Editor’s note: This was a live account of updates from Sunday, March 29, as events unfolded. Click here to find the latest extended coverage of the outbreak of the coronavirus known as SARS-CoV-2; the illness it causes, COVID-19; and its effects on the Seattle area, the Pacific Northwest and the world.

King County has more than 2,000 confirmed cases of COVID-19, including the first four confirmed cases among the homeless population, public health officials announced Saturday. While state and local leaders confirmed federal support — including a new field hospital in Seattle’s CenturyLink Field Event Center — is on its way, health science experts continue to raise questions about how the virus first began spreading in Washington.

More COVID-19 diagnoses are made in Washington state every day, an indication both of the virus’ spread and of expanded testing capacity. The state Department of Health announced 586 newly confirmed cases Sunday, bringing the state total to 4,896 cases, including 195 deaths. The bulk of Washington’s cases remain in King County.

Throughout today, on this page, we’ll post updates from Seattle Times journalists and others on the outbreak and its effects on the Seattle area, the Pacific Northwest and the world. Updates from Saturday can be found here, and all our coronavirus coverage can be found here.

The following graphic includes the most recent numbers from the Washington State Department of Health, released Sunday night.

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Live updates:

State announces 586 additional confirmed coronavirus cases, and six deaths

Washington's tally of confirmed COVID-19 cases rose to 4,896, the state Department of Health announced late Sunday -- an increase of about 600 compared with Saturday's total. The state also announced six more deaths, compared with 14 the previous day, bringing the state's confirmed death count to 195.

King County remains the hardest hit, with more than 2,100 cases and 144 deaths, according to the state. More than 65,400 people have been tested for the novel coronavirus in the state, with about 7.5% testing positive.

The health department's update came late Sunday, and included a new reporting format on its website, which the agency said would offer greater clarity regarding the spread of the disease. The numbers show a possible slowing of the rate at which infections and deaths are rising -- a trend the health department is showing visually on its update site.

"While it's likely that there are many more people in Washington who have gotten sick with COVID-19 and not had a test, we feel the shape of the curve is still informative," the agency noted.

—Jim Brunner
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President Trump bashes Inslee as ‘nasty person’ during coronavirus briefing; says he won’t call him

President Donald Trump on Sunday attacked Gov. Jay Inslee  as "a nasty person" and "a failed presidential candidate" and said he won't call him about the novel coronavirus pandemic.

In a news conference at the White House, Trump was asked by a CNN reporter about comments last week in which he warned governors "to be appreciative" of the federal response to the COVID-19 pandemic. Trump called the question dishonest, but vented about Inslee, whom he earlier this month called "a snake" and suggested Vice President Mike Pence "should not be complimentary" in meeting with the governor.

"No, I don’t call the governor of Washington now. But Mike Pence calls, and the head of FEMA calls. I don’t stop them. Did I ever ask you to do anything negative, Mike, to Washington or the state of Washington?" he said, turning to Pence. "No, I don’t have to call because I am probably better off not, because we don’t get — he's a failed presidential candidate, he is a nasty person. I don’t like the governor of Washington."

The president also said of those criticizing the administration's coronavirus response: "When they disrespect me, they are disrespecting our government."

Read the whole story on Trump's comments here.

—Jim Brunner

Washington State Ferry employee tests positive for COVID-19

A Washington State Ferries employee has tested positive for COVID-19, the illness caused by the novel coronavirus, a spokesperson for the agency said Sunday.

The employee does not interact with the public for work and is recovering in quarantine.

The agency also said Sunday that an employee who has worked for Washington State Ferries since 1995, most recently with the terminals department, has died.

In an email to employees, WSF Director Amy Scarton said "It’s unclear at this time if COVID-19 was a factor, but it is possible that this could be the case." Any workers who had direct contact with the employee have been notified, she said.

—Michelle Baruchman

Amazon will start taking employee temperatures daily

Amazon on Sunday said it will begin screening employees for elevated temperatures each day, starting at sites in Seattle and New York City, as "an additional preventive measure" against the novel coronavirus.

