SACRAMENTO, Calif. _ Authorities in Santa Clara County on Thursday announced that a Sunnyvale man might be California's second death connected to the coronavirus.
The Sunnyvale Department of Public Safety said a 72-year-old man who had been a cruise where others contracted coronavirus was found unresponsive Thursday at his home. He later died.
"It was later learned the patient had recently been on a cruise with two passengers (who) were suspected of having COVID-19," the agency said in a statement.
It's unclear whether tests conclusively determined he had the virus.
Santa Clara County has seen at least 20 coronavirus cases and health officials Thursday issued more stringent recommendations meant to slow the spread of the virus. Guidelines urge residents to postpone large gatherings and cancel large events. Employers should also take steps to make it more feasible for employees to work in ways that minimize large groups and contact with others.
New cases of coronavirus were reported in several areas of California, while Nevada reported its first case, in Las Vegas.
The Las Vegas case was a man in his 50s who had recently traveled to Washington state; he is hospitalized in isolation, officials said.
San Francisco reported its first cases. The two patients are not related and have no travel history to areas where the coronavirus has spread, officials said.
"We do not know at this point how they were exposed to the virus, which suggests it is spreading in the community," Dr. Grant Colfax, San Francisco's director of health, said in a statement. Santa Clara and Solano counties also have reported so-called community spread cases.
Both patients were tested by the city's Department of Public Health lab Wednesday, officials said. They are being treated under isolation at separate San Francisco hospitals.
One patient is a man in his 90s who has underlying health conditions and is in serious condition, officials said. The other patient is a woman in her 40s who is in fair condition.
The Grand Princess cruise ship was being kept offshore amid concerns that more people on board might be sick after it was announced that a 75-year-old male passenger on an earlier voyage had fallen ill and died this week of the virus.
Sonoma County health officials confirmed Thursday that a second passenger on the cruise tested positive after announcing another positive result earlier in the week. Both that patient and the one announced previously were in isolation rooms at a hospital.
Health officials said they had a list of Sonoma County residents who were on the cruise, as well as the shuttle to and from the ship, and were continuing to contact passengers to make them aware of the possibility they may have contracted the virus.
In California, COVID-19 has been reported in 12 counties and sickened more than 50 people.
Additional cases were announced elsewhere in the state Thursday, including four patients in Los Angeles County who had recently returned from a group trip to northern Italy. Health officials had announced Wednesday that three travelers in that same group tested positive for the virus.
Santa Clara County announced Thursday that the number of cases there had grown to 20 from 14. Of the county's 20 cases, four are related to travel, nine had contacts with other confirmed COVID-19 cases and seven were believed to have caught it in the community.
Of the six new cases _ three men and three women _ four are at home and two are hospitalized, officials said.
"Our cases to date indicate to us that the risk of exposure to the virus in our community is increasing," Dr. Sara Cody, health officer for Santa Clara County and director of the Santa Clara County Public Health Department, said Thursday.
County health officials are calling on residents to postpone large gatherings and cancel large events, and for employers to take steps to make it more feasible for employees to work in ways that minimize large groups and contact with others.
They include suspending nonessential employee travel, canceling large in-person meetings and conference, and considering using telecommuting options and staggering start and end times to reduce large numbers of people gathering.
Health officials aren't recommending that schools be closed but said they will consider such closures on a case-by-case basis if a school staffer or student is confirmed to have COVID-19.
The San Diego area reported its third case when an employee of an AT&T retail store in Chula Vista tested positive for the virus, the company said Thursday in a statement. Six stores were closed and deep-cleaned "out of an abundance of caution," the company said.
The employee, who had recently traveled to a region considered at high risk for coronavirus, went to work Monday but went home sick later that day and notified the company, spokesman Fletcher Cook said. AT&T received notice Tuesday that the employee had tested positive for the virus, he said.
As the virus continues to spread, the U.S. Senate voted 96-1 on Thursday to approve $8.3 billion in emergency aid to help fight the outbreak. The measure next goes to President Donald Trump, who is expected to sign it. The funding package will be spent on helping develop a vaccine, with millions going directly to states and cities grappling with the disease.
