Top U.S. public health official expects coronavirus outbreak to worsen

WASHINGTON, March 10 (Reuters) - The U.S. coronavirus outbreak is likely to get worse, the country's top public health official said on Tuesday, and Americans should assess their personal circumstances when deciding whether to cancel travel plans or avoid public gatherings.

The virus, which can cause a sometimes fatal flu-like respiratory illness, has steadily spread in the United States this week, disrupting life and spooking investors who worry that a contraction in economic activity could trigger a recession.

"Not every community has an outbreak going on right now, but people should know that this is likely to get worse before it gets better," U.S. Surgeon General Jerome Adams said in an interview on ABC's "Good Morning America" program.

A total of 755 confirmed cases of the coronavirus were confirmed nationwide as of Tuesday morning, according to a tally by Johns Hopkins University. There have been 26 coronavirus-related deaths in the country, most of them in Washington state.

The Trump administration has been criticized for a slow response to the public health crisis and is under growing pressure to do more to help workers and companies hurt by the outbreak and to boost investors' confidence in the economy.

After U.S. stock indexes recorded their biggest one-day selloff since 2008 on Monday, President Donald Trump said his administration would take "major" steps to gird the economy and discuss a possible payroll tax cut with congressional Republicans on Tuesday.

He did not provide details but said a news briefing would be held on Tuesday.

A payroll tax cut could encourage consumer spending and help households that might otherwise struggle to make rent and mortgage payments on time or pay medical bills if family members' work hours are reduced during the coronavirus outbreak.

U.S. stock indexes opened higher on Tuesday.

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More than 113,000 people have contracted the coronavirus around the world and nearly 4,000 have died since it surfaced in China late last year. More than 100 nations have reported cases, with Italy bearing the brunt of the outbreak in Europe.

Italy's government on Monday took its most drastic steps yet to contain the outbreak, ordering the country's 60 million people not to move around other than for work or emergencies, banning public gatherings and suspending sporting events.

In the United States, 34 of the 50 states and the District of Columbia have reported infections of COVID-19, the illness caused by the virus, to the U.S. Centers for Disease Control and Prevention (CDC).

Washington state has been the hardest hit, with a nursing home in the Seattle suburb of Kirkland accounting for the bulk of the state's 22 confirmed deaths.

In California, the Grand Princess cruise ship docked at the Port of Oakland on Monday and had begun offloading its 2,400 passengers. The vessel was barred from returning to San Francisco last week due to a coronavirus outbreak on board.

Most of the passengers will be quarantined at military bases in the United States, with those requiring immediate medical attention heading to hospitals. The crew of 1,100 will be quarantined and treated aboard the ship, unless they are in need of acute care off the vessel.

