COVID-19 as of 03-09-20 (summary is my own):

[Some Quick Definitions for Commonly Used Terms, skip ‘em if ya know ‘em:

Community Spread – Illness with an unknown source. This typically means that there are more cases in the community that have not been detected. May also be called community acquired or local transmission.

Cumulative Confirmed Case Fatality Rate – The total number of patients who were confirmed to have COVID-19 and died, divided by the total number of confirmed COVID-19 cases, from the beginning of the outbreak to today.

Patient Under Investigation (PUI) – A person who is showing one or more COVID-19 symptoms (fever, cough, difficulty breathing) who has not yet received test results.

Presumptive Positive – The first test back for a PUI is positive, but another test is still needed to confirm this. Confirmed means that two tests have shown that the case is positive.]

[QUICK NOTE: Today’s global news is sorely limited, as there was just SO MUCH news in the US to cover. 29% of all of our COVID-19 cases were reported in the last 24 hours! I’ll try my best to catch up on global news from today that I missed in tomorrow’s post.]

Countries Albania, Bangladesh, Cyprus, Mongolia, and Paraguay and territory St. Martin report their first cases. Bahrain, Chile, Costa Rica, and Iraq are the newest countries to report community spread. The cumulative confirmed case fatality rate in countries reporting more than 500 cases are: China - 3.86%; South Korea - 0.7%; Italy - 4.96%; France - 1.7%; Germany - 0.0% (though the median age of those tested in Germany is 40, which is 20-40 years younger than most individuals who are at higher risk of severe illness from COVID-19); Spain - 1.7%; Iran - 2.95%; and the US - 3.63%. As of 10:13 pm PST, the US is reporting 754 cases, up from 537 yesterday. [1, 2, 3, 4]

Italy quickly expands its travel restrictions from a quarter of the country to the whole country; people will now have to show valid reasons for traveling outside the areas they live in, such as health conditions or work. As of 10:13 pm PST, Italy is reporting 9,172 cases; it reported its first two cases on January 31, just 38 days ago. Of note, Italy has about 3.18 hospital beds per 1,000 people, while the US has 2.73 per 1,000. (I calculated this using the total number of hospital beds in 2017, most recent data available, and total country populations as of 2018.) [2, 5, 6]

The Food and Drug Administration (FDA) and the Federal Trade Commission (FTC) issue warning letters to seven companies for selling fraudulent products claiming that they will cure COVID-19: Vital Silver, Quinessence Aromatherapy Ltd., N-Ergetics, GuruNanda LLC, Vivify Holistic Clinic, Herbal Amy LLC, and The Jim Bakker Show. The products cited in these warning letters are teas, essential oils, tinctures and colloidal silver. The FDA has previously warned that colloidal silver is not safe or effective for treating any disease or condition. The FTC chairman states, ““There already is a high level of anxiety over the potential spread of coronavirus. What we don’t need in this situation are companies preying on consumers by promoting products with fraudulent prevention and treatment claims.” [7]

The Director of CDC’s National Center for Immunization and Respiratory Diseases states that nearly half of all reported US cases are in California and Washington State. She gives recommendations for those most at risk (60+, people with chronic health conditions or otherwise weakened immune systems): make sure you have a decent supply of food and water on hand, along with essential and over-the-counter medications. (The average length of time a case is isolated is 14 days, and most cases will be self-isolated at home.) Avoid close contact with people who are sick, avoid touching often-touched surfaces in public, wash your hands often, avoid crowds, cancel cruise ship travel worldwide, and avoid nonessential travel such as long plane trips. She goes on to state that 78 state and local public health labs across all 50 states now have the capacity to test 75,000 people across the US (this is a cumulative count, not a daily one), and states that the commercial labs that have recently begun testing have more capacity than this. [8]

The CDC is now reporting how many tests are being conducted across the US daily. From January 18 to March 9, at least 8,554 tests have been conducted between CDC labs, 42 state public health labs, New York City, the US Air Force, and 5 California county labs. Data from March 6-9 is likely lower right now, as there are typically reporting lags due to the time it takes to get so much data from so many sources and verify the data’s accuracy. On March 6, at least 810 tests were conducted; this is the most testing that has been done in a single day since January 18. (Of note: the number of tests will be higher than the number of people tested, as suspected cases require multiple tests to be confirmed as a COVID-19 case.) [9]

