It seems more and more likely that the United States USA Had the coronavirus as early as December

On December 27, a man who lived in the northern suburbs of Paris presented to the emergency room with fever, chest pain and a bloody cough.

Her doctors didn't know it then, but they took frozen respiratory samples during her infection, and retested months later, would show that he had COVID-19, the disease caused by the new coronavirus, although he has not left France since August.

At the time, the disease was called Wuhan Coronavirus, a He nods where the new virus has been detected. on the radars of epidemiologists, in December.

Almost a month after the French infection, on January 21, the Centers for Disease Control and Prevention (CDC) would confirm the first known case of the virus in the United States: a man in his thirties who had recently traveled in China. On the same day, the CDC said that if the spread of the virus in Asia was troubling, the risk for Americans remained weak.

But new evidence suggests the virus is already spreading outside of Asia, not just in European countries like France and Italy, but maybe also travel to New York y Florida. In early 2020, the so-called "Wuhan virus" may have been traveling far from Wuhan, China, and beyond the Asian continent for weeks, without being detected or contained.

While the USA USA They focused on detecting the virus that was jumping from a direct flight from China, it was already busy around the world.

President Trump waited to interrupt the trip to the United States. USA From Europe to March 11, months after travelers from this continent were able to escort the virus across the Atlantic.

There are a few main reasons why it has taken the United States so long to find the coronavirus on its shores. When a new disease occurs, it is easier to assume (and hope) that someone else's problem will continue to be someone else's problem, in particular especially when your own disease detection systems and diagnostic tests are not up to scratch.

Compose these problems with people traveling at lightning speed and an infectious mu virus, and you have a recipe for a pandemic disaster.

Our pace of global travel was unprecedented

The last pandemic was the H1N1 flu that appeared in Mexico in 2009, in a difficult global economy with fewer international movements.

Global air travel almost doubled by the time COVID-19 arrived.

"Public health experts have said for years that, first, global surveillance of human disease is insufficient to actually detect infections," said Marc Lipsitch, professor of epidemiology at Harvard who studies infectious diseases. Business Insider on a haunting prophetic warning in 2018.

Lipsitch then hinted that one of the best ways for the world to prepare for future epidemics would be to have more health care professionals around the world trained to identify and report illnesses before They don't spread. Such a defensive strategy to fight the disease would have required large amounts of cooperation and trust between China, the United States and Europe.

Instead, when January ended, the The United States decided to close its doors to foreigners who had been

in China, ignoring the possibility of infections being imported from Europe and the possibility that there are more infections in the United States.

"When people disperse, it becomes a multi-point epidemic, which is much more difficult to control," said Lipsitch.

When people move, diseases spread

Epidemics of epidemic diseases have always been fueled by this human movement.

In fact, the word epidemic, which would have been used for the first time by Homer, originally it was a way to differentiate "who is at home", instead of traveling outside the country.

"As a society, we have a terrible tendency to blame each other for infectious diseases," said Dr. Edward Halperin, CEO of New York Medical College, to a crowd of health care professionals earlier this year. It reminded his audience arrival of Europeans in the Americas the two made the natives in the USA sick. USA and, in turn, they brought new venereal diseases to Europe.

The United States has again made this traditional mistake with the new coronavirus, targeting China and focusing early testing and detection only on people from that country, rather than acknowledging where the virus might have spread.

"Right now, the focus is on travelers returning from places where this disease rate is increasing," said Nancy, of the CDC. Messonnier told reporters on February 3, when Wuhan City had been closed for 11 days and the first cases of virus had confirmed in Italy, four days before.

It is not the first time in recent memory that epidemiologists have become obsessed with where a virus was found, instead of thinking of another place where it can take root.

Ebola takes its name from a tributary of the Democratic Republic of the Congo, near where the first known focus of this disease this happened in 1976. Middle East respiratory syndrome (MERS) was first seen in Saudi Arabia in 2012, and later the so-called "Spanish" flu in 1918 probably started in the United Statesbut was then towed to Europe by an American soldiers.

While the United States wondered in early 2020 if the new coronavirus found in China could have a home on its shores, the CDC continued on its own. prioritize tests and diagnosis COVID-19 for people who had been in China or exposed to someone who had, up to 12 February.

"The CDC's case definition at the outset was too strict: it required someone to go to China," the former CDC epidemic intelligence officer and professor of public health told Business Insider. Emory, Scott McNabb.

"In other words, we were two weeks late, cases were happening, people were infected and we were not prepared because the definition was too strict."

The detection of diseases is by nature retrospective.

Disease surveillance you can try to guess where a contagious disease can move prognosis, but when an unusual group of pneumonia cases is discovered (this is what happened in Wuhan in December), doctors should push the rewind and try to determine who is another could have been ill with the same disease afterwards.

"What you are doing is trying to find all cases of the disease, an undiagnosed disease," said Mike Ryan, director of the health emergencies program at the World Health Organization (WHO ) at a press conference in May. Then you develop a test, find the virus and come back to test. "

The problem with this type of research is that it only looks where a virus is coming from, and it is not very useful in alerting us where it is going next.

To make matters worse, the United States CDC works with terribly obsolete disease surveillance systems, that everyone in the White House Coronavirus Task Force recently agreed is in desperate need of digital updates, according to one Washington Post report.

The coronavirus is cunning, which makes it easier to miss than other diseases.

Monitoring the origin of viral diseases, by country or region, has worked relatively well in the United States in recent times. The United States only had eight laboratory confirmed cases of SARS during this deadly fear from 2002 to 2003y treated only 11 Ebola patients during the 2014 to 2016 epidemic of this disease.

So it's understandable that CDC disease detectives lined up at a few major American airports. USA in early 2020 to assess people leaving flights to China, check temperatures, distribute small symptom sheets and tell travelers the best course of action if they get sick when they return.

But COVID-19 is not like the viral diseases we have seen before. East often transmitted when people are asymptomatic, which makes it more difficult to contain than other coronaviruses (such as SARS). It does not always lead to telltale symptoms such as vomiting and bleeding, which makes it much less obvious than Ebola. Yes temperature control It really doesn't work for this virus.

In fact, New York probably imported most of its earliest cases of COVID-19 from Europe, as researchers at Mount Sinai suggested in a preprinted April study.

"(The coronavirus) has reached the New York area mainly across Europe, through untracked transmissions," said Dr. Viviana Simon, professor of microbiology and infectious diseases at Mount Sinai, said in a press release at the time.

"The virus was probably already circulating in late January 2020 in the New York area. This underscores the urgent need for early and continuous extensive testing to identify untreated transmission groups in the community."

Some in the the federal government had warned American health officials

that such a scenario could be underway. But if key federal decision makers were so concerned, it was not noticeable, as the United States took the time to perform the appropriate tests in March, allowing the virus to spread silently.

"The idea behind the epidemiology is for you to check the cases as quickly as possible, so that you can investigate those cases, follow the contacts and stop them, that is what is not 39; is not produced, "said McNabb.

This article was originally published by Business Insider.

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