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Edit Summary: Overview[edit]

Edit criteria[edit]

The criteria have been a great help during editing. The "Pandemic chronology" is presented as a chronology of virus progression and clinical measures. There is good reason to focalize these themes, and in making a visible contrast to administrative actions as well as social reactions. These last are represented in the section "Events, reactions, and measures", and naturally include 'many things', but essentially politic and scientific activity, social reaction and media. The focalization enables storytelling, as there is some - more or less natural - divide between the frontline engagements of healthworkers, and whatever else might be happening. Likewise, stories of institutional administrative and scientific efforts are better profiled in their own context. This is an extremely relevant heuristic for retelling the beginning of the pandemic: The virus progression and clinical measures is a dramatic focus on how things suddenly started to change, at the meanwhile stories of institutional administrative and scientific efforts shift the dramatic focus onto the intellectual realm.

Issue of patient data[edit]

Here's an example of data concerning one patient, as referred by Gao Yu,26 Feb 2020 [Caixin Online][1]

  1. 12/15 onset
  2. 12/18 hospitalization ; Wuhan Central Hospital
  3. 12/22 icu
  4. 12/24 sample
  5. 12/25 transfer ; Wuhan TongJi Hospital
  6. 12/27 quarantine
  7. 12/29 transfer ; Wuhan JinYinTan Hospital

While there is a natural sentiment connected to the story of one person, it makes little sense to include this information in a timeline of the pandemic. The one notable exception is the index case. Also exceptionally is patient data details for those patients that connect to the first clinical awareness.

Source issue[edit]

Some sources have been clipped from the article. The typology is that their content is tangential for the information referred, and overall bringing with them a tone of suspicion. The other important characteristic is that sources come from notable media. These two characteristics put together indicate something amiss, either here or there, in explitio a reason to be suspicious. The final criteria, for being clipped, is that alternative, neutrally-toned and in most cases also more comprehensive sources have been found - if, of course the information is actually relevant. But, there is still lingering this notion of suspicion, which can be conveniently summarised as two aspects:

  • An investigation of the early affairs is necessary
  • News media are telling stories of their own, without contributing original information

The decision to cut out the sources seems to me necessary but at the same time consequence - from my viewpoint - a gloss over how the story was told to the public during the pandemic. A timeline over how the story was told by the media, where the sources appear under their date of publication, would be ideal - which I think is also a feasible perspective on the current text in the timeline articles for November-December 2019 and January 2020.

Jumbled issue[edit]

Especially the text belonging to sections of 30 December and 31 December. Most concrete are the faulty or tangential references.

Edit Summary: Details[edit]

_DELETE >

Late November[edit]

A news media report by the South China Morning Post on 13 March 2020, however suggested that one man, aged 55 years, could have been infected on 17 November 2019.[D 1]

_COMMENT

Source unsubstantial. Reporter's claim of knowing cannot be documented.


_DELETE <
_NB rephrased >

1 December(nb)[edit]

A retrospective study published in The Lancet on 24 January 2020 revealed that the earliest laboratory confirmed case of COVID-19 was in a man whose symptoms began on 1 December 2019, and that he had not been to the Huanan Seafood Wholesale Market of Wuhan. No epidemiological link could be found between him and the others of the first confirmed cluster of 41 cases, which had mostly been discovered using the national pneumonia surveillance system.[x 1][D 2][J 1][x 2]

_COMMENT

Unsourced or debatable claim concerning the PUE implementation. Li et al. (China CDC Weekly,p79) mentions the implementation that might have taken place just at 31 December, following the arrival of Chinese CDC team in Wuhan. Admittedly, both Li et al. (N Eng J Med,p1200) and Cohen (Science) associate the PUE praxis with the first clinical detection. Especially Li et al. (N Eng J Med,p1200) is explicit in saying the re-implementation of the PUE was set to use on 3 January 2020. In other words, these early cases do not correlate to the claim of patient zero (here, in the Wikipedia article) being detected in this way. (#3 January) Mentioning the 'cluster of 41 patients' is only complicating the paragraph.


_ NB <
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10 December[edit]

The Wall Street Journal reported on 6 March 2020, that one of the earliest affected cases was a 57-year-old seafood merchant working at the Huanan Seafood Wholesale Market, whose symptoms began on 10 December.[D 3][D 4]

_COMMENT

RE:#Issue of patient data Irrelevant. Inclusion of patient data.


_DELETE <
_MOVE dec,part1→jan,part2 rephrase pending #9 January >

12 December[edit]

The earliest onset of symptoms of pneumonia of unknown etiology was at one time recorded as 12 December, when Chinese authorities reported on suspected cases up to 5 January 2020.[J 2]

_COMMENT

Obsoleted. Could be included at latest date of assumption.


