In January, Washington state saw the country’s first confirmed coronavirus case, with the first confirmed death from Covid-19 the next month. By early March, researchers were hypothesizing that the virus had been spreading for multiple weeks, leading to infections among an estimated 300 to 500 people.
The federal government’s early response to the growing outbreak in Washington was defined by confusion and missed chances, as illustrated by public reporting and public records previously reported on by American Oversight. We’ve recently received additional records that add to the picture of poor coordination on the part of federal agencies, leaving local public health officials scrambling to address the crisis.
In early March, the New York Times reported that the federal government had missed an opportunity to conduct more widespread testing that could have aided containment efforts during the pandemic’s early days. Researchers with the Seattle Flu Study, a program created to monitor the spread of infectious diseases, were prepared to test samples previously collected for their study to track the spread of Covid-19, but Centers for Disease Control and Prevention officials repeatedly rejected the idea and imposed bureaucratic hurdles that slowed down testing attempts. When the Seattle researchers went ahead with testing in late February, they quickly found positive cases in the area.
Records previously obtained by American Oversight also showed communication problems between CDC officials and health officials in Washington state in these early weeks. New documents now show how the federal government repeatedly left state officials in the dark about key decisions, leaving them confused by White House policies and struggling to coordinate with the CDC. Amid the confusion, researchers told CDC officials in early March that the virus had been circulating in the state since January.
One point of confusion was President Donald Trump’s Jan. 31 travel ban that denied entry to any non-American citizens coming from mainland China. Debra Berliner, an immunization consultant for Washington state, wrote in an email to Washington Department of Health officials and health officials in King County, “I think there needs to be more clarity around the new guidelines released by the White House. Do they apply retroactively (e.g. to a student that arrived from China anytime in the past 14 days) or just to students arriving from China starting on Sunday, 2/2?”
Berliner’s uncertainty was matched by Jerrod Davis, Washington’s assistant health secretary. On Feb. 1, he wrote, “Yesterday’s Whitehouse briefing was a bombshell. Our team is rolling up their sleeves to pivot accordingly.” He added, “Also, SeaTac [Seattle-Tacoma International Airport] was added to one of seven airports where travelers would be coming into. Yikes!”
By the end of February, initial confusion turned into coordination problems between federal and state officials. State officials struggled to get information about how the CDC planned to transport non-residents who had tested positive for the virus back to their home states, and had to repeatedly send information to CDC officials.
They were also dealing with stretched resources — in one exchange, a CDC epidemiologist asked Scott Lindquist, a Washington state health official, if it would be feasible to collect serum from close contacts of those infected, to gauge whether there was an immune response to the coronavirus. Lindquist agreed that such a strategy would be preferable, but went on to say, “the logistics of contacting, consenting and arranging the blood draws are beyond local staffing.”
Coordination problems were exacerbated when federal decisions about the Seattle Flu Study were made without state officials’ input. On Feb. 14, the CDC’s Nancy Messonnier announced in a press briefing that research labs in five cities, including Seattle, would begin testing some people who didn’t meet the CDC’s guidelines for getting a coronavirus test.
But state officials appear to have not been informed of this change. On the same day, Jeff Duchin, the chief of epidemiology for King County, emailed Joe Bresee, the CDC’s director of global health affairs for influenza, “Nancy just announced on a national media call that CDC is doing sentinel surveillance in Seattle – I know nothing about this – can you please fill me in ASAP?” Bresee replied, “Not sure how they [researchers Helen Chu and Trevor Bedford] were engaged initially, and assume that they assumed you were engaged as well.”
Later that day, Duchin emailed: “I just got a message from NYC saying they thought Scott [Lindquist] was planning to do this surveillance. […] So, Scott, although you expressed to me you have made no plans, multiple others are hearing it differently – maybe miscommunication happening with multiple groups.” Duchin later said that Washington health officials weren’t alone in their confusion, writing, “Apparently the other cities were surprised as we were.”
Prior to the announcement, Seattle Flu Study researchers had since Feb. 10 been attempting to reach CDC officials to ask how to overcome administrative problems so that the study could be used to share Covid-19 testing data. When this request was re-upped on Feb. 14, Daniel Jernigan, director of the CDC’s Influenza Division said he thought that the Seattle Flu Study (SFS) was already being used to test for community spread. Duchin replied: “We are not aware of that and have conflicting information from SFS.”
This confusion apparently meant that testing could not begin immediately after the CDC’s announcement was made. Duchin circulated a “draft statement in response to unanticipated HHS/CDC announcement that ‘Seattle’ is participating in a CDC sentinel surveillance project.” The statement said that Seattle, King County, the state health department, and the University of Washington were not participating in “any new surveillance or special testing project” but were “willing to consider collaborating” in the future. A testing plan utilizing the Seattle Flu Study wasn’t confirmed until almost a week later, on Feb. 22.
The emails also show that the CDC knew the extent of the virus’ spread was likely beyond current testing counts. On Feb. 29, Trevor Bedford, a scientist at the Fred Hutch research center, emailed Greg Armstrong, the CDC’s deputy incident manager, saying that he had new data on the spread of the coronavirus that “firmly suggest transmission in Washington.” Armstrong forwarded this exchange to several colleagues.
On March 4, Bedford emailed Armstrong again, saying he had sequenced new mutations of the virus and found one that had been circulating since mid-January. Armstrong said the data was “more of academic interest” and wouldn’t impact the government’s coronavirus response.
Despite this knowledge of the virus’ spread, as of March 5, the CDC was still planning for the Epidemic Intelligence Service Conference to happen in person at a hotel in early May. The next day, in a visit to CDC headquarters in Atlanta, Trump said “You have to be calm. It’ll go away.”