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March 3 Community transmission in Westchester County Trip from Miami School closings in Westchester Co and the Bronx Cuomo Presser $40 million program for state labs and hospitals 1,000 COVID tests per day https://recombinomics.co/thedrnimanshow/2020/03/030320.mp3

Video of news conference which gives age of son (20M) and daughter (14F) and school closings

Media Advisory Contra Costa County Confirms First Local Case of Novel Coronavirus Tuesday, March 3, 2020 Note to Editors: The media briefing will take place at 1220 Morello Ave., in Martinez. No interviews will be provided prior to the briefing. WHAT Contra Costa Health Services (CCHS) has confirmed the first positive case of novel coronavirus, or COVID-19, involving a resident of the county. The person tested positive this afternoon. Our County's public health lab conducted the test, which is expected to be confirmed by the Centers for Disease Control & Prevention in the coming days. The patient, who is being treated at a hospital in the county, had no known travel history and no known contact with a confirmed case of COVID-19. CCHS is conducting a thorough investigation to identify anyone who may have had close contact with the patient. WHEN: 8:30 p.m., March 3, 2020 WHERE: 2nd floor conference room at 1220 Morello Ave., Martinez, CA 94553

The potentially lethal coronavirus spread from a Manhattan lawyer to his wife, son and daughter — along with a good Samaritan neighbor who drove the ailing attorney to the hospital, Gov. Cuomo announced Wednesday. The announcement of the four new cases, all linked to the 50-year-old Westchester County resident, brings the total number of infections in New York State to six. Tests for possible coronavirus on patients in Buffalo came back negative, as did the test on the husband of the healthcare worker who became New York’s first case of the virus, the governor said. “There are going to be dozen and dozens and dozens of people and the more people you test the more will be positive,” the governor warned in announcing the new cases. The infected lawyer, hospitalized in critical condition at a Manhattan hospital, checked into a suburban hospital on Feb. 27 with respiratory problems but wasn’t diagnosed until four days later. His family members, along with his helpful neighbor, are quarantined at their suburban homes, the governor said. Cuomo will head to Westchester this afternoon to meet with local and school officials. Officials at Yeshiva University had already announced the 20-year-old son, a student at the Manhattan college, tested positive for the virus.

Wife, son and daughter of Westchester coronavirus patient test positive for illness, along with neighbor who drove him to the hospital By DENIS SLATTERY and LARRY MCSHANE NEW YORK DAILY NEWS | MAR 04, 2020 | 10:12 AM https://www.nydailynews.com/news/politics/ny-westchester-man-son-tests-positive-for-coronavirus-20200304-jmndgnvd4bhyfjhmmqmdrbl5u4-story.html

Daughter, wife, and neighbor who drove father to hospital also positive.

Son of Westchester coronavirus patient tests positive for illness - third NY case By DENIS SLATTERY NEW YORK DAILY NEWS | MAR 04, 2020 | 9:14 AM The son of a Westchester man who became the third person in the state to contract the coronavirus has tested positive for the fast-spreading disease, according to the Manhattan school he attends. “We have unfortunately received news this morning that our student has tested positive for COVID-19. Our thoughts and prayers are with him and his family as well as to all those affected.,” Yeshiva University announced on its website Wednesday morning. The private university cancelled classes at its Washington Heights campus for the day. The boy’s father, a Manhattan lawyer, tested positive Monday for the coronavirus disease despite no known travel links to countries at the center of the outbreak, leading officials to order hundreds of congregants at his New Rochelle synagogue to quarantine in their homes. The 50-year-old man, who had underlying respiratory issues and first developed symptoms in late February, remains in critical condition at the New York-Presbyterian/Columbia University Irving Medical Center in Manhattan, according to health officials. The man’s daughter attends SAR Academy and High School in the Bronx, which has been voluntarily shut down.

The son of a Westchester man who became the third person in the state to contract the coronavirus has tested positive for the fast-spreading disease, according to the Manhattan school he attends. https://www.nydailynews.com/news/politics/ny-westchester-man-son-tests-positive-for-coronavirus-20200304-jmndgnvd4bhyfjhmmqmdrbl5u4-story.html

A Contra Costa County resident has tested positive for coronavirus, health officials said Tuesday evening. The resident's results tested positive Tuesday afternoon by the county's public health lab, Contra Costa Health Services said in a news release. The health services department said the Centers for Disease Control and Prevention is expected to confirm it in the coming days. The resident's case is not related to travel nor did the person have contact with someone who tested positive for COVID-19. Officials are investigating if anyone else may have been in close contact with the patient. Similar to other viral infections, coronavirus is spread through droplets when an infected person coughs or sneezes.

A Contra Costa County resident has tested positive for coronavirus, health officials said Tuesday evening. https://www.kcra.com/article/health-officials-1st-coronavirus-case-contra-costa-county/31216682

Virus detail Virus name: BetaCoV/USA/WA-WA3_UW1/2020 Accession ID: EPI_ISL_413025 Type: betacoronavirus Passage details/history: Original Sample information Collection date: 2020 Location: North America / USA / Washington Host: Human

Sequence (BetaCoV/USA/WA-WA3_UW1/2020) of King Co WA ex-South Korea (58F) is a recombinant with polyphorphisms shared by LA2 (Orange County) and AZ (Phoenix)

