Cork man identified by CUH doctors as having first community-transmitted case of Covid-19 in the country

A Cork man has been identified by doctors at Cork University Hospital (CUH) as having the first community-transmitted case of Covid-19 in the country in February.

The 43-year-old who died after 27 days on a ventilator is said to be the first known diagnosed case of community transmission of the virus in the Republic.

It was reported in last month’s Irish Medical Journal that the man tested positive for the virus and was tested "outside the national guidance" at the time.

He presented himself at hospital four days before the first known confirmed case of coronavirus on February 29, of a man who had travelled from an affected area of Northern Italy.

The report outlined how the man had reported no recent foreign travel or unusual exposure to any area where the virus was prevalent at the time or any link to a confirmed case, and worked as a farmer.

He presented with an incidental cough and on two previous short admissions had presented with a headache and was found to have pneumonia, later requiring a high level of ventilation in intensive care before passing away almost a month after being transferred to a different hospital in early March.

It was later found that the particular strain in this case showed "very little difference" from the original strain from China's Hubei province.

Authors of the report said the patient represents the first case of community transmission of the virus in Ireland, identifying that his case had "far reaching implications" in the management of the virus.

The case "provided evidence of community transmission in spite of only six imported cases having been reported nationally at the time of diagnosis", the report read.

The “crucially important diagnosis” allowed “immediate staff and patient contact-tracing and isolation to commence” from a hospital perspective.

“It had far-reaching implications on the wider epidemiology of SARS CoV-2 in Ireland as it provided evidence of community transmission in spite of only six imported cases having been reported nationally at time of diagnosis.” This informed the national response to SAR-CoV-2 and, in turn, “suppressed the curve and saved countless lives”.

It said that the case resulted in "immediate changes" to the criteria for testing.

“This case highlights the importance of clinical judgement in deciding appropriate clinical investigation and management. IN an unprecedented moment in the history of modern medicine, where evidence-based guidance and high quality clinical trials are lacking, individual clinical acumen and reasoned decision-making are more important than ever,” the report concluded.