The coronavirus is creeping through the U.S., with Washington State reporting the nation's first two deaths and infections at a nursing home as President Trump tightened the borders to project calm amid an outbreak with sweeping human, financial and political stakes.
Five days ago, Mr. Trump said over a dozen U.S. patients were on the mend and mused that the caseload "within a couple of days is going to be down to close to zero."
Now, the Centers for Disease Control and Prevention is investigating how at least 10 people contracted the disease known as COVID-19 without traveling to a hard-hit country or having known exposure to another patient.
Along with travel-related cases, the number detected in the U.S. was at least 27 on Sunday, signaling that the crisis that has led to Wall Street sell-offs and political finger-pointing will last for a while.
Reports of person-to-person spread have been clustered in Pacific Coast states, and researchers said Sunday the the virus may have been circulating for weeks undetected in Washington state.
Rhode Island reported a case Sunday in a person who traveled to Italy, and a new case popped up in Chicago. The U.S. is also monitoring 47 patients repatriated from China and Japan, bringing the national total of cases to 74.
Vice President Mike Pence said Sunday that he is confident the nation can root out infections and tackle the outbreak, though "there will be more cases."
"There's no question," he told NBC's "Meet the Press."
Mr. Pence said thousands of testing kits have been rolled out to health care facilities as the nation mobilizes to diagnose, treat and contain the disease. Fewer than 500 people in the United States have been tested so far, but Mr. Pence emphasized that "we're ready."
"I was informed by our team in just the last 48 hours that we're going to see 15,000 kits, they're in the mail, they're rolling out, we've approved a process for local testing," the vice president told CNN's "State of the Union." "We think we've addressed the issue."
President Trump said his decision to restrict travel from China a month ago averted cases, so he is cracking down further by barring all foreign nationals who traveled to Iran within the past 14 days and advising Americans not to travel to parts of South Korea and Italy.
In a Sunday tweet, he said travelers from those countries to the U.S. will be screened twice: before leaving and "when they arrive in America."
Mr. Trump also said he is considering restrictions along the southern border, even though Mexico has reported fewer cases than the U.S.
The Washington state residents who died over the weekend were a man in his 50s and another man in his 70s. Both had underlying health conditions. Both men had been hospitalized at EvergreenHealth Medical Center in Kirkland, north of Seattle.
"We have no evidence so far that establishes a connection to somebody who traveled to an impacted area. And so we do not know how he contracted the virus," Health and Human Services Secretary Alex Azar told CBS's "Face the Nation." "That's the basic blocking and tackling right now of public health. ... We're going to trace the people that he had contact with. We're going to trace the other cases."
Officials said the younger man at least had traveled to China and isn't linked to a potential outbreak at a long-term care facility in Kirkland. An infected health care worker at the facility is doing well, but a resident in her 70s is seriously ill, state officials told reporters in a CDC call.
The facility houses 108 people and employs 180. State officials said 27 residents and 25 staff members showed symptoms of the new coronavirus. The International Association of Fire Fighters said Sunday night that 25 members who responded to calls for help at the nursing facility are being quarantined.
CDC officials said they are concerned about the cluster of cases in Washington state and other parts of the West Coast but added that the situation is limited and Americans should take basic precautions instead of panicking.
"While there is some spread in some communities, there is not national spread of COVID-19," said Nancy Messonnier, a top CDC official.
The coronavirus was discovered in China in December. It causes an illness that is mild in many people but can cause respiratory distress, organ failure and death, especially in older people or those with preexisting medical conditions.
It has sickened over 87,000 people around the globe and killed about 3,000.
China has reported nearly 80,000 cases, mainly at the outbreak's epicenter in Wuhan and the surrounding Hubei province.
Other hot spots include South Korea, with over 3,500 recorded cases; Italy, with over 1,100; and Iran, which is approaching 1,000.
Mr. Trump had already banned Iranian visitors. His latest moves expand the restriction to other foreign nationals who have been to the Islamic republic within two weeks.
The State Department issued a level 4 "Do not travel" warning for the northern Italian regions of Lombardy and Veneto, homes to Milan and Venice, respectively.
It also told Americans not to travel to Daegu, a southeastern city of South Korea that has the country's biggest outbreak.
A large number of cases have been linked to "Patient 31," who was ill while attending services at a Daegu branch of the Shincheonji Church of Jesus but assumed it was a common cold.
The patient and hundreds of other church members tested positive for the coronavirus, though the church said it is cooperating. The church also pleaded with media outlets not to portray the congregation as a "fringe" or "apocalyptic" sect because it is inaccurate and offensive.
"At a time when members should be regarded as victims and administered aid, the church as a whole is experiencing local and national discrimination, unable to gain building licensing and facing scrutiny for practicing their Christian faith," said Kim Shin Chang, general director of the Department of International Relations of Shincheonji Headquarters. "Shincheonji members generally do not recognize themselves in reports they read in the media. For instance, they do not regard their founder, Chairman Lee Man-hee, as the second coming of Jesus or as God."
More broadly, the outbreak is sparking fears of a global economic slowdown as workers stay home and supply chains, particularly from China, are disrupted.
The Dow Jones Industrial Average had its worst week since the financial crisis over a decade ago. It fell over 350 points, or 1.39%, on Friday. The decline could have been worse. Stocks rebounded a bit after Federal Reserve Chairman Jerome Powell said the Fed would act "as appropriate" to help the economy during the outbreak.
"I think the big thing we're looking for is the Fed to do its job," said Mr. Trump, who often presses Mr. Powell for rate cuts.
Speaking at the White House, Mr. Trump said Saturday that the U.S. government is prepared for anything as the outbreak progresses. It is ordering protective gear, pursuing a vaccine and placing its top specialists on the job.
"They're working round the clock," Mr. Trump said Saturday.
He asked reporters and politicians not to overhype the situation because it rattles markets and poses a key test for his administration in an election year.
"There's no reason to panic at all. This is something that's being handled professionally," Mr. Trump said.
The latest cases include an Oregonian who worked at an elementary school in the Portland area. The school will be closed so it can be cleaned.
Mr. Pence said generally, the administration generally will not interfere with local educators and governors who decide to close schools.
Officials in California are tracking down contacts of multiple people in Santa Clara who tested positive without traveling to a hard-hit area.
The cases are in addition to a California woman from Solano County who is hospitalized in Sacramento.
Washington state also said a high school student in Snohomish County received a "presumptive" positive test for the virus, prompting a three-day school closure, and Oregon reported its first suspected case of local transmission.
However, CDC Director Robert Redfield said is it fine for Americans to travel to California, Oregon or Washington state.
Officials also pleaded with Americans to stop hoarding face masks.
"Seriously people — STOP BUYING MASKS!" tweeted Dr. Jerome M. Adams, an anesthesiologist who has served as surgeon general since 2017.
He said Saturday that face masks are "NOT effective in preventing [the] general public from catching #Coronavirus, but if healthcare providers can't get them to care for sick patients, it puts them and our communities at risk!"