2nd case of COVID-19 confirmed in New Hampshire Newly confirmed case is man who had contact with previously diagnosed person 113 Shares Updated: 5:35 PM EST Mar 3, 2020 CONCORD, N.H. — A second case of COVID-19 has been confirmed in New Hampshire, state health officials said Tuesday. An adult male from Grafton County was confirmed to have the potentially deadly coronavirus, according to Dr. Benjamin Chan, the state epidemiologist. Health officials said the newly diagnosed person had contact with a Dartmouth-Hitchcock Health employee who was the first person in New Hampshire confirmed to have the virus. >> DHHS information: COVID-19 novel coronavirus The man is now under isolation. Chan said that now that New Hampshire has the ability to test for COVID-19, test results will start coming in more quickly. >> Coronavirus in New Hampshire: What you need to know Health officials said earlier Tuesday that four people were undergoing testing for COVID-19. Officials updated data to include three additional negative tests for the virus, bringing the overall total of negatives to 6. Officials at Dartmouth's Tuck Business School said Tuesday they have learned that a number of their students attended a social event with the patient who tested positive. School officials said all of the students are considered to be at low risk, but were asked to follow DHHS guidelines for self-observation. Meanwhile, classes at River Valley Community College were canceled for the day Tuesday because officials became aware of "a potential tertiary exposure of one of our instructors at the Claremont campus to a person outside the college community who is being tested for COVID-19." School officials closed the school "as a matter of caution." "We have consulted with the Division of Public Health Services who determined there is not a reason to be concerned at this time. The employee will remain off campus for 14 days or upon earlier determination by Division of Public Health Services that the employee does not present a concern," River Valley Community College officials said in a statement.

Health officials said the newly diagnosed person had contact with a Dartmouth-Hitchcock Health employee who was the first person in New Hampshire confirmed to have the virus. https://www.wmur.com/article/new-hampshire-coronavirus-update-march-3-2020/31210137#

