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In February, long before Governor JB Pritzker issued the COVID-19 order to stay home, a Chicago resident who had been traveling out of state attended a funeral.
As a close friend of the deceased’s family, the resident left despite having mild respiratory symptoms and shared a meal-style meal with the family the night before, hugging some to express their condolences.
During the 28 days that followed, 16 people between the ages of 5 and 86 were infected with COVID-19, three of whom died.
A study by medical experts from the Centers for Disease Control and Prevention followed this early “super spread” of COVID-19 to 16 people, seven of whom were confirmed cases and nine more were considered probable based on the appearance of related symptoms.
The report, released Wednesday, provides a new, step-by-step look at how COVID-19 spreads through communities and further illustrates the need for social distancing.
“Along with the evidence emerging from around the world, these data shed light on transmission beyond household contacts, including the potential for super-widespread events,” according to the study.
The Chicago resident is known as “Patient A1.1” to indicate his position as the first patient in the first generation of transmissions in family group A, according to the report.
One of the hosts of the shared dinner (patient B2.1) developed symptoms of the virus just two days after the funeral. The other host started showing symptoms two days later.
A third person who came into close contact with patient A1.1 that night developed symptoms six days after the funeral, according to the study.
Just a week later, the dinner host, patient B2.1, was hospitalized and, after being intubated and placed on a ventilator for acute respiratory failure, died on day 28 of the study.
A family member visited patient B2.1 in the hospital and “hugged [them], and provided limited personal care, without wearing personal protective equipment [PPE]”, according to the study.
Soon after, the visitor, Patient B3.1, developed symptoms consistent with COVID-19, including fever and cough.
Three days after the funeral, on the fifth day of the study, patient A1.1, who was still showing mild symptoms, attended a family birthday party with nine other people. According to the study, the family dined and hugged each other during the three-hour celebration.
This interaction led to the infection of seven family members (three confirmed and four probable) over the course of seven days. Five of them were fortunate to experience only mild symptoms of the virus: mild fever and cough.
For two family members, however; the disease worsened, resulting in hospitalization, intubation, respiratory support, and ultimately death.
As one patient’s health deteriorated, another family member and a home care professional provided care without using PPE, and both subsequently reported symptoms of the virus.
According to the study, one of them, patient A3.1, transmitted the virus to one person at home, with a case count of 15.
On the 17th day of the investigation, three symptomatic family members who had attended the birthday party went to church.
They sat near patient D3.1, a healthcare professional, and entered into “direct conversations, sitting in a row for 90 minutes and passing the plate of the offering,” according to the report.
Subsequently, patient D3.1 tested positive for COVID-19, bringing the case count to a total of 16 people in four families.
While the study does not deny the possibility that patient D3.1 could have contracted the virus while working in healthcare, according to the report, the virus was known not to be widespread in area hospitals at the time.
The report continues with the hypothesis that this early group of cases may have played a role in the spread of COVID-19 to other communities in Chicago. CDC concludes the report by urging readers to use this information as a reminder of the importance of following social distancing guidelines.
“These findings highlight the importance of complying with current recommendations for social distancing, including guidance to avoid any meeting with people from multiple households and to follow state or local orders to stay home,” according to the report.
When Pritzker announced on March 20 that he would issue a stay-at-home order, the state only had 585 confirmed cases of COVID-19 and five deaths.
Even then, Chicago University of Medicine chief epidemiologist Emily Landon said there was consensus among her colleagues that a blockade was “the only way to go.”
“We cannot care for everyone at once and we cannot deliver on that promise of low mortality if we cannot provide the support our patients need,” Landon said. “… all we have to stop the spread is distance, social distance.”
“If we let each patient with this infection infect three more people and then each infect two or three other people, there will be no hospital bed when my mother can’t breathe well or when he coughs too much,” she said. “… So please don’t give up.”
As of Thursday afternoon, there were 15,078 confirmed cases of COVID-19 in Illinois and 462 people had died from the virus, according to the Illinois Department of Public Health.
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