Monkeypox: WHO to consider again whether outbreak is public ...

(CNN) As monkeypox cases continue to rise globally, the World Health Organization plans to reassess whether the outbreak constitutes a public health emergency of international concern.

In late June, WHO's Emergency Committee determined that the outbreak did not meet the criteria for such a declaration.

But as the virus continues to spread, WHO Director-General Tedros Adhanom Ghebreyesus wants the committee to take up the issue again, based on the latest data around the epidemiology and evolution of the outbreak.

Tedros said Wednesday that he will convene the committee during the week of July 18, or sooner if needed.

WHO defines a public health emergency of international concern , or PHEIC, as "an extraordinary event" that constitutes a "public health risk to other States through the international spread of disease" and that may "potentially require a coordinated international response."

"On monkeypox, I continue to be concerned by the scale and spread of the virus. Across the world, there has now been more than 6,000 cases recorded in 58 countries," Tedros said

"Testing remains a challenge, and it's highly probable that there are a significant number of cases not being picked up," he added. "Europe is the current epicenter of the outbreak, recording more than 80% of cases globally."

Monkeypox, a viral disease, occurs mostly in central and western Africa, where the virus is endemic -- but as part of the latest outbreak, the virus has spread to many regions of the world where it is not typically seen.

Cases are also being reported in African countries that previously were not affected by the virus, and in those places where the virus is endemic, record numbers are being recorded, Tedros said Wednesday. WHO teams are following the data closely, he said.

WHO is working with countries and vaccine manufacturers to coordinate sharing of vaccines for monkeypox, which are scarce. The organization is also working with groups to break the stigma around the virus and spread information to help protect people.

"I want to particularly commend those that are sharing videos online via social media channels, talking about their symptoms and experiences with monkeypox," he said . "This is a positive way to break down the stigma about a virus that can affect anyone."

Early data on the outbreak has suggested that gay and bisexual men and other men who have sex with men make up a high number of reported cases, leading to concern about stigmatizing the disease and the LGBTQ community.

However, anyone who has been in close contact with someone who has the virus can be at risk.

The monkeypox virus can spread from person to person through direct contact with infectious body fluids or with the rash, scabs and sores that the disease can cause. Spread can also happen through indirect contact, such as through clothing or bedding contaminated with the virus.

It can also spread through respiratory secretions during prolonged face-to-face contact or during intimate physical contact, such as kissing, cuddling or sex.

Symptoms of monkeypox can include fever, headache, muscle aches, swollen lymph nodes, chills, exhaustion and a rash on the skin that can look like pimples or blisters.

The rash goes through different stages, developing into pustules before healing.

About 41,500 courses of vaccine distributed in US

About 41,500 courses of the monkeypox vaccine Jynneos have been distributed to states and other jurisdictions across the United States, according to data published Wednesday by the US Department of Health and Human Services.

A course of Jynneos involves two doses four weeks apart.

The Biden administration announced last week that the strategy for distributing monkeypox vaccines would focus on areas with the highest case rates and overall risk. The District of Columbia has the most reported cases per capita, by far, and has received the most vaccine doses per capita, the new HHS data shows.

Vaccine distribution has also been heavily concentrated in California, Illinois and New York, particularly the three largest US cities: New York, Los Angeles and Chicago.

Massachusetts, Hawaii and Colorado also received a large share of the vaccine distribution to date.

Eleven states have not received any monkeypox vaccine, according to the data; none of them has reported any cases to the CDC.

US monkeypox testing ramps up

Efforts are also underway to ramp up testing for the virus in the US.

The commercial laboratory company Labcorp will begin monkeypox testing Wednesday at its largest facility in the United States, doubling the nation's capacity to test for the virus, according to the US Centers for Disease Control and Prevention.

The CDC announced Wednesday that Labcorp will be able to accept specimens for testing from anywhere in the United States, and the company expects to perform up to 10,000 tests per week.

The outbreak has led to 605 probable or confirmed cases in the US as of Wednesday evening. Cases have been reported in 34 states, the District of Columbia and Puerto Rico. Three of the cases were non-US residents.

"The ability of commercial labs to test for monkeypox is a key pillar in our comprehensive strategy to combat this disease," CDC Director Dr. Rochelle Walensky said Wednesday. "This will not only increase testing capacity but will make it more convenient for providers and patients to access tests by using existing provider-to-lab relationships."

If someone thinks they could have a monkeypox infection, a provider will have to order a test. "The public will not be able to go to a Labcorp lab and submit a specimen," the CDC said in its statement.

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The CDC's Laboratory Response Network has been conducting most of the monkeypox-specific testing in the US, but on June 22, the US Department of Health and Human Services announced that monkeypox testing would expand to five commercial labs: Aegis Science, Labcorp, Mayo Clinic Laboratories, Quest Diagnostics and Sonic Healthcare.

The CDC confirmed Wednesday that it had shipped tests to the labs and that their employees have been trained on how to administer the tests. "CDC anticipates additional commercial laboratories will come online and monkeypox testing capacity will continue to increase throughout the month of July."

WHO to weigh whether monkeypox is a public health emergency of ...

(CNN) The World Health Organization will convene an emergency committee meeting to assess whether the monkeypox outbreak is a public health emergency of international concern, WHO Director-General Tedros Adhanom Ghebreyesus said at a news briefing in Geneva on Tuesday.

"I think it's now clear that there is an unusual situation, meaning even the virus is behaving unusually from how it used to behave in the past," Tedros said. "But not only that, it's also affecting more and more countries, and we believe that it needs also some coordinated response because of the geographic spread."

WHO defines a public health emergency of international concern, or PHEIC, as "an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response."

The organization says that the definition implies that a situation is "serious, sudden, unusual or unexpected; carries implications for public health beyond the affected State's national border; may require immediate international action."

This definition comes from the International Health Regulations, which were created in 2005 and represent a legal agreement involving 196 countries with the aim of helping the international community prevent and respond to public health risks that have the potential to spread around the globe.

Covid-19 remains a public health emergency in US, administration ...

(CNN) The Biden administration is continuing the Covid-19 public health emergency declaration beyond July 15, two administration officials told CNN, as coronavirus cases are rising again across the US.

The administration has repeatedly said it would give states 60 days' notice if it were ending the declaration, which would have been Monday. But the deadline passed without notification.

The declaration is now expected to be renewed for up to another 90 days.

Reported cases of Covid-19 have more than doubled over the past month in the US overall and they're technically trending up in all states, though three states are considered to be "steady."

The public health emergency declaration allows many Americans to obtain free Covid-19 testing, therapeutic treatment and vaccines. Once it ends, people could face out-of-pocket costs depending on whether they are covered by Medicare, Medicaid or private insurance. But vaccinations would generally continue to be free for those covered by Medicare and private insurance, while state Medicaid programs would determine whether to continue covering vaccinations for their enrollees.

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Fact check: World Health Organization has no authority in the U.S.

The claim: President Biden is giving the World Health Organization control over U.S. health care and national sovereignty

The World Health Organization's 75th World Health Assembly began May 22 with officials coming together in Switzerland to discuss the COVID-19 pandemic and the WHO's role in international outbreaks.

But some online claim something more nefarious is afoot.

"TERRIFYING. The Biden administration is setting the stage to hand ultimate control of America’s health care system and U.S. national sovereignty over to the World Health Organization," reads a Facebook post shared May 12.

The post claims that the assembly will be voting on proposed amendments the Biden administration sent in January that would allow the organization "to declare an 'international health emergency,' nullifying the powers of nation states."

The post generated over 250 shares in less than a day. Similar posts have amassed hundreds of interactions on Facebook and Instagram.

Follow us on Facebook! Like our page to get updates throughout the day on our latest debunks

But the claim is false.

The amendments referred to in the Facebook post are intended to strengthen a country's reporting measures on public health events, experts told USA TODAY. They would not grant the WHO any authority in the U.S.

USA TODAY reached out to the social media users who shared the claim for comment.

Amendments will not give WHO authority in the US

The Biden administration drafted amendments in January to the International Health Regulations, a legally binding agreement between 196 countries to detect and report public health events, according to the Centers for Disease Control and Prevention.

This agreement does not allow the WHO to dictate national health care policy or create binding law in the U.S. or any nation, according to Lawrence Gostin, director of Georgetown University's WHO Collaborating Center on National and Global Health Law.

Fact check: Claim is missing context on WHO's parental-consent guidelines for vaccinating children

The proposed amendments to the agreement won’t change that.

The amendments will essentially modify the procedures and speed up the process by which countries report health events, Thomas Bollyky, director of the Global Health Program at the Council on Foreign Relations, a nonpartisan think tank, told USA TODAY. It won't give the WHO authority in any country.

For instance, countries could refuse to "cooperate with WHO expert teams" in the past, according to the Associated Press. The amendments would "seek to have all signatories agree not to block such actions."

The amendments don't list legal consequences for countries that don't comply, the AP reported. The measures are simply intended to strengthen the WHO's declaration and response to an international health emergency and allow other countries to better respond within their own borders, Bollyky said.

Fact check: COVID-19 caused by a virus, not snake venom

The idea that the Biden administration alone can give the WHO authority over health care or national sovereignty is off the mark, Brian Abramson, adjunct professor of vaccine law at the Florida International University College of Law, told USA TODAY.

Biden does not have the power to make any aspect of U.S. governance subservient to an international organization except through a treaty ratified by a two-thirds vote in the Senate, Bollyky said.

Control of the health care system is even more farfetched. Health care in the U.S. is delivered through adisjointed array of corporate and governmental entities not susceptible to governance by any one organization, according to Abramson.

USA TODAY previously debunked a claim that WHO vaccination guidelines on parental consent were enforceable in the U.S.

Our rating: False

Based on our research, we rate FALSE the claim that Biden is giving the WHO control over U.S. health care and national sovereignty. The amendments the Biden administration proposed are intended to strengthen the WHO's response to international health emergencies. It will not give the WHO any authority in the U.S.

Our fact-check sources:

Thank you for supporting our journalism. You can subscribe to our print edition, ad-free app or electronic newspaper replica here.

Our fact-check work is supported in part by a grant from Facebook.

Coronavirus updates: A pandemic, and Seattle, San Francisco issue ...

The day was hectic enough, with the World Health Organization declaring coronavirus a pandemic, deaths rising and stocks plummeting. Then the evening came with a range of even more shattering headlines.

President Trump banned all EU air passenger travel to the U.S., the NBA suspended its season after a player tested positive, and iconic actor Tom Hanks announced to the world that he and his wife have the virus.

World Health Organization Director-General Tedros Adhanom Ghebreyesus on Wednesday declared the coronavirus outbreak a pandemic as the global death toll rose above 4,600 and the number of confirmed cases topped 126,000.

"We have rung the alarm bell loud and clear," Tedros said at a news conference. "We cannot say this loudly enough, or clearly enough, or often enough: All countries can still change the course of this pandemic."

The U.S. death toll climbed to 33 and the number of U.S. cases rolled past 1,300, federal health officials said. Centers for Disease Control and Prevention Director Robert Redfield told a congressional committee the virus has spread to at least 38 states. That number increased Wednesday when Mississippi reported its first case, along with Arkansas and Wyoming.

“Right now the epicenter – the new China – is Europe,” Redfield said. “And there’s a lot of people coming back and forth from Europe that are now starting to seed these communities.”

The current coronavirus outbreak is the first to have drawn a pandemic designation, Tedros said. For weeks, he balked at calling the outbreak a pandemic, and Wednesday he noted that 81 nations have reported no cases of the virus. Another 57 have reported 10 cases or less. More than 90% of confirmed cases are in four countries, and two of them – China and South Korea – are seeing cases decline, he said.

Containment remains as important as mass treatment of the infection, Tedros stressed.

"Several countries have demonstrated that this virus can be suppressed and controlled," he said. “Even those countries with community transmission or large clusters can turn the tide."

Here's the latest on the outbreak of COVID-19:

Trump bans people from traveling to U.S. from Europe

The president outlined strict travel restrictions on passengers arriving in the United States from hard-hit portions of Europe, a ban that will last for at least 30 days. The ban applies to people and not cargo.

Trump said there would be exemptions for Americans who had undergone appropriate screenings.

Acting Department of Homeland Security Secretary Chad Wolf said the restrictions would "deny entry to foreign nationals who have been in affected areas."

Wolf also said DHS would issue a notice in the next 48 hours "requiring U.S. passengers that have been" traveling in parts of Europe to "travel through select airports where the U.S. Government has implemented enhanced screening procedures."

Dow futures fell 1,000 points after Trump's announcement of the ban.

NBA suspends season after player tests positive

The NBA announced Wednesday night it is suspending its season after a Utah Jazz player tested positive for coronavirus (COVID-19).