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Coronavirus outbreak in the U.S.
Vice President Mike Pence points to a question as he speaks during a briefing about the coronavirus in the James Brady Press Briefing Room of the White House, Sunday, March 15, 2020, in Washington. (AP Photo/Alex Brandon)
Tyler Baldwin mops the floor after closing for the night at the Taproom at Pike Place, Sunday, March 15, 2020 where he works as a bartender in Seattle. Washington Gov. Jay Inslee said Sunday night that he would order all bars, restaurants, entertainment and recreation facilities in the state to temporarily close to fight the spread of coronavirus, as Washington state has by far the most deaths in the U.S. from the disease. Baldwin said he closed more than an hour early Sunday after he heard the announcement. (AP Photo/Ted S. Warren)
A freeway sign urging people to wash their hands to avoid the COVID-19 virus is seen along the 101 Ventura freeway Sunday, March 15, 2020, in Westlake Village, Calif. (AP Photo/Mark J. Terrill)
Shelves are emptied of paper toilet and product supplies at a Safeway store in Phoenix on Sunday, March 15, 2020. Arizona's governor and school superintendent on Sunday ordered a statewide closure of schools through at least March 27 as authorities rush to contain the outbreak of the new coronavirus. (AP Photo/Brian Skoloff)
A store vendor wears a face mask as she waits for customers in Chinatown in New York, on Sunday, March 15, 2020. President Donald Trump on Sunday called on Americans to cease hoarding groceries and other supplies, while one of the nation's most senior public health officials called on the nation to act with more urgency to safeguard their health as the coronavirus outbreak continued to spread across the United States.(AP Photo/Wong Maye-E)
Workers from a Servpro disaster recovery team wearing protective suits and respirators are given supplies as they line up before entering the Life Care Center in Kirkland, Wash., to begin cleaning and disinfecting the facility, Wednesday, March 11, 2020. The nursing home is at the center of the coronavirus outbreak in Washington state. For most people, the virus causes only mild or moderate symptoms. For some it can cause more severe illness, especially in older adults and people with existing health problems. (AP Photo/Ted S. Warren)
March 11th 2020 - Tom Hanks and Rita Wilson have tested positive for the novel coronavirus. - File Photo by: zz/KGC-11/STAR MAX/IPx 2016 9/9/16 Tom Hanks and Rita Wilson at The 5th Biennial Stand Up To Cancer (SU2C). (Los Angeles, CA)
NBA referee Marc Davis, left, takes a phone call as fellow referee Justin Van Duyne stands next to Davis before the basketball game between the New Orleans Pelicans and Sacramento Kings was postponed at the last minute in Sacramento, Calif., Wednesday, March 11, 2020. The league said the decision was made out of an "abundance of caution," because official Courtney Kirkland, who was scheduled to work the game, had worked the Utah Jazz game earlier in the week. A player for the Jazz tested positive for the coronavirus. (AP Photo/Rich Pedroncelli)
NBA referee Marc Davis leaves the court after the the NBA basketball game between the Sacramento Kings and the New Orleans Pelicans was postponed at the last minute in Sacramento, Calif., Wednesday, March 11, 2020. The postponement was due to what the league said was an "abundance of caution," because official Courtney Kirkland, who was scheduled to work the game, had worked the Utah Jazz game earlier in the week. A player for the Jazz tested positive for the coronavirus. (AP Photo/Rich Pedroncelli)
From left Ellie Unruh, Abbie Unruh, Zoe Yates, and Evi Yates bump elbows instead of high-fives while playing volleyball at a local park Sunday, March 15, 2020, in Gilbert, Ariz. The girls were playing with friends after their respective volleyball clubs and teams practices and games were canceled statewide due to the COVID-19 coronavirus. Arizona Gov. Doug Ducey announced earlier in the day that all schools and sports throughout Arizona are temporarily closed through March 27th challenging some parents to get creative in keeping their kids active. (AP Photo/Matt York)
A basketball fan walks past a sign on how to decrease the risk of catching the coronavirus outside a restroom at the American Airlines Arena during the first half of an NBA basketball game between the Miami Heat and the Charlotte Hornets, Wednesday, March 11, 2020, in Miami. (AP Photo/Wilfredo Lee)
President Donald Trump speaks in an address to the nation from the Oval Office at the White House about the coronavirus Wednesday, March, 11, 2020, in Washington. (Doug Mills/The New York Times via AP, Pool)
FILE PHOTO: Voters cast their ballot in the Democratic primary election in Houston
A trader works on the floor at the New York Stock Exchange (NYSE) in New York City, New York