Federal health officials recommended March 11 that all employers in the Seattle area screen anyone entering work sites for symptoms of coronavirus, including daily temperature screenings. Amazon, which has seen a growing number of employees in its huge fulfillment and delivery network test positive for COVID-19 — including at its Kent fulfillment center — had not been screening workers for symptoms.

The company has not provided an official tally of how many employees have tested positive for COVID-19 or at what locations. Reuters reported Saturday at least 17 Amazon locations had employees who had tested positive.

Read the entire story about the company's announcement here.

—Ben Romano
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Six additional residents test positive for COVID-19 at Bellingham nursing facility

BELLINGHAM -- Six additional residents of Bellingham’s Shuksan Healthcare Center have tested positive for the COVID-19 illness resulting from the novel coronavirus, facility officials announced Sunday.

The positive tests came from the retesting of residents who had tested negative when the outbreak, which has claimed four lives at Shuksan, was discovered one week ago. In addition to the six new positive tests, two residents retested negative, two results are pending and one resident has refused a test, Shuksan officials said.

One resident was moved to PeaceHealth St. Joseph Medical Center on Friday, Shuksan reported. That left 34 remaining residents, 29 of whom have tested positive for the illness.

The 52-bed nursing facility had 38 residents when initial testing revealed 26 positive tests among residents, as well as six staff members, on March 22. Additionally, 19 of the 98 employees connected to the facility have now tested positive, bringing the total number of infected people connected to Shuksan to at least 52.

County health authorities said new rules preventing workers from visiting multiple health care facilities were enacted March 24. Employees or former employees who are not symptomatic have not been quarantined or subjected to mandatory testing, officials said.

Positive tests at a number of other senior-care facilities have been reported in Whatcom County, which has nine skilled-nursing facilities, 19 assisted-living facilities, and 24 adult family homes, Health Department officials said.

—Ron Judd

Trump extends voluntary shutdown through April 30

President Donald Trump is extending the voluntary national shutdown for a month as sickness and death from the coronavirus pandemic rise in the U.S.

The initial 15-day period of social distancing urged by the federal government expires Monday and Trump had expressed interest in relaxing the national guidelines at least in parts of the country less afflicted by the pandemic.

But he decided to extend them through April 30, a tacit acknowledgment he’d been too optimistic. Many states and local governments have stiffer controls in place on mobility and gatherings, including in Washington state, where Gov. Jay Inslee has issued a "stay at home" order.

Trump’s impulse to restore normalcy met a sober reality check Sunday from Dr. Anthony Fauci, the government’s top infectious disease expert, who said the U.S. could experience more than 100,000 deaths and millions of infections from the pandemic. Trump’s decision to extend the guidelines reflected a recognition that the struggle will take place over the longer haul.

The U.S. had more than 137,000 COVID-19 cases reported by late Sunday afternoon, with more than 2,400 deaths.

Read the whole story on Trump's decision and Fauci's comments here.

—Associated Press

King County COVID-19 update: 2,159 known positive; 141 dead

There were 82 new confirmed COVID-19 cases in King County as of just before 1 p.m. Sunday, bringing the total to 2,159, according to the latest numbers from Public Health — Seattle & King County.

The county saw five new deaths since Saturday. A total of 141 people in the county have been killed by the disease caused by the novel coronavirus. The county's death rate stood at 6.5% of positive test results.

There have been 16,280 tests performed in King County, including 562 since yesterday.

King County has had by far the most COVID-19 cases and deaths in Washington. Statewide numbers from the Washington Department of Health are typically reported later in the afternoon.

—Benjamin Romano
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Emergency room physicians' group calls on state Attorney General to investigate Bellingham doctor's firing

An organization that represents emergency room physicians has called on the Washington State Attorney General’s Office and the State Medical Commission to investigate the firing of a Bellingham doctor who had publicly criticized what he saw as inadequate measures to protect health care workers from the novel coronavirus.

Dr. Ming Lin, who worked at PeaceHealth St. Joseph Medical Center for 17 years, was terminated on Friday by TeamHealth, a national staffing firm under contract with the hospital to provide emergency department personnel.

