As ramped-up testing for COVID-19 by individual US states exposes hidden cases, disease transmission, and deaths, officials at the Centers for Disease Control and Prevention are urging citizens to do their part to stop the spread of the new virus—including taking an extended hiatus from their daily lives.

“You may need to take a break from your normal daily routine for two weeks,” Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, said in a briefing Tuesday.

At the time of publishing this story, there were at least 118 COVID-19 cases and nine deaths reported across at least 12 states in the US. Of those cases, 48 are in repatriated citizens, and the rest are a mix of travel-related cases, cases linked to travel cases, and community-spread cases. All of the deaths have occurred in Washington state, where the first US case was detected. Many of the cases in the state have since been linked to an outbreak in a King County skilled nursing home called Life Care.

Worldwide, the COVID-19 epidemic has reached around 92,000 cases and over 3,100 deaths. While most of the cases and deaths so far have been reported from China, the daily counts of new cases in China has been steadily decreasing. On Monday, there were nearly eight times more cases reported outside of China than from within (1,598 cases outside versus 206 from China.)

The explosion of cases outside China is largely driven by outbreaks in South Korea (over 5,100 cases), Iran (over 2,300 cases), and Italy (over 2,000 cases). Iran reported over 1,000 new cases just in the last 24 hours.

“What is happening now in the United States may be the beginning of what is happening abroad,” Dr. Messonnier said in the press briefing. “We will continue to maintain—for as long as practical—an aggressive national posture of containment. That said, you might see some local communities taking specific actions to mitigate the disease.”

Those specific actions might be to close schools, cancel events and large gatherings, and isolate people in their homes.

Under fire

While state and local communities will make their own decisions about mitigation efforts, Dr. Messonnier stressed that individual actions can determine how this will play out in the United States. She urged people to practice proper hygiene and stay home if they’re sick. If you do have symptoms of COVID-19—which primarily include fever, dry cough, and trouble breathing—contact your health care provider by phone, she said.

During the rest of the press briefing, Dr. Messonnier tried to sidestep questions about the CDC’s response to the outbreak. The agency has come under extreme criticism for its hobbled COVID-19 testing, which slowed the detection of cases. The CDC has had unspecified technical problems with the tests that have been slow to resolve. A recent report in Axios suggested that the kits may have been contaminated , which Dr. Messonnier said was only one possible explanation for the problem.

The CDC has also been criticized for providing health care providers with seemingly restrictive recommendations on who should be tested. That is, the agency recommended health care workers primarily test those with travel or known contact with a case. Some health officials said the guidance kept them from testing sick patients who had COVID-19 symptoms but did not meet those criteria.

The CDC has denied that it was restricting testing in this way. In an earlier emailed statement to Ars, a CDC press officer noted that “CDC guidance for persons under investigation (PUI) for whom testing is indicated does include a sentence that is permissive of testing if a patient does not meet the specific criteria for testing but for whom clinical suspicion of COVID-19 is high.”

In the rest of today’s briefing, Dr. Messonnier responded to questions regarding testing problems generally with: “What we really need to focus on now is where we are today.”

She was also asked if she is allowed to speak freely on the outbreak or if the Trump administration is restricting her comments. She did not directly respond to the question, only saying that during this outbreak the CDC has "been very open and able to answer lots of different questions."