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Timeline of the COVID-19 pandemic in 2019

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This article documents the chronology and epidemiology of SARS-CoV-2 in 2019, the virus that causes coronavirus disease 2019 (COVID-19) and is responsible for the COVID-19 pandemic. The first human cases of COVID-19 known to have been identified were in Wuhan, Hubei, China, in December 2019. It marked the beginning of the 2019–2020 COVID-19 outbreak in mainland China.

Unconfirmed reports of early cases

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A September 2020 review noted the hypothetical possibility that the COVID-19 infection had already spread to Europe in 2019 by presumptive evidences including pneumonia case numbers and radiology in France and Italy in November and December.[1] However, a subsequent retrospective surveillance report determined there was no evidence of SARS-CoV-2 circulation in Rome (Italy) during this period.[2]

Some medical and environmental analyses in Italy, France, and the US found results which suggested the virus was circulating prior to December 2019 by several weeks. A WHO report states: "the study findings were not confirmed, methods used were not standardized, and serological assays may suffer from non-specific signals". It urges further investigation of these potential early events.[3]

October and November

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According to an ABC news report, the American National Center for Medical Intelligence shared intelligence in late November, based on analysis of wire and computer intercepts and satellite images, regarding a potential respiratory disease in Wuhan. This was denied by the Pentagon.[4] On 13 March 2020, the South China Morning Post reported that Chinese government records suggest that the first case of infection with COVID-19 could be traced back to a 55-year-old Hubei resident on 17 November.[5]

On 23 May 2021, The Wall Street Journal reported that newly disclosed U.S. intelligence obtained that three researchers working at the BSL-4 laboratory of the Wuhan Institute of Virology were hospitalized with COVID-like symptoms. The report added weight to calls for a broader probe into the theory that the COVID-19 virus could have escaped from a laboratory.[6][7] However, a WHO report states "introduction through a laboratory incident was considered to be an extremely unlikely pathway".[3] Since then, the head of the WHO COVID-19 origins investigative team, Peter Ben Embarek, has stated that the Chinese authorities exerted pressure on the WHO report conclusions, and that he in fact considers an infection via a researcher's field samples to be a "likely" scenario.[8]

1 December

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Symptoms of the index case, or patient zero, began on 1 December.[9] The man had not been to the Huanan Seafood Wholesale Market. His family was unaffected, and no epidemiological link was found between him and the other laboratory-confirmed cases as of 2 January.[9]

8 December

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First hospitalizations

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This was the onset of the first 41 people who were tested and later confirmed positive for COVID-19, as reported by the Wuhan City Health Committee and the WHO in 2020.[10]

10 December

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Symptoms of three more cases began on 10 December, which were later confirmed by laboratories. These patients are known because they became hospitalized on 16 December and thus sampled. Their results were confirmed two of these three had no direct exposure to the Huanan Seafood Wholesale Market, while the other did.[9]

15 December

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The fifth and sixth cases that were later confirmed by laboratories first felt symptoms on 15 December. Both patients had direct exposure to the Huanan Market.[9]

16 December

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As of February 2020, the first documented COVID-19 hospital admissions worldwide were dated to 16 December 2019 in Wuhan.[9]

24 December

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An unresolved clinical case sparks off the first scientific involvement: a bronchoalveolar lavage fluid (BAL) sample was sent from Wuhan Central Hospital to Vision Medicals (广州微远基因科技) in Guangzhou, a private company specializing in metagenomic massive parallel sequencing analysis.[11] According to the GenBank record, the sample was obtained 23 December, whereas Ren et al.,Chin Med J, 2020 sets the date to 24 December 2019.[12][13]

27 December

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First novel disease report

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According to news reports in February 2020—Workers Daily, Global Times—at the Hubei Provincial Hospital of Integrated Chinese and Western Medicine and following the report from Doctor Zhang Jixian, the hospital immediately alerted the local CDC, Wuhan Jianghan Disease Prevention and Control Center,[14] however, the report of 22 January 2020 from the Chinese CDC seems to claim this contact falling on 29 December.[15]

28 December

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First sequencing of genome

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On 28 December 2019, Dr. Lili Ren, a virologist at the Peking Union Medical College in Beijing submitted a complete sequence of SARS-CoV-2 structure to GenBank. The sequence was never made public as it failed to include the annotations required for publication, and attempts by the NIH to contact Dr. Ren went unanswered.[16]