Lin had become a high-profile figure in the Seattle medical community during the COVID-19 outbreak by speaking up on social media about the need for more medical supplies and stronger standards to protect health care workers.

The American Association of Emergency Medicine, in a position statement issued Saturday, condemned Lin’s firing and challenged the legality of TeamHealth’s business structure and Lin’s termination. “[TeamHealth’s] hand in this termination is not only inexcusable but likely impermissible,” the statement said before calling on the attorney general and the State Medical Board to launch inquiries into the matter.

Dr. Robert McNamara, a Philadelphia emergency room physician and past president of the American Association of Emergency Medicine, said the organization has rallied its members in Washington to complain to regulators that TeamHealth’s system of physician employment violates the state’s law prohibiting the corporate practice of medicine, a guardrail intended to prevent profiteering from eroding standards of care.

“Most states have a prohibition on this,” McNamara said Sunday in a phone interview. “They were basically meant to keep the business relationship out of the physician and patient relationship.”

The Washington State Nurses Association also decried Lin's firing and filed a complaint with the state Department of Labor over working conditions at the hospital.

Read more here.

—Patrick Malone

Fauci says U.S. could experience more than 100,000 deaths

As President Donald Trump looks for ways to restore normalcy in parts of the U.S., his foremost infection disease expert says the country could experience between 100,000 and 200,000 deaths and millions of infections from the coronavirus pandemic.

Dr. Anthony Fauci, speaking on CNN’s “State of the Union” on Sunday, offered his prognosis as the federal government weighs rolling back guidelines on social distancing in areas that have not been as hard-hit by the outbreak at the conclusion of the nationwide 15-day effort to slow the spread of the virus.

Fauci said he would only support the rollback in lesser-impacted areas if more testing is in place to monitor those areas. He said “it’s a little iffy there” right now.

Models released on Thursday by the University of Washington Institute for Health Metrics and Evaluation forecast 81,000 people in the U.S. — and more than 1,400 in Washington state — could die from COVID-19 by the first of July.

Read the whole story on Fauci's comments here.

—Associated Press

Monroe inmate receiving health care treatment away from prison tests positive for COVID-19

An inmate from the Monroe Correctional Complex is receiving health care treatment at an unidentified Snohomish County medical center after testing positive for COVID-19 on Wednesday, according to the Washington Department of Corrections (DOC).

The individual has not been in the prison since being transferred to the medical center March 3 — for health care unrelated to COVID-19 symptoms — and an earlier COVID-19 test on March 15 came back negative, the department said in a news release Saturday.

A DOC spokesperson said the department does not release the name of medical facilities where incarcerated patients receive treatment for their safety and security.

The DOC was informed of the positive test late Friday and notified its staff members who may have been exposed to the patient during hospital watch shifts. Those staff members are quarantining at home, as tracing of other potential close contacts continues, the department said.

"Based on contact tracing, there is not thought to be a connection between the patient and the staff member from Monroe Correctional Complex, who was confirmed positive for COVID-19 on March 12," the department said.

Four DOC employees and one contractor have tested positive as of Friday. The DOC said 111 incarcerated people had been tested. Of those, 78 were negative and 33 results are pending.

A group of inmates sued the DOC last week, seeking the release of inmates who are age 50 or older or have health problems, or who have scheduled early release dates within the next 18 months.

Many inmates and advocates for incarcerated people are concerned that COVID-19 could rapidly spread through the prison system, which offers little flexibility for social distancing.

Editor's note: This story was updated at 12:52 p.m. with comments from a DOC spokesperson, current information about the number of COVID-positive DOC staff and contractors, and the number of tests conducted among the incarcerated population.

—Benjamin Romano
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Travel advisory for New Jersey, New York, Connecticut

After calling for a quarantine for coronavirus hotspots in New York, New Jersey and Connecticut, President Donald Trump backed off the idea and instead directed Saturday night that a “strong Travel Advisory” be issued to stem the spread of the outbreak.

Vice President Mike Pence tweeted that the CDC was urging residents of the three states “to refrain from non-essential travel for the next 14 days.”

The notion of a quarantine had been advocated by governors, including Republican Gov. Ron DeSantis of Florida, who sought to halt travelers from the heavily affected areas to their states.

