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Strategies & Market Trends : 2026 TeoTwawKi ... 2032 Darkest Interregnum -- Ignore unavailable to you. Want to Upgrade?

To: Haim R. Branisteanu who wrote (174310)	7/6/2021 9:33:14 AM
From: TobagoJack	Read Replies (3) \| Respond to of 218265

Puzzle #5 In other words, perhaps, just might be, that China successful testing and containment of CoVid is the same evidence folks are using to blame China for originating CoVid. In hindsight perhaps China, like all other domains, refrained from testing. nytimes.com Scientists Report Earliest Known Coronavirus Infections in Five U.S. States Blood drawn from nine people in the earliest days of the pandemic tested positive for the infection. But some experts questioned the results. June 15, 2021 A coronavirus testing site in Somerville, Mass., on March 18, 2020. “Given the horrible state of testing, there was never any doubt we were missing most early transmission,” said one scientist.Cj Gunther/EPA, via Shutterstock When did the coronavirus arrive in the United States? The first infection was confirmed on Jan. 21, 2020, in a resident of Washington State who had recently returned from Wuhan, China. Soon after, experts concluded that the virus had been in the country for weeks. A study published on Tuesday offers new evidence: Based on an analysis of blood tests, scientists identified seven people in five states who may have been infected well before the first confirmed cases in those states. The results suggest that the virus may have been circulating in Illinois, for example, as early as Dec. 24, 2019, although the first case in that state was confirmed a month later. But the new study is flawed, some experts said: It did not adequately address the possibility that the antibodies were to coronaviruses that cause common colds, and the results could be a quirk of the tests used. In addition, the researchers also did not have travel information for any of the patients, which might have helped explain the test results. “This is an interesting paper because it raises the idea that everyone thinks is true, that there were infections that were going undiagnosed,” said Scott Hensley, an immunologist at the University of Pennsylvania. But the small number of samples that tested positive made it difficult to be sure that they were true cases of infection and not just a methodological error. “It’s hard to know what is a real signal and what isn’t,” he said. Your Coronavirus Tracker: We’ll send you the latest data for places you care about each day. If the findings are accurate, however, then they underscore the notion that poor testing in the United States missed most cases during the early weeks of the pandemic. “Without testing, you can’t see what’s going on,” said Keri Althoff, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health and lead author of the study. “In these earlier months in some of these states where we were not suspecting, there was a lot of infection going on there.” It is not a surprise that there may have been undocumented cases early in the pandemic, said Sarah Cobey, an evolutionary biologist at the University of Chicago. Experts “already knew that was the case from studying trends in excess mortality and hospitalizations,” she said. Dr. Cobey’s most recent model estimated that there were roughly 10,000 infections in Illinois on March 1, 2020. “Given the horrible state of testing, there was never any doubt we were missing most early transmission,” she added. In the study, published in the journal Clinical Infectious Diseases, Dr. Althoff and her colleagues analyzed blood samples from more than 24,000 people. They found nine people who had donated blood between Jan. 2 and March 18 of last year who appeared to have antibodies to the coronavirus. Seven of the samples came from blood donated before the date of the first diagnosis in their states — Illinois, Wisconsin, Pennsylvania, Mississippi and Massachusetts. The results are consistent with those of another study that identified coronavirus antibodies in blood donated as early as mid-December 2019. The participants were enrolled in a long-term National Institutes of Health project, called All of Us, that aims to include a million people in the United States in order to increase the representation of minorities in research. Only about half of the people in the study were white. Early in the pandemic, the virus would have infected very few people. A low prevalence increases the odds that an antibody test mistakenly identifies a sample as having antibodies when it does not, Dr. Hensley said — a false positive. The researchers tried to minimize that possibility by using two antibody tests in sequence. The first test flagged 147 samples as possibly having antibodies to the coronavirus; the second slashed that number down to nine. The team also analyzed 1,000 samples of blood from the 2018-19 cold and flu season, and found none that tested positive for antibodies to the coronavirus. “It’s still very possible that some of them might be false positives,” said Dr. Josh Denny, chief executive of All of Us. But “the fact that all of them would be false positives seems pretty unlikely with what we’ve done.” The researchers said they planned to contact the participants to ask about travel history and would continue to analyze additional samples to estimate when the coronavirus reached American shores. “The exact month at which it probably came into the U.S. is still unknown,” Dr. Althoff said. “It’s essentially a puzzle right now, and our study is just one piece of that puzzle.” Sent from my iPad

