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Is the Coronavirus an Epidemic or a Pandemic? It Depends on Who’s Talking Is the Coronavirus an Epidemic or a Pandemic? It Depends on Who’s Talking
(1 day later)
Update: On March 11, the W.H.O. declared the coronavirus outbreak a global pandemic.Update: On March 11, the W.H.O. declared the coronavirus outbreak a global pandemic.
All eyes have been on the coronavirus since it crept up in Wuhan, China, in late 2019. Since then, the virus has sickened tens of thousands of people in more than three dozen countries, and its quick advance across Asia, the Middle East and Europe has raised fears that a pandemic could be on the horizon.All eyes have been on the coronavirus since it crept up in Wuhan, China, in late 2019. Since then, the virus has sickened tens of thousands of people in more than three dozen countries, and its quick advance across Asia, the Middle East and Europe has raised fears that a pandemic could be on the horizon.
The World Health Organization has referred to the outbreak as an “epidemic” as opposed to a “pandemic.” But late last month, it increased its assessment of the global risk of spread and the risk of impact of the coronavirus outbreak from “high” to “very high.”The World Health Organization has referred to the outbreak as an “epidemic” as opposed to a “pandemic.” But late last month, it increased its assessment of the global risk of spread and the risk of impact of the coronavirus outbreak from “high” to “very high.”
According to the W.H.O., an epidemic is explained as a regional outbreak of an illness that spreads unexpectedly. The C.D.C. calls it “an increase, often sudden, in the number of cases of a disease above what is normally expected” in that area.According to the W.H.O., an epidemic is explained as a regional outbreak of an illness that spreads unexpectedly. The C.D.C. calls it “an increase, often sudden, in the number of cases of a disease above what is normally expected” in that area.
In 2010, the W.H.O. defined a pandemic as “the worldwide spread of a new disease” that affects large numbers of people. The C.D.C. says it is “an epidemic that has spread over several countries or continents, usually affecting a large number of people.”In 2010, the W.H.O. defined a pandemic as “the worldwide spread of a new disease” that affects large numbers of people. The C.D.C. says it is “an epidemic that has spread over several countries or continents, usually affecting a large number of people.”
“Typically, an outbreak becomes an epidemic when it becomes quite widespread in a particular country, sometimes in a particular region, like Zika,” said Lawrence O. Gostin, a professor of global health law at Georgetown University, said. “Whereas a pandemic is thought to be a wide geographic spread of a disease on many parts of the world, many continents.”“Typically, an outbreak becomes an epidemic when it becomes quite widespread in a particular country, sometimes in a particular region, like Zika,” said Lawrence O. Gostin, a professor of global health law at Georgetown University, said. “Whereas a pandemic is thought to be a wide geographic spread of a disease on many parts of the world, many continents.”
Both terms are often used in reference to the coronavirus outbreak, but how they are used is subjective, and there are no hard and fast rules on when to use them, Mr. Gostin said.Both terms are often used in reference to the coronavirus outbreak, but how they are used is subjective, and there are no hard and fast rules on when to use them, Mr. Gostin said.
Last month, the W.H.O. declared the outbreak a global health emergency. Last week, Tedros Adhanom Ghebreyesus, the director-general of the W.H.O., said the decision whether to use the word “pandemic” was based on “an ongoing assessment” of the geographical spread of the virus, the severity of its effects and its impact on society.Last month, the W.H.O. declared the outbreak a global health emergency. Last week, Tedros Adhanom Ghebreyesus, the director-general of the W.H.O., said the decision whether to use the word “pandemic” was based on “an ongoing assessment” of the geographical spread of the virus, the severity of its effects and its impact on society.
He added: “Does this virus have pandemic potential? Absolutely, it has. Are we there yet? From our assessment, not yet.”He added: “Does this virus have pandemic potential? Absolutely, it has. Are we there yet? From our assessment, not yet.”
So far, health officials have not witnessed “the uncontained global spread” of the virus, or evidence of “large-scale severe disease or death,” Dr. Tedros said.So far, health officials have not witnessed “the uncontained global spread” of the virus, or evidence of “large-scale severe disease or death,” Dr. Tedros said.
According to Mr. Gostin, there are two reasons Dr. Tedros stopped short of calling the outbreak a pandemic: Because the outbreak can still be contained, and to try to avoid unnecessary panic.According to Mr. Gostin, there are two reasons Dr. Tedros stopped short of calling the outbreak a pandemic: Because the outbreak can still be contained, and to try to avoid unnecessary panic.
“He wanted to create a seriousness, a purpose, but not an overreaction,” Mr. Gostin said. “Not more travel bans. Not more closures of cities. Not more drain on human rights and economic activity.”“He wanted to create a seriousness, a purpose, but not an overreaction,” Mr. Gostin said. “Not more travel bans. Not more closures of cities. Not more drain on human rights and economic activity.”