On March 3, the Environmental Protection Agency released a list of disinfectants that are approved for use against SARS-CoV-2, the virus that causes COVID-19; they state that they will update the list as additional disinfectants meet the criteria. [10]

House Representatives Mark Meadows, Doug Collins, Matt Gaetz, Paul Gosar, and Julia Brownley, and Senator Ted Cruz, are each self-quarantining after learning that they came into contact with a confirmed COVID-19 case (I reported on Cruz yesterday). Both Collins and Gaetz have been in contact with President Trump in recent days; Collins accompanied Trump on a CDC visit and Gaetz flew with him on Air Force One. None of the five are currently showing symptoms. [11, 12, 13]

In the US, here are states and territories that have updates for today, in alphabetic order:

Late last night, Arizona announced that one of its two presumptive positive cases either worked or attended school at American Leadership Academy, Ironwood K-12 campus; however, the individual was not on campus while visibly ill. The school is enhancing its sanitation practices and installing hand sanitizers in hallways while students are out on spring break. [AZ]

The Grand Princess cruise ship began disembarking its passengers in Oakland, CA around noon today, supervised by the Department of Health and Human Services’ Assistant Secretary for Preparedness and Response. The 11-acre perimeter of the port was fenced off and watched by federal officials to ensure that no Oakland employees or residents would come in contact with the passengers or crew. Passengers were screened by federal Disaster Medical Assistance Teams, who wore personal protective equipment, conducted risk assessments, and determined who needed immediate medical care (whether related to COVID-19 or not). Passengers disembarked in small groups to allow for social distancing, and after full disembarkation, officials pressure washed the site with a bleach solution to sanitize it. [CA1]

California announces 133 positive COVID-19 cases today (19 more since yesterday). It now has 24 from repatriation flights (no change), 44 travel-related (7 new), 28 due to person-to-person contact with a known case (5 new), 19 from community spread (5 new) and 18 from currently unknown sources being investigated (2 new). 19 public health labs now have test kits and 17 of them are testing as of today (2 new). [CA2]

Los Angeles County announces two cases, one of which is its first case of community spread – it now has 16 cases, of which 1 has recovered. Santa Clara County announces its first death in an individual who was diagnosed on February 28; the county is now reporting 43 cases. Coachella and Stagecoach, two large California music festivals, are in talks to postpone their events at least 6 months; they should confirm their decision within the next 48 hours. Five Bay Area colleges cancel all in-person classes. [CA3, CA4, CA5, CA6]

Colorado announces three new presumptive positive cases and one indeterminate case that the CDC will confirm or rule out with additional testing; she is currently isolated as if she were a positive case. This brings the state’s total count to 12 positive and 1 indeterminate. [CO1, CO2, CO3]

On March 7, Connecticut announced a positive COVID-19 case in a New York resident who works as a community physician in Connecticut; officials state that he was not showing symptoms while working at Bridgeport Hospital and is currently self-isolated. On March 8, the state announced its first presumptive positive case in one of its residents. This case is thought to have been infected during a recent trip to California and is currently hospitalized. (Note: these press releases appear to have been backdated and uploaded to the Connecticut website today.) [CT1, CT2]

Delaware urges those at high risk for developing severe illness from COVID-19 to follow the CDC’s recommendations (as summarized above for reference 5). [DE]

Florida urges residents with recent international travel to follow CDC guidance for self-monitoring or self-quarantine based on which country they visited. Of the 12 positive cases identified in Florida residents currently in the state, 1 is 20-29, 1 is 50-59, 5 are 60-69, 4 are 70-79, and 1 is 80-89 years old. [FL]

In Georgia, the Fulton County School District announces that an employee in the district has tested positive for COVID-19, and that all schools and offices will be closed tomorrow while they work with public health officials to determine next steps. This district includes 106 schools, 14,000 employees, and 93,500 students. [GA1, GA2]

Illinois announces four new presumptive positive cases, bringing its total count to 11 (4 confirmed and 7 presumptive). One of the new cases was from a cruise ship to Egypt, and 2 were contacts to a confirmed case from another cruise ship; the health department reports the last case as “a woman in her 50s from California who traveled to Illinois”; it is unclear whether this is how they meant to write it, or if they meant to say “from Illinois who traveled to California”. I’ve reached out to confirm. [IL1, IL2]

