The World Health Organisation (WHO) warned Friday that the window to stem the deadly coronavirus outbreak was shrinking, amid concern over a surge in cases with no clear link to China.
WHO chief Tedros Adhanom Ghebreyesus has for weeks insisted the low number of cases of Covid-19 outside the epicentre of the deadly outbreak in China's central Hubei province presented a "window of opportunity" to contain the international spread.
But as cases surged across the Middle East and in South Korea Friday, he cautioned for the first time that while "we are still in a phase where containment is possible ... our window of opportunity is narrowing."
He warned that if countries did not quickly mobilise to fight the spread of the virus, "this outbreak could go in any direction. It could even be messy."
The outbreak which began in December has already killed more than 2200 people and infected more than 75,500 in China.
China reported 118 more deaths on Friday, raising the toll to 2236, most of them in Hubei.
The National Health Commission also said in its daily update that China tallied 889 new cases, up from the previous day when it reported the lowest number of new infections in nearly a month, fuelling hopes that the epidemic is nearing its peak.
But Hubei's figures have raised questions as officials have changed methods of counting cases twice and amended their figures.
A 29-year-old Wuhan doctor died on Thursday, making him one of the youngest known fatalities of the epidemic and the eighth among medical workers.
New hot spots were found in several prisons and hospitals, prompting the firing of a number of officials.
More than 1150 people have also been infected and more than a dozen have died across 27 other countries.
On Friday, cases of the deadly virus were reported in a range of countries in the Middle East, including in Israel and Lebanon for the first time, while Iran said four people there had died and 18 been infected in the outbreak.
Infections also nearly doubled in South Korea to 204, making it the hardest-hit country outside China.
In Europe, meanwhile, a small northern Italian town closed bars, schools and offices for up to five days to try to quell fears over six cases of the virus.
And in Ukraine, buses carrying evacuees from China bound for a medical facility were attacked by protesters hurling rocks.
Tedros stressed though that the number of cases outside of China still remained "relatively small".
But he voiced concern "about the number of cases with no clear epidemiological link, such as travel history to or contact with a confirmed case", urging countries worldwide to be "very, very serious" about preventing the spread of the virus.
"We must not look back and regret that we failed to take advantage of the window of opportunity we have."
China has meanwhile pointed to official figures showing new cases in the country slowing this week as evidence that its drastic containment measures are working, but fresh infections emerged at two Beijing hospitals, and more than 500 others were reported in prisons across the country.
Chinese authorities have placed tens of millions of people under quarantine in hard-hit central Hubei province, restricted movements in other cities far from the epicentre and closed schools nationwide.
At a Politburo meeting chaired by Chinese President Xi Jinping Friday, the leadership said the epidemic's peak "has not yet arrived", and the situation in Hubei and Wuhan remains "grim and complex", according to state media.
Many nations have banned travellers from China and airlines have suspended flights to and from the country.
WHO does not recommend any international travel or trade restrictions, but Tedros called on countries to take "proportionate" actions to protect against the international spread of the virus.
In hard-hit South Korea, more than 120 members of Shincheonji Church of Jesus, a religious sect in the southern city of Daegu, have now been infected.
The mayor of Daegu — South Korea's fourth-biggest city, with a population of over 2.5 million — has advised residents to stay indoors.
Most people on the streets were wearing masks Friday, but many businesses were closed and workers sprayed disinfectant outside the church.
"With so many confirmed cases here I'm worried that Daegu will become the second Wuhan," said 24-year-old Seo Dong-min.
Two Australians and an Israeli evacuated from the Diamond Princess cruise ship meanwhile tested positive for coronavirus on returning to their home countries, despite being cleared in Japan.
Hundreds of people are being tested and several towns are locked down in northern Italy as authorities scramble to contain a coronavirus outbreak.
In less than 24 hours, the number of people who tested positive for the potentially deadly Covid-19 disease in Codogno, a small town 60km southeast of Milan, rose from zero to 14.
"We were expecting it, even though we hoped it would not happen," Giulio Gallera, health commissioner for the Lombardy region, said about the rising infection numbers.
A 38-year-old Italian man was the first case, detected on Thursday at 9pm.
He had been hospitalised since Wednesday but since he had no obvious connection to China, doctors did not immediately treat him as a potential coronavirus case.
Only after his condition worsened and he was admitted into intensive care did his wife reveal that earlier this month he spent time with a friend who had recently returned from China.
From him the virus passed on to his pregnant wife, a friend he went running with, five doctors and nurses and three patients from the hospital he checked himself in, and three elderly men.
The three senior citizens were customers of a cafe run by the father of the 38-year-old's running partner, regional authorities said in a statement.
"We have around 250 people whom were are putting into isolation and testing," Gallera said.
The figure includes about 70 medical staff in Codogno hospital and 160 co-workers of the 38-year-old.
In addition, authorities announced lockdown orders for Codogno and nine neighbouring municipalities, thus seriously affecting the lives of tens of thousands of people.
The friend of the 38-year-old who was in China tested negative for the coronavirus, but he was being kept in hospital for more tests to see if he had ever carried the virus.
