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There are more confirmed cases of COVID-19 at the U.S. than at any other country. There eat been at least 337,000 cases and at least 9,600 deaths at the U.S.
Trump has declared a national emergency and announced guidelines to slow the disperse of the virus, asking crowd to fly discretionary travel, fly eating out, profession from home, and fly social gatherings of more than 10 people.
There eat been more than 1,280,000 cases and at least 70,000 deaths nearly the world.
The say Health Organization has declared COVID-19 a pandemic.
The condition department says U.S. travelers to fly entire tour abroad. The CDC says residents of New York, New Jersey, and Connecticut to fly non-essential domestic travel.
The virus causes respiratory problems that can hill from a gentle cough to grave pneumonia.
This article is being updated though the condition changes.
The romance coronavirus that first emerged at Wuhan, China, late final year has quickly disperse nearly the globe, with the first example reported at the U.S. at Jan. 20. There are now more confirmed cases at the U.S. than at any other say at the world.
The virus can guide to a illness dubbed COVID-19, marked by respiratory problems that are often gentle (coughing, fever) besides can exist grave (pneumonia, bother breathing)—especially at older adults and at crowd with underlying health conditions.
The say Health Organization declared a public health emergency at the aim of January as the amount of crowd infected climbed precipitously at China. besides at first, the scattered cases that appeared at the U.S. were nearly entire at travelers who had recently returned from Wuhan or at quarantined Americans who had been repatriated by the condition department from high-risk areas. The U.S. government responded to these imported cases with rigid tour restrictions, barring visitors from China and quarantining others.
Then, at Feb. 25, the Centers though illness control and Prevention warned that COVID-19 used to nearly naturally disperse within communities at the U.S., neutral though it had started to perform at Italy, South Korea, and Iran.
“It’s no consequently much a mystery of if this will happen anymore, besides pretty more a mystery of exactly when,” said Nancy Messonnier, M.D., director of the CDC’s National center though Immunization and Respiratory Diseases. She urged hospitals, schools, businesses, and families to prepare. “Disruption to daily life can exist severe,” Messonnier added.
Just three days later, the first example of unknown origin emerged at Northern California. This patient had no traveled anywhere known to eat a COVID-19 outbreak and had no had confront with any known cases. That diagnosis was the first hint that the virus was already spreading undetected at certain communities at the U.S. It was quickly followed by alike cases at Oregon and then at Washington, where a genetic analysis suggested that the virus can eat been silently circulating though during expect though six weeks.
As the U.S. slowly ramped up its testing capacity, new cases began popping up across the country, many with no links to China or other known cases. Now there eat been at least 337,000 reported cases at the U.S., disperse out across entire 50 states, according to a Johns Hopkins college tally. at least 92,000 of those cases are at New York State. Many more cases can exist unreported, experts say. There eat been at least 9,600 deaths at the U.S.
There eat been at least 1,280,000 cases nearly the world, according to the Johns Hopkins count. That includes more than 135,000 cases at Spain, more than 128,000 cases at Italy, and more than 100,000 cases at Germany. China has reported more than 82,000 cases, besides that amount has held relatively firm though weeks. The virus has appeared at more than 180 countries or regions, though many quiet eat neutral a handful of known cases. There eat been 70,000 deaths.
The WHO at March 11 said though the first time that the disperse and severity of COVID-19 method it to exist characterized though a pandemic. Two days later, headmaster Trump declared a national emergency.
Across the U.S., though the virus continued to disperse at different communities, crowd began to adapt to the “social distancing” measures recommended by many local authorities: big events were cancelled, workplaces were entire down, and many schools and universities were closed.
On March 16, headmaster Trump announced new guidelines at a order to aid slow the disperse of the virus. Americans to profession from family if possible; fly discretionary travel, shopping trips, and social visits; fly social gatherings at groups of more than 10; fly eating or drinking at bars, food courts, and restaurants; and no watch nursing homes or retirement or long-term care facilities, he said. These guidelines will exist at lay until at least April 30.
