- United States Coronavirus: 30,785,572 Cases and 559,945 Deaths
- Timeline of Events
- Travel Alert: Do Not Travel to China
- Screening incoming passengers at 20 airports in the U.S.
- Sources for the historical account
- US reports third consecutive single-day record of new coronavirus cases
- Azar warns 'window is closing' to stop coronavirus transmission
- Pence says federal government won't mandate face coverings
- How much is coronavirus spreading under the radar?
- Has the coronavirus that causes COVID-19 been spreading undetected in some populations?
- Can scientists estimate the size of an outbreak without widespread testing?
- With so many cases undetected, how can the WHO make claims about how many countries have sustained transmission?
- Is it time to ditch the idea of containing COVID-19?
United States Coronavirus: 30,785,572 Cases and 559,945 Deaths
Information collected on the first 20 domestic cases (not including repatriated cases and Diamond Princess cruise ship evacuee cases) is presented in the table below:
CDC in the early stages released information regarding the number of cases and people under investigation that was updated regularly on Mondays, Wednesdays, and Fridays. Below we provide the historical reports that we were able to gather in order to track the progression in the number of suspected cases and US states involved through time in the initial stages
As of Feb. 10:
|Number of U.S. States with PUI||36|
|Pending(specimens awaiting testing)||68|
As of Feb. 7:
|Number of U.S. States with PUI||36|
|Pending(specimens awaiting testing)||100|
As of Feb. 5:
|Number of U.S. States with PUI||36|
|Pending(specimens awaiting testing)||76|
As of Feb. 3:
|Number of U.S. States with PUI||36|
|Pending(specimens awaiting testing)||82|
As of January 31:
|Number of U.S. States with PUI||36|
|Pending(specimens awaiting testing)||121|
Previously, as of January 29, there were 92 suspected cases awaiting testing.
|Number of U.S. States with PUI||36|
|Pending(specimens awaiting testing)||92|
Timeline of Events
- On January 31, HHS declared Coronavirus a Public Health Emergency in the USAs of Jan. 31, the Wuhan coronavirus is officially a public health emergency in the United States, Alex Azar, secretary of the US Department of Health and Human Services (HHS), announced at a White House press briefing.
- On Jan. 31, the U.S. Centers for Disease Control and Prevention (CDC) issued a federal quarantine for 14 days affecting the 195 American evacuees from Wuhan, China. Starting Sunday, Feb. 2, U.S. citizens, permanent residents and immediate family who have visited China's Hubei province will undergo a mandatory 14 days quarantine and, if they have visited other parts of China, they would be screened at airports and asked to self-quarantine for 14 days. The last time the CDC had issued a quarantine was over 50 years ago in the 1960s, for smallpox.
- President Donald Trump signed an order on Jan. 31 for the U.S. to deny entry to foreign nationals who traveled to China within the preceding two weeks, aside from the immediate family of U.S. citizens.
- On Jan. 30, the CDC had confirmed the first case of person to person transmission in the U.S.:  the husband of the Chicago, Illinois case who had returned from Wuhan, China on Jan. 13 and who tested positive for the virus on Jan. 24).
- CDC stated on Jan. 30 that “It is ly there will be more cases of 2019-nCoV reported in the U.S. in the coming days and weeks, including more person-to-person spread.”
- The virus had been confirmed in 5 states.
- On Jan. 31, New York City health officials vehemently denied the rumor regarding a coronavirus case in the city .. On Feb. 1, however, the city's health commissioner did report that there was a test being performed on a person under 40 who had returned from China, developed matching symptoms, and tested negative to the seasonal flu.
- Most US patients had recently visited Wuhan.
- All of the first five U.S. cases were described as mild.
- A study on the first US case of novel coronavirus detailed mild symptoms followed by pneumonia
On Friday, January 31, Delta, American and United announced they would temporarily suspend all of their mainland China flights in response to the coronavirus outbreak.
Prior to this January 31 announcement:
- UNITED AIRLINESon Jan. 28 had announced it would cut 24 flights between the U.S. and China for the first week of February.
- AMERICAN AIRLINESon Jan. 29 had announced it would suspend flights from Los Angeles to Shanghai and Beijing from Feb. 9 through March 27, 2020. It will maintain its flight schedules (10 daily A/R) from Dallas-Fort Worth to Shanghai and Beijing, as well as from Los Angeles and Dallas-Fort Worth to Hong Kong.
