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UN, May 26: Countries could see a "second peak" of coronavirus cases during the first wave of the pandemic if lockdown restrictions were lifted too soon, the World Health Organization (WHO) has warned.

Mike Ryan, the WHO's head of emergencies, told a briefing on Monday that the world was "right in the middle of the first wave", the BBC reported.

He said because the disease was "still on the way up", countries need to be aware that "the disease can jump up at any time".

"We cannot make assumptions that just because the disease is on the way down now that it's going to keep going down," Ryan said.

There would be a number of months to prepare for a second peak, he added.

The stark warning comes as countries around the world start to gradually ease lockdown restrictions, allowing shops to reopen and larger groups of people to gather.

Experts have said that without a vaccine to give people immunity, infections could increase again when social-distancing measures are relaxed.

Ryan said countries where cases are declining should be using this time to develop effective trace-and-test regimes to "ensure that we continue on a downwards trajectory and we don't have an immediate second peak".

Also on Monday, Tedros Adhanom Ghebreyesus, WHO Director-General, said that a clinical trial of hydroxychloroquine (HCQ) on COVID-19 patients has come to "a temporary pause", while the safety data of the the anti-malaria drug was being reviewed.

According to the WHO chief, The Lancet medical journal on May 22 had published an observational study on HCQ and chloroquine and its effects on COVID-19 patients that have been hospitalized, reports Xinhua news agency.

The authors of the study reported that among patients receiving the drug, when used alone or with a macrolide, they estimated a higher mortality rate.

"The Executive Group of the Solidarity Trial, representing 10 of the participating countries, met on Saturday (May 23) and has agreed to review a comprehensive analysis and critical appraisal of all evidence available globally," Tedros said in a virtual press conference.

The developments come as the total number of global COVID-19 cases has increased to 5,508,904, with 346,508 deaths, according to the Johns Hopkins University.

Shanghai, Jan 27: The death toll from a coronavirus outbreak in China rose to 81 on Monday, as the government extended the Lunar New Year holiday and more big businesses shut down or told staff to work from home in an effort to curb the spread.

Chinese Premier Li Keqiang visited the central city of Wuhan, the epicenter of the outbreak, as the government sought to signal it was responding seriously to the crisis.

The total number of confirmed cases in China rose about 30% to 2,744, about half of them in Hubei province, whose capital is Wuhan.

As worries grew around the world, Chinese-ruled Hong Kong, which has had eight confirmed cases, banned entry to people who had visited Hubei in the past 14 days. The ban did not cover Hong Kong residents.

The number of deaths from the flu-like virus in Hubei climbed to 76 from 56, health officials said, with five deaths elsewhere in China, including the southern island province of Hainan, which reported its first fatality on Monday.

While a small number of cases have been confirmed in more than 10 countries, linked to people who traveled from Wuhan, no deaths have been reported elsewhere.

Li is the most senior leader to visit Wuhan since the outbreak began. Clad in a blue protective suit and mask, he inspected efforts to contain the epidemic and spoke to patients and medical staff, the government said.

The government is extending the week-long Lunar New Year holiday by three days to February 2, in a bid to slow the spread of the virus. The Lunar New Year is usually a time for millions of people to travel, but many have had to cancel their plans because of travel curbs over the virus.

Incubation

Wuhan is already in virtual lockdown and severe limits on movement are in place in several other Chinese cities.

The city of 11 million clamped down further on Monday, announcing the suspension of visa and passport services until January 30.

Despite the curbs, the mayor of Wuhan said on Sunday that five million people had left the city for holidays and other reasons.

Images from Wuhan showing hospital corridors packed with people seeking treatment have circulated on social media, along with complaints of soaring prices for essentials such as vegetables.

Chinese leaders have urged transparency in the crisis, after public trust was eroded by the cover-up of the spread of Severe Acute Respiratory Syndrome (SARS), a coronavirus that originated in China and killed nearly 800 people globally in 2002 and 2003.

Much is not known about the newly identified coronavirus, including how easily it spreads and just how dangerous it is. It can cause pneumonia, which has been deadly in some cases.

National Health Commission minister Ma Xiaowei said on Sunday the incubation period could range from one to 14 days, and the virus was infectious during incubation, unlike SARS.

That compares with a World Health Organization (WHO) estimate of two to 10 days for the incubation period.

“Understanding the time when infected patients may transmit the virus to others is critical for control efforts,” the WHO said.

The virus is believed to have originated late last year in a Wuhan market illegally selling wildlife. It has spread to other cities, including Beijing and Shanghai, as well as more than 10 countries including France, Japan and the United States.

‘Overwhelmed’

Australia confirmed its fifth case on Monday involving a woman on the last flight out of Wuhan to Sydney before China’s travel ban.