To: Haim R. Branisteanu who wrote (174310)	7/6/2021 9:33:22 AM
From: TobagoJack	1 Recommendation Recommended By marcher Read Replies (1) \| Respond to of 218265

Puzzle #4 washingtonpost.com NIH study suggests coronavirus may have been in U.S. as early as December 2019 Joel Achenbach June 15, 2021 at 9:00 p.m. GMT+8 A study released Tuesday and other analyses could nudge the timeline of the coronavirus pandemic’s effect on the United States to earlier dates. (Jeenah Moon for The Washington Post) A research study run by the National Institutes of Health has turned up evidence of possible coronavirus infections in the United States as early as December 2019, weeks before the first documented infection in this country. The new report, published in the journal Clinical Infectious Diseases, bolsters earlier studies indicating that the virus entered the country under the radar and may have been spreading in the first two months of 2020, well in advance of warnings to that effect from the Centers for Disease Control and Prevention. A volunteer in Illinois who gave blood on Jan. 7, 2020 — in a study unrelated to the emergent virus — tested positive for antibodies to SARS-CoV-2, according to the NIH report. It noted that the antibodies typically take 14 days, on average, to develop, and this “suggests the virus may have been present in Illinois as early as December 24, 2019.” This and other studies could nudge the timeline of the pandemic’s effect on the United States to earlier dates. The first case of a coronavirus infection in the United States was confirmed Jan. 20, 2020, in a patient in Everett, Wash., who had traveled from Wuhan, China, and had become symptomatic Jan. 14. But the CDC did not identify community spread of the virus — meaning, infections unrelated to travel from China — until Feb. 26. The NIH report states that the CDC testing guidelines early in the pandemic had a narrow focus: Only people who had been in contact with a person confirmed to have an infection, or who had traveled to an area known to have coronavirus transmission, were advised to be tested. Elements of that guidance “may have been in place too long, obscuring the geographic spread of SARS-CoV-2 found in our results.” The volunteers had given blood samples as part of NIH’s “All of Us” research program, a multiyear effort to advance “precision medicine” by gathering detailed health data from a large and diverse group of people. The program has enrolled and collected samples from about 280,000 people so far and has a goal of at least 1 million participants. Precision medicine tailors health care for individuals and their circumstances, rather than a one-size-fits-all approach. As a result, NIH has a vast supply of blood samples capable of being scrutinized — in this case for evidence of coronavirus infections. The researchers employed two distinct antibody tests on 24,000 subjects who gave blood between Jan. 2 and March 18, 2020. Nine of those people came up positive on both tests for SARS-CoV-2 antibodies. Seven of those gave blood in five states — Illinois, Massachusetts, Mississippi, Pennsylvania and Wisconsin — before the first official cases in those states. The report noted briefly that, of the nine people who tested positive, seven were from racial or ethnic minorities: five were Black and two were “Hispanic, Latino or Spanish.” The pandemic revealed the heightened vulnerability of people of color in the United States to exposure to the coronavirus in part because of their overrepresentation as essential workers, and although the data set in this study was small, it carried a possible signature of that disparity. The report states, “Although the numbers are limited, these findings reinforce scientific hypotheses of the impact of social factors on viral circulation, including structural discrimination against racial and ethnic minority groups.” Another striking finding is that no positive test results were found in California, New York or Washington state, which were known as the initial entry points in the country for the virus. An earlier study, published in late 2020, also found signs of antibody responses to the novel coronavirus among blood donors in mid-December 2019. The authors of the report hedged on whether it was a true signal of SARS-CoV-2 or an artifact from immunity to other coronaviruses. Josh Denny, chief executive of the All of Us program, said the new report “raises the specter, essentially, that there was community spread” of the virus earlier than previously documented. But he said the data do not confirm that. When the pandemic began, many people across the country reported they had been sick in early 2020 and speculated they had suffered from an undiagnosed case of covid-19, the illness caused by the virus. Denny said the new report potentially bolsters the case that some of those people had covid, but he doubted it was a large number. “I would suspect that most people who had a cold in early 2020, it wasn’t covid,” he said. “We found nine people out of 24,000.” Missing from the report are travel histories of the people involved. It’s unclear if the people with these early potential cases were initially infected in China or had a close contact with someone infected there. The NIH plans to follow up with individuals to try to ascertain where they were infected. Experts say waiving patents