Indiana is now reporting four COVID-19 cases, two of which were exposed at recent business events, and one who also had a history of travel; the fourth case’s source of exposure has not been mentioned. [IN]

Iowa reports an additional 5 cases, bringing their total case count to 8, all of which were exposed during travel. The governor signs a proclamation of disaster emergency, allowing the state to better respond to the outbreak. [IA]

Kentucky is now reporting 6 positive COVID-19 cases but does not give information beyond the line listing of cases. [KY]

Louisiana announces its first presumptive positive case but does not mention the case’s source of exposure. The case is currently hospitalized. [LA]

Massachusetts reports 13 new presumptive positive cases, bringing its total count to 41. 9 of the 13 new cases attended the BioGen conference; of the 41, 32 came from exposure at BioGen. [MA]

Mississippi gives guidance for long-term care facilities, personal care homes and group care sites for those with disabilities in DeSoto, Marshall, Tate and Tunica counties, to cancel group social activities, restrict visitation, keep ill visitors away from facilities, among other things. [MS]

New Jersey’s health commissioner holds a conference call with long-term care facility leaders to give them guidance: facilities should continue to monitor residents for symptoms of respiratory virus, sick employees with respiratory symptoms (e.g., cough, shortness of breath) should be instructed not to report to work, staff should be trained on how to properly put on and take off personal protective equipment, etc. [NJ]

New Mexico activates its Department Operations Center to prepare for a COVID-19 outbreak in the state; no cases have been reported to date. [NM]

New York’s governor states that the state government will produce and distribute up to 100,000 gallons of alcohol-based hand sanitizer each week to most impacted and high-risk areas, and to state agencies. The state is now reporting 142 positive cases. The governor also sent the paid sick leave bill that specifically protects people who stay home from work because they are being isolated or quarantined as a result of novel coronavirus to the legislature today. [NY]

North Carolina announces six new positive cases today (at least 5 specified as presumptive); 5 of these cases were exposed at the recent BioGen conference. One of the individuals is isolated in Indiana and the 5 BioGen attendees are isolated at home in NC. [NC1, NC2]

North Dakota states that four individuals whose tests were run over the weekend were each negative for COVID-19. [ND]

Ohio announces its first 3 COVID-19 cases today. Two of the cases were exposed on the river cruise on the Nile, and one was exposed at AIPAC. All three are in Cuyahoga County. The governor declares a state of emergency to assist in mobilizing resources to combat the new outbreak in the state. [OH1, OH2, OH3]

Pennsylvania announces four new presumptive positive cases today, bringing their total case count to 10. One is hospitalized in chronic condition and had recent international travel. The state’s secretary of health states, “you have a higher chance of testing positive for COVID-19 if you have traveled to a country or state with known community outbreaks or have come in contact with someone who has the virus.” [PA1, PA2]

South Carolina announces its seventh presumptive positive case today in a contact of another case. This individual was assessed at a healthcare facility; it is not immediately clear whether healthcare personnel were wearing personal protective equipment when evaluating him. [SC]

Tennessee announces its fourth COVID-19 case today in middle Tennessee; the case’s source of exposure is not reported. The state has its first meeting of the state coronavirus task force. [TN1, TN2]

Texas announces five new presumptive positive cases today, bringing its total case count to 12. One case is an individual who recently traveled to California; the other four were exposed on the river cruise on the Nile. [TX1, TX2]

This past weekend, after announcing Vermont’s first COVID-19 case, the Southwestern Vermont Medical Center has begun offering drive-up testing to minimize potential exposure to staff and other patients. [VT]

Virginia announces three new presumptive positive cases, bringing its total case count to 5. 2 of these individuals were exposed during international travel (one on the Nile river cruise), and one does not yet have a source of exposure identified. [VA1, VA2]

Washington State is now reporting 162 cases, up from 136 yesterday. King County now has 116 cases and 20 deaths, and Snohomish has 37 cases; these two counties contain the bulk of the cases in the state. [WA]

West Virginia opens a hotline for the public to ask questions related to the COVID-19 outbreak; as of now, no cases have been identified in the state. [WV]

Wisconsin announces its second positive COVID-19 case in the state; this individual was exposed during travel inside the US. [WI]

