Fears over containing novel coronavirus grow as cases outside China spike

Concerns are growing over the global spread of the novel coronavirus after a spike in cases outside of mainland China among people with no connection to China or the city of Wuhan, ground zero for the outbreak.

World Health Organization (WHO) director general Tedros Adhanom Ghebreyesus said on Friday that there was still a chance to contain the virus, “but the window of opportunity is narrowing.”

The WHO has called on countries to continue containment measures while preparing for community transmission, he said, adding that the outbreak could still go in any direction.

“We must not look back and regret that we failed to take advantage of the window of opportunity we have,” he said.

His words come as countries outside of China report a sharp increase of coronavirus cases – particularly in South Korea and Iran. Italy has also reported two deaths, raising fears of self-sustaining epidemics.

Authorities in China’s Hubei province confirmed an additional 366 cases of the virus on Friday, 45 fewer than the previous day, taking the total number of cases at the epicenter of the outbreak to over 63,400. The total number of cases in mainland China is now more than 76,200.

The global death toll from the outbreak has reached2,372, after 109 deaths were reported in mainland China Friday, including 106 in Hubei, nine fewer than the previous day.

Outside of mainland China, at least 17people have died from the coronavirus,including five people in Iran.

Medical staff wearing protective suits ride down an escalator at Moscow's Sheremetyevo International Airport on Wednesday, March 18.

Hasidic Jewish men take part in a "social distancing" minyan in New York on Tuesday, March 17.

A patient in a biocontainment unit is carried on a stretcher in Rome on March 17.

A pedestrian walks a dog through a quiet street in New York on March 17.

People gather to collect free face masks in New Delhi on March 17.

Dermot Hickey, left, and Phillip Vega ask a pedestrian in New York to take their picture on a thinly trafficked Fifth Avenue on March 17. Many streets across the world are much more bare as people distance themselves from others. In the United States, the White House has advised people not to gather in groups of more than 10.

Students at the Attarkiah Islamic School wear face masks during a ceremony in Thailand's southern province of Narathiwat on March 17.

People wait outside a Woolworths store in Sunbury, Australia on March 17. Australian supermarket chains announced special shopping hours for the elderly and people with disabilities so that they can shop in less crowded aisles.

A member of Spain's Military Emergencies Unit carries out a general disinfection at the Malaga airport on Monday, March 16.

Displaced families near Atme, Syria, attend a workshop aimed at spreading awareness about the coronavirus.

French President Emmanuel Macron is seen on a screen in Paris as he announces new coronavirus containment measures on March 16. France has been put on lockdown, and all nonessential outings are outlawed and can draw a fine of up to €135 ($148). Macron also promised to support French businesses by guaranteeing €300 billion worth of loans and suspending rent and utility bills owed by small companies.

A police officer checks the temperatures of bus passengers at a checkpoint in Manila, Philippines, on March 16.

Flowers are stored prior to their destruction at a flower auction in Aalsmeer, Netherlands, on March 16. Lower demand due to the coronavirus outbreak is threatening the Dutch horticultural sector, forcing the destruction of products.

Two nuns greet neighbors from their balcony in Turin, Italy, on Sunday, March 15.

Pope Francis, inside the Church of San Marcello in Rome's city center, prays at a famous crucifix that believers claim helped to save Romans from the plague in 1522.

Passengers wait for their flights at Marrakesh Airport in Morocco on March 15.

US Vice President Mike Pence takes a question during a White House briefing about the coronavirus on March 15.

A Sea World employee sprays disinfectant in Jakarta, Indonesia, on Saturday, March 14.

People wait in line to go through customs at Dallas/Fort Worth International Airport on March 14. Travelers returning from Europe say they were being made to wait for hours at US airports, often in close quarters, as personnel screened them for the coronavirus.

Hundreds of people lined up to enter a Costco in Novato, California, on March 14. Many people have been stocking up on food, toilet paper and other items. As a response to panic buying, retailers in the United States and Canada have started limiting the number of toilet paper that customers can buy in one trip.

A member of the White House physician's office takes a media member's temperature in the White House briefing room on March 14. It was ahead of a news conference with President Donald Trump and Vice President Mike Pence.

Reporters in Arlington, Virginia, sit approximately 4 feet apart during a briefing by Marine Corps Gen. Kenneth F. McKenzie on Friday, March 13.

People walk past a closed Broadway theater on March 13 after New York canceled all gatherings over 500 people.

Body temperatures are scanned as people enter the Buddhist temple Wat Pho in Bangkok, Thailand, on March 13.

A Costco customer stands by two shopping carts in Richmond, California, on March 13.