won’t help poorer nations acquire the technical complexity of manufacturing coronavirus vaccines. (Luis Velarde/The Washington Post) “We don’t know that they didn’t go to Wuhan. We don’t know that they didn’t interact with someone who came from Wuhan,” Denny said. “It would be good if they could dig up the travel history of the positive individuals, as this will provide a more complete picture,” said Jeffrey Shaman, an epidemiologist at Columbia University, who was not part of the NIH research project. He said the report echoes what he and his colleagues have already concluded through modeling: The virus was present before the first documented cases. One limitation of the new study is that it cannot rule out that some of the positive test results were false positives. The earliest result from Illinois, when coronavirus cases were only beginning to spread in Wuhan, is the most likely candidate for a false positive, said Michael Worobey, a professor of ecology and evolutionary biology at the University of Arizona, who was not part of the NIH research team. In an email, he noted that the study looked at a type of antibody, immunoglobulin G, that takes time to develop after an infection. He said he is “very dubious” that there was community transmission in the United States in early January 2020. But the NIH researchers took steps to limit false positives. The use of two different tests reduced the likelihood. They also studied blood samples from early 2019, long before the pandemic began. No positives were found then. The team also used a statistical analysis to determine the likelihood that all nine of the positives were false positives. The probability of that was vanishingly low, about 1 in 100,000. However, the analysis showed it is likely that at least one, maybe two, results were a false positive. Denny said he believed the number of false positives is likely “pretty low.” Sent from my iPad

To: Haim R. Branisteanu who wrote (174310)	7/6/2021 9:33:28 AM
From: TobagoJack	1 Recommendation Recommended By marcher Read Replies (1) \| Respond to of 218265

Puzzle #3 nytimes.com Study Suggests Coronavirus Emerged Much Earlier Than Thought. Some Are Skeptical. Scientists not involved in the study seriously doubt the findings, which challenge the current consensus on where and when the virus originated. Published June 26, 2020Updated July 23, 2020 A coronavirus patient in Barcelona, Spain, was taken outside after spending some weeks in the I.C.U. at the Hospital del Mar earlier this month.David Ramos/Getty Images In a study not yet published in a journal, scientists have reported that the new coronavirus was present in wastewater in Barcelona, Spain in March 2019, a finding that, if confirmed, would show that the pathogen had emerged much earlier than previously thought. But independent experts who reviewed the findings said they doubted the claim. The study was flawed, they said, and other lines of evidence strongly suggest the virus emerged in China late last year. Up until now, the earliest evidence of the virus anywhere in the world has been from December 2019 in China and it was only known to have hit mainland Spain in February 2020. “Barcelona is a city that is frequented by Chinese people, in tourism and business, so probably this happened also elsewhere, and probably at the same time,” said the lead author, Albert Bosch, a professor in the Department of Microbiology of the University of Barcelona who has been studying viruses in wastewater for more than 40 years. Several experts not involved in the research pointed out problems with the new study, which has not yet been subjected to the critical review by outside experts that occurs before publication in a scientific journal. They suggested that the tests might very well have produced false positives because of contamination or improper storage of the samples. “I don’t trust the results,” said Irene Xagoraraki, an environmental engineer at Michigan State University. Researchers at the University of Barcelona posted their findings online on June 13. Most of their report described research on wastewater treatments from early 2020. The surprising finding about March 2019 was only mentioned briefly at the end of the report. The research gained more attention when the university issued a news release on Friday. For months, scientists have been struggling to assemble clues about the origin of the new coronavirus. The earliest official reports came from the city of Wuhan in China in December 2019. Researchers have studied the mutations that have arisen in coronavirussamples collected from across the world since then and have estimated on the basis of their findings that the samples shared a common ancestor that dated to late 2019. More evidence for the origin of the novel coronavirus has come from other viruses that scientists have found in animals. The closest relatives to the coronavirus infect bats in China. Because the virus can be shed in feces, researchers have begun examining wastewater to detect the pathogen’s genes. In Europe, Australia and the United States, researchers discovered rising levels of the virus’s genes in wastewater days before confirmed cases began to arise. These discoveries have led a number of researchers to examine frozen wastewater samples from earlier periods, seeking evidence of the virus’s presence before anyone knew to look for it. Last week, Italian researchers reported finding the virus in Milan and Turinon December 18, two months