US has first ‘unknown origin’ coronavirus case
Patient’s testing delayed; did not meet criteria
Discovery of a California coronavirus patient believed to be the first U.S. case from an unknown, community-spread source is an alarming twist that means it could be time to practice “social distancing,” experts say.
The U.S. has confirmed 60 patients, but this one is alarming because no exposure chain has been found. The Centers for Disease Control and Prevention says it remains possible that the patient at UC Davis Medical Center was somehow exposed to a returned traveler who was infected in China. But investigators have been unable to find that connection.
The alternative is “community spread,” meaning the source of infection is unknown, CDC said.
That’s a problem for the effort to identify those who have come into contact with the patient, says Ogbonnaya Omenka, an assistant professor and public health specialist at Butler University’s College of Pharmacy and
Health Sciences.
“Contact tracing may not suffice in containing the spread if the source cannot be identified,” Omenka told USA TODAY. “The implication for other states, both proximate and remote, is big.”
William Haseltine, a former Harvard Medical School professor who returned last fall from Wuhan – the epicenter of the global outbreak – says the unknown exposure indicates that many people may be unaware they have the virus because they barely notice the symptoms.
“On one hand, that is good news as it means the virus causes very mild symptoms in many people,” Haseltine said. “On the other hand, it means that people can unknowingly infect others.”
Linda Lee, chief science officer at UV Angel, a technology disinfection company, says the tenets basic to combating the flu must be prioritized. Stay away from people to prevent the transmission to others, cover your cough and wash your hands frequently for at least 20 seconds.
“It appears this virus is easily spread, so it is important that anyone feeling sick protects others from getting ill,” she said. “Practice social distancing.”
The patient was transferred to UC
Davis Medical Center on Feb. 19, according to a staff memo from Dr. David Lubarsky, the CEO of University of California, Davis, Health. But the CDC did not test for the virus until four days later, despite a request from the hospital, the memo says.
“Upon admission, our team asked public health officials if this case could be COVID-19,” the memo says. “Since the patient did not fit the existing CDC criteria for COVID-19, a test was not immediately administered.”
The CDC ordered the test four days later. The patient was also put on strict contact precautions “because of our concerns about the patient’s condition,” the memo said. The CDC confirmed the patient’s test was positive Wednesday.
“The delay in testing equally delayed the required tracing of contacts and other required answers,” Omenka told USA TODAY. “For instance, who else have been infected by the original case, and who else have they been in close contact with?”
Haseltine said the delay in testing should not be surprising since coronavirus remains so rare in the U.S. Lee said it’s difficult to gauge the impact of the testing delay.
“This virus did not start in the U.S., so I think everyone on the front line of this is pedaling as fast as they can with the information that changes daily,” she said. “There are infrastructures already in place to deal with these types of emergencies – and they have happened before.”
Lubarsky said the COVID-19 patient was not the first treated at the hospital.
“Because of the precautions we have had in place since this patient’s arrival, we believe there has been minimal potential for exposure here at UC Davis Medical Center,” he said.