29 December

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On this day and the previous, three similar cases arrived at Hubei Provincial Hospital of Integrated Chinese and Western Medicine, all associated with the seafood market. The health authorities had been informed, and medical experts from Wuhan Jinyintan Hospital, "a hospital designated to treat infectious diseases"[17] came to transfer six of the seven patients. Zhang Jixian took the further initiative to let doctors and nurses in the respiratory department wear face masks, and put out an order for 30 hospital coats of fine canvas.[18] The administration at Hubei Provincial Hospital of Integrated Chinese and Western Medicine convened an interdepartmental panel of doctors, whose conclusions were the cases were unusual and required special attention, and also having learned of two similar cases in the city, decided to report their findings to the municipal and provincial health authorities, Wuhan Municipal Health Commission and Hubei Province Health Committee.[14]

The Wuhan CDC staff found also additional patients with similar symptoms who were linked to the market.[15] The Wuhan 'Center for Disease Control and Prevention' (CDC) is part of Chinese Center for Disease Control and Prevention.

30 December

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Wuhan Central Hospital received a report from Beijing Boao Medical Laboratory stating that their sample (obtained 27 December) contained SARS coronavirus.[11] At the time, the laboratory only obtained a short partial sequence, which was rapidly shared with Vision Medicals, so that Vision Medicals could confirm that the sequence was SARS-CoV-2, i.e., roughly identical to the one they obtained 3 days before, and relatively distant to the original SARS coronavirus.[19]

Several doctors at Wuhan Central Hospital shared the test report on social media in discussions mainly aimed at colleagues.[11] As referred to by Caixin Online, from the social media account of Li Wenliang, it is stated that there are seven cases of SARS at Wuhan Central Hospital, all connected to the Huanan Seafood Wholesale Market.[11]

For Vision Medicals, too, these are hectic days (27–30 December) with the Chinese CDC requesting all results from Vision Medicals and from the Chinese Academy of Medical Science: "this was an urgent, secret and serious investigation".[19]

First official messages

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Wuhan Municipal Health Commission sent a hard-copy message to its affiliate institutions.[20] containing guidelines in confronting a possible outbreak of infectious pneumonia.[20] Two scanned copies also found their way, the same day, to the Weibo QQ service—a social media platform.[21][22][23]

  • Supervising doctors shall hold fast on discipline and create specialised team-units.
  • General staff must be alert to the situation, especially keeping an eye out for patients with symptoms of infectious pneumonia.
  • Statistical material must be gathered ongoingly and send to Wuhan Municipal Health Commission and Hubei Province Health Committee.
  • Statistical material for the previous week, relating to patients with symptoms of infectious pneumonia, is to be sent to Wuhan Municipal Health Commission before 4 o'clock, this day.
  • Without permission from authorized personnel, no one is allowed to spread information about the medical treatment.[21][22]

First international alert

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FluTrackers, an international disease tracking website established in 2006, was the first report reaching an international context on the situation in Wuhan on 30 December at 23:35:00 as recorded in the Internet Archive and reported by The Washington Post, Forbes, and CIDRAP.[24][25][26][27] The ProMED reporting program, under auspice of the International Society for Infectious Diseases (ISID), reported on the situation in Wuhan. The full date is actually 30 December 23:59:00.[20]

WHO may also have noticed the information coming out from Wuhan.[28]

31 December

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First public message

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The Wuhan Municipal Health Commission released a briefing on its website about early signs of a pneumonia outbreak in the city.[29] The message conveys the impression of alertness, by summarizing 30 December's orders to the city hospitals; emphasizing ongoing scientific and clinical investigations and to seek hospital care when having persistent fever while showing symptoms of pneumonia; as well advising the public to wear face masks and to avoid enclosed public places and crowded areas.