The league said it is halting operations “following the conclusion of tonight’s schedule of games until further notice. The NBA will use this hiatus to determine next steps for moving forward in regard to the coronavirus pandemic.”

While the league did not name the Jazz player in its news release, a person familiar with the situation confirmed it was Utah center Rudy Gobert. The person requested anonymity because he was not authorized to speak publicly because of the sensitive nature of the situation.

- Jeff Zillgitt

State Department raises global health advisory, advises against travel abroad

The U.S. Department of State raised its health travel warning to level 3 late Wednesday, saying that U.S. citizens should reconsider travel abroad due to the global impact of COVID-19. "Even countries, jurisdictions, or areas where cases have not been reported may restrict travel without notice," the state department warned.

- Curtis Tate

‘Bottom line: It’s going to get worse'

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told lawmakers Wednesday that the U.S. has yet to see the worst of the new coronavirus outbreak. He explained that any time there is an outbreak with enough cases of “community spread,” which means the source of the infection is unknown, “you’re not going to able to effectively and efficiently contain it.”

How much worse will depend on the ability of the U.S. to contain the influx of infected people from other countries and the ability to contain and mitigate the virus here.

“Bottom line: It’s going to get worse,” he said.

– William Cummings

March Madness behind closed doors

March Madness will go on, but without fans.

The NCAA announced Wednesday that its popular men's and women's basketball tournaments will be played without spectators in an attempt to prevent further spread of the coronavirus.

NCAA President Mark Emmert said in a statement he made the decision after consulting with public health officials and an advisory panel. Only essential staff and some family members will be allowed at the games.

"While I understand how disappointing this is for all fans of our sports, my decision is based on the current understanding of how COVID-19 is progressing in the United States,'' Emmert said.

The tournaments begin next week and conclude with the championship games, April 5 for the women and April 6 for the men.

– Jorge L. Ortiz

Tom Hanks says he has tested positive

The actor confirmed on Instagram and Twitter Wednesday that he and wife Rita Wilson tested positive for COVID-19 in Australia after feeling ill.

"We felt a bit tired, like we had colds, and some body aches," Hanks wrote on Instagram. "Rita had some chills that came and went. Slight fevers too. To play things right, as is needed in the world right now, we were tested for the Coronavirus, and were found to be positive."

The Oscar-winning actor has been shooting Baz Luhrmann’s Elvis Presley film in Australia. Hanks said he will be "tested, observed, and isolated for as long as public health and safety requires."

- Cydney Henderson

SAT test still scheduled for Saturday — at least for some students

Saturday is one of three scheduled test dates this spring when students can take the SAT college entrance exam. Generally, the test will go on as planned at schools and testing centers around the country, although dozens of locations are scheduling make-up dates or asking students to report to alternate locations.

The list of closed testing centers is here, but officials cautioned they're not updating it in real time.

If a student's testing center is closed, the College Board site may list an alternate date or location. If one has not been confirmed, test takers will be notified once arrangements have been made.

In other parts of the world, the College Board canceled Saturday's test in 17 countries affected by the coronavirus, including China, Italy, South Korea, Japan and much of the Middle East.

– Erin Richards and Chrissie Thompson

Seattle, San Francisco, Oregon ban large gatherings

Washington Gov. Jay Inslee announced a ban on gatherings and events of more than 250 people in the Seattle metropolitan area, where the virus has killed more than 20 people.

“This is not just your ordinary flu,’’ Inslee said in a news conference. “This is a virus that the experts tell us is at least 10 times more potentially fatal than the flu, and this demands a response consistent with the nature of the threat.’’

San Francisco will also forbid large events, but with a cutoff of 1,000 people, Supervisor Matt Haney tweeted. He added that the ban would last two weeks and that, starting Thursday, the Golden State Warriors would play their home games during that stretch without fans.

Public schools in San Francisco remain open, but some private ones have closed.

Late Wednesday night, Oregon Gov. Kate Brown announced that all "large gatherings over 250 people will be canceled statewide effective immediately for four weeks" and recommended "implementation of distancing measures" as part of the state's strategy to slow the virus.

Inslee said that as of Tuesday there had been 268 confirmed cases and 24 deaths in Washington state; 19 deaths are linked to one suburban Seattle nursing home. Authorities in King County believe the virus has spread to at least 10 long-term care facilities. The three counties affected by the ban, King, Pierce and Snohomish, are home to nearly 4 million people.

The prohibition — aimed at social, recreational and spiritual functions as well as community meetings but not businesses like supermarkets and restaurants — will remain in place at least through the end of March. Inslee said it would likely get extended, and suggested the federal government will probably follow suit in implementing social distancing measures in the coming weeks.

Schools in the three counties were not ordered to close yet but were asked to make contingency plans. Later in the day, the Seattle school district announced a two-week closure beginning Thursday, keeping 53,000 students out of the classrooms.

Inslee said more than 25,000 cases of COVID-19 are projected for Washington by early April if authorities don't intervene.

Asked about penalties for violations of his emergency order to ban large gatherings, the governor said, “Penalties are that you might be killing your granddad if you don’t do it.’’

– Jorge L. Ortiz

Seattle Archdiocese cancels mass, citing coronavirus outbreak

The Seattle Archdiocese on Wednesday suspended mass, effectively immediately, because of coronavirus.

Citing Washington Gov. Jay Inslee’s announcement that all gatherings of more than 250 people in three Seattle-area counties would be banned, Archbishop Paul Etienne shared in a video message that he’s asking every parish within the archdiocese to “suspend public celebration of the eucharist.”

Other dioceses and parishes across the U.S. — as well as churches of other denominations — have changed protocols at services, including many Catholic parishes opting to not serve wine during communion. Additionally, many churches are using technology as a way to communicate with congregants, from streaming services live online to sharing podcasts.

Etienne encouraged his parishioners to “pray with confidence, with faith, with hope that the Lord accompany us and protect us,” but also made sure to mention that they should “be very aware of the scientific facts at play in how the virus spreads.”

He also encouraged elderly parishioners to stay home and self-quarantine, if possible.

– Lindsay Schnell

Senate staff member tests positive, first case on Capitol Hill

A staff member working in Washington, D.C. for Senator Maria Cantwell, D-WA., tested positive for COVID-19, the senator's office announced Wednesday night.

“The individual has been in isolation since starting to have symptoms. On the advice of the Attending Physician, the senator has closed her Washington, D.C. office this week for deep cleaning and staff will be teleworking,” the statement said, explaining the senator will now be working remotely.

“The individual who tested positive for COVID-19 has had no known contact with the senator or other members of Congress,” the statement said. “The senator is requesting that testing be done on any other staffers who have been in contact with the individual and show symptoms.”

So far, this is the first known positive case of coronavirus on Capitol Hill.

There have been several U.S. lawmakers who have self-quarantined over fears of contracting the virus after interacting with individuals who had tested positive.

- Savannah Behrmann

JetBlue's business loss worse than 9/11

JetBlue's president, Joanna Geraghty, echoed fellow industry leaders who have said the drop in demand due to the coronavirus is not unlike the downturn airlines experienced after 9/11.

Geraghty said that so far it looks even worse. JetBlue is seeking to cut its capacity by 5% in the coming months, and Geraghty said the airline will consider further cuts as needed.

She also sought to reassure passengers fearful of getting infected on a plane.

"If you’re outside of the high-risk category," she told USA TODAY, "it’s as safe as anything else in your life."

– Curtis Tate

Coronavirus cover-up in China 'cost the world community'

National security adviser Robert O'Brien, a member of the coronavirus task force, accused Beijing of concealing the outbreak and hampering a faster response worldwide.

"Unfortunately, rather than using best practices, this outbreak in Wuhan was covered up," he said, referring to doctors who were silenced while trying to sound alarm bells over the coronavirus. "It probably cost the global community two months to respond."

Speaking at the conservative Heritage Foundation, O'Brien said that if teams from the WHO and CDC had earlier access on the ground in China, it would have "dramatically curtailed what happened in China and what's happening across the world."

– Courtney Subramanian

Markets tumble; tax deadline could be delayed

The Standard & Poor's 500 plunged again Wednesday, narrowly avoiding its first bear market since the financial crisis with a dip of 4.9%. The broad index is off about 19.2% from its Feb. 19 high. The Nasdaq Composite shed 4.7%, also off just under 20% from its record last month.

The Dow Jones industrial average dropped 1,464 points, entering a bear market, or a drop of 20% from its Feb.12 high. That marks its largest decline since the financial crisis.

Stocks have been swinging wildly for days, in large part over news of the coronavirus outbreak, and Wednesday's losses wiped out much of Tuesday's gains.

The Trump administration is weighing extending this year's April 15 deadline for filing income taxes to soften the outbreak's impact on U.S. households and businesses, The Wall Street Journal reported.

– Jessica Menton and Jazmin Goodwin

Coronavirus can live for hours or days, study finds

New tests reveal the coronavirus can live in the air for several hours and on some surfaces for as long as two or three days, though that doesn't necessarily mean people get infected by breathing it in or touching something that's contaminated.

The leading means of infection is still believed to be person-to-person contact.

University and U.S. government researchers simulated the effect of an infected person sneezing or coughing the virus into the air by using a nebulizer. They found the virus could be detected in the air up to three hours later and on plastic and stainless steel as much as three days later. The results were similar to those from tests done on the virus that caused the 2003 SARS outbreak.

“We’re not by any way saying there is aerosolized transmission of the virus,” but this work shows that the virus stays viable for long periods in those conditions, so it’s theoretically possible, said study leader Neeltje van Doremalen at the National Institute of Allergy and Infectious Diseases.

Arkansas reports first coronavirus case

Arkansas Gov. Asa Hutchinson confirmed the state's first case of coronavirus, a male currently at a hospital in Pine Bluff. The patient is being held in isolation, and the hospital and the Arkansas Health Department are gathering information about where he has traveled. He is reported to be stable and improving.

– Pine Bluff (ArkCommercial

Grand Princess to unload 1,000 passengers

The Grand Princess cruise ship was set to continue unloading passengers for a third day Wednesday in Oakland, California. As of Tuesday, 1,406 people had disembarked from the ship, leaving at least 1,000 still on board. Nineteen crew members who tested positive but "have been deemed asymptomatic" remain on the ship in isolated cabins, Princess Cruises said. The ship floated in limbo from Thursday, when 21 coronavirus cases were discovered on board, until docking in Oakland on Monday.

At least 30 cruise ships currently at sea with about 100,000 people list port destinations in the United States sometime this week, according to a USA TODAY satellite tracking analysis of 380 of the world’s largest cruise ships. It's not clear if all ports will be open to receive them.

Meanwhile, a proposal submitted to the White House by the leading cruise trade organization would deny cruise boarding to any person over 70 unless they are able to present a doctor's note verifying their fitness for travel, according to a person familiar with the situation but not authorized to speak publicly. Cruise Lines International Association (CLIA) submitted a plan to Vice President Mike Pence proposing enhanced measures across the industry. Coronavirus concerns have forced two ships of passengers into quarantine and escalating fears on others.

– Morgan Hines and David Oliver

G7 ministers to meet virtually instead of in Pittsburgh

The State Department said it would change a planned in-person meeting of G7 foreign ministers to a virtual session conducted by video conference. Secretary of State Mike Pompeo was scheduled to host the Group of 7 leaders – from Canada, France, Germany, Italy, Japan, the United Kingdom and the United States – in Pittsburgh on March 24-25.

– Deirdre Shesgreen

Massachusetts infections more than double

Gov. Charlie Baker declared a state of emergency after state health officials said the number of presumptive positive cases of coronavirus in Massachusetts is now up to 92, more than doubling in one day.

The state identified 51 new cases since Monday, Massachusetts Health Secretary Marylou Sudders said at a news conference with the governor. The vast majority, 70, are tied to a conference the biotech company Biogen held in Boston last month. Four are travel-related and 18 are under investigation.

Boston Mayor Marty Walsh said the Boston Marathon scheduled for April 20 is still on – for now. The annual St. Patrick’s Day Parade has been canceled.

– Joey Garrison

Germany: 70% of country could get coronavirus

German Chancellor Angela Merkel said 60%-70% of her country's population could eventually become infected with the coronavirus and that the key was to slow the spread as much as possible. The government has recommended the cancellation of all events with more than 1,000 people, among other measures.

Merkel said the focus should be on making sure the "health system not be overwhelmed," according to a translation from Deutsche Welle. "So, it's not the case that it doesn't matter what we do," she said. "First and foremost, it's about gaining time."

– William Cummings

Michigan reports first cases, declares state of emergency

In announcing Michigan's first two coronavirus cases Tuesday night, Gov. Gretchen Whitmer pledged to harness all of the government's resources to slow the spread of the virus. "We're Michiganders. We're tough," Whitmer said. "We know how to take care of each other. We will get through this, but for now, please make sure your family and friends are taking every preventative measure available to keep yourselves safe."

