April 22 coronavirus news

Health officials in California are now recommending coronavirus testing for asymptomatic people who live or work in high-risk environments like nursing homes and hospitals, according to new guidelines from the California Department of Public Health.

The move, announced in an April 19 memo to public health departments and others, makes California the first state in the nation to broaden its guidelines for testing to include asymptomatic people, state health officials told CNN.

The updated guidelines from the CDPH says the testing of asymptomatic people who work or live in high-risk settings such as nursing homes and prisons is now considered to be a top priority, along with hospitalized patients and symptomatic health care workers.

Standards vary across the United States when it comes to who can and can’t get a coronavirus test. But while most of the country has focused on testing patients who are already sick, California is describing itself as a pioneer in recommending tests for people without any symptoms at all, so long as they’re in high-risk settings.

According to a CDPH spokesperson, the previous guidance from the US Centers for Disease Control and Prevention was to test high-risk patients with symptoms and health care workers with symptoms.

Newsom said that the state must expand testing before it can begin to reopen. He is expected on Wednesday to detail how the state will continue to expand testing as part of the state’s “Road Map to Reopening.”

In the Brazilian city of Manaus, the capital of the northwestern state of Amazonas, excavators are digging mass graves, which are later filled with several coffins by cemetery workers, according to CNN affiliate CNN Brasil.

The city is handling more than 100 burials a day due to coronavirus, according to the office of Manaus Mayor Arthur Virgilio Neto. Before the spread of the disease, the average was 30 burials a day.

The department responsible for burials in the city started to dig trenches to carry out the burials of Covid-19 victims.

This practice is used by other countries and preserves the identities of the bodies, with distance between the coffins and the respective identifications.

In an interview with CNN Brasil Tuesday evening, Virgilio Neto said the health system is no longer able to serve those who need treatment and people have started to die at home.

At least 824,438 people in the United States have been diagnosed with Covid-19, according to Johns Hopkins University's tally of cases. The total includes at least 45,039 deaths.

The University has reported at least 37,179 new cases and 2,731 deaths so far on Tuesday.

The number of fatalities could begin to increase significantly in the coming days because some states will begin including “probable deaths” in their tallies, and so will Johns Hopkins. Those could look like surges in the number of Covid-19 related deaths in the United States. 

CNN is tracking US coronavirus cases here:

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Tracking Covid-19 cases in the US

South Korea recorded 11 new cases of Covid-19 and one coronavirus-related fatality on Tuesday, the country's Centers for Disease Control and Prevention said.

Six of the new cases were imported from abroad.

Total numbers: South Korea has recorded 10,694 coronavirus infections and 238 fatalities since the pandemic began, according to public health authorities.

Sixty-four more recovered patients have been discharged from isolation, bringing the national total of recovered cases to 8,277 -- 77.4% of all people diagnosed with the virus.

China reported 30 new cases of novel coronavirus and no additional deaths on Tuesday, according to the country's National Health Commission.

Among the new cases, 23 were imported and seven were locally transmitted. The local cases were reported in the country's northernmost Heilongjiang province, which shares a border with Russia.

Another 28 patients were discharged.

Total numbers: The NHC has reported 82,788 Covid-19 infections as of the end of the day Tuesday. Since the pandemic began, 77,151 people have recovered, while 4,632 deaths have been reported, according to the NHC.

Now is "no time to pop the champagne bottles" despite the fact that construction has stopped on temporary field hospitals, New York Gov. Andrew Cuomo warned.

New York state identified and received federal government approval for eight facilities for use as temporary field hospitals, CNN previously reported.

However, as of Tuesday, not all are needed or in use at this time, according to a state government administration official. If the need for hospital beds or facilities spikes then “we’re ready to re-engage with our federal partners,” the official said.

But while new construction has stopped on temporary field hospitals, Cuomo said he is not ready to stop those projects completely.

“We stopped any new construction when we saw the rates starting to stabilize but I’m not ready to close anything down yet, either,” Cuomo said Tuesday night. “Now you have some health experts, CDC today starts to warn about an outbreak in the fall, I don’t even want to think about that yet.”

New York state has recorded more than 258,000 coronavirus cases, including at least 19,114 deaths, according to data compiled by Johns Hopkins University.

Indonesia has banned all citizens from traveling to their hometowns for Eid al-Fitr celebrations in an effort to contain the spread of novel coronavirus, the country’s President Joko Widodo said Tuesday.

Millions of people normally go back to their hometowns to see their families every year in a homecoming tradition known as "mudik," the report said.

Jokowi did not provide specifics on how the ban will be enforced.

The President also said the decision was taken to curb travel after a recent government study showed the majority of the population did not intend to return home for the festival. However, around 24% of Indonesians were still planning to make the journey, Antara reported.

Indonesia has recorded more than 7,000 coronavirus cases and at least 616 deaths, according to Johns Hopkins University.

This post was updated to reflect that Jokowi did not provide specifics on enforcement of the ban.

New York Gov. Andrew Cuomo said Tuesday that US President Donald Trump agreed to take ownership of the national supply chain to get coronavirus testing kit manufacturers the supplies they need to produce kits

The problem with bringing testing up to scale is the national manufacturers who make the testing kits and send them to state labs, Cuomo said. Those companies say they have a problem with the supply chain getting swabs, vials and chemicals to produce the testing kits, Cuomo added.

The governor said his meeting at the White House was “very productive, positive, got a lot done."

Some of the meeting focused on the importance of dividing the responsibilities between states and federal government to scale up testing, he said.

The state will be responsible for managing diagnostic and antibody testing, who to test, where to test and tracing cases, Cuomo said.

The goal is to double New York State’s testing from 20,000 diagnostic tests to 40,000 diagnostic and antibody tests, he said.

“It will take several weeks at best, this is an enormous undertaking,” Cuomo added.

As several states make plans for reopening their communities during the coronavirus pandemic, a group of top public health experts cautioned Tuesday against reopening society before testing capacity expands significantly.

Different parts of the country are in different stages of the epidemic, with New York well into the first wave and other places just beginning to see the impact of the disease. This matters, said Dr. Caroline Buckee, Harvard associate professor of epidemiology and the associate director of the university’s Center for Communicable Disease Dynamics. 

Knowing the location of the virus is key to relaxing social distancing and returning to normalcy, Buckee told a symposium sponsored by Harvard’s T.H. Chan School of Public Health and the New England Journal of Medicine.

The lack of testing capacity is a big problem because the disease has “a very broad clinical spread,” Buckee said. So even when people show up at the hospital and get tested there are many more cases in the community, including mild and asymptomatic cases. “And those are the people that are spreading the disease,” she said.

It’s important to learn whether people who have recovered can still spread the disease, noted NEJM editor Dr. Eric Rubin.

Buckee added that without knowing the answers, the nation could reopen too soon and risk a deadly second pandemic wave.

“Right now, we don’t have good estimates for where we are on the epidemic curve in different places. So, discussions of relaxation of physical distance, which do seem to be having an effect, curbing some of the worst impacts of the outbreak, need to be based on the capacity to test people so we know where we are,” she said.