Below are 28 updates from the six states hit hardest by the COVID-19 pandemic:
New York (258,589 confirmed cases as of 7:25 a.m. CDT April 22)
1. New York, New Jersey and Connecticut will launch a joint contact tracing program, New York Gov. Cuomo said at a media briefing April 22.
To reopen the state and gradually lift restrictions, testing, tracing and isolating will have to be conducted on a large scale, he said. This includes testing people, and when a person tests positive for the virus, tracing all the people the infected person had contact with and testing them, and then isolating all those who test positive for the virus. Former New York City Mayor Michael Bloomberg has volunteered to help develop and implement the testing/tracing/isolation program.
New York currently has 225 tracers, and plans to build out a “tracing army,” Mr. Cuomo said. “We will literally need thousands [of people].”
2. President Donald Trump agreed to waive New York’s state match for Federal Emergency Management Agency, said Mr. Cuomo April 22. Normally, New York has to pay 25 percent of FEMA costs.
“That would [have been] a cruel irony for New York,” Mr. Cuomo said. “New York has the highest number of cases in the country, so our FEMA cost was the highest in the nation.”
3. Some hospitals in some counties will be allowed to resume elective outpatient procedures in New York, Mr. Cuomo said at an April 21 media briefing.
Hospitals may begin performing elective outpatient procedures once again on April 28, "if the hospital capacity is over 25 percent for the county and if there have been fewer than 10 new hospitalizations of COVID-19 patients in the county over the past 10 days," a statement reads. If a hospital's capacity dips below that 25 percent threshold or if a county experiences an increase of 10 or more in COVID-19 patients, they must stop performing these elective surgeries.
Also, patients undergoing elective outpatient procedures must test negative for COVID-19 prior to treatment.
4. The Navy ship Comfort will leave New York City and get "ready for its next mission," President Trump said April 21, according to CNBC. The ship was sent to New York to support the state's coronavirus response. About 71 of 500 available beds onboard the ship were occupied as of April 17. The Federal Emergency Management Agency will determine the ship's next mission.
5. Mr. Cuomo met with President Trump April 21 to discuss testing, and at the meeting they agreed that while the state government would be responsible for managing the actual tests in the laboratories, the federal government would step in and take responsibility for the federal supply chain for national manufacturers of testing kits, Mr. Cuomo said.
"The national manufacturers have said they have a problem with the supply chain to quickly ramp up those tests," said Mr. Cuomo. "They need swabs, they need vials and they need chemicals... That is where the federal government can help."
New York can currently perform about 20,000 tests per day, and the goal is to double that amount, he said.
6. Secretary to the Governor Melissa DeRosa and the New York State Council on Women and Girls launched a COVID-19 maternity task force. The task force will review literature and make recommendations on the effects of COVID-19 on pregnancy, and it will examine best approaches to authorizing and certifying additional birthing centers to provide pregnant women with a safe alternative to going to hospitals amid the pandemic.
7. Teams from New York City-based NewYork-Presbyterian started offering voluntary antibody testing for healthcare workers who have recovered after contracting the new coronavirus, according to MedPage Today.
Read more about how New York is fighting the coronavirus here.
New Jersey (92,387 confirmed cases as of 7:25 a.m. CDT April 22)
1. On April 21, New Jersey again saw its highest single-day increase in COVID-19 deaths, NJ.com reports. New Jersey Gov. Phil Murphy reported 379 fatalities associated with the virus for the 24-hour period prior.
"These are not numbers, these are human beings," Mr. Murphy said during an April 21 media briefing. "Too many lives have been lost. Sadly, we expect more will be lost."
2. A list of 425 nursing homes and healthcare facilities that have experienced COVID-19 infections and deaths in New Jersey was released by state officials on April 20, northjersey.com reports.
The list was published in the interest of transparency, according to New Jersey Department of Health Commissioner Judith Persichilli, RN. But concerns have been raised about its accuracy as it does not "reflect real-time data" and COVID-19 numbers "are constantly changing."
Jon Dolan, president of the Health Care Association of New Jersey, graded the list "an A for transparency but an F for accuracy," and has volunteered to work with the state to ensure future lists are more complete.
