On the morning of January 27, a message awaited in the email inbox of the Webasto offices, the content of which would soon go around the world. The employee who had traveled from China the previous week to meet at the auto parts company reported that she had covid-19. Hours later, a German-based employee tested positive and Bavarian health authorities reported the first case of human-to-human transmission outside Asia.The coronavirus had reached Germany.
German scientists have now reconstructed to the last detail what happened in those days, through interviews, documents and analysis of the virus’s genome. They have gutted how an outbreak spread that the company and the authorities managed to stop short. 16 people were infected in that focus and all have recovered in this unique success story. The reconstruction published in the magazine Lancet, together with the account of what happened in those hours in the infected company sheds light on what was the exact moment of transmission in each case, but also on the importance of early detection and action.
Patient zero had landed in Germany on Sunday 19 from Shanghai to hold a series of meetings at her company’s mother house. Before traveling to Bavaria, he had received a visit from his parents, who came from Wuhan, at that time, the zero zone of the epidemic in China. When she landed in Germany, patient zero was infected, but did not know it.
The following Monday, he showed up at the Webasto headquarters in Stockdorf, near Munich, to give a two-day training. On the night of the 22nd he flew back to Shanghai and already on the plane he felt that something was wrong. “The time he was here, he did not feel bad. Maybe a little tired, but she attributed it to jet lag ”, Now remembers Nadine Schian vice president and head of communication for Webasto, who was part of the crisis cell from the outset. Already in China, the patient went to the doctor and on the 26th she received a positive result for coronavirus. He immediately sent an email to the company in Germany, which due to the time difference did not open until the 27th.
“The first thing we did was inform the entire company”, Schian recalls. Patient zero sent a list of people she had been in contact with during her stay in Germany. Employees who had been face-to-face for more than 15 minutes with the infected person produced another list. The company informed the taxi driver that he transferred patient zero to the hotel where he slept and to the restaurant where he had dinner. They decided to publish an interview in a newspaper so that everyone who might have been in contact with patient zero knew about it and reported. “So there was not so much information on what to do. We have learned a lot in this time, ”thinks Schian now.
On the same day 27, the first positive was confirmed among the employees. He had been with patient zero in a meeting and during the weekend he found himself a bit flu, but on Monday morning, he went to work. When he arrived, he saw the news on the Intranet and his boss sent him home. Upon testing positive, another list was drawn up with people who had been in contact with him in the past 14 days. That was Monday, Tuesday, they decided to close and disinfect the company where 1,200 people work. Nine people tested positive at the company and seven others were infected as a result of the initial infection in Webasto. The focus was extended to a total of 16 people, 12 men and 4 women.
The analysis by the German researchers indicates that patient 1 sat next to patient zero in an hour-long meeting and in a 12-square-meter room. The sequence of the virus genome of patient 2 also allows us to conclude that patient zero transmitted the disease to him. Patient 3 was in contact with patient 1 when they both worked on the same computer at the same time for a short time. Patient 3 later sat next to patient 12 for 90 minutes in a private meeting. Patient 12 flew to Spain on January 28, where he was isolated in a Canarian hospital two days later. Patient 4 also had direct contact with patient zero.
Establishing the contagion between patient 4 and 5 was more complicated. They had not met in meetings together, nor had they met. Except once. It was in the company canteen. They were sitting with their backs to each other. Number 5 turned and asked the salt shaker for number 4. That was two days before patient 4 developed symptoms. “The genome sequence was used to confirm the epidemiological link and clarify the transmitting event in cases where the contact account was ambiguous”, iThey indicate in the scientific article. They assure that the analysis of the virus sequence of both patients leads them to conclude that the salt shaker episode could have caused transmission. The rest of the 16 infections were people who had been in contact with the patient 0, 1, 2 and 5 and who had participated in meetings, at a short distance and for more than 15 minutes and, in the case of 5, also his family, which was infected.