_MOVE dec,part1→jan,part2 rephrase pending <
_MOVE dec,part1→jan,part2 rephrased #25 January >

18–29 December[edit]

Five people with severe pneumonia admitted to the Wuhan Jin Yin-Tan Hospital from 18 to 29 December at the beginning of the outbreak were the subject of a study published in January 2020 in the Chinese Medical Journal. Bronchoalveolar lavage fluid (BAL) that was eventually used for viral genome sequencing was collected from these patients between 24 December and 1 January. In another study later published in Nature, samples from 7 ICU patients were collected on 30 December and sent to the laboratory at the Wuhan Institute of Virology for the diagnosis of the causative pathogen. Patient ICU-01 was not proven to be linked to the Wuhan Seafood Market, but the other six were either sellers or deliverymen at the market.[J 3][x 3]

_COMMENT

Irrelevant. Information is partly notable, for mentioning the study presumably most close to the initial scientific awareness of Sars-CoV-2. A recent edit did confuse matters, by referring to yet another study, without any source link. The Wikipedia article text mention patient data and clinical measures, scientific engagement and publication dates - summarily said, an ultra-short abstract of two scientific studies. This is a good heuristic, in a timeline showing the scientific progress. The proposed rephrased text should go to 25 January. Patient data - so far as relevant - and clinical measures, including the naming of involved hospitals, have been duly noted in the present version, at #24 December, #27 December, #29 December, although these mentions were already in place.


_MOVE dec,part1→jan,part2 <
_MOVE dec,part1→jan,part2 #21 January >

21 December[edit]

Chinese epidemiologists published an article on CCDC Weekly (Chinese Center for Disease Control and Prevention) on 21 January 2020 stating that the first cluster of patients with "pneumonia of an unknown cause" occurred beginning 21 December 2019 and that the virus was more prevalent in older adults.[J 4]

_COMMENT

Unsourced claim. Information (without "first") is partly notable, mentioning a CDC study. Again, mentioning scientific engagement and publication dates/an ultra-short abstract points to the scientific progress and an inclusion by the publication date of the study.


_MOVE dec,part1→jan,part2 >
_NB rephrased >

24 December(nb)[edit]

Doctors from Central Hospital of Wuhan took fluid samples from the lungs of a 65-year-old deliveryman who worked at the Wuhan seafood market and sent them to Vision Medicals, Guangzhou, for testing.[x 3]

_COMMENT

Emphasis on virus detection, which is - at this stage - not a clinical matter but a scientific proces. Notable in this section, on virus evolution and clinical measures, because it brings attention to the fact that it was the clinically unresolved situation that motivated the request for a genetic analysis.


_NB <
_MOVE dec,part1→jan,part2 #28 January >

25 December[edit]

According to the China Youth Daily, Wuhan Fifth Hospital gastroenterology director Lu Xiaohong said that she heard some hospital staff might be infected on 25 December.[J 5]

_COMMENT

Hearsay. Could be qualified as 'leak' or 'field observation'. Nature of information almost certainly defies possible documentary evidence. Notable because )it shows controversial matter expressed in Chinese media )it might be a useful information for investigative purposes. In the context of being part of a Wikipedia article it is not proper to let hearsay be the source of information. The real substantial information is that Chinese media express a concern on controversial matters, and the valid inclusion in a timeline arrangement is therefore the date of the report.


_MOVE dec,part1→jan,part2 <
_NB rephrased >

26–27 December[edit]

Zhang Jixian, director of the Department of Respiratory and Critical Care at Hubei Provincial Hospital of Integrated Chinese & Western Medicine, examined an elderly couple who presented themselves at the hospital with fever and cough on 26 December 2019.[x 4] Having observed that CT scans of their chests showed a different pattern from other viral pneumonias, she asked the couple's son to undergo a scan and found the same pattern, although he had no symptoms. Another patient, a merchant from the Huanan Seafood Wholesale Market, also arrived at the hospital with fever and cough that day. Zhang, having conducted tests to rule out known respiratory ailments and believing this to be an infectious disease, reported the four cases to her superiors at the hospital on 27 December 2019.[D 1][x 5]

_COMMENT

RE:#Source issue Rephrased with added information. Also avoiding the doubled date entries.


Vision Medicals had sequenced most of the virus from fluid samples of the 65-year-old deliveryman sent by Central Hospital of Wuhan on 27 December. The results showed an alarming similarity to the deadly SARS coronavirus between 2002 and 2003.[1][D 5]

_COMMENT

RE:#Source issue


28–29 December[edit]

During the following two days, Hubei Provincial received three similar cases, all associated with the seafood market. On 29 December, hospital administration convened a multi-departmental panel of doctors who concluded the cases were unusual and required special attention, whereupon they reported their findings to the provincial CDC.[x 5] Wuhan CDC staff initiated a field investigation and found additional patients with similar symptoms who were linked to the market. (According to a CCDC publication, the initial admissions to Hubei Provincial Hospital occurred on 29 December.)[2]

_COMMENT

Rephrased with added information. Also avoiding the doubled date entries. The CDC report seem to sum up, rather than give detail. This could be profiled in the Wikipedia article text, but I have chosen not to.


30 December(nb)[edit]

A genetic sequencing report from CapitalBio Medlab of Beijing on the pathogen of a 41-year-old patient the sample of which was collected by Wuhan Central Hospital mistakenly diagnosed as severe acute respiratory syndrome coronavirus (SARS coronavirus). This mistaken result alerted the authority and some of the Wuhan doctors.[x 3]

_COMMENT

Unsourced claim: "This mistaken result alerted the authority(..)"


