Patricia Dowd died in San Jose on February 6th, 2020. Everyone believed for the last year that she was the first person in the U.S. to die from coronavirus, but now it appears she died weeks after several other people in California and five other states. According to information from the Centers for Disease Control's National Center for Health Statistics (NCHS) uncovered by Bay Area News Group, there were deaths in Oklahoma, Kansas, California, Georgia, Alabama, and Wisconsin as early as January 5th, 2020.

Wisconsin was the only state to offer a specific date of its first death which was a woman 50-to-59-years-old on January 22nd of 2020. No other details were released about the person. Bay Area News Group reports that the other states didn’t dispute their January 2020 deaths or they acknowledged they happened without giving any specifics. It’s also unclear what evidence medical officials gathered that led them to make the changes to the death certificates. 

“Certifiers are reluctant to amend death certificates unless there’s a good reason to do so,” Robert Anderson, chief of the Mortality Statistics Branch at the NCHS told Bay Area News Group. Now that we know the early deaths were much more spread out over the country, some health officials say mask, social distancing, and travel rules may have been enforced sooner in places like the Midwest and South where they lagged behind the West.

“We need to sit back and really assess what was this thing, when it started, how did we handle it, did we create more of a problem than we needed to, could we have handled things differently? There’s a lot to think about here,” Matthew Memoli from the National Institutes of Health told Bay Area News Group. “I always thought it had to have been here in the U.S. well before we identified it as a big problem.”

UC Berkeley infectious disease expert John Swartzberg agrees and says COVID-19 may have been in America as early as November. “I would certainly guess the virus was introduced on multiple occasions before it was identified as a problem,” Swartzberg told Bay Area News Group. China’s first death was reported to be January 9th, 2020.

It’s not totally uncommon for death certificates to be amended, but it is typically only done for significant reasons. Changes can be made years after someone’s death if new information is revealed. Santa Clara County health officials didn’t announce that the 57-year-old Dowd died from coronavirus until two months after she had passed. 

Experts say the updated death information shows a clear need for more studies on any connections between the cases. The CDC isn’t saying whether it is investigating the deaths and their possible relations.