The Novel Coronavirus Went Global In November - Or Maybe Even Much Earlier?

May 11, 2020

moon of alabama

The first wide outbreak of the Covid-19 disease caused by the SARS-CoV-2 virus was identified in late December 2019 in Wuhan, China. But recent reports suggest that the virus circulated much earlier, and not only in China, than was previously known.

It is known that the virus is genetically ~96% similar to a virus that currently occurs in bats in south China. The genome of the virus has a length of 30,000 nucleic acids. A 4% is difference suggest that 1.200 must have changed through mutations, recombination and natural selection for the differences to evolve.  Experts estimate that it took 20 to 70 years for the SARS-CoV-2 virus and its relative in bats to develop from a common ancestor. The development of SARS-CoV-2 likely did not take place within bats but in some animal which has an organism more similar to the human one. The German virologists Christian Drosten, who is an acknowledged expert in coronaviruses, has suggested raccoon dogs as a possible intermediate host.

The genome sequences of the viruses show slight mutations which can evolve with each imperfect replication. The mutations usually do not change the functioning of the virus but they can be used to build a genealogical tree of the virus. Researchers have shown that the first known case in Washington State probably came directly from Wuhan while the prevalent virus types in New York are similar to ones previously seen in Europe and likely came from there.

Such analyses point to Wuhan as the source of the current outbreak and to October as the time of the first jump from an animal to a human. But the data is naturally incomplete, only relatively few occurrences of the viruses get sequenced, and there may be previous mutations no one is yet aware of.

China is still trying to find the first person in China that carried the virus. Old blood samples and radiographic chest pictures of previous pneumonia cases are now being retested and reviewed to find earlier cases.

The South China Morning Post says that earliest known Chinese patient one fell ill on November 17:

According to the government data seen by the Post, a 55 year-old from Hubei province could have been the first person to have contracted Covid-19 on November 17.From that date onwards, one to five new cases were reported each day. By December 15, the total number of infections stood at 27 – the first double-digit daily rise was reported on December 17 – and by December 20, the total number of confirmed cases had reached 60.

In late December doctors in Wuhan connected six cases of pneunomia which had similar rare progression of the disease and concluded that there was a new bug in town. After it was established that the disease was caused by a new virus a systematic look for earlier occurrences was launched. It is not at all astonishing that previously unrecognized cases were found.

But it was not only in Wuhan that earlier cases were found.

Anecdotal evidence from Bergamo, Italy, that was ravaged by the virus in February, strongly suggests earlier cases:

A “strange pneumonia” was circulating in northern Italy as long ago as November, weeks before doctors were made aware of the novel coronavirus outbreak in China, one of the European country’s leading medical experts said this week.“They [general practitioners] remember having seen very strange pneumonia, very severe, particularly in old people in December and even November,” Giuseppe Remuzzi, the director of the Mario Negri Institute for Pharmacological Research in Milan, said in an interview with the National Public Radio of the United States.
“This means that the virus was circulating, at least in [the northern region of] Lombardy and before we were aware of this outbreak occurring in China.”

France recently also reported a case in November:

Covid-19 cases in France can be dated back to as early as November 16, nearly 10 weeks before the country’s first confirmed cases of the disease were thought to have occurred, according to a French hospital.The November case was identified by the hospital’s medical imaging department after carrying out a retrospective study on about 2,500 chest scans performed between November 1 and April 30.
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In France, some cases were already in circulation in November, said Michel Schmitt, chief doctor of the medical imaging department at Albert Schweitzer Hospital in the town of Colmar in Alsace, near the border with Germany.
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“[There was a] very slow progression of the pathology’s negative impact until the end of February, then a rapid increase in its impact, peaking on March 31.”

A chest scan that shows a widespread 'ground glass opacity' is typical for Covid-19 patients and differs significantly from scans of typical pneumonia patients.

But archived chest scans are not the only signs that the disease has occurred in a former patient. Subsequent blood tests for antibodies can identify patients who recovered from the disease. That apparently happened in New Jersey:

