A Series of Unfortunate Events

 “Photo Credit: Shutterstock.com”

In this blog, Jeffrey Jones, Managing Partner at The Deerborne Group, takes a brief lookback at the origins and associated key milestones related to the initial spread of the COVID-19 global pandemic.

Since December 12, 2019, when a cluster of patients in Wuhan, China began experiencing shortness of breath and fever,¹ a series of unfortunate events had already unfolded behind the scenes but would shortly be played out on the world’s stage for all to see.

The novel coronavirus belongs to the same family of viruses that causes severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). COVID-19, as the disease would come to be known, produces mild symptoms in most people, but can also lead to severe respiratory illness and even death in others. Compared to SARS and MERS, COVID-19 spread strikingly fast: while MERS took two and a half years to infect 1,000 people, and SARS took roughly four months to hit that number, COVID-19 reached 1,000 cases in just 48 days.²

By December 31, 2019, China had notified the World Health Organization (WHO) of 27 cases of “viral pneumonia” in the central city of Wuhan.¹ On January 7, 2020, Chinese researchers shared the full genetic sequence of 2019-nCoV through the National Institutes of Health GenBank database and the Global Initiative on Sharing All Influenza Data (GISAID) database.³

On January 11, 2020, Chinese state media announced that a new type of coronavirus had claimed its first victim, a 61-yearold Chinese man. Thereafter, the first case outside of China was reported in Thailand on January 13, 2020. Two days later, Japan reported its first case followed by South Korea reporting their first case on January 15, 2020. On January 20, 2020, the Center for Disease Control (CDC) confirmed the first US laboratory confirmed case of COVID-19 in the US from Washington state.¹

By January 23, 2020, China’s death toll had risen to 18 and Chinese authorities placed Wuhan under quarantine, suspending all flights, trains, and long-haul buses into and out of the city. However, by the time the quarantine had been implemented, an estimated 5 million people who were potentially exposed to the virus had already left Wuhan, further complicating efforts to contain the virus.² The first cases in Europe were reported in France on January 24, 2020. As of January 30, 2020, a total of 9,976 cases had been reported in at least 21 countries.³

By January 31, 2020, a nationwide travel ban from China took effect in the US for non-US citizen who had been in China within the last 14-days. The first death outside of China, a 44-yearold Chinese man who had traveled from Wuhan, was reported in the Philippines on February 2, 2020. Hong Kong reported its first death on February 4, 2020, and both American Airlines and United Airlines suspended their flights to Hong Kong followed by Macau shuttering its casinos. On that same day, the US Food & Drug Administration approved the first Emergency Use Authorization (EUA) for the Centers for Disease Control (CDC) for their 2019-Novel Coronavirus (2019-nCoV) Real-Time RT-PCR Diagnostic Panel.¹

On February 5, 2020, given no specific antiviral therapy for fast-spreading COVID-19, coupled with the availability of Gilead’s remdesivir as a potential antiviral agent based on pre-clinical studies previously conducted in SARS-CoV and MERS-CoV infections, a phase III trial was registered at the Capital Medical University (CMU) in Beijing, China to determine safety and efficacy of remdesivir in hospitalized patients with mild to moderate SARS-CoV-2 infection.

Within days, Hong Kong residents began hoarding toilet paper for some bizarre reason that foreshadowed what was to come for much of the world’s population. On February 11, 2020, the World Health Organization (WHO) officially named the disease causing the 2019 novel coronavirus outbreak; they called it COVID-19.¹ The following day, the state daily newspaper Iran, reported the death of a 63-yearold women who was suspected of dying from COVID-19; the first such reported case in the Islamic Republic.

On February 24, 2020, Zunyou Wu, MD, PhD et al published in JAMA¹⁰ that the coronavirus in China had a 1% to 2% fatality rate — but that number soars to 8% to 15% in the elderly population. These findings were based on 72,314 cases in mainland China as of February 11, 2020.

The United States reported its first coronavirus case on January 20, in Washington State. In late February, officials at a Seattle-area hospital reported two deaths, marking the first known coronavirus fatalities in the U.S.³ “What we’re seeing is the tip of the iceberg,” said Dr. Frank Riedo, the Medical Director for Infection Control and Prevention at EvergreenHealth Hospital in Kirkland, WA where the deaths occurred.¹¹

With the 24/7 news cycle, coupled with social media, it should have been no surprise to anyone watching that on February 28, 2020, the S&P suffered its biggest weekly drop since the 2008 financial crisis due to fears of a global recession. More than $5 trillion was reportedly wiped from the global market value. As the stock market continued to fall, the US Federal Reserve cut interest rates by half a percentage point on March 3, 2020, to try and stem the economic fallout from the epidemic. On March 6, 2020, the number of COVID-19 infected people exceeded 100,000 globally and the death toll toped 3,400. By March 9, 2020, crude oil prices had plummet 25%, the biggest daily rout since the 1991 Gulf War.

