Thursday, February 27

Feb 27: The Dow Jones Industrial Average and S&P each fall by 4.4 percent. A whistleblower files a complaint saying the Department of HHS “improperly deployed” more than a dozen workers without proper virus-prevention training or gear to receive the first Americans evacuated from Wuhan, China. Vice President Mike Pence presides over his first meeting as leader of President Trump’s coronavirus task force. HHS Secretary Alex Azar tells lawmakers that it’s unlikely that large numbers of Americans will need to be hospitalized. “The immediate risk to the public remains low,” says HHS Secretary Alex Azar in testimony before the House Committee on Ways and Means. Senator Burr informs a private luncheon that the coronavirus is “much more aggressive” than the United States has seen in recent history and is probably “more akin to the 1918 pandemic.” “There’s one thing that I can tell you about this: It is much more aggressive in its transmission than anything that we have seen in recent history,” Senator Burr informs the private luncheon. President Trump calls Azar to complain that CDC Director Nancy Messonnier’s warnings about the outbreak are scaring the stock markets. The president threatens to fire Messonnier. The Washington Post’s reporting at the time that President Trump was cautioning aides not to make public forecasts of the virus that might unsettle the market.*

From the Cutting Room Floor...

Do you remember, a month ago, when a dozen workers from the Administration for Children and Families (ACF, which is a division of HHS), greeted hundreds of evacuees from Wuhan, China at the March Air Reserve Base near Riverside, California, with its open expanse and swaying palm trees? Another dozen met with more evacuees at Travis Air Force in Solano County, California. I worried for them then, it turns out with good reason. Though other HHS workers wore full hazmat gear, a significant number of the ACF workers had little to no protective equipment, though they were interacting with potentially infected people. Early this month, a whistleblower inside ACF complained about the oversight. HHS Secretary Alex Azar’s office responded by reassigning the whistleblower. They told her that they would fire her if she didn’t accept the reassignment. In her complaint, the whistleblower adds that ACF workers were allowed to leave quarantine after these unprotected interactions with evacuees from Wuhan and even went on commercial flights to other parts of the United States.

Voices

Memories of Sharon Sanders about the first public word of a new virus in China. Sharon Sanders is the director of flutrackers.com, January 25, 2020, shared on February 27, 2020. 

 Typically, every night I make one last check on the site to be sure everything is running smoothly. On the night of December 30 at 11:40 pm I glanced and saw a new post made by a long time but infrequent poster, “penguinsix”. I knew that he had been living for some years in Hong Kong but had recently returned to the United States. What he posted on FluTrackers was a media report from a Hong Kong newspaper describing an outbreak of acute respiratory disease in 27 people who all had contact to an open market in Wuhan city. 

 This immediately got my attention because penguinsix still had family in Hong Kong and I knew he could effectively evaluate the media reports originating from there. I did a quick search using Chinese language sources and saw that the English media report in Hong Kong was backed up by two major China government sponsored media. I called Michael Coston who authors the Avian Flu Diary blog at that late hour because we have an agreement to call each other if a very significant item comes across our desk. In 14 years I have never called him late at night. 

 What was significant about those media reports was their mere existence. Nothing gets through the China internet firewall unless the government approves. For a single outbreak of any disease involving 27 humans that was being widely broadcast meant something serious was going on. I have been tracking diseases in China since 2006 and I can not remember any initial human outbreaks that large. For instance, in the H7N9 avian flu epidemic the announcements of China’s human cases were in the range of 1-4 persons per event. 

I did not know what this acute respiratory illness was but my guess was some strain of avian flu since all of the known cases were tied to an open market (South China Seafood market) where chickens were probably sold. 

 I posted the two Chinese media reports and then also searched our archives for related information. I posted three links to interesting articles from the summer of 2019. I collect articles about China’s disease status to get a hint of what is actually going on there. Dr. Stefano Prandoni (tetano) in Italy signed in and made the next post.  

 I slept for a couple of hours and then posted announcements by the Taiwan and Hong Kong governments. Another participant (Pathfinder) was able to finally access the Wuhan city internet site and posted their confirming announcement. It specifically stated that there was no apparent human-to-human transmission and that no health care workers were infected. More of our team added posts: alert, Shiloh, Ronan Kelly, Treyfish, Commonground, Emily, Vibrant62, and FrenchieGirl, In the first 24 hours we published about 18 items.  

The next day (January 1) a virologist friend from Australia, Ian Mackay, asked me on skype when did I think this outbreak started and I answered, “Tricky”. I then forwarded to him several links of possibly related articles from 2019. Also on January 1st several doctors were detained in Wuhan for posting about the “mystery pneumonia” cases on the internet. China warned about spreading rumors regarding this outbreak.  

