Tropical Storm Laura to become a hurricane as it heads toward U.S.

By Jonathan Allen and Maria Caspani

(Reuters) – Tropical Storm Laura strengthened in the Caribbean on Monday and was poised to accelerate into a hurricane, while Tropical Storm Marco weakened sooner than expected, sparing the U.S. Gulf Coast from two simultaneous hurricanes that had been forecast.

The dual storms have taken offline nearly 10% of the United States’ crude oil production, as energy companies shuttered operations to ride out the weather.

The changed forecast from the National Hurricane Center bought a little more time for residents along Louisiana’s coast to prepare for the one-two punch. Marco could still bring dangerous winds and rain on Monday evening, with Laura forecast to make landfall on the U.S. Gulf Coast on Wednesday night.

“Having two storms in the Gulf at one particular time made the last few days pretty stressful,” said Archie Chaisson, the president of Lafourche Parish on the Louisiana coast.

The coronavirus pandemic had complicated preparations, Chaisson said, with officials modifying their shelter plans to ensure social distancing and the wearing of face coverings.

HOWLING WINDS

Laura traced the southern coast of Cuba on Monday morning, but the brunt of the storm was offshore, helping the largest island nation in the Caribbean avoid serious damage after Laura killed at least 10 people in Haiti and the Dominican Republic.

The storm downed trees in Cuba, ripped away flimsy roofs and caused minor flooding on Sunday evening, according to residents and news reports. In Jamaica, there were reports of landslides and flooded roads.

“I slept well last night, except when the wind howled,” Nuris Lopez, a hairdresser, said by telephone from a town in the foothills of the Sierra Maestra mountains in Cuba’s eastern Granma province.

Laura was heading toward the Gulf of Mexico at 20 miles per hour (31 kilometers per hour), according to the NHC. By Tuesday, it was expected to have reached hurricane strength. By Wednesday night, stronger still, it was expected to hit the U.S. Gulf Coast, the NHC said.

By then, it could be a Category 2 or 3 hurricane on the 5-step Saffir-Simpson scale for measuring hurricane intensity, said Chris Kerr, a meteorologist at DTN, an energy, agriculture and weather data provider.

OIL HIT HARD

Despite Marco’s weakening, with the NHC predicting it would slow to a tropical depression by Monday night, that storm still threatened to soak the Louisiana coast.

The Federal Emergency Management Agency has sent teams to operations centers in Louisiana and Texas.

This year’s hurricane season has been complicated by the coronavirus pandemic, forcing many people to weigh the risks of leaving their homes and potentially exposing themselves to the virus.

Officials in Louisiana said that testing for COVID-19 was suspended in the state on Monday and Tuesday.

Energy companies moved to cut production at U.S. Gulf Coast oil refineries after shutting half the area’s offshore crude oil output as back-to-back storms took aim at the coast.

Producers have shut more than 1 million barrels per day of Gulf Coast offshore oil production, 9% of the nation’s total output, facing a storm that is forecast to become a damaging Category 2 hurricane.

(Reporting by Jonathan Allen and Maria Caspani in New York, Marc Frank in Havana, Kate Chappell in Kingston and Brad Brooks in Lubbock, Texas; Editing by Matthew Lewis)

HHS to open ‘surge’ COVID-19 testing in Florida, Texas, Louisiana

(Reuters) – The U.S. government is creating short-term “surge” testing sites for the novel coronavirus in three metropolitan areas in Florida, Louisiana and Texas to meet demand from rising COVID-19 cases and hospitalizations, the U.S. Department of Health and Human Services (HHS) said on Tuesday.

The program adds testing for 5,000 people per day for a five- to 12-day period and will help identify new cases, particularly among asymptomatic people, and potentially limit the spread of the disease, Assistant Secretary for Health Admiral Brett Giroir said during a call with reporters.

The sites are opening on Tuesday in several locations in the Baton Rouge, Louisiana, area and on Wednesday at multiple sites in the Jacksonville, Florida, area and at one location in Edinburg, Texas.

Florida and Texas are among many U.S. states with high infection rates as a percentage of diagnostic tests conducted over the past week and long testing lines.

After assessing the impact of the testing on the rate of new cases in these areas, the government could deploy such surge testing sites in other locations around the country, Giroir said. He said no decisions have been made yet about other possible sites.