The hardest hit state so far is Washington, where the number of confirmed cases jumped to 70 and 10 people have died. In total, 51 cases have been reported in King County, 18 in Snohomish County and one in Grant County.
The Grand Princess cruise passenger is the first person to die in California from the illness. After the man's death, the cruise line said it was notified by the federal Centers for Disease Control and Prevention that the agency was investigating a small cluster of coronavirus cases in Northern California related to the cruise.
The company said 62 guests who had made the same Mexico voyage as the man who died remained aboard the Grand Princess for a subsequent trip to Hawaii. That trip was cut short, and guests and crew members who might have come in close contact with the passenger who died were asked to remain in their cabins until they could be screened.
Those people and any others experiencing flu-like symptoms or other respiratory distress were tested Thursday, according to the cruise line.
The U.S. Coast Guard delivered kits via helicopter Thursday morning so the ship's medical team could administer the tests. The samples then were flown to a lab in Richmond, Calif., for processing, Princess Cruises said.
The ship, which is currently off the coast of San Francisco, will not be allowed to dock until those test results are back, Gov. Gavin Newsom said at a news conference Wednesday.
Princess Cruise spokeswoman Negin Kamali said she had no information on when results are expected or when the ship might return to port.
A passenger said that she had been told results may come Friday.
Passengers on the vessel _ both current and those who may have been exposed earlier _ told the Los Angeles Times that the response to the outbreak by the company and health officials had been filled with missteps. In particular, passengers said that Princess Cruises was lax on health screening protocols prior to boarding and withheld information about the risks they faced, even as the ship's condition became international news.
Thursday afternoon, two passengers aboard the Grand Princess said all passengers had been confined to their quarters, with public activities canceled. Meals were being delivered by room service beginning Thursday evening, a passenger said.
Kamali confirmed that the CDC had "recommended that guests should remain in their staterooms for the remainder of the cruise."
Placer County was asking any other individuals who were on the cruise to Mexico to self-quarantine. County officials on Tuesday declared a local emergency in response to the outbreak.
The ship was supposed to depart for another cruise to Hawaii on Saturday, but that trip was canceled and the cruise line said all guests would receive a full refund.
Newsom, who declared a health emergency Wednesday, said he felt confident that the state could prevent the virus from being spread by passengers on the cruise who already had returned to California.
"We have the resources," Newsom said. "We have the capacity. By this evening, we will have contacted every county health official that has someone who came off this cruise. They will have their contact information and begin a process to contact those individuals."
World Health Organization officials emphasized Thursday that it is not too late to beat back the spread of the virus.
Worldwide, there have been 95,265 cases reported globally and 3,281 deaths. Parts of China _ where the outbreak originated _ have brought their daily new infection numbers down to the single digits, health officials said. Eight provinces have not reported any new cases in the last 14 days.
"This is a time for pulling out all the stops," WHO Director Tedros Adhanom Ghebreyesus said. "If we take the approach that there is nothing we can do, that will quickly become a self-fulfilling prophecy. It's in our hands.
"Ultimately, how deadly this virus is will depend not only on the virus itself but how we respond to it," he said.
At a news conference Thursday, WHO officials were asked about a prediction that 40% to 70% of the world will ultimately contract the coronavirus. Officials said they take all predictions into account, but China's progress in containing the virus and lowering case numbers makes that seem increasingly unlikely, said Mike Ryan, who heads the agency's emergencies program.
"There are obvious real things happening in the real world that contradict that," he said. "That's flying in the face of that prediction.
"We need to fight. We need to fight now," he said. "Our (direst) predictions will come true if we do nothing."
Officials emphasized that tried-and-true public health measures, like testing and isolation, are working to control the virus. Countries need to take proactive steps, said Dr. Maria Van Kerkhove, the WHO's acting head of emerging diseases.
"You need to look for all of your cases aggressively," she said.
Tedros said he was concerned that some countries have not taken the epidemic seriously enough or have decided there is nothing they can do about it. He said some countries' political commitment does not seem to match the level of threat faced globally. There must be strong leadership from the top, he said.
"This epidemic can be pushed back _ but only with a collected, coordinated and comprehensive approach that engages the entire machinery of government," Tedros said. "We're calling on every county to act with speed, scale and clear-minded determination."
