When COVID-19 progresses from epidemic to pandemic status, we examine what effect this may have on all of us and explain how experts have responded. We also share some anxiety coping strategies.
On 11 March 2020, the World Health Organization (WHO) officially changed the COVID-19 classification from a public health emergency of international importance to a pandemic.
COVID-19 is the name of the respiratory disease caused by the new coronavirus SARS-CoV-2.
What does this classification move mean?
In a press briefing yesterday afternoon, Dr. Tedros Adhanom Ghebreyesus, Director-General of the WHO, clarified that the organization’s evaluation of this outbreak has taken place around the clock, and we are deeply concerned by both the alarming levels of spread and intensity and the alarming levels of inaction.
“Pandemic is not a word that can be used loosely or carelessly. It is a word that, if misused, can trigger excessive anxiety or unjustified belief that the fight is over, leading to needless suffering and death,” Dr. Tedros went on to explain.
So, if the strategy is business as usual, do we expect any major changes imminently, and what can we do as individuals to resolve the challenges that we may face in the future?
What’s behind a pandemic?
The Centers for Disease Control and Prevention (CDC) use the word “epidemic” when thinking about “an increase, often immediate, in the number of cases of disease above what is normally expected in that population in that region.”
“Pandemic” is an outbreak and “refers to an epidemic that has spread across several countries or continents, generally affecting a large number of people.”
Most people may be familiar with the term flu pandemic.
The CDC states that a flu pandemic happens when a new version of the influenza virus infects people easily and spreads rapidly from person to person in a sustainable manner.
Three flu pandemics existed in the world in the 20th century.
Estimates put the number of deaths from the Spanish flu at across 50 million worldwide in 1918. The Asian flu caused about 1.1 million deaths between 1957 and 1958, and the Hong Kong flu pandemic caused about 1 million deaths in 1968.
The most recent flu pandemic occurred in 2009, when a novel strain of influenza called (H1N1)pdm09, more commonly referred to as swine flu, spread around the globe.
Approximately 60.8 million infections, 274,304 hospitalizations and 12,469 deaths were recorded in the United States in the first year after the virus emerged, according to CDC figures.
Across the globe, during this time, the CDC estimates the number of deaths in the region of 151,700–575,400.
At the time, school closures and social gaps were taking place in an attempt to limit the spread of the virus within and around populations.
Vaccine development was extremely rapid, with four H1N1 influenza vaccines approved by the Food and Drug Administration (FDA) by September 2009.
Experts Comment On COVID-19 Pandemic
COVID-19 is the first pandemic caused by coronavirus disease. Yet, while this change in status may leave us terrified, the WHO and other experts take a careful look at the phrase.
In his assessment of the situation, Dr. Tedros was clear:
“Describing the situation as a pandemic does not change WHO’s assessment of the threat posed by this virus. It doesn’t change what WHO is doing, and it doesn’t change what countries should do.”
“We can not say that loud enough, or clearly enough, or often enough: all countries can still change the course of this pandemic,” he went on to say.
So, how did the other experts respond to the situation?
“[ WHO] has agreed that the SARS-CoV-2 outbreak should now be referred to as a pandemic,” said Nathalie MacDermott, PhD, academic clinical lecturer in pediatric infectious diseases at King’s College London, United Kingdom, adding, “This decision is likely to have been made on the basis of the majority of the world’s continents that are now experiencing substantial and continuing people-to-people.
“The change of term does not alter anything practically, as the world has been advised for the last few weeks to prepare for a potential pandemic, which has hopefully been taken seriously by all countries,” she continued.
However, she adds that “the use of this term, however, underlines the importance of countries around the world working cooperatively and openly with each other and coming together as a united front in our efforts to bring this situation under control.” Meanwhile, Prof. Mark Woolhouse, Chair of Infectious Disease Epidemiology at the University of Edinburgh, U.K., explained that COVID-19 is one of them.
“[ WHO] has now acknowledged that COVID-19 is a pandemic. The statement also states that this does not alter their advice on how to respond and that’ urgent and decisive’ action is needed by countries with major outbreaks,” he said.
“An important word missing from this sentence is’ sustainable.’ It is now clear that COVID-19 will be with us for a considerable period of time, and the decisions that we take must be acts that we can live with for a long period of time.”
‘Turning the tide’
Dr. Tedros had some very clear messages in his press briefing for countries around the world.
“Even those countries with population transmission or large clusters can turn the tide on the virus. Some countries have shown that this virus can be suppressed and regulated,” he said.
“Some countries are struggling with a lack of capacity. Some countries are struggling with a lack of resources. Some countries are struggling with a lack of resolve.”
Michael Head, Ph.D., Senior Research Fellow in Global Health at the University of Southampton, U.K., said,”[ WHO] said that some countries are grappling with a lack of resources, but also’ a lack of commitment.’ This is obviously a direct indication that many countries have been unable to scale up their responses,” he said.
In the final part of his press briefing, Dr. Tedros used these terms: “There has been so much attention to one word. Let me give you a few other words that mean a lot more and are much more workable.” “Prevention. Preparation. It’s public health. Political leadership, of course. And most of all, the people. We’re in this together to do the right things wisely and protect the world’s citizens. It’s feasible,” he concluded.
Travel bans, social barriers and fear
Governments around the world have taken a number of different approaches to preventing the spread of SARS-CoV-2.
While the U.S. is expected to ban entry for tourists coming from many European countries from midnight on Friday, authorities in China claim that the peak of new cases in China has passed and that the pandemic may be over by mid-summer.
In Italy, social isolation steps are in full swing, with a large part of the country locked in. Ireland has announced today that all schools, colleges and daycare centers will be closed, along with museums, galleries and tourist sites, until 29 March.
Schools are also closed down in several jurisdictions across the state of Washington.
It is not shocking, given the speed of these incidents, that the levels of anxiety have risen significantly for many people. Guideline on mental health issues was released by the WHO earlier this week during the COVID-19 pandemic.
We suggest, among other things, to the general public:
- Avoid watching, reading, or listening to news that causes you to feel anxious or distressed.
- Seek information mainly to take practical steps — to make plans and protect yourself and loved ones.
- Seek information updates at specific times, once or twice during the day — a sudden, near-constant stream of news about an outbreak can cause anyone to feel worried.
- Get the facts — gather information at regular intervals from the WHO website and local health authorities, to help distinguish facts from rumors.
We echo some of these in our Spotlight feature “Anxious about the news? Our top tips on how to cope,” in which we delve deeper into coping strategies.