“We need to do this and see what the effect is,” he said.

The U.S. government has largely left testing for COVID-19 to the states after closing down most of the federal testing sites opened in March and April. The surge sites would supplement each state’s own testing plans.

HHS has tapped eTrueNorth, a U.S.-based company that has done community health center testing, for the sites. The tests are free and lab results are available in three to five days.

(Reporting by Caroline Humer in New York and Manojna Maddipatla in Bengaluru; Editing by Shounak Dasgupta and Jonathan Oatis)

Where COVID-19 is spreading fastest as U.S. cases rise 46% in past week

By Chris Canipe and Lisa Shumaker

(Reuters) – The United States saw a 46% increase in new cases of COVID-19 in the week ended June 28 compared to the previous seven days, with 21 states reporting positivity test rates above the level that the World Health Organization has flagged as concerning.

Nationally, 7% of diagnostic tests came back positive last week, up from 5% the prior week, according to a Reuters analysis of data from The COVID Tracking Project, a volunteer-run effort to track the outbreak.

The World Health Organization considers a positivity rate above 5% to be a cause for concern because it suggests there are more cases in the community that have not yet been uncovered.

Arizona’s positivity test rate was 24% last week, Florida’s was 16%, and Nevada, South Carolina and Texas’s were all 15%, according to the analysis.

Thirty-one states, mostly in the U.S. West and South, reported more new cases of COVID-19 last week compared to the previous week, the analysis found. Florida, Louisiana, Idaho and Washington state saw new cases more than double over that period.

In response to the new infections, Louisiana and Washington state have temporarily halted the reopening of their economies. Washington also mandated wearing masks in public.

Florida ordered all bars and some beaches to close. Idaho was not immediately available for comment.

Nationally, new COVID-19 cases have risen every week for four straight weeks. While part of that increase can be attributed to a 9% expansion in testing, health experts have also worried about states relaxing stay-at-home orders that had been credited with curbing the outbreak.

State officials across the country report the same trend in the new cases: People under 35 years old are going to bars, parties and social events without masks, becoming infected, and then spreading the disease to others.

Cases continue to decline in Northeast states, but some Midwest states that had new infections under control are seeing cases once again rise, including Illinois, Michigan and Pennsylvania.

 

(Reporting by Chris Canipe in Kansas City, Missouri, and Lisa Shumaker in Chicago; Editing by Tiffany Wu)

U.S. Supreme Court strikes down Louisiana abortion clinic restrictions

By Lawrence Hurley

WASHINGTON (Reuters) – The U.S. Supreme Court on Monday defended abortion rights by striking down a Louisiana law placing restrictions on doctors who perform the procedure, dealing a blow to anti-abortion advocates.

The 5-4 ruling, with conservative Chief Justice John Roberts joining the four liberals justices in the majority, represented a major victory for Shreveport-based abortion provider Hope Medical Group for Women in its challenge to the 2014 law. The measure had required doctors who perform abortions to have a sometimes difficult-to-obtain formal affiliation called “admitting privileges” at a hospital within 30 miles (48 km) of the clinic.

Anti-abortion advocates had hoped that the Supreme Court, with its 5-4 conservative majority, would be willing to permit abortion restrictions like those being pursued by Louisiana and other conservative states.

The decision, authored by liberal Justice Stephen Breyer, marked the second time in four years that the court ruled against an “admitting privileges” requirement.

In 2016, the court struck down a Republican-backed Texas law that mandated admitting privileges and required clinics to have costly hospital-grade facilities, finding that the restrictions represented an impermissible “undue burden” on a woman’s ability to obtain an abortion.

Several other cases involving legal challenges to abortion restrictions in other states are heading toward the justices that could provide other avenues for its conservative majority to roll back access to the procedure.

Two of Louisiana’s three clinics that perform abortions would have been forced to close if the law went into effect, according to lawyers for Hope Medical Group.

(Reporting by Lawrence Hurley; Editing by Will Dunham)

Where U.S. coronavirus cases are on the rise

By Chris Canipe and Lisa Shumaker

(Reuters) – Most U.S. states reported a drop in new cases of COVID-19 for the week ended May 17, with only 13 states seeing a rise in infections compared to the previous week, according to a Reuters analysis.

