83%, are in China.
This chart shows the rate at which the coronavirus has spread.
The virus' global fatality rate has hovered around 3.4% for about a week.
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The World Health Organization announced that the estimated death rate was 3.4% on Tuesday, though some health experts predict it could ultimately be lower as more cases get reported.
A previous study from the Chinese Center for Disease Control and Prevention found a fatality rate of 2.3%.
Cases have been confirmed in at least 86 countries beyond China.
Outside of China, cases have been reported in:
- Afghanistan
- Algeria
- Andorra
- Argentina
- Armenia
- Australia
- Austria
- Azerbaijan
- Bahrain
- Belarus
- Belgium
- Bosnia and Herzegovina
- Brazil
- Cambodia
- Canada
- Chile
- Croatia
- Czech Republic
- Denmark
- Dominican Republic
- Ecuador
- Egypt
- England
- Estonia
- Faroe Islands
- Finland
- France
- Gibraltar
- Georgia
- Germany
- Greece
- Hungary
- Iceland
- India
- Indonesia
- Iran
- Iraq
- Ireland
- Israel
- Italy
- Japan
- Jordan
- Kuwait
- Latvia
- Liechtenstein
- Lithuania
- Lebanon
- Luxembourg
- Malaysia
- Mexico
- Monaco
- Morocco
- Nepal
- The Netherlands
- New Zealand
- North Macedonia
- Nigeria
- Norway
- Oman
- Pakistan
- Palestine
- The Philippines
- Poland
- Portugal
- Qatar
- Romania
- Russia
- Saint Barthelemy
- San Marino
- Scotland
- Senegal
- Singapore
- Slovenia
- South Africa
- South Korea
- Spain
- Sri Lanka
- Sweden
- Switzerland
- Taiwan
- Thailand
- Tunisia
- United Arab Emirates
- Ukraine
- US
- Vietnam
The US has reported at least 224 coronavirus cases in total, including 49 repatriated citizens.
"We are asking the American public to prepare for the expectation that this might be bad," Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, said in a press briefing last week.
Twelve deaths have been confirmed in the US — 11 in Washington state and one in California.
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The most recent US death from the coronavirus was reported in King County, Washington. County health officials confirmed the victim was a woman in her 90s.
The first death — a man in his 50s who had chronic underlying health issues — was reported on Saturday at EvergreenHealth, a hospital in King County.
Two deaths announced March 3 were actually patients who died February 26, but their coronavirus diagnoses weren't confirmed until later. They are now the earliest known coronavirus fatalities in the US.
The California death, announced March 4, was a Placer County patient who traveled on a Grand Princess cruise ship in February. The ship went from San Francisco to Mexico, and another person who was onboard at the same time has also tested positive.
"While we have expected more cases, this death is an unfortunate milestone in our efforts to fight this disease, and one that we never wanted to see," Aimee Sisson, Placer County's health officer, said in a statement.
The US has recorded several cases of "community spread"— patients who had no known exposure to the virus or travel history in China.
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Sixteen US states have reported coronavirus cases in total, though in Nebraska, the infections are only among repatriated citizens.
Forty-six of the US patients were passengers on the Diamond Princess cruise ship in Japan.
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On February 17, more than 300 Americans who had been quarantined on the Diamond Princess cruise ship in Japan were brought back to the US. Fourteen sick people were flown on the same plane as healthy people (though they were kept isolated), and many others on the flight later tested positive. Everyone who was on the cruise was quarantined at US military bases for two weeks. Many were released on Monday.
Health experts and US officials have criticized the decision to quarantine people on the ship, suggesting that the confined spaces and poor hygiene practices on board may have helped the virus spread.
Three US citizens who were evacuated from Wuhan and put under quarantine also tested positive for the virus.
The World Health Organization said last week that the virus has "pandemic potential."
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The WHO declared the coronavirus outbreak a global public-health emergency on January 30. For now, the organization doesn't recommend limiting the movement of travel or trade.
The global-health emergency declaration has been used five times since it was created in 2005.
"They only do this for extraordinary illnesses that are of international concern," Hyzler said. "Suddenly the world is alerted to a much greater extent and they'll start pouring a lot more assistance and aid to airports, to transport hubs, and do their best to control this outbreak."
The WHO said the virus isn't yet a pandemic.
"Does this virus have pandemic potential? Absolutely, it has. Are we there yet? From our assessment, not yet," WHO Director-General Tedros Adhanom Ghebreyesus told reporters.
The first case of the coronavirus was reported in Wuhan in December.
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The central Chinese city has a population of 11 million.
The virus' pneumonia-like symptoms include fever and difficulty breathing.
