Coronavirus fatalities in the US have doubled in two days and while the President Donald Trump talked of quarantining some states, hot spots are emerging across the country.
The President has now said it would not be necessary to bring in state quarantines, but instead he would ask federal health officials to issue a 'strong travel advisory'.
As well as the big cities like New York, Detroit, New Orleans and Chicago, new clusters have erupted everywhere from small Midwestern towns to Rocky Mountain ski areas.
The US leads the world in reported cases with more than 115,000, out of the global total of 650,000. Confirmed deaths surpassed 2,000 on Saturday, twice the number just two days before, highlighting how quickly infections are escalating. Five countries have higher death tolls, with Italy alone having more than 10,000 deaths
Illinois Governor J.B. Pritzker said on Saturday that an infant with COVID-19 died in Chicago and the cause of death is under investigation.
New York remained the worst-hit US city. Governor Andrew Cuomo said defeating the virus will take "weeks and weeks and weeks." The UN donated 250,000 face masks to the city, and Cuomo delayed the state's presidential primary from April 28 to June 23.
As President Donald Trump made his way to Norfolk, Virginia, to see off a US Navy medical ship sent to New York City to help, he suggested imposing some kind of quarantine for New York and parts of New Jersey and Connecticut, all hit hard by the coronavirus. The federal government generally does not have the power to impose such restrictions on states.
Cuomo pushed back hard on the suggestion, saying on CNN that he believed it would be illegal, economically catastrophic, unproductive since other areas are already seeing a surge and amount to "a federal declaration of war."
But some states without known widespread infections began to try to limit exposure from visitors from their stricken neighbours.
Rhode Island National Guard troops were instructed to go door to door in coastal communities to find New Yorkers and advise them about a mandatory 14-day quarantine for people from the state.
Florida Governor Ron DeSantis, a Republican and close Trump ally, told reporters he had spoken with the president about the possibility of a quarantine for the greater New York City area. DeSantis had already ordered anyone arriving from Louisiana to self-quarantine and said law enforcement officers would set up checkpoints to screen cars from the state.
Louisiana has surpassed 3,300 infections with 137 dead from COVID-19, according to the health department. Governor John Bel Edwards said the region was on track to run out of ventilators by the first week of April.
Cases also have been rising rapidly in Detroit, where poverty and poor health have been problems for years. The number of infections surged to 1,381, with 31 deaths, as of noon Saturday.
"At this time, the trajectory of Detroit is unfortunately even more steep than that of New York," said Dr. Teena Chopra, the medical director of infection prevention and hospital epidemiology at the Detroit Medical Centre.
"This is off the charts," she said.
Trump approved a major disaster declaration for Michigan, providing money for the outbreak. He has done the same for New York, Louisiana and Illinois.
The governor of Kansas issued a stay-at-home order to begin Monday, as the virus takes hold in more rural areas where doctors worry about the lack of ICU beds.
A cluster of three counties in rural Indiana have surging rates of confirmed cases. One of them, Decatur, population 26,000, has 30 cases with one confirmed death and another suspected, said Sean Durbin, the county's public health emergency preparedness coordinator. Several cases were traced to large gatherings earlier in the month, including a religious retreat and a high school basketball tournament.
Blaine County, Idaho, a scenic ski haven for wealthy tourists, now has around 100 confirmed cases of COVID-19, the highest rate per capita outside the New York area. Two people have died.
More than 135,000 people have recovered, according to Johns Hopkins.
Australian Associated Press