Virus spreads to more countries as new cases slow in China; risk in Tennessee remains low

A patient is removed from Life Care Center, a nursing home, in Kirkland, Wash., on Feb. 29, 2020. At least four residents of the nursing center have died in Washington State and four others in the center and an employee have also learned they have the virus. (Grant Hindsley/The New York Times)
A patient is removed from Life Care Center, a nursing home, in Kirkland, Wash., on Feb. 29, 2020. At least four residents of the nursing center have died in Washington State and four others in the center and an employee have also learned they have the virus. (Grant Hindsley/The New York Times)

The coronavirus spread to ever more countries and world capitals Monday - and the U.S. death toll climbed to six - even as new cases in China dropped to their lowest level in over a month, the Associated Press reported.

April Priest, emergency management planner at the Chattanooga-Hamilton County Health Department, said during a Regional Health Council meeting Monday that Tennesseans' risk of contracting the virus is still low. However, that could change if the virus becomes widespread in the U.S., she said.

A shift in the crisis appeared to be taking shape: Hundreds of patients were released from hospitals at the epicenter of the outbreak in China, while the World Health Organization reported that nine times as many new infections were recorded outside the country as inside it over the past 24 hours.

More than 100 cases have been confirmed in the U.S., with more almost certain in the coming weeks. Thousands of test kits were on their way to state and local labs, and new guidelines intended to expand screening were put in place.

Georgia Gov. Brian Kemp announced Monday evening that there were two confirmed cases of the coronavirus in Georgia.

Health officials in Washington state, where a particularly troubling cluster of cases surfaced at a nursing home outside Seattle, said that four more people had died from the coronavirus, bringing the number of deaths in the U.S. to six, all in Washington, The AP reported. New cases were also reported in New Hampshire and New York.

In Seattle, King County Executive Dow Constantine declared an emergency and said the county is buying a hotel to be used as a hospital for patients who need to be isolated.

"We have moved to a new stage in the fight," he said.

Tennessee Gov. Bill Lee said at a news event Monday that he feels confident in the state's process and ability to respond to an outbreak.

"We have developed a team of officials who are in daily connection locally with one another and across the state but also with the federal government and federal health officials," he said. "What's most important is that we deal with the facts, and the facts right now are there are no reported cases in Tennessee. And when that changes, we'll make sure everyone knows."

Lee also acknowledged that the situation is rapidly evolving.

"There are likely folks who have contracted the disease and don't know it," he said. "We just need to be ready for it and be adaptive to changes as they come."

photo Director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health Anthony Fauci, with White House coronavirus response coordinator Dr. Deborah Birx, left, and Vice President Mike Pence, speaks to reporters in the Brady press briefing room of the White House, Monday, March 2, 2020, in Washington. (AP Photo/Manuel Balce Ceneta)

As of Feb. 24, Priest said, the Tennessee Department of Health began performing coronavirus tests at its lab to speed up and expand the surveillance efforts of the U.S. Centers for Disease Control and Prevention. She said greater capacity to test for possible infection is necessary since screening criteria have broadened.

Now, any person with flu-like symptoms who's had close contact with someone that has laboratory-confirmed COVID-19 - the official name of the new coronavirus - or a history of travel from the most affected geographic areas - China, Iran, Italy, Japan, South Korea - should be tested, according to CDC protocol. Health care providers have also been instructed to test hospitalized people with severe acute lower respiratory illness, such as pneumonia, after other illnesses are ruled out.

"That's because Friday we found in California, and now a small cluster in Washington, people that have no travel exposure and no close-contact exposure now have become positive for COVID," Priest said.

Since there's no vaccine or antiviral medicine to treat coronavirus, she said, public health officials are focused on prevention and supportive care to combat potential spread. So far, the state department of health has monitored a total of 159 people for possible infection, according to Priest. Test results for 40 of those people have yet to return, but the rest came back negative, she said.

"Unless they start developing symptoms at the end of their 14-day monitoring period, their social movement restrictions placed upon them would be released," Priest said. "As far as boiling this down to Hamilton County, we've actually only had five asymptomatic - meaning no symptoms - travelers in our county, and only two of those have met the risk criteria to undergo public health monitoring."

Symptoms typically appear between two and 14 days after exposure. Priest said those two people undergoing monitoring in Hamilton County haven't developed symptoms as of noon on Monday - the day their monitoring period ends.

In an online video posted Friday, Dr. Lisa Piercey, commissioner of the Tennessee Department of Health, encouraged people to avoid misinformation by looking to the CDC, World Health Organization or department of health for updates.

