WAS IT ALREADY TOO LATE WHEN FIRST CASES WERE DIAGNOSED IN WALES?
TWO weeks after Wales’ first case of coronavirus was confirmed a Six Nations rugby match between Wales and Scotland was still set to go ahead in front of a packed Principality Stadium in Cardiff.
It was eventually called off on March 13, 24 hours before kick-off and after Scottish fans had already arrived in the Welsh capital.
In hindsight, waiting so long was baffling and reckless – the match would have almost certainly been dubbed a “super-spreader event” with 70,000 people in a stadium and thousands more crammed into the bars of Cardiff and other Welsh towns and cities.
It is an example of how little we knew about coronavirus and its threat to our lives and livelihoods.
Even Welsh Government Health Minister Vaughan Gething had spoken about his own plans to attend the rugby match at the Principality Stadium.
Hundreds of cases of coronavirus had been detected across all four nations when Italy entered lockdown on March 9, but there were no signs of the UK following suit.
It would be another two weeks before action was taken. Another two weeks when the virus was able to spread like wildfire.
During a press conference on March 12, England’s chief medical officer Sir Patrick Vallance said the number of confirmed cases in the UK stood at 596, but that the true number of infections was likely to be 10 or 20 times higher.
Just days before the planned Six Nations clash in Cardiff, the threat to UK citizens from the virus was raised from “moderate” to “high” and the four nations moved from a stance of trying to contain the disease to attempting to slow its spread.
New cases were not going to be tracked, it was announced, and contact tracing was abandoned.
On the anniversary of Wales’ first confirmed Covid case, February 28, 2020, this is the story of the early days of the pandemic in Wales when things were moving fast, but not fast enough.
On the evening of February 27, 2020, Mark Hosking received a call from Public Health Wales at the home he shares with his wife and two teenage children in Mumbles, Swansea.
The person on the other end of the line asked then 53-year-old Mark to “please sit down”.
The day before, medics in full PPE had been to his house to test him for coronavirus and the results had come back positive – making Mark the first of more than 200,000 people in Wales to be told they have the virus so far in the pandemic.
Mark had been skiing in the Lombardy region of Italy the previous week. After feeling “peculiar” during the evening of Saturday, February 22, and seeing that Lombardy was now considered a hotspot for the virus, he called 111 the following day.
“I did a lengthy 20-minute discussion and questionnaire with them but they assessed me as having a holiday flu and advised me to take paracetamol and left it at that.
“I felt worse and worse over Monday and Tuesday and there started to be a lot more on the news about Lombardy. I was feeling so bad I called Public Health Wales [on February 25] and that was when they advised us to take the kids out of school and start self-isolating,” he said.
Two days later, following persistence on his part, Mark became Wales’ first confirmed coronavirus patient. He was told he would be taken by ambulance to the Royal Free Hospital in London, where he would eventually spend 17 days fighting the virus.
Mark was placed into an induced coma and put onto a ventilator for four days as the now familiar course of the virus took hold.
“My wife, Gemma, called the consultant at one point and asked: ‘How ill is Mark?’ She was told I was the sickest person on the ward.
“Being put on the ventilator was the scariest bit. When you’re conscious you at least have some control and can give consent and understand what’s going on.
“I just didn’t want to be put out and on the ventilator,” he said.
It is impossible to know how many people in Mark’s position did not take their condition as seriously or returned from holidays abroad with coronavirus but were asymptomatic in the early days of the pandemic.
Although contact tracing was carried out to find those who had been in contact with Mark in the days preceding his diagnosis, testing was not widespread at the time.
However, in the days and weeks after Mark’s diagnosis, things began to escalate rapidly.
The first widespread community transmission of the virus was confirmed in Caerphilly on March 11, and four days later a man in Wrexham became the first person to die after testing positive for coronavirus in Wales.
Mark Hosking was Wales’ first confirmed coronavirus case – the real patient zero will probably never be known, but others were almost certainly carrying the virus in Wales before Mark’s case was confirmed.