before northern Italy was besieged by Covid-19 cases. Separately, in Spain, Dr. Bosch and his colleagues began taking weekly samples of wastewater from two of Barcelona’s treatment plants in April. They found the virus in these samples, prompting them to look back at earlier samples. The researchers found the virus in a number of samples from early 2020, in the months before the pandemic struck Spain. Dr. Bosch and his colleagues then went back even further, examining nine samples taken every few weeks or months between January 2018 and December 2019. In a single sample, taken March 12, 2019, they got a positive result from their tests for the virus. Dr. Bosch found it plausible that the virus could appear in March but not show up in more recent samples. “Respiratory viruses usually have peaks around this time of the year,” Dr. Bosch said. “Probably the virus then disappeared.” But Dr. Xagoraraki noted that the researchers used tests that search for bits of three different genes. The only tests that came back positive were for a gene called RdRp. One of the other tests, for a gene called N, is known to be more sensitive. “It should have shown a signal as well,” Dr. Xagoraraki said. It was possible that the positive results were the result of contamination from other samples that did have the virus, Dr. Xagoraraki said. She also doubted whether the delicate coronavirus could have survived for over a year without the sample having been put in a deep freeze. “If the samples were not stored in -80 degrees, you can’t trust the results,” she said. Gertjan Medema of the KWR Water Research Institute in the Netherlands said that the study came from a “knowledgeable research team,” and so should be taken seriously. But, he added, “they need to confirm this finding in multiple ways.” Dr. Bosch said that his team would not be able to repeat the experiments in the positive sample from March 2019 because it was depleted during the first test. “We proved it from this sample but we cannot repeat it,” he said. But contamination was unlikely, he said. “The way we work, when there is contamination, we notice it.” Another way to confirm the finding would be to search through stored samples of blood from patients in Barcelona hospitals in March 2019. If the virus were circulating, even briefly, in Spain, some people would most likely have been hospitalized complaining of flulike symptoms. [ *Like the Science Times page on Facebook.* \| Sign up for the *Science Times newsletter.*] Sent from my iPad

To: Haim R. Branisteanu who wrote (174310)	7/6/2021 9:33:33 AM
From: TobagoJack	1 Recommendation Recommended By marcher Read Replies (1) \| Respond to of 218265

Two puzzles theguardian.com Prosecutors examine claims Covid spread in Italy before official confirmationNew evidence ‘could change the timeline of the pandemic in Italy’, say lawyers for victims’ families Angela Giuffrida Italian prosecutors are examining fresh evidence that suggests coronavirus was spreading in the country weeks before the first case of local transmission was officially detected as criminal investigations continue into continental Europe’s deadliest outbreak. Lawyers representing the families of Covid-19 victims say the medical records of a man in his 50s who was admitted to a hospital with bilateral pneumonia at the end of January 2020 in Bergamo, the Lombardy province severely hit during the first wave of the pandemic, “could change the timeline of the pandemic in Italy”. “The impact of this possible negligence is that many deaths could have been avoided,” said Consuelo Locati, representing families in two legal cases. “And if this was a choice that came from high up, like a political choice, it would mean people were killed by politics more so than the virus.” According to the medical records seen by the Guardian, the patient was discharged on 17 February, four days before Italy’s first locally transmitted infection was confirmed in Codogno, a Lombardy town south of Milan. Before the Codogno case, two Chinese tourists from Wuhan, who arrived in Milan on 23 January before being hospitalised in Rome a week later, had been the only confirmed Covid-19 patients in Italy. Italy was the first country in the western world to be engulfed by the pandemic, and has the highest Covid-related death toll (127,649 as of Sunday) in Europe after the UK. At the time of the diagnosis in Codogno, coronavirus testing was only for those who had travelled to China within the 14 days prior to initial symptoms. But, according to guidelines published by the health ministry on 22 January 2020, testing was also supposed to be done on those “with an unusual and unexpected clinical course, especially if followed by an abrupt deterioration despite adequate treatments, irrespective of their place of residence or travel history”. The Bergamo patient had developed symptoms of “coughing, with a fever” days before being admitted to hospital in the town of Seriate, according to the medical records. A CT scan of the patient’s lungs showed “the left lung had shaded parenchymal thickening looking like ground glass”. The results of the scan reflected features of Covid-19 in patients who had either clinical or radiological evidence of pneumonia. Prosecutors in Bergamo will now need to verify whether a test for Covid-19 was done on the patient, as part of their investigations into criminal negligence by Italian authorities in the handling of the pandemic. If a test was not carried out, they will need to