A top U.S. health official says regional lockdowns are possible and warns the most vulnerable against travel. A cruise ship prepares to dock.

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The State Department advises that U.S. citizens, particularly those with medical conditions, not take cruises.


Credit…Alessandro Grassani for The New York Times

The global fight against the coronavirus entered a new stage this weekend.

In Italy, cases and deaths shot up over the last week, its tolls second only to China, and the entire Lombardy area has been locked down.

The country accounts for more than 7,350 of the world’s 109,400 cases, which are spread across at least 95 countries, and more than 360 of some 3,800 deaths.

More and more countries have adopted or are considering stronger measures to try to keep infected people from entering and to contain outbreaks.

On Sunday, Saudi Arabia cut off access to Shiite Muslim towns and villages in the east of the kingdom, cordoning off an area in Qatif Governorate where all 11 of the country’s confirmed coronavirus cases have been identified. And local Saudi media reported that the country would temporarily close down all educational institutions and block travel to and from a number of countries in the region. The kingdom had already suspended pilgrimages to the Muslim holy cities of Mecca and Medina.

In Iran, which has been hit the hardest in the Middle East, state media reported that all flights to Europe would be suspended indefinitely.

The health minister in France, one of Europe’s bigger trouble spots, announced a ban on gatherings of more than 1,000 people.

Israel, with 39 cases, is considering requiring all Israelis and foreign nationals arriving from abroad to go into self-quarantine, Prime Minister Benjamin Netanyahu said on Sunday.

The U.S. has counted at least 533 cases across 33 states — Connecticut reported its first case on Sunday — and the District of Columbia, and logged 21 deaths. Washington State, New York, California and Oregon have declared emergencies. A growing number of schools are shutting down across the country, raising concerns about the closings will affect learning, burden families and upend communities.

The U.S. Army suspended travel to and from Italy and South Korea, now the world’s third largest hot spot, until May 6, an order that affects 4,500 soldiers and family members. And the Finnish armed forces announced that troop exercises planned for March 9-19 with Norway would be scrapped.

On Sunday, the leading U.S. expert on infectious diseases, Dr. Anthony S. Fauci, said that it was possible that regional lockdowns could become necessary and recommended that those at greatest risk — the elderly and those with underlying health conditions — abstain from travel.

Dr. Fauci, the director of the National Institute of Allergy and Infectious Diseases, said the Trump administration was prepared to “take whatever action is appropriate” to contain the outbreak, including travel restrictions in areas with a high number of cases.

“I don’t think it would be as draconian as ‘nobody in and nobody out,’” Dr. Fauci said on “Fox News Sunday.” “But there’ll be, if we continue to get cases like this, particularly at the community level, there will be what we call mitigation.”

Italy reported a huge jump in deaths from the coronavirus on Sunday, a surge of more than 50 percent from the day before, as it ordered an unprecedented peacetime lockdown of its wealthiest region in a sweeping effort to fight the epidemic.

The extraordinary measure restricted movement for a quarter of the country’s population.

“We are facing an emergency, a national emergency,” Prime Minister Giuseppe Conte said in announcing the government decree in a news conference after 2 a.m.

The move is tantamount to sacrificing the Italian economy in the short term to save it from the ravages of the virus in the long term. The measures will turn stretches of Italy’s wealthy north — including the economic and cultural capital of Milan and landmark tourist destinations such as Venice — into quarantined red zones until at least April 3.

They will prevent the free movement of roughly 16 million people.

Funerals and cultural events are banned. The decree requires that people keep a distance of at least one meter from one another at sporting events, bars, churches and supermarkets.

The Italian outbreak — the worst outside Asia — has inflicted serious damage on one of Europe’s most fragile economies and prompted the closing of Italy’s schools. The country’s cases nearly tripled from about 2,500 infections on Wednesday to more than 7,375 on Sunday. Deaths rose to 366.

Amid the backdrop of the growing restrictions to contain the virus, Pope Francis on Sunday for the first time live-streamed his Sunday Prayer, an event that usually draws thousands to St. Peter’s Square.

The Vatican also said on Sunday that it, like Italy, would close its museums and pontifical villas.

Even as the rate of new infections appeared to taper in China, the number of cases around the world continued to rise on Sunday, with some of the biggest clusters emerging in Europe.

Besides the sharp rise in Italy, Germany reported more than 930 cases; Switzerland’s total reached 281; and Britain’s health department said that three people with the virus had died and that the number of cases in the country had jumped to 273 by Sunday.

