President Trump today announced he has activated the National Guard for three hard-hit states, and Ohio and Louisiana today became the latest states to issue mandatory shelter-in-place orders, as the number of COVID-19 infections in the United States soared past 33,000.

Meanwhile, an increasing number of infections and exposures have been reported in lawmakers on both sides of the Atlantic. And surges continue in western Europe, with disease activity picking up pace in some African countries, lifting the global total today to 335,957 in 171 countries, 14,632 of them fatal, according to the Johns Hopkins online dashboard.

The United States, with 33,276 infections, now has the third most COVID-19 cases in the world, behind China and Italy.

National Guard activated

At a briefing this evening, Trump said the National Guard will be deployed to New York, California, and Washington state to help with their response to the pandemic coronavirus, adding that the action will be funded by the Federal Emergency Management Agency (FEMA).

He also said supplies, including gloves, beds, N95 respirators, and gowns will be delivered from the federal stockpile within the next 48 hours. According to an ABC News report, Trump said the National Guard in the three states will be under local control, with federal funding.

Trump also said FEMA will provide four 1,000-bed medical stations to New York, eight 2,000-bed medical stations to California, and three 1,000-bed medical stations for Washington, CNN reported.

Shelter-in-place states grow to 6

Ohio Governor Mike DeWine today issued a stay-at-home order that goes into effect tomorrow and lasts until Apr 6. It allows essential businesses to remain open, but exempts religious organizations, though the order warns that gathering in groups is dangerous. The state also set temporary rules for childcare centers, such as maintaining a 1:6 teacher-child ratio.

So far, Ohio—with a population of about 11.7 million—has reported 351 cases, 3 of them fatal.

DeWine also said that, following an emergency meeting, the Ohio Board of Pharmacy passed a rule to restrict dispensing of malaria medications because of hoarding. Over the past few days, President Trump has voiced hope that malaria drugs such as chloroquine are useful, though federal health officials have warned that so far, the benefits are anecdotal and that large randomized controlled trials are needed to assess if the drugs are safe and provide any treatment benefit.

In a related development, Louisiana Governor John Bel Edwards announced a stay-at-home order that begins tomorrow at 5:00 pm and is in effect until Apr 13. The order affects 4.6 million people; the state has reported 837 cases, 20 of them fatal.

The announcements today bring the number of states with shelter-in-place orders to six. The others are California, New York, Illinois, and New Jersey.

As one of the main US hot spots, New York today reported 5,429 more cases, plus 58 more deaths, pushing its totals to 15,168 cases, 114 of them fatal. New York City has reported 9,045 of the cases.

Neighboring New Jersey added 587 new cases today, plus 4 more deaths, lifting its respective totals to 1,914 and 587. And late yesterday, Washington state, the third most affected state, said it had 1,793 cases, 94 of them fatal.

The California Department of Public Health today reported 224 more cases and 4 more deaths, putting the state's respective totals at 1,468 and 27.

Lawmakers infected or exposed

Kentucky Senator Rand Paul today on Twitter announced that he has tested positive for COVID-19 after testing under an abundance of caution because of extensive travel and events. He said he is asymptomatic and in quarantine.

In a related development, Utah Senator Mitt Romney's office announced a statement that since he sat next to Rand for extended periods during recent days, Romney will self-quarantine and not vote on the Senate floor. He has no symptoms and is undergoing testing.

Last week, two US House members tested positive for the virus.

In addition, German Chancellor Angela Merkel is in home quarantine after she was recently vaccinated by a doctor who tested positive for the virus, CNN reported.

Slow progress on federal relief package

US members of Congress are working on a COVID-19 relief and stimulus package worth $1.8 trillion, but Democrats have aired concerns about oversight of $500 billion in loans to companies selected by the US Department of Treasury, the Washington Post reported today.

House Democrats have signaled that they might release their own version of the bill, which could further delay a final agreement, the Post reported.

Gilead changes access to remdesivir

On the medical treatment front today, Gilead, the maker of the experimental antiviral drug that is in clinical trials and has been used on a compassionate use basis, announced today that it is transitioning emergency access from individual compassionate use requests to expanded access programs through clinical trials.

The company said it can't accept any new compassionate use requests owing to overwhelming demand over the past several days and is focusing on processing earlier approved requests.

Gilead emphasized that it will make exceptions for pregnant women and for children who have confirmed severe disease. And it urged doctors to enroll patients in clinical trials, if possible, rather than pursue emergency treatment requests.

Italy cases approach 60,000

Italy's health ministry today reported 5,560 new cases, down from 6,557 new cases reported yesterday, raising its total to 59,138. It also reported 651 more deaths, putting the fatality count at 5,476.

In Spain, Europe's second most affected nation, the country's prime minister extended the state of emergency for another 15 days, CNN reported. Spanish officials today reported 394 more deaths, lifting its fatality count to 1,720, and 3,107 new cases, raising Spain's overall total to 28,603.

And in Germany, the total is at 18,610, reflecting the addition of 1,948 cases, according to the most recent information from the Robert Koch Institute.

MSF sets up treatment unit in Iran

In Iran today, health officials reported 1,028 more cases, up from 966 new cases reported yesterday, for a total of 21,638 cases. They also reported 129 more deaths, putting the fatality count at 1,685.

Doctors Without Borders (MSF) today announced that it is setting up an inflatable treatment unit in the Iranian city of Isfahan to treat critically ill patients.

The 50-bed unit will be installed on the grounds of the city's Amin Hospital and will be staffed by an MSF emergency team that includes nine doctors and logisticians who will work with local medical staff and coordinate with Iranian health officials.

Julie Reverse, MSF's Iran representative, said Iran is the hardest-hit country in the region, and Isfahan is the country's second most affected province. "We hope our assistance will relieve at least some of the pressure on the local health system," she said.

MSF teams are also helping with pandemic response in other countries, including Italy, France, Belgium, and Spain.

In other Middle East developments, Syria detected its first case, which involved a 20-year-old woman who had traveled abroad, Reuters reported.

Africa totals rise; more nations affected

Uganda's health minister today announced the country's first case, a citizen who arrived on a flight and was found to have a fever during airport screening. A media report said he had been in Dubai. A day earlier, the country's president had banned all flights into the country, effective today.

Mozambique's health ministry today announced its first case, the World Health Organization African regional office said on Twitter. It also said Kenya has confirmed 8 more cases, raising its total to 15. And Rwanda's government yesterday announced a 2-week lockdown to slow the spread of the virus, which followed the detection of 6 more cases that raised the country's total to 17, Anadolu Agency reported today.

In Burkina Faso, 4 government ministers have tested positive for the virus, and the number of cases has risen to 40, the highest in West Africa, Reuters reported today.

As of today, Africa has reported 1,187 cases, up from 327 on Mar 16.

In addition, a flight carrying medical supplies donated by a foundation headed by Jack Ma, the founder of Chinese company Alibaba, arrived in Ethiopia today. It contained 100,000 masks, 20,000 test kits, and 1,000 protective suits targeted to 54 countries. The firm has also announced shipments for Latin America, South Asia, and Europe.