Coronavirus Disease 2019 (COVID-19) Situation Summary

Background

CDC is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus that was first detected in China and which has now been detected in more than 100 locations internationally, including in the United States. The virus has been named “SARS-CoV-2” and the disease it causes has been named “coronavirus disease 2019” (abbreviated “COVID-19”).

On January 30, 2020, the International Health Regulations Emergency Committee of the World Health Organization declared the outbreak a “public health emergency of international concern” (PHEIC). On January 31, 2020, Health and Human Services Secretary Alex M. Azar II declared a public health emergency (PHE) for the United States to aid the nation’s healthcare community in responding to COVID-19. On March 11, 2020 WHO publicly characterized COVID-19 as a pandemic.

Source and Spread of the Virus

Coronaviruses are a large family of viruses that are common in people and many different species of animals, including camels, cattle, cats, and bats. Rarely, animal coronaviruses can infect people and then spread between people such as with MERS-CoV, SARS-CoV, and now with this new virus (named SARS-CoV-2).

The SARS-CoV-2 virus is a betacoronavirus, like MERS-CoV and SARS-CoV. All three of these viruses have their origins in bats. The sequences from U.S. patients are similar to the one that China initially posted, suggesting a likely single, recent emergence of this virus from an animal reservoir.

Early on, many of the patients at the epicenter of the outbreak in Wuhan, Hubei Province, China had some link to a large seafood and live animal market, suggesting animal-to-person spread. Later, a growing number of patients reportedly did not have exposure to animal markets, indicating person-to-person spread. Person-to-person spread was subsequently reported outside Hubei and in countries outside China, including in the United States. Some international destinations now have apparent community spread with the virus that causes COVID-19, as do some parts of the United States. Community spread means some people have been infected and it is not known how or where they became exposed. Learn what is known about the spread of this newly emerged coronaviruses.

 

 

Situation in U.S.

In addition to CDC, many public health laboratories are now testing for the virus that causes COVID-19. View CDC’s Public Health Laboratory Testing map.

With this increase in testing, more and more states are reporting cases of COVID-19 to CDC. View latest case counts, deaths, and a map of states with reported cases.

U.S. COVID-19 cases include:

Imported cases in travelers

Cases among close contacts of a known case

Community-acquired cases where the source of the infection is unknown.

Illness Severity

The complete clinical picture with regard to COVID-19 is not fully known. Reported illnesses have ranged from very mild (including some with no reported symptoms) to severe, including illness resulting in death. 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 of all ages with severe underlying health conditions — like heart disease, lung disease and diabetes, for example — seem to be at higher risk of developing serious COVID-19 illness.

Learn more about the symptoms associated with COVID-19.

There are ongoing investigations to learn more. This is a rapidly evolving situation and information will be updated as it becomes available.

Risk Assessment

Outbreaks of novel virus infections among people are always of public health concern. The risk to the general public from these outbreaks depends on characteristics of the virus, including how well it spreads between people; the severity of resulting illness; and the medical or other measures available to control the impact of the virus (for example, vaccines or medications that can treat the illness). That this disease has caused severe illness, including illness resulting in death is concerning, especially since it has also shown sustained person-to-person spread in several places. These factors meet two of the criteria of a pandemic. As community spread is detected in more and more countries, the world moves closer toward meeting the third criteria, worldwide spread of the new virus.

It is important to note that current circumstances suggest it is likely that this virus will cause a pandemic. This is a rapidly evolving situation and CDC’s risk assessment will be updated as needed.

Current risk assessment:

For the majority of people, the immediate risk of being exposed to the virus that causes COVID-19 is thought to be low. There is not widespread circulation in most communities in the United States.

People in places where ongoing community spread of the virus that causes COVID-19 has been reported are at elevated risk of exposure, with increase in risk dependent on the location.

Healthcare workers caring for patients with COVID-19 are at elevated risk of exposure.

Close contacts of persons with COVID-19 also are at elevated risk of exposure.

Travelers returning from affected international locations where community spread is occurring also are at elevated risk of exposure, with increase in risk dependent on location.

CDC has developed guidance to help in the risk assessment and management of people with potential exposures to COVID-19.

What May Happen

More cases of COVID-19 are likely to be identified in the United States in the coming days, including more instances of community spread. It’s likely that at some point, widespread transmission of COVID-19 in the United States will occur. Widespread transmission of COVID-19 would translate into large numbers of people needing medical care at the same time. Schools, childcare centers, and workplaces, may experience more absenteeism. Mass gatherings may be sparsely attended or postponed. Public health and healthcare systems may become overloaded, with elevated rates of hospitalizations and deaths. Other critical infrastructure, such as law enforcement, emergency medical services, and sectors of the transportation industry may also be affected. Healthcare providers and hospitals may be overwhelmed. At this time, there is no vaccine to protect against COVID-19 and no medications approved to treat it. Nonpharmaceutical interventions would be the most important response strategy.