establish if the pandemic guidelines specified by the health ministry were violated by the local health authority. Five health managers in the Lombardy region and a former director at the health ministry who are under investigation by prosecutors have denied any wrongdoing. The new evidence will also be presented in the first hearing at Rome’s civil court on Thursday in a case brought by the same group of families as they seek a total €100m in compensation from the Italian government. Locati said she is convinced the evidence gathered so far represents “solid proof of systemic negligence”. “And [the medical records] show how coronavirus might have spread undetected for at least one month in Italy due to a lack of compliance with the guidelines on epidemiological surveillance,” she added. At the start of the pandemic in Italy, doctors said they believed the virus had been circulating in the country for weeks before it was officially detected. Some medics in Lombardy, by far the region worst affected, reported seeing cases of “strange pneumonia” in patients dating back to late December 2019. Annalisa Malara, an anaesthetist at Codogno hospital, pushed for Mattia Maestri, an otherwise healthy 38-year-old who became known as Italy’s “patient one”, to be given a Covid test after seeing images of his lungs on 20 February 2020. Maestri was not tested before then as he had not travelled to China prior to becoming ill. His Covid-19 diagnosis was confirmed on 21 February 2020. Sent from my iPad

To: Haim R. Branisteanu who wrote (174310)	7/6/2021 9:33:40 AM
From: TobagoJack	1 Recommendation Recommended By marcher Respond to of 218265

One puzzle globaltimes.cn US scientists report earliest known COVID-19 case a solid proof; next stage should be focused especially on the US: Chinese epidemiologist Next stage virus tracing should be focused on the US: epidemiologist By GT staff reporters A recent US CDC report found #COVID19 antibodies in blood samples as early as Dec 13, 2019. With more & more evidence surfacing about the coronavirus' origins in places outside China before Wuhan detected it, the world is remapping the history of the #COVID19 pandemic. Infographic:GT More scientific evidence in countries such as the US and France has emerged to suggest that those countries may have had COVID-19 cases way before they officially confirmed. A US government study suggested that the coronavirus may have already been circulating among people one month earlier than it was officially confirmed, and French scientists also presented scientific evidence that the country's cases were caused by an indigenous virus strain prevailing before 2020. Chinese scientists urged that such evidence should not go unnoticed, and should serve as evidence that the next-stage virus-tracing investigations should be focused on countries which reported cases earlier than they previously identified, especially the US. A study of more than 24,000 samples taken for a National Institutes of Health (NIH) research program in the US between January 2 and March 18, 2020 suggested that seven people in five states - Illinois, Massachusetts, Mississippi, Pennsylvania and Wisconsin - may have been infected well before the country's first confirmed cases that were reported in January 21, 2020. The results suggest that the virus may have been circulating in Illinois, for example, as early as in December 24, 2019, one month earlier than the US authorities confirmed. The data suggests the virus was in the five states far away from the initial hot spots and areas that were considered its points of entry into the country, the study said. Zeng Guang, chief epidemiologist of the Chinese Center for Disease Control and Prevention, told Global Times on Wednesday that the US should be prioritized in the next-stage investigation, as the country was slow to test people at an early stage, and it possesses so many biological laboratories all around the world. "All bio-weapons related subjects that the country has should be subject to scrutiny," Zeng said. Ju Liya, chief scientist of the European precision medicine platform in France, also told the media last week that after having studied the genetic sequence of the viruses from earlier patients, they found the outbreak in France was caused by an indigenous virus, which was prevailing in the country even before 2020. She also claimed that the France outbreak had no link with the Chinese city of Wuhan, where the first coronavirus case was reported, as the hereditary feature of the virus strain detected in France is very different from that found in COVID-19 patients in China. In response to a question about the US study, Zhao Lijian, spokesperson of China's Ministry of Foreign Affairs, said at a Wednesday briefing that scientific journals and scientists around the world have pointed out similar evidence, including chief Swedish epidemiologists who believe that there were cases of coronavirus in Sweden as far back as November. "It is obvious that the outbreak had multiple origins," said Zhao. The spokesperson said under this perspective, next-stage virus-tracing investigations should be focused on various countries and regions, instead of just one. He also urged other countries to cooperate with WHO on virus tracing, like what China did with the organization. The WHO and some of its scientists confirmed to the Global Times previously that the agency is working with researchers in Italy and a reference laboratory to retest the samples of