
How coronavirus spread from patient zero in Seattle - pseudolus
https://www.bloomberg.com/news/features/2020-03-09/how-coronavirus-spread-from-patient-zero-in-seattle
======
galoisgirl
> returning four days earlier from a visit with family in Wuhan, China

> County health officials located more than 60 people who’d come in contact
> with him, and none developed the virus in the following weeks. By Feb. 21,
> he was deemed fully recovered. Somehow, someone was missed.

A flight from China sounds like way more than 60 people to come in indirect
contact with: same plane, same airport facilities,...

~~~
nikofeyn
the u.s. has been extremely lackadaisical regarding the virus. somehow they
thought that a travel ban was an end all solution. when i came back from china
in january, there wasn't any tracking, questioning, checking, or anything of
the sort. it was two CDC guys standing around talking to each other,
completely ignoring the masses going through customs.

~~~
s_y_n_t_a_x
The ban went into effect Feb. 2nd so it's normal they weren't stopping people.

I wouldn't judge the direction of the country based on your 2 second visual of
CDC agents talking at an airport.

I don't think they think it's an end all solution, but it helps bide time for
research and helps control the spread.

~~~
nikofeyn
how do you go from literally not even monitoring people to banning all travel
(and then continue to not monitor)? that isn't "normal". it isn't logical.

~~~
s_y_n_t_a_x
You just said you arrived in January. The ban wasn't in place until February.

Are you arguing they don't know how to stop flights?

Did you go back to the airport and stake it out?

------
learc83
It wasn't failed isolation procedures like the title implies. He likely
infected people before he was quarantined. We also don't even know that he was
patient zero--he was just the first one diagnosed.

~~~
Devagamster
given his recent travel records and the genetic testing that linked his
particular strain to subsequent patients, it's highly likely he was patient
zero

~~~
rthomas6
He flew from Wuhan to Seattle. Presumably there were many other people on that
flight. How likely is it that another passenger, who was asymptomatic or just
didn't seek medical care, was the real patient zero?

~~~
alex_young
I didn’t see any indication that this was a direct flight. Was there such a
flight or did this person transfer somewhere in China?

~~~
rthomas6
Oh. True. I didn't think about that.

------
ChrisCinelli
Up to 1 week ago in California they did not let you test people that did not
have contacts with people that were tested positive to COVID-19 or that have
travelled in counties that have the virus.

I know a person in Menlo Park that the whole family "had CODVID-19 symptoms"
(Stanford doctor's word) and they were diagnosed with viral pneumonia but they
were refused of being tested (after asking permission to the CDC) and sent
home asked to be in "isolation and do not tell anybody because it may spread
panic." The first person to get it in the family was one of the child in
school that started have symptoms at the end of Jan.

I supposed that they were not the only ones.

Even nurses dealing with patients were refused to be tested according to this
video: [https://youtu.be/DiqVCQv__pE](https://youtu.be/DiqVCQv__pE)

~~~
frankosaurus
> The first person to get it in the family was one of the child in school that
> started have symptoms at the end of Jan

When you say "get it", do you mean viral pneumonia or coronavirus ?

San Mateo County's dept of health web page currently indicates 9 cases. All
adults, no children.
[https://www.smchealth.org/coronavirus](https://www.smchealth.org/coronavirus)

~~~
messick
That's literally the point. Tests are getting refused so someone (like
yourself) can respond with "But so-and-so says there are only X cases!!!!!"

This isn't an accident.

------
Shivetya
There is no reasonable method to have a travel ban within the United States
short of isolating regions by military force. At the individual level the only
guarantee is imprisonment which is the not so nice way of saying you cannot
leave this facility. This still requires people to volunteer to be tested!

Voluntary travel bans are only as good as the person applied to, especially in
an age where self entitlement is near an all time high. Then throw in the
malcontents who will just expose people for whatever irrational reason they
want.

Even if we could test at point of departure what does that gain us? Say you
could test at the Airport, you are positive, does the tester get taken off the
line, how many people before and after? Everyone on that concourse?

~~~
wayoutthere
> Then throw in the malcontents who will just expose people for whatever
> irrational reason they want.

I've heard some younger folks saying they want to spread coronavirus because
it will kill off some of the old people who vote republican. So yeah, even if
it's not happening some people do feel this way.

