U.S. HEALTH ALERT - COVID-19 UPDATE

Updated on 24 April 2020


The Situation:

Currently, the U.S. has at least 886,442 confirmed cases – the highest in the world – with 268,581 of those located in New York, which accounts for 9.98% of cases worldwide. Additionally, New Jersey has 100,025 cases and Massachusetts has 46,023 cases. Together, the top three states, New York, New Jersey, and Massachusetts, account for 46.8% of all cases in the U.S – totaling 414,629

There have been 85,922 recorded recoveries and 50,236 recorded deaths. On 23 April, the U.S. recorded its highest daily death toll with 3,332 deaths in 24 hours.

Under CDC guidelines states should report case numbers, including probable cases, and deaths, including probable deaths. New York City began reporting the deaths of untested individuals suspected of succumbing to COVID-19– raising their count by approximately 3,000 between March 11 and April 14.

The first case on human to animal transmission of COVID-19 in the US was recorded after several large cats displayed symptoms at the Bronx Zoo in New York on 27 March. Four tigers and three lions were infected by an asymptomatic zoo employee. On April 22, two cats in two different locations in NY tested positive for COVID-19.

On 27 March, the $2.2 trillion Coronavirus Aid, Relief, and Economic Security Act (or CARES Act) passed in the House and was signed by President Trump. The Act will provide aid to supply chains including those in the distribution and agriculture sectors as well as the airline industry and direct payments to Americans.

On March 28, The CDC issued a strong advisory against non-essential domestic travel of New York, New Jersey, and Connecticut residents. The governors of these states have full discretion on how to implement this advisory. Some states are advising individuals travelling from these states to self-quarantine upon arriving.

On March 29, President Trump extended the nationwide stay at home policy and social distancing guidelines until April 30.

On 30 March, the FDA issued an Emergency Use Authorization to Illinois-based Abbott Labs on 27 March for a coronavirus test that delivers positive results in as little as five minutes and negative results in 13 minutes. The company expects the tests to be available by 1 April and expects to deliver 50,000 tests per day.

On 31 March, President Trump and the Coronavirus Taskforce officially released a new model suggesting that the US death toll could rise to 240,000 with the current mitigation measures in place and 2.2 million without any mitigation.

On April 14, President Trump announced a temporary halt in funding to the World Health Organization until a review can be conducted on the initial handling of COVID-19 in China.

On April 16, President Trump revealed a new taskforce and new guidelines to begin reopening the United States. This will be a three phase State-led initiative. In order for states to begin these phases, they must meet specific criteria, including a downward trend of positive cases for 14 days. Criteria and phases can be found here.

On April 21 and 23, The Senate and House passed a $484 billion coronavirus relief package that would replenish a depleted loan program for distressed small businesses and provide funds for hospitals and coronavirus testing. President Trump approved and signed the aid package on 24 April.


States are taking various measures to slow the spread:

  • Extended school closures

  • Closure of bars and restaurants

  • Banning gatherings of 10 or more (recommended by the US CDC)

  • Recommend residents avoid nursing homes and hospitals

  • Recommend elderly (60+) and those with pre-existing conditions to self-isolate

  • Curfews

Governors across all 50 states, Puerto Rico, Guam, the U.S. Virgin Islands and Washington D.C. have mobilized components of their Army and Air National Guard to assist in their state’s response. U.S. Navy Hospital Ships Comfort and Mercy arrived New York and California, respectively, between 27-30 March

Many states’ stay-at-home/ shelter-in-place orders are set to expire on April 30. It is possible that states may extend these orders. Expiratory dates and guidelines are subject to change (Please see below for State-by-State measures for lifting restrictions).


Travel Restrictions and Recommendations:

  • On March 14, the Department of State authorized the departure of U.S. personnel and family members from any diplomatic or consular post in the world who have determined they are at higher risk of a poor outcome if exposed to COVID-19 or who have requested departure based on a commensurate justification. These departures may limit the ability of U.S. Embassies and consulates to provide services to U.S. citizens.

  • Canada and the U.S. mutually decided to close border on 18 March. As of April 18, the U.S./ Canadian Border will remain closed for an additional 30 days.

