LOS ANGELES — About 200 Americans evacuated from Wuhan, China, landed at a military base in Southern California on Wednesday, as countries around the world began pulling their citizens from the epicenter of the coronavirus outbreak.
“The whole plane erupted in cheers when the crew said, ‘Welcome home to the United States,’” said Dr. Anne Zink, the chief medical officer for Alaska, where the plane stopped en route to California.
But “home” was not immediately in the cards for the evacuees.
Upon landing at the March Air Reserve Base in Riverside, the passengers were met on the tarmac by personnel in biohazard suits, loaded onto waiting buses and instructed to remain on the base for three days of medical screening. Only when they are cleared will they be allowed to continue on home.
The authorities, however, were at pains to to say it was not a quarantine.
“We are respecting the rights of them as individuals,” said Dr. Nancy Knight, a senior official with the federal Centers for Disease Control and Prevention. “We are doing that in a way that protects their health, the health of uniformed service members and the health of the community.”
The passengers, mostly American consular officials and their families, returned to the United States as the coronavirus continued to spread around the globe, with the number of cases spiking dramatically and two major airlines canceling all flights to and from China.
On Wednesday, there were confirmed reports of infection in at least 16 countries, with more than 6,000 cases in China alone — topping the SARS outbreak there in 2002 and 2003. The official death toll there stood at more than 130, but the real number is believed to be much higher. On Thursday, the World Health Organization will again take up the question of whether to declare a global health emergency.
As governments around the world struggle to detect and prevent infection, it was clear on Wednesday that there was no international consensus on the best way to proceed.
However carefully the health authorities chose their words, the evacuees in the United States, for example, appeared to be, for all practical purposes, quarantined. They will also be monitored for 14 days by medical teams in their own communities when they go home.
In Australia, Prime Minister Scott Morrison said citizens evacuated from Wuhan would be held for a two-week quarantine on Christmas Island, also the site of an Australian immigration detention center.
And South Korea’s National Police Agency said that it had instructed its officers that they have the power to detain people who are suspected of carrying the coronavirus and refuse to be quarantined.
But other countries were taking a less strict approach.
Japan, for example, also evacuated citizens from China, but acquiesced when two evacuees who did not have symptoms declined to see a doctor. A third evacuee who did show symptoms was allowed to wait for test results at home.
As it spreads globally, the new coronavirus, which was first discovered in China last month, has begun to infect people who never visited China. Some have fallen ill in Germany, Japan, Taiwan and Vietnam.
“We’ve seen it spread between people in Wuhan, in other parts of China, and now these countries,” said Benjamin Cowling, a professor of epidemiology at the University of Hong Kong.
“What we don’t know is how quickly it spreads,” Dr. Cowling said. “We’ve seen small clusters, but we don’t know if those turn into chains of transmission that grow from two to four to eight to 16 — or if it can be controlled and won’t be further transmitted.”
As countries evacuated their citizens from Wuhan — among them France, South Korea, Morocco, Germany, Kazakhstan, Britain, Canada, Russia, the Netherlands and Myanmar — commercial airlines curtailed service to China. British Airways and Air Canada suspended flights altogether.
The Americans who were repatriated on Wednesday landed at the air base shortly after 8 a.m. after the State Department-chartered flight stopped in Anchorage to refuel and for the passengers to be screened — twice — for the virus.
At a news conference later in Riverside, Christopher R. Braden, a deputy director of the disease control centers, said the Americans would be “fully evaluated,” said Christopher R. Braden, a deputy director of the Centers for Disease Control.
“We think we can do the full evaluation in three days,” Dr. Braden said. “Some of that evaluation is taking tests and flying samples to the C.D.C. in Atlanta.” The agency has the country’s only laboratory that can test for the coronavirus.
At a raucous, packed news conference, Dr. Braden and Dr. Knight were peppered with questions about the wisdom of releasing the former Wuhan residents into communities across the country.
Dr. Braden said that if an evacuee deemed a danger to the community insisted on leaving before the 72-hour period expired, “we can institute an individual quarantine for that person — and we will.”
But he also said there was no indication that anyone wanted to leave right away.
Some Americans remained stranded in Wuhan, unable to secure a seat on the plane. Family members were incensed to learn that the Boeing 747 had taken off with empty seats. Some passengers lacked the proper documentation, and others did not show up, Dr. Braden said. In the end, around 200 passengers were evacuated, not the expected 240, he said.
“I don’t even know what to say to those numbers,” said Jiacheng Yu of Dallas, whose mother, Ying Cheng, a 61-year-old American citizen, was visiting her own mother in Wuhan for the Lunar New Year and could not get a seat.
When asked whether other flights were planned, a State Department official said its embassy in Beijing “continues to work with the Chinese authorities on other options for U.S. citizens in Wuhan to depart Wuhan and/or China.”
At least one American chose not to try to board Wednesday’s flight. Winifred Conrad, a 27-year-old English teacher, had a lingering cough and was afraid she would instead be handed over to Chinese officials, said her mother, Anastasia Coles of Lubbock, Texas.
But there was another reason: Ms. Conrad’s cat, Lulu.
In text message to her mother, she said: “Don’t freak out. I was offered a seat and I surrendered it to a 10-year-old girl.” She added, “I was told I can’t bring an animal.”
The number of confirmed cases in China increased by nearly 25 percent from Tuesday to Wednesday, when 6,065 cases were reported, according to the country’s National Health Commission.
The Chinese health authorities said Wednesday that 132 people had died from the virus in the country. The previous count, on Tuesday, was 106.
Wang Xiaodong, the governor of Hubei, the home of province of Wuhan, said Wednesday evening that the fight against the virus was at a crucial point, and that medical supplies were severely insufficient.
As cases emerged outside China, some appeared to involve infections between family members, who are at greater risk while caring for sick relatives. Others, however, appear to have spread between people with less intimate connections.
A Japanese tour bus driver in his 60s who had driven two tour groups visiting Japan from Wuhan was confirmed to have the virus, officials said on Tuesday. He had no history of traveling to Wuhan.
“I think what that says is, if we can get transmission in such a setting, then we can certainly get it in the waiting room of a clinic or a hospital,” said Dr. Arthur Reingold, a professor of epidemiology at the University of California, Berkeley. “That’s very concerning.”
On Tuesday, German officials said a 33-year-old man from Starnberg, a town near Munich, was apparently infected with the virus after attending a training event with a Chinese colleague on Jan. 21. The colleague flew home two days later. The German man was being treated in isolation and officials were tracing people who had been in contact with him.
Late Tuesday, health officials in Germany said three more people from the same company had also been infected. They were admitted to a clinic in Munich, where they, too, were to be isolated. Forty other people who came into close contact with the company employees were to be tested on Wednesday, officials said.
The outbreak and the travel restrictions it has led to have already had a big impact on businesses, some of which are temporarily halting operations in parts of China.
Starbucks, for example, said it was temporarily closing half of its stores in the country. Closing were also announced by McDonald’s and Yum China, which operates the KFC, Pizza Hut and Taco Bell brands in China.
And Apple said the outbreak could disrupt suppliers and its revenues.
Miriam Jordan reported from Los Angeles, and Austin Ramzy from Hong Kong. Reporting was contributed by Russell Goldman from Hong Kong; Motoko Rich, Makiko Inoue and Eimi Yamamitsu from Tokyo; and Choe Sang-Hun from Seoul, South Korea.
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