The US death toll from the strain of coronavirus known as Covid-19 has reached 11 following the death of a patient in California.
Officials in California’s Placer County, near Sacramento, said an elderly person who tested positive after returning from a San Francisco-to-Mexico cruise had died.
The victim, who was the first person to die of coronavirus outside Washington state, had underlying health problems, authorities said.
California Governor Gavin Newsom has declared a statewide emergency, with the state now following in the footsteps of Washington and Florida.
Washington and Florida had already declared emergencies.
Washington also announced another death, bringing its total to 10.
Most of those who died were residents of a nursing home near Seattle.
Seema Verma, head of the federal Centers for Medicare and Medicaid Services, said the agency is sending inspectors to the nursing home along with experts from the Centers for Disease Control and Prevention to figure out what happened.
Meanwhile, public officials in Washington came under pressure to take more aggressive steps against the outbreak, including closing schools and canceling large events.
While the state and Seattle have declared emergencies, giving leaders broad powers to suspend activities, they have not issued any orders to do so.
“We have encouraged people who are responsible for large gatherings to give consideration whether it really makes sense to carry those on right now,” Governor Jay Inslee said.
“Right now, we are deferring to the judgement… of these organisations.”
While some individual schools and businesses have shut down, the governor said large-scale school closings have not been ordered because “there are so many ramifications for families and businesses,” especially for health care workers who might not be able to go to work because of child care responsibilities.
Local and state health officials have not recommended school closings unless the schools have had a confirmed case of the disease.
However some schools, businesses and other employers are not waiting.
Seattle and King County public health officials urged businesses to allow employees to work remotely if possible, and the county said it will allow telecommuting for some of its workers for the next three weeks.
Microsoft said it has asked its Seattle-area workers who can do their jobs at home to work from home until March 25.