Multiple doctors in Wuhan shared the test report via internet, including Li Wenliang, an ophthalmologist at Wuhan Central Hospital, who posted a warning to alumni from his medical school class via a WeChat group in the late afternoon that a cluster of seven patients treating within the ophthalmology department had been unsuccessfully treated for symptoms of viral pneumonia and diagnosed with SARS.[D 6][x 3][D 7]

In the WeChat post, Li posted the erroneous diagnostics that "there had been 7 confirmed cases of SARS".[D 8]

Li posted a snippet of an RNA analysis finding "SARS coronavirus" and extensive bacteria colonies in a patient's airways.[D 9]

_COMMENT

RE:#Source issue Repetitive and jumbled but partly notable information. Although information concern social media, and another arena or event horizon in the pandemic, this particular reaction seems to concern and affect the hospital environment, just when the first soundings of the outbreak becomes tangible. The specifics and high-profiling of Li Wenliang is also notable information, and duly mentioned in the "Events, reactions, and measures" section.


_NB <
_DELETE >

Because these patients did not respond to traditional treatments, they were quarantined in an ER department of the Wuhan Central Hospital.[D 10]

_COMMENT

Erroneous. The source is a 'tweet' from "PingAnWuHan" that summarizes the prosecution of doctors in Wuhan, an article from Xinhua News following the incident of 30 December 2019. Possibly this is a jumble-issue. RE:#Jumbled issue

_DELETE <
_NB rephrased >

Wuhan Municipal Health Committee issued an "urgent notice on the appropriate treatment to patients with pneumonia of unknown cause" to medical institutions under its jurisdiction.[x 6][x 7][D 11][x 8]

_COMMENT

RE:#Jumbled issue One source, a public announcement in the affairs of Li Wenliang, has been cut. Another source, 'Deutsche Welle' has been moved to date of publication and reading the source as a reaction. It also mostly concerns the public message from Wuhan falling that date. Yet another source, the CCTV timeline, has been moved to #External links.


News of an outbreak of "pneumonia of unknown origin" started circulating on social media on the evening of 30 December 2019.[x 9][x 10]

The WHO noticed these reports, and sought more information as a matter of urgency.[x 11]

_COMMENT

Unsourced claim: News of an outbreak of "pneumonia of unknown origin" started circulating on social media on the evening of 30 December 2019. Just as a precaution it may not be proper to read the information from 'South China Morning Post' and 'Reuter' at face-value. 'Reuters' seem to be quite understandably entangled in the social media rumours from Wuhan Central Hospital, concerning SARS. Apart from these rumours, it is therefore not clear, just based on 'Reuters', what rumours exactly are present at 30 December 2019 in the Chinese social media. These sources, 'South China Morning Post' and 'Reuters' are not succinct enough to be used here. They are notable news agencies, and their reports, as such, are notable for inclusion at the date of publication, 31 December. The mentioning of WHO noticing something is unclear, in the Wikipedia article and in The Guardian. The first ProMed awareness is dated 30 December 23:59:00, and perhaps the timelapse and a presumed information pathway between ProMed and WHO is likely.


31 December(nb)[edit]

The Wuhan Municipal Health Committee informed WHO of 27 "cases of pneumonia of unknown etiology (unknown cause) detected in Wuhan."[x 12][D 12]

_COMMENT

Unsourced claim.


There had been "a successive series of patients with unexplained pneumonia recently"—27 suspected cases in total, seven of which were in critical condition and 18 were stable, two of which were on the verge of being discharged soon.[x 7][x 13][x 8]

_COMMENT

RE:#Source issue Rephrased as case statistics.


The People's Daily said the "exact cause remained unclear and it would be premature to speculate."[x 9][x 10][D 13][x 7]

_COMMENT

Quote is from South China Morning Post.


_NB rephrased <
_DELETE >

As a result of the official announcement of the Wuhan Municipal Health Commission, Hong Kong, Macau and Taiwan immediately tightened their inbound screening processes.[D 14][D 15]

_COMMENT

Unsorced claim.


Taiwan said it had heard about mainland medical staff getting ill,[D 16]

_COMMENT

Unsourced claim.


China and Taiwan both notified the World Health Organization (WHO) of a new virus on 31 December 2019.[D 17]

_COMMENT

Source tangential. Information seem to be irrelevant: What information value could Taiwan message possibly contain? This was my POV. Information is notable and has been included. (Source:[x 11] )


In March 2020, Taiwan claimed that the WHO had ignored a warning about human-to-human transmission in its email and failed to communicate with the state, which is not a WHO member due to diplomatic pressure from China.[D 18][D 19]

and Taiwan CDC chief Chou Jih-haw stated that WHO confirmed the UN body had received the letter but did not respond to it.[D 20]

WHO disputed the claim that the email contained a mention of human-to-human transmission, and stated that the organization had considered the situation "very serious" since the first report.[D 20][D 21]

Taiwan admitted the email did "not state directly and conclusively that there had been human-to-human transmission" and argued it had "strongly hinted" at the possibility.[D 22]

In April, The Guardian reported that Taiwan's email was sent hours after China had gone public about the outbreak, and that it contained no new information for the WHO as the organization had obtained the same details a day earlier.[x 11]

_COMMENT

Irrelevant. Wrong timeline? Sources not consulted, may or may not actually support claim. The matter of human-to-human transmission was evidently raised some time in March.