– Kristen Jordan Shamus, Detroit Free Press

National Guard rolls out in New York City suburb

The National Guard has been deployed to a New York suburb after Gov. Andrew Cuomo ordered schools, houses of worship and other large gathering places in a portion of New Rochelle to temporarily close. Cuomo announced a plan Tuesday to enforce a "containment area" of a 1-mile radius around the Young Israel synagogue at the center of the cluster, which includes part of the city of New Rochelle and stretches into the town of Eastchester, both of which are about 20 miles north of New York City in Westchester County.

Any large gathering places within that containment area will be required to shut down through March 25, Cuomo said. Westchester remains at the epicenter of New York state’s coronavirus outbreak with more than 100 confirmed cases. The National Guard will help residents under precautionary quarantine and help disinfect public areas, Cuomo said.

– Jon Campbell and Joseph Spector

Italy's deaths surge

Italy remained in a nationwide lockdown as confirmed coronavirus cases jumped past 12,000. The death toll stood at 827, second only to China, with rapid increases continuing.

Premier Giuseppe Conte said he will consider requests from Lombardy, Italy’s hardest-hit region, for a shutdown of nonessential businesses and public transportation on top of travel and social restrictions already in force. Conte said all stores except pharmacies and grocery stores would be closed nationwide.

Dozens of universities switch to online classes, tell students to stay home

In-person classes had been canceled at close to 100 universities by mid-afternoon Wednesday, according to a list maintained by Georgetown scholar Bryan Alexander. Across the country, dorms were emptying, fans were banned from sporting events, graduation plans were up in the air.

Elite schools such as Harvard, Princeton and Stanford and large schools such as the state and city universities of New York, UCLA, the University of California-Berkeley, the University of Maryland and the University of Washington are among dozens going virtual.

Even campuses that don’t yet have active cases of the virus have started to shut down their in-person offerings as the coronavirus spreads rapidly across the country.

On Wednesday alone, Duke University in North Carolina, Georgetown and George Washington universities in Washington, D.C., the University of Virginia, Pepperdine University in California, the University of Notre Dame in Indiana and others announced they would move to online instruction.

Tracking college closures:Colleges closing, going online due to coronavirus

– Chris Quintana

'Taped, from New York ...'

All New York-based late-night shows have adopted plans to tape episodes without studio audiences starting Monday as the spread of the coronavirus escalates.

Although they reported no specific cases of staffers afflicted by the virus, CBS's "The Late Show with Stephen Colbert," NBC's "The Tonight Show starring Jimmy Fallon" and "Late Night with Seth Meyers," HBO's "Last Week Tonight with John Oliver" and Comedy Central's "The Daily Show with Trevor Noah" say they will begin taping shows without an audience next week.

Earlier Wednesday, Walt Disney Co. confirmed that its own news and talk shows, including ABC's "The View" and "Good Morning America" and the syndicated "Live with Kelly and Ryan" and "Tamron Hall," will go audience-free indefinitely. So will NBC's "Today," as of Thursday.

– Anika Reed and Bill Keveney

More on the outbreak of COVID-19:

Map: Which states have coronavirus cases?

Here's a look at which U.S. states have reported cases of COVID-19:

What's the worldwide death toll?

The global death toll jumped to 4,630 early Thursday, according to a Johns Hopkins University data dashboard.

The total of confirmed cases was more than 126,000; more than 80,900 in mainland China, where the virus has killed more than 3,100 people.

The virus causes only mild or moderate symptoms for most people, such as fever and cough, but can progress to serious illness including pneumonia, especially in older adults and people with existing health problems. The WHO says mild cases last about two weeks, while most patients with serious illness recover in about three to six weeks.

Contributing: Steve Kiggins, USA TODAY; The Associated Press

More on coronavirus

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'Not good for the game':MLB players express concerns about impact of coronavirus

Is it safe to ride? Coronavirus fears are challenging public transit across US

Health or a paycheck?Workers with no paid sick leave face tough choice

COVID-19: Trump threatens to withdraw from World Health ...

President Donald Trump threatened to permanently cut U.S. funding to the World Health Organization and "reconsider" membership if the WHO does not adopt "major substantive improvements" within 30 days.

Trump's demands, made in a letter Tuesday to WHO Director-General Tedros Adhanom Ghebreyesus, are an escalation of his attacks on the organization. He accused the WHO of "repeated missteps" during the coronavirus pandemic and demanded it "demonstrate independence" from China.

'This will kill you':People warn others after Trump's apparent use of hydroxychloroquine

"My administration has already started discussions with you on how to reform the organization. But action is needed quickly. We do not have time to waste," Trump wrote in his ultimatum, which comes about a month after he froze WHO funding, pending a formal investigation into the international health body and its coronavirus response.

The letter lists Trump's allegations that the United Nations agency missed warning signs of the virus's spread, then blithely accepted China's lack of transparency over the outbreak. The WHO initially circulated preliminary Chinese claims that there was no clear evidence of human-to-human transmission of the coronavirus.

COVID-19:Health Secretary Alex Azar slams WHO as China backs coronavirus investigation

In his letter, Trump did not outline specific actions the WHO needs to take to satisfy his demands. Monday, Trump called the U.N. health body a "puppet of China."

Zhao Lijian, a spokesman for China's foreign ministry, said Trump's letter was "smearing and slandering China’s efforts in epidemic prevention." He called it a Trump administration attempt "to shift responsibility in its own incompetence in handling the epidemic."

The WHO said in a statement it was "considering the contents" of Trump's letter, but otherwise, it had no comment.

The organization has disputed claims from the Trump administration that it acted too slowly in sounding the alarm over coronavirus. Public health experts have long warned the agency is overly bureaucratic and in need of reform. Little evidence has emerged to substantiate accusations from Trump administration officials that the WHO deliberately acted in concert with China to obfuscate what it knew about the outbreak.

Monday, Ghebreyesus said he would launch an independent evaluation of the WHO’s coronavirus response "at the earliest appropriate moment." Chinese leader Xi Jinping said he would support an independent investigation into the pandemic, though it remains unclear whether any such review would probe the origins of the virus. Trump has speculated, without giving evidence, that the coronavirus escaped from a lab in Wuhan, China, where the virus emerged late last year.

The United States is the WHO's biggest donor. It paid $400 million to the WHO for 2018-2019, according to the organization's website. That money represents about 15% of the WHO's budget. When Trump said last month that he would temporarily freeze WHO spending, he said he would "channel" the money into other areas to combat the coronavirus outbreak. He has not provided specifics on that pledge.

Among the other accusations made in Trump's letter:

He suggested that the WHO, bowing to pressure from China, delayed an emergency declaration connected to the outbreak. (There is no known evidence for this claim.)

He highlighted the global health body's praise of China's government for its "transparency" with respect to the coronavirus, setting a "new standard for outbreak control." (True. The WHO has gone on record that it believes China has done a good job fighting the coronavirus.)

Trump accused the WHO of "inexplicably" opposing his closure of the U.S. border and travel ban from China. (The WHO has consistently argued for years against closing borders and travel bans during pandemics, saying such actions can exacerbate the spread of infectious disease. But it has not publicly questioned Trump's decision.)

He said the agency failed to publicly address accusations of "China's racially discriminatory actions" in China against African nationals. (True.)

Trump suggested The Lancet, a British medical journal, published a report in early December about a virus spreading in Wuhan. (False, according to The Lancet. Its editor said the first reports it published were from Chinese scientists Jan 24.)

Analysis: Trump halts funding to WHO. Experts say we need it now more than ever

The WHO held its annual general assembly online, which ends Tuesday. The forum was dominated by many of its 194 members pushing for a review of how the organization responded to the outbreak.

In an interview with the BBC, former Australian Prime Minister Kevin Rudd said it would be "grossly irresponsible in international humanitarian terms" for the United States to permanently withdraw its funding for the WHO because of its potential impact on poor countries around the world where the virus has yet to have its full impact.

"The WHO goes in and advises and/or provides direct material help with the setting up of health systems to deal with the crisis on the ground," he said.

Coronavirus in Iowa: A look back, March 16-22: Reynolds closes ...

Register staff

State and federal officials say there are simple, everyday steps you can take to avoid catching or spreading respiratory diseases, including COVID-19: Cover your coughs and sneezes, thoroughly wash or sanitize your hands and stay home if you are sick. Get more information from the Centers for Disease Control and Prevention at CDC.gov/coronavirus, or call 211, the Iowa Department of Public Heath's hotline, which is available 24 hours a day, seven days a week.

Personnel at health care facilities, schools, the state government and businesses in Iowa are taking a series of measures in response to the novel coronavirus, which causes a disease known as COVID-19.

► Looking for the latest? Here's what we know, March 23-29.

Here's the latest on what Iowans need to know:

Reynolds signs executive order closing salons, spas, tattoo parlors and more

March 22: Iowa's salons, barber shops, medical spas, massage therapists, tattoo shops and swimming pools will be closed until March 31, Gov. Kim Reynolds announced at a news conference Sunday.

She signed an executive order, which will take effect at 10 p.m. Sunday, she said. She has also suspended foreclosures on residential, commercial and agriculture properties.

Reynolds and DHS Director Kelly Garcia are also asking schools, churches and community centers that have space to open day care for children of essential workers, such as hospital staff and first responders.

The department will conduct an on-site visit to ensure it's age-appropriate, can accommodate groups of 10 children, and that all caregivers have passed background checks. The department will also help locate caregivers, Garcia said.

Iowa day care centers have not been ordered closed, but DHS has asked caregivers to do temperature checks of all children before check-in, remove all plush toys and to keep children far apart.

► Read the full story here.

Reynolds asks spring break travelers to self-quarantine for 14 days

March 22: In announcing Iowa's 22 new cases Sunday, Gov. Kim Reynolds said spring break and other travelers "should strongly consider" self-quarantining for 14 days. That extends to domestic and international travelers, she said.

"This will support Iowa's ongoing efforts to mitigate the spread of COVID-19, and limit the introduction of the virus from other points of travel," Reynolds said in a statement.

If school was in session, children would be returning back from spring break Monday. Many Iowa families still took their spring break vacations as planned.

On March 15, Reynolds recommended all schools close for four weeks.

Iowans turn to homemade masks, hospitals plead for donations

March 22: Nurses and other health-care workers across the nation and in Iowa have made pleas for donations of personal protective equipment as they face a nationwide shortage while trying to keep up with an influx of patients.

Joyce Flinn, director of Iowa Homeland Security, said Sunday the state has submitted a request to FEMA for protective medical supplies — based on needs at hospitals and other clinics — and is expected to receive a shipment Monday or Tuesday. The Iowa National Guard and the Iowa Department of Public Health has prioritized "hot zones" and will get the equipment to those areas "as quickly as the product comes in," she said.

Meanwhile, Iowans are volunteering during their self-quarantine time to sew homemade masks for hospitals to have as a back-up option and for non-profit organizations like homeless shelters that are also in need of protective masks during the shortage.

A Facebook group of seamstresses has grown to more than 600 members since it started Friday. They're connecting volunteers to organizations who have requested homemade masks.

►Read the full story here.

Another 22 positive cases in Iowa

March 22: There are 22 new positive cases of COVID-19 in Iowa, the Department of Public Health announced Sunday, bringing the total number of cases to 90 across 24 counties.

The new cases were reported in:

Cerro Gordo County — two adults 18- to 40-years-old

Dallas County — one adult 61-to 80-years-old

Dubuque County — two adults 18- to 40-years-old

Harrison County — two adults 61-to 80-years-old

Johnson County — two adults 18- to 40-years-old; one adult 41- to 60-years old; two adults 61-to 80-years-old

Kossuth County — one adult 18- to 40-years-old

Linn County — one adult 41- to 60-years old

Poweshiek County — one adult 81-years-old or older

Scott County — one adult 41- to 60-years old

Sioux County — one adult 61-to 80-years-old

Tama County — two adults 18- to 40-years-old; one adult 41- to 60-years old

Washington County — one adult 41- to 60-years old

Woodbury County — one adult 41- to 60-years old

► MORE:Here's a map of the coronavirus cases in Iowa

Johnson County mayors urge residents to stay home

March 22: Mayors in Iowa City, Coralville and North Liberty are asking residents to only leave their homes for essential items. They represent the state's third larges

The Johnson County mayors are also asking residents to strictly adhere to Gov. Kim Reynolds' order to restrict gatherings of 10 people or less and her guidance to self isolate for 14 days if returning from out-of-state for business or spring break vacation. The three mayors represent Iowa's third largest metropolitan area.

