As the number of cases and deaths from novel coronavirus increase across the US, federal health officials are expanding testing for the fast-moving outbreak.
The new guidance issued by the US Centers for Disease Control and Prevention on Wednesday formalizes an announcement by Vice President Mike Pence that any American with a doctor's order can be tested with no restrictions.
It removes earlier restrictions that limited testing for the virus to people who'd been hospitalized with a fever and respiratory symptoms -- or a patient who had close contact with a confirmed coronavirus patient.
Clinicians should now "use their judgment to determine if a patient has signs and symptoms compatible with ... (coronavirus) and whether the patient should be tested," the CDC said.
Experts have questioned whether the United States can meet the likely surge in testing demand that will follow the change in guidelines.
Two kinds of coronavirus tests in the United States have FDA emergency use authorizations and are in use nationwide.
One kind is the CDC test kits that are distributed to public health laboratories across the country, and another test has been designed and used by New York state.
At least 163 coronavirus cases have been reported across 16 states, most of them in California and Washington states.
The number of cases includes 46 repatriated citizens from the Diamond Princess cruise ship, which docked in Japan last month after an outbreak and quarantine, as well as three Americans repatriated from Wuhan, China, the epicenter of the outbreak.
Another cruise ship is linked to coronavirus
California's first coronavirus death was reported Wednesday -- a former passenger on Princess cruise line's Grand Princess ship who died almost two weeks after he returned home.
The unidentified man was 71 and had underlying health conditions, Placer County health officials said. He was likely exposed to the virus on his cruise from San Francisco to Mexico between February 11 to 21.
On Thursday morning, the Grand Princess was headed back to the California coast from another voyage to Hawaii. Federal health officials will screen people on aboard, including some who went on the same voyage as the California man who died.
The cruise line said 62 passengers currently on the ship had also traveled on the San Francisco-Mexico trip last month and remained on board for this voyage.
"We have shared essential travel and health data with the CDC to facilitate their standard notification to the state and county health authorities to follow up with individuals who may have been exposed to people who became ill," Princess Cruises said in a statement.
To screen passengers, the US Coast Guard will deliver kits to the ship Thursday via helicopter, and a medical team aboard will administer the tests.
The samples will be sent by helicopter to a lab in Richmond, California, Princess Cruises said.
There are 11 passengers and 10 crew members who've developed symptoms Gov. Gavin Newsom said. The ship is carrying 2,500 passengers.
The governor declared a state of emergency, which allows for more money to be allocated for the state's response.
The Grand Princess is the second cruise ship recently linked to coronavirus. More than 600 cases of coronavirus were reported from Diamond Princess cruise ship last month.
Passengers on that ship were quarantined in Tokyo Bay.
Washington state is hard-hit
The vast majority of deaths in the US have been in Washington state, where 10 people have died.
Nine of those deaths happened in King County, and most of them had ties to Life Care Center, a long-term nursing home in the Seattle suburb of Kirkland.
The nursing home's outbreak more recent cases in states such as Florida, Georgia and Rhode Island have heightened concerns among health care experts, said Nancy Messonnier, director of CDC's National Center for Immunization and Respiratory Diseases.
"As more areas see community spread, local communities may start employing tools that encourage social distancing," Messonnier said.
"The goal of social distancing is to limit exposure by reducing face-to-face contact and preventing spread among people in community settings."
One reason why the number of confirmed cases keeps rising is because more tests are becoming available.
Public health labs using CDC test kits are expected to test up to 75,000 people by the end of the week, the CDC said.
That's on top of the nearly 1 million people expected to be tested through commercial labs approved for testing by the US Food and Drug Administration.
Schools, festivals affected
At least 57 schools were closed Thursday in the United States due to the Novel Coronavirus. Of those 57, 36 are in Washington State, 20 are in New York State, and one is in Rhode Island.
Additional schools that announced closures last week and earlier this week have reopened.
The South by Southwest (SXSW) festival in Austin, Texas, lost one major participant.
A Netflix spokesperson confirmed to CNN that the streaming company is pulling out due to concerns about the coronavirus. The pullout was first reported in Variety.
SXSW is an annual conference combining technology, music, media, and film scheduled from March 13 to March 22. Austin public health officials announced the conference would continue as planned despite concerns about the coronavirus.
In Ohio, Gov. Mike DeWine announced Thursday that while athletic events will continue at the Arnold Sports and Fitness expo in Columbus, general spectators will be prohibited from attending.
In a statement, the governor said health officials are "concerned that that almost all the athletic competitions at the festival are not single-ticket events and are rather general admission, which allows for spectators to attend dozens of events and travel freely from facility to facility. ... With these public health concerns in mind, the State has issued an order prohibiting general spectators from attending."