It appears that the first confirmed cased of the novel coronavirus (COVID-19) has been traced back to a 55-year-old from Hubei province on 17 November 2019, according to data from the Chinese government that the South China Morning Post (SCMP) has seen. However, it was also noted that this patient might not be the first to contract the virus.

In a report today (13 March), SCMP noted that at least 266 people were identified so far as being infected last year, all of whom were placed under medical surveillance by Chinese authorities. Some of these cases might have been backdated after specimens taken from these suspected cases were later tested by health authorities, said SCMP.

The article explained that interviews with whistle-blowers from the medical community suggest that doctors in China only realised they were facing a new virus later in December.

Before the outbreak become an international health crisis, scientists had already started trying to map the pattern of transmission from early on when the epidemic was reported in the city of Wuhan in January.

A better understanding of how the virus is transmitted and how undetected and undocumented cases might contribute to the spread will help scientists get a better idea of how big a threat this really is.

From the day of the first case on 17 November, between one to five new cases were reported daily. After a month, the total number of infections were 27. But by 20 December, the total number of confirmed cases soared to 60.

Following this, a doctor from Hubei Provincial Hospital of Integrated Chinese and Western Medicine, Zhan Jixian, informed local health authorities that the disease was in fact a new coronavirus. By then, over 180 people had been infected, though not all were identified by healthcare professionals at the time.

By the end of 2019, there were 266 cases. The next day, on 1 January 2020, the number of cases reached 381.

SCMP noted that while government records haven’t been made public, they do provide clues about the spread of the virus in the early stages and how many confirmed cases were recorded.

Who is patient zero?

Right now, scientists are looking into who might be the first patient, patient zero, so that they can trace the source of the virus. Scientists believe that the virus might have jumped from a wild animal, possibly a bat, to patient zero.

So far, none of the first nine patients reported to have the virus in November 2019 have been confirmed as being patient zero. The four men and five women were aged between 39 and 79. Unfortunately, it is unknown if they were residents of Wuhan, which has been identified as the epicentre of the outbreak.

SCMP noted that there might have been cases dating back even further.

According to the World Health Organistion (WHO), the first case of COVID-19 was confirmed in China on 8 December. However, the organisation doesn’t track the spread of the disease on its own, relying instead on the information provided by each country.

On the other hand, an article in the medical journal The Lancet identifies the first known infection date as 1 December. This was a report by Chinese doctors from Jinyintan Hospital in Wuhan.

Alternatively, the first known whistle-blower in this crisis, Dr Ai Fen told People magazine that tests revealed a patient at Wuhan Central Hospital had contracted an unknown coronavirus on 16 December. This interview was later censored.

SCMP points out that reports from other doctors in Wuhan suggest that they were aware of the disease in late December.

Doctors asked to hold back on revealing information

Previous reports noted that while doctors in Wuhan collected samples from suspected cases in later December, they were unable to confirm their findings. This was because they were bogged down by bureaucracy including having to secure approval from the Chinese Centre for Disease Control and Prevention, which would take days.

They were also instructed not to reveal anything to the public about the new disease.

Even as late as 11 January, Wuhan’s health authorities still claimed that there were only 41 confirmed cases.

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