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Monday, March 2, 2020

Is the coronavirus causing covid-19 a pandemic? It looks like one, and health officials across the world are treating it like one

By Paige Winfield Cunningham
The Washington Post

Officials have been slow to use the “P” word to refer to the spread of coronavirus.

Yes, that word: “Pandemic.”

. . . The story of covid-19, the disease caused by the virus, isn't the same as a Hollywood thriller. But some health experts are frustrated by the hesitancy of officials to describe it as a pandemic, even though it checks just about every box of criteria.

“Personally, I think we're doing everyone a disservice by continuing this debate,” Lauren Sauer, director of operations for the Johns Hopkins Office of Critical Event Preparedness, told me. “It is creating more panic than just declaring it and moving on.”

A pandemic refers to an infectious disease spreading so rapidly across multiple countries that it can’t be contained. The World Health Organization defines “pandemic” this way: “The worldwide spread of a new disease” that sickens a large number of people because they don’t have immunity to it.

One could argue — and most epidemiologists do — the coronavirus is a pandemic under that definition; cases have been reported in more than 50 countries and on every continent (except Antarctica) and nearly 3,000 people have died from it.

Japan and South Korea have shuttered their schools. China has dramatically scaled back its manufacturing under intensive quarantines. Heck, even the Louvre in Paris is closed.

When officials do use that term, it indicates they’re worried the virus has hit a tipping point where drastic actions such as closing schools, canceling public gatherings and urging people to stay at home are necessary. While containment is the goal under an epidemic — where a disease is spreading only regionally, not globally — mitigation becomes the goal under a pandemic.

There are growing signs that health officials around the world are viewing coronavirus as a pandemic — even if they're not willing to state it yet directly.
  • Last Tuesday, the U.S. Defense Department raised its “Risk of Pandemic” warning from “probable crisis” to “imminent crisis,” according to a document obtained by Newsweek. Officials expect the coronavirus will “likely” become a global pandemic within the next 30 days.
  • Nancy Messonnier, a top official at the Centers for Disease Control and Prevention, said the following day the coronavirus has met two criteria of a pandemic: causing illness resulting in death and spreading person to person in a sustained way.
    “The world moves closer toward meeting the third criteria — worldwide spread of the new virus,” Messonnier told reporters.
  • And yesterday, the WHO director general used the word “pandemic” as he warned “the window of opportunity for containing it is narrowing.”
    “We need to be preparing side by side for a pandemic,” Tedros Adhanom Ghebreyesus told CNBC.
In some regards, it doesn't matter much whether officials say they're dealing with a pandemic or not. Global authorities are already responding to the novel coronavirus as though it’s the highest-level health threat, regardless of the terms used to describe its spread. . . .

WHO no longer uses “pandemic” as a term to classify the threat of infectious diseases. The agency changed its classification system after calling the 2009 swine flu outbreak a “pandemic.” At the time, it was accused of exaggerating the alarm for an illness that turned out milder than initially expected.

But the agency has already given coronavirus its highest threat level — dubbing it a “Public Health Emergency of International Concern” — and its leaders have been wary of using the term pandemic casually.

“Using the word pandemic carelessly has no tangible benefit, but it does have significant risk in terms of amplifying unnecessary and unjustified fear and stigma, and paralyzing systems,” Ghebreyesus said last week.  But WHO spokesman Tarik Jasarevic told me this morning “we are at a critical juncture in the outbreak.”

“While we must continue efforts to contain Covid-19 — focusing on strengthening surveillance, conducting thorough outbreak investigations to identify contacts and applying appropriate measures to prevent further spread — countries should also use this time to prepare for the possibility of wider transmission,” Jasarevic wrote in an email.

In public, top Trump administration officials are staying away from the term “pandemic” as they try to reassure Americans the threat of getting the virus is still low and do damage control after reports suggested the administration's response has been internally chaotic.

Pence said on CNN's “State of the Union” that the Trump administration is leading an aggressive, coordinated response, keeping the threat of the flulike illness at a low level for the average person.

“The good news is, of the 22 Americans that have contracted the coronavirus, more than half of them are almost fully recovered,” Pence said. “And I think it’s all a reflection of the fact that early on in this crisis, the president took the unprecedented step of suspending all travel from China and establishing a quarantining effect.” 

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