At the end of February, when the United States believed it had isolated itself from the coronavirus, a Chicago resident with mild respiratory symptoms paid tribute to a funeral as a family friend.
Three days later, he would celebrate at a birthday party with his own parents.
The man, who did not know he had COVID-19, started a chain of transmission that infected 15 other people, three of whom have died, the Centers for Disease Control and Prevention (CDC) said on Wednesday.
The state of Illinois, of which Chicago is the largest city, did not issue a foreclosure order until a few weeks later, on March 21 – around the same time as many other jurisdictions.
But the case is a telling example of the vital need to comply with social distancing recommendations and foreclosure orders, the CDC said, as it revealed in a detailed report how the super-spread event occurred.
– “Patient index” –
It all started when the man, called the “patient index”, enjoyed a take-out meal using shared plates the day before the funeral with two members of another family with whom he was friends.
During dinner, which lasted approximately three hours, and a funeral, which lasted approximately two hours and involved a “trendy” shared meal, the man reported kissing four people, both of whom he had met the day before to express his condolences.
Three developed symptoms of COVID-19 in two to six days, including one who had to be hospitalized and died almost a month later.
The other two were treated on an outpatient basis and recovered.
While the patient who ultimately died was being treated in intensive care, he was visited by another family member who had been in contact with the index patient at the funeral.
The person, who was not wearing protective gear, later developed a cough and fever but recovered.
– Chain reaction –
Three days after the funeral, the index patient attended a birthday party attended by nine members of his own family, and was in close contact with each other for three hours.
Seven then developed COVID-19 three to seven days after the event. Two were hospitalized and had to be ventilated, and both died.
Two people involved in the care of one of the deceased, including a family member and an unrelated home care professional, both developed a likely COVID-19.
The family member likely passed the virus on to another relative, who did not attend the party.
Three of the birthday participants who presented with symptoms went to church six days after developing their first symptoms, where they likely infected an independent health professional.
The health worker sat nearby and conversed with them for 90 minutes.
The CDC wrote that the patients were between the ages of five and 86.
“Extended family reunions (a birthday party, a funeral, and church attendance), all of which occurred before significant social distancing policies were implemented, could have facilitated the transmission of SARS-CoV -2 beyond family contacts in the community at large, “says the report.
History shows how contagious the virus is, with scientists still trying to better understand how it is transmitted.
At the start of the pandemic, it was said to be more contagious than the flu and less than the measles – although it is not clear if this is really the case, and it can be just as or even more contagious than measles.
It was thought that the respiratory droplets from coughing or sneezing that fell directly on a person or had just touched contaminated surfaces were the main driver, but the growth of studies suggests that an infected person breathing and speaking could be enough.
In addition, a very high proportion of those infected is now considered asymptomatic – between 25 and 50 percent – reinforcing the argument for everyone to cover their faces outside, which is the updated advice from the CDC.
© 2020 AFP