The genetic sequences of patients in the Seattle-King County region suggest the virus has been circulating there since about mid-January, when the first USA patient - a man who returned from Wuhan - was diagnosed, Bedford wrote in the analysis, published online. Through Monday, 3,056 people had died from the virus worldwide.
The shift in strategy, with an emphasis on enlisting the public at large to take a more active role in curtailing the spread of the virus, came as health authorities announced on Monday that 18 Washington state residents had tested positive, including six who died.
Public Health - Seattle and King County announced Tuesday that officials have confirmed that three more patients have died as a result of the coronavirus, most of which had been residents of LifeCare, a nursing home facility in Kirkland.
In San Antonio, a woman who had been brought to the U.S. from Wuhan, China, tested "weakly positive" for the virus after being released from quarantine on Saturday following two negative test results, according to a separate report in the Associated Press.
After the operation, the 66-year-old COVID-19 patient is now in stable condition, with the transplanted lungs oxygenating well, the hospital said.
The nursing home cases especially troubled health care experts because of the vulnerability of sick and elderly people to the illness and existing problems in nursing facilities. And more than 10 schools in the Seattle area were closed for deep cleaning over virus concerns.
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Of the new Washington cases, two were women, one in her 80s and another in her 90s.
That person remains in stable condition, in isolation, but officials in Sonoma did not disclose where they were being treated. In California, two health care workers in the San Francisco Bay Area who cared for an earlier coronavirus patient were diagnosed with the COVID-19 virus on Sunday, the Alameda and Solano counties said in a joint statement. Instead, the testing is likely to reveal a picture of the virus' spread that was previously invisible.
The U.S. Centers for Disease Control and Prevention (CDC) confirms the number of confirmed cases will rise because it's expanded and more vigorous testing will uncover more patients.
The coronavirus, which emerged in the central Chinese city of Wuhan late previous year, has spread rapidly around the world over the past week, with more new cases now appearing outside China than within.
The WHO says the virus appears to particularly hit people over the age of 60 and those already weakened by other illnesses.
With 14 confirmed cases and five fatalities, Washington's King county has declared a state of emergency. They posted their research online, but it was not published in a scientific journal or reviewed by other scientists.
Lawmakers on Capitol Hill expressed skepticism about US health officials' claims that testing for the new virus should be widely available soon.
"China saw not much of an epidemic outside of Hubei because they acted early", Bedford said.