Coronavirus USA Update: US Death Toll At 21; 547 Confirmed Cases In 33 States

COVID-19 continues its inexorable march across mainland United States, even as the scandalous lack of testing kits and the slow pace of testing continue to hound president Donald Trump and vice president Mike Pence, his coronavirus czar.

Because COVID-19 has gained a strong foothold in the U.S., the federal government Sunday announced a shift in its strategy to mitigation from containment.

"Initially, we had a posture of containment so that we could give people time to prepare for where we are right now," said Surgeon General Dr. Jerome Adams on CNN's "State of the Union" on Sunday. “We're shifting into a mitigation phase, which means that we're helping communities understand you're going to see more cases. Unfortunately, you're going to see more deaths. But that doesn't mean that we should panic."

Dr. Adams cautioned that those that aren't sick from the disease shouldn't wear face masks as this gear often causes more harm than good. Face masks aren't designed to protect a wearer from inhaling airborne bacteria or virus particles. They're normally worn to reduce the chance of spreading airborne diseases and prevent the inhalation of airborne dust particles and air pollution. Instead of using face masks, people should wash their hands with soap and water frequently for at least 20 seconds and stop touching their faces, said Dr. Adams.

As of Sunday, 33 states and Washington D.C. have confirmed COVID-19 cases in their populations. At least 547 people in the U.S. have tested positive for the disease. This total includes 70 people repatriated to the U.S. from China and Japan in early February and now quarantined at U.S. Air Force bases in California and Texas.

At least 21 people have died from COVID-19 in the U.S. as of Sunday, with 18 deaths in Washington state (the country's COVID-19 epicenter), two in Florida and one in California. The deaths in Washington state include 16 linked to the Life Care Center of Kirkland nursing home.

On Saturday, the day when 26 of the 50 U.S. states and D.C. reported confirmed cases arising from COVID-19 infections, two more people died from the disease in Washington State; Kansas, Virginia, Missouri, Maryland and Washington, D.C., confirmed their first cases and New York declared a state of emergency.

Virginia recorded its first case Saturday when a U.S. Marine stationed at Fort Belvoir was found to have the virus. It confirmed its second COVID-19 case Sunday. The Virginia Department of Health said the second case in Virginia is a Fairfax city resident in his 80s. This man first fell ill on Feb. 28 after traveling home from a Nile River cruise. Three other people, all residents of Montgomery County, Maryland, also took ill after taking the same Nile River cruise.

On Sunday, New York state announced 16 new cases, bringing the state's total to 105. State officials are urging more than 2,500 people to self-quarantine as they search for people that might have come in contact with confirmed infections. It was only on March 1 New York confirmed its first COVID-19 infection.

D.C. Mayor Muriel Bowser said Saturday a man in his 50s tested positive for coronavirus in Washington, D.C. She also said another person also in his 50s (who lived in Nigeria and had travelled through the city) had tested positive in Maryland.

Asked if he was worried about the virus getting closer to the White House, Trump said he was "not concerned at all." The White House said there was little chance Trump came into contact with one of the guests at last week's Conservative Political Action Conference in the suburb of Oxon Hill that tested positive for the coronavirus.

Meanwhile, the coronavirus-stricken cruise ship, Grand Princess, received permission Saturday to dock in Oakland, California.

"Grand Princess will proceed to the Port of Oakland on Sunday to begin disembarking guests who require acute medical treatment and hospitalization," said Princess Cruises, the ship's owner. "Guests who are California residents will go to a federally operated facility within California for testing and isolation, while non-Californians will be transported by the federal government to facilities in other states."

With 2,500 passengers and 1,100 crew, Grand Princess has been stranded off the San Francisco coast for four days. It has 21 confirmed COVID-19 cases, of which 19 are crew members and two American passengers.

U.S. health officials have begun tracking another cruise ship, the Regal Princess, which might have shared crew with the Grand Princess and the Diamond Princess. The latter ships have been hit hard by COVID-19 infections. All three ships are owned by the Princess Cruises, the world's second largest cruise line by net revenue.

The Diamond Princess has been anchored at Yokohama, Japan, since the first week of February. It became infamous due to the huge number of passengers and crew that were infected by the coronavirus. As of Sunday, there were 697 infections on this ship and seven deaths.

On Saturday, Stephen Hahn, commissioner of the U.S. Food and Drug Administration (FDA), said a total of 2.1 million coronavirus test kits will have been shipped to non-public labs by Monday. The scramble to deliver these kits comes as the Trump administration aims to counter criticism its response to the disease has been sluggish and political. Hahn said the focus is on getting tests to the highest risk areas in Washington state and California. He claimed that many manufacturers will soon send millions more test kits.

“What they told us is they believe they could scale up by the end of next week ... for the capacity for 4 million additional tests that could be shipped,” said Hahn.

As of 9.30 ET Sunday, there are 109,965 confirmed global cases of COVID-19 as tracked by Johns Hopkins CSSE. Of this total, 547 are in the U.S. and 80,735 in mainland China. There have been 3,824 deaths worldwide from the coronavirus.