Wyoming reminds its residents to follow CDC guidance to prevent contracting COVID-19 and to help limit its spread. [WY]

[1] WHO COVID-19 Situation Report, 03-09-20

https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200309-sitrep-49-covid-19.pdf?sfvrsn=70dabe61_4

[2] Johns Hopkins COVID-19 Map

https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

[3] Experts: Rapid Testing Helps Explain Few German Virus Deaths

https://www.nytimes.com/aponline/2020/03/09/world/europe/ap-eu-virus-outbreak-germany.html

[4] Mongolia locks down cities after reporting first COVID-19 case

https://www.channelnewsasia.com/news/asia/coronavirus-mongolia-lock-down-first-covid-19-case-12520786

[5] Italy Extends Travel Restrictions to the Entire Country to Try and Contain Spread of COVID-19

https://time.com/5799873/italy-coronavirus-travel-restrictions/

[6] OECD Health Care Resources

https://stats.oecd.org/index.aspx?DataSetCode=HEALTH_REAC#

[7] Coronavirus Update: FDA and FTC Warn Seven Companies Selling Fraudulent Products that Claim to Treat or Prevent COVID-19

https://www.fda.gov/news-events/press-announcements/coronavirus-update-fda-and-ftc-warn-seven-companies-selling-fraudulent-products-claim-treat-or

[8] CDC Media Telebriefing: Update on COVID-19

https://www.cdc.gov/media/releases/2020/t0309-covid-19-update.mp3

[9] Public Health Laboratory Testing for COVID-19

https://www.cdc.gov/coronavirus/2019-ncov/testing-in-us.html

[10] EPA’s Registered Antimicrobial Products for Use Against Novel Coronavirus SARS-CoV-2, the Cause of COVID-19

https://www.epa.gov/sites/production/files/2020-03/documents/sars-cov-2-list_03-03-2020.pdf

[11] Meadows, Other Members of Congress Self-Quarantine After CPAC Coronavirus Exposure

https://www.npr.org/2020/03/09/813782214/reps-matt-gaetz-doug-collins-self-quarantine-after-cpac-coronavirus-exposure

[12] SoCal Rep. Julia Brownley among 4 members of Congress to self-quarantine after possible coronavirus exposure

https://ktla.com/news/coronavirus/socal-rep-julia-brownley-among-5-lawmakers-self-quarantining-after-possible-coronavirus-exposure/

[13] Trump had contact with congressmen Collins and Gaetz before they self-quarantined over coronavirus concerns

https://www.cnbc.com/2020/03/09/collins-gaetz-had-contact-with-trump-before-coronavirus-self-quarantine.html

[AZ] Public Health Confirms Previously Identified Case of COVID-19 is Member of Arizona School Community

https://www.azdhs.gov/director/public-information-office/index.php#news-release-030820

[CA1] Federal and State Partners Protect the Community of Oakland while Supporting the Safe Return of Passengers from the Grand Princess Cruise Ship

http://www.oesnews.com/federal-and-state-partners-protect-the-community-of-oakland-while-supporting-the-safe-return-of-passengers-from-the-grand-princess-cruise-ship/

[CA2] State Health & Emergency Officials Encourage Individuals at Higher Risk of Severe Illness due to COVID-19 to Take Precautions

https://www.cdph.ca.gov/Programs/OPA/Pages/NR20-016.aspx

[CA3] 2019 Novel Coronavirus (COVID-19) Advisory - Two new cases of confirmed COVID-19 in Los Angeles County

http://publichealth.lacounty.gov/phcommon/public/media/mediapubhpdetail.cfm?prid=2258

[CA4] County of Santa Clara Public Health Department Announces First Death from COVID-19 in Santa Clara County

https://www.sccgov.org/sites/phd/news/Pages/first-covid-19-death.aspx

[CA5] Coachella & Stagecoach in Talks to Move to October Due to Coronavirus

https://www.billboard.com/articles/business/touring/9330145/coachella-stagecoach-move-festivals-october

[CA6] UC Berkeley, San Jose State, SF State Cancel In-Person Classes Over Coronavirus Fears

https://sanfrancisco.cbslocal.com/2020/03/09/coronavirus-uc-berkeley-san-jose-san-francisco-state-academy-of-art-moves-classes-to-online-delivery-fears/

