In mid to late January we saw about 15 patients (aged 20-60) in our clinic with high fever (up to 104), headache, sore throat, dry cough, weakness, and watery diarrhea…several needed IV fluids for dehydration, do not know if any ended up in hospital. We were not aware or thinking of #COVID-19 at the time. One of my patients who had these symptoms still has a cough; she told me two days ago that her friend, a healthy 49 y/o female, came down with similar symptoms in late January and died a few days later of fulminant pneumonia. My patient works at a park where international travelers visit. One of the other park employees just tested positive for COVID-19 and the park is now closed. A nurse at our clinic has a son who traveled to Italy late last year. After he returned she became ill with high fever and headache and dry cough and was incapacitated for weeks. In Late January I saw several members of one rural fire department with all the symptoms I have described. We are in rural northern New Mexico and several people in the area had traveled to Europe. Wondering if this-was an early representation of COVID-19… Would you consider this a cluster of suspected COVID or something like adenovirus? Btw I saw no children with these symptoms. Shared by an NP from New Mexico, US and posted by Figure 1 on March 21, 2020.