Could have imagined. Narrator and, the tale of two washings. That governor is a snake. Okay. Inslee. We are not going to be distracted by any rhoric that the president or anyone else uses. Thats the only thing thats going to get us through this. Narrator now on frontline, coronavirus pandemic. Frontline is made possible by contributions to your pbs station from viewers like you. Thank you. And by the corporation for public broadcasting. Major support is provided by the john d. And catherine t. Macarthur foundati, committed to building more jt, verdant and peaceful world. More information at macfound. Org. The Ford Foundation working with visionaries on the frontlines osocial change worldwide. At fordfoundation. Org. Additional support is provided by the abrams foundation, committed to eellence in journalism. The park foundation, dedicated to heightening publicr ess of critical issues. The john and Helen Glessner family tst. Supporting trustworthy journalism that informs and inspires. And by the frontline journalism fund, with major support from jon and jo ann hagler. seagulls squawkinen blaring it was one of the most vibrant cities in america. Our economy was strong, a port that was one of the leading ports in the country. We had one of the most vibrantra rest scenes, Small Businesses flourishing. And we went from that to almost zero overnight. ship horn blares miles obrien ved in seattle in mid march, a city and state in the process of shutting down before that was the norm in the rest of the country. S ive coverence stories for nearly 30 years, but this felt more like science fiction. The deadly disease covid19 was about to bring the countryth anworld to its knees. Its like watchina slowmoving landslide move towards you. Obrien how did it eva our warning systems, our best science . A lot of people died because we werent ready. Obrien why was our government so slow to act, so unprepared . I havent cried ever as much i have in the last week. Obrien and what lies ea i came to seattle g for answers. My first stop. How e you . Providence Regional Medical center in nearby everett. Nd have you traveled outside the u. S. In the last0 days . I have. Okay, so were gonna ask you to put on a mask. Obrien okay. This is the hospital that treated the first known case of covid19 in the country. There we go, 97. 6. Obrien i met dr. George diaz, an expert in Infectious Diseases who treated patiente a 35yearold local man whod flown into seattle on january 15. He was having a cough, he had been having feen having fevers e hadnt been eating well, he generally felt poorly and he had been complaining of diarrhea at home. Obrien he is 35 years old and otherwise healthy. Totally healthy pson. He began developing symptoms the day after he arrived. Obrien he went to this walkin inic and described his symptoms and told them where he had been for about six weeks wuhan, china. A preliminary investigationou into a mystepneumonia outbreak in wuhan, china, has identified. Obrien that was a cruci detail. The mysterious new pneumos a viruckened dozens of people. Obrien for weeks, wuhan had been the center of a grong storm. Scientists in china trying. Obrien . As news trickled out about cases of a strange new pneumonia. Still a lot that is unknown, the w. H. O. Has said. Obrien in seattle, a city known for cuttingge medicine and technology as well as ties to asia, officials told me they had been on alert. It clearly had the ion of our Public Health folks, and they in turn were starting to line up the other departments, starting with human se, about how were going to respond when and if it arrived on our shores. Obrien at the cliere the man returning from wuhan was chances. Treatment, they took no at that point the clinic appropriately isolated him. De Health District contac the cdc, who advised testing. And fortunately that clinic had the appropriate gear to be abl to safely test the patient. Se he was then adto go home and quarantine. Obrien the clinic sent a nasal swabheyd taken from the man to the centers for Disease Control and prevention in atlanta. And then, witn 24 hours, we had a call from the cdc saying that the test was positive and at they wanted us to admit him for observation. Obrien e first covid19 patient had been confirmed in the United States. Around 10 00 p. M. On januaryon 20, patienwas brought to the providence Regional Medical center. This is a photograph of his arrival, encased in whats called an isopod, designed to keep a patient quarantined. Patient number one arrived here in this . He did. When we were going through the Transportation Plan with the ambulance company, they wanted to keep their staff safe. Completely contained, doesnt allow any possibility of infection. So our patient was pd in this by ems and brought to our hospital and unloaded in his room. So, it took us about two hours from the time the cdc called for us to get all our staff personnel, supplies, and the facilities all in place to beve able to he ems folks the greenlight to come in. Obrien you did at in two hours . R in two hours. We were ready fo. Obrien one of the reasons they were so ready less than three weeks earlier, diaz and his lleagues had conducted elaborate simulation pandemic training. W were aware of what was going on in wuhan at that point, but it was part of our routine structure already to prepare. Obrien you really had a goto plan. We had a game plan in place alady. We had everyone involved, including the local ems, those people that bring the patients from point a to point b, Public Health officials, and other partners we have in the community to drill. So we had a variety of scenarios we went through. Obrien by the time patient one was hospitalized, local Public Health officials wereto going inigh gear. The reason Washington State found that first casause we were ready for it. The Ambulance Service was ready, they knew the right personal protective equipment to wear, it was one of those absolute coordination between the