Covid-19: Early Cases and Disease Spread

Jacques Reis, Alain Le Faou, Alain Buguet, Guy Sandner, Peter Spencer

Research output: Contribution to journalReview articlepeer-review


The emergence and global spread of the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is critical to understanding how to prevent or control a future viral pandemic. We review the tools used for this retrospective search, their limits, and results obtained from China, France, Italy and the USA. We examine possible scenarios for the emergence of SARS-CoV-2 in the human population. We consider the Chinese city of Wuhan where the first cases of atypical pneumonia were attributed to SARS-CoV-2 and from where the disease spread worldwide. Possible superspreading events include the Wuhan-based 7th Military World Games on October 18–27, 2019 and the Chinese New Year holidays from January 25 to February 2, 2020. Several clues point to an early regional circulation of SARS-CoV-2 in northern Italy (Lombardi) as soon as September/October 2019 and in France in November/December 2019, if not before. With the goal of preventing future pandemics, we call for additional retrospective studies designed to trace the origin of SARS-CoV-2.

Original languageEnglish (US)
JournalAnnals of Global Health
Issue number1
StatePublished - 2022


  • early SARS-CoV-2 circulation
  • index case
  • Military World Games
  • Primary case
  • retrospective assessment methods
  • Wuhan

ASJC Scopus subject areas

  • Medicine(all)


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