A teacher works in an empty classroom at the Pompeu Fabra University in Barcelona, Spain.

A woman looks at an empty bread aisle in Antwerp, Belgium, on March 13.

Employees of the Greek Parliament wear plastic gloves ahead of the swearing-in ceremony for Greek President Katerina Sakellaropoulou.

A motorcyclist drives through disinfectant sprayed in Jammu, India, on March 13.

Workers prepare to construct an additional building on a hospital on the outskirts of Moscow.

Paul Boyer, head equipment manager of the NHL's Detroit Red Wings, wheels out equipment bags in Washington on Thursday, March 12. The NHL is among the sports leagues that have suspended their seasons.

Students leave Glacier Peak High School in Snohomish, Washington, on March 12. Beginning the following day, schools in the Snohomish school district planned to be closed through April 24.

An Uber Eats delivery biker stands at a deserted Piazza di Spagna in Rome.

People at a railway station in Seoul, South Korea, watch a live broadcast of US President Donald Trump on March 12. Trump announced that, in an effort to slow the spread of the coronavirus, he would sharply restrict travel from more than two dozen European countries.

Workers in protective suits disinfect Istanbul's Dolmabahce Palace on March 11.

A person wearing a face mask walks outside of a shopping mall in Beijing on March 11.

Police officers restrain the relative of an inmate outside the Sant'Anna jail in Modena, Italy, on March 9. Riots broke out in several Italian jails after visits were suspended to curb the spread of the coronavirus.

Medical staff in Wuhan, China, celebrate after all coronavirus patients were discharged from a temporary hospital on March 9.

Traders work on the floor of the New York Stock Exchange on March 9. Stocks plummeted as coronavirus worries and an oil price race to the bottom weighed on global financial markets.

Rescuers search for victims at the site of a collapsed hotel in Quanzhou, China, on March 8. The hotel was being used as a coronavirus quarantine center.

The Grand Princess cruise ship, carrying at least 21 people who tested positive for coronavirus, is seen off the coast of San Francisco on March 8. The ship was being held at sea.

Sumo wrestlers attend a tournament in Osaka, Japan, that was being held behind closed doors because of the coronavirus outbreak.

A couple rides a bicycle at a park in Seoul, South Korea, on March 7.

A volunteer from Blue Sky Rescue uses fumigation equipment to disinfect a residential compound in Beijing on March 5.

Airmen from the California National Guard drop coronavirus testing kits down to the Grand Princess cruise ship off the coast of California on March 5.

Municipal workers are seen at the Kaaba, inside Mecca's Grand Mosque. Saudi Arabia emptied Islam's holiest site for sterilization over coronavirus fears, an unprecedented move after the kingdom suspended the year-round Umrah pilgrimage.

Passengers react as a worker wearing a protective suit disinfects the departure area of a railway station in Hefei, China, on March 4.

Teachers at the Nagoya International School in Japan conduct an online class for students staying at home as a precaution against the spread of coronavirus.

Soldiers spray disinfectant throughout a shopping street in Seoul.

A Muslim worshipper attends a mass prayer against coronavirus in Dakar, Senegal, on March 4. It was after cases were confirmed in the country.

People wear face masks in New York's Times Square on March 3. New York reported its first case of coronavirus two days earlier.

A security guard stands on the Shibuya Sky observation deck in Tokyo on March 3.

US President Donald Trump, flanked by Vice President Mike Pence, left, and Health and Human Services Secretary Alex Azar, speaks during a meeting with pharmaceutical executives and the White House coronavirus task force on March 2. Throughout the meeting, Trump was hyperfocused on pressing industry leaders in the room for a timeline for a coronavirus vaccine and treatment. But experts at the table -- from the administration and the pharmaceutical industry -- repeatedly emphasized that a vaccine can't be rushed to market before it's been declared safe for the public.

Medical staff stand outside a hospital in Daegu, South Korea, on March 1.

Healthcare workers transfer a patient at the Life Care Center in Kirkland, Washington, on March 1. The long-term care facility is linked to confirmed coronavirus cases.

British Prime Minister Boris Johnson visits a London laboratory of the Public Health England National Infection Service.

Tomoyuki Sugano, a professional baseball player on the Yomiuri Giants, throws a pitch in an empty Tokyo Dome during a preseason game on February 29. Fans have been barred from preseason games to prevent the spread of the coronavirus.

Commuters wearing masks make their way to work during morning rush hour at the Shinagawa train station in Tokyo on February 28.

Medical staff transport a coronavirus patient within the Red Cross hospital in Wuhan on February 28.

Inter Milan plays Ludogorets in an empty soccer stadium in Milan, Italy, on February 27. The match was ordered to be played behind closed doors as Italian authorities continue to grapple with the coronavirus outbreak.

