The coronavirus outbreak intensified overnight in the US as the number of confirmed cases jumped, the death toll increased to 37 and a top federal health official warned America on Wednesday that the worst was yet to come.

Two more states declared a state of emergency the number of US cases exceeded 1,000 nationwide. There have been a total of 37 confirmed deaths.

Around the country authorities are undertaking the most sweeping efforts yet to contain the nation’s coronavirus outbreak, with authorities banning large gatherings in the hard-hit Seattle area and San Francisco and closing Seattle’s schools on Wednesday, while the NCAA announced it will hold March Madness basketball games around the country in near-empty arenas, off limits to most fans.

In Oakland, California, restless passengers on a coronavirus-struck cruise ship awaited their turn to disembark. Efforts were under way to methodically take most of the 3,500 people on the Grand Princess off the ship and move them to quarantine in their home countries or at military bases in California, Texas and Georgia. California’s governor, Gavin Newsom, strongly warned the elderly to stay away from cruise ships.

Meanwhile Los Angeles reported the region’s first death from the virus, the second in the state.

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Testifying before Congress on Wednesday morning, Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases (NIAID) and a key member of the White House taskforce formed to tackle the US response the outbreak, said: “The bottom line is it’s going to get worse.”

Fauci urged a more aggressive approach to limit the spread of the virus.

“Even in areas of the country where there are no or few cases, we’ve got to change our behavior,” he said. “We have to essentially assume that we are going to get hit. And that’s why we talk about making mitigation and containment in a much more vigorous way.”

Fauci said it was impossible to make projections on how far the virus would spread in the US as too much depended on what steps were taken to mitigate it, but he added: “If we are complacent and don’t do really aggressive containment and mitigation, the number could go way up and be involved in many, many millions.”

NBC reported that the official doctor serving both Congress and the supreme court, Brian Monahan, had told Senate staff on Tuesday that he expected between 70 million and 150 million people in the US to contract coronavirus.

The Trump administration said it planned to urge US states and localities to take stronger steps to fight the coronavirus, with new information from the federal public health agency the Centers for Disease Control and Prevention (CDC).

“You’re going to hear from CDC today and the White House that we’re going to be making recommendations to those local communities about aggressive steps that we think they should be taking,” the health secretary, Alex Azar, told Fox News.

Azar added that federal leaders were working with local officials in the hardest-hit states so far, including Washington, California, New York, Massachusetts and Florida, as they grappled with the virus, saying “strong mitigation steps” could help buy valuable time to control the virus.

The governor of New York, however, said federal officials had left states scrambling to act on their own.

New York sends in national guard as US coronavirus death toll hits 29 Read more

“We can’t wait for the federal government because it’s not going to happen,” said Andrew Cuomo, who has deployed the national guard to help contain an outbreak in New Rochelle, just outside New York City.

“The federal government has just fallen down on the job,” Cuomo, a Democrat, told MSNBC, adding that he has told other state governors “you’re on you own”.

New York is prepared to send up to 200 national guard troops to a suburban virus cluster on Thursday. Meanwhile in neighboring Massachusetts, the governor, Charlie Baker, declared a state of emergency as the number of cases there doubled to 92.

State and local officials have said the delay in distributing diagnostic tests has hampered their ability to manage the outbreak, despite Trump’s assurances that anyone who wanted a test could get one.

On 2 March, the administration said it would provide a million test kits by the end of that week, but Robert Redfield, the CDC director, told the House oversight committee on Wednesday that 75,000 tests had so far been sent out.

Redfield also said there were no CDC plans to set up drive-through test facilities.

“We’re trying to maintain the relationship between individuals and their healthcare providers,” he told the committee.

Jim Cooper, a Democratic congressman from Tennessee, replied: “Most Americans don’t really have a doctor. They rely on [hospital emergency rooms] to help and people are panicking.”

Reuters reported on Wednesday that the White House had ordered federal health officials to treat all high-level coronavirus meetings as classified, with the result that many of the country’s top experts, who did not have security clearances, were unable to take part, and information from the meeting could not be freely disseminated.

For most people, the virus causes only mild or moderate symptoms such as fever and cough. For some, especially the elderly and people with existing health problems, it can cause more severe illness, including pneumonia, and the lethality rate of this novel coronavirus strain, known as Covid-19, is many times greater than seasonal influenza.

Most people recover in a matter of weeks, as has happened with three-quarters of those infected in China.



Judy Aqua, who is in her 60s, is quarantining herself at home in New Rochelle, outside New York City, after possibly being exposed to someone with the virus.

“People are really afraid to go to the supermarket. They’re afraid to go to the cleaner,” she said. When her husband made a recent run to a post office, she told him to wear gloves.

Mike Pence had told reporters on Tuesday that recommendations by the CDC would be aimed at communities that have already seen spread of the disease.

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The Council on Foreign Relations (CFR) canceled a roundtable scheduled for Friday in New York due to the spread of the infection. The roundtable is one of three events the CFR has shuttered due to the virus, both in New York and Washington.

Around the world, more than 100 countries have now reported cases, totaling an estimated 125,000 cases worldwide since the disease surfaced in China late last year, according to the Johns Hopkins University tracker. There have been about 4,600 deaths. Other developments around the world include:

More than 15 countries have completely shut down their school systems, including Italy, which has the highest death toll outside China. Italy began a lockdown of its entire population of 60 million on Tuesday.

Jamaica registered its first imported case of the virus, becoming the first in the English-speaking Caribbean. Christopher Tufton, with the island’s ministry of health, confirmed the patient is a Jamaican female who had traveled from the UK. She is receiving treatment in Kingston. Jamaica joins the Dominican Republic, Martinique and St Barthélemy with confirmed coronavirus cases in the Caribbean.

In South Korea, where authorities had hoped a severe outbreak was being contained, cases jumped again on Wednesday by 242 compared with fewer than 100 the day before.

Japan reported 59 new cases on Wednesday, its biggest one-day rise since the outbreak began. The country was also forced to scale back ceremonies to mark the ninth anniversary of the triple disaster of tsunami, earthquake and Fukushima nuclear meltdown in March 2011.

According to India’s union health ministry, the country has seen a total of 60 confirmed coronavirus cases and one death.

Associated Press contributed reporting.