On March 9, 2020, Quest Diagnostics introduced a new laboratory developed test (LDT) for COVID-19 at their infectious disease laboratory in San Juan Capistrano (SJC), California.¹² But it wasn’t until March 11, 2020, when the WHO officially declared COVID-19 a global pandemic. Two days later, the US declared a nationwide emergency in the US and by March 15, 2020, individual US states began shutting down to prevent the spread of COVID-19.¹

On March 16, 2020, it was announced that the first-in-human clinical trial had begun in Seattle, WA at Kaiser Permanente in the NIH-led Phase I study of Moderna’s investigational mRNA Vaccine (mRNA-1273) against the novel coronavirus.¹³

On March 17, 2020, Quest Diagnostics received their emergency use authorization (EUA) for their SARS-CoV-2 RNA, Qualitative Real-Time RT-PCR (“Quest SARS-CoV-2 rRT-PCR”) test for the qualitative detection of nucleic acid from SARS-CoV-2 in respiratory specimens from individuals suspected of COVID-19 by their healthcare provider.¹² That same day, Quidel received Emergency Use Authorization (EUA) from the US Food and Drug Administration (FDA) to market its Lyra® SARS-CoV-2 Assay, a real-time RT-PCR test intended for the qualitative detection of nucleic acid from SARS-CoV-2.¹⁴ Other news that day, Brazil reported its first death on March 17, 2020, and the European Union began to bar outside travelers.

On March 19, 2020, Italy’s death toll overtakes China. Russia records its first death, and the virus has spread to more than 170 countries. By March 20, 2020, California issued an unprecedented state-wide “stay at home order” and New York closed non-essential businesses. The US Congress thereafter approved an unprecedented $2 trillion coronavirus aid package on March 25, 2020, dubbed “the largest rescue package in American history.” Starting on March 27, 2020, South Africa began a nationwide lockdown while Kenya, the Democratic Republic of Congo, and other African countries try to ringfence cities.

On March 27, 2020, Abbott announced that the U.S. Food and Drug Administration (FDA) had issued an Emergency Use Authorization (EUA) for the point-of-care test for the detection of novel coronavirus COVID-19. The test is run on the company’s ID NOW™ platform, providing rapid results in a wide range of healthcare settings such as physicians’ offices, urgent care clinics and hospital emergency departments.¹⁵

So went the early days of the COVID-19 global pandemic in 2020. It seemed like every day there was some earthshattering breaking news from some unnamed source not authorized to comment, that was even more sensational than the day before. But it would be less than ideal to site unverified accounts in a meta-analysis such as this. For that reason, I’ve attempted to use only verifiable, publicly available, and reputable sources — leaving conjecture aside. While the COVID-19 pandemic may be the deadliest viral outbreak the world has seen in more than a century, it will most likely take years for the full impact of the novel coronavirus outbreak to be known — because it will take that long for researchers to conduct their studies, publish them, and the convening health authorities to reach consensus. But to put this pandemic in perspective, as of this writing, there have been more than 400 million reported cases and nearly 5.8 million deaths worldwide.¹⁶ Those are staggering numbers, and as regrettable as they are, they should be reason enough why it’s so vitally important that we get to the bottom of this and fully understand how these series of unfortunate events unfolded to ensure that it doesn’t happen again.

About The Deerborne Group:

The Deerborne Group is a boutique management consulting firm that focuses exclusively on the global biotechnology, in-vitro diagnostics, and life sciences industries. Their primary focus is advising corporations, venture capital, and private equity firms on commercial, operations, and corporate strategy. They help clients identify opportunities, minimize risks, and how best to navigate some of their most difficult management challenges.

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References ___________________________________________________________________

1. CDC Museum COVID-19 Timeline, [https://www.cdc.gov/museum/timeline/covid19.html]

2. Mapping the COVID-19 Pandemic, [https://storymaps.arcgis.com/stories/4fdc0d03d3a34aa485de1fb0d2650ee0/]

3. First Case of 2019 Novel Coronavirus in the United States, [First Case of 2019 Novel Coronavirus in the United States | NEJM]

4. COVID-19 Timeline, [https://bfpg.co.uk/2020/04/covid-19-timeline/]

5. Trump bans flights from China to U.S. amid tensions over coronavirus, Hong Kong, [https://www.usatoday.com/story/travel/news/2020/06/03/trump-bans-china-flights-amid-tensions-over-coronavirus-hong-kong/3133820001/]

6. Coronavirus kills Chinese man in Philippines, first death outside China, [Coronavirus kills Chinese man in Philippines, first death outside China | Reuters]

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8. A Trial of Remdesivir in Adults with Mild and Moderate COVID-19, [A Trial of Remdesivir in Adults With Mild and Moderate COVID-19 — Full Text View — ClinicalTrials.gov]

9. Iran woman dies of suspected coronavirus infection: state daily IRAN, [Iran woman dies of suspected coronavirus infection: state daily IRAN | Reuters]

10. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China, [https://jamanetwork.com/journals/jama/fullarticle/2762130]

11. King County patient is first in U.S. to die of COVID-19 as officials scramble to stem spread of novel coronavirus, [King County patient is first in U.S. to die of COVID-19 as officials scramble to stem spread of novel coronavirus | The Seattle Times]

12. Quest Diagnostics Media Statement about COVID-19 Testing, [Quest Diagnostics Newsroom — News Releases]

13. Moderna Announces First Participant Dosed in NIH-led Phase 1 Study of mRNA Vaccine (mRNA-1273) Against Novel Coronavirus, [Moderna Announces First Participant Dosed in NIH-led Phase 1 Study of mRNA Vaccine (mRNA-1273) Against Novel Coronavirus (q4cdn.com)]

14. Quidel Receives Emergency Use Authorization for Molecular COVID-19 Diagnostic Assay, [Quidel Corporation — Quidel Receives Emergency Use Authorization for Molecular COVID-19 Diagnostic Assay]

15. Abbott Launches Molecular Point-of-Care Test to Detect Novel Coronavirus in as Little as Five Minutes, [Abbott Launches Molecular Point-of-Care Test to Detect Novel Coronavirus in as Little as Five Minutes — Mar 27, 2020 (mediaroom.com)]

16. Coronavirus Statistics: New Cases & Deaths, [covid deaths worldwide — Google Search]