The County of Santa Clara (California) has confirmed the first COVID-19-caused death in the community occurred on Feb. 6, 2020—more than 3 weeks before the United States’ first confirmed COVID-19 fatality of a Washington state man on Feb. 29. As a result, California Governor Gavin Newsom (D) has asked medical examiners and coroners across the state to review autopsies dating back to December to “help guide a deeper understanding of when this pandemic really started to impact Californians.”
The 57-year-old woman who died on Feb. 6 is not the only “early” death in Santa Clara County. A 69-year-old man was also found dead in his house on Feb. 17.
“When this occurred is important forensic information, profoundly significant in understanding the epidemiology of this disease, all of those things are brought to bear with more clarify and light,” Newsom said in a press briefing last week.
Samples from the two individuals were sent to the Centers for Disease Control and Prevention. On Tuesday, the Santa Clara medical examiner-coroner received the test results that confirmed SARS-CoV-2, the virus that causes COVID-19, in both tissue samples.
“The medical examiner has a protocol in place in which individuals who died, who exhibited flu-like symptoms prior to death, undergo studies for viral illnesses,” said Santa Clara County Health Officer Sara Cody. “Prior to the end of February, COVID-19 tests were not available for these earlier cases. These individuals tested negative for other viruses but because there was continued suspicion by the medical examiner that these deaths were caused by COVID-19, the medical examiner sent autopsy tissue to the CDC for definitive testing.”
California had a particularly intense flu season at the end of 2019/beginning of 2020. Thus, before the development of a rapid COVID-19 test, it was difficult for medical practitioners and medical examiners alike to determine the difference between influenza and the SARS-related virus.
“As far as we understand, none of these cases had a significant travel history,” Cody said. “We presume that each of them represents community transmission and that there was some significant level of virus circulating in our community far earlier than we had known,” Cody said.
Newsom said he expects other counties in California will report COVID-19-related deaths in early and mid-February as statewide reviews get underway. He did not indicate what the guidelines will be for autopsies, nor how many bodies the state anticipates corners will ultimately test.