U.S. HEALTH ALERT - COVID-19 UPDATE

Updated on 4 May 2020


The Situation:

Currently, the U.S. has at least 1,188,826 confirmed cases – the highest in the world – with 323,883 of those located in New York, which accounts for 9% of cases worldwide. Additionally, New Jersey has 127,438 cases and Massachusetts has 68,087 cases. Together, the top three states, New York, New Jersey, and Massachusetts, account for 43.7% of all cases in the U.S – totaling 519,408

There have been 178,594 recorded recoveries and 68,606 recorded deaths. On 23 April, the U.S. recorded its highest daily death toll with 3,332 deaths in 24 hours.

CDC adds six symptoms to Covid-19 list: chills, repeated shaking with chills, muscle pain, headache, sore throat, and new loss of taste or smell.

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 April 28, there was a case of COVID-19 reported in a small dog (pug) in North Carolina- the dog’s owners are medical professionals who had both been diagnosed with the virus.

On 27 March, the $2.2 trillion Coronavirus Aid, Relief, and Economic Security Act (or CARES Act) was passed. The Act will provide aid to supply chains and 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 rapid coronavirus test. 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 24, Trump signed 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.


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 Updated 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. This was extended to May 30.

  • 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)

  • Sore throat

  • Chills, sometimes with repeated shaking

  • Headache

  • Fatigue

  • Muscle aches or pain

  • 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 o Navajo Nation extended the closure of their government until May 17.


Affected Travelers and others:

All travelers have the potential for exposure


Plans for Lifting Restrictions (As of 2 May) by State:

  • Alabama- Alabama's stay-at-home order expired April 30. · A new ‘Safer-at-Home’ Order went into effect at 5 p.m. on April 30 until May 15. All retail businesses can reopen with a 50 percent occupancy rate. Beaches are open and elective medical procedures can resume. Barbershops and salons will remain closed for the initial phase of re-opening. Gatherings should still be limited to 10 people, expect in a workplace.

  • 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 was extended to May 15. Elective medical procedures are allowed to resume May 1 with restrictions. Schools are to remain closed for the remainder of the academic year. On May 4, Retail stores my begin opening for curbside pick-up and delivery.

o Navajo Nation extended the closure of their government until May 17.

  • 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. On May 4, gyms and fitness centers may open. On May 11, restaurants my begin dine-in services at reduced capacity.

  • 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. Responses vary between counties. California is allied with Oregon and Washington to coordinate reopening.

  • Colorado- Colorado’s stay-at-home order expired April 26. Social distancing measures will remain in place until further notice. On April 26, the state entered a "safer at home" phase, where residents are recommended to stay home but not required to. Small businesses and personal services were allowed to reopen. Schools are to remain closed for the remainder of the academic year. Some counties and cities, including Denver, remain under a stay-at-home order.

  • 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 expired 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. Gov. DeSantis will be beginning a reopening plan called ‘Safe. Smart. Step-by-Step’ through executive order. On May 4, restaurants and retail stores will be allowed to reopen at 25% capacity and social distancing. Elective surgeries will be allowed to resume.

  • Georgia- Georgia’s stay-at-home order expired April 30, however, older persons and the chronically ill, must remain sheltered-in-place through June 12. 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. Distancing rules limiting the number of customers remain in effect through May 13. Bars, nightclubs, swimming pools and amusement parks will closed through May 13.

  • Hawaii- Hawaii’s stay-at-home order was extended toMay 31, however beaches will be reopened for exercise and elective surgeries may resume. 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 expired April 30. Some churches nonessential businesses may reopen on May 1 with strict distancing rules. All school reopening decisions belong to the State Board of Education.

  • Illinois- Illinois's stay-at-home order was extended until May 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 expiredMay 1. Schools are to remain closed for the remainder of the academic year.

  • Iowa- Iowa had the equivalent of a stay-at-home order until April 30. Schools are to remain closed for the remainder of the academic year. On May 1, restaurants, fitness centers and malls in 77 of Iowa's 99 counties may reopen at 50% capacity.

  • 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. The state will begin the gradual restart and reopening of Phase 1 health care services and facilities. Manufacturing and construction work may resume on May 11, with restrictions.

  • Louisiana- Louisiana's stay-at-home order was extended to May 15. Schools are to remain closed for the remainder of the academic year. Restaurants are now allowed to open outdoor seating areas, with no table-side services.

  • Maine- Maine’s stay-at-home order was extended to May 31. Gov. Mills is planning a "phased-in" reopening. Some state parks, carwashes, and personal services will be able to open on 1 May. Drive-in theaters, vehicle religious services, and golf will be allowed.

  • 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 was extended to May 15. Schools are to remain closed for the remainder of the academic year. Lawn service companies, landscapers, plant nurseries and bike repair shops may reopen but must follow social distancing rules. 

  • Minnesota- Minnesota’s stay-at-home order was extended to May 18. On April 18, recreational activities, including golfing, boating, fishing, hunting and hiking were allowed to restart. On May 4, retail business may open for curbside pickup and delivery. Schools are to remain closed for the remainder of the academic year.

  • Mississippi- Mississippi's stay-at-home order expired April 27. The state entered a ‘Safer-at-home’ order effective 27 April at 0800. Retail stores may reopen at half capacity. Schools are to remain closed for the remainder of the academic year.

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

  • Montana- Montana’s stay-at-home order expired 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 was extended to May 15. All retail businesses, will be allowed to operate under a “curbside commerce model”

  • New Hampshire- New Hampshire's governor issued a stay-at-home 2.0 order that expires May 31. 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 was extended to May 29. 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. On May 1, Health procedures that don't require an overnight stay can begin. On May 4, general office spaces, distribution centers, manufacturing centers and construction can continue. On May 12, consumers, retail and services can reopen.

  • 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, state parks opened, and hair and nail salons were allowed to reopen. 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 way extended to May 15. On April 20, some public beaches and retail stores were allowed to reopen with limited capacity. 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 expired April 30. The state entered a ‘Safer-At-Home’ order effective as of 12:01 p.m. April 29 and will remain in effect until 11:59 p.m., May 29. Gov. Lee stated that many businesses would be allowed to re-open on May 1. On April 24, state parks and dine-in restaurants were allowed to reopen at reduced capacity. Decisions to reopen schools belongs to individual districts.

  • Texas- Texas’s stay-at-home order ended 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. Retail stores, malls, restaurants, libraries, museums, and theaters to will be allowed to reopen May 1 but with limited occupancy to 25%.

  • Utah- Utah’s equivalent of a stay-at-home order expired May 1. Gov. Herbert issued an order under ‘moderate’ risk in effect from May 1 to May 16.He 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 was extended to May 31. Gov. Inslee said the state is not close to reopening. Schools are to remain closed for the remainder of the academic year. On May 5, golfing, fishing, hunting, and use state parks and public lands may resume.

  • West Virginia- West Virginia’s stay-at-home order expired May 4, a Safer-at-Home order is due in its place. 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. Orders prohibiting gatherings of 10 or more, closing schools have been extended to May 15. On May 1, Gyms, barber shops, hair salons and other personal care services will be allowed to open, with restrictions.


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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