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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.


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.

    • I feel sorry for you working in nursing. You get less sick leave and vacation then teachers, much lower pay then teachers, work longer hours then teachers, can not abandon patients (teachers can abandon class rooms), can be sue for malpractice and teachers can not, get no holidays, have worse care in insurance e then teachers, have e virtually no retirement, and you work twice as many days as teachers.

      Nursing is a horrible profession and teachers have too much pay and too many benefits.

      P.s. if you can read don’t thank a teacher: good job on figuring it out on your own. If you can’t do complex math thank a teacher. Next time you talk to a teacher ask them to show you some trig or calculus. Ask them why if there are no differences soars above the KT layer then how are birds dependent from dinosaurs.

      Nurses are all smarter then teachers.

  • My big concern are the Casino’s, they are open 24 hours why are we closing schools and sanitizing public transportation and we never mention casinos. As far as I’m concerned casinos spread more virus than school and public transportation.

  • A deadly and overwhelming disease affecting an entire community is called a pestilence in the Bible. It is part of the prophecies listed in the Book of Revelation. Psalm 91:1-3 says that those who put their trust in God can be delivered “from the deadly pestilence.”

    • What you are saying is not in context… it doesn’t mean “literal” deliverance from pestilence. It means you will be saved from hell.. it doesn’t mean you will be saved from bad things happening to you. Bible also says “He causes his sun to rise on the evil and the good, and sends rain on the righteous and the unrighteous.” Matt. 5:45.. which means bad things happen to good and bad people… Saved or unsaved, righteous or unrighteous. Go doesn’t promise to erase bad things in this world because this world is ruled by Lucifer. But God *does* promise to be a source of hope and constant truth in times of need. So don’t expect to be saved from Corvid19 just because you’ve misinterpreted the Bible’s context.

    • In response to “S,” I was only quoting what the Bible says. While it is correct that bad things can happen to everyone, God has the power to deliver people from whatever they might be going through, including pestilence. It is a matter of people making a choice between putting their confidence and hope in human agencies or calling upon the grace of God for their health and safety.

  • I’m a little worried… All of my work comes from Kirkland. I am a handyman and am in and out of people’s homes all day. Even though I make sure I am as sanitized as humanly possible, I worry about my customers and (heaven forbid) I get sick, I don’t want to pass it around. This self employment is all I have income wise and at a loss for what to do as the bills keep rolling in… Also, let’s say it gets so bad out there that the city puts a “curfew” or lock down on everyone…. Will those that are paycheck to paycheck just loose everything while those who are rich or work from home or have a nest egg are able to keep their homes, bills and lights on?

    Could it come down to that being a valid worry or am I just narrowing trouble by worrying about nothing?

  • Accurate information can be found on the CDC website. Expecting balanced reporting from media and from posts by anonymous people with perspectives entirely unknowable is as impetuous as gambling fever that leads a person to pull down on the lever yet again against common sense and statistics. Don’t fall for the spin.

    • My concern is the mail maybe all mail aught to be quarentined my friend orders stuff from wish apparently alot of that stuff comes from Asia has anyone thought about the safety of mail coming from across seas?

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