- DELTA had not adjusted its schedule of direct flights from the U.S. to China. It is the only airline with direct flights to not take action so far.
The White House was considering issuing a ban on flights between the United States and China, as of late Jan. 28.Italy has announced on January 31 that it was suspending all flights to and from China following the first 2 cases of coronavirus in Italy.
Travel Alert: Do Not Travel to China
- The U.S. State Department on January 30 issued a Level 4: Do Not Travel to China Alert (the highest level of alert).
- Previously, on January 29, the advisory was set at a lower “Level 3: Reconsider Travel” advising not to travel to Hubei Province: (Level 4) and reconsider travel to the remainder of China (Level 3).
- The CDC on Jan. 28 issued a Level 3 Warning, recommending that travelers avoid all nonessential travel to China .
Screening incoming passengers at 20 airports in the U.S.
On January 17, the CDC announced that 3 airports in the United States would begin screening incoming passengers from China: SFO, JFK, and LAX  Other 2 airports were added subsequently, and on January 28, the U.S. Department of Health and Human Services (HHS) announced that 15 additional U.S. airports (bringing the total to 20) would begin screening incoming travelers from China.
Below is the complete list of airports where screening for the 2019 Novel Coronavirus (2019-nCoV) is in place:
- Los Angeles International (LAX)
- San Francisco International (SFO)
- Chicago O'Hare
- New York JFK
- Atlanta Hartsfield-Jackson International
- Houston George Bush Intercontinental
- Dallas-Fort Worth International
- San Diego International
- Seattle-Tacoma International
- Honolulu International
- Anchorage Ted Stevens International
- Minneapolis-St. Paul International
- Detroit Metropolitan
- Miami International
- Washington Dulles International
- Philadelphia International
- Newark Liberty International
- Boston Logan International
- El Paso International
- Puerto Rico's San Juan Airport
Sources for the historical account
- Novel Coronavirus (2019-nCoV) situation reports -World Health Organization (WHO)
- 2019 Novel Coronavirus (2019-nCoV) in the U.S -. U.S. Centers for Disease Control and Prevention (CDC)
- Symptoms of Novel Coronavirus (2019-nCoV) – CDC
- China Travel Advisory – U.S.
State Department, accessed January 31, 2020.
- Novel Coronavirus in China – Warning – Level 3, Avoid Nonessential Travel – CDC, January 28, 2020.
- Public Health Screening to Begin at 3 U.S.
Airports for 2019 Novel Coronavirus (“2019-nCoV”) – CDC January 17, 2020
- First Travel-related Case of 2019 Novel Coronavirus Detected in United States – CDC, January 21, 2020
- Second Travel-related Case of 2019 Novel Coronavirus Detected in United States – CDC, January 24, 2020
- CDC confirms additional cases of 2019 Novel Coronavirus in United States – CDC, January 26, 2020
- 2019 Novel Coronavirus (2019-nCoV) in the U.S. – CDC, Updated January 29, 2020
- White House considers ban on flights to China amid coronavirus outbreak – USA Today, Jan. 28, 2020
- CDC Confirms Person-to-Person Spread of New Coronavirus in the United States – CDC Press Release, Jan. 30, 2020
- NYC Officials Deny Report Of Coronavirus Amid Confusion – Forbes, Jan. 31, 2020
- Delta, American, United to suspend all China mainland flights as coronavirus crisis grows – USA Today, Jan. 31, 2020
- Secretary Azar Declares Public Health Emergency for United States for 2019 Novel Coronavirus – U.S. Department of Health and Human Services (HHS), Jan. 31, 2020
- Man returning from Wuhan, China is first case of 2019 Novel Coronavirus confirmed in Massachusetts – Massachusetts Department of Public Health, Feb. 1, 2020
- County of Santa Clara Public Health Department Reports First Case of Novel (new) Coronavirus – Santa Clara County Public Health, Jan. 31, 2020
- Coronavirus: First case confirmed in Santa Clara County – Mercury News, Jan. 31. 2020
The global number of reported deaths linked to the new coronavirus surpassed 500,000 on Sunday, as the number of cases reported worldwide topped 10 million—with the United States accounting for more than 25% of those deaths and North America accounting for about 25% of those cases.