~~~
lukev
Sounds like you are mistaking gallows humor for sincere intent. I've heard the
same jokes but I'm 100% sure none of the people making them actually intend to
spread disease.

~~~
Natsu
I have heard the same things. I want to believe it's all internet bluster, but
when I hear an angry group on r/politics talking about how they hope certain
people will die, it doesn't sound very much like a joke, especially when you
can go into the comment history of some of the people and find out that they
have a long history of angry political comments.

------
zaroth
> _On Jan. 15, when the traveler to Wuhan who became the first known U.S. case
> returned to Seattle-Tacoma International Airport, ... At the time, 41 people
> in Wuhan had been diagnosed with the novel coronavirus_.

Just goes to show how much the known case count lags the true infection count
in the community.

------
Tepix
They got unlucky. But it‘s highly likely that the procedures successfully
delayed or prevented some infections for now.

------
ConfusedDog
Considering flying from WuHan to Seattle, there would be more than a few
people could be infected on the plane, at the airport. Yeah, it would have
already spread prior to the lockdown. It doesn't really say anything about the
effectiveness of Ebola-style Lockdown at all...

~~~
hef19898
But the title sounds better that way. Why resort to calm, fact base reporting
when clickbaiting is the alternative?

------
jonplackett
I find reading this irritating because of the logical gaps in arguments.

The whole lead in to this doesn't hold together. They say this guy was patient
zero but did everything right - as if to say that wan't enough, but then fail
to explain how he spread anything. Maybe he didn't? Maybe someone else did?

~~~
alistairSH
The author completely misses the people on the airplane. They started the
analysis with his public transport from airport to home.

------
fxtentacle
What these measures seem to overlook is that there have been cases where
people looked and felt fully healthy, didn't have fever or cough symptoms, but
still had the virus in their blood.

As such, quarantining only the people that are visibly sick is not enough to
prevent the virus from spreading.

~~~
hutzlibu
But it slows it down, as people who do not have the symptoms also do not
spread it so much as they do not sneeze.

Also, what is the alternative? Quarantining everyone? That works only to a
certain amount, before the system collapses.

------
everybodyknows
> the number of active infections could reach 1,100 by March 10

That's today. How old is this article?

~~~
downerending
Does anyone think the number today could possibly be this low?

~~~
hef19898
Reported 647 across the US, 162 in Washington. Obviously that number is
severely limited by testing capacity. But they are the only numbers to go
with, everything else is just guessing.

~~~
downerending
Given that we know testing is behind, and that patients take about five days
(?) to show symptoms, and that it's an exponential growth phenomenon, and that
we have several other countries farther along in the process to observe, I'd
say an educated guess is a _lot_ better to go with than those numbers.

------
checker659
There's no evidence to indicate that he was in fact patient zero. Just because
he was the first person to be diagnosed in Seattle doesn't mean he was the
person responsible for the breakout.

~~~
all_blue_chucks
On the contrary, Trevor Bedford has done extensive genetic analysis of the
strains circulating in the area and has confirmed they are all descended from
the one case.

~~~
s1artibartfast
Can you share a link?

How precise is the genetic analysis? Could it distinguish between if this
individual is patient zero, or if they caught it from another theoretical
individual on the same plane from Wuhan to seattle, who did not quarantine?

~~~
all_blue_chucks
He has been tweeting his results as they come in. The latest is here:
[https://twitter.com/trvrb/status/1237394739143438338](https://twitter.com/trvrb/status/1237394739143438338)

------
davidw
What specific measures have they taken in South Korea? It seems to have been
fairly effective. Lots of tests is the thing I know about. What else?

~~~
williw
Everyone is wearing a mask, whether or not they are showing symptoms. SK gov
has a mask delivery program through the post office. This helps limit the
spread. While the US gov tells everyone to not wear a mask, unless they are
showing symptoms.

~~~
bluGill
There are not enough masks in the world for everybody to wear one. The US is
best rationing the masks we have to those who need them most.

In many Asian countries the air is bad enough that most people wear a mask
anyway for pollution reasons. Thus there is more mask availability
infrastructure in place (I don't think SK was ever that bad but I don't know)

~~~
davidw
The implication is that South Korea has the resources and technology to
produce and distribute masks to its citizens.

But I'd love to hear the details from someone that knows more. That's
potentially a _lot_ of masks to be churning out.

~~~
bluGill
they are taking masks that could be used here instead. There are so any masks
made in the world so every use of one is a mask that someone else couldn't
use.

Obviously factories have abilities to ramp up production to meet demand so the
above is simplistic. However they can only ramp up so far (or fast) when the
limit is reached the above applies.

------
ComputerGuru
Do we know how long 2019-ncov can survive on contaminated inorganic surfaces
if not sanitized?

~~~
sp332
At least 24 hours, possibly 48. There are a few similar viruses that can
survive up to 9 days if they are humid and cold (near freezing).
[https://www.journalofhospitalinfection.com/article/S0195-670...](https://www.journalofhospitalinfection.com/article/S0195-6701\(20\)30046-3/fulltext)
But we don't have good info for SARS-CoV-2 specifically.