The mayor of Belleville is making a startling yet uncorroborated claim that he contracted the coronavirus in New Jersey in November, two months before the first confirmed U.S. case in Washington State.Mayor Michael Melham said he recently asked his doctor, days after a routine physical, to test his blood for COVID-19 antibodies — and got a positive finding on Wednesday.
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He recounted becoming ill while in Atlantic City attending the New Jersey League of Municipalities Conference.
“I was definitely feeling sick when I was there, and fought my way through it," he told NJ Advance Media on Thursday.
After returning home Nov. 21 from the convention, Melham said a doctor diagnosed his worsening symptoms — including a 102-degree fever, chills, hallucinations and a sore throat that ended up lasting for three weeks — as a bad case of the flu.
“I have never been sicker in my entire life,” Melham said, though he acknowledged that he did not have the respiratory problems often associated with the coronavirus.
In a phone interview, Melham conceded he does not know he had the coronavirus.
“Nobody can be sure,” he said.
“But I am nearly certain, for two reasons: I have never been that gravely ill in my adult life, and the antibodies that I have are the longer-term ones, not the most recent ones,” he said.
His test result showed the IgG antibody, which according to Science News lasts longer than the IgM antibody that typically is produced about a week after infection.
Melham said he has done no traveling in recent months, other than a late-January trip to Puerto Rico. He lives alone.

The symptoms the mayor describes, especially the hallucinations which are uncommon in patients with a flu, fit those of a 'mild' case of Covid-19. And while the quick blood tests can have some false positives they only rarely react on antibodies to other viruses. Some enterprising researcher will hopefully ask the mayor for another blood sample and use a more specific laboratory test to give a definitive judgment of the case.

The above show likely and definitely mid-November occurrences of Covid-19 in China, Italy, France and the United States. More such findings from elsewhere are likely to come up in the near future.

That the virus had traveled so far back in November means that it must have been around for much longer than anticipated.

A conspiracy theory by one George Webb had suggested that a U.S. soldiers, Sergeant Maatje Benassi, carried the virus to the Military World Games in Wuhan and had spread it there. The claim has been debunked and in the text below his original video Webb, who is known to peddle disinformation, retracted it while spinning a new conspiracy theory:

I am officially retracting my earlier reporting that Maatje Benassi tested positive for CoronaVirus. I realize now I was being fed bad information to entrap me ...

The Military World Games in Wuhan ended on October 27. It is unlikely that the virus spread from there to come up just two weeks later in completely unrelated persons in four different countries.

One will probably have to go back further to find possible first outbreaks. This July 2019 cluster of pneumonia of unknown cause in Fairfax County now looks awfully suspicious:

A third person has died following an outbreak of respiratory illness at a Fairfax County assisted-living facility that began more than two weeks ago, county health officials said Wednesday.The outbreak at Greenspring Village in Springfield also spread to the unit’s staff, affecting 19 employees, Fairfax County Health Department officials said.
At a news conference Wednesday at the agency’s headquarters, Benjamin Schwartz, director of epidemiology and population health at the Fairfax County Health Department, said tests, including those conducted on 17 samples by the federal Centers for Disease Control and Prevention, have failed to identify a likely cause. Tests for Legionnaires’ disease have also come up negative. Officials tested for a range of common virus- or bacteria-borne respiratory illnesses.
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[In a] notice that went out on July 10 from Donna L. Epps, an administrator at Greenspring, said several residents had been having symptoms of respiratory illness, including fever, coughing and body aches. Epps’s notice, which says the symptoms recede in about five to seven days with treatment but have caused pneumonia, also announced limits on visitors, enhanced sanitation measures and other steps.
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Late Tuesday, the Health Department gave an updated tally, saying 63 people in the assisted-living and skilled-nursing unit have become sick. The agency said there have been no new hospitalizations since 23 people were admitted after the outbreak began June 30. The agency was alerted to the outbreak on July 8.

Greenspring Village has high ratings and is expensive. They presumably have qualified staff. They isolated early and thereby probably prevented a further spread. The symptoms and the timing of the disease fit to a Covid-19 diagnosis and the patients tested negative for all other known causes. One hopes that the chest scans from the pneumonia patients still exist and can be used to make a definite judgment.

Who the first human was who carried the virus and where it was infected is still unknown. That the virus was first detected in Wuhan does not mean that it originated there. Th experts agree that the virus evolved naturally. The epidemic was certainly not caused by someone who recently ate a bat. It is likely unrelated to the 'wet' farmers market where a cluster of early patients came from. While the virus was definitely spreading there in December it is unlikely that the market is the original place where the virus moved from an animal to a human.

The appearance of cases in November in different global regions points to a much earlier first infection than previously assumed. All the early accusations against China have now shown to be as false as the promotion of the useless but potentially dangerous Hydroxychloroquine as a therapy for Covid-19.

Posted by b on May 11, 2020 at 18:35 UTC | Permalink

https://www.moonofalabama.org/2020/05/cornonavirus-went-global-in-november-or-maybe-even-much-earlier.html