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US surgeon general warns 'this week, it's going to get bad'

By Madeline Holcombe and Holly Yan, CNN | Updated - Mar. 23, 2020 at 2:36 p.m. | Posted - Mar. 23, 2020 at 2:16 p.m.



WASHINGTON (CNN) — The war against coronavirus has intensified across the country as more workers are laid off, medical supplies dwindle, and states enact new rules to get Americans to stay home.

"I want America to understand — this week, it's going to get bad," US Surgeon General Jerome Adams told NBC's "Today" show Monday.

"We really, really need everyone to stay at home. I think that there are a lot of people who are doing the right things, but ... we're finding out a lot of people think this can't happen to them."

More than 41,200 Americans have been infected with coronavirus across all 50 states, and at least 501 people have died.

Indiana, Michigan and West Virginia joined a growing number of states ordering people to stay home, with a few exceptions.

Massachusetts and Maryland said all non-critical businesses must shut down their physical workplaces. And Virginia, like Kansas, has canceled all classes for the rest of this school year.

"If we do nothing, cases will increase fivefold," said Dr. Joneigh S. Khaldun of the Michigan Department of Health.

President Donald Trump has activated the US National Guard in three of the hardest-hit states — California, Washington and New York. Almost half all US cases — 20,875 — are in New York state.

Trump said those National Guard units will remain in the command of the states' governors.

Across the country, at least 12 states have issued stay-at-home orders that are either in effect or will take effect this week. By Wednesday, more than 126 million Americans will be subject to those new rules.

It's all in an effort to control the deadly virus and prevent a catastrophic overload of the US health care system.

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'A point where people can't be saved'

Medical workers from coast to coast say they're facing a dire shortage of masks, ventilators and staff as more doctors and nurses also fall sick.

New York City's 11 public hospitals will only be able to get through this week before they start reaching "a point where people can't be saved," Mayor Bill de Blasio said Monday.

"I literally want to see hundreds of ventilators. I want to see first hundreds of thousands and millions of masks," de Blasio said.

"If we don't get ventilators this week, we are going to start losing lives we could have saved."

Many are calling for Trump to fully use the Defense Production Act to ensure the necessary supply of medical equipment.

The 1950 law gives the president the ability to force factories to produce key equipment and allocate resources where they are needed. President Trump invoked the bill last week, but said he does not plan to use it.

On Monday, Sens. Chris Murphy of Connecticut and Brian Schatz of Hawaii are introducing a bill to require the president to fully use the Defense Production Act.

The bill would require the President to ensure the production of at least 500 million N95 respirators, 200,000 ventilators, 20 million face shields, 500 million pairs of medical gloves and 20 million surgical gowns.

Even GOP Sen. Lindsey Graham, a Trump ally, said the US needs to go "all in" with increasing medical supplies.

"Anything that can provide relief to the frontline troops, do it," the South Carolina senator said. "Be all in on the medical supply front."

Since hospitals are about to get overwhelmed, authorities are redoubling efforts to get the public to stay home — especially since coronavirus is easily transmitted between people who don't even know they have it.

Stricter rules go into effect as people ignore social distancing orders

Americans should stay at least 6 feet away from others and avoid crowds, health officials say. Yet people keep ignoring that guidance.

Sun worshipers have been flocking to beaches. Young people have been gathering at parks as many schools are now closed.

So more states are enacting strict stay-at-home orders. California, Illinois, New York and New Jersey were already practicing them over the weekend.

Ohio, Louisiana and Connecticut joined that list Monday.

And similar orders will go into effect Tuesday in Delaware, Indiana, Michigan and West Virginia.

The orders say residents must stay home, with few exceptions such as grocery shopping, getting medicine and going to work at an essential job.

People can still go outside and be active, as long as they stay at a healthy distance from others.

Violating the orders could result in fines in states like New York and Connecticut.

"There will be a civil fine and mandatory closure for any business that is not in compliance," New York Gov. Andrew Cuomo said.

Maryland Gov. Larry Hogan ordered the closure of all non-critical workplaces as of 5 p.m. Monday.

Massachusetts Gov. Charlie Baker also ordered all nonessential businesses to shut down their physical workplaces, from noon Tuesday until April 7. Those employees can still work from home.

Like in many other states, restaurants and bars can still sell food, but only as takeout.

Massachusetts is also banning gatherings over 10 people "a reduction from the 25-person limit established in an earlier order," Baker's office said.

Related:

More drive-thru testing becomes available

While testing has become more available, there are still challenges — and increased strain on the healthcare system.

About 254,000 Americans have been tested, Vice President Mike Pence said Sunday. That total does not include local hospitals or local health care labs, he said.

But increasing testing has put pressure on dwindling medical supplies and increased the possibility of exposure in medical facilities.

In some places, authorities have decided to test only high-risk patients or those whose results would significantly change the course of treatment.

While the US plays catchup with widespread testing shortages and delays, cities are getting creative in helping expedite testing.

The city of Los Angeles is implementing a new web portal that would direct those who might be at highest risk to a testing center.

In Chicago, two Walmart center parking lots are being designated as drive-thru testing sites.

And a new drive-up testing facility in Miami will give health care workers and first responders priority testing, Florida Gov. Ron DeSantis said.

More outbreaks in nursing homes

While more evidence shows young adults can become seriously ill from coronavirus, the elderly are especially vulnerable.

That's why new outbreaks in nursing homes have families riddled with anxiety.

Seven nursing homes across Arkansas have reported cases, state Department of Health Secretary Dr. Nate Smith said.

At least 41 cases are linked to Briarwood Nursing Home in Little Rock, Smith said. Residents accounted for 35 of those cases, and staff members for six.

West Virginia Gov. Jim Justice said four members of the National Guard are testing everybody at a nursing home after a woman there tested positive for coronavirus.

Justice did not identify the facility nor say whether the woman is a resident or an employee. But West Virginia — with its large populations of elderly residents and coal miners — faces special challenges.

"We are a very high risk, if not the highest risk state," Justice said Monday.

In Broward County, Florida, at least three people from the Atria Willow Wood facility have died from coronavirus. Seven other people have tested positive, Senior Vice President of Care Mike Gentry said.

Gov. DeSantis said the Florida facility did not take precautions against the virus, allowing staff who hadn't been screened for symptoms to freely enter the building. But Atria disputed the governor's claims.

In New Orleans, at least seven deaths and 24 confirmed cases are linked to the Lambeth House retirement community, said Dr. Alexander Billioux, Louisiana assistant secretary of health. Seven other facilities in Lousiana have reported cases, he said.

The first known nursing home outbreak was at the Life Care Center in Kirkland, Washington. The center is linked to 35 deaths from coronavirus.

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Madeline Holcombe
    Holly Yan

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