PHOENIX (AP) — Arizona's health director warned Monday that community spread of the new coronavirus is now happening and case numbers could reach what is seen in a flu season.

The state added one more confirmed case Monday, upping the number to six. The new case is in Pima County, adding to three in Pinal and two in Marcopa counties.

Gov. Doug Ducey acknowledged that the state's economy has taken a hit and repeated that he could order steps to limit spread if disease cases ramp up.

State Health Services Director Dr. Cara Christ said at an afternoon news conference that a case identified on Friday had no known link to either foreign travel or another case. That means the virus is circulating in the community.

“While it is impossible to predict how many cases we might have, the number of cases could be similar to a flu season in Arizona,” Christ said.

“This current year we are at about 28,000 flu cases, but normally we are somewhere in the high thousands to tens of thousands of cases. So we expect large numbers of this,” she answered when asked for numbers.

That number is just “the top of the iceberg” since most flu cases never are formally diagnosed with a test.

For most people, the COVID-19 virus causes only mild or moderate symptoms, such as fever and cough. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia, health experts have said.

The vast majority of people recover from the new virus. According to the World Health Organization, people with mild illness recover in about two weeks, while those with more severe illness may take three to six weeks to recover. In China, more than 80,000 people have been diagnosed and more than 58,000 have so far recovered.

With older people at most risk of serious complications, Ducey said the health department is sending surveyors to nursing homes to check whether they have implemented stringent infection-control procedures. Christ said they are recommending a series of steps, including limiting visitors, ensuring patients with respiratory illness are separated and that staff treating them don't also treat well patients. Older Arizonans should take steps to stay away from crowds if possible.

Ducey participated with other governors in a video conference call with Vice President Mike Pence on Monday morning and said he's made preparing for an outbreak a top priority.

In other developments, a popular annual book festival in Tucson set for next weekend was cancelled after over 100 authors pulled out over concerns about the virus. The board of the directors for the Tucson Festival of Books said in a statement Monday it feared even more authors would cancel. Over 100,000 people attend the festival, which was first held in 2009.

Phoenix Mayor Kate Gallego said the city expects the March 15 Democratic presidential debate to proceed as planned. And officials at Phoenix Sky Harbor International Airport announced that two passengers who passed through the airport on Feb. 28 and took WestJet flight 1199 to Toronto had the virus. Passengers seated nearby are being told to self-isolate.

Ducey downplayed questions about the potential hit to the state's revenues, despite moves in the state Legislature to enact new tax cuts that could result in hundreds of millions of lost revenue. The Republican governor is proposing a $45 million tax cut by exempting pensions received by retired military members, but a much larger package is being pushed by Republicans who control the Legislature.

Arizona's proposed proposed budget for the fiscal year that starts July 1 is $12.3 billion.

Ducey said he will be cautious when it comes to negotiating a budget with the Legislature.

“Of course we’re going to factor in what’s happening in the economy, which has been robust up until this point,” he said. “And this is affecting the economy, no doubt about it."