[CO1] Two new presumptive positive cases of COVID-19 identified in Colorado today

https://www.colorado.gov/pacific/cdphe/news/two-new-presumptive-positive-cases-covid-19-identified-colorado-today

[CO2] One presumptive positive case of COVID-19 identified in Colorado today

https://www.colorado.gov/pacific/cdphe/news/one-presumptive-positive-case-covid-19-identified-colorado-today

[CO3] Colorado COVID-19 Daily Fast Facts

https://docs.google.com/document/d/e/2PACX-1vRSxDeeJEaDxir0cCd9Sfji8ZPKzNaCPZnvRCbG63Oa1ztz4B4r7xG_wsoC9ucd_ei3--Pz7UD50yQD/pub

[CT1] Governor Lamont: Physician Who Worked at Bridgeport Hospital and Is a New York State Resident Tests Positive for Coronavirus

https://portal.ct.gov/Office-of-the-Governor/News/Press-Releases/2020/03-2020/Governor-Lamont-Physician-Who-Worked-at-Bridgeport-Hospital

[CT2] Governor Lamont Announces First Positive Case of Novel Coronavirus Involving a Connecticut Resident

https://portal.ct.gov/Office-of-the-Governor/News/Press-Releases/2020/03-2020/Governor-Lamont-Announces-First-Positive-Case-of-Novel-Coronavirus-Involving-a-Connecticut-Resident

[DE] Division of Public Health Urges At-Risk Populations to Follow CDC Guidance on Coronavirus Disease

https://dhss.delaware.gov/dhss/pressreleases/2020/cdcguidance_030920.html

[FL] UPDATE REGARDING INTERNATIONAL TRAVEL: Department of Health COVID-19 Update

http://www.floridahealth.gov/newsroom/2020/03/030920-department-health-covid19-update.pr.html

[GA1] Fulton County Schools Coronavirus Update, 04:30 pm

https://www.fultonschools.org/site/handlers/filedownload.ashx?moduleinstanceid=36576&dataid=50321&FileName=20200309_FCSCoronavirusUpdate430PM.pdf

[GA2] Fulton County Schools: About Us

https://www.fultonschools.org/aboutus

[IA] Gov. Reynolds signs Disaster Proclamation Following Additional COVID-19 Cases in Iowa (3/9/20)

https://idph.iowa.gov/News/ArtMID/646/ArticleID/158298/Gov-Reynolds-signs-Disaster-Proclamation-Following-Additional-COVID-19-Cases-in-Iowa-3920

[IL1] Public Health Officials Report Four Additional COVID-19 Cases in Illinois

http://www.dph.illinois.gov/news/%E2%80%8Bpublic-health-officials-report-four-additional-covid-19-cases-illinois

[IL2] Coronavirus Disease 2019 (COVID-19) in Illinois Test Results

http://www.dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/coronavirus

[IN] State Health Department Reports Increase in Covid-19 Cases

https://calendar.in.gov/site/isdh/event/state-health-department-reports-increase-in-covid-19-cases/

[KY] Department for Public Health: COVID-19

https://chfs.ky.gov/agencies/dph/pages/covid19.aspx

[LA] Gov. Edwards Confirms Louisiana's First Presumptive Positive Case of COVID-19

https://gov.louisiana.gov/index.cfm/newsroom/detail/2392

[MA] Massachusetts Department of Public Health Updates New COVID-19 Cases in New Online Dashboard

https://www.mass.gov/news/massachusetts-department-of-public-health-updates-new-covid-19-cases-in-new-online-dashboard

[MS] MSDH Announces COVID-19 Precautions for North Mississippi Care Facilities

http://www.msdh.state.ms.us/msdhsite/_static/23,21806,341.html

[NC1] Indiana Individual with Confirmed COVID-19 Traveled to North Carolina

https://www.ncdhhs.gov/news/press-releases/indiana-individual-confirmed-covid-19-traveled-north-carolina

[NC2] Five More People in North Carolina Test Positive for COVID-19

https://www.ncdhhs.gov/news/press-releases/five-more-people-north-carolina-test-positive-covid-19

[ND] State lab tests individuals for novel coronavirus; tests are negative

https://www.health.nd.gov/news/state-lab-tests-individuals-novel-coronavirus-tests-are-negative