  • U.S. Department of State issues Global Level 4 Health Advisory – Do Not Travel on 19 March: The Department of State advises U.S. citizens to avoid all international travel due to the global impact of COVID-19.

o In countries where commercial departure options remain available, U.S. citizens who live in the U.S. should arrange for immediate return, unless they are prepared to remain abroad for an indefinite period.

o U.S. citizens who live abroad should avoid all international travel. Many countries are experiencing COVID-19 outbreaks and implementing travel restrictions and mandatory quarantines, closing borders, and prohibiting non-citizens from entry with little advance notice.

  • Airlines have cancelled many international flights and several cruise operators have suspended operations or cancelled trips.

  • On March 20, land ports of entry along the United States-Mexico border were limited to “essential travel” until April 20.

  • Current CDC Travel Alerts for Covid-19:

o Level 3 – Avoid all nonessential travel: Brazil, Canada, Israel, Japan, China, Europe, Italy, Iran, Malaysia, South Korea, UK and Ireland and Cruise ships

o Level 2 – Practice Enhanced Precautions

* Global COVID-19 Outbreak Notice

o As of April 3, the CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain, especially in areas of significant community-based transmission.

* Cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance.

Symptoms to Watch Out For:

Officials say the respiratory disease, is capable of spreading through human-to-human contact, droplets carried through sneezing and coughing, and germs left on inanimate objects. The virus might spread during the incubation period – which is believed to be from 1 to 14 days. Be on the lookout for the following symptoms:

  • High fever

  • Difficulty breathing or shortness of breath

  • Cough (usually dry) and/or sore throat

  • Fatigue

  • Muscle aches

  • Diarrhea, nausea, and/or vomiting

  • Loss of smell and/or taste (uncommon)

  • Confusion, stroke-like symptoms, and/or seizures (rare)

  • Pneumonia (secondary infection)

Mitigating Measures to Apply while in the US:

  • Monitor local authorities for updates

  • Avoid non-essential travel to areas where the infection is known or spreading rapidly

  • Travelers who return from infected areas should self-quarantine

  • Practice social distancing at the workplace and in public spaces

  • Consider work from home arrangements for employees in locations where the virus is spreading or if employees must transit through those areas

  • Employees who feel ill or who have flu-like, respiratory or other symptoms should consider self-quarantine and or stay at home instead of attending office or other functions

  • Weigh the risks of conducting large scale gatherings where the virus is located and the potential for attendees to transit through higher risk areas

  • Avoid contact with animals (alive or dead), animal markets, and products that come from animals (such as uncooked meat)

  • Wash hands frequently with soap and water; use an alcohol-based hand sanitizer if soap and water isn’t available

  • Older travelers and those with underlying health issues may be at higher risk and should speak to their healthcare provider before travel

  • Avoid exposure to those presenting the above symptoms

  • Avoid populated areas and gatherings if you feel ill (if at all possible)

  • Allow extra time for temperature screening at airports

  • Seek medical care immediately if you experience symptoms and have recently traveled to the infected areas; notify your healthcare provider of your recent travel

  • Confirm travel schedule is not impacted by the coronavirus (including quarantines, which may be individually-imposed, visit/visa restrictions etc.)

  • Ensure the validity of all visas prior to travel as this could be subject to restrictions and changes


Affected Travelers and others:

All travelers have the potential for exposure


Plans for Lifting Restrictions (As of 23 April) by State:

  • Alabama- Alabama's stay-at-home order expires April 30. Gov. Kay Ivey plans to allow small retailers, restaurants and other businesses to reopen with protective measures in place. Schools are to remain closed for the academic year.

  • Alaska- Alaska's stay-at-home order expired April 21. Nonessential medical procedures may restart May 4. K-12 schools are to remain closed for the remainder of the academic year. On April 24, restaurants, retail services, personal services, and non-essential services may reopen with limited services

  • Arizona- Arizona's stay-at-home order expires April 30. Elective medical procedures are allowed to resume May 1 with restrictions. Schools are to remain closed for the remainder of the academic year.

  • Arkansas- Arkansas does not have a stay-at-home order. Gov. Hutchinson launched said he hopes to begin to ease restrictions in the state on May 4. Schools are to remain closed for the remainder of the academic year.

