PARIS — Health investigators around the world are racing back in time.
While it was thought COVID-19 only began to spread beyond China and across Europe in January and February, French doctors this week said they have established the coronavirus was already present in Paris by late December — a month before the country’s first official recorded case and two and a half months before a nationwide lockdown.
The patient, Amirouche Hammar, 43, from the suburbs of Paris, has been dubbed France’s potential “patient zero” by researchers and was possibly even the first case in Europe.
The French team is among researchers across the world now poring over old medical reports hunting for clues from the very start of the COVID-19 outbreak, hoping to paint a wider, more accurate picture of how the virus spread so quickly.
A team at Avicenne Hospital in Paris, led by Dr. Yves Cohen, its head of emergency medicine, started digging last month. They went back to the end of the year and re-examined medical records of intensive care patients admitted for influenza-like illness between Dec. 2 and Jan. 16.
According to the study, they narrowed the list of 58 patients to 14 who had tested negative for pneumonia. But one sample came back positive for COVID-19.
“It’s surprising, but also exciting,” Cohen told NBC News. At the time, he didn’t suspect COVID-19 “because at the end of December, there was no coronavirus in France.”
But then the team tested the sample again to be sure and contacted French health authorities. Two weeks ago, Cohen called Hammar, 43, with the news.
"I was shocked," Hammar said, as he sat in his garden just 15 minutes away from Avicenne, surrounded by his four kids, life looking almost normal five months on. "I'm a miracle," he said.
Hammar explained his December symptoms, now obvious hallmarks of COVID-19: cough, chest pain, trouble breathing. "I began having pain in my chest that felt like knife stabs," he remembered. And most frighteningly, he coughed up a lot of blood.
"Everyone was panicking," he said of his time in the hospital. "Honestly, no one had the key to this." Cohen doesn't dispute his patient's recollection -- at the time, he had assumed it was another unknown virus.
Hammar's wife, Fatiha, at home with their four children, called every 20 minutes for news, so he sent her videos to reassure her.
Watching her husband gasp for air on her phone was far from reassuring, Fatiha Hammar recalled.
In a statement, the French health authorities said they will “consider other investigations if they prove to be necessary.”
Since the COVID-19 diagnosis, Hammar and his wife have replayed the events of December in their minds: Where had they been? Whom had they seen? Neither had been on a plane since August when they traveled to Algeria. Fatiha Hammar works at a supermarket close to the airport and said that sometimes “passengers would come in right off the flights with their suitcases.” They wondered, could a traveler have infected her?
In late December, she felt run-down. "Tired. Very tired," she recalled. She had a small cough, a light fever -– what she thought was a winter cold. A week later, her husband drove himself to the emergency room at 5 a.m.
Where they picked it up remains a mystery, but Cohen says the new timeline is a step closer to understanding how quickly the illness might have jumped from China to Europe. At a briefing Tuesday in Geneva, the WHO took notice of the French study.
"This gives us a whole new picture on everything," WHO spokesman Christian Lindmeier said, encouraging other countries to follow France's lead.
Dr. Vin Gupta, a pulmonologist and a public health expert at the University of Washington, said discoveries such as Cohen's may disprove current models and lead authorities to question where their populations really are in terms of the magnitude of the spread of COVID-19.
"Maybe we are talking about true herd immunity? Maybe most of us are actually truly infected," Gupta said, emphasizing the number of unknowns.
"If we know that this as a respiratory pathogen can move that quickly, that changes everything with respect to the next one and we know there's gonna be a next one." he added.
Cohen agreed. His research isn't for now, he said, it's for the next pandemic.
He stressed that every doctor should be doing this same study and doing it now.
"To fight an enemy, we have to know the life of the enemy," he said.