A bank clerk disinfects banknotes in China's Sichuan province on February 26.

A child wearing a protective face mask rides on a scooter in an empty area in Beijing.

A Catholic devotee wears a face mask as he is sprinkled with ash during Ash Wednesday services in Paranaque, Philippines, on February 26.

People disinfect Qom's Masumeh shrine in Tehran, Iran, on February 25.

A worker in Daegu stacks plastic buckets containing medical waste from coronavirus patients on February 24.

Paramedics carry a stretcher off an ambulance in Hong Kong on February 23.

People attend a professional soccer match in Kobe, Japan, on February 23. To help stop the spread of the novel coronavirus, the soccer club Vissel Kobe told fans not to sing, chant or wave flags in the season opener against Yokohama FC.

A team of volunteers disinfects a pedestrian bridge in Bangkok, Thailand.

A man rides his bike in Beijing on February 23.

Hospital personnel in Codogno, Italy, carry new beds inside the hospital on February 21. The hospital is hosting some people who have been diagnosed with the novel coronavirus.

Doctors look at a CT scan of a lung at a hospital in Xiaogan, China, on February 20.

A sales clerk wears a mask as she waits for customers at a hat shop in Beijing on February 18. Small companies that help drive China's economy are worried about how much damage the coronavirus outbreak will cause to business.

Buses carrying American passengers arrive at the Haneda Airport in Tokyo on February 17. The passengers were leaving the quarantined Diamond Princess cruise ship to be repatriated to the United States.

A medical worker rests at the isolation ward of the Red Cross hospital in Wuhan on February 16.

Authorities watch as the Westerdam cruise ship approaches a port in Sihanoukville, Cambodia, on February 13. Despite having no confirmed cases of coronavirus on board, the Westerdam was refused port by four other Asian countries before being allowed to dock in Cambodia.

A worker has his temperature checked on a shuttered commercial street in Beijing on February 12.

Beds are made in the Wuhan Sports Center, which has been converted into a temporary hospital.

A child rides a scooter past a police officer wearing protective gear outside the Hong Mei House in Hong Kong on February 11. More than 100 people evacuated the housing block after four residents in two different apartments tested positive for the coronavirus.

Relatives of quarantined passengers wave at the Diamond Princess cruise ship as it leaves a port in Yokohama, Japan, to dump wastewater and generate potable water. Dozens of people on the ship were infected with coronavirus.

The Deneway branch of the County Oak Medical Centre is closed amid coronavirus fears in Brighton, England, on February 11. Several locations in and around Brighton were quarantined after a man linked to several coronavirus cases in the United Kingdom came into contact with health-care workers and members of the public.

A police officer, left, wears protective gear as he guards a cordon at the Hong Mei House in Hong Kong on February 11.

A worker wears a protective suit as he waits to screen people entering an office building in Beijing on February 10. China's workforce is slowly coming back to work after the coronavirus outbreak forced many parts of the country to extend the Lunar New Year holiday by more than a week.

Chinese President Xi Jinping has his temperature checked during an appearance in Beijing on February 10.

Photojournalists wearing face masks take photos of a bus carrying passengers after they disembarked from the World Dream cruise ship in Hong Kong on February 9. More than 5,300 people were quarantined on two cruise ships off Hong Kong and Japan.

People participating in a Lunar New Year Parade in New York City hold signs reading, "Wuhan stay strong!" on February 9.

A shopper walks past empty shelves at a grocery store in Hong Kong on February 9. China's Ministry of Commerce encouraged supermarkets and grocery stores to resume operations as the country's voluntary or mandatory quarantines began to take an economic toll.

A worker wearing a protective suit uses a machine to disinfect a business establishment in Shanghai, China, on February 9.

Workers in protective gear walk near the Diamond Princess cruise ship docked in Yokohama on February 7.

People in Hong Kong attend a vigil February 7 for whistleblower doctor Li Wenliang. Li, 34, died in Wuhan after contracting the virus while treating a patient.

A woman grieves while paying tribute to Li at Li's hospital in Wuhan on February 7.

The Anthem of the Seas cruise ship is seen docked at the Cape Liberty Cruise Port in Bayonne, New Jersey, on February 7. Passengers were to be screened for coronavirus as a precaution, an official with the Centers for Disease Control and Prevention told CNN.

A light installation is displayed by striking members of the Hospital Authority Employees Alliance and other activists at the Hospital Authority building in Hong Kong on February 7.

Passengers are seen on the deck of the Diamond Princess cruise ship, docked at the Yokohama Port on February 7.

