Much bigger outbreak than you could have imagined. Narrator and, the tale of two shingtons. That governor is a snake. Okay. Inslee. We are not going to be distracted by any rhetoric that the president or anyone else uses. Facts and science. Thats the only thing thats going to get us through this. Narrator now on frontline, coronavirus pandemic. Frontline is made posble by contributions to your pbs thank you. Om viewers like you. And by the corporation for public broadcasting. Injor support is provided by the john d. And catht. Macarthur foundation, committed to building more jt, verdant and peaceful world. More information at macfound. Org. The Ford Foundation working with visionaries on the frontlines of social change worldwide. At fordfoundation. Org. Ad tional support is provided by the abrams foundation, committed to excellence in journalism. The park foundation, dedicated to heightening Public Awareness of critical issues. E hn and Helen Glessner family trust. Supporting trustworthy jourlism that informs and inspires. And by the frontline jonalism fund, with major support from jon and jo ann hagler. seagulls squawking, siren 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 vibrant restaurant scenes, sma businesses flourishing. And we went from that to almost zero overnight. ship horn blare miles obrien i arrived 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. Ive covered science stories for nearly 30 years, but this felt more like science fiction. The deadly diseaseovid19 was about to bring the country and the world to its. Its like watching a slowmoving landslide move towards you. Obrien how did it evade oun g systems, our best science . F a lotople died because we werent ready. Obrien why was our government so slow to act, so unprepared . I havent cried ever as much as i have in the last week. obrid what lies ahea i came to seattle looking for answers. My first stop. How are you . Providence Regional Medical center in nearby everett. And have you traveled outside the u. S. In the last 30 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 infs one a 35yearolld patient 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, hey generalt poorly and he had been complaining of diarrhea at home. Obrien he is 35 years old and otherwise healthy. Totally healthy person. He began developing symptoms the day after he aived. Obrien he went to this walkin clinic and described his symptoms and told them where he eehad been for about six w wuhan, china. A preliminary investigation into a mysterious pneumonia identified. Uhan, china, has obrien that was a crucial detail. The mysterious new pneumonia virus has sickened doz people. Obrien for weeks, wuhan had been the center of a growing storm. Scientists in china trying. Obrien . As news tricklede out about of a strange new pneumonia. Still a lot that is unkno, the w. H. O. Has said. Obrien in seattle, a city known for cuttingedge medicine and technology as well as ties to asia, officials told me they had been on alert. It clearly d the attentio of our Public Health folks, and they in turn were starting to line up the other departments, starting with human services, about how were going to responn nd if it arrived on our shores. Obrien athe clinic where the man returning from wuhan was seeking treatment, they took no chances. At that point the clinic appropriately isolated him. The health districcontacted the cdc, who advised testing. And fortunately that clinic had the appropriate gear to be able to safely test the pat he was then advised to go home and quarantine. Obrien the clinic sent a nasal swab theyd taken from the control and prevention insease atlanta. And then, within 24 hours, we had a call from the cdc saying that the test was positive and u that they wantto admit him for observation. Obrien the first covid19 patient had been confirmed in the United States. Around 100 p. M. On january 20, patient one was brought to the providen Regional Medical center. This is a photograph of his arrival, encased in whats called an isopod, designed to keep a patient quarantined. Patient number onehe arrived in this . He did. When we were going through the Transportation Plan with tho f bulancany, they wanted to keep their stfe. Completely contained, doesnt allow any possibility of infection. So our patient was placed 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 be hele to give the ems folks greenlight to come in. Obrien you did that in two hours . In two hours. Weere ready for it. Obrien one of the reasons they werso ready less dian three weeks earlier, az and his colleagues had conducted an elaborate simation pandemic traing. We were aware of what was going on in wuhan at that point, but it was part of our routine structure already to prepare. En obyou really had a goto plan. We had a game plan in place already. 