Tennessee had the biggest weekly increase with 33%. Louisiana’s new cases rose 25%, and Texas reported 22% more cases than in the first week of May, according to the Reuters analysis of data from The COVID Tracking Project, a volunteer-run effort to track the outbreak.

(Open https://tmsnrt.rs/2WTOZDR in an external browser for a Reuters interactive)

Michigan saw new cases rise 18% after five weeks of declines. Michigan was hit hard early in the outbreak and has seen more than 4,800 deaths.

Nationally, new cases of COVID-19 are down 8% in the last week, helped by continued declines in New York and New Jersey. Nearly all 50 U.S. states, however, have allowed some businesses to reopen and residents to move more freely, raising fears among some health officials of a second wave of outbreaks.

The Centers for Disease Control and Prevention (CDC) has recommended states wait for their daily number of new COVID-19 cases to fall for 14 days before easing social distancing restrictions.

As of May 17, 13 states had met that criteria, down from 14 states in the prior week, according to the Reuters analysis.

WHERE NEW CASES ARE FALLING

Kansas and Missouri saw the biggest declines in new cases from the previous week, after an outbreak at a St. Joseph, Missouri meatpacking plant resulted in over 400 cases in the first week of May. St. Joseph sits on the Kansas-Missouri border, just north of Kansas City.

Washington D.C. saw a 32% decline after several weeks of growth.

Georgia, one of the first states to reopen, saw new cases fall 12% in the past week and now has two consecutive weeks of declining cases.

Globally, coronavirus cases top 4.5 million since the outbreak began in China late last year. On a per-capita basis, the United States has the third-highest number of cases, with about 45 for every 10,000 people, according to a Reuters analysis.

(Reporting by Chris Canipe in Kansas City, Missouri, and Lisa Shumaker in Chicago)

Six killed as severe storms, tornadoes rip through U.S. South

(Reuters) – At least six people were killed on Sunday as a strong storm system swept across Mississippi and Louisiana, spinning off more than a dozen tornadoes and leaving behind a path of destruction, state and local authorities said.

The storms hit on Easter Sunday as residents across the U.S. South, like most Americans, were under strict “stay-at-home” orders by the governors of Mississippi and Louisiana due to the nationwide coronavirus pandemic.

Damaged planes and buildings are seen in the aftermath of a tornado in Monroe, Louisiana, U.S. April 12, 2020, in this still image obtained from social media. Courtesy of Peter Tuberville/Social Media via REUTERS.

All six fatalities were recorded in Mississippi, the state’s emergency management agency said on Twitter, and tornado warnings remained in place across several counties into the evening.

The National Weather Service said 13 tornadoes were believed to have touched down across the region.

Images on local media showed the devastation left behind by twisters, including destroyed homes, downed power lines, twisted billboards and overturned cars.

The city of Monroe, Louisiana, posted photos of wrecked buildings on social media and said that Monroe Regional Airport had canceled all flights until further notice due to debris on the runway and weather conditions.

“By the grace of God, early reports show only a few minor injuries. Pray for our city! Many neighbors & friends suffered catastrophic damage,” Monroe Mayor Jamie Mayo said on Twitter.

Tornado warnings were also issued for parts of Texas into Sunday night.

(Reporting by Dan Whitcomb; Editing by Himani Sarkar)

New Orleans doctors scramble as coronavirus deaths, cases soar

By Brad Brooks

(Reuters) – Emergency room doctor Thomas Krajewski stopped at the hospital room door at 2 a.m. to glance at the chart. He knew instantly the long odds faced by the patient inside: A man in his 70s, with a fever, short of breath.

“Do you mind calling my son?” the patient asked him. “My two grandsons tomorrow morning are going to crawl in my bed because they wake me up on the weekends, and if I’m not there, they will wonder.”

Twelve hours later, the man needed a ventilator. After a day, his kidneys started to fail. In three days, he was dead – one of 151 people who had succumbed to COVID-19 in Louisiana by late Sunday. The state has confirmed 3,540 cases since March 9 – among the world’s fastest-growing infection rates. That pace, Governor John Bel Edwards has said, signals that the state could become the next Italy, with overwhelmed hospitals forced to turn patients away.

