In a significant twist that could reshape our understanding of the early days of the coronavirus pandemic, death records now indicate the first COVID-related deaths in California and across the country occurred in January 2020, weeks earlier than originally thought and before officials knew the virus was circulating here.

A half dozen death certificates from that month in six different states — California, Alabama, Georgia, Kansas, Oklahoma and Wisconsin — have been quietly amended to list COVID-19 as a contributing factor, suggesting the virus’s deadly path quickly reached far beyond coastal regions that were the country’s early known hotspots.

Up until now, the Feb. 6, 2020, death of San Jose’s Patricia Dowd had been considered the country’s first coronavirus fatality, although where and how she was infected remains unknown.

Even less is known about what are now believed to be the country’s earliest victims of the pandemic. The Bay Area News Group discovered evidence of them in provisional coronavirus death counts of the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) — widely considered the definitive source for death data in the United States — and confirmed the information through interviews with state and federal public health officials. But amid privacy concerns and fierce debate over pandemic policies, the names, precise locations and circumstances behind these deaths have not been publicly revealed. That is frustrating to some experts.

“We need to sit back and really assess what was this thing, when it started, how did we handle it, did we create more of a problem than we needed to, could we have handled things differently?” said Matthew Memoli, director of the clinical studies unit at the Laboratory of Infectious Diseases at the National Institutes of Health in Bethesda, Md. “There’s a lot to think about here.”

For instance, the far-flung nature of the deaths — in the West, Midwest and South — might suggest that restrictions on travel and social interactions should have been used in more places much earlier — and that such rapid response could be a more critical tool in the next pandemic. In January, when the United States announced it would begin limiting travel from China and other international hotspots, the virus may already have been speeding across state borders.

While California, Georgia, Alabama and Oklahoma acknowledged or didn’t dispute that a death certificate in their states from January 2020 had been changed to include COVID-19, none of the states would provide further details to reporters from this news organization, citing privacy laws. The Wisconsin Department of Health Services now lists the probable COVID-19 death of a 50-59-year-old woman on Jan. 22, 2020, in its data. Kansas did not respond to a request for comment.

This new data appears to be the result of months-long efforts by so-called certifiers — the coroners, medical examiners and doctors across the country tasked with explaining when and why people die — to take a closer look at deaths that occurred in the months before the outbreak.

The Bay Area News Group first reported in April that the CDC was investigating why multiple COVID-related fatalities before Dowd’s death began appearing earlier this year in state and federal records.

But this past week, the federal agency said that it had worked with state officials to contact the certifiers in five cases and confirmed that death certificates from January 2020 have now been intentionally revised to include COVID-19.