A study published in the JMIR medical journal today suggests that COVID-19 may have been present in Los Angeles as early as December last year. The research undertaken by UCLA and the University of Washington investigated electronic health records from UCLA Health to determine the number of outpatient visits that included the word ‘cough’ in winter 2019, compared to the same period in the 5 years prior. Health records from patients hospitalized with acute respiratory failure during that timeframe were also analyzed. The study found that a ‘significantly higher number of patients presented to outpatient clinics and emergency departments in this health system with a complaint of cough starting the last week of December 2019 and continuing through January and February 2020.’ The JMIR paper continues that a ‘significant excess in the number of patients hospitalized with acute respiratory failure during this same time period was also noted.’