20 December (Events)[edit]

On 20 December 2019, Winner Medical Group decided to cancel their executive meeting in Hubei.[D 23]

_COMMENT

Presumptive, leading, insinuating. Source of information is the webpage of the company showing their recent events schedule. Anyone reading the Wikipedi-article will make an association between the cancellation of a meeting at 20 December 2019 and the outbreak of Sars-Cov-2 in Wuhan. Anyone reading the webpage might not.


_DELETE <
_NB rephrased >

30 December (Events)[edit]

By the night of 30 December, local media in Wuhan informed public about the notice of urgency from Wuhan Municipal Health Committee. The notice began circulate around social media in China.[x 14]

_COMMENT

Maybe. The scan copies were at QQ and perhaps that's what First Finance alludes to when claiming they were "widely circulated" (广泛传播). Precisely how this was needs more solid or numerous source(s). The source nowhere make the claim it was local media.


_NB <
_DELETE >

31 December (Events)[edit]

A famous police officer in Jiangning District, Nanjing mentioned the BSL-4 laboratory of Wuhan Institute of Virology when commenting on the outbreak by expressing confidence on its technological power and ability to fix the incident.[D 24]

_COMMENT

Misleading. Even with no knowledge of Chinese or any other social media, I presume that this particular 'tweet' may be representative, inasmuch as it is a reassuring tweet made by a police officer. It would require rephrasing, since the Wikipedia article text place undue weight on his mentioning Wuhan Institute of Virology whereas the sentimental matter of creating confidence and reassurance is barely reflected.


_DELETE <

Deleted sources[edit]

  1. ^ a b Ma, Josephine (13 March 2020). "China's first confirmed Covid-19 case traced back to November 17". South China Morning Post. Archived from the original on 13 March 2020.
  2. ^ Cohen, Jon (26 January 2020). "Wuhan seafood market may not be source of novel virus spreading globally". Science | AAAS. Archived from the original on 27 January 2020. Retrieved 8 February 2020.
  3. ^ Oliveira, Nelson (27 March 2020). "Shrimp vendor identified as possible coronavirus 'patient zero,' leaked document says". New York Daily News. Archived from the original on 29 March 2020. Retrieved 27 March 2020.
  4. ^ Page, Jeremy; Fan, Wenxin; Khan, Natasha (6 March 2020). "How It All Started: China's Early Coronavirus Missteps". The Wall Street Journal. Archived from the original on 26 March 2020. Retrieved 27 March 2020.
  5. ^ Yu, Gao; Yanfeng, Peng; Rui, Yang; Yuding, Feng; Danmeng, Ma; Murphy, Flynn; Wei, Han; Shen, Timmy (28 February 2020). "How early signs of the coronavirus were spotted, spread and throttled in China". The Straits Times. Caixin Global. Archived from the original on 28 March 2020. Retrieved 5 April 2020.
  6. ^ "Chinese Coronavirus Whistleblower Li Wenliang Dies of the Disease – Caixin Global". www.caixinglobal.com. Archived from the original on 2020-02-07. Retrieved 2020-02-08.
  7. ^ Hegarty, Stephanie (6 February 2020). "The Chinese doctor who tried to warn about coronavirus". BBC News. Archived from the original on 6 February 2020. Retrieved 8 February 2020.
  8. ^ "情况通报2019年12月31日,武汉市卫健部... 来自平安武汉 - 微博". 2020-02-06. Archived from the original on 6 February 2020. Retrieved 2020-03-22.
  9. ^ Shih, Gerry (2020-02-04). "Chinese doctor Li Wenliang, detained for coronavirus warning, now has the illness". The Washington Post. Archived from the original on 2020-02-07. Retrieved 2020-03-30.
  10. ^ "Google Translate". translate.google.com.
  11. ^ 范梓萌 [Fàn Zǐ Méng] (19 March 2020). "关于群众反映的涉及李文亮医生有关情况调查的通报" [Announcement concerning the investigation of Li Wenliang's missteps of public response] (in Chinese). Xinhua News Agency. Archived from the original on 28 March 2020. Retrieved 28 March 2020 – via www.gov.cn.
  12. ^ Riou, Julien; Althaus, Christian L. (30 January 2020). "Pattern of early human-to-human transmission of Wuhan 2019 novel coronavirus (2019-nCoV), December 2019 to January 2020". Eurosurveillance. 25 (4). doi:10.2807/1560-7917.ES.2020.25.4.2000058. ISSN 1025-496X. PMC 7001239. PMID 32019669.
  13. ^ "China CDC Weekly". weekly.chinacdc.cn. Archived from the original on 2020-02-07. Retrieved 2020-02-08.
  14. ^ "Undiagnosed pneumonia - China (HU) (01): wildlife sales, market closed, RFI Archive Number: 20200102.6866757". Pro-MED-mail. International Society for Infectious Diseases. Archived from the original on 22 January 2020. Retrieved 13 January 2020.
  15. ^ Parry, Jane (8 January 2020). "Pneumonia in China: lack of information raises concerns among Hong Kong health workers". BMJ. 368: m56. doi:10.1136/bmj.m56. ISSN 1756-1833. PMID 31915179. Archived from the original on 8 January 2020. Retrieved 17 January 2020.
  16. ^ "Taiwan says WHO failed to act on coronavirus transmission warning". Financial Times. 20 March 2020. Archived from the original on 28 March 2020. Retrieved 21 April 2020.
  17. ^ Kessler, Glenn (17 April 2020). "Trump's false claim that the WHO said the coronavirus was 'not communicable'". The Washington Post. Archived from the original on 23 April 2020. Retrieved 23 April 2020.
  18. ^ Blanchard, Ben (11 April 2020). "Taiwan, WHO spar again over coronavirus information sharing". Reuters. Archived from the original on 20 April 2020. Retrieved 23 April 2020.
  19. ^ "Why Taiwan has become a problem for WHO". BBC News. 30 March 2020. Archived from the original on 31 March 2020. Retrieved 26 April 2020.
  20. ^ a b "Taiwan says WHO ignored its coronavirus questions at start of outbreak". Reuters. 2020-03-24. Archived from the original on 24 April 2020. Retrieved 2020-04-13.
  21. ^ AFP (10 April 2020). "WHO denies ignoring Taiwan's early coronavirus warning". The Straits Times. Archived from the original on 20 April 2020. Retrieved 21 April 2020.
  22. ^ CNA (11 April 2020). "Taiwan reveals email, blasts WHO for possible 'dereliction of duty'". Focus Taiwan. Archived from the original on 21 April 2020. Retrieved 21 April 2020.
  23. ^ 稳健医疗用品股份有限公司 (27 January 2020). "稳健医疗用品股份有限公司". www.winnermedical.cn (in Chinese (China)).
  24. ^ 王海丁 [in Chinese] (2019-12-31). "武汉这个事儿吧,要重视但不要恐慌。图二最 - 内容神器". 5CE.COM (in Chinese (China)). Archived from the original on 1 March 2020.

