COVID-19 will likely spread worldwide, affecting almost every country in every corner of the globe. The World Health Organization today declared the disease a pandemic, which the WHO defined in 2010 as “the worldwide spread of a new disease.” Tedros Adhanom Ghebreyesus, PhD, the WHO’s director general, said at a press conference today: “We expect to see the number of cases, the number of deaths, and the number of affected countries climb even higher.”
As of today, 114 countries on six continents have reported that 118,000 people have contracted COVID-19, the disease caused by the virus SARS-CoV2. In the United States, over 1000 cases have been diagnosed and 29 people have died. “This is not just a public health crisis, it is a crisis that will touch every sector—so every sector and every individual must be involved in the fight,” said Tedros, as the director general is known.
In about 80% of those infected, the virus causes mild respiratory infections. But another 15% develop severe illness and 5% need critical care. The virus originated in bats but was passed on to people by an as yet unknown intermediary animal species.
The WHO had avoided using the term pandemic to describe the COVID-19 epidemic, fearing that countries would think its unstoppable. “We cannot say this loudly enough or clearly enough or often enough,” Tedros said at the news conference in Geneva. “All countries can still change the course of this pandemic.”
Anthony S. Fauci, MD, the director of the National Institute of Allergy and Infectious Diseases at the US Centers for Disease Control and Prevention (CDC), echoed the WHO’s prognosis in testimony before the House Oversight Committee today. “The bottom line: It is going to get worse. We would recommend that there not be large crowds. If that means not having any people in the audience as the N.B.A. plays, so be it.”
There have been 2 schools of thought regarding how to best fight the disease. One is containment, which the WHO has been pushing for weeks and includes drastic measures such as quarantines of entire cities, a throwback to bygone eras. The other is mitigation, or simply trying to lesson the virus’ blow.
Fauci is a fan of containment, telling reporters recently: “If you look at the curves of outbreaks, they go big peaks, and then come down. What we need to do is flatten that down. That would have less people infected. That would ultimately have less deaths. You do that by trying to interfere with the natural flow of the outbreak.”
Evidence is mounting that containment might be the way to go. COVID-19 is believed to have originated in Wuhan, China. China has gone all in on containment, going so far as to lock down tens of millions of people days in advance of the Lunar New Year. That approach seems to have worked. China yesterday reported 24 cases. South Korea, another country rocked by COVID-19, also adopted drastic measures and appears to be bringing the outbreak under control. Countries that have not bought into containment up until now—such as Italy and Iran—have seen the number of outbreaks increase.
Italy, with more than 10,000 cases and more than 600 deaths, has changed course, imposing strict travel limits across the entire country and banning public gatherings.
“The bottom line is: We’re not at the mercy of the virus,” Tedros said recently. “The great advantage is that the decisions we all make as governments, businesses, communities, families and individuals can influence the trajectory of this epidemic.”
A preprint analysis by researchers with Harvard’s T.H. Chan School of Public Health looks at what would happen if US hospitals had to endure what China has just experienced. Investigators wrote that, “If a Wuhan-like outbreak were to take place in a U.S. city, even with strong social distancing and contact tracing protocols as strict as the Wuhan lockdown, hospitalization and ICU needs from COVID-19 patients alone may exceed current capacity.”
Michael Mina, associate medical director of clinical microbiology at Boston’s Brigham and Women’s Hospital, says that he understands the wariness about overreacting, but it’s better to error on the side of safety. “Should we be canceling classes? Should we be canceling our flights? Should we not be shaking hands? All of these things are things that I want the public to keep wondering if we should be doing this. Because the moment we’re no longer wondering whether we should be doing it, it’s too late,” Mina tells STAT. “That means that we know we should be doing it. And that is a bad place to be.”