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Workers driving excavators at the construction site of a field hospital in Wuhan.Wang He/Getty Images

  • The death toll from the 2019-nCoV virus is now at 41
  • China has expanded its lockdown to include 14 cities
  • The virus is spreading globally, with new cases confirmed in France, Malaysia, Vietnam, Singapore, Australia and a second U.S. case
  • New research shows the virus kills 14 per cent of those hospitalized
  • The World Health Organization has not declared the virus an international emergency

In the midst of a lockdown unlike any the world has ever seen, some 35 million people in China spent the year’s most important holiday in a state of confusion, dread and anger over heavy-handed government actions to curb the spread of a SARS-like virus that has already reached the distant corners of the country.

The fear quotient rose further when authorities disclosed the death of a 36-year-old man in Wuhan, the epicentre of the new coronavirus, and two deaths in provinces far from that city of 11 million, Hebei and Heilongjiang, which borders Russia.

Until then, only older people had died from the fast-spreading 2019-nCoV virus, which by early Friday evening had killed 41 people and infected 1,284 in China, including high-speed rail workers in Tianjin, a thousand kilometres from Wuhan. Authorities are tracking thousands more suspected cases and said 237 people remain in critical condition.

It is killing 14 per cent of hospitalized patients, according to new research published by the University of Hong Kong, and is reaching a growing number of other countries, with newly confirmed cases in France, Nepal, Vietnam, Singapore and Australia, as well as a second case in the U.S., in Chicago. That city’s health authorities said the 60-year-old woman had travelled to Wuhan.

But much remains unknown about the virus, including who is most at risk – or why, exactly, Chinese authorities have locked down Wuhan and numerous surrounding cities, even as inundated hospitals in those cities turn away the sick because they are full.

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Transportation has been restricted in 14 cities, and public spaces such as theatres and cafés have been closed in some areas. Flights and train service have been cancelled, commercial vehicles barred from entering Wuhan, highways and tunnels closed, and ride-hailing services curbed across the broader region.

In Beijing, Shanghai and 13 other provincial jurisdictions, health authorities raised the emergency preparedness alert to the highest level and ordered airlines and railways to offer ticket cancellations without penalties.

Officials shut down large Lunar New Year gatherings in Beijing, closed the Forbidden City, barred access to parts of the Great Wall and, Bloomberg reported, ordered a halt to all sales of domestic and international tours. Shanghai Disney closed its gates, and cinemas closed their doors.

The lockdowns, infectious-disease experts said, constitute an unprecedented attempt to isolate a large population. But they have only served to increase doubts among local residents about the trustworthiness of information provided by authorities.

“I am absolutely scared. This is a question of our lives,” said Huang Zhengjun, 27, a hotel worker in Ezhou, one of the cities around Wuhan where roads and transportation services were shut down with little notice. “It’s not fair,” he said. “Locking people up before the city is prepared, and before people have a chance to react, isn’t fair anywhere.”

Mr. Huang also suspected that authorities knew more than they were letting on. Why had Ezhou,

  • A man wears a protective mask as he ride a bicycle across the Yangtze River Bridge in Wuhan, China.wanghe/Getty Images

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which is 70 kilometres southeast of Wuhan, been locked down when there were no official reports of infected people there? There must be “many buried cases,” he said.

He was aware that authorities had arrested people for spreading rumours by posting information about the virus, first drawing attention to the issue in mid-December, before its seriousness was formally acknowledged. “As an ordinary resident here, I have to say that I don’t think the government has fulfilled its responsibilities on this matter.

"We can only get updates from WeChat and social media, half-believing and half-doubting what information we have. It feels terrible,” Mr. Huang said. But because officials had provided assurances until this week that the problem was not serious, Mr. Huang said, “we missed the best point in time to take preventative measures. Now, we know how it tastes when everything is covered up.”

The sudden restrictions for people inside the lockdown zone haven been unnerving. Liu Nan, 24, lives in Tuanfeng County, a small district in Huanggang City. Officials shut down roads in the area at 10 a.m. Friday, she said. "We can’t go anywhere now.”

There, too, there were no officially reported cases. “The problem is we have a right to be informed about the real situation,” Ms. Liu said. “The fact that our county is blocked suggests that there are cases of infection, but the government has not disclosed anything. This is making people more nervous and more scared.”

On social media and in local news reports, people in the Wuhan area said loved ones were refused treatment or diagnosis by overwhelmed hospitals, raising questions about the effectiveness of the response and the accuracy of statistics. Journalists in Wuhan posted images of long queues at hospitals and patients attached to intravenous drips on the street. An analyst at investment bank Raymond James published research estimating the number of cases is “at least 10 times the number reported publicly.”

Excavators work at the future site of the Wuhan field hospital.Wang He/Getty Images

On Friday, China’s State Council pledged serious consequences for concealing or underreporting the scope of the epidemic. Wuhan is the capital of Hubei province, where Communist Party Secretary Jiang Chaoliang called for treatment of “all suspected patients unconditionally.” But the city’s health commission has acknowledged long queues at hospitals. It also said no virus diagnostic kits were available locally before Jan. 16. By this week, the city could process about 2,000 diagnostic kits a day in the city of 11 million.

Construction has already begun on a thousand-bed medical facility that, authorities said, would use prefabricated components and be completed within a week. China flew military medical personnel to Wuhan on air-force transport jets and dispatched doctors from other provinces to the city, amid reports in local media that the virus was spreading widely through hospital staff and even officials overseeing response efforts.

Some virologists have questioned the value of the lockdown, which was imposed long after many had left Wuhan for hometowns around the country. Only Tibet remains formally unaffected.

The last major quarantine of an entire urban area took place “in Sierra Leone surrounding the 2014 Ebola epidemic,” said Raina MacIntyre, a doctor and epidemiologist who leads the biosecurity research program at Australia’s University of New South Wales. What China is doing is “unprecedented,” she said. “We haven’t seen a lockdown at this level before.”

But it could help prevent a Chinese health crisis from becoming a global one, she said. The World Health Organization has balked at declaring the Wuhan virus an international emergency, with spokesman Tarik Jasarevic saying Friday, “It’s still too early to draw conclusions on how severe the virus is.”

By halting air travel from the region, “it will instantly reduce the risk of cases ending up in other countries,” Dr. MacIntyre said. “Perhaps while there’s so much uncertainty about … the source of this infection [and] the exact mode of transmission – we need to know those things to control the disease – then it’s probably a good strategy.”

The virus’s 14-per-cent fatality rate among hospitalized cases, versus roughly 12 per cent of all SARS cases and 24 per cent for MERS, show that the Wuhan virus does not appear to be as serious as those other coronaviruses, since hospitalized cases tend to be the most serious, Dr. MacIntyre said. But it remains “a serious infection.”

She also raised questions about the information coming from Chinese authorities. “Was there really an increase from 40 to 800 cases in a period of two weeks?” she said. “It’s really hard to say whether the cases just weren’t reported or whether they just began testing more actively.”

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