MONDAy, MARCH 2 , 2020. THE WASHINGTON POST eZ sU A
the coronavirus outbreak
This weekend marked a clear
turning point in the coronavirus
crisis in the United States, with the
first reported death and additional
cases of community spread. As of
Sunday afternoon, the CDC listed
nine cases in the United States of
person-to-person spread.
Although the World Health or-
ganization has declined to describe
covid-19 as pandemic, it has spread
to every continent but Antarctica,
and there is widespread agreement
among infectious disease experts
that a significant fraction of the
human population could become
exposed to it in the coming year or
two.
Vice President Pence on Sunday
offered assurances that the admin-
istration has a handle on the crisis
and that the threat to most Ameri-
cans is low. He said that the Trump
administration is leading an ag-
gressive, whole-of-government re-
sponse to the coronavirus and
pointed to the president’s order to
restrict travel from China as key to
keeping Americans safe.
“I think it’s all a reflection of the
fact that early on in this crisis, in
January, t he president took the un-
precedented step of suspending all
travel from China and establishing
a quarantining effect,” Pence said
on CNN’s “ State of the Union.”
on the same show, former vice
president Joe Biden criticized the
administration’s response so far,
saying there should have been
more protective gear and test kits
available sooner. “We knew this
was coming. Back as far as January.
They didn’t even begin to prepare
the testing kits. This is something
that’s elementary,” h e said.
HHS Secretary Alex Azar de-
clined to comment on how many
cases the United States may be
facing. “We cannot make predic-
tions as to how many cases we’ll
have, but we will have more, and we
will have more community cases,”
he said on CBS’s “face the Nation.”
“It’s simply just a matter of math.”
[email protected]
[email protected]
[email protected]
[email protected]Carolyn y. Johnson, alex Horton, meryl
Kornfield and Tory newmyer
contributed to this report.consultant who spoke on the con-
dition of anonymity for fear of on-
line harassment, said she normally
commutes by metro to downtown
Washington to work but has self-
quarantined since returning from
Italy. Had she not chosen to do so,
she said, “I could have been passing
this all over D.C.”
A 30-year-old man who flew
from virus-stricken Japan into
Newark airport on Tuesday said he
checked into NYU Langone’s e mer-
gency department in Cobble Hill,
Brooklyn, with a 102-degree fever
and cough. But because he did not
meet the criteria as set at that time
by the CDC — h e lacked chest pains
or shortness of breath — h e was not
tested for covid-19.
The man, who spoke on the con-
dition of anonymity because he did
not want to be associated with the
outbreak, told The Washington
Post he would be self-quarantined
in his Brooklyn apartment for the
next two weeks.
“my thought process was: What-
ever I had, now it’s starting to get
worse, so I better go to the hospi-
tal.” He wrote about his experience
on the social media site reddit.
After he arrived at the hospital,
he was tested for flu strains and
dozens of other microbes, all of
which came back negative. A chest
X-ray also returned negative. on
Thursday he was informed that the
CDC had not approved his case for
testing because his symptoms were
too mild.
He was sharing his story be-
cause he “wanted people to realize
that there are probably more peo-
ple like me.” His flight from Japan
into Newark on Tuesday was full,
he said.
“A t no point am I saying ‘I have
coronavirus.’ I’m just saying I have
symptoms that are like it, and no
one is testing me,” h e said.
“A ll NYU Langone Health facili-
ties follow the testing guidelines
and infection prevention protocols
issued by the CDC and state and
city Departments of Health,” Lisa
Greiner, a spokeswoman for NYU
Langone, said in a statement. “As
the situation concerning CoVID-
19 remains fluid, we are continual-
ly aligning our testing protocols to
ensure the safety a nd welfare o f our
patients and staff.”“very important.”
Until a few days ago, the CDC
had specific, narrow criteria for
who should be tested for possible
coronavirus infection — and most
tests had to be sent to Atlanta be-
cause of faulty tests sent out to state
labs. The focus was on people who
had been to China or been in con-
tact with someone who had trav-
eled there. As a result, people with
respiratory infections and fevers
were not being widely tested for
coronavirus. Last week, the CDC
altered the criteria to expand test-
ing.
Clinicians always have discre-
tion to request testing, the CDC has
said. A top CDC official said last
week that no such requests for test-
ing have been turned down.
