First U.S. Unknown Origin Coronavirus Patient is at UC Davis Medical Center

Posted on February 27, 2020

The U.S. has its first novel coronavirus case of unknown origin. This means that so far health experts and officials have not been able to determine how the patient contracted the virus. It also a severe case of the virus. The patient is currently on a ventilator at the UC Davis Medical Center.

UC Davis Medical Center has published a statement about this patient. This is not the first coronavirus patient at the center and they say they followed appropriate precautions. They also say the patient was at another hospital before arriving.

This patient was transferred to us from another Northern California hospital. Since the patient arrived with a suspected viral infection, our care teams have been taking the proper infection prevention (contact droplet) precautions during the patient's stay.
The statement also says, "This is not the first COVID-19 patient we have treated, and because of the precautions we have had in place since this patient's arrival, we believe there has been minimal potential for exposure here at UC Davis Medical Center."

The fact the patient was at another hospital first is concerning because they may not have taken the same precautions as UC Davis. There are also concerns about community spread because the complete transmission chain for this patient is not known. This is how clusters can form in the community.

UC Davis Medical Center also says that it requested a Covid-19 test from the CDC upon the patient's admission. The astute physicians there recognized the symptoms and had experience with them having already treated a prior Covid-19 patient. However, the test was "not immediately administered" because the patient "did not fit the existing CDC criteria for COVID-19." Later, the CDC conducted the test and the result was positive for the coronavirus.

On Sunday, the CDC ordered COVID-19 testing of the patient and the patient was put on airborne precautions and strict contact precautions, because of our concerns about the patient's condition. Today the CDC confirmed the patient's test was positive.
Clearly, the CDC's testing criteria needs to be updated in order to catch more potential community cases like this one elsewhere in the U.S. An SF Gate story focuses on this delay in getting the test. It says a small number of medical center employees have been asked to self-monitor at home as a precaution.

It is noteworthy that the patient was placed on even stricter contact precautions following the positive test result.

The California Department of Health has also released a statement on the new case. It says, "The individual is a resident of Solano County and is receiving medical care in Sacramento County. The individual had no known exposure to the virus through travel or close contact with a known infected individual."

The CDPH press release also says that contact tracing in this case has already begun.


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2019-nCoV


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Image: IVDC, China CDC via GISAID