Updated at 9:50 p.m. ET
Wuhan's public health authorities say they are in a "state of war" as they quarantine the Chinese city in an attempt to halt the spread of a never-before-seen strain of coronavirus.
"Strictly implement emergency response requirements, enter into a state of war and implement wartime measures to resolutely curb the spread of this epidemic," urged a committee of Wuhan's top officials. "Homes must be segregated, neighbors must be watched."
Later Thursday, health officials from the World Health Organization decided not to declare the outbreak an international health emergency. WHO Director-General Tedros Adhanom Ghebreyesus said that after two days of meetings in Geneva with the organization's Emergency Committee, the group was divided.
"Make no mistake. This is an emergency in China, but it has not yet become a global health emergency," Tedros said. "It may yet become one."
The WHO is not recommending any international restrictions on trade or travel, but does recommend exit screenings at airports.
Beginning at 10 a.m. local time (9 p.m. Wednesday ET), authorities in Wuhan, about 500 miles west of Shanghai, started sealing off public transportation, including its metro system, airport, train station and long-haul bus hubs. Livestreamed videos from the city show soldiers wearing face masks barricading the entrances to the city's train station Thursday morning to prevent passengers from entering and leaving the city.
As of early afternoon, cars were still allowed to exit Wuhan, the epicenter of a rapidly growing outbreak of a coronavirus that has sickened 830 people within China and killed 25, according to health authorities.
But officials also began sealing off highways entering the city. Authorities said they were screening passengers leaving and entering Wuhan, checking for fever and the illegal transport of wild animals thought to be the original vector for the virus.
Online, people expressed doubt about whether the quarantine came in time to check the disease's spread. Influential bloggers have been calling on the mayor of Wuhan, Zhou Xianwang, to step down after he admitted the city government's initial public health responses "were not sufficient." The disease has spread to virtually all other Chinese provinces as well as Hong Kong, none of which has been quarantined.
The sudden decision to lock down the city of 11 million residents, who were given less than eight hours' notice of the suspension of public transportation, suggests the severity of the outbreak has alarmed China's leaders. Wuhan's lockdown comes only two days before the official start of Lunar New Year, a major, weeklong holiday during which hundreds of millions normally travel within and outside China.
The recent jump in the number of confirmed cases in China has also raised suspicions among both researchers and residents that authorities have delayed reporting the true extent of a public health threat.
Isolated cases of the virus, known as 2019-nCoV, also have been found in Japan, Thailand, South Korea, the U.S., Macao and Hong Kong. On Thursday, Singapore announced its first confirmed case — a 66-year-old Chinese national from Wuhan, according to the Ministry of Health.
Thursday's front page of the People's Daily, the official newspaper of the Chinese Communist Party, made no mention of the viral outbreak and focused instead on the country's leadership. The top story covered Chinese leader Xi Jinping's New Year's wishes to former senior officials.
A London Imperial College study published Wednesday estimated that the number of those infected in China with the new coronavirus should be at least 4,000 based on past outbreaks of similar viral diseases, far more than the 570 or so officially acknowledged as of Thursday.
"This is a mathematical model. The number you were referring to was the maximum in the range predicted. Faced with viruses like this, facts must be facts and theories are just theories," Gao Fu, the director of China's Bureau of Disease Prevention and Control, told reporters Wednesday when asked about a similar study from the same authors.
Part of the problem with reaching an accurate count may be that overstretched hospitals have been unable to cope with the numbers of potential cases needing to be screened. Hundreds of residents with fevers posted on social media Wednesday night that they had been turned away from overloaded Wuhan hospitals while seeking screening. The posts were deleted by the following morning.
In one case, a man from Liaoning province who sought treatment in a Wuhan hospital on Jan. 12 was simply prescribed oral medication and turned away, according to a notice posted by the Liaoning Public Health Commission. Five days later, he flew to Dalian, a major city in Liaoning, for further care as his symptoms worsened and were diagnosed as coronavirus pneumonia. He is currently in critical condition.
Wuhan says it will add 3,400 more beds to hospitals that are equipped to treat the virus, bringing the overall number to 5,400 and indicating that authorities expect the scale of the outbreak to grow. Caixin, an independent Chinese-language outlet, quoted doctors in Wuhan saying they expected the outbreak to eventually infect as many as 6,000 people, though they did not give a timeline. SARS, which also belongs to the coronavirus family, infected more than 8,000 from 2002 to 2003.