Frontline health workers scrambled to prepare for that grim prophecy as patients started to stream through their doors last week. The governor said on Face the Nation Sunday that the state has only a tiny fraction of the about 13,000 ventilators it will need, and that it has yet to receive federal approval to tap a national stockpile. In New Orleans, the state’s epicenter, authorities are setting up a field hospital to handle the expected overflow of patients at the Ernest N. Morial Convention Center – the same site where thousands of Hurricane Katrina refugees suffered in 2005.

Then as now, many doctors fear they won’t get enough supplies and support to keep up with the deluge of victims. This time they are fighting a pathogen that threatens them – and their families – every time they extend a hand to help a patient.

Krajewski, a 31-year-old Cincinnati native who is just two years out of residency, works the overnight shift at St. Bernard Parish Hospital, in a working class suburb just east of the city. After work, Krajewski comes home to his newborn son, Cal, just three weeks old, and his wife Genevieve. He strips off his clothes on the porch before entering his house. He drops his glasses and phone into a small UV light sterilizer and heads straight to the shower.

“I come home – and I’m horrified,” Krajewski said. “I’m wearing an N95 respirator-level face mask anytime I’m near my child, and that is after I’ve fully decontaminated.”

Doctors across New Orleans are calling colleagues in New York and Seattle, sharing intelligence on the virus. They trade suggestions on how to hook two patients up to a single respirator. Some health workers are renting out apartments to quarantine themselves from their families, said Joseph Kanter, an emergency room physician and lead public health official for the New Orleans area.

“They’re using all these stop-gap measures” to protect themselves, said Kanter, calling it a “damning indictment” of the nation’s lack of preparedness for such a pandemic.

‘IT CAN HAPPEN TO ME’

With more than 141,000 infected and nearly 2,500 dead in the United States, health workers in hard-hit places like New Orleans are feeling the strain of taking in hundreds of contagious patients who often deteriorate quickly.

While older patients are by far the most at-risk, some Louisiana doctors say they have been shocked at the severity of some cases in which younger people have just one underlying condition, such as hypertension or diabetes. Some patients in their 30s or 40s have been quickly put on life support, said Jeff Elder, an emergency physician at University Medical Center in downtown New Orleans.

Such cases are worrisome because doctors are still struggling to understand why certain younger patients are hit so much harder than others – and because they make younger caregivers fear for their own safety.

“You treat them and think, ‘If it is happening to him, it can happen to me,’” said Elder, who is 40.

EXPONENTIAL RISE

Louisiana’s soaring infection rates mean some hospitals will have to start turning away patients in the next week unless statewide efforts to curtail social contact start to show an impact, Governor Edwards has said. The governor’s pleas for residents to stay home in daily news conferences have become increasingly laced with anger and frustration.

“It’s not that hard to understand!” Edwards said on Friday, talking about what awaits New Orleans. “The trajectory we’re on right now takes us to a place where we cannot meet the demands on our health care system.”

Even as fears rise inside overtaxed hospitals, caregivers are working in an unsettling silence. Many have bans or severe limitations on visiting family members, who normally fill their hallways with conversation, comforting loved ones and waiting on scraps of news.

Patients with COVID-19 suffer quietly, too. In survival mode, they focus almost solely on breathing. Fevers make them sweat through their hospital gowns as they sit upright in bed, the position that makes it easiest to breathe. Ventilators hum in the background.

Krajewski decided early in college to become a doctor, in part because of a self-described hero complex. In his young career, he has thrived on seeing patients get well in response to his treatments.

That’s all changed in the last few days. He has put about a dozen patients on life support, and only one has come off. Five have died.

“There is a sense of gravity when you know you are one of the last people that will talk to somebody,” Krajewski said. “Those conversations are happening more often.”

(Reporting by Brad Brooks; Editing by Brian Thevenot)

Pentagon eyes Chicago, Michigan, Florida, Louisiana as coronavirus spreads

By Phil Stewart and Idrees Ali

WASHINGTON (Reuters) – The U.S. military is watching coronavirus infection trends in Chicago, Michigan, Florida and Louisiana with concern as it weighs where else it may need to deploy, after boosting aid to New York, California and Washington, a top general said on Friday.

Air Force General John Hyten, vice chairman of the Joint Chiefs of Staff, said the military was doing its own analysis as well as looking at data on infections compiled elsewhere in the government.

“There’s a certain number of places where we have concerns and they’re: Chicago, Michigan, Florida, Louisiana,” Hyten told a group of reporters, when asked where field hospitals could head next.