Transcript for the CDC Telebriefing Update on COVID-19 Press Briefing Transcript Tuesday, March 3, 2020 Please Note: This transcript is not edited and may contain errors. playstopskip-backwardskip-forwardvolume Volume Range Slider Scrub Range Slider Welcome and thank you for standing by. At this time all participants will be in the listen only mode until the question and answer session of today’s conference. Please press star 1 on your phone and record your name when prompted. This call is being recorded. If you have any objections, please disconnect at this time. I will now turn the call over to your host Paul Fulton. You may begin. Hello and thank you all for joining us today for this briefing to update you on CDC’s COVID-19 response. We’re joined by Dr. Nancy Messonnier who will give opening remarks before taking your questions. At this time, I will turn the call over to the Dr. Messonnier. Good afternoon and thank you all for joining us. Over the weekend, multiple states announced new presumptive positive cases of COVID-19. As of Monday evening, there were 60 cases that includes presumptive positives or CDC-confirmed positive cases of COVID-19 detected through the U.S. public health system. This does not include people repatriated on U.S. State Department flights. 22 of the 60 cases are travel associated. 11 are likely person to person and 27 are under investigation, which means that state and local public health officials are still investigating how these people were infected. Many states are now testing and reporting their own results. While these results will be confirmed at CDC, the state and local health departments are taking public health actions based on these presumptive positives. And CDC is counting these as cases. We would be updating our online case count on weekdays by noon. I just want to mention that we are no longer reporting the number of PUIs or patients under investigation nor those who have tested negative. With more and more testing done at states, these numbers would not be representative of the testing being done nationally. States are reporting results quickly and even — states are reporting results quickly and in the event of a discrepancy between CDC and state case counts, the state case counts should always be considered more up to date. Developments since I last spoke to you have heightened our concern for certain communities in the U.S. We have seen more reports come in from what is likely an outbreak in a long-term care facility in Washington state. Sadly, now we have six deaths reported to CDC. We have seen the first reports from Florida, Georgia, Rhode Island and New Hampshire state. We expect to continue to find more cases. These will probably result from a mixture of instances of travel-related, contact-related and community-associated cases where we don’t immediately know where people became exposed. Right now, we have 12 states that have reported cases of COVID-19. Many of these have occurred within the past 14 days. Meaning that we may still find contacts of cases in those states who test positive for COVID-19. The greatest risk of infection is among those who are in close contact with people who have COVID-19. This includes family members and health care workers who care for people who are infected. Right now, with still aggressive containment measures being taken to find and isolate cases in order to prevent spread, we want anyone with suspected exposure to someone with COVID-19 to reach out to their health care provider. You should do that by phone. There may come a day when we’re only looking for severe illness, but we’re trying to understand how the virus behaves and prevent additional spread. I talked about risk of infection. Now I would like to make a comment about the risk for serious outcomes. While information so far suggests that most COVID-19 illness is mild, a report out of China suggest serious illness occurs in 16% of cases. Older people and people with underlying health conditions, like heart disease, lung disease and diabetes, for example, were about twice as likely to develop serious outcomes versus otherwise younger, healthier people. We are particularly concerned about these people given the growing number of cases in the United States as well as those with suspected community spread. What is happening now in the United States may be the beginning of what is happening abroad. We will continue to maintain for as long as practical an aggressive national posture of containment. That said, you might see some local communities taking specific actions to mitigate the disease. It’s possible to contain the virus as well as work to mitigate future spread. We ask for people’s patience and understanding and most importantly their cooperation. If a health care provider or a public health worker tells you to stay home for 14 days unless you need medical care, please do that. Right now, especially individual actions, can have an important impact on how this situation plays out. You may need to take a break from your normal daily routine for two weeks. We have seen this especially in patients from the Diamond Princess cruise ship where a significant number of people have had very mild illness and don’t feel particularly bad. So staying home when you are sick is really important. Don’t let the illness spread beyond you. Stay away as much as you can from other people. We have guidance on our website about how to minimize the risk to others in your household. As more areas see community spread, local communities may start employing tools that encourage social distancing. The goal of social distancing is to limit exposure by reducing face-to-face contact and preventing spread among people in community settings. What these actions look like at the community level will vary depending on local conditions. What is appropriate for one community seeing local transmission won’t necessarily be appropriate for a community where no local transmission has occurred. People, communities, local and state governments should begin thinking about what this might look like for them and local action that might work best in their community to blunt the impact of this virus. There are a spectrum of actions that can reduce spread and impact. These are science-based and come from our play book on mitigating disease impact. I want to stress the personal action that individuals can take. Each year we recommend people wash their hands, cover their cough and sneezes and stay away from people who are sick. This is the other side of not spreading the disease, which is not catching it. Think twice before you expose yourself to someone who is showing symptoms. This is especially important for people who are older and have underlying health conditions. For seniors, preparedness may also mean making sure you have adequate supplies of routine medications, like medication for blood pressure and diabetes. This is always part of what CDC recommends for preparedness. If you’re 65 and older and particularly if you live in areas where there’s on going community spread, you need to think about what actions you can take to reduce your exposure. CDC’s role is to provide technical advice to states and counties. The decision of what steps to implement will be local. It’s also very important that clinicians have the information they need to make the best decisions for their patients. In addition to information on CDC’s website, we have open calls with clinicians. The last call had more than 10,000 listeners. We’re holding another call on Thursday. You can find more information at emergency.CDC.gov. I want to assure you that on other fronts partners in the U.S. Government and across the pharmaceutical industry are working quickly to develop effective tools to treat and prevent this virus, including anti-viral drugs and vaccines. With the global increase in cases and the spread that is occurring here in the United States, there have been a lot of questions about what might happen to us. I wish I could give you that answer. Unfortunately, I cannot. But I can assure you that CDC staff are working incredibly hard to assist the state and local health departments as they investigate and follow the new cases they have identified as well as provide guidance to all audiences on how to prepare. I speak on behalf of all of our staff and staff all across the U.S. Government when I say, our hearts go out to the people who have been affected by this new virus both here and around the world. We need to continue to work together within the federal government, across the public health infrastructure and in local communities. All of us have a role to play in keeping ourselves, our families and our communities safe. I would be happy to take some questions now. We will now begin a question and answer question. To ask a question from the phone lines please press star 1, enter your phone as unmute and record your name at the prompt. Please keep your questions to one questions and one follow-up. Our first question comes from Carolyn Johnson with the Washington Post. Your line is open. Thanks for taking my question. There’s been a lot of criticism from epidemiologists about the narrow criteria for testing and how that might have been linked to the limited availability to test due to the problems with the test. Can you just speak to that issue? What was the cause of the limited criteria? Do you now regret not expanding it earlier since the minute they start testing they’re finding cases? Messonnier: CDC’s criteria for patients under investigation has always started with the importance of astute clinicians who are making judgments about what their patients are likely to have. So we’ve always allowed those patients to be part of the testing criteria. But what we really need to focus on now is where we are today. There is spread across many countries across the world and spreading communities in the United States. We need to be focused on what we’re doing today to identify patients who are ill, make sure that they’re getting appropriately treated and tested and make sure that we’re protecting our communities by keeping — by keeping yourselves and each other safe. Next question, please. Our next question comes from Craig Figner with CBS Los Angeles. Your line is open. Thank you. Dr. Messonnier, a couple of questions. Here in California, do we have new information on testing kits, exactly how many have been shipped, will be shipped, when they will arrive? And also, if you can give, are you able to speak freely? Is anybody in the White House telling you to tamp down anything that you otherwise would like to say? Messonnier: Yeah. So the answer to the first question about California’s test kits is i really have to refer you to the state of California. What i can say is over the weekend we shipped additional test kits to California. And i understand from the FDA commissioner that by the end of the week they expect many more test kits to be available through other pathways besides CDC, which i know is great news for the clinicians out there. In terms of my telebriefings, as many of you know, i have been doing these telebriefings regularly since the start of the outbreak. I think we at CDC have been very open and able to answer lots of different questions, including those posed on these conferences. Thank you. Next question, please. Our next question comes from Rebekah Lindstrom from 11 Alive. Your line is open. Thank you. So, i’m trying to understand exactly how this process is going to be changing now that manufacturers are allowed to produce these test kits independently. So, if I understand it correctly, the test kits were sent out to various states, to the public health department and then they were sending it back to the CDC for verification of the results. Talk to me a little bit about now how that process is going to be working. Messonnier: Sure. Thanks for the opportunity to really clarify CDC’s role. CDC’s role in this space is in getting a diagnostic quickly and correctly and