Mystery virus cluster could rewrite history
When in early May, New York State Governor Andrew Cuomo revealed a young boy had died from a rare inflammatory disease believed to be linked to coronavirus, it sent shockwaves across the country.
Children, who have thought to be immune from the worst ravages of COVID-19, were - at least in some cases - seemingly not.
The five-year-old perished from a condition known as paediatric multisystem inflammatory syndrome. Its symptoms, that can include high fever, joint pain as well as organ and heart failure mirrored those seen in an illness called Kawasaki disease.
"This would be really painful news and would open an entirely different chapter," Mr Cuomo said.
But new information from the other side of the country could open yet another chapter in the meandering tale of COVID-19. Other children could have been dying of the disease far earlier than the case in New York.
And it's not just children. Up to 40 cases of people who passed away in California - including a man in his 60s - are now being re-examined to see if coronavirus played a role in their deaths.
It adds to a growing body of evidence that scores of people worldwide may have died from coronavirus before China even announced its first death from the condition on January 11.
One cluster of possible cases can be found in the rural Shasta County of northern California.
Dr Deirdre Amaro, the forensic pathologist for the county has told the Los Angeles Times she was concerned by the deaths of two children in January from respiratory illnesses.
In addition, another two children were sent from Shasta County to hospitals outside the county suffering with COVID or Kawasaki like symptoms.
"Since I've been here … we have never had sequential cases that are paediatric deaths," she told the newspaper.
Another case under investigation is that of Jeremiah DeLap, a 39-year-old man who died Orange Country, south of Los Angeles.
On Friday 3 January, while visiting his parents, he complained of feeling poorly and suspected food poisoning. On Monday, he was well enough to go for a walk. On Tuesday 7 January, he fell ill again.
"He was having trouble breathing and I told him he should try and go to urgent care," his mother Maribeth Cortez told the LA Times.
"He told me he'd talk to me later and he went and lay down."
Hours alert, he was found dead in his bed, drowned by fluid entering his lungs and still hot from a fever.
At this point, China was still several days away from announcing its first death from coronavirus.
With no COVID-19 tests being done on the recently deceased in January in the US, the coroner ruled Mr DeLap had died from severe pneumonia.
It's only in hindsight his death, those of the Shasta County kids and others have raised concerns.
Health officials in Orange County are now also looking into other respiratory system deaths from December to March including a homeless man and a young surfer who collapsed.
Today, these deaths would warrant a COVID-19 test.
Across the state, more than 40 deaths have now been flagged for re-examination to see if COVID-19 was present.
However, only the federal Centres for Disease Control can examine preserved tissue which would be the sole way to check for coronavirus.
And the CDC is under the pump responding to a virus that is continuing to sweep thorough the country. The organisation is taking weeks to provide these post-mortem results.
Of course, not all of the 40 Californians who died, including the Shasta County children, may have done so with coronavirus in their systems. Indeed, none may have had it.
But in recent weeks, information from around the world - even from China itself - has suggested COVID-19 was in circulation for longer than most health officials first thought.
It's possible that rather than exploding into countries early in the year, the virus may have slowly built up in late 2019, often going unnoticed as it worked its way through populations patiently waiting to find someone vulnerable enough to succumb.
In multiple countries, when the first victim died is being reassessed. The US's first death was originally thought to have been in late February but it's now known a Californian woman died of COVID-19 earlier that month.
The first known case in France was originally diagnosed on 24 January, However, an infection has now been discovered from late December.
A Paris man complained of a dry cough and trouble breathing just after Christmas. He hadn't travelled but did work at a supermarket close to one of the city's major airports where travellers often shopped.
A swab taken at the time was looked at again and his COVID-19 infection then confirmed. Doctors said that would have meant he was infected anytime from mid-December onwards.
Samples of sewage in the Italian cities of Milan and Turin - two places hit hard by the pandemic - have also shown the virus that causes COVID-19 was present in December. Yet the first initial diagnoses were on 20 February.
If some of the tests from Shasta County, and California as a whole, come back positive, it will add further weight to the theory that long before China announced its first case of COVID-19 it was already rampaging around the world.
If only that had been known, scores of lives would likely have been saved.
Originally published as Mystery cluster could rewrite history