Health authorities said he never had any symptoms since his return from China on January 21, and if he had the virus, his infection may be over.
With Friday's developments, the total number of coronavirus patients in Italy rose to 17, including three previous cases who are being treated in a Rome hospital.
The cases will fuel questions about Tokyo's policy of allowing former Diamond Princess passengers to return home after testing negative.
Two former passengers, both Japanese and in their 80s, died in Japan on Thursday.
Americans should avoid travelling by cruise liner within Asia because the vessels act as amplifiers of the novel coronavirus, a senior US official said Friday, adding that future evacuations of ship passengers were not guaranteed.
The warning came as the number of confirmed cases of people on US soil who have been infected with the pathogen rose to 34, 21 of them repatriated from abroad.
More than 300 Americans were flown back from the Diamond Princess cruise ship off the Japanese coast earlier this week, and there have also been several flights bringing home citizens from the Chinese city of Wuhan, where the virus first emerged in December.
Ian Brownlee, a senior State Department official, said in a briefing that the government had "advised all US citizens to reconsider travel by cruise ship to, or within Asia."
"While the US government has successfully evacuated hundreds of hundreds of our citizens in recent weeks, such repatriation flights do not reflect our standard practice and should not be relied upon as an option for US citizens under potential risk of quarantine by local authorities," he added.
Eighteen of the passengers from the Diamond Princess ship have so far tested positive for the virus and were being treated, either at a medical centre in Nebraska or at hospitals near air bases in California and Texas.
Three people repatriated from Wuhan have also tested positive.
Nancy Messonnier, a senior official with the Centers for Disease Control and Prevention, said she expected the number of cases to rise among those who had returned from the Diamond Princess, because of their proximity to one another while on board the ship.
There are also many Americans with the Covid-19 illness who are hospitalised in Japan, several of whom are seriously ill, she added.
"We're not seeing community spread here in the United States yet, but it's very possible, even likely that it may eventually happen," she warned.
Israel confirmed Friday its first case of new coronavirus in a citizen who flew home from Japan earlier this week after being quarantined on the stricken cruise ship Diamond Princess.
"One of the passengers who returned home from the cruise ship in Japan tested positive in a check-up by the health ministry's central laboratory," a ministry statement said.
A total of 15 Israelis were among the passengers quarantined on board the Diamond Princess, of whom 11 have flown home.
The others all tested negative for the virus.
The returning Israelis had all been placed in quarantine for 14 days at the Sheba Medical Center near Tel Aviv.
"They are in full isolation," said Dr Gili Regev-Yochay, director of the hospitals' infectious diseases unit. "It's in many ways like a jail. We try to make it as best as we could to have them in a very nice and comfortable place, but very isolated."
The woman who tested positive for the virus "is not sick", Dr Regev-Yochay added. "She is totally healthy. She feels she is asymptomatic but she is a carrier of the virus."
The other four Israelis who were on board the Diamond Princess are still in Japan.
At the start of the month, Prime Minister Benjamin Netanyahu said it was "inevitable" that the Covid-19 outbreak would reach Israel.
He urged health authorities to focus on developing a vaccine.
In late January, the government banned all flights from China from landing in Israel.
This month it also began refusing entry to foreign nationals who had visited Hong Kong, Macau, Singapore or Thailand over the past two weeks.
New coronavirus cases surged across the Middle East on Friday, after a rapid spread in Iran, where authorities say the death toll from the virus has hit four, prompting alarm and travel bans.
Two elderly men in Iran were the first confirmed deaths from the virus, which has also spread to the United Arab Emirates, Egypt, Israel and Lebanon.
Iran's health ministry Friday reported two more deaths among 13 new diagnosed cases of the Covid-19 virus, doubling the total number of deaths in the Islamic republic and taking the total number of diagnosed infections there to 18.
Hours later, Lebanon confirmed the first case of the novel coronavirus, making it the latest country in the region to be hit by the epidemic.
It was found in a 45-year-old Lebanese woman who had travelled from the holy city of Qom in Iran, Lebanon's health ministry said, adding that two other cases were being investigated.
Iraq and Kuwait, which share borders with Iran, were on high alert for a potential outbreak after banning travel to and from the Islamic republic although they have not confirmed any cases domestically.
The outbreak in Iran has raised concerns, especially since many of the coronavirus cases involved residents of Qom, a popular destination for Kuwaiti and Iraqi Shiites.
Shiite leader Moqtada Sadr, a major figure in Iraqi politics, himself studies in an Islamic seminary in Qom.
Iraq is a popular destination for millions of Iranian Shiite pilgrims, including religious scholars from Qom, who visit holy sites in the southern provinces of Najaf and Kerbala.
Iran is also the second-largest exporter of goods to Iraq, sending products to the value of around nine billion dollars annually.
On Friday, Iraq's top Shiite cleric Grand Ayatollah Ali Sistani urged authorities to be ready to stem any outbreak.
"The scale of preparations should match that of the threat," he said in comments delivered by a representative. "We call on relevant authorities to be up to the level of responsibility".
Iraq on Thursday clamped down on travel to and from Iran, as the health ministry announced that travellers from were barred from entering the country "until further notice".