 Our team was busy finding everything they could. By the end of the fourth day it was reported that 25% of the people who were sick needed treatment in the ICU. I was concerned at this point. The South China Seafood market is only a couple of blocks from one of the largest transportation hubs in China. 

Over the next few days the cases in China increased to 59 and Hong Kong began seeing cases. There was a run on masks.   

On January 6th the US CDC issued a “watch” on the mystery pneumonia in China. This was highly unusual. In the first week we had over 100 posts on our thread.  

On January 20th it was announced that some health care workers in China were sick. Always a bad sign.  

On January 21st the city of Wuhan was quarantined. This was alarm bell time. China would have never closed a city of 11 million unless the disease was out-of-control. We had made 367 posts on our thread and China was now reporting 440 cases.  

 The videos from inside China began to circulate. Some unconscious or dead people laying on the streets and sidewalks. Health care workers in full protective gear. Overrun hospital waiting rooms and corridors. Bodies being stacked in vans outside a hospital.  

 Everyone I knew in the disease tracking world was aghast. Despite assurances that this illness may not be human-to-human efficient.  It sure looked efficient to most of us. I began to personally prepare for eventual spread inside U.S. Our site began to warn both on the site and on our twitter account. We rearranged FluTrackers to feature this emerging situation and preparations for it.  

 While I kept hoping that somehow the disease could be stopped I knew it was probably impossible after seeing coordinated street spraying efforts on videos from China. This meant not only was the illness probably highly contagious but had the doubly bad effect of fomite transmission.  

 Japan, Taiwan, Hong Kong, Macau, Vietnam, South Korea, Hong Kong, Thailand, Singapore, United States had all reported cases by January 23rd. Huanggang, a city of 8 million, was newly locked down. W.H.O. declined to declare a Public Health Emergency of International Concern.  

 I kept asking myself, “Am I seeing what I think I am seeing?”

Read more

Images
Videos
Trump White House Archived. President Trump Attends a Meeting and Photo Opportunity with Black Leaders, 2020. https://www.youtube.com/watch?v=Aas3YQKIFeY.
The Late Show With Stephen Colbert. Wall Street Panics After Trump Unveils Lackluster Coronavirus Response Plan, 2020. https://www.youtube.com/watch?v=tvmX4a4UiyM&list=PLiZxWe0ejyv_ttdaGYyhyBkWSLFn_q_Fg&index=2.
TheHotViolinist. WATCH: WHO Updates on Spread of Novel Coronavirus — Feb. 27, 2020, 2020. https://www.youtube.com/watch?v=sof6YO1Mb-k.
Documents

*If the pdf thumbnails are not appearing, please reload the page.

Fowler, Geoffrey A., Lenny Bernstein, and Laurie McGinley. “California Undertakes Extensive Effort to Trace Contacts of Woman with Coronavirus.” Washington Post, February 27, 2020. https://www.washingtonpost.com/health/northern-californian-tests-positive-for-coronavirus-in-first-us-case-with-no-link-to-foreign-travel/2020/02/26/b2088840-58fb-11ea-9000-f3cffee23036_story.html.
Sun, Lena H., and Yasmeen Abutaleb. “U.S. Workers without Protective Gear Assisted Coronavirus Evacuees, HHS Whistleblower Says.” Washington Post, February 27, 2020. https://www.washingtonpost.com/health/2020/02/27/us-workers-without-protective-gear-assisted-coronavirus-evacuees-hhs-whistleblower-says/.
Al-Tawfiq, Jaffar A. “Asymptomatic Coronavirus Infection: MERS-CoV and SARS-CoV-2 (COVID-19).” Travel Medicine and Infectious Disease, February 27, 2020, 101608. https://doi.org/10.1016/j.tmaid.2020.101608.
Huang, Eustance, and Fred Imbert. “Dow Falls 350 Points Friday to Cap the Worst Week for Wall Street since the Financial Crisis.” CNBC, February 27, 2020. https://www.cnbc.com/2020/02/27/dow-futures-fall-100-points-after-another-massive-rout-amid-coronavirus-fears.html.
“Importation and Human-to-Human Transmission of a Novel Coronavirus in Vietnam | NEJM,” February 27, 2020. https://www.nejm.org/doi/10.1056/NEJMc2001272.
World Health Organization. “Coronavirus Disease (COVID-19) Situation Report – 38,” February 27, 2020. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports.
Social Media
Additional Links

* Timeline summaries at the top of the page come from a variety of sources:, including The American Journal of Managed Care COVID-19 Timeline (https://www.ajmc.com/view/a-timeline-of-covid19-developments-in-2020), the Just Security Group at the NYU School of Law (https://www.justsecurity.org/69650/timeline-of-the-coronavirus-pandemic-and-u-s-response/), the “10 Things,” daily entries from The Week (theweek.com), as well as a variety of newspapers and television programs.