lnteragency VTC Centers for Disease Control and Prevention Situation Update Coronavirus Disease 2019 ( COVID - 19) Currentepidemic curve status*, by U . S . County, 30 April 2020 Epicurve status Low incidence growth Elevated incidence growth Elevated incidence plateau Sustained decline NYC PR Low incidence plateau 1-5 cases in the pasttwoweeks cases in the pasttwo weeks GU No reported cases AS RMI Purpose of this map Provides the most detailed view MP PW Main Findings remains a large number of counties whose burden continues to grow or are in an elevated incidence plateau, including in the Great Lakes region, parts of the Southeast, Northeast, and around southern FSM into both the burden of illness and the trajectory of new illnesses California is to have all communities be represented in the lightercolors, demonstratinglittle to no disease burden and no increase in trajectory MAN *Categorized according to the slope of a spline fit to the 3 day moving average ofdaily incidence and the number of new cases (per 100, 000 in the past two weeks. & the past 2 weeks. Elevated incidence is defined as > 10 new cases per 100, 000 CORTROL Sources: USAFacts, US Census HUMAN RVICES 2 OF ECURIT CoronavirusDisease 2019 (COVID- 19) Change in Daily Incidence* , by U . S . County, 30 April 2020 Change in incidence per 100, 000 per day Greater decline Moderate decline NYC Plateau Moderate increase Greater increase 1-5 cases in the past 2 weeks cases in the past 2 weeks AS No reported cases RMI MP PW Purpose of this map Describesthe trajectory of new illnesses as recently increasing, being stable, or decreasing in number Main Findings FSM rates continue to decrease in multiple counties , including hard hit areas in Louisiana and in the New York City region Incidence rates have recently plateaued in areas around Chicago *Measured as the change in slope of a spline fit to smootheddaily incidence Incidencewas smoothed using a 3- day moving average. These values therefore represent the change in 3- day averagenumberofnew casesper 100.000 CES per day Greaterdeclines are - 1 moderatedeclines are > . 1 plateaus are > - 0. 1 to . 1 moderate increases are > 0 . 1 to 1. greater increases are > 1. Counties denoted as O cases in the past 2 weekshave had atleast 1 case previously. CORTROL Sources: USAFacts, US Census HUMA SERVICES & OF ENT 3 OMELAS Daily change in cumulative COVID - 19 case and death counts Daily change in cumulative COVID - 19 case counts Daily change in cumulative COVID - 19 death counts As ofMay 1 (preliminary) N = 1, 092, 815 ( 30, 369 new ) % 50000 As ofMay 1 ( preliminary ) N =64, 283 ( 1, 877 new ) % change in last day : 3 .0 % ( range last 7 days: 2 .5 % - 4 .4 % ) 4000 changein lastday : 2. 9 % (range last 7 days: 2. 4 % - 3. 7 % ) Probable Cases 45000 4 , 062probable ProbableDeaths deathsreported 3500 Confirmed Cases ConfirmedDeaths on 4 / 15 40000 3000 35000 2500 30000 2000 25000 20000 1500 15000 1000 10000 500 5000 25 10 12 14 16 18 20 22 24 26 28 30 1 3 5 February HUM March 7 9 11 13 15 17 19 21 23 25 27 29 1 April 25 10 12 14 16 18 20 22 24 26 28 30 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 April * Preliminary Note, asof 12 April, totals and figures include confirmed and probable cases and deaths reported from states May February March May SERVICES 4 OF OMELAVD States with High % Lab Test Positives : NJ, NY Total test volume per 10,000 state residents and % positive by day New York New Jersey 40 Test Results per Test Results per 10k Residents 10k Residents 25 0-0513 2020 Last14 Days -0-3 2020 0-2 04 2020 -0-4 2020 3-01 0-4 2020 Last 14 Days --03 2020 -03 2020 0-2 04 2020 -- 16 04 2020 3-01 -2020 04 Source : protect. hhs. gov SERVICES 5 H OF ENT OMELAVD SEC States that are Reopening : GA, FL Total test volume per 10, 000 state residents and % positive by day Georgia Florida 15 60 Test Results per 10k Residents Test Results per 10k Residents 12 .5 10. 