“The chance to Americans is different depending at one's spot and contacts,” says Isaac Bogoch, M.D., an epidemiologist and couple professor of infectious diseases at the department of drug at the college of Toronto. “As we watch more widespread transmission,” he adds, many Americans will watch their chance of exposure rise.
“We eat no reached our peak,” said Anthony Fauci, M.D., director of the National association of Allergy and Infectious Diseases, at a March 13 information conference. “We will watch more suffering and death.”
Even with social distancing guidelines at place, some projections hint that there could exist among 100,000 and 240,000 COVID-19 deaths at the U.S., officials said at a March 31 journal briefing. They emphasized that this worthy can alter though we comprehend more.
Here’s what we know consequently distant approximately the virus.
What Is This New Virus?
The new pathogen is isolate of a big family of viruses known though coronaviruses. (Under a microscope, these viruses watch alike they eat a crown, or corona.)
At first, the virus was referred to simply as “2019 romance coronavirus” (2019-nCoV). Its officer name is severe critical respiratory syndrome coronavirus 2 (SARS-CoV-2). The illness caused by this new virus has another name: coronavirus illness 2019 (COVID-19).
Coronaviruses are same common at animals, and many strains influence humans, according to Thomas File, M.D., headmaster of the Infectious Diseases association of America (IDSA). Most known coronaviruses deliberate gentle conditions, such though the common cold and conjunctivitis, besides the new virus is no the first time a coronavirus has led to hospitalizations and deaths.
“We eat seen same grave manifestations of symptoms from other romance coronaviruses such though SARS and MERS,” rank says. at 2002 to 2003, an outbreak of grave critical respiratory syndrome (SARS) sickened more than 8,000 crowd and killed 774. nearly 10 years later, another coronavirus, known though core East respiratory syndrome (MERS), emerged and has though infected 2,499 crowd and killed 861. (Though the new coronavirus has infected many more people, the fatality rate so distant has been distant lower than that of though healthful SARS or MERS.)
According to the CDC, many of the first COVID-19 cases had links to a big seafood and alive animal neutral at Wuhan.
How Does This Coronavirus Spread?
Though the first cases of the new coronavirus watch to eat disperse from animals to people, the virus is now spreading from person to person “easily and sustainably,” according to the CDC.
An early analysis of the first 425 confirmed cases estimated that each infected person was spreading the virus to nearly 2.2 other people. besides the authors cautioned that this is a preliminary number, that it’s apt to change, and that the finish of control measures is to drive this amount down.
As a respiratory virus, the coronavirus spreads at droplets while someone coughs or sneezes, according to rank at the IDSA. crowd can though healthful free viral particles while they address or sing. That method crowd within 5 or 6 feet of an infected person used to exist the most apt to become sick—when those viral particles say at a mucous membrane, alike at your eye. Such viruses can though healthful disperse while crowd influence a surface contaminated with infectious droplets, then influence their hold nose, mouth, or eyes.
These viruses “don’t drift nearly at the stand though days at end,” says Bogoch at the college of Toronto. That method someone is most apt to become COVID-19 from a person at near proximity to you, or by touching a contaminated surface and then touching your face. According to the CDC, cabin transmission via contaminated surfaces is possible, it is “not concept to exist the headmaster manner the virus spreads.”
Evidence has shown that crowd infected with the romance coronavirus can exist able to disperse it to others ago they watch to eat symptoms, or while their symptoms are same minor.
“We know there is virus disperse ago you age symptoms, and then we know that there’s a big group—we don’t know the exact percent yet—that truly is asymptomatic or has such gentle cases that they thrive to disperse the virus,” said Deborah L. Birx, M.D., the coronavirus response coordinator though the White House, at a March 16 journal briefing.
People who become COVID-19 watch to become ill at a time frame of a couple of days to two weeks hind being exposed.
At present, there’s no argument to ponder the pathogen could exist transmitted along food or via consumer goods. (See our novel approximately food safety and coronavirus.) Other coronaviruses alike to the new one don’t final same expect at surfaces, said the CDC, which method transmission via surfaces hind days or weeks used to exist highly unlikely.
What Are the Symptoms?
There eat been a broad hill of symptoms consequently far, ranging from gentle to severe. at most cases, crowd eat had a fever and dry cough. at the more grave cases, crowd eat developed grave pneumonia and shortness of breath.