CDC Response

Global efforts at this time are focused concurrently on lessening the spread and impact of this virus. The federal government is working closely with state, local, tribal, and territorial partners, as well as public health partners, to respond to this public health threat.

CDC is implementing its pandemic preparedness and response plans, working on multiple fronts, including providing specific guidance on measures to prepare communities to respond to local spread of the virus that causes COVID-19. There is an abundance of pandemic guidance developed in anticipation of an influenza pandemic that is being adapted for a potential COVID-19 pandemic.

Highlights of CDC’s Response

CDC established a COVID-19 Incident Management System on January 7, 2020. On January 21, CDC activated its Emergency Operations Center to better provide ongoing support to the COVID-19 response.

The U.S. government has taken unprecedented steps with respect to travel in response to the growing public health threat posed by this new coronavirus:

Foreign nationals who have been in China or Iran within the past 14 days cannot enter the United States.

U.S. citizens, residents, and their immediate family members who have been in China or Iran within in the past 14 days can enter the United States, but they are subject to health monitoring and possible quarantine for up to 14 days.

On March 8, CDC recommended that people at higher risk of serious COVID-19 illness avoid cruise travel and non-essential air travel.

Additionally, CDC has issued the following additional specific travel guidance related to COVID-19.

CDC has issued clinical guidance, including:

On January 30, CDC published guidance for healthcare professionals on the clinical care of COVID-19 patients.

On February 3, CDC posted guidance for assessing the potential risk for various exposures to COVID-19 and managing those people appropriately.

On February 27, CDC updated its criteria to guide evaluation of persons under investigation for COVID-19.

On March 8, CDC issued a Health Alert Network (HAN).

CDC has deployed multidisciplinary teams to support state health departments case identification, contact tracing, clinical management, and public communications.

CDC has worked with federal partners to support the safe return of Americans overseas who have been affected by COVID-19.

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This is a picture of CDC’s laboratory test kit for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). CDC tests are provided to U.S. state and local public health laboratories, Department of Defense (DOD) laboratories and select international laboratories.

An important part of CDC’s role during a public health emergency is to develop a test for the pathogen and equip state and local public health labs with testing capacity.

CDC developed an rRT-PCR test to diagnose COVID-19.

As of the evening of March 8, 78 state and local public health labs in 50 states and the District of Columbia have successfully verified and are currently using COVID-19 diagnostic tests.

Combined with other reagents that CDC has procured, there are enough testing kits to test more than 75,000 people.

In addition, CDC has two laboratories conducting testing for the virus that causes COVID-19. CDC can test approximately 350 specimens per day.

Commercial labs are working to develop their own tests that hopefully will be available soon. This will allow a greater number of tests to happen close to where potential cases are.

CDC has grown the COVID-19 virus in cell culture, which is necessary for further studies, including for additional genetic characterization. The cell-grown virus was sent to NIH’s BEI Resources Repository for use by the broad scientific community.

CDC also is developing a serology test for COVID-19.

CDC Recommends

Everyone can do their part to help us respond to this emerging public health threat:

Individuals and communities should familiarize themselves with recommendations to protect themselves and their communities from getting and spreading respiratory illnesses like COVID-19.

Older people and people with severe chronic conditions should take special precautions because they are at higher risk of developing serious COVID-19 illness.

If you are a healthcare provider, be on the look-out for:

People who recently traveled from China or another affected area and who have symptoms associated with COVID-19, and

People who have been in close contact with someone with COVID-19 or patients with pneumonia of unknown cause. (Consult the most recent definition for patients under investigation [PUIs].)

If you are a healthcare provider or a public health responder caring for a COVID-19 patient, please take care of yourself and follow recommended infection control procedures.

If you are a close contact of someone with COVID-19 and develop symptoms of COVID-19, call your healthcare provider and tell them about your symptoms and your exposure. They will decide whether you need to be tested, but keep in mind that there is no treatment for COVID-19 and people who are mildly ill are able to isolate at home.

If you are a resident in a community where there is ongoing spread of COVID-19 and you develop COVID-19 symptoms, call your healthcare provider and tell them about your symptoms. They will decide whether you need to be tested, but keep in mind that there is no treatment for COVID-19 and people who are mildly ill are able to isolate at home.

For people who are ill with COVID-19, but are not sick enough to be hospitalized, please follow CDC guidance on how to reduce the risk of spreading your illness to others. People who are mildly ill with COVID-19 are able to isolate at home during their illness.

If you have been in China or another affected area or have been exposed to someone sick with COVID-19 in the last 14 days, you will face some limitations on your movement and activity. Please follow instructions during this time. Your cooperation is integral to the ongoing public health response to try to slow spread of this virus.