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According to the Centers for Disease Control and Prevention, a person is at risk if they:
- Experience fever, coughing, or shortness of breath within 14 days of traveling to China
- Have come into close contact with someone who has shown these symptoms and recently traveled to China
The study from the Chinese CDC showed that patients older than 80 have a 15% chance of dying.
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The study looked at 44,000 confirmed patients in China. The data suggests that patients in their 50s were about three times more likely to die than patients in their 40s.
Coronavirus patients with underlying health problems are also more likely to die than otherwise healthy people.
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Patients with heart disease had a 10% chance of dying, according to the study. The fatality rate for patients who reported no pre-existing conditions was less than 1%.
Chinese and US health officials both say the incubation period for the virus ranges from one to 14 days.
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Many countries have formulated quarantine policies based on a 14-day incubation period — the amount of time that passes between when a patient gets infected and when their coronavirus test comes back positive.
But one recent study revealed that a patient's incubation period was 19 days. Another study published early in February analyzed 1,099 coronavirus cases in China and reported that incubation period could be as long as 24 days.
A female tour guide in Japan tested positive for the virus a second time last month — evidence that people could get the coronavirus multiple times.
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The patient — as a woman in her 40s living in Osaka, Japan — first tested positive for the virus on January 29. She was discharged from the hospital on February 1 and declared virus-free on February 6.
Nearly two weeks later, she developed throat and chest pains. She tested positive again on February 26. China has also reported cases of people getting reinfected.
Few children have gotten sick, but Chinese authorities reported that a baby received a diagnosis just 30 hours after being born.
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Other one-off cases of the virus in children include a 9-month-old girl in Beijing, a child in Germany whose father had the virus as well, and a child in Shenzhen who was infected but displayed no symptoms.
But the virus seems to affect mostly adults. A study published in late January speculated that "children might be less likely to become infected or, if infected, may show milder symptoms" than adults.
Disease experts say it's good that the virus hasn't spread much among kids because children are less likely to wash their hands and cover their mouths — behaviors that can spread germs.
Nearly 3,400 Chinese healthcare workers have been infected. At least 13 have died.
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Research published in February found that nearly a third of hospitalized patients studied at the Zhongnan Hospital of Wuhan University were healthcare workers.
On February 7, Li Wenliang, a doctor in Wuhan who was censored after sounding the alarm about the coronavirus, died from the disease. The 34-year-old doctor alerted a group of alumni from his medical school about a worrisome pneumonia-like illness in December. But Li was silenced by the police in Wuhan and forced to sign a letter saying he was "making false comments."
He later caught the coronavirus and died. In total, at least 13 healthcare workers have died from COVID-19. Neurosurgeon Liu Zhiming, a director at the Wuchang hospital in Wuhan, also died of the coronavirus, as did Peng Yinhua, a 29-year-old doctor who postponed his wedding to help treat patients.
The CDC has issued a warning to avoid all nonessential travel to China, South Korea, Italy, and Iran.
The virus has forced school closures in China, Japan, India, the US, Iran, and Italy. The UN warned on Wednesday that nearly 300 million kids have had their education disrupted.
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Japan has closed all elementary, junior high, and high schools until early April.
On Thursday, Iran announced it was closing schools and universities until at least March 20, and India announced closures of all primary schools up to 5th grade through March 31. A day earlier, Italy said it was closing all schools as well.
One coronavirus case in New York — a 50-year-old attorney who infected nine other close contacts— has prompted some school closures in Manhattan, the Bronx, and Westchester. One of Washington state's largest school districts, Northshore, moved its classes online for two weeks starting Thursday, after a parent volunteer tested positive for the virus.
Tourist attractions around the world have been shuttered temporarily.
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Shanghai Disneyland, Hong Kong Disneyland, and Tokyo Disneyland have all been shuttered, though the Tokyo park plans to reopen on March 16. The Badaling section of the Great Wall is temporarily closed as well.
The Church of the Nativity in Bethlehem closed on Thursday for two weeks. The Louvre also closed for three days but reopened on Wednesday.
A senior member of the International Olympic Committee said the future of the Tokyo Games could be in jeopardy.
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IOC member Dick Pound told the Associated Press that a decision about the games will likely come in May. For now, he added, athletes should continue training.
"As far as we all know, you're going to be in Tokyo," Pound said. "All indications are at this stage that it will be business as usual. So keep focused on your sport and be sure that the IOC is not going to send you into a pandemic situation."
The CEO of the Olympic organizing committee, Toshiro Muto, told CNN on Wednesday that that officials intend for the games to go on as planned.
South Korea's total cases have surpassed 6,000.
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South Korea has confirmed 6,088 infections and 35 deaths as of Thursday.
The nation saw a spike in coronavirus cases after a 61-year-old woman transmitted the virus to other members of a fringe religious group, the controversial Shincheonji Church of Jesus.