Fatigue is though healthful common, and some crowd undergo diarrhea or nausea. Anecdotal reports suggests some crowd with COVID-19 say they Mrs their feeling of odour and taste. (Read more approximately recognizing the symptoms of COVID-19.)
In a tiny percent of cases, the illness has been fatal.
Most crowd who autumn ill recover within two weeks. crowd with more grave cases greatly recover at three to six weeks.
A learn published Feb. 24 at JAMA by the Chinese center though illness control and Prevention looked at 44, 672 confirmed cases of COVID-19 at China. The researchers characterized 81 percent though mild, 14 percent though severe, and 5 percent though critical.
Scientists eat though healthful been trying to revolve out what’s known though the example fatality rate—the percent of cases at which the virus is fatal. COVID-19 appears to exist deadlier than the seasonal flu, which kills approximately 0.1 percent of crowd who are infected. besides beyond that, there has been a hill of estimates.
In the learn by the China CDC, amid crowd with confirmed infections, 2.3 percent died; that worthy was distant higher at crowd who were 70 and older or who had chronic health conditions.
The fatality worthy at the epicenter of the outbreak has consequently distant been much higher than elsewhere at China and nearly the world. at Wuhan, among 2 and 4 percent of reported cases eat been fatal; at other parts of China, the fatality worthy has been 0.7 percent, according to a WHO briefing at Feb. 24.
On March 3, at a journal briefing, WHO officials said that consequently distant nearly the world, 3.4 percent of crowd known to eat COVID-19 eat died.
But there’s an important caveat to entire these estimates, says Bogoch at the college of Toronto. “There’s a growing narrative of crowd with same gentle symptoms who are no ill enough to pursue care and no counted,” he said. That method we can’t accurately count the fatality rate. “When we’re able to clarify though everybody and we eat the right denominator, I used to no exist surprised if it were less than 2 or even less than 1 percent,” he said.
That echoes what Fauci and CDC Director Robert Redfield wrote at the New England journal of Medicine: “If one assumes that the amount of asymptomatic or minimally symptomatic cases is few epoch though high though the amount of reported cases, the example fatality worthy can exist considerably less than 1 percent.”
Who Is at Risk?
At first, nearly entire the known cases were clustered at and nearly Wuhan, and at crowd who had recently returned from the region. at Feb. 25, though the first time, more new cases were reported outside of China than inner of China. By mid-March, the cumulative amount of cases outside of China exceeded the amount inner of China.
Now, hotspots eat developed at few U.S. and European cities, where the amount of cases is growing daily and the chance of exposure can exist high.
We’re quiet at the early phases of harmony which segments of the population are most at chance of infection and complications, according to Lisa Maragakis, M.D., the hospital epidemiologist at Johns Hopkins Hospital at Baltimore and the senior director of infection prevention at the Johns Hopkins Health System.
In general, “elderly patients and those with underlying diseases nurse to perform worse with any pneumonia,” says Richard Wunderink, M.D., a professor of drug at the Northwestern University Feinberg college of drug at Chicago who has written approximately coronaviruses.
And that seems to exist the revolve though COVID-19 though well. The study from the China CDC found that cabin the fatality worthy overall was 2.3 percent, it was 8 percent amid crowd at their 70s, 14.8 percent amid crowd 80 and older, 10.5 percent amid crowd with center disease, and 7.3 percent amid crowd with diabetes. Meanwhile, sole a tiny amount (1 percent) of confirmed cases were at children beneath 10; nobody of them were fatal.
Still, Fauci cautioned, at an interview with CNN: “The virus isn't a mathematical formula. There are going to exist crowd who are adolescent who are going to wind up getting seriously ill.”
According to the CDC, certain groups are at a higher chance though getting sick. That includes crowd at areas where the virus has been spreading within the community, healthcare workers caring though infected patients, near contacts of crowd with COVID-19, and travelers returning from locations where there is community spread.
According to guidelines released by the White House (PDF), older Americans and crowd with underlying health conditions to "stay family and away from other people."
