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The New York City coronavirus outbreak grew so large in early March that the city became the leading source of new infections in the United States, new research reveals, as thousands of infected people traveled from the city and they planted outbreaks across the country.
Research indicates that a wave of infections spread from New York City to much of the country before the city began to set social distancing limits to stop growth. That helped fuel the outbreaks in Louisiana, Texas, Arizona, and as far away as the west coast.
The findings come from distinctive virus mutations made by geneticists, travel stories of infected people, and models of the outbreak by infectious disease experts.
“We now have enough data to feel fairly confident that New York was the main gateway to the rest of the country,” said Nathan Grubaugh, an epidemiologist at the Yale School of Public Health.
The central role of the New York outbreak shows that decisions made by state and federal officials, including waiting to impose distancing measures and limit international flights, helped shape the outbreak’s trajectory and allowed it to grow in the rest of the year. country.
The city joins other densely populated urban hot spots around the world, starting with Wuhan, China, and then Milan, which have become vectors for the spread of the virus.
Travel from other U.S. cities also caused infections across the country, including an early outbreak centered in the Seattle area that spread infections in More than a dozen states, researchers say. Even if New York had managed to stop the virus, it probably would have continued to spread from other places, they say.
But the Seattle outbreak turned out to be a storm before the biggest storm in New York, where, in late February, thousands of infected people filled trains and restaurants, crowded tourist attractions, and passed through its three major airports.
During the crucial weeks of March, New York political leaders He waited to take aggressive action, even after identifying hundreds of cases, giving the virus an initial advantage. And in mid-March, when President Trump restricted travel from Europe, the restrictions were essentially useless, according to the data, as the disease was already spreading widely within the country.
According to the researchers, acting earlier would probably have slowed down the virus throughout the country.
“It means we lost the boat from the start, and the vast majority in this country comes from domestic spread,” said Kristian Andersen, a professor in the department of immunology and microbiology at Scripps Research. “I keep hearing that it is someone else’s fault. That is not true. It is not someone else’s fault, it is our fault.”
Dani Lever, communications director for Governor Andrew M. Cuomo, criticized federal authorities and described a “tremendous failure by the federal government to leave New York and the East Coast exposed to flights from Europe, while at the same time infusing a false sense of security in telling New York State that we had no Covid cases for the entire month of February. “
A White House spokesman Judd Deere said Trump had acted quickly. The president blocked most visitors to Europe from March 13, more than a month after he restricted travel from China.
Just as he acted from the start to cut travel from the source of the virus, his health and infectious disease experts informed President Trump that he should cut travel from Europe, an action he took decisively without delay to save lives while Democrats and the media criticized him and the global health community still did not fully understand the level of transmission or spread, ”said Mr. Deere.
The trip from New York that helped spread the virus includes residents who traveled, travelers who work in the city, and people who visited or passed. Now that infections are scattered across the country, traveling from New York is no longer a major factor shaping the progression of the epidemic, the researchers said.
As states across the country begin to relax their restrictions, the results show that it is difficult, if not impossible, to prevent those actions from affecting the rest of the country.
Geneticists have analyzed and shared more than 2,000 samples of the virus from infected people. As the virus infects new people and replicates, it picks up mutations along the way. These mutations generally do not change the behavior of the virus, but can provide a signature of the origin of the virus.
Most of the samples taken in Texas, Ohio, Louisiana, Idaho, Wisconsin, and many other states have distinct mutations that date back to viruses introduced into New York.
Overall, Dr. Grubaugh estimated, infections that spread from New York account for 60 to 65 percent of sequenced viruses across the country.
Other scientists said they would like to see more samples before calculating accurate figures. But they agreed that New York’s prominence in the spread of the national spread appears to have started in early March, two weeks before orders to stay home were established.
“New York acted as the Great Central Station for this virus, with the opportunity to move from there in so many directions, to so many places,” said David Engelthaler, head of the infectious disease branch of the Translational Genomics Research Institute in Arizona.
The most commonly detected viruses linked to New York have a different genetic signature that links them to outbreaks in Europe. Those that extend from Washington state have a signature that links them directly to China.
Benjamin M. Branham, port spokesman The New York and New Jersey Authority, which controls airports, said that prior to flight restrictions from Europe, the federal government’s Customs and Border Protection “only inspected passengers from China,” not Europe.
At this stage, scientists say, genetic fingerprints alone are not enough to identify the source of the viruses. But the travel patterns and case histories of the earliest known cases support the idea, they said.
“It is a combination, still, of what genomic epidemiology and shoe leather epidemiology are going to tell us,” said Dr. Engelthaler.
Scientists modeling disease progression nationwide said New York’s prominence as a national center was broadly consistent with their findings, though the picture was still emerging.
“I would say this is not surprising in a way,” said Alessandro Vespignani, director of the Network Science Institute at Northeastern University in Boston. “The emerging image is consistent with numerical models.”
Previous research by Dr. Vespignani showed how fast and invisible the outbreak was in New York. By March 1, when the first case of coronavirus was confirmed in New York, the city likely had more than 10,000 undetected infections, his research group showed.
New York and Washington state are not the only sources of the outbreak. Other large domestic centers contributed to the spread, scientists believe, and a more diverse genetic mix is still seen in some parts of the country, particularly in the Midwest and parts of the South.
Even as domestic travel began to trigger the outbreak, international travelers spread some infections across the country, geneticists said. Some of the virus samples attributed to New York may have been planted in other cities by direct flights from Europe, or by travelers who stayed in New York before traveling elsewhere, experts say.
For that reason, some scientists said they would like to see more samples before linking most infections in the United States to New York.
“I think that is probably the story that is going to emerge, but I would like to see more data,” said Harm van Bakel, a geneticist at Mount Sinai in New York.
An analysis of the New York Times’ travel data supports the idea that the infection chains originated in New York, experts said. The number of cases across the country was closely related to the number of travelers each place received from New York in early March, according to anonymous cell phone tracking data from Cuebiq, a data intelligence company.
“It appears that the majority of the household spread is basically people traveling from New York,” said Dr. Kari Stefansson, founder and CEO of deCODE Genetics, a leading genome analysis firm based in Reykjavik, Iceland.
Last week, Dr. Andersen of Scripps Research and other scientists who analyzed the outbreak in New Orleans reported that all samples taken from New Orleans came from the line linked to New York. The virus swept through the area in March and killed more than 1,000 people.
“It can be discovered, with travel patterns, that they most likely happened in New Orleans directly from New York,” said Dr. Grubaugh.
Josh Holder, Michael Crowley and Derek Watkins contributed reporting.
