Severity: Warning Alert

Health: Nationwide COVID-19 activity continues in the US during April. New York and New Jersey report the most cases. Use basic health precautions.

This alert affects United States

This alert began 23 Apr 2020 20:58 GMT and is scheduled to expire 31 May 2020 23:59 GMT.

  • Incident: Coronavirus disease (COVID-19), community transmission
  • Location(s): Nationwide (map)
  • Period: January-April 2020
  • Cases: 828,441

Summary
US authorities have identified 828,441 confirmed and presumptive positive cases of coronavirus disease (COVID-19) according to US CDC data through April 23. These figures may change or fluctuate as additional data becomes available during this rapidly evolving situation. At this time, approximately 42-percent of all confirmed cases have occurred in the states of New York and New Jersey. Preliminary data indicates the US may soon reach peak transmission, though additional time and data is required to confirm this trend.

States with widespread transmission indicate COVID-19 activity is not confined to particular areas of that state; people have been infected with the virus, but how or where they became infected is not known, highlighting the importance of diligent use of basic health precautions, including hand and respiratory hygiene.

States reporting community transmission:

  • Alabama: 5,831 cases
  • Alaska: 335 cases
  • Arizona: 5,459 cases, widespread community transmission
  • Arkansas: 2,281 cases, widespread community transmission
  • California: 35,396 cases, widespread community transmission
  • Colorado: 10,825 cases, widespread community transmission
  • Connecticut: 22,469 cases, widespread community transmission
  • Delaware: 3,308 cases, widespread community transmission
  • Florida: 27,791 cases, widespread community transmission
  • Georgia: 20,769 cases, widespread community transmission
  • Hawaii: 537 cases
  • Idaho: 1,802 cases, widespread community transmission
  • Illinois: 35,108 cases, widespread community transmission
  • Iowa: 3,748 cases, widespread community transmission
  • Kansas: 2,211 cases
  • Louisiana: 25,317 cases, widespread community transmission
  • Maine: 907 cases, widespread community transmission
  • Maryland: 15,737 cases, widespread community transmission
  • Massachusetts: 42,944 cases, widespread community transmission
  • Michigan: 33,966 cases, widespread community transmission
  • Minnesota: 2,721 cases, widespread community transmission
  • Mississippi: 5,153 cases, widespread community transmission
  • Missouri: 6,137 cases, widespread community transmission
  • Montana: 442 cases
  • Nebraska: 1,813 cases, widespread community transmission
  • Nevada: 4,081 cases, widespread community transmission
  • New Hampshire: 1,588 cases, widespread community transmission
  • New Jersey: 95,865 cases, widespread community transmission
  • New Mexico: 2,210 cases, widespread community transmission
  • New York: 253,219 cases, widespread community transmission
  • North Carolina: 7,220 cases, widespread community transmission
  • North Dakota: 679 cases, widespread community transmission
  • Ohio: 14,117 cases
  • Oklahoma: 2,894 cases, widespread community transmission
  • Oregon: 2,059 cases, widespread community transmission
  • Pennsylvania: 35,684 cases, widespread community transmission
  • Rhode Island: 6,012 cases, widespread community transmission
  • South Carolina: 4,761 cases, widespread community transmission
  • South Dakota: 1,858 cases, widespread community transmission
  • Tennessee: 7,572 cases
  • Texas: 21,069 cases
  • Utah: 3,540 cases, widespread community transmission
  • Vermont: 823 cases
  • Virginia: 10,998 cases, widespread community transmission
  • Washington: 12,494 cases, widespread community transmission
  • West Virginia: 963 cases, widespread community transmission
  • Wisconsin: 4,845 cases, widespread community transmission
  • Wyoming: 447 cases, widespread community transmission


States where community transmission has not been determined:

  • Washington, DC: 3,206 cases
  • Indiana: 12,438 cases
  • Kentucky: 3,373 cases



Background and Analysis
Additional cases may be added to this list at any time as disease surveillance and testing continues. Significant increases in case counts are expected as laboratory test results become available. The total case count includes individuals on repatriation flights and those returning from cruise ships; adding together the state totals will not denote 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 a "Warning-Level 3" travel health notice for the global COVID-19 outbreak. This is the highest of three levels and indicates US authorities recommend avoiding all nonessential travel. Furthermore, older individuals and people of any age with chronic medical conditions or otherwise compromised immunity should consider postponing nonessential travel, including domestic 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.

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: www.cdc.gov/publichealthgateway/healthdirectories/healthdepartments

US CDC: Guidance for Businesses and Employers: www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response

US CDC: Preventing COVID-19 Spread in Communities: www.cdc.gov/coronavirus/2019-ncov/community

Mental Health Considerations during COVID-19 Outbreak: www.who.int/docs/default-source/coronaviruse/mental-health-considerations

US CDC: Manage Anxiety and Stress: www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety

US CDC Global COVID-19 Travel Health Notice: wwwnc.cdc.gov/travel/notices/warning/coronavirus-global

WHO: Getting your workplace ready for COVID-19: www.who.int/docs/default-source/coronaviruse/getting-workplace-ready-for-covid-19

WHO advice for international travel: www.who.int/news-room/articles-detail/updated-who-recommendations-for-international-traffic-in-relation-to-covid-19-outbreak

WHO coronavirus knowledge base: www.who.int