Seattle, United States - It took less than a month after China alerted the World Health Organization to the emergence of a new coronavirus in the country for the infection to cross the Pacific Ocean, and another month for it to claim its first life in the United States.

Two days later, in the same hospital, it claimed its second.

More:

The virus and the disease it causes, COVID-19, have killed more than 3,000 people around the world, with approximately 90,000 confirmed cases. The US has seen two deaths and dozens of cases of the virus, and hundreds more are expected.

After the first patient, a man in his 50s with an underlying health condition, died outside Seattle in Washington state on the country's northwest coast, Governor Jay Inslee announced a state of emergency.

"Our hearts go out to their family and friends. We will continue to work toward a day where no one dies from this virus," Inslee said. The most recent death, as well as three more patients in hospital, are all elderly with underlying conditions and lived in a local nursing home that has since been sealed off.

The second person to die of the coronavirus in the US was being treated at the EvergreenHealth Medical Center in Seattle, Washington. The state's governor has declared a state of emergency in an effort to contain the spread of the virus [Chona Kasinger/EPA]

Washington's state of emergency is the first in the US to mirror some Asian countries' intensified policies to ensure government facilities can get all the resources they need to address the virus's spread.

Seattle residents have been depleting some stores of food, medicines and pet food. Officials recommend having at least two weeks of supplies in case people are told to stay inside as protection either for themselves or for the community.

'Don't panic, get prepared'

"We didn't have a single break for an hour and a half on Saturday," said AJ Jones, 27, a worker at a Seattle grocery store. Jones does not feel she needs to stockpile at home herself but was told by her manager that sales had jumped 60 percent above normal at the store that day. Shops across the area ran out of stocks of hand sanitiser on Thursday, and face masks weeks before that.

"We're asking for personal responsibility. Get informed, don't panic, get prepared," Jeffrey Duchin, a health officer at Seattle's Public Health office, told reporters.

"Our priority now is to slow the spread of this virus," Governor Inslee said in a statement. "Our health care professionals say the easiest way to do that is to practice good hygiene - wash your hands often, sanitize frequently-touched surfaces and stay home when you're sick. Preventing future cases will require the work of all of us."

US President Donald Trump on Saturday increased travel restrictions in an effort to prevent the spread of the virus, urging citizens to stay away from affected regions of Italy and South Korea, as well as extending an Iran travel ban to foreign nationals who had visited the country in the previous 14 days.

The first cases confirmed in the US were among people evacuated from Wuhan in China but experts think the virus may have been circulating undetected in Seattle, where a second person died on March 1, for at least six weeks [Krysten I. Houk/US Department of Health and Human Services via AP Photo]

But the Trump administration has been accused of taking an approach similar to that by the Chinese government in the early days of the virus - downplaying its spread.

In the US, 472 people have been tested but, by Sunday, only 15 cases were confirmed to have the novel coronavirus. Of those, three were transmitted between people in the US, according to the CDC. The majority of confirmed cases involving US citizens have been from two cruise ships where passengers were quarantined before being brought home.

Marc Lipsitch, an infectious disease epidemiologist at the Harvard School of Public Health, said each new case leads to a better understanding of the spread of the virus. His team of 12 has been working long hours to track and prepare for the outbreak.

"For some people, so far, it has been possible to avoid it. But the nature of an epidemic is that it exponentially grows," Lipsitch told Al Jazeera.

No sick days, high costs

The majority of US-based cases have been on the west coast; the first was one county away from where the man in Seattle died.

The infection had probably been spreading around the Seattle area for six weeks before the first death, a team at the Fred Hutch research lab found.

The CDC is sending a team of experts to support the investigation of the virus's spread in Washington.

CDC spokeswoman Dr Nancy Messonnier said: "We will continue to respond to COVID-19 in an aggressive way to contain and blunt the threat of this virus. While we still hope for the best, we continue to prepare for this virus to become widespread in the United States."

Dr Jeff Duchin, health officer at Public Health of Seattle and King County announces the first death in the US from the novel coronavirus on February 29. A second person died on March 1 [Ryan Henriksen/Reuters]

The CDC has also told people to contact a healthcare professional if they suspect they are showing symptoms of the virus. For many Americans, however, that may come with an added insurance cost that can quickly add up to thousands of dollars. Some citizens may avoid a check-up to avoid being charged more than they can pay.

Jones, the grocery store worker, is not worried about health insurance, but some Americans have already been hit with high medical bills after they sought a doctor's help. A man in Miami, Florida, was found not to have coronavirus after a flu test but was charged $1,400, according to the Miami Herald.

"Panic never serves anyone well," said biologist Carl Bergstrom at the University of Washington, who has studied infectious diseases and the spread of misinformation. While experts cannot predict the spread, they have not been surprised at the directions it has taken as it travels mainly by community transmission.

"It's easy to see how the effort to downplay can be bad because it can reduce responses but if you overplay it, people start to lose trust," Bergstrom said. "If people don't believe the public offices, they can't carry out an effective campaign."

Cases in Rhode Island, New York

Scientists expect the virus will continue to spread but citizens and government can take steps to mitigate it.

On Sunday, officials in Rhode Island in the northeast confirmed the state's first case, the first linked to European travel. New York state also confirmed its first case, in a man who had returned from Iran.

"There's probably ongoing transmission that's being missed because testing has been unbelievably low, because of a mix of technical and legal issues," said Lipsitch

Cases of coronavirus have been reported in states on both the west and east coasts of the US at a time when many already worry about seasonal flu [File: Erik S Lesser/EPA]

Data was probably lost as a result of test kit problems as well, leaving patients undiagnosed.

Lipsitch said the cases that will reach the news in the coming days and weeks will mostly be ones that have been circulating for some time.

"It's that we're becoming aware of cases, rather than the situation escalating," Lipsitch said.

Health professionals and epidemiologists recommend people stay up-to-date with vaccines, limit or stop smoking and stay home from work as the infection spreads, urging employers to comply with flexible working.

Jones's grocery store job, like many in the US, offers limited paid sick leave, if any is given at all. A recent paper by academics in Switzerland and the US showed that paid sick leave could reduce the spread of influenza-like illnesses by 11 percent, but only 10 states in the US have passed sick leave laws.

Vice President Mike Pence has been put in charge of the US response to the epidemic, rather than a scientist, drawing criticism.

"There has been an unusual effort to control health experts," said Bergstrom.

Lipsitch said scientists needed to be at the forefront of efforts to contain the virus.

"Americans expect when they get scientific and public health information that it is from people whose goal it is to spread the truth, not politicians whose goal it is to keep the stock market up or some other political goal."