Confirmed cases of coronavirus transmitted by people who have never travelled to China could be the “tip of the iceberg”, the head of the World Health Organization has warned.
Tedros Adhanom Ghebreyesus’ remarks come as China attempted to return to some form of normalcy, with people returning to work on Monday as an extended Lunar New Year break ended.
Meanwhile 60 more cases were confirmed on a cruise ship docked in Japan, and the UK declared that the virus constituted a serious and imminent threat to public health.
“There’ve been some concerning instances of onward 2019nCoV spread from people with no travel history to [China],” Ghebreyesus tweeted, using the virus’s provisional scientific name. “The detection of a small number of cases may indicate more widespread transmission in other countries; in short, we may only be seeing the tip of the iceberg.”
On Monday, members of a WHO “international expert mission” flew to China to help coordinate response to the crisis, which has infected more than 40,000 people and killed at least 908. China said reported 97 new deaths on Sunday, its largest death toll in a single day since the outbreak was first detected in December.
More than 3,000 new cases had been reported over the previous 24 hours, raising the number of infections to 40,171. The uptick follows after a sharp decline in new cases reported on Sunday, less than 2,700, which prompted optimism prevention methods such as a strict quarantines may be working.
Around the country, workers have began trickling back to offices and factories as the government eased some restrictions on work and travel. In Beijing, roads were busier than they have been in the last few weeks but normally packed trains were nearly empty. The few commuters seen on the street or using public transport were all wearing face masks. Many businesses have asked their staff to work from home.
Authorities had told businesses to tack up to 10 extra days on to lunar new year holidays that had been due to finish at the end of January. The epidemic has caused huge disruptions in China, with usually teeming cities becoming virtual ghost towns during the past two weeks as Communist party rulers ordered virtual lockdowns, cancelled flights, closed factories and shut schools.
The southern city of Guangzhou said it would start to resume normal public transport from Monday. Hubei province, which has been hardest hit by the crisis, remains in lockdown, with train stations and airports shut and roads sealed off.
Despite government efforts to soothe the public about returning to work, some Chinese people have expressed concern.
“Of course we’re worried,” said a 25-year-old man in a beauty salon in Beijing, which reopened on Monday. He said the salon takes the temperature of all customers and asks them to wash their hands.
Others were relieved to leave their homes after weeks of self-quarantine. “Because going to work is normal life. Every day that I don’t go out and stay at home, I feel like people are going to die,” one commentator on Weibo said.
The car manufacturer Volkswagen said while some of its factories would reopen on Monday, others had delayed production for another week. Toyota has extended the closure of its Chinese plants to 16 February.
Schools in provinces across China will be shut until the end of February.
Outside mainland China there have been more than 350 infections reported in nearly 30 places. There have been two deaths, one in the Philippines and the other in Hong Kong.
British authorities said on Monday that four more patients had tested positive, bringing the total number of UK cases to eight. The development came as the government declared the outbreak a serious and imminent threat to public health, a step that gives authorities additional powers to fight the spread of the virus.
Sixty-six new infections have been confirmed on board the Diamond Princess ship off the coast of Japan, the ship’s operator said in a statement on a Monday. Quarantined passengers posted on social media that depression was setting in over their confinement, which began on 3 February after a man who disembarked in Hong Kong was diagnosed with the virus.
While the virus’s spread outside China has appeared to be slow, Ghebreyesus warned it could accelerate.
“Containment remains our objective, but all countries must use the window of opportunity created by the containment strategy to prepare for the virus’s possible arrival,” he said.
An advance team of international experts led by the WHO is heading for Beijing to help investigate the epidemic.
But it has taken nearly two weeks to get the government’s green light on its composition, which was not announced, other than to say that WHO veteran Dr Bruce Aylward, a Canadian epidemiologist and emergencies expert, was heading it.
