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Coronavirus Has Become a Pandemic, W.H.O. Says

But the virus can still be stopped if nations are willing to take aggressive measures, said the organization’s director-general.

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The spread of the coronavirus is now a pandemic, officials at the World Health Organization said on Wednesday.

“We have rung the alarm bell loud and clear,” said Tedros Adhanom Ghebreyesus, the W.H.O.’s director-general.

Dr. Tedros called for countries to learn from one another’s successes, act in unison and help protect one another against a common threat.

“Find, isolate, test and treat every case, and trace every contact,” Dr. Tedros said. “Ready your hospitals. Protect and train your health care workers.”

“Let’s all look out for each other, because we’re in this together to do the right things with calm and to protect the citizens of the world.”

Although this is the first pandemic caused by a coronavirus, “we also believe that this is the first pandemic that is able to be controlled,” Dr. Tedros added.

He pointed several times to the success of China, which has cut new infections from over 3,500 a day in late January to a mere 24 in the most recent daily count. The world is watching to see whether China can keep its numbers down as it gradually releases millions of city dwellers from quarantine and lets them go back to work.

South Korea and Singapore have also begun to see cases drop. But the rest of the world is seeing alarmingly rapid rises.

The W.H.O. is emphatically not suggesting that the world should give up on containment, Dr. Tedros said.

“We are suggesting a blended strategy,” he said, referring to a blend of containment and mitigation. “We should double down. We should be more aggressive.”

China, South Korea and Singapore have shown that aggressive contact tracing and rapid isolation of the sick can work. Unlike Western nations, all three rejected the idea of home quarantine, because cases rapidly spread in families.

Some alarmed public health experts have described Beijing’s approach as draconian or brutal, but the W.H.O. has referred to it simply as aggressive.

Wuhan and surrounding cities, the outbreak’s epicenter, have been shut down since late January, and travel elsewhere is strictly limited.

Everyone must wear a mask outdoors and submit to constant temperature checks, which are administered at the doors to every office building, store and restaurant, as well as bus, train and subway stations — even at the entries to apartment houses and residential neighborhoods.

The use of sanitizer or hand-washing on entry is mandatory.

People who think they are infected are screened at special “fever clinics,” not at doctors’ offices. They get temperature checks, flu tests, white blood cell counts, CT lung scans and laboratory tests for the virus, according to Dr. Bruce Aylward, leader of the W.H.O. observer mission that visited China in February.

Anyone who appears to have the new virus, instead of flu or bacterial pneumonia, is held until the lab results are in or while testing is repeated. Some are held at repurposed hotels.

If they are found to be infected, they may not return home — almost 80 percent of infections were within families, studies in China found.

If infected persons are seriously ill or elderly, they are hospitalized. Those with milder cases recuperate in isolation centers with hundreds of beds and nursing care. The centers are segregated by sex and age; even children who are infected must go.

No visitors are allowed, but there activities like dance classes to fight the boredom and keep people active.

As difficult and aggressive as they are, such measures “reduce the number of cases that are wheeled through the doors of hospitals,” said Dr. Michael Ryan, head of the agency’s emergencies program.

The largest number of deaths in China occurred in Wuhan, because its hospitals were overwhelmed in early January, when the authorities were suppressing news of the danger.

The fact that 90 percent of the world’s cases are in four countries — China, Italy, Iran and South Korea — indicates that the pandemic can still be contained if countries act fast, Dr. Tedros said.

There are only about 1,100 confirmed cases in the United States, but experts fear that is only a fraction of the real prevalence, because testing for the coronavirus has been unavailable or haphazard in the United States.

The number of cases in the world doubles every six days, epidemiologists have estimated.

The epidemic is thought to have begun with a single infection of a person in Wuhan, presumably by a butchered animal, in mid-November last year. Without any containment measures, it would now be at about one million cases; by the end of April, there would have been over 250 million.

Exactly how many cases were prevented by China’s crackdown is unknown, said Dr. Aylward, “but it’s in the hundreds of thousands.”

The goal of an aggressive containment response, W.H.O. officials explained, is to hold down the number of deaths and critical illnesses until a vaccine can be rolled out, possibly by early next year.

Although declaring a pandemic is largely symbolic, given that the virus has been spreading around the world for weeks, health officials hope the action will raise public awareness of the approaching danger.

Many countries have been slow to prepare, and the W.H.O.’s appeals for funds to help the poorest countries get ready have largely gone unanswered as the world’s wealthiest countries struggle to protect themselves.

Declaring a pandemic does not change what the W.H.O. will do, Dr. Ryan said. It is an effort “to galvanize the world to fight.”

A lot of thought was given to finally using the word, he said, because of the fear that it would cause countries to give up the fight as hopeless.

The Coronavirus Outbreak

  • Frequently Asked Questions and Advice

    Updated June 16, 2020

    • I’ve heard about a treatment called dexamethasone. Does it work?

      The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.

    • What is pandemic paid leave?

      The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.

    • Does asymptomatic transmission of Covid-19 happen?

      So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.

    • What’s the risk of catching coronavirus from a surface?

      Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

    • How does blood type influence coronavirus?

      A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

    • How many people have lost their jobs due to coronavirus in the U.S.?

      The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

    • Will protests set off a second viral wave of coronavirus?

      Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.

    • My state is reopening. Is it safe to go out?

      States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.

    • What are the symptoms of coronavirus?

      Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

    • How can I protect myself while flying?

      If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

    • Should I wear a mask?

      The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

As of Wednesday, the virus had infected more than 120,000 people in 114 countries, killing about 4,300 of them.

For many days, when pressed on whether the disease is a pandemic, W.H.O. officials have drawn a distinction between “uncontrolled spread” and “uncontrollable spread.” They argued that China’s thus far successful effort to drive new cases down proved that the global outbreak could be controlled in places even without a vaccine.

Although Dr. Tedros said some countries were not moving fast enough or taking the threat seriously enough, Dr. Ryan declined to name them.

“The W.H.O. does not criticize its member states in public,” he said. “You know who you are.”

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Declaring a pandemic has no legal meaning and does not impose any new measures.

On Jan. 30, the W.H.O. declared the virus a public health emergency and said that distinction was more important than whether to call it a pandemic.

Agency officials have often declared themselves frustrated by pressure — which often comes from journalists — to say exactly when a pandemic is officially underway.

After the 2009 pandemic of H1N1 swine flu from Mexico to the Americas to Europe and beyond, the W.H.O. gave up its old definition of a pandemic: “sustained human-to-human transmission of a novel pathogen in two or more W.H.O. regions.”

Journalists quibbled with a W.H.O. media representative over the judgment that the spread in both North America and South America did not qualify as pandemic. (They comprise a single W.H.O. region.) And reporters wondered how many cases in Britain constituted “sustained transmission.”

In February, W.H.O. media representatives said they had given up declaring pandemics so as not to reopen a never-ending discussion.

But the usefulness of the term for raising alarm apparently proved irresistible.

The W.H.O. has sought $675 million for the fight against the coronavirus. It has received only $100 million in pledges and $51 million in cash, according to its website.

Dr. Ryan urged countries to hire thousands more contact-tracers, who find everyone known to have come in contact with an infected person and isolate anyone who may be infected. At the height of its outbreak, the city of Wuhan, China, where the pandemic began, had 18,000 contact-tracers working in teams of five.

Many were government employees who had been reassigned from various government departments and retrained on the job, according to Dr. Bruce Aylward, a W.H.O. assistant director-general who led the agency’s mission to China in February.