COVID-19: PANDEMIC STATUS?
The SARS-CoV2 virus, newest member of the coronavirus family has proven to be especially contagious, with over 80,000 cases and 2700 deaths so far. Cases of COVID-19 (the name for the disease) have been reported in more than 30 countries and community-wide outbreaks are confirmed in places like Italy in Europe, Iran in the Middle East, and South Korea (among others).
Although the grand majority of cases are still in mainland China, more cases are being reported outside China than inside these days. South Korea has more than 1,260 cases and one of them is a U.S. soldier. Italy has 320 cases and 12 dead. Iran only claims 139 cases but 19 deaths, much more than the 2 percent fatality rate seen in other countries. Most suspect this means that many tens of thousands are still undetected.
Meanwhile, The Centers for Disease Control and Prevention (CDC) gave an opinion that “the immediate risk of this new virus to the American public is believed to be low at this time,” while also saying: “It’s not so much a question of if this will happen anymore but rather more a question of exactly when”.
Despite the many cases that are popping out throughout the world, Most U.S. experts and World Health Organization (WHO) officials believe that COVID-19 is not yet at pandemic status. If the COVID-19 outbreaks all over the world aren’t a pandemic, what is?
The World Health Organization should consider following their own definitions for pandemic disease. The different WHO phase alerts for infectious disease outbreaks are:
Phase 1: The disease is found circulating in animals; no known infections in humans. An example would be an outbreak in 2019 of vesicular stomatitis virus, a disease that affected more than a thousand premises holding horses. No cases were reported among humans, even those who worked daily with the animals.
Phase 2: The disease has caused proven infection in humans. The bird flu affected millions of poultry as well as a number of people who lived and worked in close contact with them.
Phase 3: Small clusters of disease occur in humans but do not affect entire communities. Measles virus may affect a number of non-vaccinated people in an area, but the large number of vaccinated individuals prevents it from running rampant.
Phase 4: The disease affects entire communities. The disease now qualifies as an epidemic, but the risk for a pandemic, although increased, is not certain. With COVID-19 in early 2020, large areas in China were saturated with cases but no major community-wide outbreak had originated anywhere else for a time (outside of a cruise ship). Since then, other countries are reporting spikes in cases, with cases in South Korea doubling over the course of one day. In my opinion, COVID-19 has now passed this stage.
Phase 5: Spread of disease between humans is occurring in more than one country in a region. The Ebola virus outbreak of 2014 is an example of this phase; cases affected communities in several different adjacent West African countries but no community outbreaks occurred outside of the region. In 2020, COVID-19 cases in nearby nations like South Korea and Japan are starting to accumulate, just as Ebola did in West African countries in 2014.
Phase 6: Community-level outbreaks exist in at least one additional country in a different region. With Ebola, cases in North America and Europe didn’t originate there and the infection didn’t take hold locally in any significant manner. Influenza, however, commonly reaches pandemic status on an annual basis.
COVID-19 in 2020 is developing large numbers of cases of human-to-human transmission outside of China. With outbreaks in Italy, Iran, South Korea, and elsewhere predicted to get worse before they get better, it’s clear you’ve got a pandemic on your hands. Right now.
I say this not just because of the cases that have been reported, but because we can only surmise that the number of cases documented is less than what really exist.
That doesn’t necessarily mean that real numbers are being held back. Statistics may be affected by the limitation on lab facilities to test for a disease. In some emerging infectious diseases, no test may be accurate enough to give proven results. In the COVID-19 outbreak, a number of people have tested negative using the current technology and still show symptoms.
Quarantines of entire cities in the face of a dangerous disease may lead those who are mildly ill to stay inside their homes and not seek care in overcrowded hospitals. As a result, many cases may not be counted.
Sometimes, however, a government may put out inaccurate numbers in an effort to avoid panic in its citizens. Certain regimes may limit the dissemination of information to give an unclear picture of the epidemic’s real effect on the country.
For example, we have no idea of how many cases of COVID-19 may exist in North Korea, a nation which borders China and most certainly has been affected. Yet, the government is completely silent about the SARS-COV2 virus.
When people are prepared, they can purposefully and rationally act to decrease their chance of infection. But to get prepared, most people look to their government’s health agencies for advice. Those health agencies should alert citizens with enough time to get the supplies they need and prepare.
Epidemics don’t just make people sick; they also disrupt the chain of supply. China, a major producer of face masks, has already mandated that they are no longer for export. In the U.S., many personal protection gear items are already scarce.
It’s important to know that there’s no need to panic. Hopefully, the CDC opinion is correct in its assessment that the immediate risk to Americans is low . If we are to weather this storm, however, we need to be shown the black clouds on the horizon. Declare a pandemic and let’s work to get our communities ready with a plan of action. Complacency can be hazardous to your health.
Joe Alton MD