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.

  • This CANNOT continue, where you have business after business closing, people pent up in their homes (or rooms) for weeks, no social gatherings, no school, no travel– the youngest and most productive members of our society pent up in their homes indefinitely. No way is this gonna last more than a week. Just to protect a KNOWN segment of the population that appears to be, by far, the most vulnerable. We are lucky this is not a pandemic affecting everyone equally. Now let’s get the message out for the elderly and vulnerable to do the right thing on their own and self isolate. And if they do not, then have it be mandated instead of mandating that the whole society, whole countries, are “locked down”. This is absurd. I’m sure that we could work out arrangements for elderly and vulnerable to get food and supplies delivered to them. The expense of caring for them in isolation pales in comparison to the economic AND psychological damage this will cause as a result of long-term social isolation, job loss, etc. Think of how this is impacting children in particular, who absolutely are not directly benefiting from this isolation and being deprived of education, but are doing it as a forced sacrifice for the benefit of others who could more easily and feasibly self isolate.

  • Actually if you had bothered to even read my comment, you would see that I was not talking primarily about the “homeless” you’re talking about– the ones who indeed choose the street lifestyle– although their lack of adequate quarantine housing affects us all, fair or not.

    I was talking about others who have insufficient housing to deal with pandemic at no fault of their own. Students who are working hard with their studies and paying over $1,000/month to live in a packed dorm room with 1 or 2 other students is NOT sufficient safe housing. Workers who have to share an apartment with 10 other people because housing is so expensive in Seattle don’t have safe sufficient housing either. International students and others without a home base to easily return to, especially if their dorms close due to the virus, are in a world of hurt and have nowhere to go to isolate or quarantine. Also, I wouldn’t wanna be someone who is looking for housing now, no matter what the income; nothing is open in the area, and I’m not even sure Airbnb’s are a safe option now if someone needs to quarantine. Only option seems to be paying minimum $200/night for a hotel room.

    Honestly, it’s not a mystery who is getting sick and dying. It’s mostly old people with underlying health issues. Why not isolate them, and let everything and everyone else get on as normal? Indeed, why not ENCOURAGE the young and healthy to mingle closely and become infected to develop herd immunity ASAP? I guess we could try to “flatten” the curve, even though it’s probably too late now and will ruin the economy.

    • Immunity:: the ability of an organism to resist a particular infection

      Herd immunity, there is no such thing in the world for immunity from coronavirus 2019-nCoV Covid-19 as there are those that have got it the second time in China. Herd immunity would go down the path of constantly spreading it, and that I would call you’re not immune. See the definition above. Some governments will have no choice but their outlook to change soon. As many already have rapidly in EU since its now the epicenter

      Google below for the full article
      WHO spokeswoman Dr Margaret Harris said today that scientists do not yet know enough about the virus. She added that while ‘we can talk theories’, countries needed to take action to lessen the impact.

    • Hi Aussie,

      So do you think the UK virologists advising the UK government on its strategy based on herd immunity are wrong? It seems the UK is the only country that has any sense at all by the way they are handling things currently. This includes the new announcement that elderly people over 70 should self-isolate. As I see businesses closing, children traumatized by social isolation, students being deprived of education– I wonder why more countries are asking the elderly and vulnerable to step up and do their duty and SELF ISOLATE

  • As for “ensuring we have plans for what we’re going to do with homeless or marginalized populations” this category is much larger than is commonly thought. What about people who are doubled up in small apartments? Students who live 2-3 people per dorm room? People living in crowded shelters and transitional housing? International students who have no familial home base to retreat to at times like these?

    The living environment is key to restricting spread. People need to have a safe place to wait out this virus and isolate if need be– both in the short term and longer term– at least until summer. Those living in crowded dorms and shelters need to be given their own self-contained spaces– at the very least, their own rooms.

    In a public emergency like this, we should consider commandeering empty vacant spaces in hotels and apartment buildings.

  • Surely they are watching what is going on up here. No one should be going out except to get supplies so they can stay in their homes. From my observations being in the center of the US epicenter, Seattle Wa everybody needs to stay inside their homes. Essential personnel should stay where they are needed to keep power and water on and should stay where they need to be untill this is over. It got out of hand so fast up here they don’t know what they are doing. I’ve been yelling to shut down close schools for 2 weeks they finally did that today. I don’t think it was soon enough. God bless everyone. Please stay safe if you can.

  • How can informing people or minimizing the facts about the infection & health risks, contagion probability, numbers and percentages of the tested population’s confirmed cases & fatalities for an internationally widespread disease that is neither preventable, treatable & to a significant number of people could be deadly actually be beneficial, ethical & effective in handling & containing public health & safety?? Is the lack of accurate information, comprehension & public trust by downplaying, omitting & misrepresenting facts in the interest of keeping the public from panicking (which wouldn’t be a bad thing if that fear combined with knowledge produces behavior, awareness & prevention practices!)
    Never is—nor should it ever be—ignorance & deception the answer to addressing public concerns &/or crisis by any govt! As a member of the population with a high risk & high susceptibility of death due to chronic illnesses manipulating & limiting the truth as close to real time as possible will probably make the difference between life & death for people like us. So please consider that fact & people like us who are dependent on the rest of humanity to protect & prevent exposing us to avoidable & unnecessary but consequential & critical risks.

  • The state of Washington has the authority to declare Marshall law in infected areas. They could restrict travel from abroad and to boundaries surrounding the infected areas. This map could expand as needed.

  • Good job on the article. We are in big trouble here in Monterey event organizers like the Big Sur Marathon is going on with its plan to allow people from all over the World and the USA to the Marathon. The director said he is going to follow the Counties advice who has no test kits. The city of Monterey has no plans to curtail the Cruise ships from coming into port, many in the next few months. The blind are leading the blind here.

  • Why is it so hard to for people to understand that it’s our duty as citizens to do what we can in order to prevent a public health crisis. New evidence comes to light each day the more scientists learn about this virus, which may now have 2 strains. There could be tens of thousands of infected ppl but since we have so few test kits the actual # is really anyone’s guess. While most ppl who get it will think they just have a cold or the flu, some ppl end up dead or gravely ill. Let’s try n keep that in mind. Whatever is necessary to limit the # of dead from this outbreak we should b doing. And if u dont care about ppl dying perhaps your 401K will motivate you to take this seriously

    • I hear you, but…..I know…there is a but…. the over-saturation of this flu is ridiculous. We have 7.78B people in the world and 3,800 people have perished.

      As people, we have over anti-bacterialized ourselfs to a point of saturation, that even common bugs are mutating to out-smart our modern medicine. Therefore, as a species, we no longer have an apex predator to help quell the population.

      Quite frankly, I am content with this ‘outbreak,’ this “Manufactured Drama,” at 7.78B people, worldwide, we can use some culling.

  • So you’re wishing the spread of disease often fatal to the elderly and/or immune-compromised on Seattleites as retribution for liberal policies ? Or at the very least you’d be unconcerned. Compassionate conservatism?

  • Vino….90,000 deaths? I beg to differ. Uhhhhhh no. There are over 90k cases WW. The death rate is in the 3800s. Nice try. Also, the coronavirus has been around since the mid-60s. Again, nice try.

    I have more concern with my loved ones when they get into their automobiles vs fretting over this manufactured drama.

    It’s amusing to see you get all worked up over a flu. Nothing more than the flu.

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