Health minister Greg Hunt told the Australian Broadcasting Corporation (ABC) authorities aimed to get about 100 Australian children and young people out of Wuhan.

One father of two, Nathan Wang, told the ABC his wife was stuck in Wuhan with the children. “We absolutely want the children to come back, because hospitals in Wuhan are overwhelmed,” he said.

Airports around the world have stepped up screening of passengers from China, although some health experts have questioned its effectiveness.

Last week the WHO stopped short of calling the outbreak a global health emergency, but some health experts question whether China can contain the epidemic.

WHO Director-General Tedros Adhanom Ghebreyesus is due to travel to Beijing to meet officials and health experts.

Australia, France, Italy, Japan and the United States have all said they are working to evacuate citizens from Wuhan.

Some of China’s biggest companies have been affected, with hotpot restaurant chain Haidilao International Holding shutting branches nationwide from Sunday until Friday.

Gaming giant Tencent Holdings Ltd advised staff to work from home until February 7, and e-commerce firm Alibaba removed vendors’ offers of overpriced face masks from its online Taobao marketplace as prices surged.

As the deadly coronavirus has spread worldwide, it has carried with it xenophobia -- and Asian communities around the world are finding themselves subject to suspicion and fear.

When a patient on Australia's Gold Coast refused to shake the hand of her surgeon Rhea Liang, citing the virus that has killed hundreds, the medic's first response was shock.

But after tweeting about the incident and receiving a flood of responses, the respected doctor learned her experience was all too common.

There has been a spike in reports of anti-Chinese rhetoric directed at people of Asian origin, regardless of whether they have ever visited the centre of the epidemic or been in contact with the virus.

Chinese tourists have reportedly been spat at in the Italian city of Venice, a family in Turin was accused of carrying the disease, and mothers in Milan have used social media to call for children to be kept away from Chinese classmates.

In Canada, a white man was filmed telling a Chinese-Canadian woman "you dropped your coronavirus" in the parking lot of a local mall.

In Malaysia, a petition to "bar Chinese people from entering our beloved country" received almost 500,000 signatures in one week.

The incidents are part of what the Australasian College for Emergency Medicine has described as "misinformation" which it says is fuelling "racial profiling" where "deeply distressing assumptions are being made about 'Chinese' or 'Asian-looking' people." Disease has long been accompanied by suspicions of foreigners -- from Irish immigrants being targeted in the Typhoid Mary panic of 1900s America to Nepali peacekeepers being accused of bringing cholera to earthquake-struck Haiti in the last decade.

"It's a common phenomenon," said Rob Grenfell, director of health and biosecurity for Australia's science and research agency CSIRO.

"With outbreaks and epidemics along human history, we've always tried to vilify certain subsets of the population," he said, comparing the behaviour to 1300s plague-ridden medieval Europe, where foreigners and religious groups were often blamed.

"Sure it emerged in China," he said of the coronavirus, "but that's no reason to actually vilify Chinese people." In a commentary for the British Medical Journal, doctor Abraar Karan warned this behaviour could discourage people with symptoms from coming forward.

Claire Hooker, a health lecturer at the University of Sydney, said the responses from governments may have compounded prejudice.

The World Health Organisation has warned against "measures that unnecessarily interfere with international travel and trade", but this has not stopped scores of countries from introducing travel bans.

The tiny Pacific nation of Micronesia has banned its citizens from visiting mainland China altogether.

"Travel bans respond largely to people's fears," said Hooker, and while sometimes warranted, they often "have the effect of cementing an association between Chinese people and scary viruses".

Abbey Shi, a Shanghai-born student in Sydney, said the attitude shown by some of her peers has "become almost an attack on students who are Chinese".

While Australia's conservative government has banished its citizens returning from Wuhan -- the central Chinese city at the epicentre of the virus -- to a remote island for quarantine, thousands of students still stuck in China risk their studies being torpedoed.

"Right now it looks like they have to miss the semester's start and potentially the whole year, because of the way the courses are set up," Shi said.

According to Hooker, studies in Toronto on the impact of Severe Acute Respiratory Syndrome, or SARS -- another global coronavirus outbreak in 2002 -- showed the impact of xenophobic sentiment often lasted much longer than the public health scare.

"While there may be a cessation of direct forms of racism as news about the disease dies down, it takes quite a bit of time for economic recovery and people continue to feel unsafe," she said.

People may not rush back to Chinese businesses or restaurants, and may even heed some of the more outlandish viral social media disinformation -- such as one popular post imploring people to avoid eating noodles for their own safety.

"In one sense you might think the effects lasted from the last coronavirus to this one because the representation as China being a place where diseases come from has been persistent," Hooker said.