In November 2019,
, China. China publicly reported the cluster on December 31, 2019. After China confirmed that the cluster of infections was caused by a novel infectious coronavirus on January 7, 2020, the CDC issued an official health advisory the following day. On January 20, the World Health Organization (WHO) and China both confirmed that human-to-human transmission had occurred. The CDC immediately activated its Emergency Operations Center (EOC) to respond to the outbreak in China. Also, the first report of a COVID-19 case in the U.S. was publicly reported, though the All of Us study (released in 2021) showed five states already had cases weeks earlier. After other cases were reported, on January 30, the WHO declared a Public Health Emergency of International Concern (PHEIC) – its highest level of alarm – warning that “all countries should be prepared for containment.”[d] The same day, the CDC confirmed the first person-to-person case in the U.S. The next day, the country declared a public health emergency. Although by that date there were only seven known cases in the U.S., the HHS and CDC reported that there was a likelihood of further cases appearing in the country.
The Trump administration evacuated American nationals from Wuhan in January. On February 2, the U.S. enacted travel restrictions to and from China. On February 6, the earliest confirmed American death with COVID-19 (that of a 57-year-old woman) occurred in Santa Clara County, California. The CDC did not report its confirmation until April 21, by which point nine other COVID-19 deaths had occurred in Santa Clara County. The virus had been circulating undetected at least since early January and possibly as early as November. On February 25, the CDC warned the American public for the first time to prepare for a local outbreak. The next day, New York City saw the sickening of its “patient zero”, Manhattan attorney Lawrence Garbuz, then thought to be the first community-acquired case. Another case known as “patient zero” in Los Angeles is a man named Gregg Garfield, a man who spent 64 days in the Burbank Hospital, on a ventilator for 30 days, with a 1% chance to live. Contracting the virus from a ski trip, Garfield is back on the slopes, although with fingers and toes amputated. In February, Vice President Mike Pence took over for Secretary Alex Azar as chair of the White House Coronavirus Task Force.