Kept[edit]

(full list → #References)
  1. ^ [ed. The Lancet article]
  2. ^ [ed. China CDC 2020 01 22]
  3. ^ a b c d [ed. caixin news report]
  4. ^ [ed. Global Times]
  5. ^ a b [ed. Sina News]
  6. ^ [ed. ProMED 2019 12 30]
  7. ^ a b c [ed. Deutsche Welle 2019 12 31]
  8. ^ a b [ed. CCTV timeline]
  9. ^ a b [ed. Reuters 2019 12 31]
  10. ^ a b [ed. South China Morning Post 2019 12 31]
  11. ^ a b c [ed. The Guardian March 2020]
  12. ^ [ed. WHO 2020 01 05]
  13. ^ [ed. Wuhan Municipal 2019 12 31]
  14. ^ [ed. First Finance 2019 12 31]

Pandemic chronology[edit]

From late January 2020 onwards a series of studies from different research teams published results ascertaining the clinical situation, and, as well providing preliminary analysis for characterizing the early evolutionary progress of SARS-CoV-2. Key technical terms in the genetic research are 'most recent common ancestor', or MRCA, and comparative studies of genomes using massive parallel sequencing or second-generation sequencing (NGS), both of which facilitated the discovery.

Worth emphasizing is that the early Chinese laboratory-confirmed cases have been determined in retrospect.[3]

November

According to an early preliminary study using phylogenetic analysis, the expert estimate suggested the most recent common ancestor (MRCA) evolved between 22 and 24 November 2019.[4][5] As of May 2020 this estimate was corroborated with a larger dataset, setting the date interval to "6 October 2019 – 11 December 2019", noting that the "SARS-CoV-2 global population has accumulated only moderate genetic diversity".[6] Also, although near-conclusive evidence points to bats as the natural reservoir host for the virus,[7][8] the path of transmission to humans - the zoonotic origin - most likely occurred via an intermediary wildlife host.[4][5] It was assumed[8] and further evidenced[7] that the novel coronavirus uses ACE2, the same entry receptor as SARS-CoV. It is possible that the ability for human-to-human transmission has evolved after the zoonotic transfer.[5]

1 December[edit]

A clinical study documents the index case, or patient zero - his symptoms started on 1 December.[9] The study summarized the laboratory-confirmed cases as of 2 January 2020, and although not explicit on every single case, it was noted the first case was male, had not been to the Huanan Seafood Wholesale Market of Wuhan, that his family was unaffected and that no epidemiological link between him and the other cases was found.[10] The BBC Chinese Service later confirmed that they had received information from Wenjuan Wu, one of the authors from the article in Lancet and who was one of Wuhan's JinYinTan Hospital's senior doctors, that this first man was in his 70s, had Alzheimer's disease, lived several bus rides away from the market and did not venture out from his home.[11][12]

16 December[edit]

The first documented admission to a hospital.[13]

24 December[edit]

An unresolved clinical case sparks off the first scientific involvement: A bronchoalveolar lavage fluid (BAL) sample is sent from Wuhan Central Hospital to Vision Medicals (广州微远基因科技有限公司) in Guangzhou - a private company specializing in metagenomic massive parallel sequencing analysis.[1][14]

26 December[edit]

An elderly couple, both suffering from fever and coughs, sought treatment at the Hubei Provincial Hospital of Integrated Chinese and Western Medicine (湖北省新华医院). Zhang Jixian, director of the Department of Respiratory and Critical Care examined the couple and made the preliminary diagnosis of their illness as something that "looked like flu or common pneumonia".[15][16][17]

