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An ambulance drives past Italian Finance guards at a checkpoint at one of the entrances to the town of Zorlesco, on Feb. 26, 2020.MIGUEL MEDINA/AFP/Getty Images

Several European countries have reported their first cases of COVID-19, all of them linked to Italy, where the continent’s outbreak is at its most severe and intensifying by the day.

Switzerland and Austria, which share a border with Italy, and Croatia, which has a maritime boundary with it, have all reported their first cases of the disease.

In a statement Wednesday morning from Geneva, World Health Organization director-general Tedros Adhanom Ghebreyesus said other cases linked to the Italian outbreak had surfaced in Germany, Spain and Algeria. “The sudden increases of cases in Italy, the Islamic Republic of Iran and the Republic of Korea are deeply concerning,” he said in the UN agency’s weekly COVID-19 briefing.

Later Wednesday, Norway, Greece, Romania and Georgia also announced their first patients.

In a major turning point for the outbreak, Dr. Tedros said, the number of new cases outside China exceeded those inside China. As of Wednesday night, China had reported 2,716 COVID-19 deaths.

Despite the spread of the virus from Italy, international travel to and from the country continues unobstructed, and the borders between Italy and the rest of the European Union remain largely open, raising fears the virus could spread quickly across the EU.

At a news conference in Rome on Wednesday at the Italian Health Ministry, Stella Kyriakides, the European commissioner for health and food safety, said national health ministries “must be ready to deal with increased COVID-19 infections.”

But she did not propose tight border restrictions, nor did Dr. Tedros. The WHO has yet to declare COVID-19 a pandemic, even though it was present in 48 countries and territories as of late Wednesday, with more than 81,000 confirmed cases, 3 per cent of them outside China. But Dr. Tedros said “this virus has pandemic potential,” even if the number of new cases in China has fallen rapidly.

In the United States, which had 60 cases, U.S. President Donald Trump declared the country is “very, very ready” for whatever the coronavirus threat brings, and he put the Vice-President in charge of overseeing the country’s response. Mr. Trump sought to minimize fears of the virus spreading widely across the country, but said he was ready to spend “whatever’s appropriate” to fight it.

Italy is one of three coronavirus hot spots outside China, where the outbreak started in December. The others are South Korea and Iran, where the number of confirmed cases is thought to be underreported. Officially, the Iranian death toll stood at 19, with 139 confirmed cases. Unofficial estimates are far higher.

Italy had 470 confirmed cases, almost all of them in the northern part of the country, and 12 deaths, all of them elderly patients. At least seven of the cases were children, although their symptoms were described as mild. A dozen towns, most of them just south of Milan, have been in lockdown since the weekend, when the number of cases began to surge from the three cases confirmed on Friday.

Italian visitors or non-Italians who had visited Italy appear to be responsible for the European cases. The first case on the Spanish mainland, in Barcelona, was a Spanish woman who had recently been to northern Italy. On Spain’s Tenerife, in the Canary Islands, an Italian doctor and his wife tested positive for the virus, prompting several hundred guests in their hotel to be put into lockdown. Two of them have tested positive.

Ten schools in England and Northern Ireland were closed after some of their students returned from ski trips in northern Italy. Paul Cosford, England’s medical director of public health, is not advising schools to shut down, but said anyone who has recently visited northern Italy should be especially vigilant and self-isolate if they have a cough, shortness of breath or fever and call the local medical authorities.

Also Wednesday, Brazil confirmed the first case of COVID-19 in Latin America, Pakistan reported its first two, and Germany’s health minister said the country is at the beginning of a coronavirus epidemic.

“The infection chains are partially no longer trackable, and that is a new thing,” Jens Spahn said. “Large numbers of people have had contact with the patients, and that is a big change to the 16 patients we had until now where the chain could be traced back to the origin in China.”

The tight lockdowns in China have slowed the transmission of the virus substantially. The WHO said Tuesday that just 10 new cases were reported outside Hubei province and its capital, Wuhan, the epicentre of the outbreak.

While the number of new cases outside China is now higher than those inside the country, there is some encouraging news: The WHO said 14 countries have not reported new cases in more than a week and nine countries – including Belgium, Russia, the Philippines and Cambodia – have not noted new cases for more than two weeks.

In Rome, Hans Kluge, the WHO’s regional director for Europe, said the mortality rate in China for COVID-19 patients has dropped to 1 per cent, half the rate elsewhere.

Stock markets initially fell on Wednesday as coronavirus fears spread in Europe and North America, but recovered somewhat later in the day. Still, share prices were down sharply since Monday. Oil prices, which have fallen rapidly since January, were down 2 per cent to less than US$54 a barrel. Less than two months ago, oil was trading at US$68.

With reports from Reuters, Associated Press

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