COVID-19: 1 year ago, medical bulletin went out on 'undiagnosed pneumonia'

LOS ANGELES - Wednesday marks the one-year anniversary of when the global medical community received an alert about an unidentified cluster of a pneumonia-like illness that would later come to be known as COVID-19. 

A year later, the deadly virus has exploded into a global pandemic, infecting more than 82 million people around the world and upending the lives of nearly everyone on Earth.

Last year on Dec. 30, 2019 a minute before midnight, the ProMed bulletin service released a notice warning of the then-unidentified virus. 

"The so-called unexplained pneumonia cases refer to the following 4 cases of pneumonia that cannot be diagnosed at the same time: fever (greater than or equal to 38C); imaging characteristics of pneumonia or acute respiratory distress syndrome; reduced or normal white blood cells in the early stages of onset The number of lymphocytes was reduced. After treatment with antibiotics for 3 to 5 days, the condition did not improve significantly," the alert read.

In the year since, more than 1.7 million deaths have been attributed to the virus globally and more than 339,000 Americans have died of the novel coronavirus, according to the latest data from Johns Hopkins University. 

Dr. Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, shared a message on the anniversary of the first alerts of the virus. 

"As people around the world celebrated New Year's Eve 12 months ago, a new global threat emerged," Tedros said in a video posted to YouTube by the WHO. "Since that moment, the COVID-19 pandemic has taken so many lives and caused massive disruption to families, societies and economies all over the world."

"Going into 2021, we have a simple, yet profound, choice to make: Do we ignore the lessons of 2020 and allow insular, partisan approaches, conspiracy theories and attacks on science to prevail, resulting in unnecessary suffering to people’s health and society at large?" Tedros said, "Or do we walk the last miles of this crisis together, helping each other along the way, from sharing vaccines fairly, to offering accurate advice, compassion and care to all who need, as one global family?"

"The choice is easy. There is light at the end of the tunnel, and we will get there by taking the path together," Tedros said.

The first case of COVID-19 in the United States was reported on Jan. 21, 2020, according to Johns Hopkins University. 

On March 31, as the virus rapidly spread across the U.S., the White House coronavirus task force predicted up to 240,000 total deaths from the virus. The U.S. reported more than 4,300 coronavirus deaths on March 31, according to the Covid Tracking Project.

The country has since surpassed the death toll estimate by White House health officials in March with more than 340,000 deaths, and counting, as of Dec. 30. The seven-day rolling average for daily new deaths in the U.S. was 2,256.6 as of Dec. 29, according to data from Johns Hopkins University.

By mid-December, five in every 100 Americans — more than 16 million — had been infected by COVID-19.

In China where the virus originated, life has returned to normal — almost

As the U.S. continues to be inundated with wave after wave of coronavirus cases and deaths with no apparent end in sight, things appear to have returned to normal in China, where the outbreak first occurred.

Workers have returned to factories and offices, students are back in the classroom and once again long lines form outside popular hot pot restaurants. In the cities, wearing a surgical mask — though no longer required outside of subways and other crowded places — has become a habit.

In the early days, authorities squelched warnings about the outbreak, reprimanding several Wuhan doctors for "rumor-mongering" after they alerted friends on social media. They delayed releasing critical information about the virus, even as hundreds of patients showed up at hospitals and the potential dangers became increasingly evident.

Once the Communist Party leadership mobilized, it moved decisively. The Jan. 23 lockdown announcement came in the middle of the night, and as often in China, with no warning or public debate. No one could enter and no one could leave the city of Wuhan, home to 11 million people. In the ensuing days, it was expanded to most of the rest of Hubei province.

By mid-December of this year, the country had reported just six cases per 100,000 population. China does not include people who test positive but show no symptoms in its confirmed case counts.

But life there has still changed. Virtually everyone has a smartphone app that indicates if they have been in an infected area. It must be shown to gain admission to many office buildings, shopping centers and tourist sites. Some attractions limit the number of daily visitors.

The virus spread rapidly in Europe — a harbinger of what was to come

France had Europe’s first coronavirus case in January, but French President Emmanuel Macron’s government came under criticism for not having enough masks or tests and not confining the population quickly enough. A strict two-month lockdown brought infections down, and France sent children back to school and their parents back to work.

But infections surged again in the fall, leading Macron to declare a new, softer lockdown in October aimed at relieving pressure on hospitals. The measures were relaxed slightly, though restaurants, tourist sites, gyms and some other facilities remain closed.

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Meanwhile, Italy became the epicenter of the COVID-19 pandemic in late February. 

Italy’s first domestic case was recorded Feb. 21, at a time when the World Health Organization was still insisting the virus was "containable" and not nearly as infectious as the flu.

Italy was the first European country to halt all air traffic with China on Jan. 31, and even put scanners in airports to check arrivals for fever. But by Jan. 31, it was already too late. Epidemiologists now say the virus had been circulating widely in the country’s hardest-hit region of Lombardy since early January, if not before.

Doctors treating pneumonia in January and February didn’t know it was the coronavirus, since the symptoms were so similar and the virus was still believed to be largely confined to China. Even after Italy registered its Feb. 21 case, doctors didn’t understand the unusual way COVID-19 could present itself, with some patients experiencing a rapid decline in their ability to breathe.