then working with our public health laboratory partners and state and local health departments to make sure that the public health labs have early access to diagnostic capacity. As part of that process, CDC has sent test kits out to states and those test kits are being used right now by many state health departments because of the FDA regulations, those are still considered presumptive positive until those are confirmed test at CDC, but those are actionable results that is state and local health departments are using those to make public health decisions. That part is CDC’s role. In order to get diagnostics to the front lines, that is, in the clinician’s hand at the bedside in the hospital, that’s really not the CDC public health test kit. That’s the availability of test kits from commercial test manufacturers which is something that is overseen by FDA. Again, based on the comments of the FDA commissioner over the weekend, I guess, last week, they are moving quickly to get those test kits out to commercial test manufacturers. That means it will be a tool in the toolbox of clinicians in clinics and in hospitals that they can use based on clinical suspicion to test their patients. That’s why it’s really important that clinicians look at the CDC guidance on our website, join our webinar so they can hear from us what information they need and also for clinicians to be in close touch with their own health departments so they can understand the local situation and how that might impact how they perceive and treat patients. Next question. Next question. To make sure I’m understanding real quick, you’re saying that those tests then that might be in the clinics or at the bedside, would still be presumptive positive and then tests would still go back to the CDC for confirmation? Messonier: Thanks for letting me clarify. No, those kits — those test kits that are commercially manufactured are overseen by FDA, and they won’t have that same public health confirmatory process I was just talking about. Our next question comes from Dennis Thompson with Health Day. Your line is open. Hi, Dr. Messonnier. Thank you for taking my question. Today in the MMWR there was report of patients with confirmed COVID-19 and in that it was noted that there was a second — a symptomatic secondary attack rate of about .45% among all close contacts and 10.5% among household members. Should we read that as good news that this maybe isn’t as — as infectious to those around us as we would think? Or how should we read those numbers coming out of CDC? Messonnier: Yeah. So thanks for bringing that up. CDC did have an MMWR that came out today and I think it reflects the aggressive early stance of looking for contacts, aggressively around cases to see if we could find spread. And among those early cases in the United States, we actually didn’t find a lot of spread in close contacts. And I do think that’s good news. But it is a relatively small number of cases compared to, for example, the 80,000 cases that are around the world. So we take that as optimistic but we still need to be cautious with these early cases and do complete investigations which our state and local health departments are doing. We are looking at the information both from the U.S. cases but certainly also from the information that’s coming in from other countries to try to understand the transmission dynamics and how it might impact the responses of state and local health departments. Next question, please. Our next question comes from Zara ? with Buzzfeed News. Your line is open. Hey, thanks so much for letting me ask a question. I wanted to clarify on the testing, so I know there’s been numbers going around saying by the end of the week to be a million tests a day. Is that exclusively based on the tests that CDC is sending out or is that accounting for the other tests that FDA is approving. Similarly, can you clarify what the CDC will be posting now on in terms of case counts. Thanks. Messonnier: Yeah. So thanks. The number that you’re quoting is the number that the FDA commissioner has quoted as the commercially available kits. So if there are questions about that i would definitely refer those to the FDA. The CDC number is test kits that are going to public health labs. And we expect that by the end of this week the public health labs will be able to test up to 75,000 people. As you say, that will be a small part of the overall testing that will be available. That’s why when I started my comments, I talked about the complications with expecting CDC’s case count to be up to date. It’s a good thing that these tests are going to be widely available, but it also means that CDC will not always be up to the minute in terms of the latest number of cases, especially out of state local health departments. So that’s why we say we really do need you to look to the states to those updated numbers. CDC’s numbers may be a little more delayed because there are so much testing kits going out. Next question, please. Our next question comes from Lisa Krieger with San Jose Mercury News. Your line is open. Yes, thank you. At the World Health Organization conference this morning there was concern of the global supply chain of PPEs and we heard from some hospitals Stanford and Harvard that they’re concerned about the stockpile. Can you address that, please. Messonnier: I can address part of it. CDC’s role is working closely with our state and local health departments, including providing technical input to them. And CDC’s part of this is in helping the state and local health departments with the variety of partners, including OSHA and NIOSH and health care association partners in thinking through how to make the best use of the supplies that we have. In other words, our priority is making sure that the highest risk health care exposure is health care workers have appropriate PPE and looking at other ways in which other folks might be protected. But the questions of our — the U.S. supply of PPE, those questions really need to go to the ASPR they have responsibility for the Strategic National Stockpile in the United States. We have time for three more questions. Next question, please. Our next question comes from Sheila Kaplan. Your line is open. … what the contaminant was that was found in the test kits, please. Sheila, we could not hear the first part of your question. Please repeat. Can you please tell us what the contaminant was that was found in the original CDC test kits? Messonnier: So i think you’re talking about a report in AXIOS that attributed some issues with the CDC test kits to a contaminant. What I can say about that is contamination is one possible explanation but there are others. And I can’t really comment on what is an ongoing investigation. Our focus is on moving forward. That is on making sure that the test kits we are sending out now are well done and making sure that our state and local health department partners have access to the full resources of CDC to diagnose cases. Next question, please. Our next question comes from John Bonnefield with CNN. Your line is open. Hi. Thank you for taking my question. Can you explain to us why CDC isn’t somehow aggregating the testing that’s being done by public health labs to provide a national figure for the number of tests that are being conducted and on the number of PUIs? Right now, what I’m inferring is there’s not going to be any kind of national figure and that’s very different than what we have been seeing from places like South Korea where they’ve been routinely updating on a national level? Are you not asking public health labs to communicate this information to you or is there really no way for us to expect a national figure at all? Messonnier: I’m sorry and I’m really glad you asked that question so I can correct that misunderstanding. Of course we will be aggregating data on a daily basis and will have daily case counts up on our website. What I meant to comment on is that sometimes our numbers come up on our website by noon but when there’s a case that’s reported from a state at 5:00, we don’t go back and reupdate our numbers. It waits until the next day. We update your numbers everyday. We are certainly going to be aggregating national numbers. We are certainly going to be providing a national and state specific picture of what’s going on, but sometimes you all in the media are covering individual cases that are being reported that aren’t on our counts yet because we’re, again, we’re updating them only once a day. It’s just otherwise really difficult to continue to update the numbers when basically cases are getting confirmed and reported all night long. So, definitely going to be providing national data and state level data. But if you see, for example, a news report from the state that’s coming out in half an hour, we’re not going to go back and reupdate the numbers that came up on CDC’s website at noon. Does that help? Okay. I’m hoping that helps. Okay. Last question, please. Our final question comes from Mike Stobbe with the Associated Press. Your line is open. Hi. Thank you for taking my call. Many things I want to ask but I’ll just ask two. In reference to your response to Sheila Kaplan’s question, I take it from your response that there’s an investigation going on and that you haven’t established what the problem was with the reagent in the kits. Is that what you’re saying? Or do you know what the problem was? And the second question, if I may, as you know over the weekend researchers at Fred Huchinson Cancer Center in the University of Washington said they had done a study that had suggested that the virus was circulating for weeks in Washington and perhaps that was related to the lack of availability of tests or the testing criteria it suggests that the spread of the virus may have been worse because of some of the policies or availability of test kits that were in place based on federal decisions. So, could you speak to that? Thank you. Messonnier: Sure. So, in reference to the first question, you know, clearly it’s a priority at CDC and every level of our organization to make sure that our state and local health department, public health labs have access to the best tools possible. And our focus right now is moving forward to make sure that the test kits that they’re getting from us meet the high quality standards that we and FDA hold ourselves to and we are very confident in the kits that are being sent out now. There will be time in the future, I think, to look back and think about what we — what happened when, but our focus today is on — is how we’re moving forward. The second question is, is a really intense question. Researchers in Seattle were looking at the genetic sequencing of the strains that have been in Seattle and having an interesting hypothesis of how transmission might have worked. What I would say is that it’s really interesting finding and interesting research. There are alternate hypothesis for the same finding, for example, the sequences of the most recent strains coming out of Seattle actually also I understand match strains that were identified from later in the outbreak from China. So I think this is another place where I’m happy to see so much research going on, but I still think that it’s in the hypothesis phase and we’ll need to wait for more data to come in to really fully understand how valid that hypothesis is and how to interpret it. I’m really happy that researchers all around the country and all around the world are doing this kind of work because we’re clearly going to learn a lot from it. Thank you. And thank you all for joining us for today’s briefing. Please check CDC’s COVID-19 website for the latest updates on CDC’s response efforts. If you have further questions, please call the media line at 404-639-3286 or email media @CDC.gov. Thank you. This concludes today’s conference. Thank you for your participation. You may disconnect your lines at this time. https://www.cdc.gov/media/releases/2020/t0303-COVID-19-update.html

