We know very little about patient zero – the first person to be diagnosed with COVID-19 in Wuhan. What about the early patients in South Korea, Australia, Italy and other parts of the world? Were any epidemiological links found between them?

By Health Analytics Asia

Patient zero is a term used to describe the first human infected by a viral or bacterial disease in an outbreak. In the COVID-19 pandemic, there are not much details available about patient zero who was infected in Wuhan, Hubei province of China, except that he had no connection with the Huanan Seafood Wholesale Market.
In December 2019, following a series of pneumonia cases of unknown cause in Wuhan, China alerted the World Health Organization (WHO) that it had been noticing some strange pneumonia cases since December 12. Since then, the virus has engulfed – almost – the whole world.

Questions galore
The Lancet medical journal has claimed that the first person to be diagnosed with COVID-19 on December 1, 2019, had “no contact” with the Huanan Seafood Wholesale Market, thus raising questions whether Wuhan was the real ground zero of the pandemic. Apparently, none of the patient zero’s family members developed fever or any respiratory symptoms. WHO has also said that no epidemiological link was found between the first patient and later cases.
According to the research paper titled ‘2019 novel coronavirus of pneumonia in Wuhan, China: emerging attack and management strategies’, most of the early infected patients were linked to Huanan Seafood Wholesale Market in Wuhan. However, there were 13 of the 41 cases that had no link to the marketplace.

Most importantly, in the earliest case, the patient became ill on December 1, 2019, and had no reported access to the seafood market. The virus probably came into the market place first then it went out of there. Hence, the hypothesis that the outbreak started at the market and could have been transmitted from a living animal to a human host before spreading human-to-human is still considered the most likely. There are not much details available about the patient zero in Wuhan.

Super spreaders
In South Korea though, when a member of a secretive religious sect, who had never been to Wuhan, was diagnosed with COVID-19, the world was privy to a lot of details. The woman was nicknamed ‘Public Harm Auntie’ after she went out for lunch with friends, got a scrub at a spa, and argued with public health officials before finally submitting to a COVID-19 test. Known as patient number 31, she was tested positive for the virus on February 18, 2020. Soon after, the infection figures in South Korea skyrocketed and the patient was dubbed a ‘super spreader’.

A study of previous epidemics indicates that the world was not devoid of such super-spreaders in the past. A woman known as ‘Typhoid Mary’ was accused of causing an outbreak of typhoid fever in New York in 1906. Doctors called her a healthy carrier – someone infected by a disease, but displaying little or no symptoms; which means they often go on to infect many other people.

Around the world
A 73-year-old woman in Thailand, who had travelled from Wuhan, was the first person outside China to contract the coronavirus. Back in India, the first case of coronavirus was of an Indian student studying at Wuhan University who had returned home to the state of Kerala. In the Philippines too, the first case of the new coronavirus, a 38-year-old Chinese woman, had travelled from Wuhan.

In Australia, the first confirmed case of COVID-19 was a man in his fifties who had travelled from Wuhan to Melbourne on January 25, 2020. However, the country’s biggest clusters came not from outside the borders, but from within. Images of a packed Bondi beach in March went viral as people ignored recommendations to stay home. In the following days, dozens of backpackers in Bondi tested positive for COVID-19.

In Italy, the first person diagnosed with the virus was a healthy 38-year-old man. He had arrived at the local emergency room in Codogno, south of Milan, with flu-like symptoms. His condition quickly worsened and the doctors tested him for the coronavirus. On February 20, 2020, he was declared COVID-19 positive and within days, the world saw Italy get into an unprecedented lockdown.

Apparently, the Italian man had no known contacts with anyone from China and probably caught the disease from someone else in Italy. He was asymptomatic for close to a month and was playing soccer, going jogging, attending dinner parties. Experts claim that he may not be Italy’s Patient One; he could very well have been Patient 10 or 100. The man spent weeks on a ventilator before being discharged from the hospital on March 22. He said he was happy to do “the most simple and beautiful thing: that is, to breathe.”