~~~
ComputerGuru
Thanks. Earlier this year we closed our school for two days plus the weekend
to disinfect after we had an unprecedented near twenty percent of the student
body absent due to an incredibly virulent strain of the flu. Trying to keep
all these factors in mind while we make decisions on remote learning for this
mess.

~~~
cryoshon
disinfection isn't going to do much of anything. the virus lives in people and
spreads between people, even when they are mostly asymptomatic, at least for a
few days.

sure, it'll stop people from picking up trace viral particles on surfaces,
which is better than nothing.

but i see many places "closing for disinfection" as their go-to response to
the virus, and if you understand the way that this disease transmits, it's
mostly for show.

~~~
bluGill
Closing for disinfection works in part because people don't go to those places
while it is being disinfected and thus don't spread things in them.

------
tejohnso
> Ultimately, Seattle’s experience shows the futility of travel bans

Is there a word or phrase for the act of poorly implementing an idea, then
using the failed result as a way to discredit the idea? It's like a straw man
argument but done in practice rather than in argument.

~~~
crankylinuxuser
It's fair to assume that everyone will get this, and 2.5% will die.

(Edit: when I said everyone, I'm thinking of 'everyone' with regards to
contagion like the normal flu that goes around. There are always outliers and
people who miss it. Didn't think I had to spell _that_ one out. Evidently I
did.)

However controlling the rate of infection (coefficient of the exponent) can
make the difference between hospitals able to handle the disease, versus
hospitals getting completely flooded and having more die due to not enough
care.

Tl;dr. You're going to get it, but you don't want everyone getting it at once.

~~~
irrational
Why are you being downvoted? Is this the equivalent of people sticking their
hands over their ears and saying “la la la la! I can’t hear you!”

It seems obvious that you are right that everyone will get it. The real
quibble is what will the death rate actually be. 2.5% seems like a middle-of-
the-road estimate according to current knowledge.

~~~
ksdale
I don't think it's obvious at all that everyone will get it, especially now
that so many people are practicing social distancing and handwashing and
avoiding gatherings. Yes, there are still a lot of people going about their
lives without worry, but it seems totally plausible to me that if some
percentage of people behave more responsibly, it will decrease R0 to some
number below 1.

I think using simple exponential numbers to predict future cases is too
simplistic if we don't take into account how people's changing behavior will
affect the spread.

~~~
irrational
I guess it depends on where you live. In the city where I live I have seen
absolutely 0 changes in behavior. All gatherings are going on as normal, no
special social distancing. There are lots of jokes about it (we probably
shouldn't shake hands, ha ha! [still shake hands]), but nobody is actually
doing anything differently.

~~~
ksdale
I've seen that same thing! But I live about an hour away from Seattle, and I'm
generally seeing way fewer people shake hands and several people I know (my
family included) are avoiding unnecessary trips into public.

I mostly just wonder where the threshold is between population density and
social distancing and R0. Obviously total quarantine does wonders, and
completely normal behavior is terrible, but is it enough if half the
population takes precautions? Or 2/3 or 1/3?

I've been thinking of it kind of like a graph or a web, and if you cut enough
of the connections, the spread stops, and "enough" isn't anything like "all,"
and the more strategically placed the cuts are, the fewer there can be, but
it's not easy to figure out exactly how many cuts you need.

------
codeulike
The headline is stupid. Its pretty obvious that the transmission happened
_before_ they got the patient into an 'ebola-style lockdown'. Based on another
sentence in the article, you could change the title to 'Seattle's Coronavirus
spread despite a lack of testing in a critical six-week window'.

My point is, its pretty obvious how you slow this thing down, and its not much
to do with 'ebola-style lockdowns', its to do with lots of testing, social
distancing and hand washing. South Korea has a 2 hour turnaround on tests, in
the USA its still 5 days I believe.

~~~
bilbo0s
> _South Korea has a 2 hour turnaround on tests, in the USA its still 5 days I
> believe._

Those kinds of inefficiencies don't have to exist. I wish I knew what the
bottleneck was there. That time differential is so large that it has to be
something pretty braindead that's holding the process up. Like we're still
using test kits of type A when we should be using test kits of type B. Or
everyone, nationally, is sending tests to a single lab with 2 staffers for
evaluation. Etc etc.

The problem is, at once, solved in other places, and at the same time so
glaring in our case that there is no way it can be insurmountable. We just
have to get our heads out of our butts.

