michael barbaro

From The New York Times, I’m Michael Barbaro. This is “The Daily.” Today, a strategy of containment was supposed to protect Washington State from the coronavirus. It didn’t. Mike Baker on what led to the first major outbreak in the U.S. It’s Thursday, March 5th. Mike, tell me about how this outbreak in Washington State starts.

mike baker

So it really began January 20.

michael barbaro

Tonight, the C.D.C. is confirming the first case in the U.S. of a new and deadly coronavirus. A man in Washington State has the same virus that has sickened about 300 people in China, killing at least six.

mike baker

That was when the officials here announced that the first case of coronavirus in the United States was in Washington State. It was in north of Seattle. There was a man in his 40s who had been traveling to the Wuhan region in China. He had come back. He had developed symptoms after he returned to the United States. And as kind of a savvy guy, he certainly made the connection that he was potentially infected with the coronavirus, and presented himself at a health clinic in the area to ask for some help.

michael barbaro

And what happens to him? How is he treated?

mike baker

Officials there, the doctors take a sample. They’re sending it off to the C.D.C. There’s certainly an awareness this very likely could be a case. He ends up being taken to the hospital and quarantined there in a special portion of the hospital. At that point, you have health officials sort of tracking down who was he on the plane with when he returned? How did he get from the airport back to his house? What was he doing in the hours and days after he landed? So there’s a huge effort just to find out who might have been in contact with him, to make sure that this wasn’t going to be spreading further.

michael barbaro

And what were the results of those efforts to track people he might have been in contact with?

mike baker

They ended up tracking dozens of people. And I don’t believe any of them ended up developing symptoms. We went six weeks here in Washington State without another case popping up. There were a number of tests done on a couple dozen people, and none came back positive. So there was certainly a sense that the case that had shown up on the shores here was one that was contained.

michael barbaro

So far, so good.

mike baker

Yes. In fact, there was a press conference last Thursday where the state still just had one confirmed case, the first case. And they talked publicly about how the risk to the general public remained low.

michael barbaro

OK, so what happens next?

mike baker

On Friday, I’m working, helping colleagues around the west coast track coronavirus cases that are starting to emerge. And there’s cases in California, cases in Oregon. And then I get a notification that at 8:00 PM on Friday night, the health officials here in Washington State were going to have a press conference. And 8:00 PM press conferences generally are not a sign that good information is about to come out.

michael barbaro

Fair.

archived recording (jeff duchin) I’m Jeff Duchin. I’m the Health Officer for Public Health, Seattle and King County. And I’m here to share with you that we have a preliminary positive result for COVID-19.

mike baker

So at that meeting, they announced two new cases.

archived recording (jeff duchin) A woman in her 50s, a female who traveled to South Korea, was visiting.

mike baker

They have a woman who was traveling in South Korea came back and tested positive.

archived recording (jeff duchin) And noted symptoms at the end of the workday when she got home on Tuesday. And on Wednesday evening, her husband called to report her symptoms and travel history to us. And we had her tested yesterday.

mike baker

And then they also had a teenager.

archived recording (jeff duchin) As Dr. Lofy mentioned, we do have a new case of coronavirus in Snohomish County.

mike baker

A high schooler in the area, whose tests came back positive, as well.

archived recording (jeff duchin) — have today for a school-aged adolescent. This individual became ill on Monday with fever, body aches and a headache.

mike baker

The remarkable thing about those two cases is here, the state and federal governments had been spending much of their time focused on tracking people who had come back from Wuhan or from mainland China. Those are the people are getting screened at the airports. Those are the people who are getting tested. And here we had two cases that really didn’t fit that pattern at all, they weren’t really on that standard set of guidelines where testing would have taken place.

archived recording (jeff duchin) There was no travel history associated with this case. Our team is still in the midst of the contact investigation, so we do not yet know the possible source of infection.

mike baker

Along with cases in Oregon and California, we’re sort of setting this new standard that this wasn’t just people coming back from China anymore. There were people who were in our communities who are getting the virus. And no one really knew where it was coming from. And so in the middle of these questions about whether we’re testing the right people, whether the regimen around the country is going to catch the cases that might be here already, there is an escalation in the news.