Their plea comes a day after Des Moines' mayor issued a similar voluntary "stay home, stay healthy" request to help stop the spread of the novel coronavirus.

UIHC asks for donated face shields

March 22: Leaders at University of Iowa Hospitals and Clinics have made an "urgent request" for face shields to protect all employees who interact with patients, visitors and coworkers as it works to fight COVID-19 in Johnson County — the epicenter of positive cases in Iowa.

The health system is asking businesses and individuals to donate new or used protective face shields.

UIHC currently has a supply of face shields for staff who provide patient care or do screenings at hospital entrances, but are wanting all employees to wear them.

According to a posting on its website, the protective face shields should be lightweight and adjustable, with a shield area that extends below the chin. Staff will disinfect any used face shields that are donated.

The hospital is also in "critical need" of N95 masks, isolation/surgeon masks, face masks with attached eye shields and isolation gowns.

Information on how to donate can be found on UIHC's website, UIHC.org/kind-donations.

► Read the full story here.

Metro orthopedic employee tests positive for COVID-19

March 22: An employee of Iowa Ortho, a metro orthopedic clinic, has tested positive for COVID-19, according to a statement from the company Friday.

The employee did not display symptoms while working on-site, the company said.

Iowa Ortho is working with public health officials to determine its next steps and will continue its enhanced screening measures and temperature checks of all patients coming in its Des Moines and Clive locations.

"We are proceeding with the utmost caution as the safety and well-being of our patients and staff is our top priority," the statement reads. " ... As essential health care workers, it is critical for our doctors and staff to continue to care for emergent and urgent orthopedic issues."

DHS: Keep kids at home, run fever screenings at day cares

March 22: The Department of Human Services released new guidance Friday, advising parents working from home to keep their children with them. It also directed day-care providers to take the temperatures of children as they arrive each morning, sending home those running fevers.

DHS also encouraged day-care providers to limit the number of people in a room to 10 or fewer; to keep children farther apart; and to report clusters of absences.

Parents and day-care operators across the state are grappling with how to care for their children while also attempting to reduce the spread of the novel coronavirus.

In other states where cases of COVID-19 are more widespread than in Iowa, child care centers have shut down statewide to stem the spread.

► Read the full story here.

First downtown Des Moines hotel closes

March 22: The Des Lux Hotel in Des Moines has closed temporarily because of the COVID-19 outbreak, making it the first downtown Des Moines hotel to close because of the coronavirus.

Other downtown hotels remain open with skeleton staffs and reduced amenities.

► Read the full story here.

Help us report this story

The news surrounding the coronavirus outbreak in Iowa is unlike anything the Register has covered. We'll be updating this story as news develops.

You can read what happened in central Iowa prior to this week regarding COVID-19 here.

You can help us report this story by letting us know how novel coronavirus is affecting your routine, your workplace and your day-to-day family life. We also take requests: Just tell us what you want to know. Send news tips to our online contact form, or call us at 515-284-8065.

More on the outbreak:

More on preventing the virus' spread:

More on the impact:

Iowa sees largest single-day spike in positive tests

March 21: Twenty-three more Iowans have tested positive for COVID-19 — the largest single-day jump in positive cases, according to the Iowa Department of Public Health.

There are now 68 cases of the novel coronavirus across 17 counties in the state.

Des Moines mayor asks residents to leave home only for essentials

March 21: Des Moines Mayor Frank Cownie has asked residents to voluntarily stay home — only leaving for essential items like groceries, medicine and health care — for at least two weeks to help reduce the spread of COVID-19 in Iowa's capital city.

He has also waived all enforcement at downtown parking meters, recognizing that downtown residents are likely parking on city streets as they work from home or have been laid off.

Cownie said the decision was made after consulting mayors from across the country who are considering or have implemented similar measures.

"I just think it's best practice and I'm hopeful that other mayors, county officials and other elected officials would follow suit," he said. "I think each day that we don’t take these kinds of measures we're threatened by the spread of this coronavirus pandemic.

"And I just think that advising anything different is a step in the wrong direction."

More: Read the entire news release

Loans available to small businesses

March 21: The United States Small Business Administration has issued a disaster declaration for Iowa, allowing "pandemic-impacted" small businesses to apply for low-interest loans, Gov. Kim Reynolds announced Saturday.

The Economic Injury Disaster Loans offer up to $2 million in assistance to small businesses and private, non-profit organizations that can be used to pay fixed debts, payroll, accounts payable or other bills.

The interest rate for small businesses is 3.75% for small businesses and for non-profits is 2.75%.

Applications can be made online at DisasterLoan.sba.gov/ela/. For questions, contact the disaster assistance customer service center at 1-800-659-2955 or email disastercustomerservice@sba.gov.

Meskwaki Tribe issues emergency declaration

March 21: The Meskwaki Tribe in Iowa issued an emergency declaration after members of the tribe tested positive of COVID-19 from community transmission on the Meskwaki Settlement, according to a Meskwaki Tribal Council news release.

"Tribal Council hereby determines and directs that all individuals residing on the Settlement shall shelter in place and shall not leave their homes unless going to and from grocery stores, pharmacies, or the Meskwaki Health Clinic effective March 21, 2020; and that all social, community, recreational, leisure, and sporting gatherings and events of more than 10 people are hereby prohibited at all locations and venues on the Meskwaki Settlement; and close the Meskwaki Settlement to outside visitors," the statement reads.

Auditor: Public funds can be used to promote businesses

March 21: Iowa Auditor Rob Sand said Saturday that public funds can be used to "encourage the public to patronize local businesses," such as printing flyers or using newspaper or radio ads that emphasize ordering take-out or delivery from local restaurants.

Such use of public money would generally raise red flags in an audit, however, Sand's office said during the novel coronavirus pandemic, it meets the "public purpose" test as a way to retain jobs.

The auditor says governments should follow three procedures: Record the public purpose prior to spending money, don't show favoritism to particular businesses and avoid conflicts of interest.

Local officials considering other unusual measures should first contact the auditor's office at drew.stensland@aos.iowa.gov.

Iowa National Guard cancels some plans, stands ready to help

March 20: The Iowa National Guard is postponing and canceling planned drill and training to minimize the possible spread of coronavirus, it announced in a news release Friday evening.

It has also closed the Iowa Gold Star Military Museum, the Camp Dodge Wellness Center and the USO. It canceled all armory and facility rentals through May 19.

The National Guard is prepared to send service members to help with coronavirus response "if necessary" to help with things such as storage, transportation and delivery of personal protective gear and providing tents to communities affected by the pandemic. Col. Michael Wunn said they may have orders to carry out those missions next week, but expects it would be a small-scale operation to help with transportation and logistics.

Nine of its service members are currently supporting the State Emergency Operations Center at Joint Force Headquarters in Johnston. The soldiers attached to the operations center are helping to coordinate with other state agencies that are leading the response to the spread of COVID-19, the disease caused by the coronavirus, Col. Wunn said.

Iowa suspends routine hotel, home bakery and restaurant inspections

March 20: The Iowa Department of Inspections and Appeals is temporarily suspending routine inspections of hotels, home bakeries, restaurants, bars, food trucks and other food establishments, it announced in a Friday evening news release.

Reynolds closed all bars and suspended dine-in options at restaurants on Tuesday as part of the state's effort to limit the spread of coronavirus.

The state department is also temporarily suspending inspections of food processing plants. It has a contract with the U.S. Food and Drug Administration to inspect those plants, but the FDA ordered it to stop.

It is also waiving late fees for businesses that need to renew their food licenses if the tardiness is during the governor's disaster proclamation. This does not affect current late fees.

Secretary of State reschedules upcoming special elections

March 20: Iowa Secretary of State Paul Pate announced on Friday that upcoming special elections in three Iowa counties will be rescheduled for Tuesday, July 7. Concerns over the spread of the novel coronavirus prompted the change, he said in a news release.

The Cedar Falls special election in Black Hawk County, the Craig special election in Plymouth County, and the Board of Supervisors special election in Woodbury County are now set for July 7, which is the first available date, according to release.

Pate said he consulted with county auditors before the decision and noted that under Iowa law the special elections can not be held within four weeks of the June 2 primary. Any absentee ballots that were already cast will be counted on July 7, Pate tweeted.

Additional COVID-19 case identified; total at 45

March 20: The Iowa Department of Public Health announced Friday it has been notified that another Iowan has tested positive for COVID-19, bringing the total number of known cases in Iowa to 45.

According to a news release, the person is between the ages of 41 and 60 and lives in Allamakee County.

Sen. Ernst requests 'immediate action' to help Iowans abroad

March 20: After multiple Iowans stranded in Peru during the coronavirus pandemic expressed frustration with a lack of communication from the U.S. Embassy there, wheels seem to be turning on getting them home.

U.S. Sen. Joni Ernst called for "immediate action" to get those stuck in Peru and elsewhere abroad returned quickly. Ernst's office said a letter she sent to Secretary of State Mike Pompeo urged him to act quickly to ensure the health and safety of these Americans.

Kohl's stores close nationwide

March 20: Beginning March 19, Kohl's announced it was closing all of its stores nationwide through April 1 "to support efforts underway to slow the spread" of coronavirus.

In a statement, the company said it was giving all of its store associates two week's pay to help them get through the period when they won't be receiving regular hourly wages.

The department store chain has four stores in metro Des Moines.

► More:Here's a map of the coronavirus cases in Iowa

Federal assistance available to Iowa cities, counties

March 20: Local governments in Iowa can apply for federal disaster funds to help pay for costs incurred while fighting the spread of COVID-19.

Cities, counties and some nonprofits can now request money from the Federal Emergency Management Agency after President Donald Trump declared a national emergency because of the pandemic last week.

Among other things, FEMA can offer funds to help governments build additional medical shelters, buy medical equipment, disinfect public facilities, pay for emergency operation center costs, procure and distribute food and medicine and cover overtime costs.

“This grant is designed to reimburse costs associated with emergency operations for jurisdictions and specified private nonprofit organizations that are on the front lines of the COVID-19 response,” said Melissa Spencer, deputy coordinator of the Story County Emergency Management Agency in a news release.

According to a fact sheet provided by Polk County officials, the state will receive the FEMA funds before disbursing them to the individual recipients. Governments have 30 days after the disaster declaration — until April 12 — to request the grants.

Iowa suspends property tax fee collections, evictions

March 20: Gov. Kim Reynolds on Friday suspended the collection of some fees on property taxes and halted most home evictions through a series of relaxed regulations aimed at helping Iowans impacted by the coronavirus.

Reynolds' office initially announced she was suspending the collection of property taxes as part of her orders, but her office later corrected that and said it was just for penalties and interest for property taxes.

Reynolds announced the temporary changes through a state public health emergency declaration that went into effect immediately.

The declaration pauses restrictions and regulations from certain statutes and other state rules. That includes suspending the collection of property taxes and related penalties and interest.

The order also suspends some evictions under the Iowa Uniform Residential Landlord and Tenant Act, or the Manufactured Home Communities or Mobile Home Parks Residential Landlord and Tenant Act.

Read more on the proclamation:Iowa suspends property tax fee collection, evictions; relaxes or extends deadlines on regulations in reaction to coronavirus outbreak

CORRECTION: The governor's office initially said Iowa was suspending property taxes, it later corrected that information. Iowa is suspending penalties and interest as it relates to the collection of property taxes. This article has been corrected.

UIU will hold virtual commencement ceremony

March 19: The Upper Iowa University in Fayette will now hold their commencement ceremony on May 9 as a virtual ceremony.

"I understand an in-person ceremony is preferred, but I also have no doubt that everyone would agree that the health, safety and welfare of our students, visitors and employees drive this decision," Duffy said. "To provide the graduates their much-deserved recognition, UIU is making arrangements to continue to celebrate this momentous occasion virtually."

As details become available, the school will post them on the commencement web page.

UI dentistry student tests positive for COVID-19

March 19: University of Iowa officials informed campus and community members Thursday that a dentistry student has self-identified as having tested positive for the novel coronavirus. It's the first COVID-19 case reported on campus.

In a letter sent Thursday to the UI community, school officials said others who had contact with the student have been notified of the test results. The student, who was last on campus March 12, also saw a dentistry patient while symptomatic, according to the letter. After learning of the results, school officials informed the Johnson County Public Health department. The student does not live on campus and is self-isolating, according to the letter.

"It is not the practice of Iowa Department of Public Health to notify employers or institutions of a positive case," the letter reads. "The university is able to share this news because the student self-identified, but the university will not be able to report each time a member of the UI community tests positive, moving forward."

Read the full letter and learn of campus resources here.

801 Grand building to undergo deep clean after COVID-19 exposure

March 19: A visitor to Principal Financial Group's downtown Des Moines office tested positive for COVID-19, leading to nearly 20 floors at 801 Grand to go through a "deep clean" starting tomorrow. The building is expected to

According to a notice sent to employees Thursday evening, all workers in the building are being required to self-quarantine for at least 14 days.

