Percentage of fully vaccinated Americans, April 2021 - January 2022. Data: Centers for Disease Control and Prevention. Graphic: CNBC

By Spencer Kimball and Nate Rattner
21 January 2022

(CNBC) – A 35-year-old man returned to the U.S. from Wuhan, China on Jan. 15, 2020 and fell ill with a cough and fever.

He had read an alert from the Centers for Disease Control and Prevention about an outbreak of a novel coronavirus in Wuhan and sought treatment at an urgent care clinic in Snohomish County, Washington four days later.

On Jan. 21, the CDC publicly confirmed he had the first known case of coronavirus in the U.S., although the agency would later find the virus had arrived on the West Coast as early as December after testing blood samples for antibodies.

The man said he had not spent time at the Huanan seafood market in Wuhan, where a cluster of early cases were identified in December. He was admitted to isolation unit at Providence Regional Medical Center in Everett, Wash. for observation.

We don’t yet understand how these variants emerge and what they are capable of doing. Look at how omicron caught us as a global community surprised by the rapid transmission, the immune evasion. Look at delta and all the impact it had on disease severity.

Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy in Minnesota

After confirming the Washington state case, the CDC told the public it believed the risk “remains low at this time.” There was growing evidence of person-to-person transmission of the virus, the CDC said, but “it’s unclear how easily this virus is spreading between people.”

Then President Donald Trump told CNBC the U.S. had it “totally under control.”

“It’s one person coming in from China. We have it under control. It’s going to be just fine,” Trump told “Squawk Box” co-host Joe Kernen in an interview from the World Economic Forum in Davos, Switzerland.

However, Dr. Anthony Fauci would confirm the public’s worst fears on Jan. 31: People could carry and spread the virus without showing any symptoms. Dr. Helen Chu’s research team at the Seattle Flu Study started examining genomic data from Wuhan. It became clear early on that person-to-person transmission was happening, Chu said. By using the flu study’s databank of nasal swab samples, the team was able to identify another Covid case in a 15-year-old who hadn’t recently traveled, indicating it was spreading throughout the community.

In late February, a senior CDC official, Dr. Nancy Messonnier, warned that containing the virus at the nation’s borders was no longer feasible. Community spread would happen in the U.S., she said, and the central was question was “how many people in this country will have severe illness.”

Coronavirus in the U.S., January 2020-January 2022, showing case rates, hospitalizations, and mortality. Data: Johns Hopkins University / Department of Health and Human Services. Graphic: CNBC

In the two years since that first confirmed case, the virus has torn through the U.S. with a ferocity and duration few anticipated. The human toll is staggering, with more than 860,000 people dead and more than 69 million total infections. Hospitals around the nation have been pushed to the breaking point with more than 4 million admissions of confirmed Covid patients since August 2020, when the CDC started tracking hospitalizations. The hospital admissions are an undercount because they do not include the wave of cases that first hit the U.S. in the spring 2020 when hospitals were caught flat footed and testing was inadequate.

Though the U.S. now has effective vaccines and therapeutics to fight Covid, the future course of the pandemic remains uncertain as the virus mutates into new variants that are more transmissible and can evade vaccine protection. The highly contagious omicron variant has pushed infections and hospitalizations to record highs across the globe this month, a shock to a weary public that wants a return to normal life after two years of lockdowns, event cancellations, working from home and mask and vaccine mandates.

The rapid evolution of the virus and the dramatic waves of infection that would follow, from alpha to delta and omicron, came as a surprise to many elected leaders, public health officials and scientists. Dr. Michael Osterholm, a top epidemiologist, said the Covid mutations are the big unknown that will determine the future course of the pandemic.

“We don’t yet understand how these variants emerge and what they are capable of doing,” Osterholm, director of the Center for Infectious Disease Research and Policy in Minnesota, told CNBC. “Look at how omicron caught us as a global community surprised by the rapid transmission, the immune evasion. Look at delta and all the impact it had on disease severity,” he said. […]

“Everybody wants to get to this thing called endemic. I still don’t know what the hell that means,” Osterholm said, noting that he has 46 years of experience as an epidemiologist. “With variants, we can go for a period of time with relatively low activity, like we’ve seen in many places in the world, and then a new variant could change all that overnight. We don’t really understand our future yet.” [more]

Two years since Covid was first confirmed in U.S., the pandemic is worse than anyone imagined