And significantly - no travel to China. Which means community spread had begun in CA by mid-January. That is significant. A few implications: https://twitter.com/EricTopol/status/1253149355256672256

Assuming ~3 weeks from exposure to death, this would put her exposure around 16 Jan. That means the person who infected her (perhaps someone who had traveled from China) was in the US and spreading in early January.

That's before China officially acknowledged human transmission.

This underscores the risk China created by delaying earlier release of that data.

But it also has to be said - it's hard to see how that would have meaningfully changed US behavior.

H2H transmission was confirmed by 22 Jan, and still didn't prompt much US action.

WHO confirmed H2H on 22 Jan after initial visit to Wuhan. Characterized virus on 23 Jan. Declared PHEIC 30 Jan.

All before 6 Feb death of this individual.

US should at that point have concluded domestic transmission might already be present and ramped up testing. But didn't.

So shame on China for not sharing H2H confirmation a few weeks earlier. But shame on the US for not treating that information seriously even when it was received. The latter is much more of a problem, in the grand scheme.

Final point - this again reveals the futility and damage of the travel ban. By the time it was imposed (Feb 2), community transmission was already underway in both WA and CA.

But instead of aggressively watching for signs of that, public health officials were focused on travel.

Federal public health officials prioritized enforcing the China ban and screening incoming travelers. And that focus also diverted local public health depts, who had to carry out those tasks rather than focusing on local surveillance and readiness.

This new info confirms again that the travel ban had failed before it had even started, and the distraction it caused from domestic readiness meant it damaged the homeland rather than protecting it.