The smallest E.U. nation, Malta, reported its first confirmed case on Saturday: a 12-year-old girl recently returned from a vacation in northern Italy. Her condition was described as good.

The Spanish authorities announced on Sunday that three more people diagnosed with coronavirus had died in Madrid, raising the number of coronavirus fatalities in the country to 13. There are now over 500 cases, the authorities said.

Salvador Illa, Spain’s health minister, said at a news conference in Madrid that several cases in Spain were linked to people who recently traveled to Italy.

“Italy has taken very drastic measures and the most immediate impact is to halt the influx of people from northern Italy,” Mr. Illa added.

Iraq reported 62 confirmed cases and four deaths.

Among Iran’s more than 6,000 cases number a vice presidents, 23 members of Parliament, the deputy health minister and several other senior officials. The country raised its death toll to 149 from 100 a day earlier, which includes a senior adviser to the country’s supreme leader and Fatemeh Rahbar, a member of Parliament.

The State Department on Sunday advised Americans against traveling on cruise ships, warning that cruises presented a higher risk of a coronavirus infection and made U.S. citizens vulnerable to possible international travel restrictions, including quarantines.

“U.S. citizens, particularly travelers with underlying health conditions, should not travel by cruise ship,” the State Department wrote in an alert posted to its website. “U.S. citizens should not rely on being evacuated if other countries try to stop them from leaving ships or subjects them to quarantine.”

The posting noted that the Centers for Disease Control and Prevention recommended that older adults, in addition to those with underlying health problems, should avoid any setting that makes them more vulnerable to disease, like cruises, long plane trips and other crowded places.In response to the State Department’s alert, Carnival Corporation said in a statement that its brands, which include Carnival Cruises, Holland America Line, Princess Cruises, Cunard and others, will conduct thermal scans and temperature checks before passengers board and during the cruise.

“We are currently in discussions with the C.D.C., World Health Organization and other health officials,” the statement said, noting that the cruise industry committed to an aggressive industry-wide response plan when it met with Vice President Mike Pence on Saturday.

The Grand Princess cruise ship that has been held off the coast of California after 21 people onboard tested positive for the coronavirus was on its way to dock on Monday at the Port of Oakland, the vessel’s operator said.

More than 3,500 passengers and crew members are aboard, and 19 crew members and two passengers have tested positive.

After the ship docks, those aboard will be taken to military facilities around the country to be tested and quarantined for 14 days, according to the U.S. Department of Health and Human Services.

According to a statement from the department, about 1,000 passengers who are California residents are to go to the Travis Air Force Base in Fairfield, Calif., or the Miramar Naval Air Station in San Diego. Residents of other states will be taken to the Joint Base San Antonio-Lackland in Texas or Dobbins Air Force Base in Marietta, Ga.

The Department of State is working with other countries to repatriate “several hundred passengers,” according to the statement.

Princess Cruises initially said on Saturday that the ship would dock on Sunday. It later amended that statement after what it called a change in planning by the Centers for Disease Control and Prevention.

To guard against the coronavirus, health officials have instructed people to stop touching their face and regularly wash their hands. But how risky is the gym?

There’s more risk of picking up the coronavirus at a church service — where people are in close proximity and sometimes shake hands — than a gym, according to Dr. David Thomas, a professor of medicine and director of the Division of Infection Diseases at Johns Hopkins University School of Medicine.

Some gyms are disinfecting more often (the delicate coronavirus is easily killed) and are minimizing skin-to-skin contact with instructors. You can do a few things to protect yourself and others:

  • Bring your own wipes. Diluted household bleach solutions, alcohol solutions with at least 70 percent alcohol and several common household disinfectants should be effective against the coronavirus, according to the Centers for Disease Control and Protection. The E.P.A. also released a list of disinfectants that can be used against the virus.

  • Avoid frequently handled machines and equipment. Sweat cannot transmit the virus but high-contact surfaces, such as doorknobs and barbells, can pose a problem. Scientists are still figuring out how this virus spreads, but a study of other coronaviruses found they remained on metal, glass and plastic for two hours to nine days.

  • If you’re feeling sick, stay home. Wash your hands often and don’t touch your face, and don’t risk spreading the virus to others if you feel unwell.

The Egyptian health ministry said that a 60-year-old German tourist died on Sunday in Hurghada, on the Red Sea, after contracting the coronavirus. It is believed to be the country’s first fatality from the outbreak.

The man was traveling from Luxor, one of Egypt’s most popular areas for international tourism, which emerged over the weekend as the only place where the country has identified cases. He was admitted to a hospital on Friday, tested positive for the virus on Saturday and died on Sunday. The authorities said they were sterilizing the hospital and tracking the people the man had contact with.