a study that suggested the coronavirus may have been circulating in Italy since fall 2019. Only China, which upholds the principles of science and justice, had invited the WHO to investigate the virus origins, Zeng noted. He also urged other countries to trace back samples of their previous pneumonia patients, as early as in 2018, to check if there were earlier cases of COVID-19. Aside from pointing directions for next-stage virus tracing, scientists also called Western politicians and media to stop politicalizing the issue, as their deeds are stifling genuine scientific research into the virus origins. US President Joe Biden in late May ordered US intelligence agencies to report to him in the next three months on whether the COVID-19 virus was come from an animal source or from the Wuhan Institute of Virology (WIV). Ju said that after she published her paper disproving the connection between France's outbreak and Wuhan, the French government and politicians were angry with her institute. Her institute, which has prominent achievements in virus research and vaccine development, was silenced. Western politicians' playing with the "lab-leak" theory or jab at China for being responsible are just tricks to get themselves away from their mishandling of the pandemic, a Beijing-based immunologist who requested anonymity told the Global Times on Wednesday, noting that their politicalizing the issue is standing in the way of scientists to find answers to the pandemic. Sent from my iPad

To: Haim R. Branisteanu who wrote (174310)	7/6/2021 9:39:15 AM
From: TobagoJack	1 Recommendation Recommended By marcher Read Replies (1) \| Respond to of 218265

One for the road latimes.com New signs suggest coronavirus was in California far earlier than anyone knew By Paige St. John Staff Writer April 11, 2020 5 AM PT A man found dead in his house in early March. A woman who fell sick in mid-February and later died. These early COVID-19 deaths in the San Francisco Bay Area suggest that the novel coronavirus had established itself in the community long before health officials started looking for it. The lag time has had dire consequences, allowing the virus to spread unchecked before social distancing rules went into effect. “The virus was freewheeling in our community and probably has been here for quite some time,” Dr. Jeff Smith, a physician who is the chief executive of Santa Clara County government, told county leaders in a recent briefing. How long? A study out of Stanford suggests a dramatic viral surge in February. But Smith on Friday said data collected by the federal Centers for Disease Control and Prevention, local health departments and others suggest it was “a lot longer than we first believed” — most likely since “back in December.” “This wasn’t recognized because we were having a severe flu season,” Smith said in an interview. “Symptoms are very much like the flu. If you got a mild case of COVID, you didn’t really notice. You didn’t even go to the doctor. The doctor maybe didn’t even do it because they presumed it was the flu.” Just as New York has strong ties to travelers from Europe, who are believed to have brought the coronavirus there from Italy, the Bay Area is a natural hub for those traveling to and from China. Santa Clara County had its first two cases of COVID-19 almost a week before federal approval of emergency testing for the disease Feb. 4. Both were in travelers returning from Wuhan, China, where the virus was rampant. In January and most of February, there was little, if any, community testing in California. The CDC provided testing materials to only some health departments, with restrictions that confined testing and thus the tracking of the novel coronavirus to those who were sick or exposed to someone already known to have COVID-19. The federal agency’s focus was on cruise ships, with Princess Cruises’ Diamond Princess carrying the largest known cluster of COVID-19 cases outside of China. The first passenger tested positive for COVID-19 five days after the ship’s Jan. 20 departure from Japan. Eventually, 712 passengers and crew tested positive, and nine of them died. COVID-19 did not reappear in the Bay Area until Feb. 27, when doctors finally decided to test a hospitalized woman who had been ill for weeks. She became the region’s first case of community-spread coronavirus. But from there, almost every positive test pointed toward local spread. “When public health [officials] tried to track down the start of the disease … we weren’t able to find, specifically, a contact,” Smith told county supervisors. “That means the virus is in the community already — not, as was suspected by the CDC, as only in China and being spread from contact with China.” Researchers still unsure how long the virus lurked are now turning to blood banks and other repositories to see if lingering antibodies can show them what was missed. A study funded by the National Institutes of Health is looking for virus antibodies in samples from blood banks in Los Angeles, San Francisco and four other cities across the country. Santa Clara County’s first community-spread case also became its first announced COVID-19 death. Azar Ahrabi, 68, died March 9, the second COVID-19 fatality in California, five days after the first. For the first few weeks, the urban county that sits at the heart of Silicon Valley, home to Stanford University and tech giants Apple and Google, led California in coronavirus deaths. Advertisement Health investigators said