AUDIO https://www.cdc.gov/media/releases/2020/t0303-COVID-19-update.mp3

Media Statement For Immediate Release Tuesday, March 3, 2020 Contact: CDC Media Relations (404) 639-3286 CDC Announces Additional COVID-19 Infections At noon on Tuesday, March 3 the Centers for Disease Control and Prevention (CDC) reported 60 cases of COVID-19 from 12 states. Twenty-two of these cases are travel-related; 11 are believed to be person-to-person spread; and for the remaining 27 the source of exposure is still under investigation. Noteworthy developments in recent days include: Florida announced its first and second presumptive positive cases of COVID-19, one in a person with recent travel history (to Italy), the other with no currently known travel or contact history. Georgia announced its first and second confirmed cases of COVID-19, one is a person with recent travel history (to Italy), the other in a close contact of the first patient. New Hampshire also reported its first presumptive positive case of COVID-19 in a person with recent travel history (to Italy). New York state announced its first case of COVID-19 in a person with recent travel history (to Iran). Rhode Island announced its first presumptive positive case of COVID-19 in a person with recent travel history (to Italy). Washington state announced more cases of COVID-19 associated with an outbreak in a long-term care facility. Washington has announced it now has 14 cases of COVID-19, including 6 COVID-19 deaths. The 12 states that have reported cases include: Arizona, California, Florida, Georgia, Illinois, Massachusetts, New Hampshire, New York, Oregon, Rhode Island, Washington, and Wisconsin. As the outbreak of COVID-19 continues to expand and as testing capacity in the U.S. increases, CDC expects more cases to be detected across the country, including more instances of person-to-person spread in more states. While information so far suggests that most COVID-19 illness is mild, a report out of China suggests serious illness occurs in 16% of cases. Older people and people with certain underlying health conditions like heart disease, lung disease and diabetes, for example, seem to be at greater risk of serious illness. The federal government has been working closely with state, local, tribal, and territorial partners, as well as public health partners, to prepare for and respond to this public health emergency. CDC expects additional instances of person-to-person spread in the coming days and weeks. Cases reported to CDC include those confirmed by CDC as well as presumptive positive cases reported by states. A presumptive positive result is when a patient has tested positive by a public health laboratory, but results are pending confirmation at CDC. For public health purposes, a presumptive positive result using the CDC test is treated as a positive. CDC will report total presumptive and confirmed cases weekdays at noon. This number is based on all state reports received by 4 p.m. the previous day. CDC is no longer reporting number of persons-under-investigation (PUIs) nor those PUIs that test negative because now that states are testing and reporting their own results, these numbers would not be representative of the testing being done nationally. States are reporting results quickly and in the event of a discrepancy between CDC and state case counts, the state case counts should always be considered more up-to-date. For more information about COVID-19 visit www.cdc.gov/covid19. https://www.cdc.gov/media/releases/2020/s-0303-Additional-COVID-19-infections.html

