U.S. HEALTH ALERT – COVID-19 UPDATE

Updated on 13 April 2020


The Situation:

Currently, the U.S. has at least 555,371, confirmed cases – the highest in the world - with 188,694 of those located in New York, which accounts for 10% of cases worldwide. Additionally, New Jersey has 61,850 cases and Massachusetts has 25,475 cases. Together, the top three states, New York, New Jersey, and Massachusetts account for just under half of all cases in the U.S.

There have been approximately 61,625 hospitalizations (43 states reporting figures) with 13,811 of those in the ICU (14 states reporting figures) and 6,059 on ventilators (8 states reporting figures). There are 34,551 recorded recoveries and 22,056 recorded deaths.

Based on death certificate data provided by the CDC, the percentage of deaths attributed to COVID-19 increased from 4.0% during week 13 to 6.9% during week 14 of 2020. The percentage of deaths due to pneumonia (excluding COVID-19 or influenza) decreased from 7.5% during week 13 to 7.2% during week 14.

According to the CDC, as of 12 April, there are 2,138 cases that are considered travel-related and 10,956 cases that are a product of close-contact. The rest of the cases are still under investigation for their origin.


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 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 limited emergency use authorization for drugs usually used to treat malaria: chloroquine and hydroxychloroquine. 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.


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


State Orders:

  • The following states have shelter-in-place orders in limited localities - these are not statewide at this time: Oklahoma, Utah, Wyoming

  • The following states have signed orders to close non-essential businesses or limit gatherings only but has not officially created a ‘shelter-in-place’: Nevada and North Dakota, Iowa, Arkansas, South Dakota, and North Dakota

  • All states not mentioned above have shelter-in-place orders currently in effect.


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.

  • 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.

- 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.

- 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:

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

- Level 2 – Practice Enhanced Precautions

* Global COVID-19 Outbreak Notice

- 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

  • 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


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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