More new cases of the COVID-19 coronavirus have been reported outside China than within the country for the first time since the outbreak, including a new case in California which may be the first indication of a “community spread” of the virus in the U.S., where a person with no exposure to an infected patient contracts the virus, the U.S. Centers for Disease Control and Prevention (CDC) warned on Wednesday.

With new cases confirmed in Brazil (marking the first in Latin America), Algeria, and hundreds more across South Korea and Europe, at least 23 new cases in Australia and others in the Middle East, the virus has now reached every continent except Antarctica.

The deadly virus, which was first identified in Wuhan city of the Hubei province of China, has infected at least 81,109 people globally, around 78,191 of whom are in China, with at least 2,718 deaths reported in the country, according to a February 26 report by the World Health Organization (WHO). There have been around 2,800 deaths from the virus reported across nearly 47 countries, according to the latest figures from Johns Hopkins University.

For the first time since December 2019, when the virus appeared in China, the number of new cases outside the country has exceeded the number within, with 459 new patients reported outside China, while 412 new cases have been confirmed in China, as of February 26.

While the WHO declared the virus a public health emergency last month, it has yet to declare it pandemic.

“Using the word pandemic carelessly has no tangible benefit, but it does have significant risk in terms of amplifying unnecessary and unjustified fear and stigma, and paralyzing systems,” WHO director-general Tedros Adhanom Ghebreyesus said at a WHO weekly mission briefing on Wednesday.

“It may also signal that we can no longer contain the virus, which is not true. We are in a fight that can be won if we do the right things.

“For the moment, we are not witnessing sustained and intensive community transmission of this virus, and we are not witnessing large-scale severe disease or death.

But he added, “Do not mistake me: I am not downplaying the seriousness of the situation, or the potential for this to become a pandemic, because it has that potential. Every scenario is still on the table.

“On the contrary, we are saying that this virus has pandemic potential and WHO is providing the tools for every country to prepare accordingly.

“The primary objective of all countries with cases must be to contain the virus,” he said.

Potential community spread in the U.S.

With the origin of the new coronavirus case in northern California unknown, the latest incident may be the first person-to-person transmission of the virus in the U.S., where the infected individual had no “relevant travel history or exposure to another known patient,” the CDC said in a statement on Wednesday, CNN reported.

The latest patient’s “exposure is unknown,” the CDC confirmed in the statement.

“It’s possible this could be an instance of community spread of Covid-19, which would be the first time this has happened in the United States,” it added.

The patient from Solano County is being treated at the UC Davis Medical Center in California and is not linked to the Diamond Princess cruise ship, the California Department of Public Health confirmed (CDPH), NBC Bay Area reported.

Several Americans had been evacuated from the Princess Cruises ship which was quarantined at sea for around two weeks in Japan after a passenger from Hong Kong was found to have been infected. Anyone diagnosed among the American evacuees were sent to hospitals in the areas surrounding the Travis Air Force Base in Fairfield. The latest patient “had no known exposure to the virus through travel or close contact with a known infected individual,” the CDPH said in a statement.

The U.S. has reported about 60 confirmed cases as of Wednesday, including 42 passengers from the Diamond Princess cruise ship, according to the latest figures from the CDC. The fourth death from infected passengers was reported earlier this week. Earlier this week, the CDC warned the U.S. to prepare for the community spread of the virus.

“We expect we will see community spread in this country [U.S.],” Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, stated at a press briefing on Tuesday.

“It’s not so much a question of if this will happen anymore, but rather more a question of exactly when this will happen and how many people in this country will have severe illness.

“We are asking the American public to work with us to prepare in the expectation that this could be bad,” she added.

“Now is the time for US businesses, hospitals, and communities to begin preparing for the possible spread of #COVID19. CDC continues to work with business, education & healthcare sectors, encouraging employers to be prepared,” the CDC wrote in a post on its official Twitter account on Tuesday.

The U.S. Health and Human Services Secretary, Alex Azar, said at a press conference on Tuesday, “The immediate risk to the general American public remains low. But, as we have warned, that has the potential to change quickly.”

First case in Latin America

Brazil reported its first coronavirus case on Wednesday, marking the first infection in Latin America.

The infected patient was reported to be a 61-year-old man who had recently returned from a trip to Lombardy, one of the Italian regions where at least 10 towns are under quarantine following the recent spike in cases across the country.

There are suspected to be around 20 cases in Brazil, 12 of which are linked to recent trips to Italy, according to Brazil’s health minister Luiz Henrique Mandetta, Reuters reported. The figure is expected to rise as more Brazilian tourists return from their travels, he added.

“We still don’t have all the answers for how coronavirus will behave in the Southern Hemisphere,” he said.

The first infected patient is being treated at the Albert Einstein Israelite Hospital, where he will remain in quarantine for 14 days. He was reported to be in good condition, according to a statement from the hospital.