"We have alerted our downtown Des Moines employees and other tenants of the building," spokesperson Jane Slusark said in an emailed statement. "We have asked all Principal employees who work in the 801 Grand office complex to self-quarantine. We will also deep clean the Principal floors on Friday. A majority of Principal employees in Des Moines are already working remote and we have significantly limited visitors to our campus. Our top priority remains protecting our employees and their families, while continuing to serve our customers.”

Story County Sheriff's Office to take reports over the phone

March 19: The Story County Sheriff's Office announced it has closed to the general public and is changing how it responds to calls in light of the COVID-19 outbreak, according to a news release Thursday.

Deputies at the sheriff's office dispatch center are asking more questions when someone calls than is standard procedure, and are trying to take reports over the phone whenever possible. If a deputy needs to meet the caller in-person, they ask them to come outside their residence.

Similarly, the office asks for residents to do as much of their business online, by mail or by phone as possible. In-person meetings are by appointment only with the exception of attorney visits, bail bonds and warrant services, according to the release.

The Story County Jail is also taking measures limiting contact: all visitations, programming and classes in the facility have been canceled until April 1.

This doesn't mean all in-person services are suspended; first responders continue to work "around the clock" on public safety issues, according to the news release.

Des Moines Public Schools' Central Campus gets a deep clean

March 19: The Des Moines Public Schools cleaned Central Campus to disinfect surfaces and clean equipment.

While teachers were pitching in, the school's director Tascha Brown found gloves, masks, gowns and other supplies from the school's nursing program, marine biology program, and other science classes. She plans on donating the supplies to Unity Point.

Bridgestone plant to close for two weeks

March 19: Bridgestone is sending about 1,400 workers home from its Des Moines agricultural tire manufacturing plant for two weeks to prevent the spread of the coronavirus, said Steve Vonk, president of U.S. Steelworkers Local 310.

The shutdown begins at 6 a.m. Sunday, Vonk said, adding that Bridgestone is closing all North and South American facilities to protect the health of employees.

"They're really looking out for their employees," he said.

No employee at the Des Moines plant, which makes tires for farm equipment, has tested positive for the coronavirus, Vonk said.

More: New Iowa unemployment figures show slight rise, but don't reflect most coronavirus impact

Hy-Vee says it's adding window panels at checkout to protect employees, customers

Hy-Vee says the grocer is adding temporary window panels at checkouts to help provide an additional layer of protection for its employees and customers.

The panels are being installed at the checkout because it’s the point in the store where customers and employees are in the closest contact, the West Des Moines-based grocery chain said Thursday.

"In the aisles or at our service counters, customers and employees have more flexibility in placing distance between themselves, but the setup of the checkout limits that ability," Hy-Vee said in a news release.

The company said the panels are in place in its Des Moines-area stores, and will be installed in all other Hy-Vee locations over the next few days.

Additionally, Hy-Vee said it will no longer allow customers to bring in reusable bags, effective Friday. The company said it's not always easy to tell how clean the bags are, and stopping their use is another step the chain can take to help prevent the spread of the virus. The bag restriction will be in place until further notice.

Des Moines Public Library offering digital cards

March 19: The Des Moines Public Library tweeted Thursday that it has created digital cards for people who do not yet have a library card to sign up and access thousands of eBooks and Audiobooks. The card also includes streaming video and free digital access to the New York Times.

The library has also added eBooks and Audiobooks that are available to everyone, including those with library cards outside of Des Moines.

People who already have a Des Moines Public Library card do not have to sign up for the digital card, as they already have access to the library's services. People can sign up for the card at www.dmpl.org.

On Twitter, the library also encouraged people needing an internet connection to drive to its branches and use the branches’ WiFi connection from outside. Even though people aren’t in the buildings, the free internet will still be accessible.

Physician assistants have expanded abilities under new law

March 18: Gov. Kim Reynolds on Wednesday signed a bill that will expand the role of physician assistants in Iowa, a move she said will assist the state in the fight against novel coronavirus.

“As the state continues to combat the spread of COVID-19 and the strains it will place on our health care system, this will be yet another tool in our arsenal,” Reynolds said in a news release.

The bill, Senate File 2357, gives physician assistants the full ability to prescribe medicine, allows them to be reimbursed by Medicaid and gives them similar legal protections to other health care professions.

The Iowa Legislature passed the bill last week, prior to suspending the session for 30 days due to the spread of the virus.

University of Iowa closes dorms, cancels commencement ceremonies

March 18: Out of fear of exacerbating the spread of COVID-19, the University of Iowa, Iowa State University, the University of Northern Iowa and Simpson College are closing dorms, canceling spring commencement ceremonies and extending virtual classes through the end of the school year.

University leaders on all three campuses stressed the need for sweeping action in announcing the news.

The University of Iowa announced "sweeping efforts to keep campus safe," including closing dorms, canceling commencement ceremonies and extending virtual classes through the end of the school year. UI officials said the decision was made after receiving word of community spread in Johnson County.

Previously, all classes were scheduled to resume virtually Monday, and in-person classes were expected to start again after two weeks. Now classes will resume as virtual classes on March 30 and continue online for the remainder of the semester.

Dining halls and most residence halls — initially planned to stay open — will close Thursday. Exceptions will be made for students who cannot easily move off-campus.

Officials said they are working to organize an alternative commencement celebration.

More:University of Iowa, Iowa State, Northern Iowa cancel spring commencements, in-person classes for the semester in response to COVID-19's spread

Nine more COVID-19 cases confirmed; state total to 38

March 18: Nine more Iowans have tested positive for COVID-19, the respiratory illness caused by coronavirus, according to a news release Wednesday from Gov. Kim Reynolds' office.

This brings the total cases in Iowa to 38. The nine new cases also represent the largest single-day increase in positive diagnoses of COVID-19 since it was first found in Iowa on March 8. The prior biggest jump was on Tuesday, with six new cases.

The new cases include three residents of Johnson County; two residents of Polk County; two residents of Dallas County; and one resident each from Washington and Winneshiek counties.

Reynolds also announced a news conference for Thursday afternoon.

Sick Iowans denied coronavirus screenings

March 18: There are Iowans frustrated with what they say are testing criteria in the state that are jeopardizing human life in the pandemic. Meanwhile, when tests are completed, the state's public health department is releasing less information about the results than officials in some other states.

The Iowa Department of Public Health, the main agency tasked with overseeing the state's response to coronavirus, did not immediately return a request for comment Wednesday regarding complaints about the lack of testing.

In recent days, the department has provided general information about Iowa's testing capabilities.

Read the complete story here.

IDPH urges groups to donate extra health care supplies

March 18: The Iowa Department of Public Health is urging businesses and organizations to donate health care-related protective devices.

Department officials welcome any kind of personal protective equipment, or PPE, but especially gloves, gowns, eye protection and masks. Donations should be made through the local county public health department or emergency management office.

"This is an unprecedented public health disaster, and stocks of personal protective equipment for health care providers are being used rapidly," said Ken Sharp, division director of Acute Disease Prevention, Emergency Response and Environmental Health. "Any organizations that have extra PPE supplies that aren't immediately needed should consider donating them to help those on the front lines of this disease."

Hospitals in Cedar Rapids have already canceled non-essential surgeries for at least the next month in part to preserve medical supplies. Des Moines hospital officials have also warned about a lack of medical supplies.

Local health department contact information can be found here. County emergency management information can be found here.

Grassley criticized for using the term 'Chinese virus' to describe coronavirus

March 18: U.S. Sen. Chuck Grassley set off a round of criticism for his Wednesday morning tweet asking why China would be upset if people call the novel coronavirus the “Chinese virus.”

“I don’t understand why China gets upset bc we refer to the virus that originated there the 'Chinese virus' Spain never got upset when we referred to the Spanish flu in 1918&1919,” Grassley tweeted.

His critics on social media told Iowa's senior senator that the term has contributed to racism towards Asian Americans.

"China is attempting to shield itself from criticism for covering up the gravity of the coronavirus and silencing whistleblowers who tried to warn the world. Despite what the communist Chinese government may want, there’s no hiding that the coronavirus originated in Wuhan, China," spokesperson Michael Zona said in a statement.

President Donald Trump has used the terms “China virus” and “Chinese virus” to refer to the coronavirus and defended the language, saying he doesn’t believe it creates a stigma.

COVID-19, the respiratory disease caused by the coronavirus, was first linked to an outbreak in Wuhan, China, but has since spread around the world. The World Health Organization has declared the virus a pandemic, meaning a disease that has spread worldwide.

Iowa Board of Regents declares state of emergency amid pandemic

March 18: Following suit with the governor, the Iowa Board of Regents president declared a state of emergency Wednesday and immediately loosened restrictions around sick leave and family leave.

In announcing the state of emergency, the Iowa Board of Regents waived limits on the number of hours of accrued sick leave employees can use to care for an immediate family member and limits on using family leave to care for a child whose school or childcare center closed during the COVID-19 pandemic. Read more here.

IDOT relaxes expired driver's license, registration rules during emergency

March 18: The Iowa Department of Transpiration will grant leniency to people with driver's licenses and license plates which expired in the past two months after Gov. Kim Reynolds' Tuesday emergency proclamation to mitigate the effects of the COVID-19 outbreak.

Drivers' licenses and license plates which expired on Jan. 17 or later will be considered valid for as long as the emergency declaration lasts, IDOT said Wednesday.

Purchasers of vehicles also will not need to obtain a title and register their vehicle within 30 days during the emergency. People purchasing vehicles from a dealer will not be required to obtain license plates within 45 days, IDOT said.

Driver’s license and ID business is being conducted by appointment only to limit the number of people waiting in line. All non-commercial drive tests will be rescheduled.

Hy-Vee, Fareway dedicate shopping hour for elderly, others vulnerable to coronavirus

March 18: Starting Thursday, Hy-Vee will offer a special shopping hour from 7-8 a.m., seven days a week, for senior citizens ages 60 and older, expectant mothers and those who are considered to be at higher risk for serious illness.

On Tuesday, Fareway said the first hour of operation each day, 8-9 a.m., will be reserved for customers 65 and over, expectant mothers, people with serious medical conditions and "anyone with an underlying medical condition that increases the susceptibility to serious illness from COVID-19."

Both Iowa grocery chains said Tuesday they're cutting store hours to give employees more time to clean and restock shelves. Fareway will be open from 8 a.m. to 7 p.m. Monday through Saturday. Hy-Vee said its new store hours will be 8 a.m. to 8 p.m. seven days a week.

DPS says people may be charged with misdemeanors for holding gatherings of 10 or more people

March 18: The Iowa Department of Public Safety said Tuesday night that people may be charged with simple misdemeanors for violating Gov. Kim Reynolds' emergency proclamation to mitigate the effects of the COVID-19 outbreak.

A news release from the governor's office said the proclamation will be in place until nearly midnight on March 31.

Under the governor's order, restaurants will end dine-in services but can provide food and beverages through drive-thru, carry-out and delivery. Other facilities such as bars, gyms, theaters and casinos must close.

The prohibition includes events considered social, such as for community, spiritual, religious, recreational, leisure and sports-related purposes.

Under Iowa law, a simple misdemeanor is punishable by up to 30 days in jail and a fine between $65 and $625.

“As this public health event rapidly unfolds, we will continue to partner with law enforcement agencies across the state to uphold and respond to Governor Reynolds’ health and safety directives,” said Stephan Bayens, Iowa Department of Public Safety commissioner in a news release. “Together, we will all see this through.”

Beaverdale family trades books for toilet paper, gloves in little free library

March 17: Bob Meeley's little free library has been a source of joy to those who stumble upon it. Now it's something more.

On March 12, Meeley took the books out of the library and put in goods that have been in short supply since the coronavirus was labeled a pandemic. In the place of stories of adventure and intrigue are now rolls of toilet paper, wet wipes, Emergen-C, and gloves. At the top of the library is a sign that says "Flatten the Curve!" with a chart advocating for proactive measures to avoid stressing the health care system. Read the story here.

► More good news:Cedar Rapids business owners team up to make, give away hand sanitizer

Six new COVID-19 diagnoses brings total Iowa cases to 29

March 17: Six more Iowans have been diagnosed with COVID-19, the respiratory disease that can stem from coronavirus infection. It is the largest single-day jump in cases, and brings the total in Iowa to 29.

According to the Iowa Department of Public Health, three of the cases are residents of Johnson County, and one each from Adair, Blackhawk and Dallas counties. The news release did not specify their ages, genders or if they had traveled to high-risk countries, been in contact with other people identified as infected with coronavirus or if they were instances of community transmission, the term for when a case has no easily identifiable point of origin.

