Hong Kong Reports Its First Coronavirus Death as Outbreak Widens

HONG KONG — A patient diagnosed with the new coronavirus became Hong Kong’s first fatality from the affliction Tuesday as Thailand reported six more cases, Japan quarantined a cruise ship because of a passenger’s infection and Macau shut its casinos, underscoring the contagion’s spread beyond mainland China.

In further signs of the epidemic’s disruptive effects, Britain and France advised all their citizens in mainland China to leave if they could, and South Korea’s Hyundai automaker idled factories because of Chinese supply-chain problems.

The developments came as President Xi Jinping of China promised a toughened response. But the World Health Organization, worried that the epidemic could widen globally, asked donors on Tuesday for an immediate $675 million infusion and said it would ship 250,000 test kits around the world to help diagnose cases.

The money primarily is intended for poor countries with weak public health systems and regular arrivals of passengers from China; many African countries fall under that heading because more than one million Chinese expatriates work on the continent and thousands of African students are studying in China.

The death of a 39-year-old man in Hong Kong was only the second reported outside mainland China, after the death in the Philippines of a man from Wuhan, the city in China’s central Hubei Province where the outbreak began.

Within mainland China, the toll of the virus continued to climb fast, with 425 deaths and 20,438 confirmed cases as of Tuesday, Chinese health authorities reported — roughly double the figures four days earlier. By Wednesday, the numbers in China had climbed to at least 490 dead and 24,324 confirmed cases, the authorities said.

More than 180 infections have been confirmed in two dozen other countries and territories.

Mr. Xi on Monday called the outbreak “a major test of China’s system and capacity for governance,” according to the state-run news media, and suggested more aggressive action to come, though without offering details.

Trying to quell complaints that the government had not responded effectively, Mr. Xi convened a second special meeting of the ruling Communist Party’s Politburo Standing Committee to address the crisis, and warned government officials not to hinder actions demanded by Beijing.

“Those who disobey the unified command or shirk off responsibilities will be punished,” he said, according to the Xinhua news agency.

Of the patients who have died in mainland China, more than 80 percent were older than 60, and more than 75 percent had an underlying health condition that put them at greater risk, Jiao Yahui, an official with China’s health commission, said on Tuesday. Two-thirds of the fatalities were men, she added.

The death in Hong Kong came as the city entered the second day of a strike by hospital workers demanding that the government close the border with mainland China. Many countries have shut off or sharply curtailed traffic to and from China to prevent the virus from spreading.

The patient had traveled to Wuhan by train on Jan. 21, and had returned to Hong Kong two days later, the Hong Kong government said in a statement. Health officials said he also had diabetes, which can impair the immune system.

His death raised further concerns in the city because of the possibility that the disease was transmitted within the man’s household. His mother, who did not travel to Wuhan, later contracted the virus. The man’s wife and two children and a domestic helper who worked for him are being quarantined.

Hong Kong has 17 confirmed cases of the new strain of coronavirus, including four that are highly likely to have been transmitted locally, said Chuang Shuk-kwan, a health department official.

Dr. Chuang said there was a “significant risk of community transmission in Hong Kong” and a large-scale local outbreak could not be ruled out.

At least 7,000 health workers in Hong Kong took part in the strike on Tuesday, including 4,500 nurses and 360 doctors, according to the Hospital Authority Employees Alliance, the union that organized it. The Hospital Authority, which has about 80,000 employees, said 4,400 workers were absent on Tuesday, suggesting that there were fewer strikers than the union had claimed.

Carrie Lam, Hong Kong’s top official, has ordered all but three of Hong Kong’s entry points from the mainland closed, and the central government has said it will stop issuing individual entry permits for people from the mainland.

But Mrs. Lam has resisted shutting the border entirely, saying that would be discriminatory and against World Health Organization recommendations.

Mrs. Lam has condemned the strike and said it had affected isolation wards, neonatal intensive care and delivery of some cancer treatments.

“I’m appealing to those who are taking part in this action that let’s put the interests of the patients and the entire public health system above all other things,” she said.

The union, which formed during last year’s antigovernment protest movement, said it would continue the strike on Wednesday.

“There is only one person who can solve this epidemic — and that is Carrie Lam,” said Winnie Yu, head of the union. “She must order a total shutdown of the border and cut off the roots of the virus.”

In nearby Macau, the top official, Ho Iat Seng, said on Tuesday that the government would shutter the city’s lucrative casinos for half a month to combat the coronavirus outbreak, a severe blow to the Chinese territory’s already ailing economy. Macau, a semiautonomous enclave that is the world’s largest gambling center, has reported 10 confirmed cases of the coronavirus, including a gambling-industry worker.

“Of course this was a difficult decision, but we must do it, for the health of Macau’s residents — this is our only goal,” Mr. Ho said. “Macau can still bear these economic losses right now.”

Macau’s casinos have struggled as the coronavirus outbreak has led to growing travel restrictions for visitors from the mainland. Macau, the only place in China where casino gambling is legal, derives a significant portion of its revenue from gamblers from the mainland.

Mr. Ho also said the city’s basic public services — except for emergency ones — would be suspended, and he urged Macau residents to “not go outside” except to get food. “This is not a holiday,” he said.

Thailand, which has 25 coronavirus cases, the highest number outside China, said that two of the six new cases reported on Tuesday were a couple who had traveled to Japan, raising the possibility they may have been infected there.

A South Korean woman who traveled to Thailand before returning home on Jan. 19 was also infected, South Korean health officials said on Tuesday. South Korea has 16 confirmed cases.

Britain and France both elevated their travel warnings on Tuesday. Britain’s Foreign Office told citizens, “if you’re in China and able to leave, you should do so,” and France’s Foreign Ministry issued similar advice.

But several major international airlines, including British Airways and Air France, have suspended China service because of the outbreak, leaving British and French citizens who wish to heed the advice limited travel options for returning home. In addition, American Airlines and United Airlines said they had suspended service to Hong Kong, primarily because of falling demand.

Fears about the potential spread of the virus led Japan to quarantine around 3,700 people aboard a cruise ship off the port city of Yokohama because a passenger had tested positive, the Japanese news media and the authorities said on Tuesday.

The passenger, an 80-year-old resident of Hong Kong, boarded the ship in Yokohama on Jan. 20, the national broadcaster NHK reported. He arrived five days later in Hong Kong, where he disembarked and was diagnosed, it said.

The ship traveled to Vietnam, Taiwan and the Japanese island of Okinawa before returning to Yokohama, where it is anchored.

Passengers were being held aboard as they awaited officials from Japan’s Health Ministry to test them for the coronavirus, the chief cabinet secretary, Yoshihide Suga, said during a regular news briefing on Tuesday.

“The quarantine office will make an appropriate judgment about whether we will approve the ship to dock and passengers to disembark,” he said, adding that the quarantine office would make the decision based on guidelines from the World Health Organization.

Reporting was contributed by Daniel Victor and Tiffany May from Hong Kong; Sui-Lee Wee from Singapore; Hannah Beech from Bangkok; Choe Sang-Hun from Seoul; Ben Dooley and Hisako Ueno from Tokyo; Benjamin Mueller from London; and Donald F. McNeil Jr., Niraj Chokshi and Rick Gladstone from New York.