Genetic clues hint at hidden virus cases in Washington state

SEATTLE — The coronavirus may have been circulating for weeks undetected in Washington state, a preliminary finding that could mean hundreds of undiagnosed cases, researchers said Sunday after analyzing genetic samples from two people. Washington state, home of the nation’s first confirmed infection, saw the nation’s first death from the virus this weekend.

State and local authorities stepped up testing for the illness as the number of new cases grew nationwide, with new infections announced in Illinois, Rhode Island and Washington state. Authorities in the Seattle area said two more people had been diagnosed with the COVID-19 virus, both men in their 60s who were in critical condition. Those cases brought the numbers to six in Seattle’s King County.

A man in his 50s died in Washington on Saturday, and health officials said 50 more people in a nursing facility in Kirkland, Wash., are sick and being tested for the virus.

Elsewhere, authorities announced on Sunday a third case in Illinois and Rhode Island’s first case as worried Americans swarmed stores to stock up on basic goods such as bottled water, canned foods and toilet paper. The hospitalized patient in Rhode Island is a man in his 40s who had traveled to Italy in February.

As the fallout continued, Vice President Mike Pence and Health and Human Services Secretary Alex Azar sought to reassure the American public that the federal government is working to make sure state and local authorities are able to test for the virus. Both said during a round of TV talk show appearances Sunday that thousands more testing kits had been distributed to state and local officials, with thousands more to come.

“They should know we have the best public health system in the world looking out for them,” Azar said, adding that additional cases will be reported and the overall risk to Americans is low.

As the cases ticked up, some Americans stocked up on basic supplies — particularly in areas with diagnosed cases — and began to take note of the impact on daily life. Stores such as Costco sold out of toilet paper, bottled water and hand sanitizer outside Portland, Ore., where a case was announced Friday. Sports games and practices were canceled into the coming school week. Some churches said they would not offer communion because of fears of viral spread.

As Americans prepared, researchers at the Fred Hutchinson Cancer Research Center and the University of Washington on Sunday said they had evidence the virus may have been circulating in the state for up to six weeks undetected — a finding that, if true, could mean hundreds of undiagnosed cases in the area. They posted their research online, but it was not published in a scientific journal or reviewed by other scientists.

Trevor Bedford, an associate professor who announced the preliminary findings on the virus in Washington state, said on Twitter late Saturday that genetic similarities between the state’s first case on Jan. 20 and a case announced Friday indicated the newer case may have descended from the earlier one. The Jan. 20 case was the first known case in the U.S.

“I believe we’re facing an already substantial outbreak in Washington State that was not detected until now due to narrow case definition requiring direct travel to China,” he said on Twitter.

Bedford did not immediately reply to an e-mail requesting an interview Sunday.

Scientists not affiliated with the research said the results did not necessarily surprise them and pointed out that for many people — especially younger, healthier ones — the symptoms are not much worse than a flu or bad cold.

“We think that this has a pretty high rate of mild symptoms and can be asymptomatic. The symptoms are pretty non-specific and testing criteria has been pretty strict, so those combinations of factors means that it easily could have been circulating for a bit without us knowing,” said Justin Lessler, an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health.

Dr. Adam Lauring of University of Michigan called the findings “high quality work” from scientists who’ve done similar work with the flu virus for years.

“They show their data and they show their work,” Lauring said. “It’s more than a series of tweets“because the researchers back up what they found with data that they’ve shared online. “If there’s something wrong, someone will find it.”

Dr. Carlos del Rio of Emory University School of Medicine said the findings are from respected researchers in genomic sequencing and they make sense because of the geographic proximity of the two cases.

“This is a good time to reinforce the things we all should be doing to stop the spread of flu. Wash your hands. Don’t touch your face. If you have a cold, stay home … It’s a good time to remind ourselves of that,“he said.

Pence, named by the president to be the point-person overseeing the government’s response, said more than 15,000 virus testing kits had been released over the weekend. And, the administration is working with a commercial provider to distribute 50,000 more, he said.