Early spread of COVID-19 appears far greater than initially reported, UT Austin researchers say

Epidemiological researchers from the University of Texas at Austin say that COVID-19 is estimated to have been far more widespread in Wuhan, China, and Seattle, Washington weeks ahead of any lockdown measures in each city.

Those findings have been published in a new paper in The Lancet's open-access journal EClinicalMedicine.

Researchers say patients with undiagnosed flu symptoms who actually had COVID-19 last winter were among thousands of undetected early cases of the disease at the beginning of this year. 

About half of COVID-19 cases are asymptomatic, according to several other studies, so that also led researchers to believe that there were thousands more infected people in Wuhan and Seattle before each city’s respective lockdown measures went into effect.

Lauren Ancel Meyers, a professor of integrative biology and statistics and data sciences who leads the UT Austin COVID-19 Modeling Consortium, worked with her team of researchers to extrapolate the extent of the COVID-19 epidemic in Wuhan and Seattle based on retested throat swabs taken from patients who were suffering from influenza-like illnesses during January in Wuhan and during late February and early March in Seattle. When the samples were analyzed later in each city, most turned out to be flu, but some turned out to be positive for SARS-CoV-2, the virus that causes COVID-19.

“Even before we realized that COVID-19 was spreading, the data imply that there was at least one case of COVID-19 for every two cases of flu,” Meyers said in a news release. “Since we knew how widespread flu was at that time, we could reasonably determine the prevalence of COVID-19.”

When the Chinese government locked down Wuhan on January 22, there were 422 known cases. but Meyers and her team found that there could have more than 12,000 undetected symptomatic cases of COVID-19.

The new technique for estimating the number of unseen COVID-19 based on the ratio of influenza cases to COVID-19 cases has also been used to determine how many children were actually infected in each city and the pace of the early pandemic in the U.S., Meyers said.

On March 9, the week when Seattle schools closed due to the virus, researchers estimate that more than 9,000 people with flu-like symptoms had COVID-19 and that about a third of that total were children.


This photo taken on January 30, 2020 shows a doctor wearing a facemask looking at a lung CT image from a patient at a hospital in Wuhan in China's central Hubei province, during the virus outbreak in the city. (STR/AFP via Getty Images)


Officials say the data do not imply that health authorities were aware of these infections, rather that they may have gone unseen during the early and uncertain stages of the pandemic.

“Given that COVID-19 appears to be overwhelmingly mild in children, our high estimate for symptomatic pediatric cases in Seattle suggests that there may have been thousands more mild cases at the time,” wrote Zhanwei Du, a postdoctoral researcher in Meyers’ lab and first author on the study.

“This helps us understand how the pandemic spread so quickly around the globe and provides insight into what we may see in the coming weeks and months,” adds Meyers.

In addition to Meyers and Du, graduate students Emily Javan and Ciara Nugent at The University of Texas at Austin and Professor Benjamin J. Cowling of the University of Hong Kong contributed to the research. The research was funded by the National Institutes of Health.



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