Hospitals are struggling to find enough doctors to treat the growing numbers of patients. An account of a 23-year-old man who was treated for the virus and eventually released last week described how his doctors had been transferred from other institutions within Wuhan and even from as far away as Beijing. As the crisis worsened, they worked 16 hours a day, "from dawn to dusk."
NOEL KING, HOST:
Officials in Beijing are canceling some major public events that are intended to mark the Lunar New Year. They're trying to stop the spread of a deadly coronavirus outbreak.
Here's the latest on the virus. It's now reached Singapore, with a case confirmed there this morning. The outbreak started in the city of Wuhan in central China. Authorities there say they are in a state of war to keep it from spreading. They've stopped all public transportation within the city, and they've canceled flights and trains that are leaving the city. Eleven million people live in Wuhan, so this might seem extreme. But more than 600 people are now infected, and 17 have died.
NPR's Beijing correspondent Emily Feng has been following all of this closely. I talked to her earlier this morning.
Good morning, Emily.
EMILY FENG, BYLINE: Hi, Noel.
KING: So 11 million people in Wuhan - that, as you have pointed out, is bigger than New York by, like, 3 million. How does this quarantine work?
FENG: By cutting off the transport lines one by one. So this morning, there were lines at the airport because they were - started canceling outbound flights starting at 10 a.m. Soldiers marched up to the train station in Wuhan. They were wearing face masks, but they stood in front of the doors to prevent passengers without tickets from entering and leaving the city.
And then that then funneled everyone to the highways. People could get out by car in the early morning, but now they're sealing off the highways as well. And we've just received reports that three smaller cities in the same province that Wuhan is in have also shut down their train stations or airports. So now they're shutting off transportation in the surrounding area of Wuhan as well.
NPR talked to a number of people in Wuhan today. One of them gave his surname as Wang (ph), and he says this sudden, much more aggressive approach to this public health crisis has really raised public anxiety.
WANG: (Through interpreter) Back then, people weren't taking things seriously at all. They still gathered to play cards or go to clubs. But gradually, as more cases were announced, you could feel the public beginning to care.
FENG: The suspension of public transport, though, means that fresh produce food is also now more scarce in Wuhan. And Wang says that prices are twice what they normally are.
WANG: (Through interpreter) Local residents did not know some produce markets were going to close. But because it's almost the new year, they have to buy something for their family to eat.
FENG: And as he mentioned, it's a holiday, so life goes on. I talked to another person in Wuhan. His name is Jan Robert Go. He's a Filipino doctoral student from Wuhan's Central China Normal University, and this is what he had to say.
JAN ROBERT GO: The attitude is to cheer each other that we can overcome this particular challenge and Wuhan will be better - at least from the conversations I am seeing among my Chinese friends.
FENG: But authorities are actually a little more grim. A commission of Wuhan's top health and government officials said that they needed to, quote, "man the battle stations and take wartime methods to avert disaster." By just quarantining Hubei province and Wuhan, it's not clear how effective that will be because there are cases in other cities.
KING: OK, including some of China's biggest cities. Do authorities there yet know why this disease is spreading so quickly?
FENG: It's because humans can pass it to humans. Before they thought animals could only pass it to humans, so it's spreading more quickly than expected. That's led to another problem, which is there just aren't enough doctors to screen all the suspected cases in Wuhan right now.
KING: During the SARS outbreak some years back, China was really criticized for not being as transparent as it might have been. So with this new strain of coronavirus, it does bring up a really, really relevant question, which is - have the authorities learned a lesson? Are they being more open and more transparent now?
FENG: To some extent, they have. They pledged this week to report every case publicly as it comes in confirmed. But online, there are still a number of accusations - though quickly taken down - from relatives who say their relatives died from a pneumonia-like illness and were not listed officially as a virus victim.
But Xi Jinping has come out - China's leader - he called on cadres personally to put public health first, implying that covering up these coronavirus cases for political expediency this time around is going to be a big no-no. But of course, there's a lot of public suspicion. Last year, there was African swine flu, which authorities delayed reporting the severity of, and of course the SARS outbreak of 2003 - so distrust runs really deep.
KING: OK. NPR's Emily Feng in Beijing. Thanks, Emily.
FENG: Thank you. Transcript provided by NPR, Copyright NPR.