27 December[edit]

After having observed the elderly couple's CT scans were abnormal, Zhang Jixian asked the couple's son to undergo a scan and found the same pattern. Zhang Jixian had been working as medical expert during the SARS outbreak in 2003, and was aware of the signs of an suspected outbreak of an infectious disease.[15][16][17]

Another patient, a merchant from the Huanan Seafood Wholesale Market,[17] arrived at the hospital with fever and cough that day, and his CT scan showed the same characteristics. All blood tests from the four patients indicated viral infection and a further array of influenza-related tests came back negative. Zhang Jixian filed a report to her superiors and also took the precaution of making a provisional quarantine area.[15][16][17]

Wuhan Central Hospital received message from Vision Medicals that the BAL sample taken on 24 December contained a new kind of coronavirus, and the patient was then quarantined[18] Also at Wuhan Central Hospital, yet another unresolved case caused a BAL sample to be taken, this time sent off to CapitalBio Medlab of Beijing (北京博奥医学检验所有限公司).[1]

SARS-CoV-2 outside Wuhan

In May 2020 mainstream media (ex. BFMTV, ABC News, Business Insider) reported of the case of a SARS-CoV-2 infected patient in France.[19][20][21] The epidemiological circumstances remain uninvestigated.[22]

29 December[edit]

On this day and the previous, three similar cases arrived at Hubei Provincial Hospital of Integrated Chinese and Western Medicine, all associated with the seafood market. The health authorities had been informed, and medical experts from Wuhan JinYinTan Hospital, "a hospital designated to treat infectious diseases"[23] came to transfer six of the seven patients. Zhang Jixian took the further initiative to let doctors and nurses in the respiratory department wear face masks, and put out an order for 30 hospital coats of fine canvas.[15][16]

The Wuhan CDC staff found also additional patients with similar symptoms who were linked to the market.[2] (The Wuhan 'Center for Disease Control and Prevention' (CDC) is part of Chinese Center for Disease Control and Prevention.)

30 December[edit]

Wuhan Central Hospital received a test report from CapitalBio Medlab, claiming an occurrence of SARS.[1] According to social media the test result was later found faulty,[18] but, back then, multiple doctors at Wuhan Central Hospital shared the test report on social media, foremost addressed to the collegial circle.[1]

The first official messages in the pandemic[edit]

Wuhan Municipal Health Commission sends a message to its affilliate institutions.[24]

  • Supervising doctors shall hold fast on disciplin and create specialized team-units.
  • General staff must be alert to the situation, especially keeping an eye out for patients with symptoms of infectious pneumonia.
  • Statistical material must be gathered ongoingly and send to Wuhan Municipal Health Commission and Hubei Province Health Committee.
  • Statistical material for the previous week, relating to patients with symptoms of infectious pneumonia, is to be send to Wuhan Municipal Health Commission before 4 o'clock, this day.
  • Without permission from authorized personnel no one is allowed to spread information about the medical treatment[25][26]

31 December[edit]

The first public message in the pandemic[edit]

The Wuhan Municipal Health Commission informed the city community about the early signs of a pneumonia outbreak.[27] The message conveys the impression of alertness, by summarizing yesterday's orders to the city hospitals; emphasizing ongoing scientific and clinical investigations and to seek hospital care when having persistent fever while showing symptoms of pneumonia; as well advising the public to wear face masks and to avoid enclosed public places and crowded areas.

Cases in sum : 27
Serious cases : 7
Recovering : 2
As yet : no fatalities, no healthcare-workers infected, no signs of human-to-human transmission, cause of pneumonia infection still under investigation

Chinese state television CCTV channel 13 in their daily news broadcasts, and through the Weibo account "YangShiXinWen", also sent an alert about the unknown virus, adding that a team of experts from the National Health Commission would arrive in Wuhan.[28][29]

Qu Shiqian, a vendor at the Huanan Seafood Wholesale Market, said government officials had disinfected the premises on 31 December and told stallholders to wear masks. Qu said he had only learned of the pneumonia outbreak from media reports. "Previously I thought they had flu," he said. "It should be not serious. We are fish traders. How can we get infected?"[30]

Events, reactions and measures[edit]

27 December[edit]

Vision Medicals inform, by phone, the hospital that requested the analysis, Wuhan Central Hospital, that they have found a new kind of coronavirus (Chinese: …"一种新的冠状病毒。" ; English: …"a new kind of coronavirus.").[1] Vision Medicals also send a written report to the Chinese Academy of Medical Science. The report tells of Chinese: …"样本里面确实有一个跟Bat SARS like coronavirus类似的新型病毒" ; English: …"a sample containing a new coronavirus similar to bat SARS coronavirus" and in the days that follow there is an intensified communication between the CEO of Vision Medicals Li Youngjun (李永军), the Wuhan Central Hospital and the local CDC[18][1]

According to news reports in February 2020 - Workers Daily, Global Times - at the Hubei Provincial Hospital of Integrated Chinese and Western Medicine and following the report from Doctor Zhang Jixian, the hospital immediately alerted the local CDC, Wuhan Jianghan Disease Prevention and Control Center,[16][17] however, the report of 22 January 2020 from the Chinese CDC seems to claim this contact falling on 29 December.[2]

29 December[edit]

The administration at Hubei Provincial Hospital of Integrated Chinese and Western Medicine convened an inter-departmental panel of doctors whose conclusions were the cases were unusual and required special attention, and also having learned of two similar cases in the city, decided to report their findings to the municipal and provincial health authorities, Wuhan Municipal Health Commission and Hubei Province Health Committee.[17]