US reports third consecutive single-day record of new coronavirus cases
As of Monday morning, officials worldwide had reported 10,151,300 cases of the new coronavirus, and 502,036 deaths linked to the virus.
In the United States, officials as of Monday morning reported 2,564,600 cases of the new coronavirus—up from 2,435,200 cases as of Friday morning.
The United States had seen a downward trend in newly reported coronavirus cases for six consecutive weeks. But new cases have now grown for more than a week and have surpassed the epidemic's previous peak.
U.S. officials on Friday reported 45,255 new cases of the coronavirus, which is the largest single-day increase reported so far. Friday marked the third consecutive day that the country reported a record-high single-day increase in new cases.
Data from the New York Times shows that 32 states—Alaska, Arizona, Arkansas, California, Colorado, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Montana, Nevada, New Mexico, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Washington, West Virginia, Wisconsin, and Wyoming—saw their average daily numbers of newly reported cases rise over the past 14 days.
On Friday, Idaho, Kansas, Oregon, South Carolina, and Utah reported their largest single-day increase in cases, while Florida on Saturday reported a single-day record increase of 9,585 new coronavirus cases.
The surges in new coronavirus cases are prompting some state officials to reimplement coronavirus-related business closures and other measures intended to curb the spread of the pathogen. For example, California Gov. Gavin Newsom (D) on June 12 allowed bars to open in the state, but on Sunday, he ordered bars in seven counties to close and recommended that bars in eight counties close.
As states experiences spikes in cases, hospitals are becoming overwhelmed with patients with Covid-19, the disease caused by the new coronavirus. For example, hospitals in Arizona, Florida, and Texas have seen their numbers of Covid-19 patients swell.
In Florida, Miami-Dade County on Thursday reported a record-high number of hospitalizations linked to the new coronavirus—with 885 patients with Covid-19 in hospitals, up from 546 hospitalizations two weeks prior. Similarly, state officials in Texas reported 4,739 hospitalized patients with Covid-19—a number twice as high as 10 days ago.
“The numbers are definitely scary,” said Judy Rich, chief executive of Tucson Medical Center, a hospital with more than 500 beds that serves patients from across southern Arizona. Since the beginning of the month, Tucson Medical Center has seen a threefold increase in its number of patients with Covid-19.
In Arizona, Banner Desert Medical Center, Valleywise Health Medical Center, and other hospitals have activated their surge plans to expand their capacity to treat patients with Covid-19.
Meanwhile, the New York Times' data shows that the average daily numbers of newly reported cases over the past two weeks remained mostly stable in Guam and 13 states: Alabama, Connecticut, Illinois, Indiana, Maine, Massachusetts, Minnesota, Nebraska, New Jersey, New York, North Carolina, North Dakota, and Virginia.
In addition, Puerto Rico, Washington, D.C., and five states—Maryland, New Hampshire, Rhode Island, South Dakota, and Vermont—saw their average daily numbers of newly confirmed cases decrease over the past 14 days, according to the data.
As of Monday morning, officials had reported a total of 125,814 U.S. deaths linked to the new coronavirus—up from 124,393 deaths reported as of Friday morning.
Azar warns 'window is closing' to stop coronavirus transmission
As America's coronavirus epidemic resurges, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, during a White House coronavirus task force briefing on Friday said recent outbreaks could spread to other regions of the country where the virus had been relatively well contained.
“We are facing a serious problem in certain areas,” Fauci said. “We have a very heterogeneous country, but heterogeneity does not mean that we are not intimately interconnected with each other. So, what goes on in one area of the country ultimately could have an effect on the other areas of the country.”
Fauci added that, “If we don't extinguish the outbreak, sooner or later even ones that are doing well are going to be vulnerable to the spread.”
To curb the spread of the virus, Fauci urged Americans to wear face coverings and practice social distancing.
“You have an individual responsibility to yourself but you have a societal responsibility, because if we want to end this outbreak—really end it, and then hopefully when a vaccine comes and puts the nail in the coffin—we've got to realize that we are part of the process,” Fauci said.
Similarly, HHS Secretary Alex Azar on NBC's “Meet the Press” on Sunday called on Americans “to act responsibly” and practice social distancing and wear face coverings, noting that the “window is closing” to stop the transmission of the new coronavirus.
