SEATTLE (AP) — The U.S. death toll from the coronavirus climbed to 11 on Wednesday with a patient succumbing in California — the first reported fatality outside Washington state — as federal authorities announced an investigation of the Seattle-area nursing home where most of the victims were stricken.

Officials in California’s Placer County, near Sacramento, said an elderly person who tested positive after returning from a San Francisco-to-Mexico cruise had died. The victim had underlying health problems, authorities said.

California Gov. Gavin Newsom declared a statewide emergency. Washington and Florida had already declared emergencies.

Washington also announced another death, bringing its total to 10. Most of those who died were residents of Life Care Center, a nursing home in Kirkland, a suburb east of Seattle. At least 39 cases have been reported in the Seattle area, where researchers say the virus may have been circulating undetected for weeks.

Seema Verma, head of the federal Centers for Medicare and Medicaid Services, said the agency is sending inspectors to Life Care along with experts from the Centers for Disease Control and Prevention to figure out what happened and determine whether the nursing home followed guidelines for preventing infections.

Last April, the state fined Life Care $67,000 over infection-control deficiencies following two flu outbreaks that affected 17 patients and staff. An unannounced follow-up inspection in June determined that Life Care had corrected the problems, Verma said.

Meanwhile, public officials in Washington came under pressure to take more aggressive steps against the outbreak, including closing schools and canceling large events. While the state and Seattle have declared emergencies, giving leaders broad powers to suspend activities, they have not issued any orders to do so.

“We have encouraged people who are responsible for large gatherings to give consideration whether it really makes sense to carry those on right now,” Gov. Jay Inslee said. “Right now, we are deferring to the judgment … of these organizations.”

While some individual schools and businesses have shut down, the governor said large-scale school closings have not been ordered because “there are so many ramifications for families and businesses,” especially for health care workers who might not be able to go to work because of child care responsibilities.

Local and state health officials have not recommended school closings unless the schools have had a confirmed case of the disease.

Jennifer Hayles, 41, of Kirkland said she was appalled that Inslee and health officials haven’t canceled next week’s Emerald City Comic Con. The four-day cosplay and pop-culture event draws close to 100,000 people each year, and some participants, including D.C. Comics and Penguin Random House, have pulled out over the virus.

Hayles said she spent hundreds of dollars on tickets and other items related to the event but will have to skip it because she has a compromised immune system.

“There’s a lot of people who are talking about the economic cost of people forced to pull out of Comic Con, but if we have an explosion of cases of coronavirus, the economic cost is going to be much higher,” Hayles said.

Comic Con’s organizer, Reedpop, announced Wednesday that it would make an exception to its no-refunds policy for those who want their money back, but said it remained committed to holding the event unless local, state or federal officials change their guidance.

Lakshmi Unni said that she was keeping her son, an eighth-grader at Redmond Middle School in Seattle’s eastern suburbs, home on Wednesday and that she had urged the school board and principal to close.

“Yesterday at least three kids were coughing,” Unni said. “We don’t know if they were sick with the virus, but if they do become sick, the chances of spreading are very, very high.”

Some schools, businesses and other employers aren’t waiting.

Seattle and King County public health officials urged businesses to allow employees to work remotely if possible, and the county said it will allow telecommuting for some of its workers for the next three weeks.

Microsoft said it has asked its Seattle-area workers who can do their jobs at home to work from home until March 25. The directive also affects Microsoft employees in the San Francisco Bay Area. The Redmond, Washington-based company said employees should still come in if they work at a data center, retail store or other location where their presence is needed, unless they have an underlying health condition, are over 60 or fall into other categories that health authorities say pose higher risks.