0 7 .5 5. 0 2. 5 Last 14 Days Last 14 Days -0-3 05 2020 -- -0-4 19 03 02 2020 2020 -0-4 16 2020 3-01 05 2020 2020 - 04 --03 -- 19 03 2020 0-0214 2020 -16 04 2020 3-01 0 -4 2020 SERVICES Source: protect. hhs. gov OMELAVD 6 Acute signs and symptoms on admission among hospitalized COVID cases, COVID -NET, March 1 May 1 ( N = 2,591) Non -respiratory signs/ symptoms Fever/ chills Muscle aches/myalgias Diarrhea HUMAN 1961(75.7 ) 805 (31. 1) 715 (27.6 ) Nausea / vomiting 641(24. 7 ) Headache Chest pain Altered mental status/confusion Abdominal pain 460 ( 17.8 ) 357 ( 13.8 ) 287 (11. 1) 253 ( 9. 8 ) 94 (3 .6 ) Anosmia /decreased smell Dysgeusia / decreased taste Rash 85 ( .3 ) Seizure Conjunctivitis (0 . 5 ) 12 (0. 5) SERVICES H OF ENT Number ( % ) OMELAVD 15 (0 .6 ) Respiratory signs/ symptoms Number % ) Cough Shortness of breath 1961(75.7) 1816 (70.1) Congested / runny nose Sore throat 406 (15. 7) Wheezing Hemoptysis/ bloody sputum 339 (13. 1) 156 (6 . 0) 44 ( 1. 7 ) * 3 of 20 (15.0 % ) pediatric cases with data on symptomshad inability to eat/ poor feeding; 1 of 20 (5. 0 % ) ofpediatric caseswith data on symptoms had cyanosis and lethargy Interventions and outcomes among hospitalized COVID - 19 cases, COVID -NET, March 1 May 1 Among cases with discharge Intervention/ Outcome date recorded and completed data Mechanical ventilation * 640 / 2045 (31.3 ) 370 / 2043 (18. 1) Vasopressor 298 / 2044 (14.6) HENC* 137/ 2043 (6 .7) RRT 99 /2041 ( .9 ) BIPAP/ CPAP * ECMO 62/2043 (3.0) ICU 6 / 2043 (0 . 3) In -hospital death *MechanicalVentilation, BIPAP /CPAP and 340/ 2045 ( 16 .6 ) arenow defined in a hierarchicaland mutually exclusive fashion . Any patientrequiring invasivemechanicalventilation assigned to invasive mech vent category ; ifno mech vent required butpatientreceived BIPAP/ CPAP, assigned to BIPAP/ CPAP category; ifnomech vent or BIPAP/ CPAP required butpatient received assigned to category SERVICES MEN 8 OMELAVD SEC Interagency VTC Data and Analytics Task Force Projected Cases per Day United States 1 , 000 , 000 - Outcomes Modelled Cases Cases Cases Range Estimates 500 , 000 - 2 . 5 % - 97. 5 % 25 .0 % - 75 .0 % of Number 250, 000 - 100 ,000 50 , 000 - 25, 000 10, 000 3 2020 -03- 15 2020- 04- 01 2020 - 05 -01 2020 -04- 15 2020-05 - 15 2020 -06 -01 Date NB : Run Date 2020 -05 - 01; IDD Combined VICES COVID - 19 Response MELA SECUR FOUO Data & Analytics Task Force Only 10 Projected Deaths per Day United States Outcomes Modelled Deaths Deaths Deaths 10, 000 Range Estimates 2.5 % - 97.5 % 25. 0 % - 75. 