More coronavirus cases outside mainland China than inside as pandemic accelerates

For the first time since the novel coronavirus was first identified last year, there are now more reported cases outside of mainland China than inside, marking a new milestone in the evolution of the global pandemic.

On Monday, China’s National Health Commission reported 16 new confirmed cases and 14 deaths, as of end of Sunday, bringing the total number of cases in the country to 80,860, of which more than 67,000 patients have recovered.

While China, the early epicenter of the outbreak, has still had more total confirmed cases than any other nation, infection rates in several other countries have surged in recent days. Italy, Europe’s hardest hit country, now has more than 24,000 cases, Iran has almost 14,000, Spain has at least 7,000 and the United States has now reported more than 3,400 cases.

The combined global caseload stands at 169,446 as of Monday morning, with the death toll passing 6,500, according to figures compiled by Johns Hopkins University, which is tracking cases reported by the World Health Organization (WHO) and additional sources.

The continued acceleration of cases comes as countries around the world rush to implement emergency measures in an effort to contain the virus and enforce social distancing, including nationwide lockdowns, imposing border and travel restrictions, school closures and ordering restaurants, cafes and bars to close or reduce services.

On Friday, the WHO director-general Tedros Adhanom Ghebreyesus said Europe had become the epicenter of the coronavirus pandemic. “More cases are now being reported every day than were reported in China at the height of its epidemic,” he said.

Italy on Sunday announced 368 new fatalities in just 24 hours, bringing the total death toll in the country to 1,809, according to the country’s Civil Protection Department.

Fears of a second wave

As cases blow up in Europe and North America, fear is growing in Asia of the possibility of a second wave of infections from imported cases.

Countries such as China, South Korea, Japan and Singapore have seen caseloads stabilize in recent weeks, thanks largely to a combination of aggressive containment and social distancing measures.

Tens of millions of people in mainland China and elsewhere in Asia were subjected to varying restrictions, with people unable to leave their homes or housing compounds, or go to work or school.

But a rise in infections linked to overseas travel has led to concerns that those sacrifices could be undone.

Governments across the region are now stepping up quarantine and travel restrictions. From Monday, all overseas travelers arriving in the Chinese capital Beijing will be sent to quarantine facilities for 14 days at their own cost, according to state media. Authorities in Beijing had previously required all passengers arriving in the capital from overseas to self-quarantine, either at home or in a designated facility, for two complete weeks.

Health officials in Wuhan – ground zero for the outbreak – told citizens to avoid going out as much as possible as the city is still facing a “severe” epidemic, amid a continuation of locally transmitted cases.

In Singapore, authorities have announced the introduction of a 14-day mandatory self-quarantine for new visitors traveling from several East Asian countries, Switzerland and the UK. And Hong Kong has urged its citizens to avoid all non-essential travel to Ireland, the UK and US.

Medical staff wearing protective suits ride down an escalator at Moscow's Sheremetyevo International Airport on Wednesday, March 18.

Hasidic Jewish men take part in a "social distancing" minyan in New York on Tuesday, March 17.

A patient in a biocontainment unit is carried on a stretcher in Rome on March 17.

A pedestrian walks a dog through a quiet street in New York on March 17.

People gather to collect free face masks in New Delhi on March 17.

Dermot Hickey, left, and Phillip Vega ask a pedestrian in New York to take their picture on a thinly trafficked Fifth Avenue on March 17. Many streets across the world are much more bare as people distance themselves from others. In the United States, the White House has advised people not to gather in groups of more than 10.

Students at the Attarkiah Islamic School wear face masks during a ceremony in Thailand's southern province of Narathiwat on March 17.

People wait outside a Woolworths store in Sunbury, Australia on March 17. Australian supermarket chains announced special shopping hours for the elderly and people with disabilities so that they can shop in less crowded aisles.

A member of Spain's Military Emergencies Unit carries out a general disinfection at the Malaga airport on Monday, March 16.

Displaced families near Atme, Syria, attend a workshop aimed at spreading awareness about the coronavirus.

