Authorities in the US state of California are preparing to disembark passengers aboard a virus-hit cruise liner held off San Francisco.
Nineteen crew members and two passengers on the Grand Princess have tested positive for Covid-19.
The vessel, which is carrying about 3,500 people from 54 countries, is due to dock in Oakland on Monday after five days stuck offshore.
The US has reported more than 560 coronavirus cases and 24 deaths.
Cases of the virus have been recorded in 34 states plus Washington DC.
The number of infections worldwide is more than 109,000, with about 3,800 deaths.
Italy now has the highest number of confirmed infections outside China, where the outbreak originated in December. It has confirmed 7,375 cases and overtaken South Korea, where the total number is 7,313.
Some 16 million people – a quarter of Italy’s population – are under strict quarantine measures.
The Grand Princess cruise ship came to the attention of authorities when a previous voyager on the vessel died last week after being stricken by the coronavirus.
The 71-year-old, who had an underlying health condition, had been on a round trip from San Francisco to Mexico in February.
The operation to move passengers from the Grand Princess will be a “two-three day process”, Governor Gavin Newsom told a news conference on Sunday.
Passengers requiring urgent medical care will first be taken to hospital. Then US residents not needing treatment will be moved to military bases in California, Texas and Georgia for a 14-day isolation period.
Several hundred foreign passengers, including 140 Britons, will be repatriated to their home countries. The UK Foreign Office said it was “working intensively” with US authorities on arranging a flight for British nationals.
The Canadian government will be also repatriating over 200 Canadian nationals on the vessel. All asymptomatic Canadians will be flown home and placed under 14-day quarantine at a military base in Ontario.
Any symptomatic individuals will be further screened and may be treated in the US, Canadian officials said.
The ship’s crew members will remain quarantined on board, which will depart from Oakland as soon as the passengers have disembarked, officials said.
“No one will be quarantined in Oakland, or released to our community,” Oakland mayor Libby Schaaf told a news conference.
The ship is operated by Princess Cruises, which also owns the Diamond Princess, which was placed into quarantine in Japan last month.
Several other Princess Cruises have been blocked, with the Regal Princess held off the coast of Florida until coronavirus testing is completed.
Another cruise ship, the Costa Fortuna, with around 2,000 aboard, was turned away by Malaysia and Thailand, an official said.
Coronavirus hits US capital
The virus’ spread has also reached Washington DC, affecting lawmakers and locals – and putting President Donald Trump only two degrees of separation away from the outbreak.
The first confirmed case of Covid-19 in the capital is a church rector in his 50s. DC officials on Monday urged the several hundred members of Christ Church Georgetown to voluntarily self-quarantine for 14 days.
The second DC case is a man currently in hospital in Maryland who had stayed in the capital for a night before being diagnosed.
Two Republican lawmakers – Texas Senator Ted Cruz and Arizona Congressman Paul Gosar – are also self-quarantining after shaking hands with an infected individual at a conservative political conference at the end of last month.
Mr Trump and Vice-President Mike Pence also attended the event. While neither directly interacted with the individual, Mr Trump did shake hands with the conference chairman who had had contact with the patient.
What’s the situation in Canada?
As of Monday morning, there were 71 confirmed or presumptive cases of people carrying the coronavirus disease in Canada.
Most of the cases are in the provinces of Ontario and British Columbia, though some have also been discovered in Quebec and Alberta.
Canadian public health officials are advising against all cruise ship travel. Just last week, Canadian passengers of the Diamond Princess cruise ship were released from quarantine.