30 December[edit]

Wuhan Central Hospital receives report from CapitalBio Medlab that their sample (obtained 27 December) contains SARS coronavirus.[1] According to a Caixin news report, this is a mistake. The same news report allege this sample was later sent on from CapitalBio Medlab to Vision Medicals, and that Vision Medicals could confirm the sample contained SARS-CoV-2, i.e. identical to the first sample Vision Medicals had received[18][1]

The alleged faulty test-report went to the social media ("社交媒体"), where a couple of doctors from the hospital joined in with warnings and cautions to their fellow colleagues. As referred in Caixin Online, from the social media account of Li Wenliang, it is stated that there are 7 cases of SARS at the Wuhan Central Hospital, all connected to the Huanan Seafood Wholesale Market.[1]

For Vision Medicals, too, these are hectic days (27-30 December) with the Chinese CDC requesting all results from Vision Medicals and from the Chinese Academy of Medical Science: "this was an urgent, secret and serious investigation"[18][1]

The first official messages in the pandemic

Wuhan Municipal Health Commission sends hard-copy messages to it's affilliated institutions, containing guidelines in confronting a possible outbreak of infectious pneumonia.[24] Two scan-copies also found their way, the same day, to the Weibo QQ service - a social media platform.[25][26][31]

The first information reaching an international context

The ProMED reporting program, under auspice of ISID, reported on the situation in Wuhan. The full date is actually 30 December 23:59:00.[24]

WHO may also have noticed the information coming out from Wuhan.[32]

31 December[edit]

The first public message in the pandemic

The Wuhan Municipal Health Commission released a briefing on its website about the pneumonia outbreak in the city.[33] The message on finding pneumonia of unknown cause was circulated through news agencies, including state television[28] , local news agencies (ex. 湖北日报网 [Hubei Daily Online])[34] and social media (ex. Weibo account "央视新闻" [ed. "YangShiXinWen", Chinese Central Television News]).[29] The People's Daily said the "exact cause remained unclear and it would be premature to speculate."[30]

Information was picked up by international news agencies Reuters and Deutsche Welle as well as Hong Kong based South China Morning Post:

Hong Kong takes emergency steps as mystery 'pneumonia' infects 27 in Wuhan[30]
China investigates SARS-like virus as dozens struck by pneumonia'[35]
Chinese officials investigate cause of pneumonia outbreak in Wuhan[36]
Inter-regional reactions

In response to Wuhan authority announcement on the "pneumonia of unknown cause", Hong Kong immediately tightened their inbound screening processes as a result.[37] Hong Kong Secretary for Food and Health Sophia Chan Siu-chee announced "[any suspected cases] including the presentation of fever and acute respiratory illness or pneumonia, and travel history to Wuhan within 14 days before onset of symptoms, we will put the patients in isolation."[30]

Tao Lina, a public health expert and former official with the Shanghai Center for Disease Control and Prevention, said, "I think we are [now] quite capable of killing it in the beginning phase, given China's disease control system, emergency handling capacity and clinical medicine support." No human-to-human infection had been reported so far and more pathological tests and investigations were underway, an official said.[30]

Information reaching an international context

According to the World Health Organisation, WHO China Country Office officially received information from the Chinese health authorities concerning the situation in Wuhan.[38] Taiwan also notified WHO.[32]

The US CDC claim to have "first learned of a “cluster of 27 cases of pneumonia”" in Wuhan on this day.[39]

Short summary[edit]

Retrospective studies consider the SARS-CoV-2 to have evolved in November 2019. Scientific comprehension of this new kind of SARS-like coronavirus took place at Vision Medicals, located in Guangzhou province, between 24-27 December 2019. Clinical apprehension of a pending epidemic started at Hubei Provincial Hospital of Integrated Chinese and Western Medicine in Wuhan almost the same time, in the days between 27 and 29 December 2019. At 31 December 2019 the Wuhan Health authorities issued a case statistic. At that day information reached WHO, U.S. CDC as well as the regions of China through official channels.

See also[edit]

External links[edit]

References[edit]

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January page[edit]

These are suggestions, with no intention of editing Timeline of the COVID-19 pandemic in January 2020.

2 January[edit]

(note:Lancet 24 Jan - earliest case studies as of 2 January 2020)

_NB rephrase pending >

3 January[edit]

A national pneumonia surveillance system for handling pneumonia cases with unknown origin has been implemented, following the SARS-epidemic, but reportedly been less practised in the later years. (Xiang et al. Emerging Infectious Disease,November 2013 DOI: 10.3201/eid1911.130865)(Xiang et al. BMC Infectious Diseases,2019 DOI: 10.1186/s12879-019-4345-0)

However, the guideline is widely known, and was re-implemented in Wuhan, following the awareness of what was happening.[J 6][J 1]

_NB <
_INS dec,part1→jan,part2 rephrase pending #12 December >

9 January[edit]

The earliest onset of symptoms of pneumonia of unknown etiology was at one time recorded as 12 December, when Chinese authorities reported on suspected cases up to 5 January 2020.[J 2]

_INS dec,part1→jan,part2 rephrase pending <
_INS dec,part1→jan,part2 #21 December >

