'Like iceberg tips': Newly discovered Santa Clara deaths indicate virus has been here for a while

Santa Clara County Public Health Department Director Dr. Sara Cody speaks during a news conference in San Jose, Calif., on Friday, Feb. 28, 2020. Santa Clara County Public Health Department Director Dr. Sara Cody speaks during a news conference in San Jose, Calif., on Friday, Feb. 28, 2020. Photo: Anda Chu, Associated Press Photo: Anda Chu, Associated Press Image 1 of / 74 Caption Close 'Like iceberg tips': Newly discovered Santa Clara deaths indicate virus has been here for a while 1 / 74 Back to Gallery

Santa Clara County public health officer Dr. Sara Cody provided additional information on the three people who died of COVID-19 before the county reported its first official death on March 9.

Autopsy results released Tuesday night revealed that the people who died on Feb. 6, Feb. 17 and March 6 all had the coronavirus, which indicates the virus was here earlier than previously thought. The U.S. Centers for Disease Control and Prevention reported the first fatality due to coronavirus complications in the United States on Feb. 28.

During a Wednesday press conference, Cody said the Feb. 6 death was a 57-year-old woman, the Feb. 17 death was a 69-year-old man and the March 6 death was a 70-year-old man.

"None of these cases had significant travel history, and all represent community transmission," she said. "This means there was some significant degree of virus transmission in early February, probably late January, and who knows how much earlier."

There is a significant lag time between infection and death, which suggests the woman who died Feb. 6 contracted the virus in sometime in January. For reference, the World Health Organization was first alerted to a "mysterious respiratory illness" in Wuhan, China at the end of December 2019. Cases were first confirmed outside of China on January 20 in Japan, South Korea and Thailand. Santa Clara County reported its first case of the virus on Jan. 31.

In early February, the testing criteria in the United States was limited to only those who had traveled to China, which means a good deal of community spread went completely undetected.

"When we first identified our travel-related cases, we had narrow testing criteria and we were wondering how we would detect community transmission if we were only testing people who traveled," she said. "We know that each of these deaths are like iceberg tips. When you have an indicator like death or ICU numbers, there are many cases that underlie those iceberg tips. There was a significant degree of community transmission."

Cody added it is possible many of the deaths in the county attributed to the seasonal flu were actually coronavirus deaths.

"We had a robust flu season, but it is difficult to pick out what was influenza and what was COVID-19," she said. "We all know in January and February we must have had the virus circulating but weren’t looking for it, might have been part of influenza numbers, had to pick those apart absent confirmatory testing."

When discussing the road ahead, Cody painted a bleak picture.

"We anticipate this pandemic will be going on for a very, very, very long time," she said. "We do not have immunity or a vaccine, so every time we let up on social distancing measures we will a see spike in cases, hospitalizations and deaths. That is certain."

Cody was not asked about the results of a large-scale antibody test conducted in the county in early April. The Stanford researchers who conducted the study estimate the county is underreporting cases by a factor of 50 to 85, which backs up the theory the virus is more widespread than thought, and also indicates the virus is less deadly than thought. However, researchers estimate that just 2.5 to 4.2 percent of the county has been exposed, which is far away from the 50-60 percent exposure needed for "herd immunity."

Click here to read more about the antibody test.

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Eric Ting is an SFGATE digital reporter. Email: eric.ting@sfgate.com | Twitter:@_ericting