On January 19, 2020, relaxing in his Snohomish County living room and watching the early news reports about Coronavirus Disease 2019 (COVID-19) in Wuhan City, Hubei Province, China—the city he'd just returned from—the patient became concerned. He had not been feeling well and decided to go to his primary care physician. Shortly after arriving at the physician's office, his doctor contacted the Health District Officer. They drew a blood sample and overnighted it to the Centers for Disease Control and Prevention (CDC) lab in Atlanta. The patient went home to await the results of the test.
The next morning, the CDC contacted Snohomish Health District to alert them that the patient's blood had tested positive for COVID-19. The Health District called their local fire department; in turn, the fire department's medical director called the medical services officer (MSO) for Snohomish County Fire District 7's, the emergency medical services (EMS) in the patient's community. As part of their response plan, District 7 contacted South County and Rescue for permission to use their hazardous isolation ambulance, constructed to care for Ebola patients.