SEATTLE _ A man in King County has died due to a novel coronavirus infection, the first fatality associated with the illness in the United States, and more local cases were identified Saturday, prompting the governor to declare state of emergency to try to contain a virus that has killed more than 2,900 people globally.
Washington Gov. Jay Inslee declared the state of emergency Saturday afternoon in response to the death and new cases in the area. The proclamation allows state agencies to "use all resources necessary to prepare for and respond to the outbreak."
The 50-year-old man was a patient at EvergreenHealth Medical Center in Kirkland. He had an underlying chronic health condition but no history of travel or contact with an infected person. He died Friday, according to EvergreenHealth.
More than 85,000 cases have been detected in more than 57 countries, including more than 60 in the United States. King County has monitored more than 500 people for signs of the illness, and 41 people have been tested in Washington state.
News of the death and additional cases arrived after health officials announced Friday night that a Snohomish County high school student who also had not traveled to any country affected by the virus had tested positive. Health officials Friday night reported him as doing well.
The Centers for Disease Control and Prevention (CDC) changed its testing guidance Friday for health care providers. Rather than only test people who had traveled to China or had come into close contact with someone diagnosed with novel coronavirus, the new CDC guidance allows clinicians to test patients they suspect of having COVID-19, even if they don't have a history of travel.
"That's how we have covered the local cases, by dropping the travel criteria and testing patients who had an illness that was serious," EvergreenHealth's Dr. Francis Riedo said Saturday at a news conference in downtown Seattle.
Two other people from the long-term care facility LifeCare Center in Kirkland also have tested positive at a state lab and have been hospitalized. A resident in her 70s is in serious condition, and a health employee in her 40s is stable condition. LifeCare has 108 residents and 180 employees, according to the CDC. Twenty-seven residents and 25 employees have symptoms, according to the CDC.
More than 50 other people associated with LifeCare are reportedly ill with respiratory symptoms or were hospitalized with pneumonia or other conditions, according to a statement from Public Health Seattle-King County. All are being tested for COVID-19, the illness caused by the virus, and "additional positive cases are expected," according to public health officials.
All local cases announced Saturday were acquired through "community transmission" in the Seattle area, said Dr. Jeffrey Duchin, health officer for Public Health � Seattle & King County. That means none of the patients had traveled overseas.
Officials declined to share what underlying health condition the patient who died had, citing patient privacy.
The three cases announced Saturday brought the total of presumptive positive cases � meaning they had tested positive in a state lab but hadn't yet been confirmed by the CDC � to four in King County, including a woman in her 50s who had recently traveled to South Korea, and one in Snohomish County.
A 35-year-old Snohomish County man who was the United States' first patient confirmed to have the virus is considered fully recovered. He had recently visited Wuhan, China, where the global outbreak began in December.
"It is a sad day in our state as we learn that a Washingtonian has died from COVID-19," Inslee said in a statement. "Our hearts go out to their family and friends. We will continue to work toward a day where no one dies from this virus."
At a quickly convened news conference at the White House on Saturday, the Trump administration announced new travel restrictions in response to the news. Vice President Mike Pence detailed additional travel restrictions on Iran, expanding an existing Iran travel ban to include "any foreign national who has visited Iran in the last 14 days." Pence also said that the administration was advising citizens not to travel to specific areas in Italy and South Korea that "have been most affected by the coronavirus."
Pence additionally announced that the president had directed the State Department to coordinate medical screenings in Italy and South Korea of any individuals coming into the United States.
Recent weeks have brought dramatic examples of actions in other nations to stop the spread of the coronavirus that have involved isolating entire cities or regions.
But local health officials have said they do not yet feel more extreme measures � like shutting down schools, for example � are required as of yet.
In Washington state, a local health officer, "at his or her sole discretion" can issue an emergency detention that causes " a person or group of persons" to be immediately detained for a period of up to 10 days for purposes of isolation of quarantine, according to rules passed by the state Board of Health.
That power can only be exercised after reasonable efforts are made to obtain voluntary compliance with requests for medical examination, testing and treatment, and the health officer must issue a written order detailing why the action is necessary.
Dr. Kathy Lofy, state health officer, said if there are more events in Washington, officials might consider measures such as canceling large public gatherings, but do not yet feel that is necessary.
On Friday, Washington state's public health lab started testing samples from patients, significantly reducing the wait time for results.
King County, which activated its Emergency Operations Center Saturday, is also exploring options for people who are homeless to rest and recover from COVID-19 away from shelter situations, including identifying potential county-owned properties for this purpose. Healthcare for the Homeless Network has scheduled four training across the county for human services providers to review and answer questions.
"We are rapidly shifting our operations here to be focused solely, primarily on dealing with this crisis," King County Executive Dow Constantine said.
Seattle Mayor Jenny Durkan has been meeting with city leaders to discuss emergency planning related to coronavirus since January. The Seattle Office of Emergency Management began convening twice-weekly sessions with local partners to plan the response to novel coronavirus earlier this month, and as of Friday afternoon, the Seattle Fire Department had planned on launching "tabletop exercises" to model different coronavirus transmission scenarios starting Monday.
"Individuals, families and businesses should make plans and prepare," Durkan wrote in a statement. "The number one thing people can do now is to heed the public health advice to keep from getting sick, and stay home if you do get sick."
Health experts believe novel coronavirus to be spread by droplets emitted when an infected person coughs or sneezes and between people who are in close contact � within six feet � of one another. Illnesses can range from something resembling a common cold to a chest infection that requires hospitalization.
Symptoms among people who have been diagnosed with novel coronavirus have been reported between two and two weeks after exposure.
But in a press briefing on Friday, Duchin said much is still unknown about the illness. It appears highly transmissible, Duchin said, though officials did not have precise numbers on transmissibility � and Duchin acknowledged that this would vary from community to community.
There's less clarity on how severe the illness is, Duchin said. The fatality rate from Hubei province in China, for example, may have been portrayed as higher than it actually was, because there may have been more total cases than reported, Duchin said.
Eighty percent of cases of the infection are mild, according to Duchin.
"Patients frequently don't even need to see health care," Duchin said. "However, as these recent cases demonstrate, it can be severe and we want people to understand that there are things that they can do to protect themselves from getting this infection."
Those actions include washing hands with soap and water and avoiding touching the face, social distancing and staying home from work or school when sick.
Health officials are also stressing that people of Chinese ancestry are not at greater risk of contracting the infection than anyone else.