Even so, a 56-year-old woman in
Chevy Chase, md., who recently
returned from Northern Italy,
where the virus has spread dramat-
ically, and who has suffered from a
cough and flulike symptoms for 10
days, told The Washington Post
that she could not get a coronavirus
test at a hospital because she was
not hospitalized or severely ill.
“It’s almost impossible to get a
damn test,” she said. The woman, acility where more than 50 residents
and staff are reportedly ill with
symptoms associated with the nov-
el virus. At least two of King Coun-
ty’s six confirmed cases are con-
nected to the Life Care facility: a
health-care worker in her 40s and a
resident in her 70s.
A statement released by the
nursing home said that the resi-
dents typically exhibit c old and flu-
like symptoms at this time of year
and that they may be sent to a
hospital for covid-19 testing. “A ll
visits to the facility from families,
volunteers or vendors are not al-
lowed,” t he statement said.
If the number of confirmed cas-
es climbs dramatically in the next
few days, it could reflect expanded
detection efforts rather than a sud-
den increase in the rate at which
the virus i s spreading.
“once we start testing more
broadly this week, we are almost
certain to learn that there has been
community transmission for a
while in many places,” said Andy
Pavia, chief of the Division of Pedi-
atric Infectious Diseases at t he Uni-
versity of Utah health system. H e
called the Washington state re-
search on the genetics of the virustravelers, rather than sustained
person-to-person spread within
the community.
The CDC has been in touch with
Bedford, and although agency ex-
perts note that his hypothesis has
validity, scientists need more data,
according to a Department of
Health and Human Services offi-
cial, who spoke on the condition of
anonymity to talk candidly. “It is far
from definitive,” the official said.
The particular strain found in
these two samples is widespread i n
China and elsewhere. It’s possible
that someone else introduced the
virus into the community “that we
didn’t p ick up,” t he official said.
But this research could be evi-
dence that the highly contagious
virus has eluded efforts to contain
it through travel bans, quarantines
and other interventions. The virus
may have been spreading in parts
of Washington state among people
who didn’t r ealize they were i nfect-
ed by it — they m ay have thought
they had a cold or the flu.
on Saturday, state and King
County health officials reported a
possible coronavirus outbreak at
the Life Care Center in Kirkland,
Wash., a long-term residential fa-ton state to 13 cases. of the four
new cases, the three surviving pa-
tients range in age from their 70s to
90s, have underlying health condi-
tions and are in critical condition,
health officials said. The first coro-
navirus death in the United States
was announced Saturday.
Health officials in Washington
state and across the nation said
they expect that numbers will con-
tinue to rise in the wake of the
decision by the Centers for Disease
Control and Prevention last week
to widen testing guidelines. over
the weekend, new cases were re-
ported in Americans who had re-
cently traveled to South Korea and
Italy, including one person in
rhode Island, the state’s first case.
The health department in Santa
Clara County, Calif., in the heart of
Si licon Valley, announced three
new coronavirus cases Sunday eve-
ning, bringing to seven the total
number of cases there. The an-
nouncement gave few details
about the cases. Late Sunday, the
office of florida Gov. ron DeSantis
announced two “presumptively
positive” cases of the coronavirus,
in manatee and Hillsborough
counties, and declared a public
health emergency.
California and oregon, like
Washington, have reported coro-
navirus infections in people who
did not travel to regions hit hard by
the outbreak or have contact with
people known to be infected. The
United States has dozens of other
confirmed infections, the majority
of them people who were among
the passengers on the cruise ship
Diamond Princess.
The international picture has
continued t o worsen, with spikes in
cases in South Korea, Iran and Italy
in recent days. Worldwide, almost
90,000 people have been infected
with the coronavirus, and 3,
have died.
The research reported by Bed-
ford is preliminary, and further
analysis could alter the conclusion.
Bedford said it is possible but very
unlikely that the genetic similarity
of the two virus samples could be a
coincidence and reflect two dis-
tinct introductions of the virus into
Snohomish County by infected
VIrus from A
Research could mean virus h as eluded containment efforts
JoVelle Tamayo for THe WasHIngTon PosT
In Kirkland, Wash., where health officials reported a possible coronavirus outbreak at a long-term
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