COVID-19 infections had first broken out in Wuhan

In November 2019,

, China.[38][39] China publicly reported the cluster on December 31, 2019.[3] After China confirmed that the cluster of infections was caused by a novel infectious coronavirus[3] on January 7, 2020, the CDC issued an official health advisory the following day.[40] On January 20, the World Health Organization (WHO) and China both confirmed that human-to-human transmission had occurred.[41] The CDC immediately activated its Emergency Operations Center (EOC) to respond to the outbreak in China.[42] Also, the first report of a COVID-19 case in the U.S. was publicly reported,[3] though the All of Us study (released in 2021) showed five states already had cases weeks earlier.[43] After other cases were reported, on January 30, the WHO declared a Public Health Emergency of International Concern (PHEIC) – its highest level of alarm[44] – warning that “all countries should be prepared for containment.”[45][46][d] The same day, the CDC confirmed the first person-to-person case in the U.S.[48] The next day, the country declared a public health emergency.[49] 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.[49]

The Trump administration evacuated American nationals from Wuhan in January.[50] On February 2, the U.S. enacted travel restrictions to and from China.[16] 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,[51] by which point nine other COVID-19 deaths had occurred in Santa Clara County.[52] The virus had been circulating undetected at least since early January and possibly as early as November.[53] On February 25, the CDC warned the American public for the first time to prepare for a local outbreak.[54][55] 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.[56][57][58] 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.[59] In February, Vice President Mike Pence took over for Secretary Alex Azar as chair of the White House Coronavirus Task Force.[60]

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