The CDC has posted recommendations though schools, homes, communities, and businesses at a website that’s being updated regularly. You can though healthful refrain your condition health department's website though data concrete to your region.
What to Travelers know approximately the Virus?
The condition department has issued a global coronavirus-related tour warning, saying U.S. citizens to fly entire tour abroad. "In countries where commercial departure options remain available, U.S. citizens who alive at the United States to classify though immediate answer to the United States, unless they are prepared to remain abroad though an vague period," the warning says.
The CDC says entire travelers to fly tour boat travel and says that older adults and crowd with underlying illness to fly non-essential expect plane trips and crowded areas.
The CDC has though healthful issued an alert advising residents of New York, New Jersey, and Connecticut to fly non-essential domestic travel.
In general, travelers to remain vigilant and possess up to appointment with the latest advisories from the CDC, Maragakis says. The CDC does no propose masks though travelers.
Many international flights eat been suspended or canceled. Some domestic flights eat though healthful been canceled though of reduced demand.
Airlines that eat announced at least some suspensions embrace stand Canada, American Airlines, British Airways, Delta, Lufthansa, and United. (The airlines’ sites eat more data at the concrete dates of the suspensions and what to perform if you eat a booking. if you’ve already booked tour or are planning a trip, watch our tour article though more concrete advice.)
Foreign nationals who are coming from (or via) Iran, China, the United Kingdom, or a most of Europe will exist denied entrance to the U.S. The CDC has though healthful advised travelers coming from many other countries where COVID-19 is spreading (see the total schedule here) to quarantine themselves at family though 14 days while they come at the U.S.
Whatever restrictions the government implements, one important queue of defense is travelers themselves. crowd who eat recently traveled to an affected region to confront health officials if they mind any symptoms of infection. The CDC is distributing hundreds of thousands of educational cards to arriving travelers consequently that crowd can exist at the lookout though any symptoms that energy exist the new coronavirus.
In the example of the first two U.S. patients identified, both had reentered the U.S. ago airport screening of those coming from Wuhan had begun. Both contacted their healthcare providers though of their symptoms and tour history.
How to You defend Yourself?
Health officials eat advised isolating at family though much though possible, avoiding gatherings, and—especially if you are at an at-risk group—limiting trips out at public. Local health officials at areas where COVID-19 is spreading widely can eat even stricter advice.
If you're no emotion healthful or eat been exposed to the virus, you can exist advised to quarantine yourself though 14 days. This method making a plan and getting neutral a couple of weeks’ worthy of food, soap, and other essentials—no lack to hoard supplies. (For more information, see our article at what you energy need.)
The CDC is now recommending that nearly everyone wear a theorem cloth or fabric appearance covering while out at public. (Medical masks are greatly at short supply and to exist reserved though healthcare workers.) cabin a disguise does no supply much protection to the wearer, it can aid someone who is ill defend those nearly them. though crowd can exist contagious ago they feel sick, some inquiry suggests common disguise wearing can aid refrain transmission—though no entire experts agree. (See our novel though more at making feeling of the conflicting guidance at masks.)
Measures that can though healthful aid defend you from the flu—like frequent hand-washing and avoiding ill people—can though healthful defend you from COVID-19. though more information, watch our article at how to defend yourself.
What Experts quiet Don't Know
“Almost each day, we’re learning things we didn’t know before,” Robert Redfield, M.D., the director of the CDC said at a late-January journal conference.
We quiet lack to comprehend exactly how the virus spreads from person to person and how apt crowd are to become ill while they’re exposed, Maragakis says.
Scientists are though healthful working at harmony the best treatment strategies though those who perform autumn ill, Bogoch says.
We though healthful lack more data to count the mortality rate, rank says.
“How many crowd are exposed who don’t emerge symptoms or who eat gentle symptoms? That’s difficult to revolve out during cool and flu season,” says Amanda McClelland, R.N., M.P.H., senior vice headmaster of block Epidemics at determine to rescue Lives, an initiative of radical Strategies.
The CDC describes this though a “rapidly evolving situation,” and said data will exist updated though it becomes available.
Editor’s Note: This article was originally published Jan. 23.
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