But it drew swift criticism from the leaders of the states in question, who warned it would spark panic in a populace already suffering under the virus.

Read the whole story here.

—Associated Press

How coronavirus impacts people by age, gender and health condition in outbreaks around the world

The majority of people who get COVID-19 have mild or moderate symptoms. But “majority” doesn’t mean “all,” and that raises an important question: Who should worry most that they’ll be among the seriously ill? While it will be months before scientists have enough data to say for sure who is most at risk and why, preliminary numbers from early cases around the world are starting to offer hints.

Senior citizens undoubtedly are the hardest hit by COVID-19. In China, 80% of deaths were among people in their 60s or older, and that general trend is playing out elsewhere.

Men are at greater risk than women, as are people with underlying health conditions including a weakened immune system, heart disease, chronic obstructive pulmonary disease, cystic fibrosis and diabetes. The more pre-existing conditions, the more likely patients were to die from the illness. In Italy, about half of people who died with COVID-19 had three or more underlying conditions, while just 2% of deaths were in people with no preexisting ailments.

Read more about how the virus is impacting various groups of people by age, gender and health condition.

—Associated Press

'Nurses — we just step up'

Carolyn Grant, 63, a retired registered nurse, was sitting comfortably in her favorite chair beside the fireplace when her phone buzzed at 2 p.m. on March 11 with a fresh text message: Could she come back to work?

Nurse Carolyn Grant, left, retired at the end of December, but she was persuaded to come back to work for UW Medical Center to help coordinate coronavirus testing.  She works here with Faith Reyes, wearing clean personal protective equipment, to plan the day at the Northgate testing station. (Dean Rutz / The Seattle Times)
Nurse Carolyn Grant, left, retired at the end of December, but she was persuaded to come back to work for UW Medical Center to help coordinate coronavirus testing. She works here with Faith Reyes, wearing clean personal protective equipment, to plan the day at the Northgate testing station. (Dean Rutz / The Seattle Times)

UW Medical Center was searching for recently retired employees to bolster its ranks as the outbreak of coronavirus stretched hospital staff thin. Grant was concerned about the risks — but also knew how she would feel if she said no.

“Nurses — we just step up,” Grant said. “I knew what they were going to be up against.”

Read more.

—Evan Bush
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2 more residents at Bellingham nursing facility die

Two additional residents of Shuksan Healthcare Facility in Bellingham have died of the COVID-19 illness, the facility announced.

The two elderly residents died at the facility, in Bellingham’s York neighborhood, on Thursday and Friday, according to an update on Shuksan’s Facebook page.

The deaths brought the total COVID-related toll at the nursing facility to four residents or former residents. Twenty-four other residents who have tested positive for COVID-19 remain at the facility. Nine other residents who had previously tested negative have been retested, and results are pending, Shuksan said.

The new cases brought the total number of COVID cases in Whatcom County to 102, including six deaths

—Ron Judd

Catch up on the last 24 hours

Washington Gov. Jay Inslee brushed off President Donald Trump's negative comments, saying that the remarks “haven’t knocked us off our game at all.” Inslee held a news conference Saturday at the site of a field hospital the U.S. Army is setting up at CenturyLink Field.

Amazon reported a case of COVID-19 in an employee at its Kent fulfillment center, saying it would notify anyone who had close contact with the person and ask them to self-quarantine for 14 days.

Inslee lifted a ban on funerals after hearing "heart-wrenching stories... of people who lost loved ones and could not stand the thought of not being present." However, strict restrictions will still apply to the services.

The first positive COVID-19 cases among the county's homeless population were announced by King County public health officials Saturday: Four positive cases in four shelters. Of the four confirmed cases, two were previously hospitalized but have been discharged.

Italy’s coronavirus deaths surpassed 10,000 on Saturday even as the contagion’s spread remained substantially stable. The country reported 889 new fatalities in 24 hours.

The charity of former Microsoft chief executive Steve Ballmer and wife Connie has donated $10 million to UW Medicine so it can expand and speed up testing of patients — the largest gift in $25 million of pledges his group so far has made to respond to the ongoing pandemic.