On February 23, South Korean president Moon Jae-in warned that the country faced "a grave turning point" in its efforts to contain the outbreak.
Iran has reported 107 deaths — the same number as Italy.
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Italy and Iran have highest number of coronavirus deaths outside of China. Sources from Iranian hospitals told the BBC that the death count in Iran could be even higher: around 210.
The total number of infections in Iran has reached 3,513.
Multiple senior Iranian officials have contracted the virus. Mohammad Mirmohammadi, a 71-year-old adviser to Iranian supreme leader Ayatollah Ali Khamenei, died of the virus on Monday.
Iran's parliament is now closed.
Iranian President Hassan Rouhani signed an order last week that banned public gatherings like weddings, concerts, and sports games. The ban is slated to lift in time for the Persian New Year on March 20.
Some Middle Eastern countries — including Afghanistan, Armenia, Azerbaijan, Iraq, Kuwait, Pakistan, and Turkey — have restricted travel to and from Iran.
Italy banned public events in 11 towns, closed public buildings, and restricted transport in the country's northern region.
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The country's case total has reached 3,089, and 107 people have died.
"We are asking basically that everyone who has come from areas stricken by the epidemic to remain under a mandatory house stay," Italy's health minister, Roberto Speranza, said in a press conference on February 22.
On Wednesday, the Italian government prohibited fans from attending sporting events until April 3.
Switzerland, which has 95 infections so far, has banned all public and private events with more than 1,000 attendees until March 15.
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"The Federal Council is aware that this measure will have a significant impact on public life in Switzerland," the Swiss government said in a statement on February 28. "However, the move is expected to provide effective protection to people in Switzerland and to public health. It should prevent or delay the spread of the disease in Switzerland, thus reducing its momentum."
China has changed the way its cases are counted multiple times.
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On February 13, the Hubei province's health commission added 14,800 people to its list of cases and reported 242 additional deaths — an enormous single-day jump. The commission said the spike was due to a change in the way cases were counted: The newer numbers included clinical diagnoses made via CT scans of patients' lungs in addition to lab-test results.
On February 20, however, the commission went back to only counting lab-confirmed cases.
The true number of infected people worldwide is probably still higher than the official total, since people with very mild symptoms are not going in to hospitals or doctor's offices.
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"There's another whole cohort that is either asymptomatic or minimally symptomatic," Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases, said in a February 6 briefing.
Once more mild cases are tallied and incorporated into models, he added, "we're going to see a diminution in the overall death rate."
The Trump administration has imposed a travel ban on foreign nationals who have been in China within the past 14 days.
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The ban went into effect February 2, with exceptions made for immediate family members of American citizens and permanent residents.
US citizens returning home who have been in China's Hubei province — where Wuhan is located — within the past 14 days may be quarantined for up to two weeks.
To prevent the spread of the coronavirus, all travelers should wash their hands frequently with soap and water, making sure to scrub for at least 20 seconds, the CDC says.
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Travelers should also avoid touching their eyes, nose, or mouth with unwashed hands. Wearing a mask is unlikely to be your best defense, however.
Some experts think the coronavirus jumped from animals to people at a seafood market in Wuhan. But a recent study suggested the virus could have originated outside the market in late November or early December.
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Since most of the early patients had links to one market where live animals were sold, scientists pinpointed it as the likely origin point of the virus.
But a group of Chinese scientists recently published a study suggesting that the virus could have started somewhere else. Though the first 41 cases were reported on December 31, the scientists determined that the virus could have started spreading from person to person as early as late November. The seafood market in Wuhan, they wrote, may have "boosted" the circulation of the virus.
Researchers think the new coronavirus originated in bats, then jumped to an intermediary species — most likely pangolins, pigs, or civets — that passed it to people.
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Researchers at the South China Agricultural University have suggested that the endangered pangolin may have been the intermediary species between bats and people.
An earlier paper in the Journal of Medical Virology suggested that the virus might have jumped from bats to snakes to humans, but that's unlikely. Cui Jie, a virologist who helped identified SARS-related viruses in bats in 2017, said the strain from Wuhan was clearly a "mammalian virus."
SARS also originated in bats. It jumped to humans from civet cats a Chinese market that sold live animals. SARS killed 774 people from November 2002 to July 2003.
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COVID-19 is more contagious but less deadly than SARS. The two belong to the same coronavirus family.
The total number of cases and deaths have far surpassed those of the SARS outbreak.
Chinese officials have warned that the virus can mutate.
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A study of a Chinese family in the southern province of Guangdong found that the virus mutated several times as it spread from one family member to the next.
But Michael Farzan, a biologist at Scripps Research, told STAT that the mutation rate for the virus is "much, much lower" than that of the flu.
