Coronavirus cases continue to surge in China while new infections are being reported around the world. Stock markets in China, reopening after the Lunar New Year holiday, recorded their sharpest falls in more than four years Monday, reflecting increasing concern about the damage the outbreak is inflicting on the local economy. Here’s what we know:

● China’s National Health Commission reported Monday that there are 20,438 confirmed cases in China, including 15 in Hong Kong and eight in Macao. The self-governing island of Taiwan reported 10 cases. The World Health Organization reported 146 confirmed cases in 23 countries outside China.

● China’s main share indexes plunged more than 8 percent, reopening after a 10-day break, as economists continue to revise growth forecasts downward.

● The U.S. Department of Health and Human Services notified Congress on Sunday that it might need to transfer as much as $136 million to help combat the epidemic.

● The United States recorded its 11th case of the coronavirus, with a couple from central California falling ill after the husband’s trip to China’s Hubei province at the epicenter of the outbreak.

Second coronavirus death outside mainland China reported in Hong Kong

3:17 a.m.
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HONG KONG — Hong Kong became the second place outside mainland China to report a death from the novel coronavirus that has killed more than 400 people and infected more than 20,000 in China.

The 39-year-old man had traveled to Wuhan on Jan. 21, returning to Hong Kong two days later, and was admitted to the hospital Jan. 31, health authorities said in previous disclosures about the case. He had a preexisting illness, officials said.

Hong Kong’s leader, Carrie Lam, further tightened the city’s border with mainland China on Monday but has resisted calls to seal the frontier, prompting public anger and a strike by medical workers.

At a news conference Monday, Lam said there were “very legitimate” reasons for keeping three of the entry points open, including the airport, citing cases of people who live in Hong Kong but work in the mainland, and vice versa.

In a statement Tuesday, the Hospital Authority warned that emergency services have been affected as “a large number of staff are absent from duty.”

Study showing coronavirus can be spread by asymptomatic people was flawed, officials say

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A widely circulated study purporting to show that the new coronavirus can be transmitted by people with no symptoms contained a critical error, according to health officials.

The study, published last week in the New England Journal of Medicine, documented a cluster of cases in Germany that were linked to a businesswoman from Shanghai who traveled to Munich in mid-January.

Researchers reported that the woman showed no symptoms while she was visiting the country, not falling ill until she was on a flight back to China.

But the researchers didn’t actually speak to the woman, relying instead on information from the four people who were infected, Germany’s public health agency wrote in a letter to NEJM, as Science Magazine reported Monday.

After the study ran, German health officials contacted the woman, who told them she was, in fact, feeling symptoms before she left, according to the magazine.

“I feel bad about how this went, but I don’t think anybody is at fault here,” virologist Christian Drosten of the Charité University Hospital in Berlin, who did the lab work for the study, told Science. “Apparently the woman could not be reached at first and people felt this had to be communicated quickly.”

Swedish health officials also told people to disregard the study, saying “sources that claimed that the coronavirus would infect during the incubation period lack scientific support for this analysis.”

Shortly after the study was released, the World Health Organization said that transmission by an asymptomatic person is rare with coronaviruses. “Persons who are symptomatic will spread the virus more readily through coughing and sneezing,” WHO wrote.

Coronavirus cases pass 20,000

1:08 a.m.
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The number of people infected with the coronavirus continued to climb Monday, with Chinese officials announcing at least 20,438 confirmed cases, up more than 3,000 from Sunday night.

Sixty-four more people died from the disease, all in Hubei province, bringing the total number of deaths in China to 425, according to the National Health Commission. Officials said 2,788 people were in critical condition and there were 23,214 suspected cases. Another 171,329 people were under medical observation.

There were 15 confirmed cases in Hong Kong, eight in Macau, and 10 in Taiwan, officials said.

First patient diagnosed with coronavirus in U.S. leaves hospital

12:30 a.m.
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The first patient diagnosed with coronavirus in the United States was released from the hospital in Everett, Wash., on Monday, health officials said.

The unidentified man, who is in his 30s, will remain isolated at home and will be monitored while he recovers, according to the Snohomish Health District.

“The patient is continuing to recuperate at home, just as you might expect after being hospitalized for the flu or pneumonia,” said Heather Thomas, the health district’s public and government affairs manager. “Our public health team is checking in with him to monitor his recuperation, just as we do for other conditions like tuberculosis, whooping cough, measles or mumps.”

The man thanked doctors and asked for privacy in a statement released through the health district.

“I am at home and continuing to get better,” he said. “I appreciate all of the concern expressed by members of the public, and I look forward to returning to my normal life.”