French President Emmanuel Macron is seen on a screen in Paris as he announces new coronavirus containment measures on March 16. France has been put on lockdown, and all nonessential outings are outlawed and can draw a fine of up to €135 ($148). Macron also promised to support French businesses by guaranteeing €300 billion worth of loans and suspending rent and utility bills owed by small companies.

A police officer checks the temperatures of bus passengers at a checkpoint in Manila, Philippines, on March 16.

Flowers are stored prior to their destruction at a flower auction in Aalsmeer, Netherlands, on March 16. Lower demand due to the coronavirus outbreak is threatening the Dutch horticultural sector, forcing the destruction of products.

Two nuns greet neighbors from their balcony in Turin, Italy, on Sunday, March 15.

Pope Francis, inside the Church of San Marcello in Rome's city center, prays at a famous crucifix that believers claim helped to save Romans from the plague in 1522.

Passengers wait for their flights at Marrakesh Airport in Morocco on March 15.

US Vice President Mike Pence takes a question during a White House briefing about the coronavirus on March 15.

A Sea World employee sprays disinfectant in Jakarta, Indonesia, on Saturday, March 14.

People wait in line to go through customs at Dallas/Fort Worth International Airport on March 14. Travelers returning from Europe say they were being made to wait for hours at US airports, often in close quarters, as personnel screened them for the coronavirus.

Hundreds of people lined up to enter a Costco in Novato, California, on March 14. Many people have been stocking up on food, toilet paper and other items. As a response to panic buying, retailers in the United States and Canada have started limiting the number of toilet paper that customers can buy in one trip.

A member of the White House physician's office takes a media member's temperature in the White House briefing room on March 14. It was ahead of a news conference with President Donald Trump and Vice President Mike Pence.

Reporters in Arlington, Virginia, sit approximately 4 feet apart during a briefing by Marine Corps Gen. Kenneth F. McKenzie on Friday, March 13.

People walk past a closed Broadway theater on March 13 after New York canceled all gatherings over 500 people.

Body temperatures are scanned as people enter the Buddhist temple Wat Pho in Bangkok, Thailand, on March 13.

A Costco customer stands by two shopping carts in Richmond, California, on March 13.

A teacher works in an empty classroom at the Pompeu Fabra University in Barcelona, Spain.

A woman looks at an empty bread aisle in Antwerp, Belgium, on March 13.

Employees of the Greek Parliament wear plastic gloves ahead of the swearing-in ceremony for Greek President Katerina Sakellaropoulou.

A motorcyclist drives through disinfectant sprayed in Jammu, India, on March 13.

Workers prepare to construct an additional building on a hospital on the outskirts of Moscow.

Paul Boyer, head equipment manager of the NHL's Detroit Red Wings, wheels out equipment bags in Washington on Thursday, March 12. The NHL is among the sports leagues that have suspended their seasons.

Students leave Glacier Peak High School in Snohomish, Washington, on March 12. Beginning the following day, schools in the Snohomish school district planned to be closed through April 24.

An Uber Eats delivery biker stands at a deserted Piazza di Spagna in Rome.

People at a railway station in Seoul, South Korea, watch a live broadcast of US President Donald Trump on March 12. Trump announced that, in an effort to slow the spread of the coronavirus, he would sharply restrict travel from more than two dozen European countries.

Workers in protective suits disinfect Istanbul's Dolmabahce Palace on March 11.

A person wearing a face mask walks outside of a shopping mall in Beijing on March 11.

Police officers restrain the relative of an inmate outside the Sant'Anna jail in Modena, Italy, on March 9. Riots broke out in several Italian jails after visits were suspended to curb the spread of the coronavirus.

Medical staff in Wuhan, China, celebrate after all coronavirus patients were discharged from a temporary hospital on March 9.

Traders work on the floor of the New York Stock Exchange on March 9. Stocks plummeted as coronavirus worries and an oil price race to the bottom weighed on global financial markets.

