First US Covid 19 death in Santa Clara county Feb 6th

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First US Covid 19 death in Santa Clara county Feb 6th - magnus - 04-22-2020

A Santa Clara County medical examiner has identified a Feb 6th death as being infected by covid19. That would make it the first documented covid related death in the US.

There was also one found on Feb 17th.

https://news.yahoo.com/autopsies-reveal-first-confirmed-u-042339932.html

RE: First US Covid 19 death in Santa Clara county Feb 6th - M T - 04-22-2020

The source press release is https://www.sccgov.org/sites/covid19/Pages/press-release-04-21-20-early.aspx

Quote:The [Santa Clara County] Medical Examiner-Coroner performed autopsies on two individuals who died at home on February 6, 2020 and February 17, 2020. Samples from the two individuals were sent to the Centers for Disease Control and Prevention. Today, the Medical Examiner-Coroner received confirmation from the CDC that tissue samples from both cases are positive for SARS-CoV-2 (the virus that causes COVID-19).

Additionally, the Medical Examiner-Coroner has also confirmed that an individual who died in the county on March 6 died of COVID-19.

The prior information about the earliest cases was

Quote:Information about our COVID-19 cases in Santa Clara County:

On January 31, 2020 we announced the first case of COVID-19 in Santa Clara County. On February 20, this case was released from isolation, fully recovered. He was never hospitalized.
On February 2, we announced the second case, who remains in home isolation, and has never been hospitalized.
On February 28, we announced a third case who is hospitalized.
On February 29, we announced the fourth case of COVID-19 in Santa Clara county, who is isolated at home.

So, the two deaths on Feb 6 & 17 were before the Jan 31 case had been released.
The Feb. 6 death would have been exposed before SCC knew of the Feb. 2 case.

A Feb. 2 death suggests a mid or early January exposure, presumably in China.

RE: First US Covid 19 death in Santa Clara county Feb 6th - Farm93 - 04-22-2020

I hope our government will try to determine how those that died earliest may have contacted the disease. Did they go to China? Did relatives go to China? Co-workers? Or were they more likely victims of community spread, presumably implying others carried the virus to the USA and survived.

In the bigger picture it does show that a few early deaths in any location were apparently easy to categorize in an existing category. I don't think that implies Santa Clara County was trying to hide deaths, and yet one COULD now claim that the USA, CA or SCC were not open about early deaths and therefore all of those levels of government in the USA should not be trusted.

I suspect China wanted to hide their total deaths and probable deaths for a number of reasons unique to China's global standing.  Unfortunately for the citizens of the USA, and even the world, those concerns were not fully reflected in the official USA Federal communications early enough. Sure hope we don't spend the summer of 2020 spending a lot of time on that blame game as the minimizing the potential wave in the winter of 2020/2021 should be the government focus.

The understanding that there were earlier deaths won't give a lot of comfort to families that have lost loved ones, but maybe it will encourage the Federal government to accelerate antibody testing nationwide.

Nothing would be more encouraging for the USA economy than to determine that a large number of citizens already have antibodies. It could reveal a much lower fatality rate, and it would also reduce the total fatality projections in models. The antibody testing could reveal information not yet understood on wall street or main street.

I am a bit surprised that President Trump's administration has not gone all in on antibody testing ASAP. Unexpected good news revealed from antibody testing would have a much bigger impact on the economy than those daily press conferences from the White House.

RE: First US Covid 19 death in Santa Clara county Feb 6th - Genuine Realist - 04-22-2020

(04-22-2020, 06:56 AM)Farm93 Wrote: I hope our government will try to determine how those that died earliest may have contacted the disease. Did they go to China? Did relatives go to China? Co-workers? Or were they more likely victims of community spread, presumably implying others carried the virus to the USA and survived.

In the bigger picture it does show that a few early deaths in any location were apparently easy to categorize in an existing category. I don't think that implies Santa Clara County was trying to hide deaths, and yet one COULD now claim that the USA, CA or SCC were not open about early deaths and therefore all of those levels of government in the USA should not be trusted.