“Those are the areas that we’re looking at and trying to figure out where to go next.”

Confirmed coronavirus cases in the United States reached 100,040 on Friday, the highest number in the world, a Reuters tally showed.

The Army Corps of Engineers said on Friday it was aiming to provide facilities for 3,000 people with the coronavirus at Chicago’s McCormick Place convention center by April 24 for about $75 million.

Lieutenant General Todd Semonite, the Corps’ commander, said the Corps was looking at potentially converting 114 facilities in the United States into hospitals.

Asked about Hyten’s remarks, Semonite said he continued to be concerned about Michigan, Florida and Louisiana and had spoken with the governor of Louisiana. He said there could be a high demand for medical resources in Florida because of the aging population and added the Corps was developing options for the state.

STRAINS ON MILITARY

The military is already deploying field hospitals to Seattle and New York. A Navy hospital ship arrived on Friday in Los Angeles and another one is expected to reach New York City on Monday, where Hyten said the city was still dredging the harbor to allow the massive ship to dock.

Each ship has a capacity of about 1,000 beds and would not treat coronavirus patients, instead taking pressure off overwhelmed civilian hospitals.

But Hyten cautioned that the U.S. military only had limited medical capacity in the United States and, at some point, it would have to tap the reserve forces — while guarding against drawing medical staff away from civilian facilities.

President Donald Trump on Friday signed an executive order authorizing the Pentagon and Department of Homeland Security to call up reservists.

“We made a decision about five or six years ago that we would downsize our military (health care) capabilities in the United States … to only really focus on our deployed requirements,” Hyten said.

He estimated that the military only had 1,329 adult hospital beds staffed at any one time in the United States.

“We’re digging into the active duty force really heavily,” he said. “So the next thing that we’re going to need is to look into the reserves.”

(Reporting by Phil Stewart and Idrees Ali; Editing by Daniel Wallis)

U.S. has most coronavirus cases in world, next wave aimed at Louisiana

By Maria Caspani and Daniel Trotta

NEW YORK (Reuters) – The number of U.S. coronavirus infections climbed above 82,000 on Thursday, surpassing the national tallies of China and Italy, as New York, New Orleans and other hot spots faced a surge in hospitalizations and looming shortages of supplies, staff and sick beds.

With medical facilities running low on ventilators and protective masks and hampered by limited diagnostic testing capacity, the U.S. death toll from COVID-19, the respiratory disease caused by the virus, rose beyond 1,200.

“Any scenario that is realistic will overwhelm the capacity of the healthcare system,” New York Governor Andrew Cuomo told a news conference. He described the state’s projected shortfall in ventilators – machines that support the respiration of people have cannot breathe on their own – as “astronomical.”

“It’s not like they have them sitting in the warehouse,” Cuomo added. “There is no stockpile available.”

At least one New York City hospital, New York-Presbyterian/Columbia University Medical Center in Manhattan, has begun a trial of sharing single ventilators between two patients.

While New York was the coronavirus epicenter in the United States this week, the next big wave of infections appeared headed for Louisiana, where demand for ventilators has already doubled. In New Orleans, the state’s biggest city, Mardi Gras celebrations late last month are believed to have fueled the outbreak.

Louisiana Governor John Bel Edwards said New Orleans would be out of ventilators by April 2 and potentially out of bed space by April 7 “if we don’t flatten the infection curve soon.”

“It’s not conjecture, it’s not some flimsy theory,” Edwards told a press conference. “This is what is going to happen.”

Nurse Tina Nguyen administers a nasal swab at a coronavirus testing site outside International Community Health Services in the Chinatown-International District during the coronavirus disease (COVID-19) outbreak in Seattle, Washington, U.S. March 26, 2020. REUTERS/Lindsey Wasson

About 80% of Louisiana’s intensive care patients are now on breathing machines, up from the normal rate of 30-40%, said Warner Thomas, chief executive of Ochsner Health System, the state’s hospital group.

Scarcities of protective masks, gloves, gowns and eyewear for doctors and nurses – reports abound of healthcare workers recycling old face masks, making their own or even using trash bags to shield themselves – have emerged as a national problem.

“Our nurses across the country do not have the personal protective equipment that is necessary to care for COVID patients, or any of their patients,” Bonnie Castillo, head of the largest U.S. nurses union, National Nurses United, told MSNBC.

