After we spent weeks looking forward to the day when the number of new cases of COVID-19 would fall below the rate of recovery, that day actually came on Thursday … but without much reason to celebrate. Even as hard-hit Hubei province in China was showing signs of finally arresting the growth of the disease in the epicenter of the outbreak, and the strain on the Chinese healthcare system eased just slightly, there were increasing signs that attempts to prevent COVID-19 from establishing fresh centers of infection in other nations were failing.
There were 29 cases in South Korea when this series first broke out the cases in a nation-by-nation chart on Tuesday. Since then, that number has doubled. Then doubled again. And again. On Friday morning, 204 cases of COVID-19 had been diagnosed in South Korea, 187 of them active, after another 93 were added overnight. Meanwhile, Iran wasn’t even on the chart at the beginning of the week, and now it’s not only climbing the charts, but it has become, in just three days, the nation with the most COVID-19 deaths other than China.
When two cases suddenly appeared in Iran on Wednesday, and just as quickly both patients died, several people—including me—suggested that it might not be COVID-19 at all, but another beta coronavirus that causes MERS. MERS first popped up in Jordan in 2012 before spreading to Saudi Arabia, where it resulted in over 2,000 cases and a case fatality rate over 30%. MERS has since been seen in a small number of cases, but has never re-emerged as a significant outbreak. So once Iran added first five, then nine, then 16 additional cases, it seemed likely that COVID-19 was the culprit. Iran has also added two more deaths, which definitely adds to the impression that the number of people infected there is potentially much higher than the number of cases that has been reported so far. There are several Chinese provinces that have had over 1,000 cases without racking up that many deaths. People have been suspicious about numbers coming out of China, but they should be really suspicious of what we’re hearing from Iran. Oh, and to make things seem even more ominous: The cases are scattered across three large cities. Brace for updates.
Over in South Korea, they’re probably telling it straight, but what they’re telling is already bad enough. The original set of cases were connected to just a couple of locations, one of them being the Shincheonji Church of Jesus in the city of Daegu. Then there were the secondary cases, with an amazing 24 apparently tied to a single individual from that church. They’re now into tertiary cases. The rapid growth in case numbers at this point seems to come from health officials testing contacts rather than waiting for people to fall ill or report symptoms—that’s a good thing. But Daegu and surrounding areas are on voluntary quarantine in hopes that this can still be contained.
Japan continued as it has for the last few days. The 14 new cases don’t show a disease that is “blowing up” out of control, but one that has a frighteningly diverse set of locations and no clear connection between many of those now falling ill. By the way, if Japan’s numbers pop up considerably in the next couple of days, it’s going to be important to differentiate between genuine new cases and people who have been moved from the Diamond Princess, which is soon going to be empty.
Some other countries are also seeing a handful of passengers trickle back from exile onboard the cruise ship. That includes the first case tallied for Israel. In almost all cases, those returning passengers are likely to face careful quarantine. Unfortunately, they’re also facing some hostility, as in Ukraine, where returning passengers were met with near-riot conditions, makeshift roadblocks, hurled stones, and demands that they be put out of the country. As the big Diamond Princess bar goes away, and the bars for other nations grow, the chart is likely to look significantly different in the next few days. Here’s hoping it doesn’t include any deaths from violence.
The overnight increase in Italy was relatively small, at just three cases, but they seem to have originated from a dinner party thrown by someone who returned from China some weeks ago. Authorities there are tracking down over 150 people were were possibly exposed. And those cases were enough to cause authorities to close schools and ask for voluntary quarantine across Milan and some surrounding areas, which is a preview of how even a handful of cases can cause a major disruption.
Buried in the reports from China on Thursday evening was the death of another doctor who worked at a hospital in Wuhan. He was 29, and in otherwise good health.
Iran becomes the only country to have resolved cases only through death. Its relatively puny bar on this chart isn’t indicative of the concern it deserves. On the other hand, Singapore shows a good example of a country that has managed to get in front of what seemed to be a growing local outbreak, More than half its cases have now recovered, and there has only been a single new case in the last few days. Sometimes it helps to be a country with a fanatical devotion to cleanliness and a government that isn’t exactly known for half-measures.
And if you were looking for a day when the world seems to be teetering on the brink … this looks like the one.
NOTE: As I was making a last pass through this before posting, another 10 cases were reported from Italy. That includes five health care workers who treated a man who was running a fever on Feb. 15. There are now 10 towns in voluntary quarantine.