Monday, December 14, 2020

When Did the SARS-CoV-2 Virus Arrive in the United States?

While the world seems to blame China for the appearance of the SARS-CoV-2 virus in late 2019 and early 2020, in fact, recent research on the Centers for Disease Control and Prevention (CDC) website shows the world that, in fact, the "China Virus" may not necessarily be a China-based virus after all. 


As background, serological studies, the study of serum and other body fluids, usually referring to diagnostic identification of antibodies, are a scientific method that can be used to determine the presence of antibodies to the SARS-CoV-2 virus.  This recent research by the CDC's Sridhar V. Bassavaraju MD et al was undertaken to determine if antibodies for the SARS-CoV-2 virus, which is responsible for the COVID-19 pandemic, was present in sera (blood) prior to January 19, 2020, the first identified case of COVID-19 in the United States in a traveller that had returned from China.  Two other cases in the United States had illness onset dates of January 14, 2020.  To put this date into context, the SARS-CoV-2 virus was first identified in Wuhan, China with notification to the World Health Organization on December 2019 about a cluster of pneumonia cases with unknown causes.  


Researchers for this study used residual archived blood samples from 7,389 routine blood donations collected by the American Red Cross from December 13, 2019 to January 17, 2020 (prior to the implementation of SARS-CoV-2 risk-based donor deferral for travel to China in February 2020).  Samples came from donors in nine states; California, Connecticut, Iowa, Massachusetts, Michigan, Oregon, Rhode Island, Washington and Wisconsin.  These samples were tested for the antibodies associated with the SARS-CoV-2 virus using a pan-IG enzyme linked immunosorbent assay (ELISA). 


Of the samples, 106 or 1.4 percent to the total were confirmed reactive by the pan-IG S ELISA screening.  These positive analyses included the following by date:


1.) December 13 to 16, 2019 - 39 samples out of 1,912 total (2 percent) from residents of California, Oregon or Washington.


2.) December 30, 2019 to January 17, 2020 - 67 samples out of 5,477 total (1.2 percent) from residents of Connecticut, Iowa, Massachusetts, Michigan, Rhode Island or Wisconsin.


The researchers that completed this study also took measures to ensure that the detected sera antibodies were specific to COVID-19, ruling out all other coronaviruses.  Statistically, from previous surveys, only a small percentage of blood donors report travel outside of the United States (3 percent) in the previous four weeks with only 5 percent of those reporting travel to Asia.


Here is the conclusion of the study:


"The findings of this report suggest that SARS-CoV-2 infections may have been present in the U.S. in December 2019, earlier than previously recognized. These findings also highlight the value of blood donations as a source for conducting SARS-CoV-2 surveillance studies.  Data from U.S. blood donation screening have been previously used for population- based incidence and prevalence monitoring during infectious disease outbreaks, most recently the Zika virus epidemic. CDC is continuing to work with federal and non-governmental partners to conduct ongoing surveillance using blood donations and clinical laboratory samples for SARS-CoV-2 infection in multiple sites across the U.S. Understanding the dynamics of SARS-CoV-2 pandemic from early introduction throughout further progression will advance understanding of the epidemiology of this novel virus and inform allocation of resources and public health prevention interventions to mitigate morbidity and mortality associated with COVID-19."


Given that a rather significant number of blood donors had antibodies to the SARS-CoV-2 virus present in their blood in mid-January certainly affects the COVID-19 narrative.  Another study has shown that the latest novel coronavirus was present in Europe during the fall of 2019, suggesting that there a great deal that we don't know about the source of the COVID-19 pandemic and, perhaps, a pharmaceutical solution to this virus.


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