"Fear, panic and misinformation can be just as dangerous as an outbreak itself," Piercey said.

Around the world, the crisis reshaped the daily routines of millions of people, and global health officials sought to reassure the public that the virus remains a manageable threat.

"Containment is feasible and must remain the top priority for all countries," WHO chief Tedros Adhanom Ghebreyesus said.

Alarming clusters of disease continued to swell in South Korea, Italy and Iran, and the virus turned up for the first time in New York, Moscow and Berlin, as well as Indonesia, Latvia, Morocco, Tunisia, Senegal, Jordan and Portugal, according to the AP. The worldwide death toll topped 3,000 and the number of those infected rose to about 89,000 in 70 countries on every continent but Antarctica.

In Japan, children stayed home after the government announced the closing of schools until April. In Paris, the galleries of the Louvre museum were off limits. With Israel holding a national election, special voting booths were set up for those under quarantine. In Germany, Chancellor Angela Merkel was rebuffed by her interior minister when she extended her hand to greet him.

photo Microbiologist Xiugen Zhang runs a Polymerase Chain Reaction (PCR) test at the Connecticut State Public Health Laboratory, Monday, March 2, 2020, in Rocky Hill, Conn. The Connecticut Department of Public Health has received federal approval from the Centers for Disease Control and Prevention and the Food and Drug Administration to run diagnostic testing for the coronavirus at the department's lab in Rocky Hill. (AP Photo/Jessica Hill)

At the United Nations, officials said they were postponing a major conference on women that had been expected to bring up to 12,000 people from its 193 member countries to New York next week.

The Organization for Economic Cooperation and Development warned that the world economy could contract this quarter for the first time since the international financial crisis more than a decade ago, the AP reported.

"Global economic prospects remain subdued and very uncertain," the agency said.

Nevertheless, the Dow Jones Industrial Average soared nearly 1,300 points as stocks roared back from a seven-day rout on hopes that central banks will take action to shield the global economy from the effects of the outbreak.

The message was echoed by global health officials, who said they were encouraged that even in some countries that had taken far less aggressive measures than China's, the virus remains largely in check.

Because the virus is not transmitted as easily as the flu, "it offers us a glimmer - that this virus can be suppressed and contained," said Dr. Mike Ryan, the WHO's emergencies chief.

China reported just 202 new cases, its lowest daily count since Jan. 21, and the city at the heart of the crisis, Wuhan, said 2,570 patients were released. At the largest of 16 temporary hospitals that were rapidly built in Wuhan in response to the outbreak, worries over the availability of supplies and protective gear eased, along with the pressure on the medical staff.

Dr. Zhang Junjian, who leads a temporary hospital in Wuhan with a staff of 1,260, said optimism is high that the facility will no longer be needed in the coming weeks.

But in other places, problems continued to multiply.

The worst-hit places outside China were South Korea, Iran and Italy. South Korea on Tuesday reported 477 new cases, bringing its totals to 4,812 with 29 deaths. Most are in the southeastern city of Daegu and neighboring towns.

In Iran, a confidant of Iran's supreme leader died from the virus. The Islamic Republic confirmed 1,501 cases and 66 deaths, but many believe the true number is larger. Its reported caseload surged more than 250% in just 24 hours.

Italy's caseload rose to 2,036, including 52 deaths. Officials said it could take up to two weeks before they know whether measures including quarantining 11 towns in northern Italy are slowing the spread of the virus

In the U.S., meanwhile, four Americans exposed to the virus aboard a Japanese cruise ship were released from quarantine in Nebraska after testing negative, the AP reported.

One of them, Jeri Seratti-Goldman of Santa Clarita, California, said leaving the hospital was bittersweet, because her husband remained quarantined. Another, Joanne Kirkland of Knoxville, Tennessee, said: "My only question is, will my friends shun me after this?"

Staff writers Elizabeth Fite and Andy Sher contributed to this story.

Contributing to this report were Josh Funk in Omaha, Nebraska; Chris Grygiel in Seattle, Carley Petesch in Dakar, Senegal; Matt Sedensky in Bangkok, Dake Kang in Beijing; Aniruddha Ghosal in New Delhi; Kim Tong-Hyung in Seoul, South Korea; Nasser Karimi in Tehran, Iran; Jon Gambrell in Dubai, United Arab Emirates; Thomas Adamson and Lori Hinnant in Paris; Mari Yamaguchi in Tokyo; Nicole Winfield and Frances D'Emilio in Rome; Colleen Barry in Milan; and Aron Heller in Jerusalem.

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