archived recording (jeff duchin) Today Public Health, Seattle and King County is announcing three new presumptive positive cases of novel coronavirus, COVID-19, including one person who died. And I want to just start by expressing our deep and sincere condolences to the family members and loved ones of the person who died.

mike baker

A Washington State man has now died of the coronavirus. It’s the first death in the United States. It’s a man in his 50s in the Seattle area who lived at a nursing home.

archived recording (jeff duchin) The person who died was a patient at Evergreen Hospital who had underlying health conditions.

mike baker

And he had not traveled abroad, either. We now have got three cases in Washington State not connected to China, two of which appear to have developed the virus within the community somewhere. And so the announcements come out. Governor Jay Inslee declares a state of emergency. The governor suggests the use of, potentially, the National Guard if needed.

michael barbaro

Wow.

mike baker

And then the main area of focus that emerged at that point was this nursing facility in Kirkland, in the Seattle suburbs, owned by a company called Life Care. Officials were reporting that potentially dozens of people were sick there. They were showing signs and symptoms, a mix of both residents and staff. And obviously, this is — it’s a terrible place for a coronavirus to take root. I mean, you’ve got people who are elderly, who have medical issues. I mean, those are the exact types of people who would be most vulnerable to any kind of illness. And there was an immediate sense that there’s potential disaster ahead, with people there who are infected and spreading. We started talking then to a number of different family members of people, who were obviously worried and trying to figure out how to support their family members that are inside the facility. And one of those people that I talked to one of those first days was Bridget Parkhill.

michael barbaro

And I called Bridget. And from the first moment we were on the phone, it was clear that she was very frustrated with this experience.

michael barbaro Hi, Bridget. bridget parkhill Yes. michael barbaro Hey, it’s Michael Barbaro. How are you? bridget parkhill I’m fabulous. How are you. michael barbaro I’m reading a little facetiousness in your voice. bridget parkhill Yes, just a bit. It’s been a pretty rough week. michael barbaro I imagine it has been. bridget parkhill Yeah.

mike baker

Her mother was in the facility trying to recover from knee surgery. She’d been there for a few months. And Bridget and others were just trying to get a handle on what was going on inside.

michael barbaro Bridget what are you thinking when you hear that this nursing home is suddenly in the news and is connected to the coronavirus? bridget parkhill Well, it is extremely scary to me. My mom has been a resident there since November when she had her knee replaced. And then all of a sudden, I’m getting frantic phone calls from my sister saying that two people had tested positive for this coronavirus. One was an employee and one was another resident, and that they were on lockdown. michael barbaro So as you get this information, what are you thinking to yourself? bridget parkhill I’m thinking, my god, mom’s had a cough since last Tuesday and she needs to get tested right away. So when I called them, I said, has my mother been tested yet? And it was the social worker I spoke with. And she pulled up mom’s chart, and she said, no. We’re going to test 50 people and your mom hasn’t had a fever. And she told me mom’s last three temperatures and they were fine. And at that point, they were taking them, I believe, every four hours.

michael barbaro

Bridget’s pressing them to get her mom tested to get a real answer it here on whether or not she has the coronavirus. There’s a great fear from her and the rest of the family that this could get much worse and. If she does, in fact, catch the coronavirus, she’s someone who was a really high risk of dying.

michael barbaro So what happens? What happens next? bridget parkhill Well, we just kept trying to call. We called the King County Health Department, because we were told to go through them to see should we be self-quarantined? Should we be doing something? michael barbaro Basically, should you, yourself, be quarantined? bridget parkhill Yes, exactly. And I couldn’t get a hold of anyone. My sister got a hold of someone, and they said, oh, this is the wrong number. This is the emergency line. You need to call this other number. So they were giving us the run-around. And so finally, this guy said, OK, I’ll take your information and someone will give you a call back. But no one did. michael barbaro No one called back. bridget parkhill No one called back. So she finally got a hold of someone, and they said, oh, no, if your mom doesn’t have a fever, no, you don’t have to do anything. You’re just fine. michael barbaro And you would explained that your mom was in a facility where coronavirus was known to have infected people. bridget parkhill Yes. michael barbaro And that you had been there. bridget parkhill Yes. michael barbaro Did any of that reaction surprise you? bridget parkhill Very much so. Very much so. They just acted like it was no big deal.

