First US COVID-19 death reported; feds expand travel ban

In quickly evolving developments today, Washington state reported the nation's first COVID-19 death and two additional cases in a Seattle area nursing home, prompting the state's governor to declare a state of emergency.

At the federal level, officials today announced new travel restrictions involving Iran, parts of Italy, and parts of South Korea.

And in international novel coronavirus developments, cases continued to surge in the three main hot spots, two countries reported cases imported from Egypt, and at least three more countries reported their first cases: Ecuador, Monaco, and Qatar.

Washington officials also probe nursing home cluster

At a US Centers for Disease Control and Prevention (CDC) briefing today, Nancy Messonnier, MD, director of the CDC's National Center for Immunization and Respiratory Diseases, said the cases lift the number detected by the US public health system to 22. She add that, although the illnesses are still under investigation, they raise the level of concern for certain communities in the United States.

Jeffrey Duchin, MD, health officer with Public Health–Seattle & King County, said that, of the three new cases reported by Washington today, none appear to be linked to travel and are considered presumed positives.

Two are related to LifeCare Center, a long-term care facility in Kirkland. One involves a female healthcare worker who is hospitalized in satisfactory condition at Overlake Medical Center in Bellevue, and the other patient is a 70-year-old resident who is in serious condition at EvergreenHealth Medical Center in Kirkland.

Duchin said health officials are evaluating several other people with symptoms at the facility, including 27 of 108 residents and 25 of 180 staff. A CDC team is expected to arrive tonight to assist with the investigation.

The fatal case, which he said doesn't appear to be linked to the nursing home outbreak, involves a man in his 50s with underlying medical conditions who was hospitalized at EvergreenHealth Medical Center.

Notice of the three new cases in Washington state today follow announcements last night of two other cases of community transmission in the state, involving a high school boy and a woman who had traveled to South Korea. Combined with cases announced yesterday by California and Oregon, the United States now has seven community-transmission cases.

White House officials unveil new response steps

At a White House media briefing, President Donald Trump and other federal officials expressed their condolences to the family of the Washington patient.

Trump said the country took aggressive early actions, and though more cases are likely, the risk to the nation is still low and infections are mild for most people. He also added that he will meet with pharmaceutical companies at the White House on Monday to discuss issues related to the development of drugs and vaccines.

Vice President Mike Pence, who heads the White House's COVID-19 task force, detailed new travel restrictions, similar to the temporary ban announced in late January on people coming from China. The new measures apply to all travelers coming from Iran, including other foreign nationals, and travelers coming from the most affected areas of Italy and South Korea.

He also said discussions are under way to step up medical screening in people in other affected countries who will be traveling to the United States. He added that the Assistant Secretary for Preparedness and Response is taking steps to increase the availability of masks—designed to provide 34 million more a month—to protect healthcare workers.

Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, said community spread now being reported in the United States will require a focus on state and local public health measures to identify and isolate cases and trace contacts. "The country as a whole is still at low risk, but this is an evolving situation."

Cases outside China surge past 6,000

The CDC yesterday boosted travel warnings for Iran and Italy to the highest level, which urges people to avoid nonessential travel due to widespread community transmission and limited access to medical care.

In Iran, the health ministry reported 205 more cases and 9 more deaths, raising those respective totals to 595 and 43. Italy today reported 161 more cases and 8 more deaths, lifting its respective totals to 1,049 and 29.

The pace of new infections surged even higher in South Korea, with 813 more cases reported today, raising the country's total to 3,150. Four more people died from their infections, putting the fatality count at 17. In one of the daily updates today, the Korea Centers for Disease Control and Prevention detailed epidemiologic information on the first 16 deaths, all involving patients who had underlying medical conditions. The deaths occurred mainly in seniors, though 1 involved a patient in his 30s. Six were younger than 60, and 10 were male.

In Iran, the health ministry reported 205 more cases and 9 more deaths, raising those respective totals to 595 and 43.

Elsewhere in Asia, China reported 427 new cases, raising its overall total to 79,251, according to the National Health Commission daily update. It also reported 47 more deaths and 288 fewer serious cases, putting those respective totals at 2,835 and 7,664.

Japan reported 9 more cases, 4 of them from the hot spot in Hokkaido, for a total of 217, and Singapore reported 4 new infections, all linked to the same workplace cluster, raising its total to 102.

In other developments, two countries—Canada and France—reported cases imported from Egypt, though only one case has been reported in Egypt. The country's health ministry said it is in contact with Canada and France, following the detection of a case in a Canadian man who been in Egypt and two French travelers who apparently contracted the virus there, according to a media report that cited Egypt's health ministry.

At least three countries reported their first cases today: Qatar (Iran travel), Monaco, and Ecuador (Spain travel).

Several already affected countries reported new cases, including France, which announced a temporary ban on indoor gatherings of more than 5,000 people.

The World Health Organization said today in its latest daily situation report that over the past 24 hours it received 1,318 new reports of illnesses outside China, raising the total to 6,009 from 53 countries.

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