21 January[edit]

Chinese epidemiologists published an article on CCDC Weekly (Chinese Center for Disease Control and Prevention) on 21 January 2020 stating that an early cluster of patients with "pneumonia of an unknown cause" occurred beginning 21 December 2019 and that the virus was more prevalent in older adults.[J 4]

_INS >
_INS dec,part1→jan,part2 rephrased #18–29 December >

25 January[edit]

Three top-executives from Vision Medicals, representatives from Wuhan Central Hospital, Wuhan TongJi Hospital, Wuhan JinYinTan Hospital, with members of The Chinese Academy of Medical Science and others submitted an article to The Chinese Medical Journal. The article reports 5 people with severe pneumonia admitted to the intensive care unit of the Wuhan JinYinTan Hospital. Implementing a metagenomic approach, bronchoalveolar lavage fluid (BAL) was used for viral genome sequencing. Dates of sampling are 24 and 30 December and 1 January (Ren et al.,11 Feb 2020,Table 1).[J 7]

Patient data for "Patient 4" has been assumed to correlate with the patient case that raised the initial scientific awareness, involving Vision Medicals - ref. Weibo account "微远基因".[J 8]

A short general description of the five patients shows no correspondance to the index case, as published by Huang et al.,24-30 Jan 2020.

_INS <
_INS dec,part1→jan,part2 rephrased #25 December >

28 January[edit]

Media reaction

According to the China Youth Daily, Wuhan Fifth Hospital gastroenterology director Lu Xiaohong said that she heard some hospital staff might be infected on 25 December.[J 5]

_INS <

References January[edit]

  1. ^ a b Li, Qun; Guan, Xuhua; Wu, Peng; Wang, Xiaoye; Zhou, Lei; Tong, Yeqing; Ren, Ruiqi; Leung, Kathy S.M.; Lau, Eric H.Y.; Wong, Jessica Y.; Xing, Xuesen; Xiang, Nijuan; Wu, Yang; Li, Chao; Chen, Qi; Li, Dan; Liu, Tian; Zhao, Jing; Liu, Man; Tu, Wenxiao; Chen, Chuding; Jin, Lianmei; Yang, Rui; Wang, Qi; Zhou, Suhua; Wang, Rui; Liu, Hui; Luo, Yingbo; Liu, Yuan; Shao, Ge; Li, Huan; Tao, Zhongfa; Yang, Yang; Deng, Zhiqiang; Liu, Boxi; Ma, Zhitao; Zhang, Yanping; Shi, Guoqing; Lam, Tommy T.Y.; Wu, Joseph T.; Gao, George F.; Cowling, Benjamin J.; Yang, Bo; Leung, Gabriel M.; Feng, Zijian (29 January 2020). "Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia". New England Journal of Medicine. 0 (13): 1199–1207. doi:10.1056/NEJMoa2001316. PMC 7121484. PMID 31995857.
  2. ^ a b MISSING_CITE:W?"Pneumonia cases possibly associated with a novel coronavirus in Wuhan, China". European Centre for Disease Prevention and Control. 9 January 2020.
  3. ^ Ren, Li-Li; Wang, Ye-Ming; Wu, Zhi-Qiang; Xiang, Zi-Chun; Guo, Li; Xu, Teng; Jiang, Yong-Zhong; Xiong, Yan; Li, Yong-Jun; Li, Xing-Wang; Li, Hui; Fan, Guo-Hui; Gu, Xiao-Ying; Xiao, Yan; Gao, Hong; Xu, Jiu-Yang; Yang, Fan; Wang, Xin-Ming; Wu, Chao; Chen, Lan; Liu, Yi-Wei; Liu, Bo; Yang, Jian; Wang, Xiao-Rui; Dong, Jie; Li, Li; Huang, Chao-Lin; Zhao, Jian-Ping; Hu, Yi; Cheng, Zhen-Shun; Liu, Lin-Lin; Qian, Zhao-Hui; Qin, Chuan; Jin, Qi; Cao, Bin; Wang, Jian-Wei (11 February 2020). Hao, Xiu-Yuan; Wei, Pei-Fang (eds.). "Identification of a novel coronavirus causing severe pneumonia in human: a descriptive study". Chinese Medical Journal. doi:10.1097/CM9.0000000000000722. PMC 7147275. PMID 32004165.
  4. ^ a b Tan, Wenjie; Zhao, Xiang; Ma, Xuejun; Wang, Wenling; Niu, Peihua; Xu, Wenbo; Gao, George F.; Wu, Guizhen (1 January 2020). "A Novel Coronavirus Genome Identified in a Cluster of Pneumonia Cases—Wuhan, China 2019−2020". China CDC Weekly. 2 (4): 61–62. Archived from the original on 7 February 2020. Retrieved 8 February 2020 – via weekly.chinacdc.cn.
  5. ^ a b 王嘉兴 (2020-01-28). "钟南山发话前,武汉这位医生向附近学校发出疫情警报". China Youth Daily (in Chinese). Archived from the original on 26 March 2020. Retrieved 21 April 2020 – via bingdianweekly.
  6. ^ [ed. China CDC Weekly 22 Jan (on dec. page)]
  7. ^ [ed. Li et al. Chin Med J (on dec. page)]
  8. ^ [ed. Caixin Online (on dec. page)]