Amy McCoy, a policy adviser for the IDPH, said at this point in the virus' spread, trying to pinpoint the source of the infection isn't as important as mitigating the spread. She emphasized the need for social distancing and other individual actions to prevent its spread.

► MORE:Here's a map of the coronavirus cases in Iowa

Photos: Downtown Des Moinies' Court Avenue closed on St. Patrick's Day

Hy-Vee making changes to stem coronavirus' spread

March 17:Hy-Vee is shortening its hours, closing the dine-in portion of its restaurants and suspending its weekly coupon ads.

The company announced Tuesday the grocer will only be open from 8 a.m. to 8 p.m., saying it will use the extra to more thoroughly clean the store. In compliance with Gov. Kim Reynolds’ order earlier in the day, Hy-Vee will not allow diners to eat in the store. It is also closing the Market Grille bar.

Customers also will not be able to order food directly from Hy-Vee’s Aisle Online program. Any shoppers who want groceries delivered will need to order through apps like Shipt and Door Dash. In its news release, Hy-Vee said this will allow workers to focus on pick-up orders and the needs in the store.

Hy-Vee is suspending the weekly coupon ads in newspapers because it cannot guarantee local stores will have those items in stock. The company already printed some of those ads, which consumers may see this weekend. Hy-Vee says it will still honor those advertised sales.

“This is an unprecedented situation for all of us,” Randy Edeker, Hy-Vee’s chairman, CEO and president, said in a statement. “We’ve never dealt with anything like this before, and we know our customers haven’t, either. We appreciate their patience and loyalty as we navigate these changing times.”

Coronavirus patients discharged from hospitals

March 17: At least two coronavirus patients have been released from Iowa hospitals.

A coronavirus patient who had been hospitalized at the University of Iowa Hospitals and Clinics in recent days has been discharged. Molly Rossiter, a spokeswoman for the Iowa City hospital system, confirmed the information Tuesday.

Rossiter did not release any other information about the patient, including whether the patient has recovered.

The University of Iowa Hospitals and Clinics announced Sunday that its latest patient was admitted. The hospital system is separately treating another patient who tested positive for coronavirus. That patient was admitted on March 11, according to the hospital.

In a news release, it said the individual was infected with the virus through community-acquired transmission, another term for “community spread” that is used to describe infections from an unknown source. At a news conference on Tuesday with Johnson County public health officials, Mercy Iowa City spokeswoman Margaret Reese said its hospital system has been treating two coronavirus patients. One has been discharged, according to Reese. She did not provide more information.

More:As UIHC treats second patient with COVID-19, staff ramp-up screening, start a hotline

DMARC hands out food to families

Des Moines Area Religious Council gave bags of food to families in the Carver Elementary parking lot. Many area public school children rely on the school system for meals. When the schools closed to prevent the virus from spreading, many lost access to that meal.

Cedar Rapids hospitals suspend non-urgent surgeries

March 17: Elective surgeries are being suspended as of Thursday at four prominent health care providers in Cedar Rapids to both prevent the spread of the coronavirus and preserve medical supplies.

“We’re getting down to critical volumes (of supplies), and it's a little uncertain when it can all be replenished,” Dr. David P. Hart, the chief medical officer and board president of the Physician’s Clinic of Iowa, said. “We don't know how bad this can get, and we just want to be prepared and to make sure we have enough supplies if things do get worse.”

The suspended surgeries include things like carpal tunnel and hip and knee replacement. Urgent procedures will still be done, Hart said. Even so, he expects this will affect hundreds of patients. The suspension is slated for at least a month, with officials revisiting the policy weekly.

The decision was jointly made by officials at UnityPoint Health – St. Luke’s Hospital, Physician’s Clinic of Iowa, Mercy Medical Center and the Surgery Center of Cedar Rapids. Mercy Medical Center is unaffiliated with MercyOne Des Moines Medical Center.

More:Des Moines hospital official warns: 'We do not have enough of supplies' to combat coronavirus

DART waving bus fares

March 17: Starting Tuesday, the Des Moines Area Regional Transit Authority is waiving bus fares in an effort to curtail the spread of the novel coronavirus.

The metro’s public transportation provider won’t accept cash, bus passes or tickets, DART said in a news release on its website.

Beginning Wednesday, bus riders will also be instructed to get on and off the bus via the rear doors, away from the driver.

DART also encouraged riders to practice social distancing: staying 6 feet apart, remaining at home when sick and only taking the bus to go to work or other location that’s absolutely necessary.

On Sunday, the authority began cleaning its buses daily with an antiviral cleaning agent recommended by the Centers for Disease Control and Prevention. Staff have cleaned the buses at the end of the service day.

Corteva says one employee in Johnston tested positive for coronavirus

March 17: Corteva Agriscience said Tuesday an employee at its Johnston campus has tested positive for COVID-19.

The seed company said it’s identifying and reaching out to people who “had close contact with the impacted employee, advising self-quarantine."

"We have informed the appropriate public health officials, the employee is quarantined, and we are working to support the employee and their family at this time," the company said in a statement.

"Within our offices, following guidelines from the Centers for Disease Control and Prevention and other local authorities, as well as our own policies, we have taken significant actions to contain any potential spread."

Corteva, the new parent of Pioneer seed, said it's cleaning and disinfecting the site as needed as well. “The health and safety of our employees is our top priority," the company said.

Fareway stores restrict operating hours

March 17: Fareway supermarkets announced that beginning Wednesday, they will limit their hours to 8 a.m.-7 p.m. Monday through Saturday because of the coronavirus outbreak.

In a statement, Fareway communications manager Emily Toribio said the reduced hours will allow extra time for cleaning, sanitation and restocking.

In addition, she said the first hour of operation each day, 8 a.m.-9 a.m., will be reserved for customers 65 and over, expectant mothers, people with serious medical conditions and "anyone with an underlying medical condition that increases the susceptibility to serious illness from COVID-19."

 National Guard deployments to go forward

March 17: Deployments announced by the Iowa National Guard prior to the pandemic will move forward as scheduled, a spokesperson said Tuesday.

About 680 Iowans from two units who received their deployment orders within the last six weeks will leave in May and June, Col. Michael Wunn said.

In late May, the 133 Infantry Battalion out of eastern Iowa — also known as the Ironman Battalion — will deploy about 550 soldiers to Operation Spartan Shield in U.S. Central Command, located in the Middle East, Wunn said.

Coming from armories in seven communities — Charles City, Davenport, Dubuque, Iowa City, Iowa Falls, Oelwein and Waterloo — this deployment is expected to last a year. Their mission will still involve security and “force protection operations,” as a news release previously announced.

In June, two troops from the 113th Cavalry Regiment will deploy about 130 soldiers to Operation Enduring Freedom in U.S. Africa Command.

Also lasting a year, this deployment will include 90 soldiers from Le Mars, Iowa, and 40 from Johnson. These troops will help with “military operations, exercises and security cooperation activities on the African continent, its island nations and surrounding waters,” as a news release previously announced.

Full-time staff members of the Iowa National Guard are following travel restrictions announced Monday by the Department of Defense, which limits military and personal travel to just “mission essential” or personal hardship trips, including funerals and family emergencies. Traditional guardsmen are not subject to the personal travel restrictions, but the Guard has significantly restricted training, conferences and any events that can be delayed or postponed.

“This is a very fluid situation,” Wunn said, adding that they are making decisions every day based on recommendations from the Iowa Department of Public Health, the CDC and the Department of Defense.

“We will protect the health of the force and make sure they are being taken care of while doing what we can to stop the spread,” Wunn said. “And we will balance that with our focus on mission readiness in case we need to support the Governor as well as the strict timeline our forces are on to prepare for deployment.”

The Iowa Gold Star Military Museum and the Wellness Center at Camp Dodge will be closed to the public by the end of the day Tuesday, though Camp Dodge will remain open, Wunn said.

The Guard is currently looking at events scheduled to take place at armories across the state and accessing next steps with organizers.

Reynolds prohibits gatherings of more than 10 people, closes theaters, casinos, restaurants, bars

March 17: Iowa Gov. Kim Reynolds is closing restaurants, bars and other recreational facilities in Iowa for two weeks in an effort to restrict the spread of coronavirus.

Reynolds made the announcement in a news release Tuesday. The order goes into effect at noon and continues until March 31.

The news release says the governor has issued a State of Public Health Disaster Emergency, a proclamation designation that allows her to take these actions.

Restaurants will be able to provide food through drive-through, carry-out and delivery only. Bars and other facilities like gyms, theaters and casinos will close.

Iowa lawmakers grant Gov. Kim Reynolds expanded power

March 17: The Iowa Legislature has suspended its session for 30 days after passing legislation early Tuesday morning to keep the government running and grant Gov. Kim Reynolds expanded powers to combat the spread of the novel coronavirus.

The bill, unanimously passed by lawmakers just after midnight, grants Reynolds, a Republican, increased ability to transfer spending between state agencies and departments, giving her flexibility to allocate funds where needed. It also allows her to tap 10% of the state's $200 million Economic Emergency Fund to deal with the coronavirus.

The bill also waives schools' requirement to make up class days canceled as a result of the virus and passes a supplemental appropriation for some state programs, including $525,000 for processing COVID-19 test kits at the State Hygienic Lab at the University of Iowa.

More:Iowa lawmakers grant Gov. Kim Reynolds expanded power as they suspend legislative session due to coronavirus

More:Iowa waives 4 weeks from school year as classes stop for coronavirus

Urbandale Community School District employee tests positive for COVID-19

March 16: An employee of the Karen Acres Elementary School in Urbandale has tested positive for COVID-19 and is currently in quarantine.

The employee, who is not being identified by the school district out of concerns for confidentiality, has sought medical attention, according to a notification from the Urbandale Community School District. The notice did not specify the person’s condition.

The district also announced that all of its schools would be closed beginning March 16 for four weeks, adhering to the recommendation from Gov. Kim Reynolds. The closure includes cancellation of all school-related programming, activities, athletics, Adventuretime and community education classes. Under current plans, students would return to school on Monday, April 13.

There have been 23 known cases of coronavirus in Iowa. Some of the cases involve people who do not know how they contracted the virus, and some of those infected have had to be hospitalized. COVID-19 is the respiratory illness caused by the virus. It is unclear if this employee is part of that 23 or if the person is an additional case.

More:Urbandale district employee tests positive for coronavirus

Des Moines-area YMCAs completely shut down for 15 days

March 16: The six membership branches and the Y-Camp serving the greater Des Moines area will shut down for 15 days, officials announced Monday night.

No coronavirus cases have been linked to a YMCA facility, but its leadership is following federal, state and local health officials' guidance to try to slow its spread, Ruth Comer, the YMCA's vice president for marketing and communications wrote in an email.

It had previously canceled all group fitness classes, personal training sessions, youth programming and facility rentals and suspended Learn and Play centers and guest passes.

Full-time staff will remain employed during the closure. President and CEO of YMCA of Greater Des Moines Leisha Barcus asked members to pay dues and register for future programs as they're able to help it operate once the crisis passes.

Des Moines Water Works suspends water shutoffs

March 16: Des Moines Water Works, which provides drinking water to most of the Des Moines metro area, announced Monday that it would stop shutting off the water service of delinquent ratepayers.

Water needs to be available to help residents sanitize, which will hopefully slow down the spread of the novel coronavirus, the utility said in a news release. The suspension is temporary.

Des Moines Water Works’ water remains safe to drink, the release said. COVID-19 hasn’t been detected in drinking water, and water works’ treatment practices kill viruses. There’s also no need to boil tap water.

The U.S Environmental Protection Agency said, “Americans can continue to use and drink water from their tap as usual.”

Starting Tuesday, water works will also prohibit walk-in customers at its general office building on George Flagg Parkway. In-home visits, except for emergencies, will also be suspended.

Water customers can pay online at dmww.com, by phone at (515) 283-8700, at the office’s dropbox, by mail or at pay stations at local Hy-Vee or Wal-Mart stores.

The utility has also started “stockpiling” chemicals, repair parts and other equipment to ensure the production and distribution of safe drinking water, the news release said.

Iowa DOT may make customers wait in cars, encourages appointments

March 16: The Iowa Department of Transportation is encouraging people to postpone in-person services and, if unavoidable, for customers to make an appointment before visiting.

Many services, including renewals, address changes and certified copies of driving records, are likely available online. To view those services, or make an appointment, visit https://mymvd.iowadot.gov/. Customers can also call 515-244-8725.

Officials hope appointments will reduce the number of people waiting at the service centers. Staff will watch the size of groups in the waiting areas and may ask people to come back another time or wait in their vehicles if the room becomes crowded, according to a news release.

