ABSTRACT
From January 21 through February 23, 2020, a total of 14 cases of coronavirus disease 2019 (COVID-19) were diagnosed in six US states, including 12 cases in travelers arriving from China and two in household contacts of persons with confirmed infections. By mid-March, transmission of SARS-CoV-2, the virus that causes COVID-19, had accelerated, with rapidly increasing case counts indicating established transmission in the United States. The first cases of COVID-19 in the United States occurred in January and February 2020 in travelers from China’s Hubei Province, where the virus was first recognized, and their household contacts. Skilled nursing and long-term care facilities and hospitals are settings in which persons at higher risk for severe COVID-19 illness are in close contact with staff members, many of whom work at multiple facilities.