A senior official told AFP border crossings with Iran had been closed, with only returning Iraqis allowed to enter.
But they would be examined and, if necessary, placed in quarantine for 14 days, the health ministry said.
Iraqis are also not allowed to travel to Iran, the ministry said. The border closure followed a backlash against a Wednesday announcement of visa waivers for Iranians wishing to travel to Iraq.
Iraqis took to social media using the hashtag "close the border" and officials called for a ban on the entry of goods and people.
Kuwait Airways on Thursday announced it would suspend all flights to Iran, while ports in the Arab Gulf state would be also to passenger traffic.
Kuwaitis were advised not to travel to Qom, and warned that anyone arriving from the city they would be quarantined.
The UAE health ministry on Friday said a Filipino national and a Bangladeshi man were infected with the virus, bringing to 11 the number of cases in the country.
Iraqi airports have been screening travellers for the virus and national carrier Iraqi Airways has suspended flights to Iran.
"Detection equipment has been installed and no cases have been found," Jaafar al-Alaoui, communications officer at Najaf airport, told AFP.
Iraqi passengers arriving from Iran on Friday wore medical masks and had there temperatures taken by airport authorities.
In the southern province of Basra, local officials called for heightened health awareness in schools and recommended that washrooms be sanitised in educational facilities.
Social media networks have become fertile ground for fears among citizens who say Iraq cannot accommodate a coronavirus outbreak.
Hospitals are generally poorly equipped in terms of equipment and medicine, while some still require reconstruction and refurbishment.
There are less than 10 doctors for every 10,000 people, the World Health Organisation says.
Iraqis are circulating prayers on social media networks, while videos circulating online show Iraqi and Iranian families lighting incense in their homes with the belief that it will prevent infection.
Some said they were turning to herbalists for natural remedies, while others joked that alcohol consumption could combat the virus.
Ukraine's health minister volunteered to spend two weeks in quarantine as authorities looked to calm panic Friday after protesters attacked buses carrying evacuees from coronavirus-hit China.
On Thursday, protesters blocked roads and hurled stones at vehicles carrying 72 people evacuated from China and bound for a medical facility in the town of Novi Sanzhary in the central Poltava region.
Protesters said they feared the evacuees carried the virus and posed a threat to their community.
Riot police with armoured vehicles moved in to disperse the protesters, sparking clashes that injured nine policemen and one civilian.
Authorities called for calm, with senior officials rushing to the town and President Volodymyr Zelensky urging solidarity.
In a bid to allay fears, Health Minister Zoryana Skaletska said she would be joining the evacuees, who include 45 Ukrainians and 27 foreigners, in quarantine.
"I will spend the next 14 days with them, in the same premises, under the same conditions," she said.
"Today we agreed on the conditions of my stay and I was sent to the observation zone," Skaletska said on Facebook later in the day.
Mr Zelensky said "unprecedented" measures had been taken to prevent the spread of the virus across Ukraine.
He also urged Ukrainians to refrain from staging protests.
"We constantly say that Ukraine is Europe. But yesterday in some episodes, it seemed that we are Europe of the Middle Ages," Zelensky said.
"Let's not forget that we are all human beings."
Ukraine's Prime Minister Oleksiy Goncharuk, who visited the site of clashes late Thursday, called the incident "provocation" and a part of an "information war" against the country.
He did not elaborate, but previously Ukraine's security service said they uncovered a distribution of fake news about coronavirus cases in Ukraine in a newsletter, while Ukrainian TV channels cited locals in Novi Sanzhary as saying they received alarming text messages.
"There is no reason to panic," Goncharuk said.
The interior ministry said it had beefed up security in the town of 10,000 people, with some 400 police on patrol around the medical facility where the evacuees would be under quarantine.
"All of those who arrived yesterday from China, including doctors, are under observation. The situation in Novi Sanzhary now is calm," the ministry said in a statement on Friday.
Police said criminal investigations had been launched after Thursday's clashes. Protesters had said the evacuees should be quarantined away from populated areas, instead of in a facility in their community.
Svitlana Ulynets said her home was only 50 metres from the facility.
"I live next door, and no one's asked me about anything. Should I leave? I have a child at home. Do you really think I could support this?" she said at the demonstration.
Ukraine has not confirmed any cases of the new coronavirus.
Amid panic and clashes, Zelensky has also promised to extricate a young woman who refused to board an evacuation flight out of virus-hit Chinese Hubei province without her small dog.
Anastasiya Zinchenko was due to fly out Thursday along with other evacuees, but the 22-year-old decided to stay when was told she could not take her Pomeranian dog Michelle on board because she lacked the necessary papers.
"We won't leave you there. We will certainly … find a way to get you back," Zelensky told her in a phone call Zinchenko posted on Instagram that was confirmed by the presidency.
Many Ukrainians took to social media to say they were ashamed of their compatriots' behaviour.
"The sick ones are not those who came back … but those who are on the streets with stones," journalist Olga Tanasiichuk wrote on Facebook.
In order to mend the situation, some Ukrainians even brought fruit and other food to the entrance of the hospital, local journalists reported.