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The coronavirus outbreak in the Seattle area is at a critical juncture and could see explosive growth in cases much like Wuhan, China, if public officials don’t take immediate, forceful measures, according to a new analysis of genetic data.

The author of the analysis, a computational biologist named Trevor Bedford, said there are likely already at least 500 to 600 cases of Covid-19 in the greater Seattle area. He urged health authorities and the public to immediately begin adopting non-pharmaceutical interventions — imposing “social distancing” measures, telling the sick to isolate themselves, and limiting attendance at large gatherings.

“Now would be the time to act,” Bedford, who is at the Fred Hutchinson Cancer Research Center in Seattle, told STAT.

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The genetic sequences of patients in the Seattle-King County region suggest the virus has been circulating there since about mid-January, when the first U.S. patient — a man who returned from Wuhan — was diagnosed, Bedford wrote in the analysis, published online.

The spread of the virus has gone undetected in part because many infected people experience only mild infections that could be confused for a cold or the flu, and in part because of stumbles in the Centers for Disease Control and Prevention’s effort to develop test kits for state and local public health laboratories, which has meant very little testing has been done in the country until the past few days.

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On Capitol Hill, Washington Sen. Patty Murray (D) expressed deep frustration with the situation.“The failure to develop and distribute working test kits to public health agencies has really cost us valuable time. I am hearing from people personally across our state who are frustrated,” Murray said.

“They believe they have been exposed, they are sick, they want to get tested, they have nowhere to go,” she added. “People want to be safe and protected, they do not want to spread this, they want to take care of themselves but we don’t have the capability right now to do it with the policies we have in place.”

Bedford said Seattle faces a stark choice — take aggressive actions to slow down the spread of the new coronavirus now or face the type of outbreak that engulfed Wuhan’s health facilities and led to a lockdown of the city that remains in place six weeks later.

Seattle is effectively in the position that Wuhan was on Jan. 1, when it first recognized it had an outbreak of a new virus, but did not realize the scale of the problem or the speed at which the virus was spreading, Bedford said.

WHO graphic - Wuhan and China
The majority of coronavirus cases in China were reported in Wuhan, in Hubei province. STAT; World Health Organization

Three weeks later, on Jan. 21, China imposed the most draconian quarantine measures ever deployed in modern times, both in that city and in others to which the virus had spread but where transmission was only just beginning.

“January 1 in Wuhan was March 1 in Seattle,” Bedford told STAT. “Now would be the time to start these interventions rather than waiting three weeks.”

Samuel Scarpino, an assistant professor at Northeastern University’s Network Science Institute, agreed time is of the essence.

“I think it’s unequivocal that there is widespread community transmission in Seattle and they have to take decisive action now,” said Scarpino, who uses mathematical and computational models of infectious diseases transmission to inform public health policy.

Washington State health authorities announced late Friday that they have found a case of Covid-19 in a teenager from Snohomish County, north of Seattle. The teen had not traveled outside the country and had no known contact with a confirmed Covid-19 patient, meaning this was likely a case of community transmission of the virus. This was the first such case for Washington State and one of the first four or five detected in the country.

The case was actually found by the Seattle Flu Study. Bedford, a co-investigator, normally works on influenza but has been one of the key players trying to assess what is happening with the new virus by studying genetic sequences from around the world.

Frustrated by the lack of testing resulting from the problem with the CDC-developed kit, the Seattle Flu Study began using an in-house developed test to look for Covid-19 in samples from people who had flu-like symptoms but who had tested negative for flu. That work — permissible because it was research — uncovered the Snohomish County teenager.

Analysis of the genetic sequence of the virus from the teenager showed it was so closely related to that of Washington State’s first case that Bedford believes the teen was infected as part of a chain of transmission that started with the first case. That would mean the virus has been circulating in the northern part of the state for about six weeks.

The pattern seen in other locations that are fighting the new virus is that it takes a while for enough people to be infected for severe cases to start showing up in hospitals for care. The Seattle area is soon going to be there, Bedford said.

“So we’re going to expect a large uptick in just the number of people presenting to hospitals,” he said.

As of Tuesday, the state was reporting 27 cases and nine deaths. That is up from 18 cases and six deaths on Monday.

The stringent actions China took drove down new infections in Hubei province — where Wuhan is located — to low levels, though transmission continues there. Other cities in the country that started to see cases were able, with the same measures, to avoid the explosive transmission Wuhan had experienced. Flattening the epidemic curve, as that phenomenon is called, helps health care systems continue to function. An eruption of cases overtaxes hospitals, leading to deaths that otherwise could have been avoided.

“China saw not much of an epidemic outside of Hubei because they acted early,” Bedford said.

Some question Bedford’s analysis. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, said it is possible that another traveler who came from Wuhan later started the chain that infected the Snohomish County teen.

While Scarpino agreed that is a possibility, he insisted that from a public health point of view, it makes little difference.

The window of opportunity “may be already shut. But we have to assume we’ve got some time left,” Scarpino said. “But that means, like yesterday, we have to start seriously testing, putting infection control policies in place, ensuring we have plans for what we’re going to do with homeless or marginalized populations.”

Scarpino urged hospitals in the Seattle area to assume anyone coming in with acute respiratory infections is infected with Covid-19 and isolate them to protect other patients and health workers.

Andrew Joseph and Nicholas Florko contributed reporting.
An earlier version of this story misstated which research group had discovered Washington State’s first community spread case.

