Coronavirus: What is a pandemic and what does the WHO’s declaration mean?

What will it mean for the way the Covid-19 outbreak is treated and prepared for?

An analyst at Fiocruz laboratory, a public health research institute, in Rio de Janeiro holds samples  to be tested for Covid-19. Photogrph: Caral De Souza/AFP

An analyst at Fiocruz laboratory, a public health research institute, in Rio de Janeiro holds samples to be tested for Covid-19. Photogrph: Caral De Souza/AFP

 

What is a pandemic?

Pandemics have nothing to do with the severity of a disease but are to do with its geographic spread. According to the World Health Organisation, a pandemic is declared when a new disease for which people do not have immunity spreads around the world beyond expectations.

How does the WHO decide whether to call it a pandemic?

Cases that involve travellers who have been infected in a foreign country and have then returned to their home country, or who have been infected by that traveller, known as the “index case”, do not count towards declaring a pandemic. There needs to be a second wave of infection from person to person throughout the community.

Once a pandemic is declared, it becomes more likely that community spread will eventually happen, and governments and health systems need to ensure they are prepared for that.

An epidemic, on the other hand, is a sudden increase in cases of an illness or disease that can be unique to one country or community.

When is a pandemic declared?

Ultimately, the WHO gets the final say. There is no threshold, such as a certain number of deaths or infections, or number of countries affected, that needs to be met. For example, the Sars coronavirus, identified in 2003, was not declared a pandemic by the WHO despite affecting 26 countries. However its spread was contained quickly, and only a handful of nations were significantly affected, including China, Hong Kong, Taiwan, Singapore and Canada.

If declaring a pandemic triggers global panic, this can defeat the purpose of trying to raise awareness. Much has been written about whether the declaration of H1N1, colloquially known as “swine flu”, as a pandemic in 2009, caused unnecessary panic, overwhelming emergency departments and causing governments to overspend on antiviral medications. Coronavirus symptoms are generally mild and most people recover within six days.

Now the WHO has declared Covid-19 a pandemic, what will it mean for the way the outbreak is treated and prepared for?

The WHO has stressed that using the word “pandemic” does not signal a change in its approach. It urges countries to “detect, test, treat, isolate, trace and mobilise their people”.

Prof Nigel McMillan of the Menzies Health Institute in Queensland, Australia, says a pandemic declaration alerts health authorities to prepare to move beyond travel bans.

“This includes preparing our hospitals for a large influx of patients, stockpiling any antivirals, and advising the public that when the time comes, they will need to think about things like staying at home if ill, social distancing, avoiding large gatherings etc,”Prof McMillan says.

He says this might prove the toughest part for governments - encouraging people to change their behaviours, such as forgoing or cancelling large social events if they are sick. – Guardian News and Media 2020