Brazilian authorities are tracing 90 or so people with whom the patient was in contact, including his wife and passengers near him on his flight, as well as the 30 guests he had received at his home the day before he was admitted to the hospital, Reuters reported.

South Korea sees nearly 500 new cases

South Korea, where the virus has been spreading rapidly, has reported at least 449 additional cases of the virus, bringing the total number of confirmed cases to at least 1,595, according to the latest report by the Korea Centers for Disease Control (KCDC).

Earlier this week, a U.S. soldier stationed at Camp Carroll, a military base in South Korea, tested positive for COVID-19, marking the first time a U.S. service member has tested positive for the virus, the United States Forces Korea announced in a statement.

The city of Daegu has become the epicenter of the outbreak, claiming around 1,017 cases so far, while the Gyeongsangbukdo province has seen 321. Seoul has reported 55 cases, while Busan, the country’s second-most populous city, has reported 58 infected patients.

The majority of the cases have been linked to members of the religious group known as the Shincheonji Church of Jesus, the Temple of the Tabernacle of the Testimony (SCJ), which reportedly holds services in large masses with members sitting on the floor in close proximity for periods of one to two hours.

Suspicions that the secretive cult may have been a major source of the recent outbreak were raised after several members of the cult reportedly contracted the virus from an infected female member in her 60s who attended a service at a SCJ facility in Daegu.

Several countries, including Japan, Singapore, and the Philippines, have since placed a ban on the entry of travelers from South Korea following fears over the spread of the virus.

Royal Caribbean, the major cruise line, has also turned away travelers from countries heavily affected by the virus, including South Korea, China, Hong Kong, Macau, and Italy, in view of the growing outbreak, the company noted in a statement on its website. It also canceled 30 cruises to Southeast Asia, Reuter reported.

The U.S. CDC’s elevated travel warning for South Korea remains in effect, advising U.S. citizens to “avoid all nonessential travel to South Korea,” warning that “there is limited access to adequate medical care in affected areas.”

The U.S. State Department also raised its travel warning for South Korea to Level 2, which advises travelers to “Exercise Increased Caution” since “sustained community spread has been reported in South Korea.”

“Sustained community spread means that people in South Korea have been infected with the virus, but how or where they became infected is not known, and the spread is ongoing,” the department wrote on its website.

The outbreak continues in Europe, with 25 percent surge in Italy

Italy, which has been hit with the greatest outbreak of the virus in Europe, has reported more than 400 cases as of Wednesday, around 80 more cases than the previous day, and 12 deaths, Reuters reported.

More than 50,000 residents of the Lombardy and Veneto regions have been placed on lockdown following the initial outbreak in the north of the country. At least two cases have also been reported in southern Italy, in Tuscany and Sicily.

The governor of the Lombardy region, Attilio Fontana, placed himself in quarantine after one of his staff was diagnosed with the disease.

“For now I don’t have any type of infection so I can continue to work… but for two weeks I will try to live in a sort of self-isolation,” he noted on Facebook, Reuters reported.

Elsewhere in Europe, seven new cases were confirmed in Germany (bringing its confirmed cases to 19), while France reported its second death from the virus, with 18 total confirmed cases as of Wednesday.

“There is no epidemic in the country, just isolated cases”, French health minister Olivier Veran said during a news conference. Twelve of the infected have been cured and four have been hospitalized, the director of the health ministry, Jerome Salomon, said according to Al Jazeera.

Health authorities in Norway, Finland, North Macedonia, and Georgia all announced their first case in each country, linked to people who’ve recently been to China, Italy, and Iran.

Several other European countries, including Greece, Switzerland, Austria, Croatia, and mainland Spain, also reported their first cases of the virus, all of which involved people who had traveled to Italy.

Evacuations ordered in Iran as virus spreads in the Middle East

There are around 220 confirmed cases across the Middle East, with the WHO confirming the virus has spread to Bahrain, Iraq, Kuwait, and Oman. Lebanon reported its second case, which was linked to a trip to Iran. The woman is currently in quarantine at a hospital, the country’s health ministry said in a statement, Al Jazeera reported.

The death toll in Iran has risen to at least 22, with 141 confirmed cases, according to Iran’s IRNA news agency, Gulf News reported.

Iraq has banned all public gatherings as well as the entry of travelers from Kuwait and Bahrain, in addition to anyone coming from China, Iran, Japan, South Korea, Thailand, Singapore, and Italy, the country’s health minister confirmed.

Saudi Arabia has also suspended all pilgrimages to Mecca and Medina in a drastic measure to help curb the spread of the virus.

The government of Qatar ordered the evacuation of all Qatari and Kuwaiti citizens in Iran, Al Jazeera reported, while Kuwait Airways is also planning to send a plane to evacuate citizens in Italy, according to a post on its official Twitter account.

The graphic below, provided by Statista, illustrates the spread of the COVID-19 virus as of February 27.

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