Judie Shape, left, who has tested positive for the coronavirus, waves to her daughter, Lori Spencer, right, Wednesday, March 11, 2020, as they visit on the phone and look at each other through a window at the Life Care Center in Kirkland, Wash., near Seattle. In-person visits are not allowed at the nursing home. The vast majority of people recover from the new coronavirus. According to the World Health Organization, most people recover in about two to six weeks, depending on the severity of the illness. (AP Photo/Ted S. Warren)
Judie Shape, center, who has tested positive for the coronavirus, blows a kiss to her son-in-law, Michael Spencer, left, as Shape's daughter, Lori Spencer, right, looks on, Wednesday, March 11, 2020, as they visit on the phone and look at each other through a window at the Life Care Center in Kirkland, Wash., near Seattle. In-person visits are not allowed at the nursing home. The vast majority of people recover from the new coronavirus. According to the World Health Organization, most people recover in about two to six weeks, depending on the severity of the illness. (AP Photo/Ted S. Warren)
As President Donald Trump listens, Vice President Mike Pence speaks in the briefing room of the White House in Washington, Monday, March, 9, 2020, about the coronavirus outbreak. (AP Photo/Carolyn Kaster)
Yirmeyahu Gourarie performs a Purim reading from the Book of Esther for residents under self-quarantine due to potential exposure to the new coronavirus, Monday, March 9, 2020, in New Rochelle, N.Y. In Westchester County, student volunteers from a Jewish secondary school were fanning out in teams to read the megillah on Monday evening and during the day Tuesday outside the homes of about 120 families from the community who are quarantined. (AP Photo/John Minchillo)
This March 9, 2020, image provided by Carolyn Wright, a passenger aboard the Grand Princess, shows the disembarkation of the passengers from the cruise ship which is docked in Oakland, Ca. For most people, the new coronavirus causes only mild or moderate symptoms, such as fever and cough. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia. (Courtesy of Carolyn Wright via AP)
Tim Killian, center, a spokesman for Life Care Center in Kirkland, Wash., talks to reporters, Monday, March 9, 2020, at the facility near Seattle. The nursing home is at the center of the outbreak of COVID-19 in Washington state. (AP Photo/Ted S. Warren)
A sign stands next to a sanitizing station at the entrance of the Vivint Smart Home Arena before an NBA basketball game between the Toronto Raptors and the Utah Jazz, Monday, March 9, 2020, in Salt Lake City. (AP Photo/Rick Bowmer)
Workers prepare a wharf at the Port of Oakland to receive the Grand Princess in Oakland, Calif., Sunday, March 8, 2020. The cruise ship, miles off the port Sunday, is expected to dock Monday for novel coronavirus quarantine after multiple people tested positive for the virus. (AP Photo/Noah Berger)
En esta imagen tomada de un video cortesía de la Guardia Nacional de California, un helicóptero del 129no batallón de rescate sobrevuela el crucero Gran Princess frente a las costas de California, el jueves 5 de marzo de 2020. (Guardia Nacional de California vía AP)
In this image from video, provided by the California National Guard, airmen with the 129th Rescue Wing drop virus testing kits down to the Grand Princess cruise ship off the coast of California Thursday, March 5, 2020. Scrambling to keep the coronavirus at bay, officials ordered a cruise ship with 3,500 people aboard to stay back from the California coast Thursday until passengers and crew can be tested, after a traveler from its previous voyage died of the disease and at least two others became infected. The California National Guard 129th Rescue Wing lowered test kits onto the 951-foot (290-meter) Grand Princess by rope as the vessel lay at anchor off Northern California, and authorities said the results would be available on Friday. Princess Cruise Lines said fewer than 100 people aboard had been identified for testing. (California National Guard via AP)
Passengers look out from balconies aboard the Grand Princess as it cruises a holding pattern about 25 miles off the coast of San Francisco on Sunday, March 8, 2020. The ship is expected to dock in Oakland in the east San Francisco Bay on Monday. California Gov. Gavin Newsom and the mayor of Oakland sought Sunday to reassure the public that none of the passengers from the ship with multiple cases of the new coronavirus will be released into the public before undergoing a 14-day quarantine. (AP Photo/Noah Berger)
Carrying multiple people who have tested positive for COVID-19, the Grand Princess maintains a holding pattern about 30 miles off the coast of San Francisco, Sunday, March 8, 2020. The cruise ship is scheduled to dock at the Port of Oakland on Monday. (AP Photo/Noah Berger)