Rescuers search for victims at the site of a collapsed hotel in Quanzhou, China, on March 8. The hotel was being used as a coronavirus quarantine center.

The Grand Princess cruise ship, carrying at least 21 people who tested positive for coronavirus, is seen off the coast of San Francisco on March 8. The ship was being held at sea.

Sumo wrestlers attend a tournament in Osaka, Japan, that was being held behind closed doors because of the coronavirus outbreak.

A couple rides a bicycle at a park in Seoul, South Korea, on March 7.

A volunteer from Blue Sky Rescue uses fumigation equipment to disinfect a residential compound in Beijing on March 5.

Airmen from the California National Guard drop coronavirus testing kits down to the Grand Princess cruise ship off the coast of California on March 5.

Municipal workers are seen at the Kaaba, inside Mecca's Grand Mosque. Saudi Arabia emptied Islam's holiest site for sterilization over coronavirus fears, an unprecedented move after the kingdom suspended the year-round Umrah pilgrimage.

Passengers react as a worker wearing a protective suit disinfects the departure area of a railway station in Hefei, China, on March 4.

Teachers at the Nagoya International School in Japan conduct an online class for students staying at home as a precaution against the spread of coronavirus.

Soldiers spray disinfectant throughout a shopping street in Seoul.

A Muslim worshipper attends a mass prayer against coronavirus in Dakar, Senegal, on March 4. It was after cases were confirmed in the country.

People wear face masks in New York's Times Square on March 3. New York reported its first case of coronavirus two days earlier.

A security guard stands on the Shibuya Sky observation deck in Tokyo on March 3.

US President Donald Trump, flanked by Vice President Mike Pence, left, and Health and Human Services Secretary Alex Azar, speaks during a meeting with pharmaceutical executives and the White House coronavirus task force on March 2. Throughout the meeting, Trump was hyperfocused on pressing industry leaders in the room for a timeline for a coronavirus vaccine and treatment. But experts at the table -- from the administration and the pharmaceutical industry -- repeatedly emphasized that a vaccine can't be rushed to market before it's been declared safe for the public.

Medical staff stand outside a hospital in Daegu, South Korea, on March 1.

Healthcare workers transfer a patient at the Life Care Center in Kirkland, Washington, on March 1. The long-term care facility is linked to confirmed coronavirus cases.

British Prime Minister Boris Johnson visits a London laboratory of the Public Health England National Infection Service.

Tomoyuki Sugano, a professional baseball player on the Yomiuri Giants, throws a pitch in an empty Tokyo Dome during a preseason game on February 29. Fans have been barred from preseason games to prevent the spread of the coronavirus.

Commuters wearing masks make their way to work during morning rush hour at the Shinagawa train station in Tokyo on February 28.

Medical staff transport a coronavirus patient within the Red Cross hospital in Wuhan on February 28.

Inter Milan plays Ludogorets in an empty soccer stadium in Milan, Italy, on February 27. The match was ordered to be played behind closed doors as Italian authorities continue to grapple with the coronavirus outbreak.

A bank clerk disinfects banknotes in China's Sichuan province on February 26.

A child wearing a protective face mask rides on a scooter in an empty area in Beijing.

A Catholic devotee wears a face mask as he is sprinkled with ash during Ash Wednesday services in Paranaque, Philippines, on February 26.

People disinfect Qom's Masumeh shrine in Tehran, Iran, on February 25.

A worker in Daegu stacks plastic buckets containing medical waste from coronavirus patients on February 24.

Paramedics carry a stretcher off an ambulance in Hong Kong on February 23.

People attend a professional soccer match in Kobe, Japan, on February 23. To help stop the spread of the novel coronavirus, the soccer club Vissel Kobe told fans not to sing, chant or wave flags in the season opener against Yokohama FC.

A team of volunteers disinfects a pedestrian bridge in Bangkok, Thailand.

A man rides his bike in Beijing on February 23.

Hospital personnel in Codogno, Italy, carry new beds inside the hospital on February 21. The hospital is hosting some people who have been diagnosed with the novel coronavirus.

