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SAN FRANCISCO – Officials in Santa Clara County, California announced Tuesday night that two residents died of the coronavirus in early and mid-February, making them the first known victims of the pandemic in the United States.
The new information may change the timeline of the virus’s spread across the country weeks earlier than previously believed.
The first report of a coronavirus-related death in the United States came on February 29 in the Seattle area, although authorities later discovered that two people who had died on February 26 also had the virus.
But Santa Clara county officials said autopsies of two people who died in their homes on February 6 and 17 showed that the people were infected with the virus. The presence of Covid-19 disease was determined by tissue samples and was confirmed by the Centers for Disease Control and Prevention, county health officials said in a statement.
“Each of those deaths is probably the tip of an iceberg of unknown size,” Dr. Sara Cody, the county’s chief medical officer, said in an interview. “It feels quite significant.”
Dr. Cody said that the people who died in February had no known travel history that would have exposed them to the virus, which first appeared in China. They are presumed to have contracted the virus in the community, he said.
The recently reported deaths suggest that the coronavirus may have spread in California much earlier than previously known, said Dr. Jeffrey V. Smith, Santa Clara County executive and physician.
“It probably wasn’t recognized for long enough,” said Dr. Smith.
It was unclear early Wednesday why it had taken so long to identify the deaths from February and the coronavirus.
Much debate has focused on the question of when the virus arrived in the United States and how early it began to spread among people. Problems and delays slowed the availability of widespread testing for the virus, which has They killed more than 40,000 people across the country.
In January, authorities identified a series of coronavirus cases from overseas travelers, but did not identify any community-wide spread of the virus for several weeks.
The federal government had strict rules on who qualified for coronavirus testing and test kits developed by the C.D.C. – that public health laboratories began receiving on February 7 – It turned out to be faulty. Strict definitions of who could be tested limited what local health officials could do to find out how widespread the virus could be.
“We had to ask C.D.C. each time: does this person meet the case definition? Can we send a sample? Dr. Cody said.
“We had this very, very uncomfortable feeling that we were hearing about a lot of patients who really felt they were cases but we couldn’t evaluate them,” he said.
Other indications have emerged that the virus may have spread earlier than previously known. The Grand Princess cruise ship that left San Francisco on February 11 had passengers who developed the coronavirus on board. The researchers believe that the virus also began circulating in the New York area in mid-February. And in early March, researchers found a variety of cases with genetic similarities to each other in the Seattle area, suggesting that it had spread undetected for weeks.
In Santa Clara County, Dr. Cody said the image of the spread was getting clearer, but there were still gaps.
“We had so few pixels that I could barely make out the image,” he said. “Suddenly, we have a lot of pixels that we suddenly didn’t even realize we were looking for.”
But, he added, “I still can’t put the story together.”
On March 16, Santa Clara County was one of the first counties in the country. to announce orders to stay home. “Clearly in hindsight, that was a good decision,” said Dr. Cody. “Now we see that there was even more transmission than we recognized.”
Although California was an early state in reporting that people carried the virus, it has had one-tenth the number of deaths that New York State, The most affected place in America. Authorities believe that the early enforcement of stay-at-home orders and the lower population density in the state are some of the factors that have helped California avoid the worst so far.
Thomas Fuller reported from San Francisco and Mike Baker from Seattle.