I suspect China wanted to hide their total deaths and probable deaths for a number of reasons unique to China's global standing.  Unfortunately for the citizens of the USA, and even the world, those concerns were not fully reflected in the official USA Federal communications early enough. Sure hope we don't spend the summer of 2020 spending a lot of time on that blame game as the minimizing the potential wave in the winter of 2020/2021 should be the government focus.

The understanding that there were earlier deaths won't give a lot of comfort to families that have lost loved ones, but maybe it will encourage the Federal government to accelerate antibody testing nationwide.

Nothing would be more encouraging for the USA economy than to determine that a large number of citizens already have antibodies. It could reveal a much lower fatality rate, and it would also reduce the total fatality projections in models. The antibody testing could reveal information not yet understood on wall street or main street.

I am a bit surprised that President Trump's administration has not gone all in on antibody testing ASAP. Unexpected good news revealed from antibody testing would have a much bigger impact on the economy than those daily press conferences from the White House.

I suspect the logistics of testing are a lot more complex than appears to an outsider.

RE: First US Covid 19 death in Santa Clara county Feb 6th - Goose - 04-22-2020

(04-22-2020, 07:44 AM)Genuine Realist Wrote:
(04-22-2020, 06:56 AM)Farm93 Wrote: I am a bit surprised that President Trump's administration has not gone all in on antibody testing ASAP. Unexpected good news revealed from antibody testing would have a much bigger impact on the economy than those daily press conferences from the White House.

I suspect the logistics of testing are a lot more complex than appears to an outsider.

There are several different antibody tests available. Their respective sensitivities are not yet well established. Some have been shown to be total junk. A big testing program with several different tests of unknown sensitivity will just yield a bunch of results that are hard to interpret at best. Such a testing program using a test with inadequate sensitivity/too many false positives will be equally difficult to use.
I do hope (and actually expect) that the "government" at all levels is chomping at the bit to do this type of testing. Fortunately (IMHO) they haven't done so with tests that are not of known quality. It may take longer to qualify the tests than one would like, but it has to be done if the results are to be useful. Then we get to worry about the logistics of making up enough tests and executing the testing, which is indeed not trivial. Unfortunately that is just how it is.

RE: First US Covid 19 death in Santa Clara county Feb 6th - magnus - 04-22-2020

More info here
https://www.cnn.com/2020/04/22/us/california-deaths-earliest-in-us/index.html

Notably, no prior travel history, so likely attained from community spread.

It'll be interesting to see how this tracing unfolds.

RE: First US Covid 19 death in Santa Clara county Feb 6th - martyup - 04-22-2020

I suspect there were many deaths of covid positive people that were never identified as infected. These deaths would have appeared as pneumonia or emphysema or heart failure. Such deaths, especially among the elderly, are not unusual and would not have raised red flags.

RE: First US Covid 19 death in Santa Clara county Feb 6th - oldalum - 04-22-2020

(04-22-2020, 06:56 AM)Farm93 Wrote: I don't think that implies Santa Clara County was trying to hide deaths, and yet one COULD now claim that the USA, CA or SCC were not open about early deaths and therefore all of those levels of government in the USA should not be trusted.

Not sure what you mean by that, but I don't think such a claim should be made. Those first two deaths were people who died at home. They probably had comorbidities and physicians and had received some medical attention before their deaths. Their physicians probably completed and signed their death certificates based on their known medical conditions and acute illness. Being under the care of a physician, and with known pre-existing conditions that could cause death, their deaths were not required to be reported to the county coroner. Or maybe they should have been reported to the coroner but weren't. Or they were reported to the coroner but there was nothing at the time that should have raised suspicion that they were related to the virus. There are many possible ways that the county realistically had no way of suspecting at the time that these were possible Covid-19 deaths. Now, the coroner is looking through all the old death certificates for possible investigation with autopsies, found these two, and is continuing to look for others.

RE: First US Covid 19 death in Santa Clara county Feb 6th - Snorlax94 - 04-22-2020

This was interesting, and I hope we investigate more, but not too surprising.

Testing swabs from people Jan-Feb, they found 2 in 2800 had Covid. Low enough that it’s clear Covid wasn’t circulating widely last fall (the previous theory du jour) — but it wasn’t zero.

If 2 In 2,900 flu swabs in the Bay Area tested positive, maybe dozens, maybe a few hundred people had it early this year.

