"What is happening now in the United States may be the beginning of what is happening abroad," says Dr. Nancy Messonnier, a director at the CDC

U.S. cases of the new coronavirus now number 108, as state health officials in Washington say that three more people have died, bringing the death toll up to nine.

All nine of the U.S. deaths have been in Washington state, with most coming from patients at a long-term nursing facility in Kirkland, just outside of Seattle. On Tuesday, health officials said that a person who died last week in a Seattle hospital has tested positive for coronavirus, meaning they were the first U.S. death from the disease. They were also a patient from the long-term nursing facility, The New York Times reported.

There are now 15 states with confirmed cases of COVID-19, the official name for this new coronavirus. Of the 108 cases, 22 are in people who recently traveled to cities with outbreaks, 11 are from those people’s close contacts and 27 are under investigation, meaning they have no direct contact with people with coronavirus and are likely cases of community spread.

The remaining 44 cases are in people who were repatriated to the U.S. by the State Department, either because they were living in China or because they were on the quarantined Diamond Princess cruise, the site of a major outbreak.

Healthcare workers transport a patient on a stretcher into an ambulance at Life Care Center of Kirkland
Workers at Life Care Center load patients into an ambulance
| Credit: David Ryder/Getty

In a press briefing on Tuesday, Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control, said that they “expect to find more cases.”

“What is happening now in the United States may be the beginning of what is happening abroad,” she said, referring to the instances of community spread in countries other than China, such as Italy, South Korea and Iran.

Messonnier said that people may have to be quarantined if they show signs of illness.

“Follow health care providers and what they say. If a health care provider, or a public health worker, tells you to stay home for 14 days, unless you need medical care, please do that,” she said. “You may need to take a break from your normal, daily routine for two weeks. Staying home when you are sick is really important. Don’t let the virus spread beyond you. Stay away from other people.”

New York confirms second coronavirus case
People wear face masks in New York City’s Times Square
| Credit: Eduardo Munoz / VIEWpress via Getty

She also said that while reports say that “most COVID-19 illness is mild,” the severe cases are worrisome.

“A report out of China suggests serious illness occurs in 16 percent of cases,” she said. “Older people and people with underlying health conditions like heart disease, lung disease and diabetes, for example, were about twice as likely to develop serious outcomes, versus otherwise younger, healthier people. We are particularly concerned about these people, given the growing number of cases in the United States, as well as those with suspected community spread.”

Messonnier said that they are working on medications and vaccines to fight the virus.

The CDC also says that the best prevention methods are basic forms of hygiene — careful handwashing, avoiding touching the face, moving away from people who are coughing or sneezing and staying home at signs of illness.