Cases in total: 27
Serious cases: 7
Recovering: 2
As of now: no fatalities, no healthcare-workers infected, no signs of human-to-human transmission, cause of pneumonia infection still under investigation

The message on pneumonia of unknown etiology was picked up by Chinese news agencies, including the state television CCTV,[30] local news agencies (such as Hubei Daily[31]), and social media (such as the Weibo account of CCTV[32] People's Daily) said the exact cause remained unclear, and it would be premature to speculate.[33] Through the Weibo account "YangShiXinWen", CCTV also sent an alert about the unknown virus, adding that a team of experts from the National Health Commission would arrive in Wuhan.[30][32][better source needed]

Some international agencies also picked up on the reports, including Reuters,[34] Deutsche Welle,[35] and the South China Morning Post.[33]

Qu Shiqian, a vendor at the Huanan Seafood Wholesale Market, said government officials had disinfected the premises on 31 December and told stallholders to wear masks. Qu said he had learned of the pneumonia outbreak only from media reports. "Previously I thought they had flu", he said. "It should be not serious. We are fish traders. How can we get infected?"[33]

Interregional and international responses

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In response to the announcement from Wuhan, Hong Kong's Center for Health Protection tightened their inbound screening processes. They announced that various "surveillance measures at all boundary control points" have begun—including thermal imaging for checks on body temperature.[36] The center appealed to the public to maintain hygiene, with detailed advice on washing hands and wearing a mask, and further precautions when traveling outside Hong Kong.[36] Hong Kong's Secretary for Food and Health Sophia Chan announced "[any suspected cases] including the presentation of fever and acute respiratory illness or pneumonia, and travel history to Wuhan within 14 days before onset of symptoms, we will put the patients in isolation."[33]

Tao Lina, a public health expert and former official with the Shanghai Center for Disease Control and Prevention, said, "I think we are [now] quite capable of killing it in the beginning phase, given China's disease control system, emergency handling capacity and clinical medicine support." No human-to-human infection had been reported so far and more pathological tests and investigations were underway, an official said.[33]

The World Health Organization office in China picked up the media statement from the website of the Wuhan Municipal Health Commission on cases of viral pneumonia.[37] The WHO China office then notified the WHO Western Pacific Regional Office about the notice from the Wuhan government.[37]

The US CDC claimed to have "first learned of a 'cluster of 27 cases of pneumonia'" in Wuhan on this day.[38]

The Taiwan Centers for Disease Control (CDC) implemented inspection measures for inbound flights from Wuhan.[39] Deputy director Luo Yi-jun raised the alarm with his colleagues after reading about the outbreak on the PTT Bulletin Board System.[40][41] Taiwan would end up having fewer than 500 total COVID-19 cases until September 2020.