It is interesting that the prevalence stayed so low early in the year, then shot up so quickly in March. If that person in January had spread it widely, things would have been worse. It’s also possible the early cases self quarantined better, or weren’t social people (I wonder of they’ll provide more details on the two deaths).

RE: First US Covid 19 death in Santa Clara county Feb 6th - BostonCard - 04-22-2020

(04-22-2020, 10:16 AM)Snorlax94 Wrote: It is interesting that the prevalence stayed so low early in the year, then shot up so quickly in March. If that person in January had spread it widely, things would have been worse. It’s also possible the early cases self quarantined better, or weren’t social people (I wonder of they’ll provide more details on the two deaths).

That's what exponential growth looks like. The number of cases creep up slowly, almost indistinguishably from background, and then will shoot up seemingly coming out from nowhere.

BC

RE: First US Covid 19 death in Santa Clara county Feb 6th - 2006alum - 04-22-2020

(04-22-2020, 10:25 AM)BostonCard Wrote:
(04-22-2020, 10:16 AM)Snorlax94 Wrote: It is interesting that the prevalence stayed so low early in the year, then shot up so quickly in March. If that person in January had spread it widely, things would have been worse. It’s also possible the early cases self quarantined better, or weren’t social people (I wonder of they’ll provide more details on the two deaths).

That's what exponential growth looks like. The number of cases creep up slowly, almost indistinguishably from background, and then will shoot up seemingly coming out from nowhere.

BC

Exactly. I was going to say - given how quickly we saw a large number of cases in CA in early March, there had to be a few cases as early as January, because the virus's standard R0 without intervention is 2-3, which means that one person who is infected on Jan. 1 will have inadvertently caused, on average, 2-3 more infections by Jan. 8, 4-9 infections by Jan. 15, 8-27 infections by Jan. 22, 16-81 infections by Jan. 29, and 32-243 infections by Feb. 6. If up to 243 people could have been infected from a single primary carrier who entered the community Jan. 1, it would be entirely predictable to see the first death by Feb. 6 with an IFR of 0.5-1.0% and over 200 people infected during that time period.

RE: First US Covid 19 death in Santa Clara county Feb 6th - burger - 04-22-2020

(04-22-2020, 09:44 AM)oldalum Wrote: Not sure what you mean by that, but I don't think such a claim should be made. Those first two deaths were people who died at home. They probably had comorbidities and physicians and had received some medical attention before their deaths. Their physicians probably completed and signed their death certificates based on their known medical conditions and acute illness. Being under the care of a physician, and with known pre-existing conditions that could cause death, their deaths were not required to be reported to the county coroner. Or maybe they should have been reported to the coroner but weren't. Or they were reported to the coroner but there was nothing at the time that should have raised suspicion that they were related to the virus. There are many possible ways that the county realistically had no way of suspecting at the time that these were possible Covid-19 deaths. Now, the coroner is looking through all the old death certificates for possible investigation with autopsies, found these two, and is continuing to look for others.

Even if the dead peoples' doctors had strongly suspected covid-19 and had wanted testing, it would not have happened because CDC guidelines at the time only allowed people who had been in Wuhan to be tested, as noted here: https://www.nytimes.com/2020/04/22/us/coronavirus-updates.html

I don't think that expanded testing earlier would have caught these specific cases. But insufficient attention has been paid to how stupid the CDC's guidelines were. At first it was only people who had been in China (or maybe just Wuhan?). Then it was expanded to people directly exposed to China travellers. I think it wasn't until March when tests were made available to everyone. And at each step, CDC lagged in updating its policies until a number of cases popped up that did not meet the current criteria. When California's first (at the time) community-acquired case was discovered in Sacramento, it was only after doctors at the hospital pleaded with CDC for 5 days to get a test.

When the all of the failings of the federal government are tallied, I hope the incredibly restrictive approach to testing gets the attention it deserves.

RE: First US Covid 19 death in Santa Clara county Feb 6th - magnus - 04-22-2020

(04-22-2020, 10:39 AM)burger Wrote: I don't think that expanded testing earlier would have caught these specific cases. But insufficient attention has been paid to how stupid the CDC's guidelines were. At first it was only people who had been in China (or maybe just Wuhan?). Then it was expanded to people directly exposed to China travellers. I think it wasn't until March when tests were made available to everyone. And at each step, CDC lagged in updating its policies until a number of cases popped up that did not meet the current criteria. When California's first (at the time) community-acquired case was discovered in Sacramento, it was only after doctors at the hospital pleaded with CDC for 5 days to get a test.

