Coronavirus has ravaged the United States, with more than 80,000 deaths and 1.3 million people infected since the outbreak began in January.
Hospitals are overrun, unemployment is comparable with the Great Depression and unrest among citizens in multiple states is growing, as President Donald Trump defends his handling of the crisis.
A television special on ABC’s Four Corners tonight attempted to shed light on what went so horribly wrong in America, highlighting a severe breakdown in co-operation between states and the federal government, as well as critical shortages of equipment and supplies.
And it also traced the COVID-19 outbreak back to what doctors called “patient one” in the state of Washington.
Dr George Diaz, an infectious disease specialist at Providence Regional Medical Centre in Everett, near Seattle, treated the man who became known as patient one.
The 35-year-old flew in to Seattle on January 15 and the next day began feeling unwell, so he went to a walk-in clinic, Dr Diaz explained.
“He was having cough, he had been having fevers at home, he hadn’t been eating well and he had been complaining of diarrhoea.
“He began developing symptoms the day after he arrived. He went to this walk-in clinic and described his symptoms and told them where he had been for about six weeks.”
It was Wuhan, China.
News of a mysterious pneumonia-like illness in the Chinese city began making ripples around the world in December.
A nasal swab was sent to the Centers for Disease Control in Atlanta, Georgia, on the other side of the country.
“And then within 24 hours, we had a call from the CDC saying that the test was positive and that they wanted us to admit him for observation,” Dr Diaz told the program.
It was the first confirmed case of COVID-19 in the United States.
The man was brought in to the hospital in what’s called an “isopod” – an encased tent-like gurney to keep him quarantined.
“So, it took us about two hours from the time the CDC called for us to get all our staff, personnel, supplies and the facilities all in place to be able to give the EMS folks a green light to come in,” Dr Diaz said.
Patient one’s condition rapidly deteriorated, and he was developing pneumonia, which Dr Diaz knew from following reports out of China was a bad sign.
“It appeared, based on their data, that once patients begin developing pneumonia that many of them end up in the ICU on a ventilator and die,” he said.
Contact tracing was undertaken and it initially seemed as though the man hadn’t spread the virus to anyone else.
That quiet relief didn’t last.
At an aged care facility in the city of Kirkland, residents began falling ill with respiratory infections.
Dr Francis Riedo, medical director of infection control at nearby Evergreen Health Medical Centre, began investigating.
“Remember, this was flu season and we’d already had a peak of influenza B in December, and now we were going through the peak of influenza A,” Dr Riedo said.
“And so, the unit was full of individuals and now we were going through the peak of influenza A. And so, the unit was full with severe respiratory infections. In the meantime, in the background, we’re watching these events unfold with increasing alarm, not only in Wuhan, but now spreading across the globe and wondering when our turn was coming.”
Federal guidelines on testing for coronavirus limited it to people who had been to China or another identified hotspot or had come into contact with a confirmed case.
Dr Riedo decided to test anyway, as a sample, picking two ill patients the following morning, who both came back with positive results.
“My initial honest response was scepticism. I thought, the odds of both tests in two randomly selected individuals with no history of travel, no history of exposure to anybody, was fairly astronomical,” Dr Riedo said.
The hospital activated an incident command and nine additional patients were tested – eight of whom had COVID-19.
“And within the first 5 days, we had 32 positives,” he said.
Many were from the aged care facility, but alarmingly, some had no link to the facility.
“We then knew that this was a much bigger outbreak than you could have imagined,” Dr Riedo said.
To date, 41 residents and two visitors linked to the care home outbreak have died.
Washington was placed into a state of emergency – the first of many states that would enact similar declarations as COVID-19 swept across the nation.
America has been the worst-hit country in the world and there’s little optimism on the horizon.