0 % of Number 2 ,500 1,000 500 250 2020-03- 15 2020 -04-01 2020- 05 -01 2020- 04- 15 2020-05- 15 2020- 06 -01 Date NB : Run Date 2020 - 05 -01; IDD Combined VICES COVID - 19Response D SECU FOUO Data & Analytics Task Force Only 11 H DE . . S U HE OF ENT VELAN URITY COVID - 19 HHS/ FEMA Interagency VTC SECU Community Mitigation Task Force CDC Assistance for High Risk Settings (asof 11:00AM EDT, May 1, 2020) ME MT ND OR MN NH SD WI WY PA NE NV RI IL IN OH MO NJ NC DE AZ NM AR MD AL D.C Stateswith CDC staff currently deployed to assist in Current high risk settings Previous term Care Facilities of Corrections/Prisons Puerto Rico Food Industry Homeless Populations *Data reflect cumulativedeploymentscoordinated by the Health DepartmentTask Force since April3 , 2020 HUMA & COVID -19 Response OMELA Community Mitigation Task Force 1 Response to Meat and Poultry Processing Facilities production considered critical To slow the spread of COVID - 19 in meat and poultry processing facilities : infrastructure reported in facilities across 23 states Screen workers for symptoms Increase space between workers Field teams currently deployed to 8 states Special considerations for IPC : Enhance cleaning and disinfection Providemultilingual education/training Facility layout and operations limit social Dyal JW , Grant MP, Broadwater distancing options , et al. COVID - 19 Among Workers in Meat and Poultry Processing Facilities Personnel and administrative policies States, April 2020 .MMWR Morb Mortal Wkly Rep . ePub : 1May 2020 . Diverse workforce Working communities and transportation HUMA SERVICES & COVID -19 Response H OF ENT OMELA Community Mitigation Task Force 14 1 MMWR: Meat and Poultry Processing As ofApril 27, COVID -19 outbreaks had been reported in 23 states; among 19 statesreporting data for the MMWR, 115 meat or poultry processing plants had COVID - 19 cases. Outofover 130,000 workers in these affectedmeat or poultry processing plants, 3 % were identified ashaving COVID - 19. Among workers , 20 COVID related deaths were reported . Several facilities noted challenges in preventing and controlling the spread of COVID - 19 , such as difficulties with increasing physical space between employees at theworksite; using face coverings as recommended; or communicating safety information to workers in a wide variety of languages . SERRVICES COVID -19 Response HE OF HOMEL AND Community Mitigation Task Force 15 H DE . . S U HE OF ENT VELAN URITY COVID -19 HHS/ FEMA Interagency VTC SECU Community Based Testing Sites Task Force CDC Guidelines : Collecting, Handling and Testing COVID - 19 Specimens Summary of Recent Changes Revisionsweremade on April 29, 2020 to reflect the following: Update guidance on viral transport medium ( ) to note that somepoint-of-care tests advise against its use. • Remove preference for NP swabs Update guidance for use of personal protective equipment while obtaining specimens. Revisionswere made on April 14, 2020 to reflect the following : Clarify specimen collection procedures for all swab types and align with other respiratory disease specimen collection guidelines SERVICES OFFICE OF THE ASSISTANT SECRETARY FOR HEALTH 17 H DE . . S U HE OF ENT VELAN URITY COVID - 19 HHS/ FEMA Interagency VTC SECU Supply Chain Task Force COVID - 19 By the Numbers 56 Major Disaster Declarations approved in all 50 states, 5 territories and Washington DC $ 5 . 8 billion in emergency protective measures 107 216 51 messages airbridge flightmissions to cellphonesvia the Wireless Emergency to broadcaststations via the Emergency Alert System Alert System critical supplies shipped 7.3 million face face shields 111.8 million surgical masks 607,283 coveralls 903.0 million 78.5 million gloves N95 respirators 17.0 million gowns 1. 2 + 6 . 4 million samples tested 140,617 tested at Community -Based Testing Sites , 067 ventilators available billion timespeople viewed info on CDCwebsites 110, 779 private partner site samples Numbersas of 5/ 02/ 2020 FEMA