Flight attendants wearing face masks make their way through Don Mueang Airport in Bangkok on February 7.

Workers check sterile medical gloves at a latex-product manufacturer in Nanjing, China, on February 6.

A woman wears a protective mask as she shops in a Beijing market on February 6.

This aerial photo shows the Leishenshan Hospital that is being built in Wuhan to handle coronavirus patients.

A passenger shows a note from the World Dream cruise ship docked at the Kai Tak cruise terminal in Hong Kong on February 5.

A mask is seen on a statue in Beijing on February 5.

An ambulance stops at a traffic light in front of the Grand Lisboa Hotel in Macao. The virus turned China's gambling mecca into a ghost town.

A dog in Beijing wears a makeshift mask constructed from a paper cup.

Striking hospital workers in Hong Kong demand the closure of the border with mainland China on February 4.

The Diamond Princess cruise ship sits anchored in quarantine off the port of Yokohama on February 4. It arrived a day earlier with passengers feeling ill.

A medical worker wearing protective gear waits to take the temperature of people entering Princess Margaret Hospital in Hong Kong on February 4.

Medical workers in protective suits help transfer patients to a newly completed field hospital in Wuhan.

People wearing protective overalls talk outside a Wuhan hotel housing people in isolation on February 3.

A man stands in front of TV screens broadcasting a speech by Hong Kong Chief Executive Carrie Lam on February 3. Lam said the city would shut almost all border-control points to the mainland.

A colleague sprays disinfectant on a doctor in Wuhan on February 3.

Commuters in Tokyo walk past an electric board displaying dismal stock prices on February 3, the first business day after the Chinese New Year. Asia's markets recorded their worst day in years as investors finally got a chance to react to the worsening coronavirus outbreak.

Medical workers move a coronavirus patient into an isolation ward at the Second People's Hospital in Fuyang, China, on February 1.

Children wear plastic bottles as makeshift masks while waiting to check in to a flight at the Beijing Capital Airport on January 30.

Passengers in Hong Kong wear protective masks as they wait to board a train at Lo Wu Station, near the mainland border, on January 30.

A volunteer wearing protective clothing disinfects a street in Qingdao, China, on January 29.

Nanning residents line up to buy face masks from a medical appliance store on January 29.

Lyu Jun, left, a member of a medical team leaving for Wuhan, says goodbye to a loved one in Urumqi, China, on January 28.

A charter flight from Wuhan arrives at an airport in Anchorage, Alaska, on January 28. The US government chartered the plane to bring home US citizens and diplomats from the American consulate in Wuhan.

South Korean President Moon Jae-in wears a mask to inspect the National Medical Center in Seoul on January 28.

Hong Kong Chief Executive Carrie Lam, center, attends a news conference in Hong Kong on January 28. Lam said China will stop individual travelers to Hong Kong while closing some border checkpoints and restricting flights and train services from the mainland.

Workers at an airport in Novosibirsk, Russia, check the temperatures of passengers who arrived from Beijing on January 28.

Alex Azar, the US Secretary of Health and Human Services, speaks during a news conference about the American public-health response.

Two residents walk in an empty park in Wuhan on January 27. The city remained on lockdown for a fourth day.

A person wears a protective mask, goggles and coat as he stands in a nearly empty street in Beijing on January 26.

Medical staff members bring a patient to the Wuhan Red Cross hospital on January 25.

People wear protective masks as they walk under Lunar New Year decorations in Beijing on January 25.

Construction workers in Wuhan begin to work on a special hospital to deal with the outbreak on January 24.

Dr. Allison Arwady, commissioner of the Chicago Department of Public Health, speaks to reporters on January 24 about a patient in Chicago who had been diagnosed with the coronavirus. The patient was the second in the United States to be diagnosed with the illness.

A couple kisses goodbye as they travel for the Lunar New Year holiday in Beijing on January 24.

Workers manufacture protective face masks at a factory in China's Hubei Province on January 23.

Shoppers wear masks in a Wuhan market on January 23.

Passengers are checked by a thermography device at an airport in Osaka, Japan, on January 23.

People wear masks while shopping for vegetables in Wuhan on January 23.

A militia member checks the body temperature of a driver in Wuhan on January 23.

Passengers wear masks as they arrive at the Ninoy Aquino International Airport in Manila, Philippines, on January 23.

A customer holds boxes of particulate respirators at a pharmacy in Hong Kong on January 23.

Passengers wear masks at the high-speed train station in Hong Kong on January 23.

A woman rides an electric bicycle in Wuhan on January 22.

People in Guangzhou, China, wear protective masks on January 22.

People go through a checkpoint in Guangzhou on January 22.