3. The Atlantic City Convention Center has completed its transition into a field hospital and began accepting patients on April 21, ABC6 reports. The facility is intended for non-coronavirus patients, but can pivot to treating those infected with the virus if necessary.
The field hospital has more than 250 beds with surrounding white curtains, five nursing stations, a pharmacy and a lab testing center. It has the capacity to expand to 3,000 beds if required.
4. The New Jersey Department of Health on April 20 partnered with United Airlines and Delta Airlines to offer free round-trip flights to healthcare workers coming to the state to help fight the coronavirus, InsiderNJ reports.
The airlines are flying previously vetted volunteers to Newark Airport from any airport in the country. The first volunteer arrived April 20 from Atlanta, with another group from Colorado arriving April 21.
Read more about how New Jersey is fighting the coronavirus here.
Massachusetts (41,119 confirmed cases as of 7:25 a.m. CDT April 22)
1. After pushback from healthcare personnel, people with disabilities and minority communities, Massachusetts is changing the guidelines for deciding who gets care if the COVID-19 crisis becomes unmanageable in the state.
The previous care-rationing guidelines advised hospitals to give patients a score, with a lower score meaning they would likely receive lifesaving access to a ventilator. Patients who are healthier, medical personnel and women further along in pregnancy would have received lower scores and were more likely to have received care.
According to the new guidelines, care-rationing decisions now must be made based on the likelihood of short-term survival.
The revised guidelines state that a person's disability should not be the sole means of deciding how to distribute ventilators and ICU beds. Patient conditions that might affect the chances of long-term survival will no longer be part of the scoring system clinicians use to distribute lifesaving resources.
2. Gov. Charlie Baker has closed all public and private schools in the state through the end of the school year. This order expands the March 25 order that suspended normal educational operations during the pandemic.
Mr. Baker also closed all nonemergency child care programs until June 29.
3. Massachusetts plans to delay sending COVID-19 testing kits to nursing homes and other long-term care facilities until state officials understand why only one-third of the tests were returned to be analyzed, according to MassLive. The state sent 14,000 test kits to long-term care facilities, and just 4,000 were returned. Of those returned, many samples were unlabeled, leaking from the tubes or in a bad condition.
"We're working with the nursing home industry so that we can restart sending test kits once we understand what some of the logistic issues are," Massachusetts Health and Human Services Secretary Marylou Sudders said April 21, according to MassLive.
Read more about how Massachusetts is fighting the coronavirus here.
California (35,845 confirmed cases as of 7:25 a.m. CDT April 22)
1. California updated its guidelines this week to urge priority COVID-19 testing for asymptomatic people in high-risk settings, according to The Los Angeles Times. With the move, California became the first state to expand testing to people beyond those outlined in the federal guidelines.
California plans to prioritize testing asymptomatic people living or working in nursing homes, prisons and some households.
2. New data from officials in Santa Clara County reveals that two residents died of coronavirus-related complications in early and mid-February, according to The New York Times. This makes them the earliest known people to die from the virus in the U.S. Santa Clara County officials said the autopsies of two people who died in their homes on Feb. 6 and Feb. 17 had the novel coronavirus. The earliest COVID-19-related death previously known occurred on Feb. 26, according to the report.
3. California Gov. Gavin Newsom announced a state initiative to connect residents with volunteer opportunities. The state launched a new website, californiansforall.ca.gov, which will organize volunteer opportunities into one location.
"Across the state, Californians are asking how they can help their neighbors during this crisis and we want to channel that energy into our Californians For All service initiative," said Mr. Newsom. "Whether it's volunteering at a food bank to feed older Californians, blood drives or supporting local nonprofits, there's no shortage of opportunities for Californians to step up and meet the moment."
4. In California, 3,704 healthcare workers have tested positive for COVID-19 as of April 20. This is an increase of 181 from April 18. The confirmed case number includes individuals who tested positive after on-the-job exposure, as well as travel and close family contact, according to data from the California Department of Public Health.