New Hampshire officials announce presumptive case of COVID-19 in Grafton County Health officials, political leaders talk about state preparations CONCORD, N.H. — A health system employee who recently returned from Italy is the first person in New Hampshire to test positive for a potentially deadly strain of coronavirus, officials announced Monday. The unidentified patient is an adult from Grafton County, officials said. Dartmouth-Hitchcock and Dartmouth-Hitchcock Health President Joanne Conroy confirmed the patient is an employee of Dartmouth-Hitchcock. DHHS information: COVID-19 novel coronavirus New Hampshire health officials said the person tested positive at the state's lab for the COVID-19 strain of coronavirus. Samples are being sent to the Centers for Disease Control and Prevention for confirmation. It is considered a presumptive case of COVID-19 until the confirmation is made. "This individual and this test still needs to be confirmed at the Centers for Disease Control and Prevention, but we are not going to wait for that confirmation," said state epidemiologist Dr. Benjamin Chan. "We are going to be beginning the investigation. In fact, we already have begun the investigation when we initiated testing over the weekend. So, we will be working very closely with the health care agency involved in this." Officials said the patient is not sick enough to be hospitalized and is currently isolated at home. Chan said the patient experienced mild symptoms of the virus after returning from a trip to Italy, where more than 1,000 cases of COVID-19 have been identified. "We'll be working tirelessly to investigate this most recent identification and to identify any susceptible contacts who may need to themselves be placed under self-quarantine," Chan said. The patient did not return to work after coming back from Italy, officials said. Dartmouth-Hitchcock officials said they are taking precautions and have created an incident command center. "It involves probably 20 individuals with their areas of expertise specific to the issue we're addressing," Conroy said. "There is a very, very structured way they develop what are the near-term issues we need to address and what are the long-term issues we need to address." The person is the fourth patient to be tested for coronavirus in New Hampshire and the first positive result. The previous three tests came back negative. "Our public health laboratory has brought on the capacity to do COVID-19 testing as of this morning," Chan said. According to the CDC, there have been dozens of confirmed cases of the virus in the United States, and six people have died. Worldwide, there have been more than 87,000 confirmed cases and more than 2,900 deaths, mostly in China, where the outbreak began. Chan said he couldn't say whether COVID-19 might become widespread in the state, but he said his office has a lot of experience dealing with outbreaks, including MERS, SARS and the H1N1 influenza outbreak from a decade ago. Health officials urged people to continue to take commonsense precautions against becoming sick or spreading illness. "We ask people that if they are sick, that they stay home, they do not go to school or work, especially if they have a fever or respiratory illness," Chan said. "People should be practicing frequent hand hygiene. People that are coughing and sneezing should be appropriately covering those coughs and sneezes and then washing their hands afterward. If anybody is sick, we encourage them to call ahead to their health care providers to talk about their symptoms and any potential travel that we will continue to work closely with our health care providers and our health care systems to address concerns and issues that arise around this new virus." Concerns over the coronavirus are prompting several New Hampshire schools to ask some students to stay home after they returned from trips to Italy during school vacation week. https://www.mynbc5.com/article/1931-history-star-spangled-banner-becomes-us-national-anthem/31213341

A health system employee who recently returned from Italy is the first person in New Hampshire to test positive for a potentially deadly strain of coronavirus, officials announced Monday.

Mar 3, 2020 A North Carolina person has tested positive for novel coronavirus (COVID-19). The test, conducted by North Carolina State Laboratory of Public Health, is presumptively positive and will be confirmed by the U.S. Centers for Disease Control and Prevention (CDC) lab. The person is doing well and is in isolation at home. “I know that people are worried about this virus, and I want to assure North Carolinians our state is prepared,” said Governor Roy Cooper. “Our task force and state agencies are working closely with local health departments, health care providers and others to quickly identify and respond to cases that might occur.” The North Carolina person from Wake County traveled to the State of Washington and was exposed at a long-term care facility where there is currently a COVID-19 outbreak. Local health department officials are identifying close contacts to monitor symptoms and contain spread. To protect individual privacy, no further information will be released. While awaiting confirmation of results from the CDC, the Department of Health and Human Services (DHHS) will treat presumptive cases as positive and follow CDC guidelines to protect public health and limit the spread of infection. Today’s announcement represents an isolated case, and COVID-19 is currently not widespread in North Carolina. Because COVID-19 is most commonly spread through respiratory droplets, North Carolinians should take the same measures that healthcare providers recommend annually to prevent the spread of the flu and other viruses, including washing your hands, avoiding touching your face, and covering coughs and sneezes. Last month, Governor Cooper established the Novel Coronavirus (COVID-19) Task Force to support the state’s ongoing effort to monitor, prepare for and respond to COVID-19. State actions include: Aggressively pursuing containment strategy of rapid identification, testing and contact tracing. Engaging in daily collaboration with federal, state and local partners to ensure rapid response. Mobilizing resources for our providers, local public health system, local emergency management, and other. Developing detailed response plans for multiple sectors for a range of scenarios. Developing guidance for planning for multiple sectors for a range of scenarios. Preparing healthcare providers and facilities to streamline and standardize response activities. Activating a Joint Information Center to provide timely information. Testing patients in the NC State Laboratory of Public Health. Leading regular calls with local health departments, hospitals and local emergency management. Providing guidelines for health care providers, child care, employers, schools, colleges and universities, and others. Monitoring residents who have returned from China through local health departments. Staffing a COVID-19 phone line to answer urgent questions from the public. Maintaining an up-to-date website with information about COVID-19 disease, risk and guidance. It is important to make sure the information you are getting about COVID-19 is coming directly from reliable sources like the CDC and NCDHHS. For more information, please visit the CDC’s website at www.cdc.gov/coronavirus and NCDHHS’ website at www.ncdhhs.gov/coronavirus, which will also include future positive COVID-19 test results in North Carolina. Governor Cooper and the Coronavirus task force to hold a media briefing on COVID-19 at the Joint Force Headquarters at 3:30 PM today. The briefing can be livestreamed at: https://www.ncdps.gov/storm-update