See also

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References

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  1. ^ Platto S, Xue T, Carafoli E (September 2020). "COVID19: an announced pandemic". Cell Death Dis. 11 (9): 799. doi:10.1038/s41419-020-02995-9. PMC 7513903. PMID 32973152.
  2. ^ Capalbo C, Bertamino E, Zerbetto A, Santino I, Petrucca A, Mancini R, et al. (January 2020). "No Evidence of SARS-CoV-2 Circulation in Rome (Italy) during the Pre-Pandemic Period: Results of a Retrospective Surveillance". International Journal of Environmental Research and Public Health. 17 (22): 8461. doi:10.3390/ijerph17228461. hdl:11573/1462409. PMC 7696939. PMID 33207548.
  3. ^ a b "Virus origin / Origins of the SARS-CoV-2 virus". www.who.int.
  4. ^ "Intelligence report warned of coronavirus crisis as early as November: Sources". ABC News. 8 April 2020. Retrieved 9 January 2022.
  5. ^ Ma J (13 March 2020). "Coronavirus: China's first confirmed Covid-19 case traced back to November 17". South China Morning Post. Archived from the original on 13 March 2020. Retrieved 16 March 2020.
  6. ^ Gordon M, Strobel WP, Hinshaw D (23 May 2021). "Intelligence on Sick Staff at Wuhan Lab Fuels Debate on Covid-19 Origin". The Wall Street Journal. ISSN 0099-9660. Retrieved 9 June 2021.
  7. ^ "Wuhan lab staff sought hospital care before COVID-19 outbreak disclosed: Report". CNA. 24 May 2021. Archived from the original on 22 June 2021. Retrieved 1 June 2021.
  8. ^ Taylor A (12 August 2021). "In new documentary, WHO scientist says Chinese officials pressured investigation to drop lab-leak hypothesis". Washington Post. ISSN 2641-9599. Retrieved 15 August 2021.
  9. ^ a b c d e Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. (February 2020). "Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China". The Lancet. 395 (10223): 497–506. doi:10.1016/S0140-6736(20)30183-5. PMC 7159299. PMID 31986264.
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  12. ^ Ren L, Wang J, Jin Q, Xiang Z, Li Y, Wu Z, et al. (4 February 2020), "Severe acute respiratory syndrome coronavirus 2 isolate BetaCoV/Wuhan/IPBCAMS-WH-01/2019, complete genome", Nucleotide, GenBank, National Center for Biotechnology Information, GenBank Accession number: MT019529.1
  13. ^ See p. 4 Table 1 in Ren LL, Wang YM, Wu ZQ, Xiang ZC, Guo L, Xu T, et al. (11 February 2020). Hao XY, Wei PF (eds.). "Identification of a novel coronavirus causing severe pneumonia in human: a descriptive study". Chinese Medical Journal. 133 (9): 1015–1024. doi:10.1097/CM9.0000000000000722. PMC 7147275. PMID 32004165.
  14. ^ a b 张翀 [Chong, Zhang] (8 February 2020). "她最早发现新冠肺炎疫情苗头 立即上报可疑病例" [She first discovered the signs of a new coronary pneumonia epidemic and immediately reported suspicious cases]. 民生 [Society]. 工人日报 [Worker's Daily] (in Chinese). Archived from the original on 16 May 2020.
  15. ^ a b The 2019-nCoV Outbreak Joint Field Epidemiology Investigation Team, Li Q (22 January 2020). "An Outbreak of NCIP (2019-nCoV) Infection in China". China CDC Weekly. 2 (5). Chinese Center for Disease Prevention and Control: 79–80. doi:10.46234/ccdcw2020.022. ISSN 2096-7071. PMC 8393104. PMID 34594812. Archived from the original on 28 January 2020. Retrieved 8 February 2020 – via weekly.chinacdc.cn.{{cite journal}}: CS1 maint: numeric names: authors list (link)
  16. ^ Strobel WP (17 January 2024). "Chinese Lab Mapped Deadly Coronavirus Two Weeks Before Beijing Told the World, Documents Show". The Wall Street Journal. ISSN 0099-9660. Archived from the original on 17 January 2024. Retrieved 17 January 2024.
  17. ^ Yao et al.,Xinhuanet, 2020
  18. ^ Yao Y, Ma Y, Zhou J (16 April 2020). "Xinhua Headlines: Chinese doctor recalls first encounter with mysterious virus". Xinhua News Agency. Archived from the original on 23 April 2020. Retrieved 23 April 2020.
  19. ^ a b Gāo Yù et al.,Caixin Online, 2019 referring to Weibo account "XiaoShanGou".
  20. ^ a b c Marjorie P. Pollack (Mod.MPP), ed. (30 December 2019). "Undiagnosed pneumonia – China (HU)". ProMed. International Society for Infectious Diseases. RFI – Archive Number: 20191230.6864153 – via promedmail.org.
  21. ^ a b 许雯 [Xǔ Wén] (31 December 2019). "武汉疾控证实:当地现不明原因肺炎病人,发病数在统计" [Wuhan CDC confirm: pneumonia infections of unknown cause has appeared in the local area, the number of infected people is being calculated]. 国内 [Inland]. 新京报网 [Beijing News Online] (in Chinese). 新京报 [Beijing News]. Archived from the original on 31 December 2019 – via bjnews.com.cn.
