For months, every time Donald Trump was confronted over his downplaying of COVID-19, his lack of a national policy, his failure to plan for the impact of the disease or to develop any consistent response, Trump had one constant reply: look at the 2009 H1N1 epidemic. In appearance after appearance, Trump declared that then-president Barack Obama had “handled that very badly,” or was “terrible,” or did nothing. Because Obama was so incompetent, claims Trump, the H1N1 epidemic was “totally awful” and resulting in “over 13,000” deaths as people were “dying all over the place.”
The actual number of people who died in the 2009 H1N1 epidemic in the United States between the first case in April of 2009 and the official end of the epidemic in April 2010 was 12,469. On Tuesday, the number of deaths from the COVID-19 outbreak in the United States passed that number. That may reduce the number of times that Trump points at H1N1 epidemic … or not. In any case, it seems like a good time to review what happened then versus what is happening now.
On April 15, 2009, the first known case of H1N1 flu was identified in a patient in California. Only two days later, a second case was identified 130 miles away. There was no known contact between the two cases, and attempts to trace their connections found no one in common. Later analysis suggested that the disease actually made the jump to humans in northern Mexico among workers at a farm raising pigs for an American company. However, these cases were only identified after the epidemic was underway.
There was never any opportunity to limit the outbreak in the United States, because it began in the United States. There was never any opportunity to move before the virus had begun to be spread through the community, because community spread inside the United States was already happening before anyone knew the virus existed. The day after that second case was identified, April 18, the United States reported the infections to the World Health Organization, and the fight against H1N1 had begun.
The origins of the 2019 novel coronavirus are obviously quite different. Though intelligence reports had indicated that there was an infection spreading through the city of Wuhan in November, the timeline from both the World Health Organization and researchers who have investigated the outbreak suggests that the first human-to-human transmission of the disease that would soon be named COVID-19 occurred somewhere in the early days of December, in or near the city of Wuhan. Attempts by a group of doctors in Wuhan to warn against the first known cases of that disease, followed by interference and a brief stint in jail for some of the doctors, happened around Dec. 22. The official notification to the WHO was made on Dec. 31, at a point where 44 patients were identified as being infected with a novel coronavirus.
Starting with the dates on which the outbreak was first definitively known to the United States government, this is what came after:
Day
2009 H1N1
2020 COVID-19
0
First confirmed H1N1 case in the U.S.
WHO is informed of the outbreak in Hubei and of 44 known patients with a novel coronavirus
2
Proof of community spread in U.S.
6
CDC begins work on candidate vaccine
7
CDC activates emergency response center
8
Additional cases in Texas show that H1N1 is already circulating widely in U.S.
9
CDC completes genetic sequencing of H1N1 virus and publishes results
10
WHO declares world health emergency
11
President Obama declares H1N1 a national health emergency
CDC distributes 25% of antiviral drugs from national stockpile to states to prepare for treatment of local cases
12
European Union suspends nonessential travel to United States following first confirmed case in Spain
China reports first death from COVID-19
13
FDA approves the first test for H1N1 virus
Federal guidelines published recommending school closures
CDC reports first death from H1N1 flu
Chinese authorities complete genetic sequence for the 2019 novel coronavirus
14
WHO raises pandemic alert to level 5
Thailand reports first known case of infection outside of China
15
CDC begins shipping tests across the country, as well as to WHO and other nations
18
First test kits for COVID-19 are made widely available after development by German scientists
19
CDC announces it will report probable cases in addition to confirmed cases to ensure resources are being allocated correctly
20
Peak day of school closures; many schools dismiss early for the year
21
CDC completes early testing and publishes guidelines and dosages for using antivirals in treating H1N1
CDC passes 1,000,000 tests shipped
23
First case of COVID-19 in U.S. is a man returning from Wuhan to Washington state
25
With schools closed, widespread testing in place, and flu season waning with the onset of summer, the first wave of H1N1 cases begins a steep decline
China imposes tough lockdown on Hubei Province, restricting travel and closing businesses and schools
26
CDC announces development of its own test
China begins using antibody test that can detect both active and recovered cases
30
Total U.S. deaths — 1
Total U.S. deaths — 0
31
WHO provides first shipment of 250,000 test kits to 150 countries
36
FDA approves test kit developed by CDC
38
CDC ships a total of 90 test kits
44
CDC announces an error in tests and withdraws shipments in progress
57
First case of suspected community transmission within the United States is identified in California
60
Slow spread of virus continues through summer, reaching all 50 states by June 19
First death from COVID-19 within the United States
Only three public health labs have CDC tests
60
Total U.S. deaths — 16
Total U.S. deaths — 1
61
CDC allows others within U.S. to begin development of their own tests
68
Mike Pence insists that 1,000,000 tests have been shipped
Actual number of tests conducted is less than 2,000
76
Donald Trump declares national health emergency
CDC provides first guidance warning against large gatherings
79
COVID-19 cases confirmed in all 50 states
90
Total U.S. deaths — 153
Total U.S. deaths — 2,583
97
Clinical trials of vaccine begin
100
Trump: “Light at the end of the tunnel.”
100
Total U.S. deaths — 204
Total U.S. deaths — 12,841
120
H1N1 cases increase with end of summer
CDC issues guidelines to businesses
CDC issues guidelines to schools and universities
120
Total U.S. deaths — 506
150
FDA announces approval of four different H1N1 vaccines
150
Total U.S. deaths — 1,062
165
States place first orders for H1N1 vaccines
180
Official national vaccination campaign begins
180
Total U.S. deaths — 1,655
184
President Obama issues second national emergency declaration to provide funds for vaccine distribution to states
204
Peak number of H1N1 cases reported
210
Total U.S. deaths — 2,659
229
First day without school closures since Day 13
240
Total U.S. deaths — 3,924
248
100 million doses of vaccine available
360
Total U.S. deaths — 12,469
366
H1N1 epidemic officially ends in United States
483
WHO declares end of global pandemic
What happens after day 100 on the COVID-19 pandemic is still unwritten. But it’s definitely worth noting that in the case of the H1N1 virus, the United States:
Got its test up and running within days of the first case
Distributed supplies to states even before their first cases appeared
Issued national guidance to close schools within two weeks of the first known case
Went all in on a vaccine, starting mass production of multiple vaccines even before trials began, in order to rush the vaccine to states when the second wave emerged in the fall
Provided consistent, federal guidance to states, schools, and businesses throughout the crisis
From “doing nothing” the White House, CDC, and FDA were consistently anticipating the course of the epidemic at every step and rushing production and approvals as well as information
In spite of all this, the bulk of deaths from H1N1 came after the vaccine was widely available. And it took a full year to reach a total that the COVID-19 epidemic has achieved just 43 days after the first identified case of community spread disease in the United States.
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