On Saturday, Egypt confirmed 45 cases on a Nile tour boat in the area, among both crew and passengers. The outbreak has been traced to a Taiwanese-American woman who was on the boat in January, suggesting the many others could have been exposed in the intervening weeks.

Several cases linked to Egypt have been reported in the United States. In Texas, at least seven Houston-area residents who tested positive were part of a tour group that had traveled to Egypt in February. Officials in Maryland said on Saturday that three people — a married couple in their 70s, and a female in her 50s — had contracted the virus while on an Egyptian cruise of the Nile River, The Associated Press reported.

Egypt is scrambling to protect its tourism industry, a vital sector of the economy, and reassure travelers it is safe to visit after the outbreak on the boat.

On Saturday, President Trump, an admitted germophobe, said he was not worried about the outbreak getting closer to the White House.

He was responding to news that a person who had attended a conservative conference outside Washington where he and Vice President Mike Pence spoke last week had tested positive.

“I’m not concerned at all,” the president told reporters at his Mar-a-Lago estate in Florida, where he was spending the weekend.

The American Conservative Union, which hosts the annual Conservative Political Action Conference outside Washington, said the attendee was exposed to the virus before the four-day event and tested positive for it on Saturday.

“This attendee had no interaction with the president or the vice president and never attended the events in the main hall,” the group said in a statement. “The Trump administration is aware of the situation, and we will continue regular communication with all appropriate government officials.”

The attendee has been quarantined in New Jersey, the statement said.

Others who spoke at the conference included Secretary of State Mike Pompeo, Transportation Secretary Elaine Chao and Labor Secretary Eugene Scalia. Also in attendance were Jared Kushner, the president’s son-in-law and adviser, and Donald Trump Jr., the president’s eldest son.

Mr. Trump also said that he had no plans to curtail his campaign rallies even though other large gatherings of people are being canceled across the country.

“We’re going to have tremendous rallies,” he said.

Misinformation about the coronavirus is spreading despite aggressive countermeasures from social media companies.

Facebook, Google and Twitter say they are removing false and malicious content about the coronavirus as fast as they can find it, and are working with the World Health Organization and other government organizations to ensure that people get accurate information.

But misinformation is slipping through. There is so much inaccurate information about the virus, the W.H.O. has said it was confronting a “infodemic.”

Misinformation spread on social media has included rumors that the coronavirus had been cooked up in a secret government lab in China, that Taiwan was covering up virus deaths and that Bill Gates, the Microsoft co-founder who now runs a philanthropic organization, was behind the spread of the virus.


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Reporting and research were contributed by Jason Horowitz, Vivian Yee, Motoko Rich, Amie Tsang, Yonette Joseph, Pat Lyons, Kirk Johnson, Andy Parsons, Thomas Fuller, Amy Qin, Tiffany May, Elisabetta Povoledo, Choe Sang-Hun, Eric Schmitt, Tess Felder, Claire Fu, Noah Weiland, Michael Levenson, Chris Cameron, Raphael Minder, Mike Baker, Isabel Kershner, Alissa Rubin and Constant Meheut.

  • Updated March 2, 2020

    • What is a coronavirus?

      It is a novel virus named for the crownlike spikes that protrude from its surface. The coronavirus can infect both animals and people and can cause a range of respiratory illnesses from the common cold to lung lesions and pneumonia.
    • How contagious is the virus?

      It seems to spread very easily from person to person, especially in homes, hospitals and other confined spaces. The pathogen can travel through the air, enveloped in tiny respiratory droplets that are produced when a sick person breathes, talks, coughs or sneezes.
    • Where has the virus spread?

      The virus, which originated in Wuhan, China, has sickened more than 89,700 in at least 67 countries and more than 3,000 have died. The spread has slowed in China, but is picking up speed in Europe and the United States.
    • What symptoms should I look out for?

      Symptoms, which can take between two to 14 days to appear, include fever, cough and difficulty breathing or shortness of breath. Milder cases may resemble the flu or a bad cold, but people may be able to pass on the virus even before they develop symptoms.
    • What if I’m traveling?

      The C.D.C. has advised against all non-essential travel to South Korea, China, Italy and Iran. And the agency has warned older and at-risk travelers to avoid Japan.
    • How long will it take to develop a treatment or vaccine?

      Several drugs are being tested, and some initial findings are expected soon. A vaccine to stop the spread is still at least a year away.

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