LOS ANGELES, Calif. — As medical officials and politicians all debate the origins of the coronavirus pandemic, a new study is raising more questions about when COVID actually arrived in the United States. Researchers in California are suggesting the virus causing the disease may have already been spreading in the state back in December of 2019.
A team from UCLA reports a sudden spike in the number of patients with coughs and acute respiratory failure in the months leading up to the global crisis. Records from UCLA hospitals and clinics report a 50-percent increase in cases compared to the average for December, January, and February. The World Health Organization did not declare COVID-19 a pandemic until March 11.
“For many diseases, data from the outpatient setting can provide an early warning to emergency departments and hospital intensive care units of what is to come,” Dr. Joann Elmore says in a university release.
“The majority of COVID-19 studies evaluate hospitalization data, but we also looked at the larger outpatient clinic setting, where most patients turn first for medical care when illness and symptoms arise.”
Tracking COVID in real time
While most studies are looking at serious cases causing hospitalizations, the COVID research from UCLA examines over 10 million patient records. Those include outpatient and emergency room visits from Dec. 1, 2019 through the end of February.
The results reveal roughly 1,000 more patients receiving treatment in the Los Angeles area for coughs and respiratory failure compared to the normal number in the previous five years. The increase remains high even after factoring in shifts in the population and seasonal changes.
Researchers say the ability to study patient data instantly, using electronic records, can help doctors spot the warning signs of an outbreak quicker. They add improving technology at all levels of the healthcare system could help curb a virus before it becomes a pandemic.
“The pandemic has really highlighted our need for agile health care analytics that enable real-time symptom and disease surveillance using electronic health records data,” Dr. Michael Pfeffer explains. “Technology, including artificial intelligence powered by machine learning, has further potential to identify and track irregular changes in health data, including significant excesses of patients with specific disease-type presentations in the weeks or months prior to an outbreak.”
Was this spike really caused by coronavirus?
Study authors caution that the true reason for this surge in illnesses may never be clear. Among the 10 million records, the outpatient visits include cases which only list a “cough” as a symptom. Researchers also suggest that some of the respiratory illnesses could be the result of smoking and vaping, even though the number of users is reportedly declining. Despite the surge being abnormally high, the UCLA team adds they can’t rule out a rise in flu cases either.
“We may never truly know if these excess patients represented early and undetected COVID-19 cases in our area,” Elmore says. “But the lessons learned from this pandemic, paired with health care analytics that enable real-time surveillance of disease and symptoms, can potentially help us identify and track emerging outbreaks and future epidemics.”
The study appears in the Journal of Medical Internet Research.