In an ominous milestone for the United States as a whole, at least 82,153 people nationwide were infected as of Thursday, according to a Reuters tally from state and local public health agencies. China, where the global pandemic emerged late last year, had the second highest number of cases, 81,285, followed by Italy with 80,539.

At least 1,204 Americans have died from COVID-19, which has proven especially dangerous to the elderly and people with underlying chronic health conditions, Reuters’ tally showed.

MORE BEDS NEEDED

For New York state, Cuomo said a key goal was rapidly to expand the number of available hospital beds from 53,000 to 140,000.

New York hospitals were racing to comply with Cuomo’s directive to increase capacity by at least 50%. At Mount Sinai Hospital’s Upper East Side location, rooms were being constructed within an atrium to open up more space for beds.

At Elmhurst Hospital in New York’s borough of Queens, about a hundred people, many wearing masks with their hoods pulled up, lined up behind barriers outside the emergency room entrance, waiting to enter a tent to be screened for the coronavirus.

The city coroner’s office has posted refrigerated trucks outside Elmhurst and Bellevue Hospital to temporarily store bodies of the deceased.

Deborah White, vice chair of emergency medicine at Jack D. Weiler Hospital in the city’s Bronx borough, said 80% of its emergency room visits were patients with coronavirus-like symptoms.

A ventilator shortfall and surge in hospitalizations has already raised the prospect of rationing healthcare.

Asked about guidelines being drafted on how to allocate ventilators to patients in case of a shortage, New Jersey Governor Phil Murphy told reporters such bioethical discussions “haunted him” but were unavoidable.

Outside New York and New Orleans, other hot spots appeared to be emerging around the country, including Detroit.

Brandon Allen, 48, was buying groceries in Detroit for his 72-year-old mother, who has tested positive and was self-quarantining at home.

“It’s surreal,” Allen said. “People around me I know are dying. I know of a couple people who have died. I know a couple of people who are fighting for their lives. Everyday you hear of another person who has it.”

RECORD UNEMPLOYMENT CLAIMS

Desperate to slow virus transmissions by limiting physical contact among people, state and local governments have issued stay-at-home orders covering about half the U.S. population. A major side effect has been the strangulation of the economy, and a wave of layoffs.

The U.S. Labor Department reported Thursday the number of Americans filing claims for unemployment benefits last week soared to a record of nearly 3.28 million – almost five times the previous weekly peak of 695,000 during the 1982 recession.

Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, said warmer weather may help tamp down the U.S. outbreak as summer approaches, though the virus could re-emerge in the winter.

“We hope we get a respite as we get into April, May and June,” Fauci said on WNYC public radio.

Washington state Governor Jay Inslee said he may extend a stay-at-home order tentatively set to expire April 6, encouraged by what he called a “very modest improvement” in the Seattle area.

Washington experienced the first major U.S. outbreak of COVID-19 and has been among the hardest-hit states. As of Thursday the state reported about 3,200 cases and 147 deaths.

In California’s Coachella Valley, a region rife with retirees who are especially vulnerable, 25 members of the state’s National Guard helped a non-profit distribute food to people stuck in their homes, as most of the regular volunteers are senior citizens.

More than 10,000 troops have been deployed in 50 states to provide humanitarian aid during the pandemic.

(Reporting by Maria Caspani in New York and Daniel Trotta in Milan; Additional reporting by Gabriella Borter, Catherine Koppel, Lucia Mutikani, Doina Chiacu, Susan Heavey, Nathan Layne, Lisa Lambert, Michael Martina, Rebecca Cook, Barbara Goldberg, Rich McKay and Dan Whitcomb; Writing by Will Dunham and Steve Gorman; Editing by Howard Goller, Bill Tarrant, Cynthia Osterman and Daniel Wallis)

Coronavirus impact spreads across U.S. as Congress readies aid

By Susan Heavey

WASHINGTON (Reuters) – The burden caused by the fast-spreading coronavirus accelerated across the United States on Wednesday beyond the hot spots of New York, California and Washington state as Louisiana and others faced a severe crush on their healthcare systems.

U.S. President Donald Trump issued the latest major federal disaster declarations for Louisiana and Iowa late on Tuesday, freeing up federal funds to help states cope with the increasing number of cases of the dangerous respiratory disease caused by the virus that threaten to overwhelm state and local resources.