  22. ^ a b Chinese Human Rights Defenders (ed.). "关于做好不明原因肺炎救治工作的急通知" [Urgent notice on best practice for the medical treatment of pneumonia of unknown cause] (PDF) (in Chinese). Archived (PDF) from the original on 17 February 2020. Retrieved 14 February 2020 – via nchrd.org.
  23. ^ 杨小刚 [Yáng Xiǎo Gāng], ed. (31 December 2019). "武汉不明原因肺炎已做好隔离 检测结果将第一时间对外公布". 第一财经 [First Finance] (in Chinese). Archived from the original on 31 December 2019 – via yicai.com.
  24. ^ "China — Original 2019-nCov news thread: weeks 1 – 4 (December 30, 2019 – January 25, 2020)". FluTrackers. 31 December 2019. Archived from the original on 26 February 2020.
  25. ^ Farhi P (14 March 2020). "How a blogger in Florida put out an early warning about the coronavirus crisis". Washington Post.
  26. ^ Stone J (11 January 2020). "Wuhan Coronavirus Outbreak Shows The Importance Of Sound Science, Sleuthing, And Cooperation". Forbes.
  27. ^ Schnirring L (9 January 2020). "More details emerge on new coronavirus in Wuhan cluster". CIDRAP.umn.edu.
  28. ^ Borger J (18 April 2020). "Caught in a superpower struggle: the inside story of the WHO's response to coronavirus". The Guardian. Washington. Archived from the original on 23 April 2020. Retrieved 23 April 2020.
  29. ^ Wuhan Municipal Health Commission (ed.). "武汉市卫健委关于当前我市肺炎疫情的情况通报" [Wuhan Municipal Health Department's message about our city's present pneumonia situation]. wjw.wuhan.gov.cn (in Chinese). Archived from the original on 9 January 2020.
  30. ^ a b "[新闻直播间]湖北武汉发现不明原因肺炎 国家卫健委专家组已抵达武汉" [Hubei Wuhan detect pneumonia of unknown cause, National Health Committee expert team soon to arrive in Wuhan]. CCTV-13 (in Chinese). 央视网(cctv.com). 31 December 2019. Archived from the original on 18 April 2020 – via tv.cctv.com.
  31. ^ "刚刚,武汉市卫健委通报肺炎疫情:尚未发现人传人现象" [Just now, Wuhan Municipal Health Commission reported a pneumonia outbreak: No sign of human-to-human transmission yet]. News Center – Public Announcements. 湖北日报网 [Hubei Daily Online] (in Simplified Chinese). 31 December 2019. Archived from the original on 28 April 2020. Retrieved 30 April 2020 – via news.cnhubei.com.
  32. ^ a b 湖北日报网 [Hubei Daily Online], ed. (31 December 2019). "武汉发现不明原因肺炎,国家卫健委专家组已达武汉" [Wuhan detect pneumonia of unknown cause, National Health Committee expert team soon to arrive in Wuhan] (in Chinese). Archived from the original on 4 December 2021. Retrieved 30 April 2020 – via py.cnhubei.com.
  33. ^ a b c d e Mandy Zuo, Lillian Cheng, Alice Yan, Cannix Yau (31 December 2019). "Hong Kong takes emergency steps as mystery 'pneumonia' infects 27 in Wuhan". Politics. South China Morning Post. Archived from the original on 14 January 2020. Retrieved 8 February 2020.
  34. ^ "Chinese officials investigate cause of pneumonia outbreak in Wuhan". Reuters. 31 December 2019. Archived from the original on 2 January 2020. Retrieved 8 February 2020.
  35. ^ "China investigates SARS-like virus as dozens struck by pneumonia". Deutsche Welle. 31 December 2019. Archived from the original on 1 January 2020. Retrieved 8 February 2020 – via dw.com.
  36. ^ a b "CHP closely monitors cluster of pneumonia cases on Mainland". Press Releases. The Government of the Hong Kong Special Administrative Region. Archived from the original on 7 February 2020. Retrieved 8 February 2020.
  37. ^ a b "Timeline of WHO's response to COVID-19". WHO. 9 September 2020. Archived from the original on 2 November 2020. Retrieved 9 November 2020. WHO's Country Office in the People's Republic of China picked up a media statement by the Wuhan Municipal Health Commission from their website on cases of 'viral pneumonia' in Wuhan, People's Republic of China.
  38. ^ Marisa Taylor (22 March 2020). "Exclusive: U.S. axed CDC expert job in China months before virus outbreak". Health News. Reuters. Archived from the original on 22 March 2020. Retrieved 25 May 2020.
  39. ^ "CDC implements extra inspection measures for Wuhan flights". Taiwan Today. Ministry of Foreign Affairs, Republic of China. 2 January 2020. Archived from the original on 17 March 2020. Retrieved 25 February 2020.
  40. ^ Borak M (17 April 2020). "How a Reddit-like forum helped Taiwan prepare early for Covid-19". Abacus News. Retrieved 17 April 2020.
  41. ^ Chang Mh, Chen Wt, Ko L (17 April 2020). "CORONAVIRUS/How an online post forewarned Taiwan about COVID-19". Central News Agency. Retrieved 17 April 2020.
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