Coronavirus is now in 34 states and a cruise ship linked to dozens of cases will soon dock in the US

Thirty-four states and the nation’s capital have confirmed cases of novel coronavirus, but the crisis continues to grow aboard cruise ships at sea.

There are at least 21 people with coronavirus aboard the Grand Princess cruise ship, which is expected to dock sometime Monday in Oakland, California, Gov. Gavin Newsom said in a news conference Sunday.

The Grand Princess has been in limbo since Wednesday, when officials learned a California man who traveled on the same ship last month later died of coronavirus. On Sunday, the US Centers for Disease Control and Prevention said four people from that February Grand Princess voyage have been diagnosed with coronavirus. It was not immediately clear whether those four include the California man who died.

Among the infected on the ship are 19 crew members and two passengers, though the number of onboard infections could rise, as not all of the approximately 3,500 people on board — including passengers and crew — have been tested.

About 1,000 California residents from the ship will go into mandatory quarantine at Travis Air Force Base and Miramar Naval Air Station, the US Department of Health and Human Services said Sunday.

Passengers will be screened by the US Department of Health and Human Services and the CDC at the port, according to a statement from Travis Air Force Base.

“Only asymptomatic passengers will be transferred” to military bases for more screening and a 14-day quarantine, the statement said.

Residents of other states will complete their mandatory quarantine at Joint Base San Antonio Lackland in Texas or Dobbins Air Reserve Base in Georgia. Throughout the quarantine, passengers will be monitored for symptoms of coronavirus, DHHS said.

Some 54 countries are represented among the passengers and crew, Newsom told reporters, and charter flights will be provided for the largest group of foreign passengers. The Canadian government said it plans to repatriate its citizens aboard the ship.

The 1,113 crew members will be quarantined on the ship, which will leave the port after passengers disembark, the governor said.

Officials anticipate the entire process will take between two and three days.

“That’s why we ask just patience as we prepare the site and make sure the screening is appropriate and make sure we have all the logistics at hand so that we’re doing this in an appropriate way,” Newsom said.

US cases top 500

At least 21 people have died from the virus in the United States — 18 in Washington state, two in Florida and one in California.

The Washington state deaths include 16 linked to the Life Care Center nursing home.

At least 565 people in the US have tested positive for coronavirus, including 70 people who were repatriated to the US.

Worldwide, the number of deaths has topped 3,500, with more than 105,000 people infected.

Hundreds of passengers have been infected from multiple cruise ships

The Grand Princess is not the only cruise ship impacted by the coronavirus.

Princess Cruises, which owns the Grand Princess, said the CDC has given a “no-sail” order for another ship, the Royal Princess.

A crew member who recently served on the Grand Princess transferred to the Royal Princess just over two weeks ago, the cruise line said. The CDC issued the no-sail order until the crew member could be tested.

But the cruise line said it was unable to obtain a test for the crew member, and “due to the unknown timing of obtaining the test and results or anticipated response,” the cruise was canceled.

Some cruise lines are letting customers reschedule for free

A similar situation played out off the coast of Florida, where another Princess Cruises ship, the Regal Princess, was held offshore for much of the day Sunday pending tests for crew members who were on the Grand Princess more than two weeks ago. Again, the cruise operator decided to cancel the ship’s next voyage.

The ship, which was supposed to dock in Port Everglades Sunday morning, was eventually cleared to dock later that evening, a spokeswoman for the port told CNN. That was confirmed by the US Coast Guard Sunday evening, which said the CDC had lifted its “no sail” order.

It was not immediately clear when passengers would be able to disembark given the port needed to figure out the logistics.

The US Coast Guard confirmed it delivered testing kits to a ship off the coast of southern Florida on Sunday morning.

The largest known outbreak on a cruise ship was on the Diamond Princess, another ship owned by Princess Cruises.

In early February, after the first handful of cases were reported from the Diamond Princess, Japanese officials decided to quarantine the ship. Eventually, more than 700 people on board became infected with coronavirus.

On Sunday, Virginia health officials announced the state’s second case of coronavirus — a patient in their 80s who had recently traveled on a Nile River cruise.

The patient, whose name and gender were not released, started developing symptoms on February 28 and was hospitalized last Thursday, the Virginia Department of Health said. The person is in stable condition Sunday.

The US State Department has warned US citizens not to travel by cruise ship, especially if they have underlying health conditions.

“CDC notes that older adults and traveler with underlying health issues should avoid situations that put them at increased risk for more severe disease,” the State Department’s website says. “This entails avoiding crowded places, avoiding non-essential travel such as long plane trips, and especially avoiding embarking on cruise ships.”

‘Unfortunately, you’re going to see more deaths’

The US response to coronavirus has now shifted from containment to mitigation, Surgeon General Dr. Jerome Adams told CNN’s “State of the Union” on Sunday.

“Initially, we had a posture of containment so that we could give people time to prepare for where we are right now. We’re shifting into a mitigation phase, which means that we’re helping communities understand you’re going to see more cases,” Adams said.

“Unfortunately, you’re going to see more deaths. But that doesn’t mean that we should panic.”

Adams said those who aren’t sick shouldn’t wear face masks as they often cause more harm than good. Instead, people should wash their hands with soap and water frequently for at least 20 seconds and stop touching their faces — something much easier said than done.

Residents at a nursing home linked to deaths are stuck in their rooms

Washington state is grappling with an outbreak at the Life Care Center of Kirkland, a suburban Seattle nursing home connected to at least 16 deaths, the King County Health Department said.

One employee of the center tested positive for the coronavirus, facility spokesman Tim Killian said Sunday. At least three employees have been hospitalized with symptoms.

Extra nurses, doctors and other health care personnel have been provided by the US Public Health Commissioned Corps Officers at the direction of Department of Health and Human Services after 70 employees showed symptoms and were asked not to return to work, Killian said.

Fifty-five residents remain at the facility — down from 120 in mid-February — while dozens have been transferred to various hospitals.

Thousands are asked to self-quarantine

New York state announced 16 new cases on Sunday, bringing the state’s total to 105.

The rising number of cases prompted Gov. Andrew Cuomo to declare a state of emergency Saturday to facilitate purchasing, hiring and testing protocols related to the disease.

State officials have urged more than 2,500 people to self-quarantine as they search for anyone who may have come in contact with patients.

In Washington, DC, officials announced the first case of coronavirus in the nation’s capital Saturday.

That patient has no travel history outside of the United States, District of Columbia Mayor Muriel Bowser said.

But DC Health is recommending a temporarily pause of services at Christ Church Georgetown in light of the confirmed case.