Staff will also ask customers questions designed to evaluate their risk of exposure to the coronavirus and risk of exposure to other customers. If someone is determined to be a “heightened risk,” they will be asked to delay their visit. The news release did not specify what criteria will be used to make that judgment.

DOT staff are also instructed to increase how often they clean and disinfect the facilities.

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A fourth Covid-19 shot might be recommended this fall, as officials ...

(CNN) As the world approaches the second anniversary of the declaration of the Covid-19 pandemic by the World Health Organization, on March 11, more nations are rolling out -- or are discussing the possibility of -- fourth doses of coronavirus vaccine for their most vulnerable. In the United States, leading public health officials say they are "very carefully" monitoring if or when fourth doses might be needed.

Israel was the first nation to roll out fourth doses , announcing in December that adults 60 and older, medical workers and people with suppressed immune systems were eligible to receive the extra shot if at least four months have passed since their third dose.

More recently, the Public Health Agency of Sweden announced last week that second booster doses are recommended for everyone 80 and older in the country. The United Kingdom's Department of Health and Social Care announced Monday that an extra booster dose of coronavirus vaccine will be offered in the spring to adults 75 and older, residents in care homes for older adults and immunosuppressed people 12 and older.

In the United States, health officials emphasized late last year that fourth doses were not yet needed and said it was too premature to be discussing a potential fourth dose of coronavirus vaccine for most people.

Now, the US Food and Drug Administration "is indeed continually looking at the emerging data on the pandemic and variants in the United States and overseas in order to evaluate the potential utility and composition of booster doses," FDA spokesperson Alison Hunt wrote in an email to CNN on Friday.

She confirmed that although Dr. Peter Marks, director of the FDA's Center for Biologics Evaluation and Research, has noted that there is still much uncertainty as to how the pandemic may further evolve, he also has said it is possible that a fourth dose might be recommended as we move into fall.

A fall timeline coincides with the administration of flu shots, which could be convenient for people and makes sense scientifically because respiratory viruses -- like the coronavirus and influenza -- tend to peak in the winter months that follow.

"As more data become available about the safety and effectiveness of COVID-19 vaccines, including the use of a booster dose, we will continue to evaluate the rapidly changing science and keep the public informed," Hunt wrote. "Any determination that additional booster doses are needed will be based on data available to the agency."

If or when the FDA authorizes a fourth dose for the public, the next step would be for the US Centers for Disease Control and Prevention to review the data before making a recommendation for use, as the agency has done for other coronavirus vaccine recommendations.

'Vaccination and boosting will be critical'

The United States has seen significant improvements recently in Covid-19 cases, hospitalizations and deaths. As of Friday, cases were down 44% from the prior week, hospitalizations dropped 26%, and deaths were 13% lower, according to Johns Hopkins University data.

"Vaccination and boosting will be critical in maintaining that downward trajectory, particularly when you're talking about the red curve of severe disease leading to hospitalization," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said during a White House Covid-19 Task Force briefing Wednesday.

The "potential future requirement" for an additional boost or a fourth shot of the Pfizer/BioNTech or Moderna mRNA vaccines or a third dose of the Johnson & Johnson vaccine "is being very carefully monitored in real time," Fauci said. "And recommendations, if needed, will be updated according to the data as it evolves."

JUST WATCHED Immunocompromised denied fourth dose despite CDC approval Replay More Videos ... MUST WATCH Immunocompromised denied fourth dose despite CDC approval 02:52

The CDC has no recommendation of fourth doses of coronavirus vaccine for the general public, but the agency updated its guidelines in October to note that certain people who are moderately or severely immunocompromised may receive a fourth dose of the Moderna or Pfizer/BioNTech vaccines.

"For the immunocompetent people, a single booster shot continues to provide high levels of protection against severe disease caused by Omicron," Fauci said Wednesday. "This should not be confused with the fact that for many immunocompromised people, already a second booster shot -- namely a fourth dose of an mRNA -- is recommended because of what we know about their poor response to the initial regimen."

Meanwhile, vaccine makers continue to study fourth doses in broader populations.

'We recognize the need to be prepared'

Pfizer announced in January that it has been studying the safety and efficacy of a fourth dose as part of its ongoing study of an Omicron-specific coronavirus vaccine among healthy adults ages 18 to 55.

For that study, participants have been separated into three cohorts. One includes 600 people who got three doses of the current Pfizer/BioNTech coronavirus vaccine before enrolling in the study. As part of the research, they will receive either a fourth dose of the current vaccine or a dose of the Omicron-based vaccine.

"While current research and real-world data show that boosters continue to provide a high level of protection against severe disease and hospitalization with Omicron, we recognize the need to be prepared in the event this protection wanes over time and to potentially help address Omicron and new variants in the future," Kathrin Jansen, senior vice president and head of vaccine research and development at Pfizer, said in the company's announcement of the study.

study published by the CDC last week showed that protection against Covid-19 hospitalization and emergency department or urgent care visits is much higher after a third vaccine dose than a second dose but that protection wanes with time.

With the Omicron variant dominant in the United States, vaccine effectiveness was 87% against Covid-19 emergency department or urgent care visits and 91% against hospitalizations in the two months after a third dose. Effectiveness fell to 66% and 78%, respectively, by the fourth month, the data showed.

"Nonetheless, the level of 78 is still a good protective area," Fauci said Wednesday.

Dr. Christopher Murray, director of the University of Washington's Institute for Health Metrics and Evaluation, told CNN on Friday that he thinks having a fourth dose "makes very little sense" right now -- but possibly makes more sense this upcoming fall or winter.

"Because Omicron is going away," he said, "third dose immunity wanes, and so fourth dose will probably wane as well. So we would want to time a fourth-dose push for when either there's a new variant or for next winter. So I think right now, unless you're immunocompromised or you're older, unless you have some personal risk, it doesn't make a lot of sense."

The research showing some waning immunity after a third dose has led to more discussion around if or when fourth doses could be needed.

"Just like with everything else, the health departments look at this data that's coming out and wait for guidance from the CDC and from the drug manufacturers. The drug manufacturers have been monitoring vaccine effectiveness," Lori Tremmel Freeman, chief executive officer of the National Association of County and City Health Officials, told CNN on Friday.

The timing for fourth doses not only depends on waning immunity "but also depends on whether we see any more variants emerge and what we discover in terms of additional vaccine effectiveness for any emerging new infections," Freeman said.

If fourth doses are needed, "health departments would go into the mode of preparing to administer the fourth dose in the way they have done previous doses," Freeman said. However, of greater concern among local public health officers is the slow -- and declining -- pace of people completing their third doses, she said.

Get CNN Health's weekly newsletter Sign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team.

About 65% of the US population is fully vaccinated with at least their initial series, and about 28% of the population has received a booster dose, according to the CDC, as of Friday. But the pace of booster doses being administered has dropped to one of the slowest rates yet.

"As time goes on, if there is the necessity of a fourth dose, we're already behind with people getting the third dose," Freeman said. "So all of a sudden, we could have a fairly large segment of the population that is not up to date on vaccines because they're behind by two doses, potentially, and more people could get sick."

Coronavirus China travel advisory: Info on flights, cruises, more

On Thursday, the rapid outbreak of coronavirus prompted the U.S. State Department to issue a level 4 travel advisory ("Do not travel") – its most severe warning – for the entire country of China, one week after it did so for Hubei Province, where the virus' epicenter, Wuhan, is located.

The move followed the World Health Organization's decision to declare coronavirus, which Chinese officials say has been diagnosed in 9,800 people and killed 213 , a global health emergency.

In the State Department's advisory, the agency notes: "Travelers should be prepared for travel restrictions to be put into effect with little or no advance notice," and recommends that those currently in China "consider departing using commercial means."

Late Friday, the Donald Trump administration declared the coronavirus to be a public health emergency in the United States, though he and aides downplayed the threat of the virus to Americans.

"The risk of infection for Americans remains low," said Alex Azar, secretary of Health and Human Services and chairman of the coronavirus task force set up by Trump. "We are working to keep the risk low."

USA TODAY has pulled together answers to questions travelers may have about traveling during the outbreak.

Coronavirus: Everything you need to know the deadly illness alarming the world

Which airlines have cut or reduced service to China?

On Friday, Delta suspended all flights to China from Feb. 6 through April 30, and American halted service through March 27. United later followed suit, saying it, too, would suspend operations from Feb. 6 through March 28.

Delta: Friday's decision made Delta the first domestic carrier to suspend all service to China. It will halt service until April 30. Earlier this week, it initially said it was planning to cut its flights in half.

American: Not long after Delta made its announcement, American followed, saying it is suspending operations to and from mainland China effective Friday through March 27. The carrier said it will continue to evaluate the schedule from March 28 onward.

United: United joined the other U.S. carriers, suspending operations between its U.S. hub and three mainland Chinese cities – Beijing, Chengdu and Shanghai – from Feb. 6 until March 28. The carrier said it would continue to operate one daily flight from San Francisco to Hong Kong.

International carriers that have suspended service to China include:

British Airways

Cathay Pacific Airways (Hong Kong)

El Al (Israel)

Finnair (Finland)

Iberia (Spain)

Jetstar Asia (Singapore)

Korean Air Lines

Lion Air (Indonesia)

Scandinavian Airlines

Swiss

I already booked a flight. What do I do now?

The three U.S. carriers that offer direct service to China – United, Delta and American – have all issued flight waivers for passengers whose plans have been scuttled by the coronavirus outbreak , allowing them to postpone or cancel plans without the usual penalty.

Delta: Covers travel to, from or through Beijing and Shanghai through April 30.

American: Covers travel to, from and through Beijing and Shanghai through March 27.

United: Covers travel to, from and through Beijing, Shanghai and Chengdu through March 31. (The waiver period for Wuhan ends March 29.)

The latest waiver information: What to do if your flight has been affected

Should I wear a face mask when flying even if I'm not going to China?

While the CDC does not discourage healthy people from wearing surgical masks as a precaution, the agency is only recommending their use for patients thought to have the virus and the medical professionals who interact with them.

Because most coronaviruses are spread through airborne droplets (sneezing or coughing), touching or touching an infected surface, hand washing is an effective way of reducing the potential for infection.

A pilot's perspective on coronavirus: Should you wear a surgical mask?

How often do they change air filters on planes?

Usually, the main HEPA (High-Efficiency Particulate Air) filters are changed when the airplane is in maintenance, which is about once a month. This can vary from airplane type to airplane type and airline to airline.

What are U.S. airports doing to screen for coronavirus?

Earlier this week, the Centers for Disease Control confirmed that it is expanding its screening efforts of passengers from China from five airports to 20, aligning with the CDC's existing quarantine stations that cover all 50 states and Puerto Rico.

Los Angeles International San Francisco International Chicago O'Hare New York JFK Atlanta Hartsfield-Jackson International Houston George Bush Intercontinental Dallas-Fort Worth International San Diego International Seattle-Tacoma International Honolulu International Anchorage Ted Stevens International Minneapolis-St. Paul International Detroit Metropolitan Miami International Washington Dulles International Philadelphia International Newark Liberty International Boston Logan International El Paso International Puerto Rico's San Juan Airport

What do the airport screenings entail?

Travelers flying from China to one of the 20 airports will be asked to fill out a short questionnaire about their travel, any symptoms and contact information.

CDC staff will also take travelers' temperatures with a handheld thermometer that doesn't touch the skin and watch for signs of a cough or difficulty breathing.

In the case of travelers who appear sick, the CDC will evaluate them further to determine whether the passenger should be taken to a hospital for further care. However, the first two U.S. cases, in Seattle and Chicago, involved travelers who didn't show symptoms at the airport.

These are the 20 U.S. airports screening for the coronavirus: Here's what it entails

What are cruise lines doing to screen for coronavirus?

Following the WHO decision classifying coronavirus as a global health emergency, Cruise Lines International Association, the trade association that represents most of the cruise industry, said in a statement Thursday that its member cruise lines have suspended crew movements from mainland China and will deny boarding to any passenger or employee who has traveled from or through mainland China within the past 14 days.

CLIA added that its members' ships are required to have medical facilities, staffed around the clock by licensed doctors and nurses to provide initial medical care in the event of illness or disease transmission, in addition to medical staff onshore.

Coronavirus: Cruise ships to deny boarding to anyone who has recently been in China

CLIA members include many major ocean lines, including Carnival Cruise Line, Celebrity Cruises, Costa Cruises, Crystal Cruises, Cunard Line, Disney Cruise Line, Holland America, MSC Cruises, Norwegian Cruise Line, Princess Cruises, Regent Seven Seas, Royal Caribbean, Seabourn, Silversea Cruises, Virgin Voyages and Windstar Cruises.

Cruise Critic has a list of updates from nearly every cruise line on what they're doing to protect passengers.