    • Who cares about liberals and conservatives right now when we ALL (that includes you AND me) are facing something that could change the world. Chill out, thank God that we have the technology that we have in order to figure out how to fight this, and realize that in order to deal with this, we have to fight TOGETHER. That includes the liberal scientists that are figuring out how to sequence the virus’ DNA, the conservative doctor that is helping sick patients, the atheist nurse that supports the doctors, and the Muslim person that helps with patient intake. That includes YOU, who benefits from the health care system that we ALL helped create, and this includes ME, the liberal that prays to God that no more deaths happen and that we can all be safe (and that includes YOU)

  • Your right , given the current status of events , why in Washington State , the home of the most brilliant people and companies , we cannot figure out how to get someone tested!!! But no , they shuffle us from call your doctor , the doctor says call the hospital , the hospital says call your doctor ….really , does this make sense to you ? We are just a number to them

    • I can answer your first question: Because the US doesn’t like to follow others. Germany created a perfectly usable test, which was taken up by the WHO and used world wide. But in the US, they like to do things their own way, and insisted on developing their own test. This initial test was flawed. So, instead of THEN taking up the test that EVERY OTHER COUNTRY IS USING, they persisted in trying to fix it … So much wasted time. THAT’S why you’re having a crisis of people not able to be tested. And that, combined with your lousy health system, is why there will be a huge number of deaths there.

      I’m very sad for those who will suffer because of this.

    • Seems we have all been caught unawares regarding this pandemic. Watching events play out in China with detached fascination, and now it’s at our shores. “Won’t happen here” has sailed out of the harbor. The general public is woefully unprepared, scared, uneducated in ways to keep themselves safe. And to make matters worse, this virus is much more insidious than people realize. It’s transmission method is more akin to Ebola and HIV than other Coronavirus, and God help us if it mutates. Reinfection has occured in some cases. This absolutely terrifies me for the future of humanity because it is well on it’s way to becoming endemic in the human population. My hope is with our best and brightest, that they are successful with the vaccine, Godspeed..

    • Why is it ridiculous? Everything in the article is factual and the number of cases in WA is exponentially increasing by the day. Complacency in this critical period will result in hundreds if not thousands of lives unless we act decisively, and soon. I’d be happy to debate you on any of the “half-truths” presented in the article and ask why you’re not as concerned, given the current characteristics of this virus.

  • I live in Pierce County “Tacoma” went to the drs on Wednesday Jan 26th with all the symptoms of the flu which they tested me for and it came back negative..sent me home with a diagnosis of upper respiratory infection, they gave me medicine like albuteral, cough medicine, ibuprofen, and mucinex…been sick since then, went to the drs again on 3-2-20 again breathing has gotten worse and was told i have broncitis because my left lung sounds where not good..I asked for a coronavirus test and the dr looked at me with this look of confusion and said i have to find out how we test because we have no clue how to test and we don’t no where to send you to get tested..they gave me a number to the CDC which doesn’t work because they are overwhelmed with calls..so I called our health department and they also told me they don’t do the testing and told me to call the CDC well they does not work i called good Samaritan hospital which told me to call the health department or my primary Dr ..I’m getting the run around from everyone i have spoken to..this is a huge problem for our community when we have no way to test for a very dangerous virus that is killing people..im very disappointed in the way its being handeled…we need testing now!!!!!

    • I applaud you for your comment . It is amazing we live in the best country in the world yet we can’t figure out how to treat our people right , give them the correct medical attention they need . Is our government so stupid that they think Coronavirus wouldn’t reach us in the USA . Politicians make promises for votes but do not deliver on them. The USA is just as corrupt as the rest of the world. Wake up people !!!!

    • As I said above: Germany created a perfectly usable test, which was taken up by the WHO and used world wide. But in the US, they like to do things their own way, and insisted on developing their own test. This initial test was flawed. So, instead of THEN taking up the test that EVERY OTHER COUNTRY IS USING, they persisted in trying to fix it … So much wasted time. THAT’S why you’re having a crisis of people not able to be tested.

  • I heard a nurse in Washington has lung problems and she started showing symptoms. So she called the hotline they told her to go to her primary care doctor so she did. They didn’t have the test so they sent her to urgent care. Same thing happened so she got sent to 3 other hospitals. The last hospital had the test and she came back positive…So, I cant imagine the number of people she might have infected being allowed to bounce around like that…

    • From what I’ve heard , people are reaching out to there doctors and they say , go to hospital . They call the hospital and they say call your doctor . No one knows what to do !!! We don’t have support from our medical system ! It appears if you have symptoms that no one wants to see you . Now my children are afraid to go out in public !!!! Thank you for spreading panic !!! Really ???

  • This is outstanding reporting. I thank Trevor Bedford and his colleagues for their research and for their initiative and drive. I applaud Statnews for reporting this. I hope Governor Inslee and King and Snohomish County officials promptly follow their advice. The Seattle area is filled with intelligent people who will understand how important it is to heed social distancing measures, to engage in testing, even to tolerate a quarantine of the city and surrounding areas to stem the spread in order to buy time, if cases begin to increase exponentially, as appears to be likely.

    • Trevor Bedford is a hero. He and team discovered the first case. He’s now sounding the alarm. I hope the Amazon case will be the clincher, and that they implement measures tomorrow. Since it’s highly possible that children fuel the spread, closing the schools, daycares, and universities is a no brainer. Caveat: keep grandma and grandpa far away from the grandkids.

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