Mr. Gostin said the outbreak was still containable, though other experts have disputed that assertion. But if the outbreak reaches a level where it could no longer be controlled, it would move into a pandemic phase.Mr. Gostin said the outbreak was still containable, though other experts have disputed that assertion. But if the outbreak reaches a level where it could no longer be controlled, it would move into a pandemic phase.
The W.H.O. no longer uses a system of six phases, which ranged from Phase 1 — no reports of animal influenza causing human infections — to Phase 6, a pandemic, according to Tarik Jasarevic, a spokesman for the W.H.O.The W.H.O. no longer uses a system of six phases, which ranged from Phase 1 — no reports of animal influenza causing human infections — to Phase 6, a pandemic, according to Tarik Jasarevic, a spokesman for the W.H.O.
“Groups in various organizations are working to define pandemic for this novel virus, which could take some time,” Mr. Jasarevic said.“Groups in various organizations are working to define pandemic for this novel virus, which could take some time,” Mr. Jasarevic said.
The terms epidemic and pandemic imply different approaches to a health crisis, said Dr. Jennifer Nuzzo, a senior scholar at the Johns Hopkins Center for Health Security.The terms epidemic and pandemic imply different approaches to a health crisis, said Dr. Jennifer Nuzzo, a senior scholar at the Johns Hopkins Center for Health Security.
An epidemic suggests that the virus may be geographically limited, and that intervention by health agencies could help stop the spread. For a pandemic, where many places could be affected, there may be consequences for how many people or how much money or supplies are available, she said.An epidemic suggests that the virus may be geographically limited, and that intervention by health agencies could help stop the spread. For a pandemic, where many places could be affected, there may be consequences for how many people or how much money or supplies are available, she said.
Updated June 5, 2020Updated June 5, 2020
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
When an outbreak covers the globe, international groups like the W.H.O. and the United Nations have to divide their resources across greater territory than during a regional epidemic, she said. That would make a pandemic far more difficult to manage.When an outbreak covers the globe, international groups like the W.H.O. and the United Nations have to divide their resources across greater territory than during a regional epidemic, she said. That would make a pandemic far more difficult to manage.
The approach to dealing with the pathogen could also be different, Dr. Nuzzo said. If cases are everywhere, the authorities might stop trying to prevent it from entering a country and focus instead on trying to treat illness, slow the pathogen’s spread and protect vulnerable people.The approach to dealing with the pathogen could also be different, Dr. Nuzzo said. If cases are everywhere, the authorities might stop trying to prevent it from entering a country and focus instead on trying to treat illness, slow the pathogen’s spread and protect vulnerable people.
There have been more than 80,000 confirmed cases of the coronavirus around the world, according to a Feb. 25 report from the W.H.O. The majority of those cases have been reported in China, where more than 2,700 people have died.There have been more than 80,000 confirmed cases of the coronavirus around the world, according to a Feb. 25 report from the W.H.O. The majority of those cases have been reported in China, where more than 2,700 people have died.
Beyond China’s borders, the virus has spread to 46 countries across Asia, Europe, the Middle East and the Americas, killing at least 57 people.Beyond China’s borders, the virus has spread to 46 countries across Asia, Europe, the Middle East and the Americas, killing at least 57 people.
“It’s not so much of a question of if this will happen anymore but rather more of a question of exactly when this will happen,” said Dr. Nancy Messonnier, the director of the National Center for Immunization and Respiratory Diseases.“It’s not so much of a question of if this will happen anymore but rather more of a question of exactly when this will happen,” said Dr. Nancy Messonnier, the director of the National Center for Immunization and Respiratory Diseases.
Cases in the United States are going to require an increase in public health measures, said Dr. Peter Rabinowitz, professor of environmental and occupational health sciences at University of Washington.Cases in the United States are going to require an increase in public health measures, said Dr. Peter Rabinowitz, professor of environmental and occupational health sciences at University of Washington.
Health officials are still determining whether some countries with coronavirus cases will stabilize, or whether new infections will drive cases up significantly.Health officials are still determining whether some countries with coronavirus cases will stabilize, or whether new infections will drive cases up significantly.
“The situation could definitely get worse and that needs to be understood,” Dr. Rabinowitz said. “At the same time, it’s sufficiently concerning now that preparations should be underway to be ready for a worsening situation.”“The situation could definitely get worse and that needs to be understood,” Dr. Rabinowitz said. “At the same time, it’s sufficiently concerning now that preparations should be underway to be ready for a worsening situation.”
Daniel Victor and Sui-Lee Wee contributed reporting.Daniel Victor and Sui-Lee Wee contributed reporting.