Coronavirus Disease 2019 (COVID-19) in the U.S.

CDC is responding to an outbreak of respiratory illness caused by a novel (new) coronavirus. The outbreak first started in Wuhan, China, but cases have been identified in a growing number of other locations internationally, including the United States. In addition to CDC, many public health laboratories are now testing for the virus that causes COVID-19.

 

COVID-19: U.S. at a Glance*

Total cases: 647

Total deaths: 25

States reporting cases: 36 (includes District of Columbia)

* Data include both confirmed and presumptive positive cases of COVID-19 reported to CDC or tested at CDC since January 21, 2020, with the exception of testing results for persons repatriated to the United States from Wuhan, China and Japan. State and local public health departments are now testing and publicly reporting their cases. In the event of a discrepancy between CDC cases and cases reported by state and local public health officials, data reported by states should be considered the most up to date.

 

COVID-19: Cases in the United States Reported to CDC*

Travel-related

83

Person-to-person spread

36

Under Investigation

528

Total cases

647

* Data include both confirmed and presumptive positive cases of COVID-19 reported to CDC or tested at CDC since January 21, 2020, with the exception of testing results for persons repatriated to the United States from Wuhan, China and Japan. State and local public health departments are now testing and publicly reporting their cases. In the event of a discrepancy between CDC cases and cases reported by state and local public health officials, data reported by states should be considered the most up to date.

CDC is no longer reporting the number of persons under investigation (PUIs) that have been tested, as well as PUIs that have tested negative. Now that states are testing and reporting their own results, CDC’s numbers are not representative of all testing being done nationwide.

As of March 8, 2020 1,707 patients had been tested at CDC. This does not include testing being done at state and local public health laboratories, which began this week.

 

States Reporting Cases of COVID-19 to CDC*

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* Data include both confirmed and presumptive positive cases of COVID-19 reported to CDC or tested at CDC since January 21, 2020, with the exception of testing results for persons repatriated to the United States from Wuhan, China and Japan. State and local public health departments are now testing and publicly reporting their cases. In the event of a discrepancy between CDC cases and cases reported by state and local public health officials, data reported by states should be considered the most up to date.

 

COVID-19: Cases among Persons Repatriated to the United States

 

Positive

Wuhan, China

3

Diamond Princess Cruise Ship

46

Cases have laboratory confirmation and may or may not have been symptomatic.

COVID-19 cases in the United States by date of illness onset, January 12, 2020, to March 8, 2020, at 4pm ET (n=137)**

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Region Name

Start Date

End Date

Illnesses that began during this time may not yet be reported

03/01/2020

03/08/2020

** Does not include cases among persons repatriated to the United States from Wuhan, China and Japan; does not include U.S.-identified cases where the date of illness onset has not yet been reported.

Testing in the U.S.

CDC is responding to an outbreak of respiratory illness caused by a novel (new) coronavirus. The outbreak first started in Wuhan, China, but cases have been identified in a growing number of other locations internationally, including the United States.

 

Public Health Laboratory Testing for COVID-19

This map includes states and territories with one or more laboratories that have successfully verified and are currently using COVID-19 diagnostic tests. As of the evening of March 9, 79 state and local public health labs in 50 states and the District of Columbia have successfully verified and are currently using COVID-19 diagnostic tests.

This list is provided by the Association of Public Health Laboratories (APHL). Contact your state health department regarding questions about testing.

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Number of specimens tested for the virus that causes COVID-19 by CDC labs (N=3,698) and U.S. public health laboratories* (N=4,856) by date of specimen collection

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* Reporting public health laboratories are 42 state public health labs (AL, AR, AZ, CA, CO, CT, DE, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, MI, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, TN, TX, VT, WA, WI and WY), New York City, USAF, and 5 California counties.

Non-respiratory specimens were excluded. If collection date is not available then, for CDC results, the date received or reported is used and, for U.S. public health laboratories, the date tested is used. Results reported as of 3:15pm on March 9 were included.

Data during this period are pending.

Lab Collection Dates

Date Collected

CDC Labs

US Public Health Labs

1/18

4

0

1/19

0

0

1/20

7

0

1/21

7

0

1/22

17

0

1/23

58

0

1/24

79

0

1/25

160

0

1/26

86

0

1/27

154

0

1/28

84

0

1/29

404

0

1/30

175

0

1/31

114

0

2/1

47

0

2/2

53

0

2/3

96

0

2/4

72

0

2/5

86

0

2/6

62

1

2/7

83

0

2/8

37

0

2/9

45

2

2/10

69

0

2/11

50

0

2/12

36

0

2/13

39

0

2/14

39

4

2/15

11

2

2/16

12

0

2/17

62

26

2/18

65

2

2/19

54

3

2/20

226

0

2/21

290

0

2/22

23

2

2/23

46

1

2/24

46

12

2/25

109

11

2/26

63

22

2/27

104

106

2/28

88

140

2/29

84

232

3/1

70

184

3/2

105

405

3/3

34

585

3/4

27

758

3/5

6

750

3/6

10

800

3/7

0

525

3/8

0

261

3/9

0

22

3698

4856

Global Map

As of 12:00 p.m. ET March 10, 2020

World map showing countries with COVID-19 cases

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Global case numbers are reported by the World Health Organization (WHO) in their coronavirus disease 2019 (COVID-19) situation report. For U.S. information, visit CDC’s COVID-19 in the U.S.