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, localpu blic Health Officials were going into high gear. The reason Washington State found thatirst case cause we were ready for it. The Ambulance Service was readyh they kneright personal protective equipment to wear, it was one of tse absolute coordination between the health care, local heal, state health, and the cdc. It went perfectl fthats howe were able d the first case in the country. Obrien it was a critical earlwarning sign that the highly contagious coronavirus could be spreading in the u. S. F but in hisst public comments, President Trump dismissed any threat to the rest of the country. Have you been briefed by the cdc . Are there worriut a pandemic at this point . No, not at all. And were. We have it totally under control. Its one person coming in from china, and we have it undernt l. Its going to be just fine. All right. Safe travels. Thank you. On your waback. 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 be able to test. So the testing piece was a huge piece of the puzzle that we didnt really fully. We werent fully able to address. Obrien by early february, with the viruspreading around the globe, the World Health Organization was recommending test kits that had been developed in germany. But u. S. Officials made afa ful decision to go their own way. 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 oin 2020 by the cdc not to utilize the test kits and the capabilities that were being shared by the World Health Organization and othe nations. Obrien the cdc wouldnt talk to me on camera, but told me they took the swiftest test would have caorse nations delays. Former cdc director tom friede said the decision made sense. Theres never been a time previously when there was a need to use a test from outside because the cdc system has not iled in the past. Obrien the cdc ben shipping its own test kits to Public Health labs around the country. But in seattle and elsewhere, ii was quickly s that something was wrong. One of the three chemical probes was faulty, generating inconclusive results. T re were checks and balances within the test. And when we validated can it detect the virus and can it no overdete it, that balance was not correct. Research and implementation laboratories said, you kw, this doesnt work. Youve given us a bogus kit, and re not going to use it. Fix it, fast. You know, or give us the right to use our ownits. Obrien at the university of washington 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 bable to detect 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 hean into a bureaucratic brick wall the food and Drug Administration had instituted emergency procedures to make sure any new tests were accurate. You can make your own tests, but you have to send it to the fda and get it reviewed and then authorized. And ill admit, im in my first couple of years here in this particular job, i had not beenth rough this process before. Obrien e fda application was 28 pages long, and required ulhim to run tests that wotake at least two weeks. And that wasnt all. One of the thin is they needed a document fedexed across the country before they could look at the docunt. Obrien you couldnt electronically transmit it . I could electronically transmit it, but they couldnt look at it until it was fedexed. And then they changed that regulation. Ted so from a couple days 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. Obrien the fda told me it did review greningers application but was incomplete. Theylso said they were balancing the need for tests with concerns about accuracy. Health emergency as thea global coronavirus reaches its 20th country. Obrien in seattle and and around the world, the clock g. The coronavirus is now considered 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 passengers at u. S. Airports,een including seattle. Or we are nating with the Chinese Government and working closely together on the enronavirus outbreak in china. Obrien prestrump was still not raising alarms, though he banned foreign travelers from china. My administration will take all necessarsteps to safeguard our citizens from this threat. Oben but, by that time, flights from the outbreak zone had been landing at u. S. Airports for weeks. The travel ban may have bought us some time, but in all actuality,ou know, people were leaving wuhan, going to beijg, traveling to western europe and ultimately to the United States in late 2019 and early 2020 anyway. Chinese hlth officials said today another 46 people have died from the coronavirus. Obrien in those critical urst weeks after the arrival of the virus in the. S. , Administration Officials and the president mself 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 American Public currently 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 of people coming in who may have this probm, the coronavirus. So were gonna see what happens, but we didhut it down, yes. Obrien that attitude didnt sit well with washingtons senior democratic senator patty murray. She spoke to me from her home. I felt like at the time lived in two different worlds. I lived here in Washington State, where people were going, oh, my gosh, we have a prlem, and in washington d. C. , where theyd say, oh, you guys worry too much out in thewe coast. Obrien a tale of two of washingtons. Yeah. The stops and checled out all everythingbut it was more like, oh, you guys quit worrying out there. Obrien there was a lot to worry about. In isolation at Providence Hospital, patient one was deteriorating. E gan 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 were also decreasi. Obrien that worried dr. Diaz, whod been