May 5, 2020

expert reaction to report of a COVID-19 case in France in December 2019

A report, published in the International Journal of Antimicrobial Agents, looked at COVID-19 in France in Late December 2019. 

Dr Simon Clarke, Associate Professor in Cellular Microbiology, University of Reading, said:

“This is an extremely interesting claim.  Assuming it’s not a case of a false-positive result, it will be important for French authorities to thoroughly investigate the movements of this patient prior to admission to hospital and to examine their medical records to see if their symptoms and disease progression were more like covid-19 than flu.  If the coronavirus had indeed spread to Europe in December, it’s worth asking why it took so long for case numbers to begin to escalate.  It seems increasingly common for people to ask whether their unpleasant flu-like illness experienced last year was covid-19, but it should be remembered that lots of other respiratory tract viruses, including influenza, circulate in the winter months, causing people to feel very unwell and can also be fatal.”

Dr Stephen Griffin, Associate Professor at Leeds Institute of Medical Research (LIMR), University of Leeds, said:

“This is a potentially important finding. However, it will be necessary to determine the viral sequence in order to track its relatedness to other SARS-COV2 sequences and to place it in context of what we know about viral evolution. Moreover, serological confirmation that the patient in question was indeed exposed to the virus would be ideal, although it is also possible that they may have been exposed/infected during the intervening period. Lastly, rigorous contact tracing would help ascertain whether this represents a genuine infection cluster. Until this information is at hand, we must be cautious when interpreting these findings.“

Prof Jonathan Ball, Professor of Molecular Virology, University of Nottingham, said:

“We know from evidence that the virus first started to infect humans around mid-November with the early outbreak focussed on Wuhan City and the immediate Hubei province.  Whilst it was possible that virus could have been exported from there to other parts of the world, the individual in the case report hadn’t had any travel history, and so would have been part of a transmission chain.  If he was infected then, you would expect a more rapid and earlier spread of virus in France than was seen.  It is also possible that the positive result could have been due to contamination of the PCR reaction.  Sequencing any virus in the sample might give you insight into whether or not the virus truly was an early isolate or likely contamination, but it looks from the data that the amount of virus in the sample was low, so would be difficult to analyse further.

“It’s not impossible that it was an early introduction, but the evidence isn’t conclusive by any means.”

Prof Rowland Kao, Sir Timothy O’Shea Professor of Veterinary Epidemiology and Data Science, University of Edinburgh, said:

“Even if this is confirmed, the identification of a positive report so early is not necessarily an indication that the spread of COVID-19 from France started this early.  Even with a relatively high reproduction number, there are likely to be many instances where, around the world, infected individuals have moved to an uninfected location, but no transmission occurred.  If confirmed, what this case does highlight is the speed at which an infection starting in a seemingly remote part of the world, can quickly seed infections elsewhere.  Why is this important?  It means that the lead time we have for assessment and decision-making can be very short, emphasizing the need for preparedness, planning and rapid global communication of disease threats.  In all these things, the role of the W.H.O. is essential, and the cooperation of all nations vital.”

‘SARS-COV-2 was already spreading in France in late December 2019 A Deslandes et al. was published in the International Journal of Antimicrobial Agents on 3 May 2020.

DOI: 10.1016/j.ijantimicag.2020.106006

https://www.sciencedirect.com/science/article/pii/S0924857920301643

All our previous output on this subject can be seen at this weblink:

www.sciencemediacentre.org/tag/covid-19

Declared interests

None received.