Doctors look at a CT scan of a lung at a hospital in Xiaogan, China, on February 20.

A sales clerk wears a mask as she waits for customers at a hat shop in Beijing on February 18. Small companies that help drive China's economy are worried about how much damage the coronavirus outbreak will cause to business.

Buses carrying American passengers arrive at the Haneda Airport in Tokyo on February 17. The passengers were leaving the quarantined Diamond Princess cruise ship to be repatriated to the United States.

A medical worker rests at the isolation ward of the Red Cross hospital in Wuhan on February 16.

Authorities watch as the Westerdam cruise ship approaches a port in Sihanoukville, Cambodia, on February 13. Despite having no confirmed cases of coronavirus on board, the Westerdam was refused port by four other Asian countries before being allowed to dock in Cambodia.

A worker has his temperature checked on a shuttered commercial street in Beijing on February 12.

Beds are made in the Wuhan Sports Center, which has been converted into a temporary hospital.

A child rides a scooter past a police officer wearing protective gear outside the Hong Mei House in Hong Kong on February 11. More than 100 people evacuated the housing block after four residents in two different apartments tested positive for the coronavirus.

Relatives of quarantined passengers wave at the Diamond Princess cruise ship as it leaves a port in Yokohama, Japan, to dump wastewater and generate potable water. Dozens of people on the ship were infected with coronavirus.

The Deneway branch of the County Oak Medical Centre is closed amid coronavirus fears in Brighton, England, on February 11. Several locations in and around Brighton were quarantined after a man linked to several coronavirus cases in the United Kingdom came into contact with health-care workers and members of the public.

A police officer, left, wears protective gear as he guards a cordon at the Hong Mei House in Hong Kong on February 11.

A worker wears a protective suit as he waits to screen people entering an office building in Beijing on February 10. China's workforce is slowly coming back to work after the coronavirus outbreak forced many parts of the country to extend the Lunar New Year holiday by more than a week.

Chinese President Xi Jinping has his temperature checked during an appearance in Beijing on February 10.

Photojournalists wearing face masks take photos of a bus carrying passengers after they disembarked from the World Dream cruise ship in Hong Kong on February 9. More than 5,300 people were quarantined on two cruise ships off Hong Kong and Japan.

People participating in a Lunar New Year Parade in New York City hold signs reading, "Wuhan stay strong!" on February 9.

A shopper walks past empty shelves at a grocery store in Hong Kong on February 9. China's Ministry of Commerce encouraged supermarkets and grocery stores to resume operations as the country's voluntary or mandatory quarantines began to take an economic toll.

A worker wearing a protective suit uses a machine to disinfect a business establishment in Shanghai, China, on February 9.

Workers in protective gear walk near the Diamond Princess cruise ship docked in Yokohama on February 7.

People in Hong Kong attend a vigil February 7 for whistleblower doctor Li Wenliang. Li, 34, died in Wuhan after contracting the virus while treating a patient.

A woman grieves while paying tribute to Li at Li's hospital in Wuhan on February 7.

The Anthem of the Seas cruise ship is seen docked at the Cape Liberty Cruise Port in Bayonne, New Jersey, on February 7. Passengers were to be screened for coronavirus as a precaution, an official with the Centers for Disease Control and Prevention told CNN.

A light installation is displayed by striking members of the Hospital Authority Employees Alliance and other activists at the Hospital Authority building in Hong Kong on February 7.

Passengers are seen on the deck of the Diamond Princess cruise ship, docked at the Yokohama Port on February 7.

Flight attendants wearing face masks make their way through Don Mueang Airport in Bangkok on February 7.

Workers check sterile medical gloves at a latex-product manufacturer in Nanjing, China, on February 6.

A woman wears a protective mask as she shops in a Beijing market on February 6.

This aerial photo shows the Leishenshan Hospital that is being built in Wuhan to handle coronavirus patients.