The man entered Providence Regional Medical Center Everett on Jan. 19 after developing a cough and fever that lasted four days, according to a paper published in the New England Journal of Medicine detailing his case. He told doctors he had recently visited family in Wuhan.

After eight days in the hospital, his condition improved, according to the paper. He was listed in satisfactory condition during the entire hospital stay, health officials said.

Eleven people have been infected with the coronavirus in the United States.

Pentagon says four military bases could house up to 1,000 people needing to be quarantined

10:30 p.m.
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WASHINGTON — The Defense Department is offering four military bases to house as many as 1,000 passengers who may need to be quarantined after traveling overseas, as part of the administration’s efforts to prevent the spread of the coronavirus.

A Pentagon spokesman, Jonathan Rath Hoffman, said Monday that travelers could be housed at the 168th Regiment, Regional Training Institute in Fort Carson, Colo.; Travis Air Force Base, Calif.; Lackland Air Force Base, Tex.; and Marine Corps Air Station Miramar, Calif..

Health and Human Services officials will oversee treatment and observation, according to Hoffman. “DOD personnel will not be in direct contact with these individuals,” he said, “nor will these individuals have direct access to the bases beyond the housing.”

The military is already housing 198 people at March Air Reserve Base in California.

As the virus spreads, federal and state officials are scrambling to find places to put quarantined travelers. The Trump administration on Friday announced mandatory quarantines for any Americans who have visited China’s Hubei province within 14 days of their arrival in the United States. The government is also requiring screening and self-quarantines for Americans who visited other parts of China.

Any non-U.S. citizens who have traveled to China within the past two weeks will not be allowed into the United States. All flights from China are being routed through 11 U.S. airports.

How a coronavirus got its name — and how it works

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In the 1960s, scientists first started to identify virus particles with a crown-like display of sugary proteins. They called the family of spiky virions coronavirus, as the Latin word for crown is corona.

These crowns, they learned, are how the virus binds to and infects a host cell to replicate itself. From outside the body, the virus may look like people with a respiratory illness coughing and sneezing, spreading it in microscopic droplets.

But inside the body, the virus looks like this, according to an illustration of the ultrastructural morphology by the Centers for Disease Control and Prevention.

Scientists know a great deal about these viruses – but there remains even more that they don’t know such as exactly how coronaviruses mutate from animals to humans, and how to stop it.

Thanks to the fast work of scientists, experiments are underway to find a vaccine for the novel coronavirus: The development of vaccines takes months to years, but they are off to a promising start after researchers were able to quickly determine the novel virus’s genetic sequence.

Coronavirus appears to be spreading exponentially in Wuhan, scientists say

9:06 p.m.
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BERLIN — The new cornovirus outbreak appears to be growing exponentially at its epicenter in Wuhan, China, according to scientists, who cautioned that only limited modeling is possible with current data.

The term “exponential” is subject to some debate. In colloquial speech, it is often used to describe fast growth, but its real definition is more specific. An outbreak that grows exponentially grows at a rate proportional to its size. In other words, it grows faster and faster as its size increases.

The growth profile is influenced by a number of factors. Among them are the mode of transmission and “the percentage of the population that is susceptible to the disease,” Gerardo Chowell, a Georgia State University School of Public Health professor, said in an email.

Alessandro Vespignani, director of the Network Science Institute at Northeastern University, said that “the exponential increase is typical of the early growth of an epidemic with sustained human-to-human transmission.”

Chowell added, “For instance, for the case of pandemic flu, we can expect early exponential growth since it involves a novel pathogen spreading through the air and via close contact in a population where most of the population is susceptible.”

But once people begin to note the start of the flu season, their behavior changes: They may wash their hands more frequently or avoid exposure to potentially ill friends and colleagues.

“Research on past outbreaks indicates that the exponential growth trend is short-lived and tends to slow down within the first few generation cycles once the effects of control interventions and behavior changes kick in,” Chowell said.

Taiwan is frustrated that WHO keeps treating it as part of China

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The coronavirus outbreak has pushed the disputed status of the self-governing island of Taiwan to the global health forefront.

Taiwan says it’s a self-functioning, independent country. China insists it’s not. Beijing says that, like Hong Kong and Macao, Taiwan’s 23 million people are part of China’s “one country, two systems” approach. It’s a long-standing dispute in which Washington has maintained a middle ground, neither recognizing Taiwan as independent nor as a part of China.

The World Health Organization, however, has in practice taken China’s side.

From 2009 to 2015, Taiwan was annually invited to be part of the WHO’s decision-making body under an observer status. Then in 2016, China blocked Taipei’s bid. The move was part of China’s overall strategy to keep Taiwan out of international organizations, said Bonnie Glaser, director of the China Power Project at the Center for Strategic and International Studies.

