Over 1 Million COVID-19 Cases Confirmed

Over 1 million cases of coronavirus disease 2019 (COVID-19) have been confirmed, according to John Hopkins University.

COVID-19 first came to the surface in late December when a cluster of 59 pneumonia cases of then-unknown etiology was reported to the World Health Organization (WHO) in Wuhan, China.

Medical countermeasures are in development and being evaluated in clinical trials but there are currently no proven effective therapies available as the peak of the pandemic approaches.

“Over the past five weeks, we have witnessed a near exponential growth in the number of new cases, reaching almost every country, territory and area,” Tedros Adhanom Ghebreyesus, PhD, WHO Director-General, said in a news briefing Wednesday.

This is the world’s first global pandemic caused by a coronavirus, though the SARS-CoV-2 virus is closely related to SARS-CoV-1 virus which caused regionally-contained outbreaks of Severe Acute Respiratory Syndrome in 2003. SARS also originated in China.

It is believed that SARS-CoV-2 originated in bats, like SARS-CoV-1. The transfer to humans, was possibly mediated by pangolins, is presently thought to have occurred in a Wuhan animal market. But much about the virus remains unknown, including its exact evolutionary history.

What we do know is that it is highly infectious, leads to many asymptomatic cases which can act as carriers, and that the mortality rate varies substantially by country and depending on whether a patient has an underlying health condition.

Older age is also a risk factor for severe infection. Conversely, clinicians have noted lessened severity in children.

The virus has spread to over 180 countries, with the United States now reporting the highest number of confirmed cases. White House science advisers recently released models predicting 100,000 to 240,000 virus deaths. The next 2 weeks, President Trump said, are expected to be “very, very painful” for the country.

It was initially floated that the US might begin to reverse stay-at-home orders by Sunday, April 12, but the US Centers for Disease Control and Prevention guidelines around social distancing were instead extended through the month of April.

“It’s absolutely critical for the American people to follow the guidelines for the next 30 days. It’s a matter of life and death,” Trump said Tuesday.

The first large-scale lockdown seen outside of China was initiated by Italy on March 11, with the country closing schools, canceling events, and restricting travel. On the same day, the WHO declared a global pandemic.

As COVID-19 spread, the possibility of containment became less realistic. Most countries have now moved to a mitigation strategy, and some scientists expect the virus to become a seasonal burden.

As Contagion® editor-in-chief Jason Gallagher, PharmD, explained in his April letter, this is neither the first nor the last pandemic the world will face.

Suffering from this pandemic, both in terms of illness and the impact of a global recession, has been exacerbated by a lack of global preparedness. Under-resourced hospital systems have had to improvise to increase surge capacity, acquire scarce protective personal equipment, and to supply enough ventilators for patients in intensive care units.

Even the strategy of social distancing is not a containment effort, but a measure to slow down the rate of infection for overwhelmed hospital systems. This means that even people who do not get sick but are out of work with rent or mortgage payments on the horizon are directly impacted by the preparedness of health care systems.

It had long been said by infectious disease experts before COVID-19 that the eventuality of a global pandemic was not a matter of “if” but of “when.” Though the current crisis is far from over, we should be taking notes to be ready for the next one.

For other stories relevant to COVID-19 and the latest infectious disease news, visit ContagionLive.com and our coronavirus condition center. To track the spread of infectious diseases in the United States and abroad, be sure to use the Contagion Outbreak Monitor.