A passenger shows a note from the World Dream cruise ship docked at the Kai Tak cruise terminal in Hong Kong on February 5.

A mask is seen on a statue in Beijing on February 5.

An ambulance stops at a traffic light in front of the Grand Lisboa Hotel in Macao. The virus turned China's gambling mecca into a ghost town.

A dog in Beijing wears a makeshift mask constructed from a paper cup.

Striking hospital workers in Hong Kong demand the closure of the border with mainland China on February 4.

The Diamond Princess cruise ship sits anchored in quarantine off the port of Yokohama on February 4. It arrived a day earlier with passengers feeling ill.

A medical worker wearing protective gear waits to take the temperature of people entering Princess Margaret Hospital in Hong Kong on February 4.

Medical workers in protective suits help transfer patients to a newly completed field hospital in Wuhan.

People wearing protective overalls talk outside a Wuhan hotel housing people in isolation on February 3.

A man stands in front of TV screens broadcasting a speech by Hong Kong Chief Executive Carrie Lam on February 3. Lam said the city would shut almost all border-control points to the mainland.

A colleague sprays disinfectant on a doctor in Wuhan on February 3.

Commuters in Tokyo walk past an electric board displaying dismal stock prices on February 3, the first business day after the Chinese New Year. Asia's markets recorded their worst day in years as investors finally got a chance to react to the worsening coronavirus outbreak.

Medical workers move a coronavirus patient into an isolation ward at the Second People's Hospital in Fuyang, China, on February 1.

Children wear plastic bottles as makeshift masks while waiting to check in to a flight at the Beijing Capital Airport on January 30.

Passengers in Hong Kong wear protective masks as they wait to board a train at Lo Wu Station, near the mainland border, on January 30.

A volunteer wearing protective clothing disinfects a street in Qingdao, China, on January 29.

Nanning residents line up to buy face masks from a medical appliance store on January 29.

Lyu Jun, left, a member of a medical team leaving for Wuhan, says goodbye to a loved one in Urumqi, China, on January 28.

A charter flight from Wuhan arrives at an airport in Anchorage, Alaska, on January 28. The US government chartered the plane to bring home US citizens and diplomats from the American consulate in Wuhan.

South Korean President Moon Jae-in wears a mask to inspect the National Medical Center in Seoul on January 28.

Hong Kong Chief Executive Carrie Lam, center, attends a news conference in Hong Kong on January 28. Lam said China will stop individual travelers to Hong Kong while closing some border checkpoints and restricting flights and train services from the mainland.

Workers at an airport in Novosibirsk, Russia, check the temperatures of passengers who arrived from Beijing on January 28.

Alex Azar, the US Secretary of Health and Human Services, speaks during a news conference about the American public-health response.

Two residents walk in an empty park in Wuhan on January 27. The city remained on lockdown for a fourth day.

A person wears a protective mask, goggles and coat as he stands in a nearly empty street in Beijing on January 26.

Medical staff members bring a patient to the Wuhan Red Cross hospital on January 25.

People wear protective masks as they walk under Lunar New Year decorations in Beijing on January 25.

Construction workers in Wuhan begin to work on a special hospital to deal with the outbreak on January 24.

Dr. Allison Arwady, commissioner of the Chicago Department of Public Health, speaks to reporters on January 24 about a patient in Chicago who had been diagnosed with the coronavirus. The patient was the second in the United States to be diagnosed with the illness.

A couple kisses goodbye as they travel for the Lunar New Year holiday in Beijing on January 24.

Workers manufacture protective face masks at a factory in China's Hubei Province on January 23.

Shoppers wear masks in a Wuhan market on January 23.

Passengers are checked by a thermography device at an airport in Osaka, Japan, on January 23.

People wear masks while shopping for vegetables in Wuhan on January 23.

A militia member checks the body temperature of a driver in Wuhan on January 23.

Passengers wear masks as they arrive at the Ninoy Aquino International Airport in Manila, Philippines, on January 23.

A customer holds boxes of particulate respirators at a pharmacy in Hong Kong on January 23.