mike baker

And that’s a theme that we’re hearing from a lot of the family members, who are feeling like they’re just in an information black hole right now at a time when it seems like there is an extreme risk to the health and lives of the people they love. I mean, we’re seeing an email chain that’s going around from Life Care where they emailed a bunch of family members, and actually kept all the email addresses open to each other. And subsequently, the family members have been responding over and over again with their outrage, and frustration, and concern they’re not getting the information they want. They have a lot of questions that are not getting answered. There is undoubtedly extreme concern about how people are doing in the facility, their health, and their exposure, and what kind of protection is available to them. It has been heartbreaking to listen to, because they feel so helpless. They feel like their family members are in this facility, and just sitting ducks waiting for this virus to come through. So as the family members are struggling to get the information and answers that they feel like they need, we get another bout of terrifying information. Some researchers here in the Seattle area had been working to trace the genetic sequences of two cases of coronavirus. They looked at both the first one that showed up in mid-January six weeks ago now. And then they looked at another case that showed up last week. And in their analysis, they can see that these two cases appear to be linked.

michael barbaro

And what do these genetic sequences of this virus tell us?

mike baker

So what it indicates is that after the first person who got the coronavirus in Washington State six weeks ago, there appears to have been a series of transmissions, a number that we can’t even count at this point, that then led to a new person showing up with the virus in more recent days. So there’s a sign here that this has been spreading throughout the community undetected for weeks.

michael barbaro

Wow. So they’re saying that that first case and that last case, they’re not isolated cases. The genetics show that they are, in fact, linked through some vast number of transmissions that mean that somehow, that first person gave it to somebody else, who gave it to somebody else, who gave it to somebody else, and eventually gives it to this last person.

mike baker

That’s right. So these researchers now believe that if, in fact, this virus has been spreading throughout the region for six weeks essentially undetected, that there are likely 300 to 500 other cases out there that we don’t know about, but potentially up to 1,500. We’ll be right back.

archived recording Two people are now dead in a Seattle suburb today from the coronavirus, after state officials confirmed that COVID-19 has been spreading quietly for weeks. Six weeks — six weeks in Washington State. That means hundreds of undiagnosed cases could be out there. And experts suggest there are many more cases circulating than have been detected so far. People have to remember — confirmed cases are not the number of cases. Confirmed cases just means that we went through the big rigmarole to get them tested. You’ve heard that there’s about —

michael barbaro

Mike, once it becomes clear that we’re dealing with a real outbreak here — and according to those projections that you just mentioned could be 100, could be thousands of people infected — does access to testing for the coronavirus change?

mike baker

So the local health officials here were talking very ambitiously about how they were going to be increasing testing. And it was more significant. They were doing about 100 tests a day, but at the same time, that’s 100 per day for the whole state. Their goal is to increase that capacity as time goes on to the point where maybe we’re doing more than 1,000 a day.

michael barbaro

But why aren’t they able to suddenly deploy thousands of tests more or less immediately? What holds that back?

mike baker

Well, part of it is a capacity issue. But the other thing is that while the C.D.C. guidelines on who should be tested have broadened, it’s still relatively narrow. The new guidelines essentially say that if you’re someone who is hospitalized with unexplained flu-like symptoms, you would get a test. But if you’re just a random person who has flu-like symptoms, and you’re concerned that you might have had coronavirus, that’s not enough for you to go to your doctor and be put in the pipeline to get tested.

michael barbaro

So basically, there are just restrictions still on who’s eligible to be tested. And that seems quite stringent.

mike baker

That’s right. Their official guidance is not everyone needs to be tested.

michael barbaro

So at this point, what’s happening to people like Bridget’s mother, who has not yet been tested, may have been exposed to this virus? What is the protocol for people like her? What happens to her?

mike baker

So right now, a lot of these people are essentially — they’re isolated in their rooms. They’re getting food delivered to them by people in protective gear. They’re trying to stay in touch with family through video chats and phone conversations.

michael barbaro

And what is she saying that that’s been like?