Dr Andrew Freedman, head of department at Cardiff University’s School of Medicine, said: “There’s quite a bit of evidence that there were cases well before that in the UK, and probably all over Europe.
“Obviously, we know about a third of cases are asymptomatic. You’re never going to find those unless you’re testing widely, which we’re still not doing, and we certainly weren’t doing any testing at that stage.
“The other difficulty is that many other viral illnesses have similar symptoms, so you wouldn’t necessarily pick it up [coronavirus].
“It’s easy to say in hindsight, but we certainly didn’t have much testing and we were starting from nothing.
“The first cases in the UK were right at the end of January, I believe” he said.
The first UK cases we know about, known only as patients A and B, were a 23-year-old Chinese student studying the University of York and his 50-year-old mother.
Patient B, the student, was suffering with fever, a dry cough and muscle pain and his mother, patient A, was feeling unwell with a fever, cough and sore throat. Patient A had flown home from the Chinese city of Wuhan, where the coronavirus outbreak started, a week earlier.
On January 30, patients A and B tested positive for Covid-19, making them the first official cases in the UK. They both made a full recovery and their identities have never been revealed.
Dr Freedman said he did not think that a “huge number” of cases had been missed in Wales during the early days but, like many people, he knows people who said they had a “nasty viral illness” in early January, 2020.
Without the data to reflect it, much of what we know about the level of coronavirus in Wales before the first confirmed case will only ever be anecdotal. However, there are studies that suggest the virus was already circulating in the UK by end of 2019, and that infection rates only took off after an influx of cases from people returning from hotspots like Lombardy after the February half-term holidays in 2020.
Tim Spector, professor of genetic epidemiology at King’s College London, is part of the team behind the Covid Symptom Tracker app, which gathers the past and present health data from about 2.6 million participants in the UK.
Speaking to The Times in April 2020, he said: “What’s impressive is the sheer volume of the reports.
“We’re getting hundreds of the people using our app telling us that they developed something soon after the new year.
“The reports I am getting are from people who were ill from early January onwards and strongly suggest they had Covid-19, but were not recognised as such.”
He added that it was hard to substantiate the reports, but the sheer number of them is powerful evidence that the virus was spreading earlier than officially reported.
We know now that in the three months leading up to the UK’s first coronavirus lockdown, of the 18.1 million people who arrived in the country from abroad, just 273 were placed into quarantine.
We may never know the extent to which coronavirus was already circulating before the first confirmed case in Wales on February 28, 2020, but the question of whether more could have been done to stem the flow of the disease sooner will remain open for years to come.
A spokesperson for Public Health Wales said: “Public Health Wales does not have any evidence that Covid-19 was circulating in Wales prior to the first case being identified, but we cannot exclude the possibility that this was the case.”
People in Britain watched the scenes of desperate patients struggling to breathe in over-flowing hospital wards in Italy – then the epicentre of Europe’s coronavirus outbreak – with detached horror. Many were still saying the same scenes would never be seen here.
UK government medical advisers said cancelling big outdoor sporting events would not be a decision supported by science.
The Cheltenham Racing Festival races went ahead between March 10 and 13 as 60,000 people a day crammed into Cheltenham Racecourse to the backdrop of rising coronavirus cases, open borders and little testing.
That week, March 9-15, 132 positive cases of coronavirus were detected in Wales. The previous week four were recorded and the week before that just one – Mark Hosking.
People were still in pubs, restaurants and shops in Wales, reassured by the noises coming from the UK and Welsh Governments.
In scenes that would now send a chill down the spine of many, thousands more people crammed into Cardiff’s Motorpoint arena to see the Stereophonics play on two consecutive nights that same weekend.
More than 5,000 people in Wales have now died within 28 days of a positive test for coronavirus and over 200,000 positive swab results have been recorded.
Whether governments and health services could, or should, have reacted sooner will be debated in the coming years, but what can be said with some certainty is that by the time Wales’ first official case of coronavirus was recorded on February 28, 2020, containment of the virus was already off the cards.