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But after much suffering during the spring, Italy won international praise for having tamed the virus thanks to the West’s first nationwide lockdown: All non-essential production and commercial activity ground to a halt for 10 weeks from March to May. 

Residents were allowed outside only for essential work, medical appointments or necessities like grocery shopping, and only then with a certificate. Police set up checkpoints and issued fines.

But it worked. By Aug. 1, Italy added a daily 295 new infections nationwide and had only 43 people in intensive care, a nearly 100-fold decrease in ICU-saturation from the springtime high.

But when a second wave hit in September, even the lessons learned from the first weren’t enough to spare Italy’s disproportionately old population. Despite plans and protocols, monitoring systems and machinery that were put in place to hedge against the expected flu season onslaught, another 30,000 people died, hospitals once again were brought to the breaking point and Italy reclaimed the dishonor of leading Europe in the gruesome death count.

Lost at sea: Cruise ships became vessels for COVID-19 early on in the pandemic

A report published in May by the U.S. Centers for Disease Control and Prevention found that the novel coronavirus had most likely been spreading within the U.S. earlier than originally thought. 

The health agency noted two important cases of COVID-19 involving two California residents, one of which became ill on Jan. 31 and later died on Feb. 6, and another unrelated resident who died between Feb. 13 and 17. According to the CDC, neither individual had traveled internationally in the weeks preceding their deaths. The CDC said their deaths were certified by a medical examiner as coronavirus-related. 

The CDC also added that an outbreak of COVID-19 occurred during two consecutive voyages of a Grand Princess cruise ship, and the health agency found evidence suggesting that an unidentified individual was infected with the virus before boarding the ship, which left the Port of San Francisco on Feb. 11 for a round-trip cruise. 

As of Feb. 20, 3,063 people on board the ship were administered tests with a total of 634 people testing positive, according to a study published on March 12 in the journal "Eurosurveillance."

Additionally, hundreds of people fell ill aboard crowded cruises earlier in 2020 before a no-sail order by the CDC went into effect. Fourteen passengers died after an outbreak aboard Carnival Corp.’s Diamond Princess, which was quarantined off the coast of Japan in February.

Since then, the industry has furloughed thousands of workers and obtained billions in bank loans to stay afloat. The Cruise Lines International Association said the U.S. cruise industry supports more than 400,000 jobs and generates $53 billion annually.

Years in the making: Decades of research made quick vaccines possible

While the novel coronavirus has only been around for one year, decades of research made it possible for scientists to create COVID-19 vaccines in record time. 

Two shots that have received approval for emergency use by U.S. regulators — one made by Pfizer and BioNTech, the other by Moderna and the National Institutes of Health — are so-called messenger RNA, or mRNA, vaccines, a brand-new technology. 

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Billions in company and government funding certainly sped up vaccine development, and the unfortunately huge number of infections meant scientists didn’t have to wait long to learn the shots appeared to be working.

But long before COVID-19 was on the radar, the groundwork was laid in large part by two different streams of research, one at the NIH and the other at the University of Pennsylvania — and because scientists had learned a bit about other coronaviruses from prior SARS and MERS outbreaks.

"When the pandemic started, we were on a strong footing both in terms of the science" and experience handling mRNA, said Dr. Tal Zaks, chief medical officer of Massachusetts-based Moderna.

1 year into the pandemic, a new, more contagious variant emerges

Now, multiple new variants of the novel coronavirus has been identified in several countries around the world, alarming medical experts due to their apparent increased risk of transmission. Health officials, however, have stressed that the current vaccines will likely be effective on the new strain.

On Tuesday, the first U.S. case of a new, more contagious, strain first discovered in the U.K. was confirmed in Colorado. By Wednesday, California’s Gov. Gavin Newsom confirmed that the variant had also been discovered in the southern part of the state, which has become the new epicenter of the COVID-19 pandemic in the U.S., besieging hospitals and overwhelming ICUs.

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Dr. Anthony Fauci, the United States’ top infectious disease expert, said that the new variant has most likely already been on U.S. soil for some time. 

"When you see something that is pretty prevalent in a place like the U.K. — there are also mutations that we’re seeing in South Africa — and given the travel throughout the world, I would not be surprised if it is already here," Fauci told PBS.

Last week, Japan banned nonresident foreigners coming from Britain and South Africa after confirming the new variant in seven people over two days — five from Britain who tested positive at airports and two others in Tokyo.

On Sunday, officials in Canada’s most populous province also identified confirmed cases of the contagious new form of COVID-19. 

For the moment, the variant is likely still rare in the U.S., but the lack of travel history in the first case means it is spreading, probably seeded by travelers from Britain in November or December, said scientist Trevor Bedford, who studies the spread of COVID-19 at Fred Hutchinson Cancer Research Center in Seattle.

"Now I’m worried there will be another spring wave due to the variant," Bedford said. "It’s a race with the vaccine, but now the virus has just gotten a little bit faster."

The Associated Press contributed to this story.