[NJ] New Jersey Health Commissioner Briefs Long-term Care Facility Leaders on Novel Coronavirus Preparedness

https://www.nj.gov/health/news/2020/approved/20200309a.shtml

[NM] Department of Health’s Bureau of Health and Emergency Management to activate Department Operations Center

https://nmhealth.org/news/awareness/2020/3/?view=844

[NY] At Novel Coronavirus Briefing, Governor Cuomo Announces State Will Provide Alcohol-Based Hand Sanitizer to New Yorkers Free of Charge

https://www.governor.ny.gov/news/novel-coronavirus-briefing-governor-cuomo-announces-state-will-provide-alcohol-based-hand

[OH1] Ohio: COVID-19

https://coronavirus.ohio.gov/wps/portal/gov/covid-19/

[OH2] Governor DeWine Signs Emergency Order Regarding Coronavirus Response

https://governor.ohio.gov/wps/portal/gov/governor/media/news-and-media/signs-emergency-order-regarding-coronavirus-response

[OH3] Coronavirus in Ohio: 3 test positive for COVID-19

https://www.nbc4i.com/community/health/coronavirus/governor-dewine-announces-3-positive-tests-for-covid-19-coronavirus-in-ohio/

[PA1] Department of Health Announces Presumptive Positive COVID-19 Case in Montgomery County, Brings PA Total to Seven

https://www.media.pa.gov/Pages/Health-Details.aspx?newsid=732

[PA2] Department of Health Provides Update on COVID-19, Three New Presumptive Positive, Bringing Statewide Total to 10

https://www.media.pa.gov/Pages/Health-Details.aspx?newsid=733

[SC] DHEC Announces Seventh Possible Case of 2019 Novel Coronavirus in South Carolina

https://www.scdhec.gov/news-releases/dhec-announces-seventh-possible-case-2019-novel-coronavirus-south-carolina

[TN1] TDH Confirms Fourth Case of COVID-19 in Tennessee

https://www.tn.gov/health/news/2020/3/9/tdh-confirms-fourth-case-of-covid-19-in-tennessee.html

[TN2] First Coronavirus Task Force Meeting March 9, 2020

https://www.tn.gov/health/news/2020/3/9/first-coronavirus-task-force-meeting-march-9--2020.html

[TX1] MEDIA STATEMENT: Texas case of COVID-19 without international travel

https://www.dshs.texas.gov/news/releases/2020/statement-20200309.aspx

[TX2] COVID-19 in Texas – March 9, 2020

https://dshs.state.tx.us/coronavirus/

[VA1] Virginia Department of Health Confirms Third “Presumptive Positive” Case of Coronavirus Disease 2019 (COVID-19) in State

http://www.vdh.virginia.gov/news/2020-news-releases/virginia-department-of-health-confirms-third-presumptive-positive-case-of-coronavirus-disease-2019-covid-19-in-state/

[VA2] Virginia Department of Health Confirms Fourth and Fifth “Presumptive Positive” Cases of Coronavirus Disease 2019 (COVID-19) in Fairfax and in Spotsylvania County, Virginia

http://www.vdh.virginia.gov/news/2020-news-releases/virginia-department-of-health-confirms-fourth-and-fifth-presumptive-positive-cases-of-coronavirus-disease-2019-covid-19-in-fairfax-and-in-spotsylvania-county-virginia/

[VT] Hospital treating Vermont's first case of coronavirus offering drive-up testing

https://www.burlingtonfreepress.com/story/news/local/2020/03/09/vermont-hospital-treating-states-covid-19-case-drive-up-test/4998718002/

[WA] 2019 Novel Coronavirus (COVID-19) in Washington

https://www.doh.wa.gov/Emergencies/Coronavirus

[WI] Second Case of COVID-19 Confirmed in Wisconsin

https://www.dhs.wisconsin.gov/news/releases/030920.htm

[WV] Information Hotline Established to Address Coronavirus Disease 2019 (COVID-19) Concerns

https://dhhr.wv.gov/News/2020/Pages/Information-Hotline-Established-to-Address-Coronavirus-Disease-2019-(COVID-19)-Concerns.aspx

[WY] Health Recommendations Updated as Coronavirus Risk Grows

https://health.wyo.gov/health-recommendations-updated-as-coronavirus-risk-grows/