5. In California, 300,100 tests had been conducted as of April 20. This is an increase of 19,200 from the number of tests conducted as of April 18. Of the 300,100 tests, 292,906 results have been received and another 7,200 are pending, according to data from the California Department of Public Health.
Read more about how California is fighting the coronavirus here.
Pennsylvania (35,339 confirmed cases as of 7:25 a.m. CDT April 22)
1. The statewide stay-at-home order issued in Pennsylvania April 1 will be extended until May 8. Initially, the order was set to expire April 30.
"It is clear that our early and aggressive efforts to mitigate this spread of this highly contagious and deadly virus are working. While we begin to seek ways to move forward, it's imperative that we continue to take strong precautions to protect Pennsylvanians and ensure that our healthcare system is not overwhelmed," Mr. Wolf said.
2. Some parts of the state may reopen before others, Mr. Wolf said April 21, Fox News reports. Some areas are more overwhelmed than others; for example, nearly 30 percent of the state's coronavirus cases are concentrated in Philadelphia.
"There is not one size that fits all. We can start to reopen the state in, I think, some areas a fairly robust way, in other areas less so," Mr. Wolf said, according to the report.
3. On April 20, a map went live on the Pennsylvania Department of Health website showing the concentration of people testing positive for the novel coronavirus in every ZIP code in the state, according to a Penn Live report. The map is color-coded, and people can use it to check the number of positive and negative test results in an area.
4. Around 2,000 people gathered April 20 in Harrisburg, Pa., to protest the state's stay-at-home order and other restrictions in effect due to the COVID-19 pandemic, according to USA Today.
"We each feel that we are responsible citizens," Matthew Bellis, a member of ReOpen PA, one of the groups that organized the rally, told USA Today. "We are adults and want to be treated as such."
But Mr. Wolf has said that the lack of testing materials is still a hurdle the state will have to overcome before reopening.
Read more about how Pennsylvania is fighting the coronavirus here.
Illinois (33,059 confirmed cases as of 7:25 a.m. CDT April 22)
1. Illinois Gov. J.B. Pritzker said April 21 that the state's COVID-19 peak may not come until mid-May, due in part to residents adhering to the stay-at-home order, the Chicago Tribune reports. Prior projections had the state's coronavirus peak in mid- to late April.
"You have to actually get to the peak and start down the other side of it before you know you've hit a peak," Mr. Pritzker said in an interview with The Washington Post.
The governor said Illinois' stay-at-home order is not likely to be fully lifted on April 30. Chicago Mayor Lori Lightfoot said the city's stay-at-home order could go into June.
2. Preliminary test results on April 21 indicated that 11 of the 158 residents at Symphony of Joliet nursing home contracted COVID-19, according to NBC5 Chicago. The University of Chicago Medicine worked with the Symphony Care Network, which operates the facility, to test residents at the nursing home.
Eighty-one COVID-19 cases have been reported at the nursing home, where 21 residents and two employees died.
3. The governor has secured two shipments of personal protective equipment from China at a cost of $88,275 each, CBS Chicago reports.
The shipments, including ventilators, masks, gloves and gowns, arrived in Chicago April 16 and April 21 and will be distributed to healthcare workers and first responders throughout the state.
4. Illinois hospitalizations linked with COVID-19 complications increased almost 7 percent from five days previously to 4,599 patients on April 20, according to the Chicago Tribune. Without public safety protocols outlined in the stay-at-home order, projections in mid-March indicated that Illinois would have surpassed its hospital capacity by 25,000 beds by April 6, the governor said.
As of 11:59 p.m. CDT April 20, the state is operating at 29 percent of its COVID-19 ICU bed capacity and 59 percent of its ventilator capacity.
5. The Coronavirus Aid, Relief and Economic Security Act will provide Illinois with $4.9 billion to help the state and local governments address rising costs inflicted by the pandemic, WAND17 reports. The CARES Act's Coronavirus Relief Fund enables state and local governments with more than 500,000 residents to apply to the U.S. Treasury Department for cash infusions.
The funding will help Illinois governments hit hardest by the pandemic, but more is needed to overcome the "significant loss in tax revenue," according to U.S. Sen. Dick Durbin.