Locations with Confirmed COVID-19 Cases, by WHO Region

Africa

Algeria

Cameroon

Nigeria

Senegal

South Africa

Togo

Americas

Argentina

Brazil

Canada

Chile

Colombia

Costa Rica

Dominican Republic

Ecuador

French Guiana

Guadalupe

Martinique

Mexico

Panama

Paraguay

Peru

United States

Eastern Mediterranean

Afghanistan

Bahrain

Egypt

Iran

Iraq

Jordan

Kuwait

Lebanon

Morocco

Oman

Pakistan

Qatar

Saudi Arabia

Tunisia

United Arab Emirates

Europe

Albania

Andorra

Armenia

Austria

Azerbaijan

Belarus

Belgium

Bosnia and Herzegovina

Bulgaria

Croatia

Cyprus

Czechia

Denmark

Estonia

Finland

France

Georgia

Germany

Gibraltar

Greece

Holy See (Vatican City)

Hungary

Iceland

Ireland

Israel

Italy

Latvia

Liechtenstein

Lithuania

Luxembourg

Malta

Moldova

Monaco

Netherlands

North Macedonia

Norway

Poland

Portugal

Romania

Russia

San Marino

Serbia

Slovakia

Slovenia

Spain

Sweden

Switzerland

Ukraine

United Kingdom

South-East Asia

Bangladesh

Bhutan

India

Indonesia

Maldives

Nepal

Sri Lanka

Thailand

Western Pacific

Australia

Brunei Darussalam

Cambodia

China

Hong Kong

Japan

Macau

Malaysia

New Zealand

Philippines

Republic of Korea

Singapore

Taiwan

Vietnam

CDC in Action: Preparing Communities for Potential Spread of COVID-19

CDC is aggressively responding to the global outbreak of COVID-19 and preparing for the potential of community spread in the United States.

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CDC Protects and Prepares Communities

Preparing first responders, healthcare providers, and health systems

Establishing visibility across healthcare systems to understand healthcare use, particularly surges in demand for medical care and associated resources.

Conducting extensive outreach to clinical and hospital professional organizations to ensure health system preparedness.

Producing more than 23 guidance documents on infection control, hospital preparedness assessments, personal protective equipment (PPE) supply planning, and clinical evaluation and management (as of February 22, 2020).

Working closely with healthcare facilities and providers to reinforce infection control principles that recognize PPE is one component of a larger set of practices that help to limit the spread of disease.

Developing a range of respirator conservation strategies, including strategies to make supplies last longer (such as using alternative products like reusable respirators) and extending the use of disposable respirators.

Leveraging existing telehealth tools to direct people to the right level of healthcare for their medical needs.

Working with supply chain partners to understand supply usage, what products are available, and when more aggressive measures may need to be taken to ensure that healthcare workers at highest risk have access to PPE.

Sharing information with stakeholders to help them recognize when to shift the strategies they are using.

Infographic: CDC Protects and Prepares Communities

CDC Protects and Prepares Communities

Reinforcing state, territorial, and local public health readiness

Assessing state and local readiness to implement community mitigation measures like home containment, including housing and transportation needs.

Coordinating with states to identify and mitigate gaps in readiness that will help reduce the spread of disease in the community while protecting workers, infrastructure, and institutions.

Linking public health agencies and healthcare systems to identify and mitigate stressors to the health system.

Tracking stockpiles of PPE across jurisdictions.

Working with state and local public health to use existing Public Health Emergency Preparedness (PHEP) funding to support COVID-19 preparedness and response activities.

Leveraging funding mechanisms to help states accelerate preparedness activities.

Providing technical assistance and guidance to states to improve their ability to respond to the outbreak.

Supporting communities, businesses, and schools

Creating business guidance to help the public and private sectors ensure they are able to operate with adaptations like telework and flexible sick leave policies, as well as how to respond if an employee gets sick.

Developing guidance for childcare programs, K-12 schools, and colleges/universities to help them plan and prepare for COVID-19 and respond if there is a local outbreak in their community.

Providing planning guides for COVID-19 that households, community- and faith-based organizations, event planners of mass gatherings, and public health communicators can use.

Educating communities about nonpharmaceutical interventions (NPIs) that help slow the spread of illness, like COVID-19.