bridget parkhill She said this is like solitary confinement. And we laughed about, wow, mom, I don’t know what your crime was, but you’re doing hard time. And she laughs, you know. My mom has a very big, bright personality, laughing all the time. She’s that kind of person. And so she’s trying to make light of it. But at the end of the conversations, she says, I’m just really lonely.

mike baker

And there’s hearing, through these family members, a lot of concern about how this is being handled, how long they’re going to be in isolation, and when this might end, and the larger, more concerning question — how is this going to end for them?

michael barbaro

Meaning are their family members going to survive this.

mike baker

That’s on their minds all day long. One of the things that’s a real struggle for the family members like Bridget was that they can’t see their family members right now. They can’t go into the facility, because it’s in quarantine.

bridget parkhill So we were told that they were under lockdown, but I really needed to see my mom. So my sister and I decided to meet there, and bring her a little care package, because they said that we could certainly bring her food, or books, or whatever we wanted to, and just to call them when we got there.

mike baker

So Bridget talks about how the other day, she went to the facility, went to the front door.

bridget parkhill So I called, and they said that someone would be right out. And there were signs that said, “No admittance,” that they were having a respiratory outbreak. So a woman came out and said that she would take it to mom. And I said, wait a minute. We can’t go in. Is there any way that I can go around outside to her window, and just see her, just wave at her so she knows that I’m here?

mike baker

Would it be OK If she walked around the exterior of the building just so she could have a chance to see her mom.

bridget parkhill And she said, oh, sure, no problem. So she took the goody bag down to mom and my sister and I went around the side. She opened up the blinds, and there was my mom. With all this stuff going on, just seeing her gave me so much relief, just because we are getting so little information from Life Care Center that we don’t know. Is she able to sit up? Is she laying in a bed? You know we had no idea. So it was just thrilling to see her sitting up, and smiling, and waving. michael barbaro When do you think you’re going to be allowed to see your mother? Are they giving you any kind of frame? bridget parkhill They’ve given me no time frame whatsoever. They don’t know. There’s ambulances going in there. And they take people out, and take them to the hospital. So I’m just waiting for that call to say that my mom is one of those people. michael barbaro Oh, no. bridget parkhill [CHOKED UP] It’s really hard.

michael barbaro

So Mike, by the end of this past weekend, from everything you’ve said, the government in Washington has pronounced a state of emergency. It’s acknowledging that things are quite serious. Testing is still very limited. People are furious about that. And from the projections you described, it’s clear that the virus has been spreading and spreading, and maybe, at this point, kind of out of control. So what is the plan by the authorities there to wrap their hands around this crisis?

mike baker

So there was really a major shift that was happening, because the news was just cascading worse and worse every time. I mean, every time they would give us an update, it was more people in critical condition. It was another death, more deaths. You had this growing cacophony of horrible news coming out from the region. And so then on Monday morning, we really see that sort of change in direction and messaging.

archived recording This morning, we are in final negotiations to purchase a motel in which we can place patients who are in need of isolation and a place to recover.

mike baker

The county executive here in the Seattle area comes out, and says, they’re now going to be going out to buy a motel in the region that he could repurpose for the sake of isolating people who have coronavirus.

michael barbaro

Wow.

archived recording The risk for all of us of becoming infected will be increasing.

mike baker

The county health officer here was talking about how the number of cases here are growing so much that at some point, coronavirus cases are going to outpace the number of flu cases in the area.

archived recording And there’s a potential for many people to become ill at the same time.

mike baker

And that means a whole different strategy. Now there’s so many cases that they no longer have the ability to track individual people and retrace their steps.

archived recording So we are making both individual and community-level recommendations to limit the spread of this disease. And our community-level recommendations are very similar to what we recommend for influenza.

mike baker

They’re shifting to a community-level approach here, that you’ve got to sort of address the problem at a bigger scale.

michael barbaro

Wow. So basically, they’re giving up on the idea of containing this by tracking each person who has it.

mike baker

Right. Now, I just got a message that came in, that said the latest guidance is that they are recommending that older residents with underlying health problems in the community stay in their homes.

michael barbaro

So Mike, in a span of really just a few days here, the State of Washington has gone from just a handful of cases to a pretty extraordinary outbreak. And it feels like a kind of terrifying demonstration of just how fast this virus can take hold across a relatively small geographical area.