COVID case visited Long Term Care Facility in King Co Washington

Public Health confirms seven new COVID-19 cases, bringing overall total to 21 March 3, 2020 Summary Public Health – Seattle & King County announced on Tuesday seven additional confirmed cases of COVID-19 in King County residents, bringing the total of confirmed cases to 21, including eight deaths. Story COVID-19 test results have come back from the Washington State Public Health Laboratory confirming seven additional cases of COVID-19 in King County residents. With these seven new results, the total number of cases in King County is 21. Today's results include 2 additional deaths, along with an individual who was previously reported as ill but who has now died. This brings the total number of deaths in King County from COVID-19 to eight. Key messages of the day: What we have seen with the level of community spread has raised the level of concern about the immediate threat of COVID-19. The coming days and weeks are likely to bring more confirmed cases of COVID-19, but if we can all follow health recommendations now, we can blunt the impact of COVID-19 in our community. What Public Health is doing: This is a massive undertaking and we have a talented, dedicated team digging in to learn everything we can to protect the health of our community. What we have seen with the level of community spread has raised the level of concern about the immediate threat of COVID-19, particularly for vulnerable populations such as people over 60, those with underlying health conditions or who are immune compromised. King County Novel Coronavirus Call Center: If you are in King County and believe you were exposed to a confirmed case of COVID-19, or if you're a healthcare provider with questions about COVID-19, contact our novel coronavirus call center: 206-477-3977. The call center will be open daily from 8:00 AM to 7:00 PM PT. For general concerns and questions about COVID-19, please call the Washington State Novel Coronavirus Call Center at 800-525-0127. When to seek medical evaluation and advice: If you have symptoms like cough, fever, or other respiratory problems, call your healthcare provider. Do not go to the emergency room. Emergency rooms need to be able to serve those with the most critical needs. If you are having a medical emergency, call 9-1-1. The public can help: Do not go to the emergency room unless essential. Emergency rooms need to be able to serve those with the most critical needs. If you have symptoms like cough, fever, or other respiratory problems, contact your regular doctor first. Stay home when sick. Practice excellent personal hygiene habits, including handwashing, coughing into tissue or elbow, avoid touching eyes, nose, or mouth. Stay away from people who are ill, especially if you are 60 and older or have underlying health conditions such as diabetes, heart disease, lung disease, or a weakened immune system. Stay informed. Information is changing frequently. Check and subscribe to Public Health's website (www.kingcounty.gov/COVID) or blog (www.publichealthinsider.com). Remember to take every day preventive action such as watching hands, and if you are sick stay home. During an outbreak with a new virus there is a lot of uncertainty. Our guidance and advice is subject to change as we learn more. We will continue to keep you updated. The seven new cases are in: A female in her 40s, worked at LifeCare, never hospitalized and is recovering at home A female in her 60s, family member of a confirmed case of COVID-19, not hospitalized A male in his 70s, a frequent visitor of LifeCare, hospitalization status unknown currently A male in his 20s, unknown exposure, hospitalized at Swedish Issaquah A male in his 20s, unknown exposure, hospitalized at Swedish Issaquah A female in her 80s, resident of LifeCare, never hospitalized, died at her family home on 2/26/20 A male in his 50s, resident of LifeCare, hospitalized at Harborview Medical Center and died on 2/26/20 14 other cases, already reported earlier by Public Health, include: A male in his 50s, hospitalized at Highline Hospital. No known exposures. He is in stable but critical condition. He had no underlying health conditions. A male in his 70s, a resident of LifeCare, hospitalized at EvergreenHealth in Kirkland. The man had underlying health conditions, and died 3/1/20 A female in her 70s, a resident of LifeCare, hospitalized at EvergreenHealth in Kirkland. The woman had underlying health conditions, and died 3/1/20 A female in her 80s, a resident of LifeCare, was hospitalized at EvergreenHealth. She is in critical condition. A female in her 80s, hospitalized at EvergreenHealth in Kirkland. This person died on 3/1/20. A female in her 90s, hospitalized at EvergreenHealth in Kirkland. The woman has underlying health conditions, and is in critical condition A male in his 70s, hospitalized at EvergreenHealth in Kirkland. The man has underlying health conditions, and is in critical condition A male in his 70s was hospitalized at EvergreenHealth. He had underlying health conditions and died on 2/29/20. A man in his 60s, hospitalized at Valley Medical Center in Renton. A man in 60s, hospitalized at Virginia Mason Medical Center. A woman in her 50s, who had traveled to South Korea; recovering at home A woman in her 70s, who was a resident of LifeCare in Kirkland, hospitalized at EvergreenHealth and died on 3/2/20 A woman in her 40s, employed by LifeCare, who is hospitalized at Overlake Medical Center A man in his 50s, who was hospitalized and died 2/28/20 at EvergreenHealth https://www.kingcounty.gov/depts/health/news/2020/March/3-covid19-8-deaths.aspx