health care, local health, state health, and the cdc. It went perfectlow thatse were able to find the first case in the country. Obrien it was a critical Early Warning sign that the highly contagious coronavirus could be spreading in the u. S. But in his first public comments, President Trump dismissed any threat trest of the country. Have you been briefed by the cdc . I have. A there worries about a pandemic at this point . No, not at all. And were. We have it totally unntrol. Its one person coming in from china, and we have it under control. Its going to be just fine. All right. Sa travels. Thank you. Obrien in seattle, doctors and scientists werent so sure they didnt have a way to test for coronavirus on their own. And while the cdc had been able to test the sample from patient one, it didnt yet have a test it could deploy on a massive scale around the country. The way to really know the burden of disease in your community is to beble to test. So the testing piece was a huge pie of the puzzle that we didnt really fully. We werent fully able to address. Obrien by early february, with the virus spreading around the globe, the World Health Organization was recommending test kits that had been developed in germany. But u. S. Officials made a own way. Decision to go their if you look at a moment when the United States may have lost its ability to control whats happing, it begins with the decision early on in 2020 by the cdc not to utilize the test kits and the capabilities that were being shared by the World Health Organation and other nations. obrie cdc wouldnt talk to me on camera, but told me they took the swiftest path and using another nationst ould have caused worse delays. Former cdc dector tom frieden said the decision made sense. Theres never been a time previously when there was a neet to uset from outside because the cdc system has not failed in the past. Obrien the cdc began shipping its own test kits tobl health labs around the country. But in seattle and elsewhere, it was quickly obvious that something was wrong. T one of tee chemical probes was faulty, generating inconclusive results. There were checks and balances within the test. And when we vadated can it t te the virus and can it not overdetect it, tlance was not correct. Research and implementation laboratories said, you know, this doesnt work. Youve given us a bogus kit, and were not going to use it. Fix it, fast. You know, or give us t right to use our ownits. Obrien at the university of shington i met virologist Alex Greninger, whod been trying to do just that. You got to have the supply of testing, absolutely do. We need to be able tct where the virus is and then try and snuff it out, i mean, right . Prevent its transmission, thats the name of the game in the coming months. Obrien but he ran into a bureaucratic brick wall the food and Drug Administration hae institutrgency procedures accurate. Ure any new tests were but you have to seto the tests, fda and get it reviewed and then authorized. And ill admit, im in my first couple of years here in th particular job, i had not been through this process before. Obrien the fda application was 28 pages long, andequiredun him to r tests that would takeee at least two. And that wasnt all. One of the things is th needed a document fedexed across the country before they coullook at the document. Obrien you couldnt electronically transmit it . I could electronically transmit it, but they t look at it until it was fedexed. And then they changed that regulation. M and so fcouple days after february 4 all the way to february 26, they didnt have a test, they were completely blind, too. Obrien this had to be incredibly frustrating. It was frustrating, it was. So we try to prioritize things in the top tier. Orien the fda told me it did review greningers application but it was incomplete. Theylso said they were balancing the need for tests with concerns about accuracy. Major developments, a Global Health emergency as the corovirus reaches its 20th country. Obrien in seattle a and around the world, the clock g. The coronavirus is now coidered a Global Health emergency and the us is warning people not to travel to china. Obrien the w. H. O. Had declared a global emergency, and the cdc was beginning to screen passengers at u. S. Airports, including seattle. We are coordinating with the chinese vernment and working closely together on the coronavirus oureak in china. Obrien President Trump was still not raising alarms, though he banned foreign travelers from china. My administration will take all necessary steps eguard our citizens from this threat. B obrien buthat time, flights from the outbreak zone. Ad been landing at u. S. Airports for wee the travel ban may have t bought us someime, but in all actuality, you know, people were leang wuhan, going to beijing, traveling to western europe and ultimely to the United States in late 2019 and early 2020 anyway. Chinese health ofs said today another 46 people have died from the coronavirus. Obrien in tse critical first weeks after the arrival of the virus in the u. S. , Administration Officials and the president himself continued to insist that the risk was small. I want to emphasize that this is a Serious Health situation in china, but i want to emphasize that the risk to the americanre public cly is low. How concerned are you . Well, we pretty much shut it down coming in from china. Weve offered china help, but we cant have thousands opeople coming in who may have thisor problem, theavirus. But we did shut it yes. Happens, obrien that attitude didnt sit well with washingtons senior democratic senator patty murray. She spoke to me from her home. Li i fel at the time i lived in two different worlds. I lived here in washington stat where people were going oh, my gosh, we have a problem, and in washington d. C. , where theyday, oh, you guys worry too much out in the west coast. Obrien a tale of two of washingtons. Yeah. We should have pulled out all the stops