"That lowers the chance that the virus will evolve in some catastrophic way to, say, become significantly more lethal," Farzan said.
In late January, officials quarantined Wuhan and nearby cities by shutting down all transportation. They remain locked down.
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All of the city's public transportation — including buses, metros, and ferries — was halted on January 23. Trains and airplanes coming into and out of the city were also shut down, and roadblocks were installed to keep taxis and private cars from exiting.
Wuhan's 11 million residents were told not to leave the city, barring special circumstances.
China has imposed travel restrictions on the rest of the Hubei province as well. Huanggang, a city of about 7.5 million people, placed its urban core under lockdown on January 23, closing subway and train stations as well as theaters and internet cafés. Additional cities followed suit with their own travel restrictions.
A CNN analysis in February found that more than 780 million people in China — more than half the population — were under some sort of travel restriction.
As the outbreak grew in January and February, doctors in Wuhan reported that there were not enough resources to treat the large number of patients.
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China has less than two physicians for every 10,000 residents, according to data from the WHO.
In Wuhan, patients have faced hours-long lines to receive medical care, the BBC reported. According to Reuters, some people with symptoms of the virus were denied full-time admission to local hospitals in Wuhan because there were no beds available.
The ban on transportation in Wuhan has also forced people to travel by foot to hospitals, The New York Times reported.
Initially, test kits were reportedly reserved for patients with the most severe symptoms.
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The New York Times reported that doctors in Wuhan were running short on test kits early in February. After a person has been tested, it takes one to two days for the results to come back. Combined, these factors created a lag time between when people were infected and when cases were confirmed via blood tests.
At the height of the outbreak in China, Wuhan constructed 16 makeshift hospitals. One of those hospitals closed on Monday.
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Two of the hospitals were constructed in just 10 days.
Construction on the first hospital, the Wuhan Huoshenshan Hospital, started January 23. The facility — which includes 1,000 beds — welcomed its first patients on February 3. By its tenth day of operation, the building was running at about full capacity, according to official figures reviewed by Business Insider.
The second hospital, the Leishenshan Hospital, is slightly larger: 1,600 beds. The site's construction started January 27, and the building was completed February 6.
China also turned an exhibition hall, gymnasium, and sports stadium into emergency medical sites. The stadium-turned-hospital closed on Monday after discharging its last 34 patients.
The Chinese government has barred citizens from booking overseas tours, flights, and hotel stays.
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Many countries have evacuated citizens and employees from China.
Airports around the world have implemented screening protocols.
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Twenty US airports — including New York's John F. Kennedy, Los Angeles International Airport, and Chicago's O'Hare — are screening passengers for the virus. Airports in Hong Kong, Singapore, Thailand, and South Korea are also screening people.
US health officials do not recommend face masks for the general public.
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For healthy people, hand-washing and avoiding close contact with sick patients is a better way to prevent infection.
"Wearing masks, except in the situation of a healthcare provider, has never been shown to be a very effective way to protect yourself from infectious diseases," Eric Toner, a scientist at Johns Hopkins Center for Health Security, told Business Insider.
Stocking up on face masks can also reduce the supply for medical workers that need them.
At a hearing last week, Health and Human Services Secretary Alex Azar said the US needed 300 million N95 masks — which filter out most airborne particles from the surrounding air — to protect healthcare workers during an outbreak. At present, it only has 30 million, he said.
The virus has weakened the tourism industry and disrupted supply chains in China, threatening to slow global economic growth to the lowest point since the financial crisis.
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Bank of America predicted last week that global GDP growth would slow to 2.8% for 2020. That would be the first reading under 3% since the financial crisis, and the lowest reading since 2009.
Bank of America economist Aditya Bhave wrote in a note that growth momentum was already weak before the outbreak, but added that the virus would likely have "large spillover effects" on the global economy.
There are no vaccines to prevent humans from contracting the virus, but drugmakers are racing to develop one.
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At least six drug companies — Johnson & Johnson, Regeneron Pharmaceuticals, Sanofi, GlaxoSmithKline, Moderna, and Gilead Sciences — have announced plans to research and develop treatments for the new coronavirus.
Some are developing vaccines from scratch, while others are testing existing drugs. Moderna appears to be leading the race so far: The company said on Monday that it had sent a vaccine candidate to US health officials.
Fauci said he hopes to start testing vaccine candidates in people by mid-April.
On February 26, Health and Human Services Secretary Alex Azar declined to promise that a coronavirus vaccine would be affordable for all Americans. A day later, he backtracked, saying that any vaccine developed in conjunction with the US government would need to be financially accessible to the public.
Rosie Perper and Aylin Woodward contributed to this report.