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China are stronger in the Bay Area than anywhere else in the United States, with flights shuttling more than half a million Chinese tourists to and from the region each year, local tech giants building their goods there, and 1 in 5 residents of San Francisco claiming Chinese heritage.

Because of that, the impact of the coronavirus spreading out of China — named COVID-19 on Tuesday — goes well beyond a health scare in the Bay Area. Last year, Chinese visitors spent $1.3 billion in San Francisco, Marin and San Mateo counties. Shuttered factories in China, vanished customers from local Chinatown restaurants and stores, and canceled flights all have bruised this region’s tourist attractions and scrambled family plans.

“We’re checking the news every hour” for virus updates, said San Francisco resident Edith Kwong, 41, whose uncle lost his chance to visit the Bay Area after airport officials in Hong Kong repeatedly canceled his flights.

Kwong is among many Chinese Americans in limbo, unsure of when — or if — stranded relatives will arrive. Business owners are concerned, and customers impatient.

“We don’t know when things are going to get resolved,” Kwong said. “We don’t know what’s going to happen the next day.”

Neither do thousands of others throughout the Bay Area, where Chinese Americans compose large segments of the population.

San Francisco appears to have the highest percentage of Chinese Americans of anywhere in the country: 21%, as of 2018. New York is next, with just above 6%, although the figure is from the 2010 census and may be higher now. Even so, New York has the most Chinese American residents, 513,000, while San Francisco is next, with 182,823.

One in four people living in Millbrae, Cupertino and Saratoga are Chinese American, while Asian Americans — many of them descended from China — make up the largest ethnic group in Alameda and Santa Clara counties.

The region’s ties to China show in its demographics, commerce, travel and cultural exchanges. The links are evident in the Chinese dialects overheard on BART and Muni, the merchants and investors drawn to the area, and the immigrant families that have planted roots in the region for generations.

“There’s really no place else in the United States with a comparable level of connectivity to China than the Bay Area,” said Sean Randolph, senior director at the Bay Area Council Economic Institute, who began studying connections between China and the Bay Area more than 10 years ago, suspecting the relationship was “something unique.”

Now, this association shows in the number of coronavirus cases: With four diagnosed cases, the Bay Area has more than any other region in the U.S.

The respiratory illness emerged in December and has spread to dozens of countries. It has sickened more than 43,101 people and killed more than 1,000, most in China. The virus has infected 13 people in the U.S., and local officials have said the risk of infection remains low. Nevertheless, World Health Organization officials on Tuesday called the coronavirus a “grave threat.”

In the Bay Area, that threat has fragmented a unique and intimate relationship with China that has endured for more than a century.

Kevin Chan, co-owner of the famed Golden Gate Fortune Cookie Factory on Ross Alley, said business has dropped by 70% since the virus broke out. The factory normally sees up to 500 customers a day.

“People are just scared. They don’t come,” Chan said. “Normally, teachers come to the factory with their students for the Lunar New Year to see how the cookies are made. But this year I don’t have any teachers coming.”

News of the virus spurred Alex Kwan into action. An E-4 specialist in the U.S. Army with a passion for philanthropy, Kwan partnered with the UC Berkeley Chinese Students and Scholars Association to raise nearly $90,000 to purchase medical supplies to ship to hospitals in Wuhan, the epicenter of the virus, and where it emerged.

The group is planning to send its first batch of supplies — from sanitizing products to hazmat suits — this week.

“I have family in Hong Kong, so this is the right thing to do,” said Kwan, an accountant and president of Hop4Kids, a San Francisco nonprofit that combats child poverty. “I don’t think that just because we’re in the U.S. we shouldn’t help with what’s going on in Asia.”

Back to Gallery Why fallout from coronavirus hits Bay Area so hard 3 1 of 3 Photo: Kevin Frayer / Getty Images 2 of 3 Photo: Carlos Avila Gonzalez / The Chronicle 3 of 3 Photo: Carlos Avila Gonzalez / The Chronicle





Kwan’s girlfriend, Edith Kwong, and her family expected a visit from her uncle, Ng Kin Sang, earlier this month. He traveled from his home in New York to Hong Kong for a funeral and had planned to finish his trip in San Francisco to see his sister, Kwong’s mom. Then came the flight cancellations.

“Things were getting more intense every single day,” said Kwong, 41. “The airlines started canceling more and more flights. They rebooked him on a United (Airlines) flight on the sixth, but it got canceled.”

Sang returned to New York Sunday but couldn’t stop in the Bay Area.

Kwong, who has family in China, said she scours several news sites for daily updates on the virus. She and her family tried to purchase multiple breathing masks shortly after learning of the outbreak, but stores were already sold out, she recalled.

Chinese immigrants first arrived in the U.S. in the mid-1800s and migrated to San Francisco in search of better economic opportunities. Many were hired to help build the first transcontinental railroad in 1865, according to the San Francisco Travel Association, the city’s tourism board. The city’s Chinatown — one of the oldest in the U.S. — emerged soon after.

Chinese tourism also plays a significant role in the region’s economy. Chinese visitors to the Bay Area spent more than $1.3 billion last year alone, according to the San Francisco Travel Association.

Imports from and exports to China through the Port of Oakland rose in January compared with a year earlier, but concerns about the coronavirus loom as shipping lines say cargo volume is expected to slow over the next few months. The port’s maritime director, John Driscoll, said Tuesday that “it’s possible” the virus will harm trade growth.

The number of visitors from China to the Bay Area has already dwindled as the coronavirus spreads and travel to and from China becomes nearly impossible.

Last year, San Francisco hosted 517,700 visitors from China. The year before, China was the second-largest source of international visitors after Mexico, according to the San Francisco Travel Association.

But now, there’s barely any way for those visitors to get here.

Flights to mainland China from any Bay Area airport are halted through the end of March, airport officials said. The last departure from the Bay Area to China is Friday, a China Southern Airlines flight from SFO to the city of Guangzhou.

Chan, the fortune cookie baker, predicts the ripple effects of the coronavirus will last several months and said he’ll consider closing the factory on some days if business doesn’t pick up.

“It’s a tragedy,” he said. “People would rather not come to Chinatown because they think they will become infected. I don’t think that’s fair.”

Tatiana Sanchez and Anna Bauman are San Francisco Chronicle staff writers. Email: tatiana.sanchez@sfchronicle.com, anna.bauman@sfchronicle.com Twitter: @TatianaYSanchez, @abauman2