Italy's Costa Cruises had its health and safety protocols tested Thursday when a passenger of Chinese nationality sailing aboard the Costa Smeralda cruise ship appeared to be symptomatic. The entire ship – and its 6,000 passengers – was put on lockdown in Civitavecchia, Italy, for the better part of a day while health officials collected samples and ran tests. In the end, the passenger was diagnosed with the common flu, and the rest of the passengers were allowed to disembark that evening.

Meanwhile, Cruise Critic reported Friday that local tribal chiefs in the South Pacific have closed the ports of Lifou and Mare, both located in the Loyalty Islands, to cruise ships out of concerns over coronavirus.

Not coronavirus: 6,000 cruise ship passengers given OK to disembark after passenger diagnosed with flu

Are theme parks in China closed?

Hong Kong Disneyland and Shanghai Disney Resort have both been closed since the weekend of Jan. 25-26 as a precaution to help prevent the spread of the virus.

Contributing: Dawn Gilbertson, Curtis Tate, John Bacon, USA TODAY; Associated Press

Coronavirus in Iowa: A glimpse at some lives in the age of coronavirus

At first, the impact of the novel coronavirus to Iowa was minor.

State public health officials suggested Iowans practice good personal hygiene to stop the spread of the virus. Officials said the risk was low for contracting the respiratory illness that can be mild in some people but serious in others. The few Iowans who had been tested for the virus didn't have it.

Then three people tested positive for the illness, Gov. Kim Reynolds announced on March 8. That number increased to eight cases by Monday and 13 by Tuesday. By Friday night, 17 Iowans had tested positive for the disease.

The virus has continued to spread across the country and around the world, hitting the famous and the unknown. Globally, it's infected more than 140,000 and caused more than 5,000 deaths.

In Iowa, some school districts, including Des Moines Public Schools, extended spring break, while colleges temporarily canceled in-person classes. Businesses told employees to work from home. And concerts and professional sporting events that typically draw crowds of thousands were canceled, postponed or closed to fans.

Responses to the spread of coronavirus are playing out in many different ways for Iowans. State officials are assessing emergency preparedness and tracking cases. Frontline medical workers are planning for worst-case scenarios. And regular Iowans — from the slightly inconvenienced to the wholly disrupted — are trying to make sense of it all.

Here is a glimpse of life in Iowa in the age of coronavirus:

'It’s a lot of pressure, and I put a lot of pressure on myself'

Monday started like any other day for Joyce Flinn, with a walk alongside Victor, her 10-pound dog.

But Flinn was up extra early. She needed to get to work.

The night before, she helped coordinate an alert to key Iowa state officials. It popped up, like a text message: Reynolds had called for full activation of the state’s emergency operations center. Minutes earlier, the governor had announced the first three confirmed cases of coronavirus in the state.

“You need to be prepared to have a representative there at eight o’clock Monday morning,” the directive concluded.

Flinn, Iowa's Homeland Security and Emergency Management director, leads that center. She and her staff are now at the epicenter of coordinating Iowa’s response to a virus that has upended daily life around the world. The World Health Organization has declared the virus a global pandemic as the number of cases grows daily.

“I'm pretty confident where we are right now,” Flinn said Thursday. “But I also know with every disaster, things change quickly. So we'll just have to be ready to punt, and adjust as new information comes out.”

Flinn has been in preparation mode for weeks. Her work is now in overdrive, with daily planning meetings involving state and federal officials. When Reynolds gets an update from public health officials, so does Flinn.

Flinn said her confidence in Iowa’s preparedness comes from the state’s “multi-hazard approach” to planning at the emergency center, which is nestled in a basement just north of Des Moines. It’s a semi-circular room, with small blue and white placards designating computer desks for the state agencies.

One semblance of normal life: St. Patrick's Day decorations taped to the walls, courtesy of an office worker who does this for every holiday, virus or no virus. (Meanwhile, Boston and New York canceled their storied St. Patrick's Day parades. Officials for the Des Moines St. Paddy’s Half Marathon & 5K postponed their annual event for a later date).

In the middle of the emergency center are large screens, with real-time news on agency assignments and what's known about the state's coronavirus cases.

On Friday, Reynolds was at the Iowa National Guard Joint Forces Headquarters, where the emergency center is located, to announce one new coronavirus case. She said all the cases in Iowa were travel-related and that there was no "community spread" yet. It's a term used to describe infections involving an unknown source.

"However, we anticipate it will happen," she told reporters at the news conference. "And now is the time to prepare."

Flinn said she understands the gravity of the moment.

“It’s a lot of pressure, and I put a lot of pressure on myself. I’m that Type A personality that takes my job very seriously,” she said. “… But I would say most of the people that work in this facility are Type A personalities. They have that passion. They work well under high-stress environments.”

Flinn's days are long. Her adult children text her periodically to make sure she’s eating and drinking water. She also keeps a thermometer close by. Symptoms of COVID-19, the respiratory illness caused by coronavirus, can include fever, cough and shortness of breath.

"I want to know if I'm running a fever," she said. "Because I'm telling my staff to stay home if they're sick."

'What to do if a large proportion of society gets sick at the same time?'

The news this week that a coronavirus patient was admitted to the University of Iowa Hospitals and Clinics did not surprise Jorge Salinas. As the hospital's epidemiologist, he thinks about infectious diseases for a living. The hospital planned for this very moment.

But he worries about the long-term ramifications of the virus, including for medical professionals who may get sick themselves.

“We can take care of one patient, two, three, four. The problem is, what to do if a large proportion of society gets sick at the same time? Many people could require medical care, and we may not have enough capacity to provide the same level of care to thousands of people at once,” he said.

When the first reports came in months ago about a virus spreading through mainland China, Salinas and his staff began to devote about two hours a day to prepare the hospital for it.

Now, Salinas is in planning meetings all day, trying to answer key questions for his frontline staff. The virus poses logistical challenges. It's contagious, so health care workers need to create isolation protocols for potentially thousands of patients.

“That is something that hospitals don't usually do,” he warned.

Salinas said what the hospital does will depend on how much transmission occurs in areas of society like schools, concerts and other large gatherings. Limiting large groups of people is key.

"Those measures of social distancing can flatten the epidemic curve, the surge in cases, and can help our state’s healthcare system better deal with every single person that may get sick with this," he said.

Salinas predicted that Iowa, along with other states, will soon have no choice but to enact more social distancing measures.

"That's what every society that deals with these infections is doing to try to mitigate," he explained. "… we should expect and plan for that."

► MORE: What is "social distancing"? What's the difference between an "epidemic" and a "pandemic"? A glossary of COVID-19 terms.

'We are thinking through what humans need'

Kelly Garcia is mapping out a lot of coronavirus scenarios.

What happens if Iowa schools close? How does that affect parents and guardians? What are the guardrails to ensure those families can receive social services, including access to food?

“We are thinking through what humans need,” said Garcia, director of the Iowa Department of Human Services.

Garcia’s role in responding to the coronavirus is critical. She runs the largest state agency in Iowa, with roughly 4,100 employees. The department oversees six facilities, some that take care of Iowa’s most vulnerable populations. On Friday, Garcia suspended visits to those state-run institutions.

Garcia is figuring out how she can make sure state employees, who play key roles in assisting others, can also take care of themselves and their own families.

Garcia is new to the job, but not to disasters. Before joining Iowa’s human services department in November, she was a top health administrator in Texas, where an Ebola virus outbreak at a Dallas hospital in 2014 prompted a large-scale public health response. More recently, she was in Texas when Hurricane Harvey hit the region in 2017.

“Harvey tested about every emergency response you could have, because of the floods, across the entire swath of Texas. It was millions and millions of people that were affected, that were displaced,” she said. “And so I’m really kind of going through my own checklist of what we would need to be looking at.”

Her workdays stretch beyond normal hours. After the text message from Flinn at homeland security came in, Garcia got to work the next day at 6:30 a.m. She had been up since 4 a.m., writing emails to her staff.

Garcia hasn’t seen her children in days. She’s at work before they’re up, and she gets home after they’re in bed.

She's also organizing for the coronavirus as she continues to lead the agency’s response to care at the Glenwood Resource Center, a state-run institution for people with disabilities that is under federal investigation.

“The load of things is a lot right now,” she said. “I think now is the time to make sure that you’re trusting your team. That you’re delivering really clear messages.”

'We need more testing'

Hans House, a doctor at the University of Iowa Hospitals and Clinics, has long, unpredictable work hours. And that was before coronavirus entered the picture. Now, he is adding planning to his days alongside meeting with patients.

House thinks health care facilities like his hospital are doing the right things to prepare for what may come.

In the days ahead, House will train within the hospital to offer care via video on a smartphone or computer to patients who seek to have flu or COVID-19 symptoms checked out. Telemedicine could potentially play a major role in the weeks and months ahead in stopping the spread of the virus.

House said keeping Iowans who have mild symptoms at home is critical.

“We want to make sure that the people who are at the ER are the ones who are sick and really need to be hospitalized," he said.

But House is also frustrated. He thinks the state and the rest of the country need to ramp up its testing capabilities.

The State Hygienic Laboratory at the University of Iowa has been the primary location for testing in the state. But supplies dwindled, at least temporarily. A spokeswoman said Thursday that the Coralville lab had supplies for 150 people, down from about 500. Officials said Friday that newly shipped materials mean about 850 people can now be tested.

Other medical professionals are expressing a similar sentiment about available supplies, as the federal government faces continued scrutiny to increase its capacity to conduct enough coronavirus testing.

On Friday, President Donald Trump declared a national emergency over coronavirus. He also announced plans to partner with pharmaceutical and retail companies to set up drive-through test sites for the virus.

Private labs are working with Iowa health care providers to expand coronavirus testing in the state, but the state is not tracking how many tests these companies are conducting in Iowa.

"We need more testing," House said. "We need to be able to test patients easier."

'When you take a minute, you see all the ways it could be spreading'

Benjamin Gabriel just wants to know.

The 39-year-old Iowa City man has been sick at home for a week, with a relentless cough that makes it difficult to speak.

Gabriel wants to get tested for the coronavirus. He was at the airport in Denver last month, an international hub, during a period that public health officials now say may have already involved community spread of the virus. He also lives in the same county, Johnson, as many of the Iowans who have tested positive for COVID-19.

"You don't want to be the one that's spreading it, and to not be able to really get an answer on that, when I'm doing everything I'm supposed to be doing," he said. "In theory, it's mind-blowing."

But Gabriel has been unable to get tested through a state laboratory that has been the primary location for testing. He doesn't meet the current federal criteria for symptoms to get tested: He hasn't come into contact with a person confirmed to be infected with COVID-19 — that he knows of — and he hasn't traveled to a country considered most at risk for the virus. He also doesn't have severe enough symptoms.

Gabriel has tried to follow directives from his local doctor's office. He's called the Iowa Department of Public Health through the 211 hotline set up for questions about the coronavirus. He's also been able to talk to a medical professional through video.

He acknowledged that he may not have the virus. But with more cases popping up around the country and upending American life, it's a lingering question that he can't answer. He fears the ramifications of the unknown. COVID-19 could cause serious illness in older people or those with compromised immune systems.

"I'd like to go down and see my nephews for their birthday party, but I don't want to be around my parents or my sister-in-law's parents," he said. "When you take a minute, you see all the ways it could be spreading."

'We're out in the wilderness … but you've got a fence."

About a thousand miles away, Sheryl Sirdoreus walks out into the open air. She takes a walk with her husband, Ray, and watches the trees.

On closer inspection, the Winterset couple is surrounded by fencing and other parameters aimed at keeping them on Lackland Air Force Base in San Antonio, Texas. Certain parts of their view are government buildings, and some are trees.

"We're out in the wilderness," Sheryl Sirdoreus said about how she tries to picture the situation. "But you got a fence that's keeping you from going any further."

The couple is in quarantine, after being passengers on the coronavirus-infected Grand Princess cruise ship. The couple has not been tested for the coronavirus. They're also not showing symptoms.

Sheryl Sirdoreus is passing the time through texts, emails and social media posts with family and friends.

She and her husband have become friends with other Iowans who are in quarantine as well — the passengers can eat together and socialize, though they have to remain six feet apart. They have a group chat with state public health officials to learn when they can go back home to Iowa to finish their quarantine.

Reynolds on Friday said 10 of the Iowans who had been on the Grand Princess cruise ship had been cleared to return home Friday, and the others would return home Saturday.

Sirdoreus was still waiting for the official word on Friday night.

"It's not bad," Sheryl Sirdoreus said about her circumstances. "… you make do with what you can."

Barbara Rodriguez covers health care and politics for the Register. She can be reached by email at bcrodriguez@registermedia.com or by phone at 515-284-8011. Follow her on Twitter @bcrodriguez.