  • California- There is no set end date for California's stay-at-home order. Some restrictions, such as masks in restaurants and bans against large gatherings, may stay in place through the summer. Schools are to remain closed for the remainder of the academic year. California is allied with Oregon and Washington to coordinate reopening.

  • Colorado- Colorado’s stay-at-home order is set to expire April 26. Social distancing measures will remain in place until further notice. On April 26, the state will enter a "safer at home" phase, where residents are recommended to stay home but not required to. Schools are to remain closed for the remainder of the academic year.

  • Connecticut- Connecticut’s stay-at-home order expires May 20. Connecticut is allied with Delaware, Massachusetts, New York, New Jersey and Rhode Island in a multistate effort to coordinate reopening.

  • Delaware- Delaware's stay-at-home order lasts until May 15. Schools are to remain closed for the remainder of the academic year.

  • District of Columbia- The city's stay-at-home order expires May 15. Schools are to remain closed for the remainder of the academic year.

  • Florida- Florida’s stay-at-home order is set to expire April 30. On April 17, Beaches reopened for “essential activities” in parts of the state. Schools are to remain closed for the remainder of the academic year.

  • Georgia- Georgia’s stay-at-home order is set to expire April 30. On April 24, some businesses, including gyms and hair salons are allowed to reopen and elective surgeries may resume. Schools are to remain closed for the remainder of the academic year.

  • Hawaii- Hawaii’s stay-at-home order is set to expire April 30. Gov. Ige has said he’s taking a “phased-in” approach to reopening the state for business. Schools are to remain closed for the remainder of the academic year.

  • Idaho- Idaho’s stay-at-home order is set to expire April 30. Some nonessential businesses may reopen on May 1. All school reopening decisions belong to the State Board of Education.

  • Illinois- Illinois's stay-at-home order is set to expire April 30. Gov Pritzker is coordinating reopening the state with the governors of Indiana, Kentucky, Michigan, Minnesota, Ohio and Wisconsin. Schools are to remain closed for the remainder of the academic year.

  • Indiana- Indiana's stay-at-home order expires April 30. Schools are to remain closed for the remainder of the academic year.

  • Iowa- Iowa has the equivalent of a stay-at-home order until April 30. Schools are to remain closed for the remainder of the academic year.

  • Kansas- Kansas’s stay-at-home order is set to expire May 3. Schools are to remain closed for the remainder of the academic year.

  • Kentucky- Kentucky’s "Healthy at Home" order has no set end date. Gov. Beshear recommended schools are to remain closed for the remainder of the academic year.

  • Louisiana- Louisiana's stay-at-home order is set to expire April 30. Schools are to remain closed for the remainder of the academic year.

  • Maine- Maine’s stay-at-home order is set to expire April 30. Gov. Mills is planning a "phased-in" reopening.

  • Maryland- Maryland have no set end date for its stay-at-home order or its executive order to wear face coverings in any retail business or on public transportation. Schools are closed until May 15.

  • Massachusetts- Massachusetts is under a stay-at-home advisory until May 4. Schools are to remain closed for the remainder of the academic year. Daycares are closed until the end of June.

  • Michigan- Michigan’s stay-at-home order expires April 30 and will likely be extended. Schools are to remain closed for the remainder of the academic year.

  • Minnesota- Minnesota’s stay-at-home order expires May 4. On April 18, recreational activities, including golfing, boating, fishing, hunting and hiking were allowed to restart. Schools are to remain closed for the remainder of the academic year.

  • Mississippi- Mississippi's stay-at-home order expires April 27. Schools are to remain closed for the remainder of the academic year

  • Missouri- Missouri's stay-at-home order is set to expire May 3. Schools are to remain closed for the remainder of the academic year.

  • Montana- Montana’s stay-at-home order expires April 24. Gov. Bullock announced a phased reopening starting April 26. Schools and restaurants (with reduced capacity) are allowed to reopen May 7.

  • Nebraska- Nebraska does not have a stay-at-home order. Social distancing measures and closures of restaurants and other businesses will remain in place through April. Schools are to remain closed for the remainder of the academic year.