A man wears a mask aboard the Grand Princess as it maintains a holding pattern about 25 miles off the coast of San Francisco on Sunday, March 8, 2020. The cruise ship is scheduled to dock at the Port of Oakland on Monday for COVID-19 quarantine after 21 people tested positive for the virus. (AP Photo/Noah Berger)
SPRINGFIELD, VA - MARCH 7: Local Target store in the D.C area depleted of cleaning and sanitizing supplies and left with empty shelves as fear grow of COVID-19 (the coronavirus) reports increasing on March 7, 2020 in Springfield, Virginia. Credit: mpi34/MediaPunch /IPX
SPRINGFIELD, VA - MARCH 7: Local Target store in the D.C area depleted of cleaning and sanitizing supplies and left with empty shelves as fear grow of COVID-19 (the coronavirus) reports increasing on March 7, 2020 in Springfield, Virginia. Credit: mpi34/MediaPunch /IPX
The headquarters for Centers for Disease Control and Prevention is shown on Friday, March 6, 2020 in Atlanta, Georgia. President Donald Trump's trip to the Centers for Disease Control and Prevention, briefly scuttled Friday because of unfounded fears that someone there had contracted the coronavirus, was back on, giving the president another chance to calm growing alarm about the spread of the virus in America. (AP Photo/ Ron Harris)
An ambulance backs into a parking lot, Friday, March 6, 2020, at the Life Care Center in Kirkland, Wash., which has become the epicenter of the COVID-19 coronavirus outbreak in Washington state. This ambulance left the facility after a short time and did not transport a patient. (AP Photo/Ted S. Warren)
Ambulance workers move a man on a stretcher from the Life Care Center in Kirkland, Wash. into an ambulance, Friday, March 6, 2020. The facility is the epicenter of the outbreak of the the COVID-19 coronavirus in Washington state. (AP Photo/Ted S. Warren)
A woman uses protective gloves as she looks at her phone wrapped in a plastic bag while riding a New York City subway train, Monday, March 9, 2020. (AP Photo/Richard Drew)
Secretary of Health and Human Services Alex Azar looks on as President Donald Trump shows a spending bill to combat the Coronavirus, at the White House, Friday, March 6, 2020, in Washington. (AP Photo/Evan Vucci)
President Donald Trump holds a photograph of coronavirus as Dr. Steve Monroe,right, with CDC speaks to members of the press at the headquarters of the Centers for Disease Control and Prevention in Atlanta on Friday, March 6, 2020. President Trump's trip to the Centers for Disease Control and Prevention, briefly scuttled Friday because of unfounded fears that someone there had contracted the coronavirus, was back on, giving the president another chance to calm growing alarm about the spread of the virus in America. (Hyosub Shin/Atlanta Journal-Constitution via AP)
Photo by: John Nacion/STAR MAX/IPx 2020 3/6/20 People wear masks to protect themselves from the Corona Virus in New York City.
Photo by: John Nacion/STAR MAX/IPx 2020 3/6/20 People wear masks to protect themselves from the Corona Virus in New York City. Shoppers have cleared store shelves of sanitizing products.
Vice President Mike Pence, left, arrives with Debi Birx, center, White House coronavirus response coordinator, and Robert Redfield, right, director of the CDC, Thursday, March 5, 2020, at Joint Base Lewis-McChord in Washington state for a visit with state officials. (AP Photo/Ted S. Warren)
Vice President Mike Pence greets Washington Gov. Jay Inslee, left, as Pence arrives, Thursday, March 5, 2020 at Joint Base Lewis-McChord in Washington state. Officials are avoiding handshakes due to the COVID-19 coronavirus. (AP Photo/Ted S. Warren)
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California and New York each have more than 140 confirmed coronavirus cases.

As the outbreak spreads, daily life in United States has been increasingly disrupted, with concerts and conferences canceled, and universities urging students to stay home and take classes online.

U.S. health officials have urged older people, especially those with chronic medical concerns, to avoid big social gatherings, cruise ships and airline flights.

The public is advised to wash hands frequently and practice "social distancing" - minimizing unnecessary contact with others in public settings. Several U.S. lawmakers have gone into self-quarantine after being in contact with a person at a conference who later tested positive for coronavirus.

Harvard University asked its students on Tuesday not to return to campus after the spring break this month, and said it would begin moving to virtual instruction for graduate and undergraduate classes. (Reporting by Susan Heavey and Lisa Lambert in Washington and Shubham Kalia in Bengaluru Editing by Paul Simao and Bernadette Baum)

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