and checked everything, but it was more like, oh, you guys quit worrying out there. Obrien there was a lot to worry about. In isolation at provence hospital, patient one was deteriorating. He began developing more shortness of breath. And because of that we got an xray which looked like he had a developing pneumonia. His oxygen levels in his blood re also decreasing. Obrien that worried dr. Dire medical reports out ofthe wuhan. Ir it appeared, based t data, that once patients begin developing pneumonia that many of them end up in thon a ventilator and die. Obrien patient one was slipping fast, and there was no known treatment. Dr. Diaz told me hed heard about an antiviral drug called remdesivir that some experts erought could potentiallhelp. It would be an eent, he said, but the patient was willing. At that point, i contacted the fdand gilead, the manufacturer, to see if they would approve it. So the fda gave us an approvalt to try a compassionate use basis, knowing that it had not been approved yet and that there were no trials available to base thatecision on. We infused it the next day. He was still having very high fevers and still was requiring oxygen the day that we gave itto im. By the next day, his fevers resolved and they stayed gone. He felt much better. He felt like he had startedru beating the obrien no one knew if the drug had an pact, or ithe virus was taking its natural course. Heres the thing, you have one data point here. One person in the world. Obrien yeah, in the world. It was an anecdote, and so we were hpy that the patient got better and was ultimately continuing to get better, able to go home. So that part was fantastic for the patient. We knew then that we needed to caudy this in a formal cli trial. Obrien although patient one was well enough to be sent home, for Public Health officials in Washington State, ere were many more questions to answer. They needed to find out who patient one might have come in contt with after returning from china and send samples from them to the cdas well. So, we find contacts, seone that you spend at least ten minutes of time talking face to face with. Ie we ident60plus contacts. We swab them multiple times toe see was thtransmission of this virus. And we found absolut ansfer amongst those contacts that this first case had. In obrien waons governor, jay inslee, remembers this as a brief, optimistic moment. I interviewed him remotely from his office at the state capitol. What we were thinking is we were very much on top of it because we did very extensiveg contact tracth all of the contacts that the person had who was the first patient and did lyeverything epidemiologic that you could ask a Public Health system to do. Obrien but soon more signs of trouble began to appear across Lake Washington in the cityf kirkland at the life care Skilled Nursing and rehab center. Scott sedlacek had brought h 86yearold father there to recover from a bad fall. So, he hit his head hard enough that he had some brain trauma and bleeding on the brain and he broke his right ankle. And the bed that opened up was at life care. And so, on februy 20, we moved my dad to life care. E and thenarted seeing some of the staff wearing respiratory gear, wearing face masks, wearing gloves. Its kind of like, whats going on . Obrien inside life care, residents had been getting sick with an unknown respiratory infectn. The sickest were brought to e nearby evergreenhealth medical center. Dr. Francis riedo is the medical director of Infection Control here. Remember, this was flu season. And wed already had a peak of influenza b in december, and now we were going through the peak of influenza a. And so the unit was full of respiratory infections. In the meantime, in the background, were wahing these events unfold with increasing alarm, not only in wuhan, and now spreading across the globe and wondering when o turn was coming. Obrien until that point, federal guidelines for testingl potentiases were very narrow patients had to have be in a hotspot li china or in contact with someone infected. Then, the rules changed. Dr. Riedo wasted no time. We settled on two individuals and we tested them the following morning. I had a regular day, saw patients in clinic, saw patients in the hospital, was sitting there as i usually do trying to complete my notes and ceived a call at 7 40 p. M. And both othe tests were positive. Obrien what goes through your mind . My initial honest response was skepticism. I thought the odds of both individuals being positive with no history of travelno history of exposure to anybody was fairly astronomical. Th was a huge shift. Incident command was activated and we made a quk decision to thtest nine additional peoat nit. Eight of those nine were positive. Obrien wow. Right. Obrien kind of stunning actually, isnt it . It was, and within the firstd fis, we had 32 positives. Obrien many were from life care, but crucially, some had connection to the nursing home. We then knew that this was a much bigger outbreak than you could have imagined. Obrien at least 41 life care residents and two visitors would eventually die with more linked to the home testing positive, including scott sedlaceks father, chu he has never shown symptoms. Obrien so, how worried are you that symptoms might appear . Extraordinarily. Because we dont kw, this is new, its uncharted waters. Obrien the sedlaceks story hit home for me my 84yearolda father is isd living in florid hellthere. Can you tilt down a little bit . Im sorry what . obrilt down, til down, a little more down. There you go, thats good. How you feeling . Well, im fine, how are you . Obrien no coronavirus so far, but hes pretty much in isolation, no visitors allowed its the same at life care, but the sedlacekhave found a way around that. My sister is here and well go up d will say hi through the wiow. We brought a big white board today so we can actually write notes use theyre double pane windows seal the noise t. laughs can you hear us .