Coronavirus may have hit Washington DC weeks before the first case was confirmed on March 7, shows report
Did the coronavirus hit Washington DC weeks before the first case was reported on March 7? The antibody test of a woman that came back positive after she recovered from an illness that struck her in February seems to indicate just that.
Kathy Hughes, a resident of Woodley Park in Washington DC, was, however, not tested for COVID-19 back then. On February 16, a day after returning from a ski trip in northern Italy, the researcher experienced fever, chills, headache and fatigue, according to a Washington Post report.
Hughes went to the doctor, but her tests for flu and mononucleosis (an infectious illness) came back negative. Her doctor told her the flu test must have been a false negative. It had not occurred to them that it could be the coronavirus.
On February 28, she went to a second doctor and was recommended a chest X-ray, which came back normal. "Hughes said that the doctor, who practices in the District and Maryland, called at least one local health department and was told that no testing was needed," says the report.
After she recovered, the 54-year-old went to a doctor in Fairfax on April 22, who gave her a serology test, which came back positive for coronavirus antibodies. Serology tests are blood-based tests that can be used to identify whether people have been exposed to a particular pathogen by looking at their immune response.
"If the result was accurate, it would mean the virus was likely present in the District at least three weeks earlier than believed," says the report. Hughes was given a separate test for the coronavirus itself, which came back negative, implying that if she had COVID-19, it may have cleared out of her system.
The report says that, at one point, her husband lost his sense of taste and smell — symptoms associated with the novel coronavirus, though they did not know that at the time. His sense of smell and taste subsequently came back, and he tested negative for the antibodies.
"We know that something happened to us, and we would like some kind of proof or understanding of what it was," Hughes told the Post. According to scientists, the true potential and accuracy of these rapidly developed antibody tests are still unknown.
Even if tests are reliable, they cannot indicate whether someone is immune to reinfection, say scientists. The tests are capable of giving rise to two kinds of errors. It might incorrectly detect antibodies when people have none, that is, false positives.
According to 12 antibody tests that were studied by the COVID-19 Testing Project, one of the tests gave false positives more than 15% of the time, or in about one out of seven samples. Three other tests gave false positives of more than 10% of the time. Conversely, it might not detect antibodies even when the person does have them.
The World Health Organization (WHO) recently issued a scientific brief, which said that there is currently "no evidence" that people who have recovered from COVID-19 and have antibodies are protected from a second coronavirus infection.
"Laboratory tests that detect antibodies to SARS-CoV-2 in people, including rapid immunodiagnostic tests, need further validation to determine their accuracy and reliability. Inaccurate immunodiagnostic tests may falsely categorize people in two ways."
"The first is that they may falsely label people who have been infected as negative, and the second is that people who have not been infected are falsely labeled as positive. Both errors have serious consequences and will affect control efforts," says the WHO.
Eileen West, the doctor who tested Hughes used a test that is currently awaiting approval by the US Food and Drug Administration (FDA). "The same test was used in a Stanford University trial published last week," West said, adding that it is considered to be "well over 90% accurate."
West said she is about a third of the way through administering 360 tests. Of the 110 she has administered, five have been positive. Two of the patients with antibodies had household contact with confirmed coronavirus cases and one had been exposed to someone in the workplace who had it.
Among them, only Hughes reported feeling ill as early as February, said West, according to the report.
The Washington DC Department of Health District announced the District's first presumptive positive case of the coronavirus disease on March 7. The person had no prior history of travel outside the US.
Back then, a statement had said that while this is the first case in the District, there is still no widespread community transmission and the general level of risk for residents was low. As of April 27, Washington DC has 3,892 confirmed cases, and 185 have died in the pandemic.
Meanwhile, Hughes has emailed Washington DC Council member Mary M Cheh (D-Ward 3), asking her to pass the information to the city’s health department. Cheh told the Post that "haphazard testing availability" has resulted in a "hazy understanding" of the coronavirus' trajectory in the region.
"The canvas of this has been so far pretty spotty. We have no idea how many people have had it and were asymptomatic," she said.
Many experts believe COVID-19 was circulating in some places weeks before the official counts started. According to a previous report, the first COVID-19 death in the US may have occurred in California on February 6, at least three weeks before the first reported death occurred in Washington state on February 29.
Two people who died in California's Santa Clara County on February 6 and February 17 have now been confirmed as COVID-19 deaths after autopsies, according to the County's public health department. This makes them the earliest known victims of the COVID-19 pandemic in the US.