Four States Report More COVID-19 Cases; Silent Washington Spread Suspected

Trevor Bedford, PhD, in Twitter comments from the open-source pathogen genome analysis project Nextstrain, said the sequence from the new case descends on a branch from the earlier Snohomish County sequence, strongly suggesting transmission in the area over the past 6 weeks, which could have resulted in a few hundred cases. Bedford is a computational biologist at Fred Hutchinson Cancer Research Center in Seattle.

He said the two sequences could also reflect separate introductions, though highly unlikely. “I believe we’re facing an already substantial outbreak in Washington State that was not detected until now due to narrow case definition requiring direct travel to China.”

Two New Washington Patients in Critical Condition
Yesterday, Public Health–Seattle & King County reported two more cases, based on state lab testing. One of the patients is a man in his 60s who is hospitalized at Valley Medical Center in Renton. He has underlying health conditions and is in critical but stable condition.

The second patient is also a man in his 60s with chronic health conditions. He is hospitalized at Virginia Mason Medical Center, where he is listed in critical condition.

Also, the health department addressed a report of an infected US Postal Service worker, noting that the patient is one of four cases reported yesterday. Media reports said the postal employee worked at a package handling facility in Seattle.

Infections in Rhode Island, California, Illinois
The Rhode Island Department of Health (RIDH) said yesterday that the patient is in his or her 40s and had traveled to Italy in the middle of February. It added that the patient had traveled little since returning from Italy and had not returned to work. Nicole Alexander-Scott, MD, MPH, said yesterday at a media briefing that the patient had also been in France and Spain.

The person is isolated in the hospital, and family members are in home quarantine. Health officials are in the process of identifying other contacts.

Last night, California’s Santa Clara County reported another case, an adult woman who is a household contact of a community-spread case it announced on Feb 28. The newly reported patient is not hospitalized or sick.

Also last night, the Illinois Department of Public Health (IDPH) and Cook County announced a presumed positive, but had no other details about the patient, pending CDC final confirmation. Public health officials are tracing contacts and have asked the CDC to deploy a team to help with the efforts.

The case is the third to be detected in Illinois; the earlier two involved a woman who got sick after a Wuhan trip and her husband, who didn’t travel but contracted the virus from his wife.