The ongoing pandemic of coronavirus disease 2019 (COVID-19), a novel infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), spread to the United States in January 2020. Cases have occurred in all fifty U.S. states and all inhabited U.S. territories except American Samoa. All fifty states have received disaster declarations from the federal government. As of April 24, the U.S. death rate was 152 per million people, the tenth highest rate globally.
The first known case of COVID-19 in the U.S. was confirmed in Snohomish County, Washington on January 20, 2020, in a 35-year-old man who had returned from Wuhan, China, five days earlier. On January 29, the White House Coronavirus Task Force was established. Two days later, the Trump administration declared a public health emergency and announced a ban of most foreign nationals arriving from China. On February 26, a case in a person with “no known exposure to the virus through travel or close contact with a known infected individual” was confirmed by the Centers for Disease Control and Prevention (CDC).
The early U.S. response to the pandemic was slow, especially in regards to testing. A manufacturing defect rendered CDC-developed test kits unusable, and regulatory rules prevented commercial laboratories from using their own tests. Initially, President Donald Trump was optimistic, dismissing the threat posed by coronavirus and claiming the outbreak was under control. By March, the Food and Drug Administration (FDA) began allowing public health agencies and private companies to develop and administer tests and loosened requirements to allow anyone with a doctor’s order to be tested. The U.S. had tested fewer than 10,000 people by March 11, but that number exceeded 1 million (1 per 320 inhabitants) by the end of the month. The Trump administration largely waited until mid-March to start purchasing large quantities of medical equipment. In late March, the administration started to use the Defense Production Act to direct industries to produce medical equipment. Federal health inspectors surveyed hospitals in late March, reporting shortages of test supplies, personal protective equipment (PPE), and other resources due to extended patient stays while awaiting test results. By April 20, the United States had processed more than 4 million tests (approximately 1 per 82 inhabitants).
The CDC warned that widespread disease transmission may force large numbers of people to seek healthcare, which could overload healthcare systems and lead to otherwise preventable deaths. On March 16, the White House advised against any gatherings of more than ten people. Since March 19, 2020, the U.S. Department of State has advised U.S. citizens to avoid all international travel. In mid-March 2020, the Federal Emergency Management Agency (FEMA) told the United States Army Corps of Engineers to construct new medical facilities, and to convert leased buildings for use as hospitals and intensive care units. State and local responses to the outbreak have included prohibitions and cancellation of large-scale gatherings (including cultural events, exhibitions, and sporting events), restrictions on commerce and movement, and the closure of schools and other educational institutions. Disproportionate numbers of cases have been observed among African American populations, and there have been reported incidents of xenophobia and racism against Asian Americans