they could find no source of Ahrabi’s infection. Her family members said she stayed mostly at home, taking care of her mother. She seldom drove, and she walked to a local grocery store to shop. But she and her mother lived in a Santa Clara apartment complex in a neighborhood with a high density of international residents. Relatives said she showed signs of illness in mid-February. For more than a week, they gave only a passing thought that her fever and sudden fatigue might be tied to the horrifying news out of China. Ahrabi’s son, Amir, said that when his mother checked into a medical clinic Feb. 20 and was diagnosed with a nonspecific pneumonia, she was prescribed antibiotics and sent home. The next day, her doctor admitted her to the intensive care unit. Amir said he asked that she be tested for COVID-19, and doctors told him the county health department would not approve the test. She met none of the qualifying criteria. Advertisement New studies out of Stanford University and the CDC, taken together, suggest that the novel coronavirus spread quickly through the Bay Area. Stanford’s virology lab, looking retroactively at some 2,800 patient samples collected since January, did not find the first COVID-19 cases until late February — from two patients who were tested Feb. 21 and Feb. 23. Neither of those patients, the researchers note in a letter published by the Journal of the American Medical Assn., would have met existing criteria for COVID-19 testing. The California Department of Public Health and the CDC did not begin community surveillance for COVID-19 in Santa Clara County until March 5. Samples were collected from 226 coughing, feverish patients who visited four urgent care centers; 1 in 4 turned out to have the flu. The state tested samples from a subset of 79 non-flu patients. Nine of them had COVID-19. Advertisement The result suggested that 8% of people walking into the urgent care centers carried the novel coronavirus, an infection rate that mirrored the 5% infection rate at a Los Angeles medical center, the CDC said in a report published Friday. It is possible the coronavirus spread widely through the Bay Area in just two weeks, said Dr. Benjamin Pinsky, the pathologist who led the Stanford study. He said Stanford’s virology clinic saw a similar increase in cases once it was cleared by the federal government to begin running its own COVID-19 tests. Pinsky said the virtual invisibility of COVID-19 in February followed by an 8% infection rate two weeks later is not “incompatible.... I think that all kind of fits together.” Advertisement Santa Clara County acted on the CDC’s local sampling immediately. Two days after the project ended, it and five other Bay Area counties ordered residents to stay home and schools and nonessential businesses to close. Azar Ahrabi by then was dead. Amir said he sees his mother as on the cruel side of history, falling ill before Californians were ready to look for the virus already in their presence. For his mother, that realization came too late. The first confirmed COVID-19 death in California was March 4 in Placer County, claiming the life of a 71-year-old man who had recently taken a Mexican cruise. A ship medical officer told The Times the man had developed symptoms during the Feb. 11-21 voyage, suggesting he brought the virus on board from California. Two days later, March 6, San Jose authorities found a 70-year-old man dead in his home. The Santa Clara County medical examiner determined the man tested positive for COVID-19, according to records provided to The Times. The discovery of this second death was never publicly announced, and county health officials did not answer questions about the case. Advertisement Research by The Times showed he lived less than four miles from Azar Ahrabi, essentially off the same main road with an interstate between them. The diagnosis of Ahrabi appeared to the family to make little difference in her steady decline. She was put into an induced coma and intubated with a ventilator. Family members were not allowed to see her. The county put them in quarantine and served a legal order to back that up. Physicians threw a slew of treatments at Ahrabi — including offering a controversial synthetic quinine used to treat malaria but using another experimental treatment, Remdesivir. But her liver failed, and her body rejected dialysis treatment. The ventilator could not deliver enough oxygen through her occluded lungs, and the hospital did not have a machine to infuse oxygen directly into her blood. Advertisement “She was essentially tested a week and a half after her first symptoms, and some of the treatments that were proposed and [that] we went with could have been way more effective if we — they — put them in place days ago,” Amir said. Amir was ordered by Santa Clara County to go into quarantine the day his mother’s test result came back, and he never saw her alive again. As she died, he stayed in his apartment with his grandmother, caring for the elderly woman without telling her the fate of her daughter. Only after the quarantine order was lifted, when the whole family could again gather, did they tell her Azar Ahrabi had died. Iranian tradition dictated that the family wash her body and prepare it to eventually return to the earth, Amir said. Instead, the county health department required that she be sealed into a plastic bag for interment. Advertisement Times staff writer Melody Petersen contributed to this report. Sent from my iPad