Medical staff of Wuhan's Union Hospital attend a gathering on January 22.

Health officials hold a news conference in Beijing on January 22.

In pictures: The novel coronavirus outbreak

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More than 9,000 self-isolating in South Korea

Outside China, the largest coronavirus outbreaks have been in South Korea and Japan, where hundreds of people were infected on the Diamond Princess cruise ship, which began disembarking passengers this week from Yokohama Bay.

On Saturday, South Korea reported a spike of more than 229 additional cases in 24 hours, bringing the country’s total to over 433, according to the South Korean Centers for Disease Control and Prevention (KCDC).

The number of cases in South Korea has soared from 28 a week ago. Two patients who have been diagnosed with coronavirus have died in the country, where the outbreak is centered around the southern city of Daegu.

More than half of the country’s cases are linked to the Shincheongji religious group in Daegu. On Saturday, South Korean health officials said that 9,300 members of the group will be tested and required to self-isolate as they try to get on top of the outbreak there.

“We have secured a list of about 9,300 members of the relevant religious group, and we are preemptively enforcing self-isolation and facility isolation,” said Kim Gang-lip, South Korea’s vice minister of health, at a press briefing.

More than 4,400 people from the list are already self-isolating and the ministry is conducting the first tests on 544 people who said they have respiratory symptoms, Kim said.

In a statement released online on Friday, the Shincheongji religious group said it “deeply regrets” the coronavirus outbreak that occurred in their Daegu branch and said it was cooperating with local authorities.

“Currently all of our church branches in the nation, including the main headquarters have stopped services, gatherings, and mission activity in churches and related spaces,” the statement said.

On Friday, the South Korean government designated Daegu and neighboring city Cheongdo as “special management areas” for infectious disease and have taken additional measures to control the outbreak, including shutting down public places in the capital, Seoul.

Cases rise in Middle East

Attention has also turned to Iran, which only recently began reporting its first cases. On Saturday the health ministry confirmed 15 new infections and one death, state news agency IRNA reported.

Iranian health officials said the source of the virus in the country could be a Chinese worker who works in the city of Qom, about 140 kilometers (87 miles) south of the capital Tehran, and had recently traveled to China.

In total, five people have died in the country and 28 infections have been confirmed. Officials warned the coronavirus may have spread to every city in the country.

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“The spread of the coronavirus started in Qom and has reached other cities in the country like Tehran, Babol, Arak, Isfahan, Rasht and other cities due to people traveling. There is a possibility that it exists in all cities across the country,” said Minnou Mohraz, a member of the National Committee for Infectious Diseases at the Ministry of Health.

On Friday, Canada’s chief public health officer, Theresa Tam, suggested further investigation was needed after a Canadian tested positive for the virus after returning from Iran. There was no indication that the patient had been to Qom.

“Any important cases linked to Iran could be an indicator that there is more widespread transmission than we know about,” Tam said.

Iran’s sudden jump in cases, Tam said, was a reminder that the novel coronavirus is a global issue and that there is the possibility that the virus could be present in countries that may not have the capacity to detect or contain it.

On Friday, Lebanon and Israel both reported their first cases of coronavirus.

Leaving the Diamond Princess

Meanwhile, hundreds of people are finally disembarking the Diamond Princess cruise ship that has been quarantined in Japan’s Yokohama for the past two weeks.

On Friday, 253 people who tested negative for coronavirus left the ship, according to a news release from the Japanese health ministry. The disembarkation of passengers from the ship will continue at least through Saturday, a spokesperson for Princess Cruises told CNN.

Japan, however, reported 12 new cases of coronavirus on Saturday, including three teenagers, bringing the number of cases in the country with no connection to the ship to 99, with 639 confirmed from the cruise ship.

Cases have also increased in Singapore and Taiwan.

In the United States, officials have confirmed 35 cases of novel coronavirus, according to the US Centers for Disease Control and Prevention (CDC). That includes 21 cases among repatriated individuals, as well as 14 other US cases.

The 21 repatriated include 18 former passengers of the Diamond Princess, plus three who had been previously evacuated from China.

The CDC said it will now track confirmed cases in two separate groups: people who have been repatriated, and those identified by the US public health network.

CNN’s Shanshan Wang, Shawn Deng, Steven Jiang and Yong Xiong in Beijing; Yoko Wakatsuki in Yokohama; Sophie Jeong, Jake Kwon, and Paula Hancocks in Seoul; James Griffiths, Chermaine Lee, and Pauline Lockwood in Hong Kong; Paula Newton in Ottawa; and Scott Reeves, Taylor Barnes and Ben Tinker in Atlanta contributed reporting.