Pence says federal government won't mandate face coverings
House Speaker Nancy Pelosi (D-Calif.) on ABC's “This Week” on Sunday said the federal government should require Americans to wear face coverings to slow the spread of the new coronavirus.
“Definitely long overdue for that,” Pelosi said. “And my understanding that the Centers for Disease Control [and Prevention] has recommended the use of masks but not required it because they don't want to offend the president.”
However, Vice President Pence on CBS News' “Face the Nation” on Sunday said the federal government would not issue a mandate requiring Americans to wear masks, saying the White House would “defer to governors.”
“One of the elements of the genius of America is the principle of federalism, of state and local control,” Pence said. “We've made it clear that we want to defer to governors.
We want to defer to local officials, and people should listen to them” (New York Times, 6/29 ; Coleman, The Hill, 6/28; Lawler, Axios, 6/28; Gamble, Becker's Hospital Review, 6/27; Wamsley, NPR, 6/25; Yamamura/Marinucci, Politico, 6/28; Levey, Los Angeles Times, 6/26; Associated Press/Modern Healthcare, 6/27; Robles, New York Times, 6/29; Klar, The Hill, 6/28; Chalfant, The Hill, 6/26; Ollstein, Politico, 6/28; Sonmez et al., Washington Post, 6/28; Gowen et al., Washington Post, 6/27; Kasler, McClatchy, 6/28; O'Reilly, Fox News, 6/28; Coleman, The Hill, 6/28; Budryk, The Hill, 6/28; New York Times, 6/29 ; New York Times, 6/29 ).
How much is coronavirus spreading under the radar?
Odisha, in eastern India, has closed theatres, swimming pools, schools and other public spaces in order to stem the spread of coronavirus.Credit: STR/NurPhoto/Getty
Just how much has the coronavirus spread? More than 137,000 people in 117 countries and regions have been confirmed as having COVID-19. And earlier this week, the World Health Organization (WHO) described the outbreak as a pandemic. But testing isn’t available to everyone, so the numbers don’t accurately reflect the extent of transmission in communities around the world.
conversations with three leaders in public health — at the WHO, the US Centers for Disease Control and Prevention (CDC) and at one of one of the largest research charities in the world — Nature explains how officials and researchers are attempting to estimate the size of individual outbreaks incomplete data.
Has the coronavirus that causes COVID-19 been spreading undetected in some populations?
“Yes, unequivocally,” says Jeremy Farrar, an infectious disease specialist and director of the research charity Wellcome, in London. A telltale sign of covert transmission in communities is finding a few confirmed but unrelated cases, with no recent history of international travel.
That means these cases are connected through a hidden web of infections.
The ideal way to know how many people in a community have had coronavirus infections , Farrar says, is to collect blood samples from people in every age group, looking for antibodies against the coronavirus, which show that someone has previously been infected.
Data from such serology studies, as they are called, can then be used to accurately determine rates of fatality and transmission. But such studies take time. “We need to make policy decisions and clinical decisions now,” Farrar says. “You can’t say, ‘Let’s wait a month until we have the data.’”
Can scientists estimate the size of an outbreak without widespread testing?
Yes. Experts say that they compare various lines of evidence. One estimate begins with the number of deaths in an area.
Farrar calls this a “guesstimate” because each of the variables researchers are using right now are subject to change, introducing uncertainty at each step in the calculation.
However, it goes something this: Data from China suggest that about three weeks passes between when a person feels sick and dies from COVID-19.
And if you assume a case fatality rate of roughly 1%, a back-of-the-envelope calculation suggests that each death represents about 100 cases in the first week. Right now, he adds, you can expect the epidemic to double each week if those cases aren’t identified and isolated — bringing the estimate to 400 at the time of death. Because the error bars on each of these variables are large, epidemiologists check their figures against further information.
For example, experts have turned to analyses of coronavirus genomes.
The best example is from Seattle, Washington, where on 29 February, Trevor Bedford, a computational biologist at the Fred Hutchinson Cancer Research Centre, and his colleagues reported that the genome of a virus collected from a teenager near the city closely matched that of one collected six weeks earlier, from an unrelated woman in her sixties who had returned to Seattle from China. The simplest explanation was that the virus had spread from the woman to other people, who spread it to yet others, eventually reaching the teenager. Bedford’s team calculated that over the six weeks, several hundred people could have been infected.