Public Health confirms seven new COVID-19 cases, bringing overall total to 21 March 3, 2020 Summary Public Health – Seattle & King County announced on Tuesday seven additional confirmed cases of COVID-19 in King County residents, bringing the total of confirmed cases to 21, including eight deaths. Story COVID-19 test results have come back from the Washington State Public Health Laboratory confirming seven additional cases of COVID-19 in King County residents. With these seven new results, the total number of cases in King County is 21. Today's results include 2 additional deaths, along with an individual who was previously reported as ill but who has now died. This brings the total number of deaths in King County from COVID-19 to eight. Key messages of the day: What we have seen with the level of community spread has raised the level of concern about the immediate threat of COVID-19. The coming days and weeks are likely to bring more confirmed cases of COVID-19, but if we can all follow health recommendations now, we can blunt the impact of COVID-19 in our community. What Public Health is doing: This is a massive undertaking and we have a talented, dedicated team digging in to learn everything we can to protect the health of our community. What we have seen with the level of community spread has raised the level of concern about the immediate threat of COVID-19, particularly for vulnerable populations such as people over 60, those with underlying health conditions or who are immune compromised. King County Novel Coronavirus Call Center: If you are in King County and believe you were exposed to a confirmed case of COVID-19, or if you're a healthcare provider with questions about COVID-19, contact our novel coronavirus call center: 206-477-3977. The call center will be open daily from 8:00 AM to 7:00 PM PT. For general concerns and questions about COVID-19, please call the Washington State Novel Coronavirus Call Center at 800-525-0127. When to seek medical evaluation and advice: If you have symptoms like cough, fever, or other respiratory problems, call your healthcare provider. Do not go to the emergency room. Emergency rooms need to be able to serve those with the most critical needs. If you are having a medical emergency, call 9-1-1. The public can help: Do not go to the emergency room unless essential. Emergency rooms need to be able to serve those with the most critical needs. If you have symptoms like cough, fever, or other respiratory problems, contact your regular doctor first. Stay home when sick. Practice excellent personal hygiene habits, including handwashing, coughing into tissue or elbow, avoid touching eyes, nose, or mouth. Stay away from people who are ill, especially if you are 60 and older or have underlying health conditions such as diabetes, heart disease, lung disease, or a weakened immune system. Stay informed. Information is changing frequently. Check and subscribe to Public Health's website (www.kingcounty.gov/COVID) or blog (www.publichealthinsider.com). Remember to take every day preventive action such as watching hands, and if you are sick stay home. During an outbreak with a new virus there is a lot of uncertainty. Our guidance and advice is subject to change as we learn more. We will continue to keep you updated. The seven new cases are in: A female in her 40s, worked at LifeCare, never hospitalized and is recovering at home A female in her 60s, family member of a confirmed case of COVID-19, not hospitalized A male in his 70s, a frequent visitor of LifeCare, hospitalization status unknown currently A male in his 20s, unknown exposure, hospitalized at Swedish Issaquah A male in his 20s, unknown exposure, hospitalized at Swedish Issaquah A female in her 80s, resident of LifeCare, never hospitalized, died at her family home on 2/26/20 A male in his 50s, resident of LifeCare, hospitalized at Harborview Medical Center and died on 2/26/20 14 other cases, already reported earlier by Public Health, include: A male in his 50s, hospitalized at Highline Hospital. No known exposures. He is in stable but critical condition. He had no underlying health conditions. A male in his 70s, a resident of LifeCare, hospitalized at EvergreenHealth in Kirkland. The man had underlying health conditions, and died 3/1/20 A female in her 70s, a resident of LifeCare, hospitalized at EvergreenHealth in Kirkland. The woman had underlying health conditions, and died 3/1/20 A female in her 80s, a resident of LifeCare, was hospitalized at EvergreenHealth. She is in critical condition. A female in her 80s, hospitalized at EvergreenHealth in Kirkland. This person died on 3/1/20. A female in her 90s, hospitalized at EvergreenHealth in Kirkland. The woman has underlying health conditions, and is in critical condition A male in his 70s, hospitalized at EvergreenHealth in Kirkland. The man has underlying health conditions, and is in critical condition A male in his 70s was hospitalized at EvergreenHealth. He had underlying health conditions and died on 2/29/20. A man in his 60s, hospitalized at Valley Medical Center in Renton. A man in 60s, hospitalized at Virginia Mason Medical Center. A woman in her 50s, who had traveled to South Korea; recovering at home A woman in her 70s, who was a resident of LifeCare in Kirkland, hospitalized at EvergreenHealth and died on 3/2/20 A woman in her 40s, employed by LifeCare, who is hospitalized at Overlake Medical Center A man in his 50s, who was hospitalized and died 2/28/20 at EvergreenHealth https://www.kingcounty.gov/depts/health/news/2020/March/3-covid19-8-deaths.aspx

These numbers will be updated daily at 11 a.m. 2019 Novel Coronavirus (COVID-19) in Washington Positive (confirmed) * † 27 Deaths 9 * Positive Snohomish County - 6, including 1 death King - 21, including 8 deaths † Please contact the local health department for information. https://www.doh.wa.gov/Emergencies/Coronavirus

These numbers will be updated daily at 11 a.m. 2019 Novel Coronavirus (COVID-19) in Washington Positive (confirmed) * † 27 Deaths 9 * Positive Snohomish County - 6, including 1 death King - 21, including 8 deaths † Please contact the local health department for information. https://www.doh.wa.gov/Emergencies/Coronavirus