Passengers wear masks at the high-speed train station in Hong Kong on January 23.

A woman rides an electric bicycle in Wuhan on January 22.

People in Guangzhou, China, wear protective masks on January 22.

People go through a checkpoint in Guangzhou on January 22.

Medical staff of Wuhan's Union Hospital attend a gathering on January 22.

Health officials hold a news conference in Beijing on January 22.

In pictures: The novel coronavirus outbreak

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US Fed cuts rate, new guidelines to be released

US Vice President Mike Pence on Sunday said new guidelines will be released Monday regarding potential curfews or closures of locations such as restaurants.

The US Centers for Disease Control and Prevention has recommended canceling or postponing events involving more than 50 people for eight weeks and several states and cities have announced widespread mandatory closures as part of attempts to curb the spread of the virus.

Illinois, Ohio, Massachusetts, Washington and Pennsylvania are temporarily closing restaurants and bars, with some exceptions, while schools are closed in 32 states. New York announced Sunday that it would be closing all theaters and concert halls and only allowing takeaway food from restaurants, as the number of cases in New York City rose to 329, with five deaths.

Passengers wearing face masks check a tablet computer with their luggage at an empty check in hall of a terminal of the Franz-Josef-Strauss airport in Munich, southern Germany on March 17, 2020 where many flights are currently cancelled by the airlines because of the new coronavirus COVID-19. (Photo by Christof STACHE / AFP) (Photo by CHRISTOF STACHE/AFP via Getty Images)

Related article Everything travelers need to know about coronavirus

In an emergency action to support the economy during the pandemic, the Federal Reserve announced on Sunday it would cut its target interest rate to zero. Fed chairman Jerome Powell said the measures were “essential to contain the outbreak,” but will “take a toll on the economy in the near term.”

It comes as US stocks plummeted into a bear market last week, with Wall Street having its worst day since October 19, 1987. On Sunday, US stock futures dropped 5%, hitting the “limit down” – meaning they can’t fall any further.

Global impact

Elsewhere, countries in almost every continent are ramping up emergency measures of their own as cases continue to climb.

Lebanon has closed its airport, borders and ports for two weeks starting Sunday until March 29, Information Minister Manal Abdul Samad said in a news conference on Sunday in Beirut. The government is banning public and private gatherings and government offices will be closed except for security, health and service offices, according to Abul Samad.

The Iraqi government announced it will place Baghdad under a curfew starting Tuesday through to March 23, according to the prime minister’s office. Under the curfew, people are not allowed to leave their houses for nearly a week.

In Europe, the Czech Republic has shut down public services to prevent the spread of the virus, while Ireland has called on pubs to close and asked people not to participate in any parties.

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Updated 11:51 PM EDT, Mon March 16, 2020

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Here's how the government can enforce quarantine rules

03:04 - Source: CNN

In France, which has closed restaurants, cafes, cinemas and clubs, more than half of the country’s 300 coronavirus patients in intensive care are under the age of 60, according to the head of the country’s national health agency. As of Sunday, French health authorities said there are 5,423 confirmed cases in the country, with 127 deaths reported.

South Africa declared a national disaster and announced far-reaching travel restrictions to combat the virus, Kenya’s government announced new travel restrictions after confirming two more cases, and Morocco has suspended all international flights to and from its territory “until further notice,” according to its foreign ministry.

Peru, which has reported 71 cases of coronavirus, closed its borders and issued a nationwide state of emergency on Sunday, ordering people to stay home and self-quarantine. Colombia said it will block entry for all non-residents and require residents who enter the country to self-isolate for 14 days.

CNN’s Ben Tinker, Samantha Beech, Michael Nedelman, Arman Azad, Jackie Castillo, Jason Hoffman, Pierre Meilhan and Nicky Robertson in Atlanta, Steven Jiang and Lily Lee in Beijing, Yoonjung Seo in Seoul, Ben Westcott, Eric Cheung and Alexandra Lin in Hong Kong contributed to reporting.