When the all of the failings of the federal government are tallied, I hope the incredibly restrictive approach to testing gets the attention it deserves.

Agreed that the CDC has performed horribly. Even by March when tests were supposed to be available to everyone, most tests were still only being administered to those showing symptoms...whether it was because of the CDC's ever changing "guidelines" or to accommodate limited testing supplies, I do not know.

If you then add the CDC's evolving stance on masks..."they will cause more harm than good" (how hard is it to teach people to wear them properly...or at least in such a way that would not increase their chances of exposure)..."bandanas can be used in a medical setting absent proper PPE" (this just allowed hospitals to lower the urgency of finding PPEs, thereby further harming healthcare workers)...the CDC's post mortem will not be short on action items. =(

RE: First US Covid 19 death in Santa Clara county Feb 6th - oldalum - 04-22-2020

I thought the initial testing criteria ideally should have been included a Bayesian standpoint of, what value is added by the test. If someone had a high-risk exposure to a known case, and comes down with typical symptoms in a typical time frame, the probability of Covid-19 infection is sufficiently high that a positive test does not change that probability much (or treatment, or isolation)--so why waste that test when they are scarce.

RE: First US Covid 19 death in Santa Clara county Feb 6th - Snorlax94 - 04-22-2020

(04-22-2020, 10:25 AM)BostonCard Wrote:
(04-22-2020, 10:16 AM)Snorlax94 Wrote: It is interesting that the prevalence stayed so low early in the year, then shot up so quickly in March. If that person in January had spread it widely, things would have been worse. It’s also possible the early cases self quarantined better, or weren’t social people (I wonder of they’ll provide more details on the two deaths).

That's what exponential growth looks like. The number of cases creep up slowly, almost indistinguishably from background, and then will shoot up seemingly coming out from nowhere.

BC

Yes and no. Ro is an average. If the Ro is 3, it does not mean each infected person will spread it to exactly 3 people. Some will spread it to 0 people, some will spread it to hundreds or thousands. Had the first cases attended concerts, soirees, ski lodges, and mega churches in late January, things could have been much worse.

“‘Patient One,’ Super-spreader
When a 38-year-old man went to the emergency room at a hospital in Codogno, a small town in the Lodi province of Lombardy, with severe flu symptoms on Feb. 18, the case did not set off alarms.
The patient declined to be hospitalized and went home. He got sicker and returned to the hospital a few hours later and was admitted to a general medicine ward. On Feb. 20, he went into intensive care, where he tested positive for the virus.
The man, who became known as Patient One, had had a busy month. He attended at least three dinners, played soccer and ran with a team, all apparently while contagious and without heavy symptoms.

Mr. Ricciardi said Italy had the bad luck of having a super spreader in a densely populated and dynamic area who went to the hospital not once, but twice, infecting hundreds of people, including doctors and nurses.

“He was incredibly active,” Mr. Ricciardi said.“

RE: First US Covid 19 death in Santa Clara county Feb 6th - chrisk - 04-22-2020

(04-22-2020, 10:48 AM)magnus Wrote:
(04-22-2020, 10:39 AM)burger Wrote: I don't think that expanded testing earlier would have caught these specific cases. But insufficient attention has been paid to how stupid the CDC's guidelines were. At first it was only people who had been in China (or maybe just Wuhan?). Then it was expanded to people directly exposed to China travellers. I think it wasn't until March when tests were made available to everyone. And at each step, CDC lagged in updating its policies until a number of cases popped up that did not meet the current criteria. When California's first (at the time) community-acquired case was discovered in Sacramento, it was only after doctors at the hospital pleaded with CDC for 5 days to get a test.

When the all of the failings of the federal government are tallied, I hope the incredibly restrictive approach to testing gets the attention it deserves.
Agreed that the CDC has performed horribly. Even by March when tests were supposed to be available to everyone, most tests were still only being administered to those showing symptoms...whether it was because of the CDC's ever changing "guidelines" or to accommodate limited testing supplies, I do not know.