“Taiwan’s interests are often ignored, and Taiwan is extremely isolated in the international community,” she said.

Flash forward to the coronavirus outbreak, and Taiwan, because it’s not part of the WHO, is not provided with the latest updates or invited to participate in meetings.

“It’s a loss both for the international community that is unable to tap into expertise that Taiwan has, as well as putting at risk citizens in Taiwan,” said Glaser.

The coronavirus has spread all around China and infected more than 17,000 people, but there are just 10 confirmed cases in Taiwan.

Nonetheless, because Taiwan is often grouped in with China, it has also been subject to flight suspensions — another area in which Taiwan’s aviation authorities are lobbying for change.

Washington has even tentatively stepped in. On Saturday, the State Department issued a statement criticizing the International Civil Aviation Organization after the U.N.-related agency blocked people on Twitter who condemned the ICAO’s exclusion of Taiwan.

In the meantime, as the coronavirus spreads, Taiwanese authorities are worried about simmering health repercussions of these politicized divides.

“If the motto of the WHO is ‘health for all’ and ‘leaving no one behind,’ well, the Taiwanese people are certainly not treated that way,” Joseph Wu, Taiwan’s foreign minister, said in a statement Monday.

Ramped-up U.S. response may require $136 million in additional funds

8:09 p.m.
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The Department of Health and Human Services notified Congress on Sunday that it might need as much as $136 million more in funding to help combat the fast-moving coronavirus epidemic, a new sign of how the White House has ramped up its response in recent days.

The notification came as the Centers for Disease Control and Prevention is quickly burning through $105 million set aside for emergency public-health responses to crises such as the coronavirus.

The additional money would address growing demands on the CDC, the HHS’s Office of the Assistant Secretary for Preparedness and Response and the HHS’s Office of Global Affairs, HHS confirmed Monday.

Of that money, about $75 million would be available for the CDC, $52 million for ASPR and $8 million for the Office of Global Affairs.

The effort to obtain more money is reflective of the White House’s response to the coronavirus outbreak in recent days. The Trump administration has sought to downplay risks to the public while working behind the scenes to bolster the government’s response, given how quickly the coronavirus has spread in China and around the world.

People in Wuhan risk infection to save pets

7:46 p.m.
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WASHINGTON — An estimated 5 million people left the Chinese city of Wuhan for the Lunar New Year holiday before authorities put the region under quarantine on Jan. 23 in a last-ditch effort to contain the spreading novel coronavirus.

Among the many fallouts of having so many people locked out of their homes: abandoned pets.

So animal lovers in Wuhan are stepping up to help.

The Wuhan Small Animal Protection Association is taking calls to rescue the pets of those unable to return to Wuhan. On WeChat, the animal welfare organization is offering free food and water deliveries for abandoned pets, according to China Global Television Network. The only catch: Homeowners will have to bear the cost of the volunteers forcing their way into a home if a key or code is not available.

Then there’s Lao Mao, or “Old Cat,” as friends of the 43-year-old man going into homes to feed cats and dogs call him. Lao has been organizing animal rescues and feedings for distressed pet owners who have contacted him through social media.

“The volunteers on our team, me included, have saved more than 1,000 pets since Jan. 25,” he told Reuters, declining to give his real name, so that his family wouldn’t know he was venturing around quarantined Wuhan.

It has additionally been no walk in the park for pet owners trying to keep their pets (and themselves) safe as the lockdown drags on. Among the many misconceptions circulating about the novel coronavirus are false claims that the disease can be contracted by and spread through cats and dogs.

Officials in the Chinese county of Suichang, in the second-most infection-hit province after Hubei province, on Friday ordered residents not to walk their dogs, according to Reuters. They even warned that dogs caught in public would be exterminated.

Chinese teenager with cerebral palsy dies after his father and sole caretaker is quarantined

7:01 p.m.
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WASHINGTON — Sixteen-year-old Yan Cheng was found dead in his home in Hubei province Wednesday. The week before, his father was placed under quarantine for a suspected case of coronavirus, which has killed more than 300 people in China.

But Cheng’s death stands out from the others because he had cerebral palsy and appears to have died from neglect, underscoring the extra burdens that people with disabilities bear during health crises such as this.

Cerebral palsy is a condition that affects a person’s movement and muscles. Cheng’s father was his sole caretaker and was left in a bind when forced into quarantine, according to Reuters. The father sought help in making sure his son was cared for in his absence. Instead, Cheng had reportedly been fed just twice in the week leading up to his death.

