Severity: Informational Alert

Health: Additional US states report first COVID-19 cases during mid-March. Maintain strict basic health precautions.

This alert affects United States

This alert began 14 Mar 2020 02:02 GMT and is scheduled to expire 22 Mar 2020 23:59 GMT.

  • Incident: Imported cases of coronavirus disease (COVID-19), community transmission in some states
  • Location(s): Nationwide; states of Washington, California, and New York report most cases (map)
  • Period: January-March 2020
  • Cases: 2,251

Summary
US authorities have identified 2,251 confirmed and presumptive positive cases of coronavirus disease (COVID-19) according to data through March 13. Alaska, Alabama, and Idaho report their first cases. These figures may change or fluctuate as additional data becomes available during this rapidly evolving situation. No confirmed cases have been identified in the state of West Virginia.

States reporting community transmission:

  • Washington: 568 cases
  • California: 282 cases
  • New York: 421 cases


States where community transmission has not been determined:

  • Alabama: 5 cases
  • Alaska: 1 case
  • Arizona: 9 cases
  • Arkansas: 6 cases
  • Colorado: 77 cases
  • Connecticut: 7 cases
  • Delaware: 4 cases
  • Florida: 50 cases
  • Georgia: 45 cases
  • Hawaii: 2 cases
  • Idaho: 1 case
  • Illinois: 46 cases
  • Indiana: 13 cases
  • Iowa: 17 cases
  • Kansas: 6 cases
  • Kentucky: 14 cases
  • Louisiana: 36 cases
  • Maine: 3 cases
  • Maryland: 17 cases
  • Massachusetts: 123 cases
  • Michigan: 16 cases
  • Minnesota: 14 cases
  • Mississippi: 6 cases
  • Missouri: 4 cases
  • Montana: 1 case
  • Nebraska: 14 cases
  • Nevada: 19 cases
  • New Hampshire: 6 cases
  • New Jersey: 50 cases
  • North Carolina: 17 cases
  • North Dakota: 1 case
  • Ohio: 16 cases
  • Oklahoma: 3 cases
  • Oregon: 30 cases
  • Pennsylvania: 41 cases
  • Rhode Island: 14 cases
  • South Carolina: 13 cases
  • South Dakota: 9 cases
  • Tennessee: 26 cases
  • Texas: 44 cases
  • Utah: 9 cases
  • Vermont: 2 cases
  • Virginia: 30 cases
  • Washington, DC: 10 cases
  • Wisconsin: 19 cases
  • Wyoming: 1 case



Background and Analysis
Additional cases and locations may be added to this list at any time as disease surveillance and testing continues. The total case count includes individuals on repatriation flights and those returning from cruise ships; adding together the state totals will not give you the overall total without these numbers. Older individuals, infants, and those with chronic illness are more susceptible to infection and are at increased risk for severe complications. Human-to-human transmission can occur, though it remains unclear how easily the virus spreads between people.

The US CDC maintains an "Alert-Level 2" travel health notice for the global COVID-19 outbreak. This indicates older individuals and people of any age with chronic medical conditions or otherwise compromised immunity should consider postponing nonessential travel and take special precautions to avoid becoming ill, especially where sustained community transmission of COVID-19 has been identified. All individuals should monitor their health and limit interactions with others for 14 days after returning from travel.

On March 11, the WHO declared the ongoing coronavirus outbreak a pandemic. This shift in posture from an earlier briefing indicating the WHO would no longer use the term "pandemic" to describe disease transmission is reflective of the current COVID-19 global impact. Per the March 11 statement, "Describing the situation as pandemic does not change WHO's assessment of the threat posed by this virus. It doesn't change what WHO is doing, and it doesn't change what countries should do."

Coronavirus disease 2019 (COVID-19) is a viral respiratory disease caused by infection with the SARS-CoV-2 virus (previously known as 2019-nCoV). Symptoms occur 1-14 days following exposure (average of 3-7 days). These symptoms include fever, fatigue, cough, difficulty breathing, sometimes worsening to pneumonia and kidney failure - especially in those with underlying medical conditions.

Advice
Emphasize basic health precautions, especially frequent handwashing with soap and water, or an alcohol-based hand sanitizer if soap and water are unavailable. Practice good coughing/sneezing etiquette (i.e., covering coughs and sneezes with a disposable tissue, maintaining distance from others, and washing hands). There is no evidence that the influenza vaccine, antibiotics, or antiviral medications will prevent this disease, highlighting the importance of diligent basic health precautions.

Resources
State and Territorial Health Department Websites

US CDC: Guidance for Businesses and Employers

US CDC: Preventing COVID-19 Spread in Communities

US CDC Global COVID-19 Travel Health Notice

WHO: Getting your workplace ready for COVID-19

WHO advice for international travel

WHO coronavirus knowledge base