Coronavirus, or COVID-19, has been infecting thousands of people since the end of December 2019 but despite the health communities concerns about its far-reaching spread, the World Health Organisation (WHO) has resisted calls to consider it a pandemic. Here's why.
Associate Professor Adam Kamradt-Scott from University of Sydney is an expert in health security and he's explained a pandemic is defined by WHO as a pathogen that spreads to two or more regions around the world as well as evidence of spreading at a community level.
That definition could suggest we are in the midst of one with COVID-19 infecting more than 90,000 people across more than 70 countries. While 70 countries sounds like the outbreak's far-reaching, the reality is the spread in most of those countries is still minimal. Only 11 countries have confirmed more than 100 cases of infection with only 23 reporting more than 20. There's another primary reason as to why it hasn't been called a 'pandemic' yet and it lies more with the inference of the word — panic-causing — rather than just its definition.
Pandemics can instil fear
The hesitance to call the coronavirus outbreak a 'pandemic' also comes down to the anxiety it could potentially cause without adding any real impact to the race to contain it.
"The term 'pandemic' can instil fear," Kamradt-Scott said to Gizmodo Australia.
WHO's Director-General Tedros Adhanom Ghebreyesus said in a coronavirus mission briefing it was not trying to avoid taking the issue seriously, just that calling it a 'pandemic' could have grave implications.
"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," he said.
"It may also signal that we can no longer contain the virus, which is not true. We are in a fight that can be won if we do the right things... I am not downplaying the seriousness of the situation, or the potential for this to become a pandemic, because it has that potential."
Outside of East Asia, however, other clusters of cases have appeared, specifically in Italy and Iran where infections have risen dramatically within the space of two weeks but it's yet to be confirmed why that's the case.
"In other countries like Italy and Iran, there are cases that have been identified where it is currently unclear how those infections have occurred. That is the more concerning situation as it may indicate the virus is spreading amongst the local community," Kamradt-Scott said.
"In the event it is proven the virus is spreading easily amongst local communities in either Italy or Iran, or even another part of the world, it is likely the WHO will then move to declare a pandemic."
Even if that were to happen, Kamradt-Scott said, it wouldn't necessarily mean much would change — just that it would now be recognised as a 'pandemic'.
"It must be remembered that the term 'pandemic' simply describes a situation where a pathogen has spread widely internationally. The term 'pandemic' does not indicate anything about the severity of the virus, which at the moment, still only results in mild illness in over 80 per cent of people infected," Kamradt-Scott said.
A member of Iran’s parliament announced on Monday that 50 people had died from the new coronavirus in the city of Qom and accused Iran’s Health Ministry of covering up the true extent of the outbreak in the country. The Health Ministry claims just 12 people have died in Iran from COVID-19, with 66 people sick from the disease. The official numbers in Iran were up from a total of 8 deaths and 43 illnesses reported on Sunday.
Coronavirus pandemic in Australia is possible
Since the outbreak, Australia has had 15 cases confirmed with those in NSW, South Australia and Victoria since recovering. An additional eight were recently confirmed after a number of Australians were evacuated from the quarantined Diamond Princess cruise off the coast of Japan but that doesn't mean a larger outbreak of pandemic potential won't occur in the country.
In a press conference on February 27, Prime Minister Scott Morrison addressed the nation stating the outbreak had very significant economic implications and initiated Australia's emergency response plan.
"Based on the expert medical advice we have received, there is every indication that the world will soon enter a pandemic phase of the coronavirus," Morrison said.
"As a result we have agreed today and initiated the information of the coronavirus and emergency response plan."
Kamradt-Scott said while Australia's free from pandemic status for now, it should be looking to help containment internationally to ensure it doesn't worsen domestically.
"Australian authorities are anticipating that we might see more cases confirmed in Australia. This is considered likely if the virus is circulating internationally in local communities. It is ultimately a reflection of the fact we now live in a very interconnected world, and so when an outbreak starts in one part of the world, it is quite easy for it now to spread," he said.
"As much as possible, we need to help countries try and contain a new disease before it spreads internationally, but then if and when it does, our focus must shift to try and contain the virus within Australia when it arrives."
Australia's kept its infection rate contained
The first COVID-19 case in Australia was confirmed on January 25 and since then, there have been 15 cases with no new cases being reported in the last two weeks from within the country.
"The infection rate has been low in Australia as we were able to identify cases early in people returning from China," Kamradt-Scott said.
It could also be due to the country's controversial quarantine plans, which saw Australians in the Hubei province taken to Christmas Island and quarantined for a few weeks. A further quarantine station was set up in Darwin's outskirts at the Howard Springs quarantine facility.
But Kamradt-Scott said it's likely people's self-isolation when returning from affected parts of China also played a crucial role.
"In addition, we have asked people returning from overseas to voluntarily isolate themselves if they think there is a chance they may have been exposed," Kamradt-Scott said.
"People have been mostly compliant in isolating themselves until the incubation period for the virus has passed. It is also important to note that we have seen very different data about the severity of the disease in places other than Hubei province in China. Even in other parts of China, the virus does not appear to be as severe."
Coronavirus cases likely to rise in some countries
While Australia's been incredibly successful at containing the spread of the virus, Kamradt-Scott said it might be harder for other countries with less-advanced monitoring systems to contain it.
"If efforts in those countries where the virus has now appeared are not able to contain their respective outbreaks, then it is very likely we will continue to see cases continue to rise," Kamradt-Scott said.
"It is also the case that if the virus has already reached those countries that don't have strong surveillance systems and laboratory testing capacity, it will be a challenge to contain. In those circumstances, we anticipate the cases will continue to rise."
This article was originally published on February 28. It has been updated to reflect the latest infection figures.
With an increasing number of confirmed cases in China and 24 other countries, the COVID-19 epidemic caused by the novel coronavirus (now known as SARS-CoV-2) looks concerning to many. As of Feb. 19, the latest numbers listed 74,280 confirmed cases including 2,006 deaths. Four of these deaths have occurred outside of mainland China: one each in the Philippines, Japan, Hong Kong and France. The case in France is the first COVID-19 death outside of Asia.