The coronavirus that causes COVID-19 has now spread to all 50 states.

A patient in West Virginia, which was the only state with no confirmed cases until now, tested positive for coronavirus, Gov. Jim Justice (R) said Tuesday. Justice didn’t offer many details, only noting that the person diagnosed lives in the eastern panhandle of the state.

The U.S. Centers for Disease Control and Prevention confirmed the first known U.S. case of the disease in Washington state on Jan. 20 in a patient who had recently traveled to Wuhan, China.

Though health officials contained the initial case, a surge of new infections nevertheless cropped up in early March with Washington, California and Oregon seeing the bulk of new infections.

It’s possible the virus has traveled further and faster than we realized. A severe nationwide shortage of coronavirus test kits has hampered officials’ ability to accurately assess its spread.

Despite President Donald Trump’s claim that “anybody that wants a test can get a test,” many U.S. citizens have been denied the test because they don’t meet certain requirements, like having traveled to a country where the virus had widely spread. Some who had come in contact with those who had tested positively for coronavirus were denied because they were asymptomatic, according to The New York Times.

Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, admitted the U.S. is lagging behind other developed countries in testing citizens for the virus. South Korea, for example, has been testing more than 10,000 people each day for the last several weeks.

“The system is not really geared to what we need right now ― what you are asking for. This is a failing. It is a failing. Let’s admit it,” Fauci said when asked about testing during a congressional hearing last week. “The idea of anybody getting it easily the way people in other countries are doing it, we’re not set up for that. Do I think we should be? Yes. But we’re not.”

States have taken action to help prevent the spread of the disease, like closing schools and banning public events attended by a certain number of people. At least one locality, New Rochelle, a suburb in New York where there were 108 cases, has placed citizens under official containment in order to slow the outbreak.

“It is a dramatic action, but it is the largest cluster of cases in the country,” New York Gov. Andrew Cuomo said of the containment. “The numbers are going up unabated, and we do need a special public health strategy.”

Trump declared a national emergency last Friday in response to the pandemic, allocating up to $50 billion in disaster relief funding to states. During the announcement, in which Trump refused to take responsibility for testing delays, he said half a million tests would be available in the U.S. by “early next week.”