SACRAMENTO, Calif. _ President Donald Trump announced the United States was suspending all travel from much of Europe for 30 days to combat the coronavirus and called for payroll tax relief to help the struggling economy.
Trump also called on nursing homes stop all non-medical visits and announced federally backed small-business loans, with a proposed increase of $50 billion.
"We are responding with great speed and professionalism," the president said in a national address. "Smart action today will prevent the spread of the virus tomorrow."
His comments come as the coronavirus toll continued to mount in California, where on Wednesday, the Los Angeles County Department of Public Health confirmed its first coronavirus-related death and six new cases, bringing the county's total to at least 28, including four cases in Long Beach. There was also a new case in Pasadena.
The county's first victim was a woman older than 60 who had underlying health issues, said Dr. Barbara Ferrer, the county health department's director. The patient was not an L.A. County resident but had been visiting here after extensive travel over the past month, including a long layover in South Korea.
"Shortly after being hospitalized, she unfortunately passed," Ferrer said.
Ferrer said that one of the new cases included the county's second instance of community spread. That individual is hospitalized.
Three individuals are household contacts of an L.A. County resident previously confirmed to have the virus. One of those people is currently hospitalized.
One individual had traveled to France and returned home ill. Another traveled to a religious conference in a different state and was a close contact of someone at the conference who later tested positive for COVID-19, the disease caused by the coronavirus.
The county has developed a risk-assessment tool that considers how many community transmissions there have been and whether new cases are accelerating, Ferrer said.
"We're trying to use that to drive our judgments about when things need to close," she said. "We will get to a point, unfortunately, here in L.A. County, where we will be asking for events to close. But we're not there yet," Ferrer said.
Ferrer stressed the public's need to be cautious in large gatherings and suggested that people assess themselves whether they should venture into crowded areas. Those who are pregnant, elderly or have underlying health issues are especially vulnerable to developing serious effects from the virus.
To date, the county's public health lab has completed 72 tests for COVID-19. That number does not include those performed by commercial labs.
Elsewhere in the county, Pasadena confirmed its first case of the novel coronavirus in a resident, officials announced Wednesday.
The patient had been in contact with a confirmed case in Southern California and has been in quarantine since that exposure occurred and is recovering, according to the Pasadena Public Health Department. Officials learned of the patient this week and they are cooperating with instructions from healthcare providers.
Since then, officials have been reaching out to everyone who had close contact with the resident to discuss their next steps because they were possibly exposed.
"We have been preparing and are ready to manage COVID-19 cases in Pasadena, in close coordination with our healthcare partners," said Dr. Ying-Ying Goh, PPHD director in a statement. "We will continue to recommend our community implement individual and community mitigation measures to reduce the risk of spread of illness."
As the outbreak continued its rapid spread across the globe, the World Health Organization, for the first time, referred to the outbreak as a pandemic.
"This is the first pandemic caused by a coronavirus," WHO chief Tedros Adhanom Ghebreyesus said. "We have rung the alarm bell loud and clear."
Coronaviruses typically cause the common cold, but deadly viruses SARS and MERS were also coronaviruses. Tedros emphasized that countries could still take aggressive steps to beat back the spread of the new coronavirus and said he believed united action could effectively combat the spreading illness.
The pandemic classification does not change the WHO's strategy for slowing the outbreak nor should it affect how countries are tackling cases, Tedros said.
"There has been so much attention on one word, and let me give you some other words that matter much more, and are much more actionable," Tedros said. "These are prevention, preparedness, public health, political leadership and, most of all, people. ... We're in this together to do the right things with calm and protect the citizens of the world."
Unlike a public health emergency _ which is declared based on specific international-law criteria _ there is no formal WHO process that governs whether the organization refers to a global outbreak as a "pandemic." Instead, the heightened rhetoric simply reflects the worsening trends that officials have been observing for some time, they said.
Across California, the number of cases has continued to grow, including the death Tuesday of a woman at a senior living facility, and officials are saying it's increasingly unlikely they can contain the virus and instead are focusing on slowing its spread.
"The community spread has already occurred," said Peter Beilenson, Sacramento County's health director.
On Wednesday, the state released guidelines on how to prepare and protect homeless Californians and service providers from the virus, which included ensuring they had enough health and personal protective equipment on hand, identified areas to isolate individuals suffering mild symptoms and identifying the people most vulnerable to the disease.
"We know that individuals experiencing homelessness are at greater risk of having an untreated and often serious health condition. This vulnerable population also has a higher risk of developing severe illness due to COVID-19," said Dr. Mark Ghaly, Secretary of the California Health and Human Services Agency in a statement. "It is important that we act now to protect this population and the compassionate people who serve them."
In Northern California, an elderly patient died in an assisted living facility of the novel coronavirus, sparking fears of an outbreak among other residents there and renewing concerns about statewide availability of testing kits.
Sacramento County health officials announced Tuesday that a patient in her 90s was the county's first fatality from COVID-19.
The woman was among about 140 patients of the facility in Elk Grove, the same suburb where all public schools were closed this week after two family members with students at multiple sites tested positive for the coronavirus. Tuesday, the district announced that an elementary-school-age student in that family had also tested positive.
Beilenson said Tuesday that all patients in the nursing home would be tested for the virus, but that effort was delayed by a lack of test kits. He said the county had access to only 20 tests per day and was having to ration those between possible cases in the community and medical professionals who might have been exposed.
"It has been very frustrating because we have been stuck now for a couple of weeks with just 20 tests a day," Beilenson said.
Beilenson said other residents of the Elk Grove facility were now subject to special protective measures, including having meals delivered to rooms and not being allowed to congregate in communal areas.
The city of Alameda on Wednesday said a firefighter had tested positive for the virus, and Stanislaus County confirmed its first two positive cases. One of the individuals was a passenger on the Grand Princess cruise to Mexico. The other is likely a case of community transmission, as officials said the person had not traveled anywhere with a known outbreak or been in contact with someone who previously tested positive.
Seventeen others in Stanislaus County are currently awaiting results, officials said.
Officials have continued to take precautionary measures in an attempt to contain the spread of the illness.
A growing number of colleges and universities, most recently Cal State Long Beach and Pepperdine, have suspended in-person classes in favor of online instruction.
San Francisco announced a ban on group events of 1,000 or more people.
"We know that this order is disruptive, but it is an important step to support public health," said Mayor London Breed, noting that city officials were following advice from state officials.
In San Mateo County, officials issued a legal order barring unauthorized visitors and non-essential personnel from licensed skilled nursing facilities, which includes family members.
According to the order, "The virus that causes Coronavirus 2019 Disease (also known as COVID-19) places residents at long-term care facilities at high risk, especially given that visitors to such facilities may have the virus but may not have symptoms or may have mild symptoms. Such visitors can easily pass the virus on to vulnerable residents."
The county has 15 of the Bay Area's 105 COVID-19 patients.
Officials in other states have also taken action.
Washington state has banned mass gatherings of 250 or more people, as cases continue to rise in Seattle's suburbs, reaching a death toll of more than 30.
In Texas, where more than 20 cases have been confirmed, local officials canceled the Houston Livestock Show and Rodeo because of concerns about the spread of the virus. It's the first time the indoor rodeo _ billed as the largest in the world _ has been canceled since 1932.
The National Basketball Association suspended its season Wednesday evening.
The National Collegiate Athletic Association also announced that its upcoming men's and women's basketball tournaments will be played before "only essential staff and limited family attendance."
As of Wednesday afternoon, California had 177 confirmed coronavirus cases.