If you then add the CDC's evolving stance on masks..."they will cause more harm than good" (how hard is it to teach people to wear them properly...or at least in such a way that would not increase their chances of exposure)..."bandanas can be used in a medical setting absent proper PPE" (this just allowed hospitals to lower the urgency of finding PPEs, thereby further harming healthcare workers)...the CDC's post mortem will not be short on action items. =(

The US should contract itS CDC function to Taiwan’s CDC. The teacher can learn from the pupil.

Of course, even if the CDC were competent, it’s not likely they could have nanaged the politics.

RE: First US Covid 19 death in Santa Clara county Feb 6th - magnus - 04-22-2020

(04-22-2020, 11:01 AM)oldalum Wrote: I thought the initial testing criteria ideally should have been included a Bayesian standpoint of, what value is added by the test. If someone had a high-risk exposure to a known case, and comes down with typical symptoms in a typical time frame, the probability of Covid-19 infection is sufficiently high that a positive test does not change that probability much (or treatment, or isolation)--so why waste that test when they are scarce.

I think your reasoning is the way to explain the CDC's guidelines...but it points to the fact that we've been behind the curve in all these areas forcing us to take shortcuts in guidelines to cover for our deficiencies. =/

RE: First US Covid 19 death in Santa Clara county Feb 6th - oldalum - 04-22-2020

basically there is no way to make up for the profound shortage of testing kits.

RE: First US Covid 19 death in Santa Clara county Feb 6th - BostonCard - 04-22-2020

(04-22-2020, 11:05 AM)Snorlax94 Wrote: Yes and no. Ro is an average. If the Ro is 3, it does not mean each infected person will spread it to exactly 3 people. Some will spread it to 0 people, some will spread it to hundreds or thousands. Had the first cases attended concerts, soirees, ski lodges, and mega churches in late January, things could have been much worse.

Fair point; this happened in South Korea with a patient who caused a large outbreak through a church. Early in an outbreak, when there are few patients infected, obviously the early spread is highly dependent on the characteristics of the early infected patients. One super-spreader among a dozen people who are infected in the early stages of a pandemic will have an out-sized influence on the early course of the outbreak. Conversely, if you have a couple of non-spreaders early, you can significantly delay the onset of the outbreak. That's why a lot of the plots of the outbreak start with cumulative cases after the number of cases exceeds a certain minimum (10 or 100, for example).

BC

RE: First US Covid 19 death in Santa Clara county Feb 6th - oregontim - 04-22-2020

(04-22-2020, 06:56 AM)Farm93 Wrote: In the bigger picture it does show that a few early deaths in any location were apparently easy to categorize in an existing category. I don't think that implies Santa Clara County was trying to hide deaths, and yet one COULD now claim that the USA, CA or SCC were not open about early deaths and therefore all of those levels of government in the USA should not be trusted.

I hope I'm interpreting this correctly. I think the point of "COULD" is that using this new information as evidence of public sector failure or public sector bad faith would be wrong. This is just the way information works, sometimes it takes time for facts to bubble up from the ooze. No bad intentions involved. Right?

(04-22-2020, 06:56 AM)Farm93 Wrote: I suspect China wanted to hide their total deaths and probable deaths for a number of reasons unique to China's global standing. Unfortunately for the citizens of the USA, and even the world, those concerns were not fully reflected in the official USA Federal communications early enough. Sure hope we don't spend the summer of 2020 spending a lot of time on that blame game as the minimizing the potential wave in the winter of 2020/2021 should be the government focus.

The understanding that there were earlier deaths won't give a lot of comfort to families that have lost loved ones, but maybe it will encourage the Federal government to accelerate antibody testing nationwide.

Nothing would be more encouraging for the USA economy than to determine that a large number of citizens already have antibodies. It could reveal a much lower fatality rate, and it would also reduce the total fatality projections in models. The antibody testing could reveal information not yet understood on wall street or main street.

I am a bit surprised that President Trump's administration has not gone all in on antibody testing ASAP. Unexpected good news revealed from antibody testing would have a much bigger impact on the economy than those daily press conferences from the White House.

Agree with this also.