mike baker

It is. I mean, we went from one known case a week ago to today, the latest was 39 total infections and 10 people dead. You can sense the growing fear around here. I mean, we have guidance that employers encourage people to telecommute instead of coming into an office. You’ve got schools preparing to educate students remotely if the virus continues to spread.

michael barbaro

Wow.

archived recording That could expand, also, to include, again, discouraging mass gatherings as we call them — sporting events, the high school basketball game, the hockey game, the convention. These things could end up becoming temporarily discouraged, if not possibly prohibited, depending on the escalation of concern.

michael barbaro

Mike, how reasonable is it to fear that what happened there in Washington, and the speed with which it happened, is going to be the story of how this unfolds pretty much everywhere else in the United States?

mike baker

I mean, we’re certainly seeing the spread everywhere at this point. One thing that I’ve stopped to think about a number of times in the last few days is, did this region just get really unlucky to have the epicenter of the outbreak take root in a nursing home, among the most vulnerable people in the region? And is that why the death toll is so high here? At the same time, the reality is the virus is continuing to spread. And the public health experts we talked to expect it to continue that way. And there’s going to be more places just like this that are going to get hit.

michael barbaro

Mike, thank you very much, and stay safe.

mike baker

Thanks.

michael barbaro Bridget, for a lot of people the coronavirus is a kind of distant news story. It’s very scary, but it’s not yet a reality in a lot of places. In the Seattle area, and definitely in this nursing home, it is a reality and a very scary reality. And I wonder as somebody who has experienced it in a very personal and visceral way, what this experience has taught you about what it’s like when this virus does come into your life. bridget parkhill Well, when it comes to your own family, I can’t express to you what it is like. It’s fear. It’s every bad emotion you could have. And she calls me first thing in the morning when she wakes up. Just hearing her voice, it’s like, OK, everything’s good for another day. But is it going to be fine in an hour? Is it going to be fine in three hours? Is she going to make it through the night, because it’s so fast when the severe illness hits, that I don’t know.

michael barbaro

The Times reports that in February, the U.S. Centers for Disease Control and Prevention distributed a test for the coronavirus to state and local laboratories, but that flaws in that test led to inconclusive results. A replacement test was promised, but was never distributed. As a result, most diagnostic testing was only conducted at C.D.C.‘s labs in Atlanta, whose results took days. Last week, amid growing criticism from doctors across the country, the Food and Drug Administration finally broke the logjam by allowing state and local officials to conduct initial testing on their own. But tests remain scarce.

archived recording Chairman, this is really a frightening time. I’m hearing from people who are sick, who want to get tested, who are not being told where to go. I’m hearing that even when people do get tested, and it’s very few so far, the results are taking way longer to get back to them.

michael barbaro

During a hearing on Tuesday, U.S. Senator Patty Murray of Washington State lashed out at federal health officials over the shortage of test kits on behalf of her constituents.

archived recording (patty murray) The administration has had months to prepare for this. And it’s unacceptable that people in my state and nationwide can’t even get an answer as to whether or not they are infected. To put it simply, if someone at the White House or in this administration is actually in charge of responding to the coronavirus, it would be news to anybody in my state. And I’ve been on —

michael barbaro

As of Wednesday, there were 44 cases of the virus in Washington State, and more than 150 in the U.S. We’ll be right back. Here’s what else you need to know today.

archived recording (michael bloomberg) If you remember, I entered the race for president to defeat Donald Trump. And today, I am leaving the race for the same reason — to defeat Donald Trump, because staying in would make it more difficult to achieve that goal.

michael barbaro

On Wednesday, Michael Bloomberg dropped out of the presidential race after a poor performance on Super Tuesday, in which he failed to win a single state, despite spending hundreds of millions of dollars on his campaign. From the start, Bloomberg’s candidacy hinged on Joe Biden’s campaign collapsing, something that never happened. On Wednesday, Bloomberg endorsed Biden, becoming the latest moderate candidate to do so.

archived recording (michael bloomberg) I’ve always believed that defeating Donald Trump starts with uniting behind the candidate with the best shot to do it. And after yesterday’s vote, it is clear that candidate is my friend, and a great American, Joe Biden. [CHEERS]

michael barbaro