  • Nevada- Nevada's stay-at-home order ends April 30.

  • New Hampshire- New Hampshire's stay-at-home order expires May 4. Schools are to remain closed for the remainder of the academic year.

  • New Jersey- New Jersey's stay-at-home order does not have an end date. Schools in the state are closed until May 15.

  • New Mexico- New Mexico’s stay-at-home order ends May 15. Schools are to remain closed for the remainder of the academic year.

  • New York- New York’s stay-at-home order lasts until May 15. Schools are also closed until May 15. NYC Mayor de Blasio has closed schools through the rest of the school year and cancelled nonessential events through June.

  • North Carolina- North Carolina's stay-at-home order expires May 8. Schools are closed until May 15.

  • North Dakota- North Dakota does not have a stay-at-home order. Nonessential businesses are closed in the state through April 30. Schools are closed “until further notice” but school facilities are allowed to reopen for some activities in May.

  • Ohio- Ohio’s stay-at-home order will expire May 1. Gov. DeWine says the state will begin to reopen with a “phased-in” approach. Schools are to remain closed for the remainder of the academic year.

  • Oklahoma- Oklahoma has a “safer-at-home” order until May 6. Gov. Stitt hopes the state can begin reopening May 1 if the “downward” trend in cases continues. On April 24, previously suspended elective surgeries resumed. Schools are to remain closed for the remainder of the academic year.

  • Oregon- Oregon’s stay-at-home order does not have an end date. On May 1, "non-urgent" medical procedures may restart. Schools are to remain closed for the remainder of the academic year.

  • Pennsylvania- Pennsylvania's stay-at-home order expires May 8. Gov. Wolf has plans to ease restrictions starting on construction, curbside alcohol pickup and vehicle sales. Schools are to remain closed for the remainder of the academic year.

  • Rhode Island- Rhode Island's stay-at-home order expires May 8. Schools are closed until the end of April.

  • South Carolina- South Carolina's "state of emergency" order closing all nonessential businesses expires April 27. All South Carolina public schools are closed through April 30. On April 20, some public beaches and retail stores were allowed to reopen. Public schools are closed through April 30.

  • South Dakota- South Dakota does not have a stay-at-home order. Schools are to remain closed for the remainder of the academic year.

  • Tennessee- Tennessee's stay-at-home order expires April 30. Gov. Lee stated that many businesses would be allowed to re-open on May 1. Decisions to reopen schools belongs to individual districts.

  • Texas- Texas’s stay-at-home order ends April 30. On April 20, state parks reopened. On April24, stores may start offering “retail to go”. Schools are to remain closed for the remainder of the academic year.

  • Utah- Utah’s equivalent of a stay-at-home order expires May 1. Gov. Herbert plans reopen the state in three phases starting at the beginning of May with sit-down dining, gyms and elective surgeries. Schools are to remain closed for the remainder of the academic year.

  • Vermont- Vermont’s stay-at-home order ends May 15. Schools are to remain closed for the remainder of the academic year. On April 20, "low contact" businesses were allowed to begin reopening with a two-person staff.

  • Virginia- Virginia's stay-at-home order expires June 10. K-12 Schools are to remain closed for the remainder of the academic year.

  • Washington- Washington’s stay-at-home order expires May 4. Gov. Inslee said the state is not close to reopening. Schools are to remain closed for the remainder of the academic year.

  • West Virginia- There is no end date West Virginia’s stay-at-home order. Schools and businesses remain closed until at least April 30.

  • Wisconsin- Wisconsin’s stay-at-home order expires May 26. K-12 Schools are to remain closed for the remainder of the academic year.

  • Wyoming- Wyoming does not have a stay-at-home order. However, orders prohibiting gatherings of 10 or more, closing schools and businesses end April 30.


DISCLAIMER and Hold Harmless

Disclaimer: LSDS™ gathers information from multiple sources and offers insight and perspective to travelers. Sources cannot be validated for accuracy in every instance. Travelers assume all risk associated with their travel and are responsible for the decisions associated with travel and for their own safety. Users of this reference document agree, to hold harmless LSDS™ (LLC) its employees and clients associated with any risk or injury incurred during travel.

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