Gregory Armstrong, deputy incident manager for the COVID-19 response at the CDC in Atlanta, Georgia, says that Bedford got in touch as soon as he finished the analysis. “I asked him to look at the probability of alternatives,” Armstrong says.
The teenager had not recently travelled internationally, so another possibility was that a second person had come to Seattle from the same region of China as the first traveller, with the same strain.
But Bedford calculated that such a scenario was less ly than a single introduction.
So, how did the teenager acquire the infection without health officials noticing a huge uptick in cases? After the woman and her husband tested positive in mid- to late January, health officials monitored 347 people with whom they had come into contact1.
One possibility, Armstrong says, is that some of these contacts were infected, but showed few, if any, symptoms of COVID-19. If they didn’t isolate themselves, they might have spread the virus in the community.
When asked why the CDC didn’t initially test more people in Seattle who complained of fevers and coughing in February, Armstrong says, “Resources, quite honestly.”
In early March, academic laboratories ramped up screening for coronavirus, and have started to reveal the extent of the outbreak. As of 12 March, King County health department, which covers Seattle, had reported 270 cases, with 27 deaths.
With so many cases undetected, how can the WHO make claims about how many countries have sustained transmission?
“We have to use the information we have,” says Maria Van Kerkhove, technical lead of the emergencies programme at the WHO in Geneva, Switzerland.
Most of the WHO’s data come from surveillance and case detection, she says, but the organization also corresponds with scientists who conduct genome analyses and other studies.
Understanding the extent of transmission in each province or state can help policymakers to tailor their responses.
Van Kerkhove says there is evidence that containment measures worked in China, which has reported just about 20 new cases per day, for the past week. (By comparison, Italy confirmed more than 2,000 cases in the past 24 hours.)
An early signal that China had begun to turn the tide on their epidemic was that most newly reported cases began to occur among known and quarantined contacts of cases, she says. In other words, the virus wasn’t spreading undetected — at least not as frequently as it once was.
“But while we are seeing a decline in cases across Asia, the big worry now is Europe,” says Van Kerkhove. “We know that with more aggressive containment, countries can hit a turning point. But in some countries it will get worse before it gets better.”
Armstrong worries that Europe's situation could foreshadow what's to come for the United States. “It’s hard to believe we won’t see that kind of spread here,” he says. “I hope we don’t, but health departments — every one of them — will tell you this is the most complex public health emergency we have dealt with.”
Is it time to ditch the idea of containing COVID-19?
Absolutely not, say Farrar, Armstrong and Van Kerkhove. Farrar explains that containment and mitigation strategies overlap because measures that help to prevent an outbreak spreading also mitigate its effects on lives and hospitals.
The most basic containment measure entails testing to identify infected people, finding their contacts and preventing them from infecting others. The WHO credits the curbing of China’s outbreak to the country’s meticulous identification of cases and contacts.
Chinese authorities quarantined contacts — at home and in facilities where they were monitored for 14 days.
“Sometimes people have hundreds of contacts, so that is a very intensive effort,” says Farrar. “But it’s absolutely critical to do it, because even though it probably won’t completely contain the outbreak, it buys you time to make sure hospitals are ready, to think about the consequences of closing schools.”
China’s mitigation measures, such as banning large gatherings, also seem to have slowed transmission.
Armstrong uses an epidemiological measurement called the basic reproduction number, or R0, to describe the number of people whom an individual with COVID-19 might infect.
“We are estimating an R0 of around two or three,” he says. “If we can more than halve that with mitigation strategies, the outbreak will no longer grow.”
“Right now, we need to do anything that buys us one week, two weeks; anything to delay will have a dramatic impact,” says Farrar. “If London, Seattle or Paris goes through what northern Italy is going through at the moment, it will be devastating.”
Hospitals in northern Italy are running beds for patients, and around 250 health-care workers have been infected.
If current rates of infection continue, an analysis in The Lancet predicts, intensive care units in Italy will be at maximum capacity at the end of next week2.
“I was on the phone with colleagues in critical care in Italy over the weekend, and it’s desperate,” says Farrar. “Anything to dampen outbreaks will save an enormous number of lives.”