March 2, 2020

America has suffered its first coronavirus deaths—and first infections of health care workers

Daily Briefing

    Health officials over the weekend announced the first two U.S. deaths tied to the new coronavirus, which occurred among patients in the Seattle suburb of Kirkland, Washington.

    Our analysis: The 'recurring themes' of disease outbreaks

    About the coronavirus epidemic

    Reports of the new coronavirus first surfaced in early December 2019 in Wuhan, China. According to the World Health Organization (WHO), the main symptoms of the virus are fever and lesions in both lungs. Some patients also have reported difficulty breathing, WHO said.

    As of Monday, officials reported more than 89,700 cases of the virus globally, with most of those cases occurring in mainland China, the New York Times reports. Officials said as of Monday there had been at least 3,056 deaths linked to the virus, and all but 144 of the deaths occurred in mainland China.

    The number of newly reported cases in China has slowed, but the number of newly reported cases in other countries has surged over the past two weeks.

    In the United States, officials as of Monday had reported a total of 88 cases of the virus and two deaths linked to the virus, the Times reports. CDC as of Saturday said 47 cases involved Americans who contracted the virus elsewhere and then repatriated to the United States, 13 cases involved patients who had contracted the virus while traveling abroad and were diagnosed after returning to the United States, and nine cases involved patients who contracted the virus via human-to-human transmission.

    CDC has noted that several U.S. patients with the virus—including patients in California, Oregon, and Washington—have no known connections to individuals who had either traveled to other countries affected by the virus or who had a suspected or confirmed case of the virus. That indicates the cases likely stemmed from so-called "community spread" of the virus in the United States, the Times reports.

    US coronavirus deaths linked to Seattle suburb

    The two patients who've died from the coronavirus in the United States both were treated at medical facilities in Kirkland, Washington.

    U.S. health officials on Saturday announced the first death, which involved a man in his 50s who had underlying health conditions. The patient died at EvergreenHealth Hospital in Kirkland on Friday.

    Officials said they do not know how the patient was exposed to the new coronavirus. Washington Gov. Jay Inslee (D) on Saturday said state officials were "strengthening [the state's] preparedness and response efforts to keep Washingtonians healthy, safe, and informed."

    On Sunday, health officials reported the second death linked to the coronavirus in the United States, which occurred among a man in his 70s who had underlying health conditions and was a resident at a nursing home in Kirkland operated by Life Care Centers of America. That patient died on Saturday, also at EvergreenHealth Hospital.

    Officials on Sunday also reported six other confirmed cases of the virus among residents and employees of the Kirkland nursing home. The officials said more than 50 people at the facility were exhibiting possible symptoms of the virus and were being tested. According to the Times, officials are unsure how individuals at the nursing home were exposed to the virus. Jeff Duchin, health officer at the Seattle and King County public health department, said a team from CDC will work with local and state health officials to investigate the outbreak.

    The nursing home in a statement posted Sunday said it is "following the infection control recommendations from the CDC, including proper hand-washing techniques and wearing masks, gowns, and gloves when caring for any symptomatic patients." The facility added that it's placing "[a]ny residents with symptoms … in isolation," and is no longer permitting visitors.

    Evergreen Health in a statement said the hospital is "working with the CDC and the Washington Department of Health to ensure that those who have come into contact with the [coronavirus] patient[s] are screened and tested as appropriate."

    Researchers say evidence suggests long-undetected spread in Washington

    Researchers at the Fred Hutchinson Cancer Research Center and the University of Washington on Sunday said some evidence suggests the virus has been spreading undetected in Washington for as many as six weeks, raising the possibility that there could be hundreds of undiagnosed cases in the state. In a study the researchers posted online, they found genetic similarities between the state's first case of the virus, which officials confirmed on Jan. 20, and a case of the virus that was diagnosed several weeks later.

    The study has not been reviewed by other scientists and hasn't been published in a scientific journal, the Associated Press reports. According to the Washington Post, CDC has reached out to the researchers, and an HHS official who spoke to the Post on the condition of anonymity said more data is needed to validate the results.

    But some scientists who weren't involved with the research said the findings weren't surprising. For example, Justin Lessler, an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, explained that, because most cases of the virus are mild, it's possible people could be infected with the virus without knowing. "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," Lessler said.

    Officials report first cases of the virus among US health care workers

    Meanwhile, officials in California over the weekend reported the first known cases of the new coronavirus among health care workers in the United States who had treated coronavirus patients outside of Washington.

    Officials in California's Alameda and Solano counties in a joint statement said two health care workers at NorthBay VacaValley Hospital in Vacaville, California, who had treated a coronavirus patient were diagnosed with the virus on Sunday. The workers had treated the first U.S. patient suspected of contracting the virus via community spread, according to officials.

    NorthBay Healthcare Group President Aimee Brewer in a statement published Thursday said they identified the cases after conducting tests of anyone at NorthBay VacaValley Hospital who had contact with the patient. Brewer said, "From [the] patient's arrival in the [ED], until the transfer to UC Davis Medical Center, we promptly identified these employees. Those that met the moderate or high risk categories were asked to stay home and monitor themselves for any sign of [infection]. Our approach is the same as we regularly manage other diseases that require airborne precautions and monitoring."

    Brewer added, "We are very proud of our health care team who provided excellent care to this patient while in our hospital, and proud of all who responded in the last two days to manage possible employee exposures."

    US officials say risk to Americans remains low

    Despite the uptick in reported cases of the virus in the United States, federal health officials have said the virus still presents a low risk to Americans—though they've added that U.S. cases likely will continue to grow.

    Nancy Messonier, director of CDC's National Center for Immunization and Respiratory Diseases, on Saturday said, "We still judge the general risk to the American public to be low and that includes residents of long-term care facilities."

    HHS Secretary Alex Azar on Sunday said, "We cannot make predictions as to how many cases we'll have, but we will have more, and we will have more community cases."

    (Johnson/Flaccus, Associated Press, 3/1; Lai et al., New York Times, 3/2; CDC website, 2/29; Borter/Gorman, Reuters, 2/29; Baker et al., New York Times, 3/2; Aleccia, Kaiser Health News, 3/1; Life Care Center of Kirkland statement, 3/1; Miller/Chastaine, Kirkland Reporter, 3/1; Achenback et al., Washington Post, 3/1; NorthBay Healthcare Group statement, 2/27).

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