In the days since, Cheng’s story has trended on Chinese social media. Outrage over the teenager’s treatment even prompted Chinese authorities to dismiss the Communist Party boss and town chief of Hong’an, Cheng’s county.

“The local government was not practical and realistic when carrying out work and failed to perform its duty,” the Central Commission for Discipline Inspection (CCDI) said in a statement after the firing, Reuters reported.

Canadians evacuated from China to be quarantined at Canadian military base

6:23 p.m.
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TORONTO — Canadian officials said Monday that Canadians evacuated from Wuhan will be quarantined for two weeks at a Canadian military base in Trenton, Ontario, to prevent the spread of coronavirus, but they could not say when they will arrive.

A total of 280 Canadian citizens and 24 others have asked to be evacuated to Canada from China. François-Philippe Champagne, Canada’s foreign minister, said the country has chartered a plane but is still waiting for the necessary authorizations from the Chinese government.

Chinese and Canadian officials will screen all passengers before boarding, said Health Minister Patty Hajdu, and those who are experiencing symptoms will not be allowed to board. If passengers become ill during the flight, they will be isolated and can be taken to a hospital during a refueling stop in Vancouver, if necessary.

“Life has become exceedingly difficult” in Wuhan, Hajdu said, citing limited supplies, travel restrictions and school closures. “There is no line of sight for the Canadians there for when that might change.”

Champagne said that China will allow Canadian permanent residents to board the flight only if they are accompanying Canadian children.

Canadian public health officials said there is still much to be learned about the virus, including whether it can be spread by people who are not exhibiting symptoms.

Theresa Tam, Canada’s chief public health officer, said that although she is aware of a number of reports of asymptomatic transmission, she believes that such cases are likely to be “rare” and unlikely to “contribute to the propagation of this epidemic.”

Federal and state officials are working out quarantine locations in U.S. amid confusion

6:01 p.m.
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WASHINGTON — Federal and state officials have are rushing to identify where to house passengers arriving from China who must be quarantined as part of the administration’s new measures to control the spreading coronavirus epidemic.

“We are working with states to determine where travelers will be quarantined,” said Nancy Messonnier, the top official overseeing the U.S. response at the Centers for Disease Control and Prevention.

The United States has 11 confirmed coronavirus cases, and 82 people are being monitored, she said.

The new travel ban went into effect Sunday at 5 p.m. Eastern time. No flights from China had arrived as of midday Monday, she said. Flights are expected to arrive later this week. As a result, no one is under quarantine under the new travel ban. Last week, U.S. officials evacuated 195 people from Wuhan who are under federal quarantine at a military base in California.

All flights from China are being funneled to 11 U.S. airports.

State and county officials where the 11 airports are located said they received no notice about the quarantine order and are scrambling to figure out where to house people. Hotels, military bases and trailers are among the options, officials said.

“Some states have already made plans for hotels” to be used for quarantine as part of their individual preparedness plans, Messonnier said.

Under new protocols announced Friday, U.S. citizens who have been in Hubei province within 14 days of their return will be subject to 14 days of mandatory quarantine to ensure they receive proper medical care. Those citizens who have been in other areas of mainland China within 14 days of their return will been screened when they enter the United States and may be subject to up to 14 days of self-quarantine to ensure that they have not contracted the virus.

Under the policy, non-U. S. citizens who have traveled in China within 14 days of their arrival will not be allowed to enter the United States.

The 11 airports are in New York (JFK), Atlanta, Honolulu, Los Angeles, San Francisco, Chicago, Seattle, Dallas, Detroit, Newark and Northern Virginia (the Washington area’s Dulles International). Flights between the United States and China have dropped dramatically after Chinese officials closed the airport in Wuhan and began restricting travel in the country. Several U.S. carriers also canceled some flights. The State Department also raised its China travel advisory to Level 4, its highest level of caution, and said Americans should not travel to the region.

Vatican donates hundreds of thousands of face masks to China

5:39 p.m.
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WASHINGTON — The Vatican told the Catholic News Service and other outlets Monday that it has donated more than 600,000 face masks to the provinces in China most affected by the coronavirus outbreak, in a collaboration of the Office of Papal Charities, the Chinese Church in Italy and the Vatican pharmacy.

Each bag was marked with Pope Francis’s coat of arms, according to Reuters.

The donation was first reported by China’s state-backed Global Times newspaper.

“I wish to be close to and pray for the people who are sick because of the virus that has spread through China,” Pope Francis said after Sunday prayers last week.

The Vatican’s long-strained relationship with Beijing has improved in recent years, since a 2018 agreement over the appointment of bishops.

Francis said last week that China has shown “great commitment” to containing the spread of the virus, Reuters reported.