That brings to five the number of states receiving major disaster declarations from the Republican president. New York – the state with by far the most infections and deaths – was given such status last weekend as well as California and Washington state.

Louisiana, where large crowds recently celebrated Mardi Gras in New Orleans and other locations, has reported a spike in infections with 1,388 total confirmed cases and 46 deaths as of midday Tuesday, according to the Louisiana Department of Health.

“I have determined that this incident is of such severity and magnitude that effective response is beyond the capabilities of state and local governments,” the state’s governor wrote the White House this week in seeking the declaration.

It was not immediately clear why Trump granted Iowa federal disaster relief and not some other states with many more cases. Iowa, where officials announced the state’s first death from the coronavirus on Tuesday, has reported 124 confirmed cases. (https://tmsnrt.rs/2w7hX9T)

A number of other U.S. states have also applied for major disaster relief status in recent days including Florida, Texas and New Jersey.

Nationwide, more than 53,000 people have been diagnosed with COVID-19, the disease caused by the virus that is particularly perilous to the elderly and people with pre-existing medical conditions, with at least 720 deaths. World Health Organization officials have said the United States could become the global epicenter of the pandemic, which first emerged late last year in the Chinese city of Wuhan.

The governors of at least 18 states have issued stay-at-home directives affecting about half the U.S. population of roughly 330 million people. The sweeping orders are aimed at slowing the spread of the pathogen but have upended daily life as schools and businesses shutter indefinitely.

Trump on Tuesday said he wanted to re-open the country by Easter Sunday, but later told reporters he would listen to recommendations from the nation’s top health officials.

The closures have rocked the U.S. economy with global markets rattled by the pandemic. Wall Street on Wednesday extended its gains from the previous session as lawmakers and the Trump administration reached a deal for a $2 trillion stimulus package to help businesses and millions of Americans hit by the economic fallout of the coronavirus pandemic.

The measure in Congress would provide a massive infusion of aid, including $150 billion in state and local governments to fight the outbreak, and could be passed by the Senate later on Wednesday. The measure would still have to pass the House of Representatives before Trump could sign it into law.

The plan also includes loan programs for hard-hit industries and small businesses, direct payments of up to $3,000 to millions of U.S. families, expanded unemployment aid and billions of dollars for hospitals and health systems.

National Guard troops have been activated to assist with the virus fight, while two U.S. Navy hospital ships have been directed to head to Los Angeles and New York City to help relieve the strain on local hospitals. The U.S. military is preparing field hospitals in New York and Seattle.

NEW YORK UNDER SIEGE

With more than 8 million people densely packed in New York City, New York has become the epicenter of the U.S. outbreak as the number of COVID-19 cases threatens to overwhelm its healthcare system.

The White House on Tuesday advised anyone who has visited or left New York to isolate themselves as the number of cases in the state swelled to more than 25,600 confirmed infections and 210 deaths.

Officials from the state have pleaded for more equipment and hospital beds and lamented a lack of urgency by federal officials in recent weeks as the threat grew increasingly dire.

New York Governor Andrew Cuomo, a Democrat, and Trump have clashed in recent days over the federal government’s response. Cuomo has called for thousands of new ventilators and urged the president to utilize his federal powers to speed up manufacturing for critical health equipment.

Trump, in a Fox News interview on Tuesday, defended his response, adding: “It’s a two-way street. They have to treat us well also.”

On Wednesday, Trump fired back against the reported tensions, tweeting: “I am working very hard to help New York City & State. Dealing with both Mayor & Governor and producing tremendously for them, including four new medical centers and four new hospitals. Fake News that I won’t help them because I don’t like Cuomo (I do). Just sent 4000 ventilators!”

A Reuters/Ipsos poll conducted from March 18-24 showed that 68% of U.S. adults agreed that the coronavirus was a serious existential threat, up 14 percentage points from a similar poll from a week earlier. This includes majorities of Democrats and Republicans, whites, minorities, young, old, urban, suburban and rural residents. The poll found that 33% now said they think it is very or somewhat likely they will be infected within the next year, up 5 percentage points from last week.

(Reporting by Susan Heavey; Editing by Chizu Nomiyama and Will Dunham)