When was the First Case of COVID-19 in the United States?

SARS-CoV-2 was not around last winter. COVID-19 truly is a novel infection.

Why do some folks continue to believe that COVID-19 has been around for a while and that it isn’t as novel a virus as the rest of us know it really is?

Jay Gordon thinks that he might have been seeing a lot of kids with COVID-19 in January, well before the first confirmed cases in the state.
Jay Gordon thinks that he might have been seeing a lot of kids with COVID-19 in January, well before the first confirmed cases in the state.

The usual suspects…

When was the First Case of COVID-19 in the United States?

While some are wondering if they were seeing COVID-19 in January, some think they were seeing in even earlier.

#COVidiots are spreading the idea that COVID-19 has been in the United States since December.
#COVidiots are spreading the idea that COVID-19 has been in the United States since December.

Were the first cases of COVID-19 here in December?

“Yeah, me too. I’ve been telling almost every patient I see that, well, you know it’s flu season, but it doesn’t seem like you have the flu, it seems like you have a really bad cough. And everyone I’m seeing, it’s like their coughs are worse this winter. And their coughs are lasting for 3 or 4 weeks, instead of 1 or 2 weeks. And something went around this winter that was not the flu. Flu went around too, but there was a really terrible cold going around and you’re right, it is really possible in hindsight that coronavirus has been here this whole time.”

Bob Sears

What do you think of when you hear Bob Sears talk about seeing kids with a “really bad cough” that lingers for a month?

Since he wrote a book pushing a non-standard, parent-selected, delayed protection vaccine schedule, my first thought is pertussis too…

That isn't the COVID-19 type of coronavirus they are talking about in the cold and flu reports from December!

This has been a fairly bad flu season though, and as early as December, there were high rates of flu in many parts of the United States.

That isn’t the COVID-19 type of coronavirus they are talking about in the cold and flu reports from December!

And since it was cold AND flu season, there were already high rates of other cold viruses, including RSV, adenovirus, rhinovirus, enterovirus, and non-COVID-19 types of coronavirus.

Still, that doesn’t prove that the SARS-CoV-2 virus that causes COVID-19 wasn’t around in December or earlier.

So what evidence do we have?

Well, we have the evidence that the first strains of SARS-CoV-2 emerged in Wuhan, China in November.

“From very early on, it was clear that the nCoV genomes lacked the expected genetic diversity that would occur with repeated zoonotic events from a diverse animal reservoir. The simplest parsimonious explanation for this observation was that there was a single zoonotic spillover event into the human population in Wuhan between mid-Nov and mid-Dec and sustained human-to-human transmission from this point.”

Trevor Bedford on Early warnings of novel coronavirus from genomic epidemiology and the global open scientific response
The first case of 2019 Novel Coronavirus was detected in Washington in January.

And we know that the first cases in the United States were seen in Washington in mid January.

Genomic epidemiological analysis traced the first case in Washington to a traveler from China in mid January.
Genomic epidemiological analysis traced the first case in Washington to a traveler from China in mid January.

Wait, how do “we” know that?

“The field of genomic epidemiology focuses on using the genetic sequences of pathogens to understand patterns of transmission and spread. Viruses mutate very quickly and accumulate changes during the process of transmission from one infected individual to another. The novel coronavirus which is responsible for the emerging COVID-19 pandemic mutates at an average of about two mutations per month.”

Trevor Bedford on Cryptic transmission of novel coronavirus revealed by genomic epidemiology

We know that because experts can examine the small mutations in the SARS-CoV-2 virus when it emerges in an area.

“We know that Wuhan went from an index case in ~Nov-Dec 2019 to several thousand cases by mid-Jan 2020, thus going from initial seeding event to widespread local transmission in the span of ~9-10 weeks. We now believe that the Seattle area seeding event was ~Jan 15 and we’re now ~7 weeks later.”

Trevor Bedford on Cryptic transmission of novel coronavirus revealed by genomic epidemiology

That has helped them track where and when the SARS-CoV-2 virus pops up in each part of the country.

The SARS-CoV-2 virus in each area is different enough that they can trace where it came from, but no, the differences aren't large enough to affect immunity.
The SARS-CoV-2 virus in each area is different enough that they can trace where it came from, but no, the differences aren’t large enough to affect immunity.

No we don’t have a time machine to test folks in November or December or even earlier, except to test those who submitted specimens in flu studies (which will be done as folks get caught up with testing new samples), but by examining the mutations in the virus, they can tell how long the virus has been spreading in each area.

And that has allowed them to create fairly detailed timelines of SARS-CoV-2 outbreaks in the United States.

Do any of these timelines show COVID-19 cases in the United States in December or early January?

Nope.

Is there any good reason you should be listening to the folks pushing misinformation about COVID-19?

Of course not!

Not surprisingly, these are the same folks who are well known to push misinformation about vaccines.

But why do they want you to think that SARS-CoV-2 has been around for awhile?

It’s propaganda to make you think that getting COVID-19 isn’t that serious.

Don’t believe them.

More on the First Case of COVID-19 in the United States

Author: Vincent Iannelli, MD

Vincent Iannelli, MD