following theic dire m reports out of wuhan. It appeared, bad on their data, that once patients begin developing pneumonia that many of them end up in the icu on a ventilator andie. Obrien patient one was slipping fast, and the was no known treatment. Dr. Diaz told me hed heard about an antiviral drug called remdesivir that some experts thought could potentially help. It woulde an experiment, he said, but the patient was willing. At that point, i contacted the fda and gilead, the manufacturer, to see if they would approve it. So the fda gave us an approval to try it on a compassionatese basis, knowing that it had n been approved yet and that there were no trials available to base that decision on. We infused it the next day. He was still having very high fevers and still was requiring oxygen the day that we gave it to him. By the next day, his fevers resolved and they stayed gone. He felt much better. He felt like he had started beating the virus. Ri o no one knew if the drug had an impact, or if the virus was taking its natural course. Heres the thing, you have one data poi here. One person in the world. Obrien yeah, in the world. D it was an ae, and so we were happy that the patient got tter 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 study this in a formal clinical trial. Obrien although patient one was well enougto be sent home, for Public Health officials in Washington State, there were many more questions to answer. They needed to find out who patient one might have come in contact with after retning from china and send samples from them to the cdc as well. So, we find contacts, someone that you spend at least ten minutes of time talking face to face with. Ts identified 60plus cont we swab them multiple times to sefwas there a transmission this virus. And we foundbsolutely no ansfer amongst those contacts that this first case had. Obrien washingtons governor, jay inslee, remembers this aief, optimistic mont. I interviewed him remotely from his office at the state capitol. What we were thinking is we were very much on top of it becae we did very extensive contt tracing with all of th contacts that the person had wh e first patient and did everything epideologically that you could ask a Public Health system to do. Obrien but soon more signs of trouble began to appear across lake shington in the city of kirkland at the life care Skilled Nursing and rehab center. Scott sedlacek had brought his86 yearold father there to recover from a bad fall. So, he hit his head hard 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 february 20, we moved my dad to life care. And then we started seeing some of the staff wearingespiratory gear, wearing face masks, wearing glov. Its kind of like, whats going on . Obrien inside life care,si nts had been getting sick with an unknown respiratory infection. The sickest were brought to e arby evergreenhealth medical center. Dr Francis Riedo is the medical director of Infection Control here remember, this was flu season. Dy and wed alrad 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 individuals with severe respiratory infections. In the meantime, in th background, were watching these events unfold with increasing alarm, not only in wuhan, and now spreading across the globe and wondering when our turn was coming. brien until that point,fe deral guidelines for testing potential cases were very narrow patients had to hav be in a hotspot like china or in contact with someone then, the rules chged. Dr. Riedo wasted no time. We settled on two individuals and we tested them the following morning. I had a regular day, sawti ents in clinic, saw patientsl, in the hospita was sitting there as i usually do trying to complete my notes and received a call at 7 40 p. M. And both of the sts were positive. Obrien what goes through your mind . My initial honest response was skepticism. I thought the odds of both tests in two randomly selectedal indivibeing positive with no history of travel, no history of exposure to anybody wasmi fairly astrol. This was a huge shift. Incident command was activated and we made a quk decision to test nine addition people that night. Eight of those nine were positive. Obrien wow. Right. Obrien kind of stunning actually, isnt it . It was, and within the first five days, we had 32 positives. Obrien many were ife care, but crucially, some had no connection to e 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 than a hundred others linked to the home testing positive, includg scott sedlaceks father, chuck. Ne he har shown symptoms. Obrien so, how worried are you th symptoms might appear . Extraordinarily because we dont know, this is new, its uncharted waters. Obrien the sedlaceks story hit home for me my 84yearold faner is in assisd living florida. Hello there. Can you tilt down a little bit . Im sorry what . Obrien tilt down, tilt down, a little more down. Ere you go, thats good. How you feeling . Well, im fine, how are you . brien no coronavirus so far, but hes pretty much in isolation, no visitors allowed. Its the same at life carebut the sedlaceks have found a way around that. My sister is here and wellwi go up an say hi through the window. We brought a big white board today soe can actually write notes use theyre double pan