THE WEEK IN REVIEW
A BRIEF ROUNDUP OF THE NEWS OF THE WEEK
It wasn’t that long ago — 17 weeks — that Pittsburghers were buzzing. It was Nov. 17, 2019, and there was no Steelers game that Sunday as the team had played on Thursday night, a game that ended in a brawl involving Cleveland Browns lineman Myles Garrett and Steelers quarterback Mason Rudolph.
Still, spirits were high. The rematch with the Browns at Heinz Field was two weeks away, and the holiday season was upon us.
We had no idea that the whole world was about to change as an individual on the other side of the globe, in Wuhan, China, became the first reported case of a deadly new virus.
It carried flu-like symptoms — fever, coughing, night sweats, aching bones, fatigue— and like other coronavirus infections, it attacked the respiratory tract and could not be treated with antibiotics.
But as more people reported for treatment, medical experts saw differences, especially among older adults and people with existing health problems. There was difficulty breathing, pain or pressure in the chest, confusion and detachment, kidney failure — and deaths.
The incubation period was what alarmed doctors. Adults with the flu have an average incubation period of two days, and they can infect others 24 hours before symptoms develop and five to seven days after becoming sick. This new coronavirus had a median incubation period of 5.1 days, meaning people could walk around infecting many others before showing symptoms.
The spread and the severity of the virus were striking.
Estimates vary, but its mortality rate is between about 1% and 3%, many times higher than that of seasonal flu. Also, there are vaccines for the flu, which likely has been around for more than 2,000 years. This disease is new. There is no vaccine for COVID-19, and it could take many months or years to get one to market, and — unlike the influenza viruses, for which there are several vaccines — humans have not built up an immunity over generations.
The World Health Organization labeled the disease COVID-19 and on Wednesday officially changed its classification of it from a public health emergency of international concern to a pandemic.
The pandemic designation
The Centers for Disease Control and Prevention use the word “epidemic” when talking about “an increase, often sudden, in the number of cases of a disease above what is normally expected in that population in that area.”
“Pandemic” is an escalation and “refers to an epidemic that has spread over several countries or continents, usually affecting a large number of people.”
“Pandemic is not a word to use lightly or carelessly,” said Dr. Tedros Adhanom Ghebreyesus, director-general of the WHO. “It is a word that, if misused, can cause unreasonable fear or unjustified acceptance that the fight is over, leading to unnecessary suffering and death.”
There were three worldwide pandemics in the 20th century. The Spanish flu (1918) claimed 50 million lives worldwide; the Asian flu (1957–58) caused around 1.1 million deaths; and the Hong Kong flu (1968) killed about 1 million.
In 2009, the H1N1 strain, commonly referred to as swine flu, infected more than 60 million people worldwide and killed hundreds of thousands — 12,469 in the United States — but a vaccine was developed extraordinarily fast and available by September of that year.
COVID-19 mainly is spread through respiratory droplets, which means to become infected, people generally must be within 6 feet of someone who is contagious. It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose or eyes, but this is not thought to be the main way the virus spreads. Symptoms of COVID-19 appear within two to 14 days after exposure and include fever, cough, runny nose and difficulty breathing.
Health officials recommend a quarantine of 14 days to get over symptoms.
COVID-19 numbers
By Saturday, more than 156,000 infections and over 5,800 deaths had been recorded worldwide.
China has seen more than 80,000 cases, including 3,189 deaths, but the safety measures taken there in the past months are showing results. In January, China made the unprecedented decision to halt outbound transportation from cities with a combined population of more than 60 million people, starting with the epicenter, Wuhan, in the central province of Hubei.
The spread of COVID-19 in the country has slowed dramatically, according to China’s National Health Commission. After reporting thousands of new cases per day only a month ago, the commission said Saturday that there were 13 new deaths and just 11 new cases, including people who recently arrived in China from other affected countries like Italy.
Wuhan is now the only city in Hubei still designated “high-risk.” Several Hubei municipalities are gradually resuming public transportation and reopening businesses.
Hundreds of parks, museums and art galleries have reopened in Shanghai.
But while the numbers are dwindling in China, the virus has spread exponentially in the Middle East, Europe and North America.
In the U.S., where President Donald Trump declared a national emergency Friday, there have been more than 2,100 confirmed or presumed positive cases in 49 states (West Virginia being the exception). The death toll Saturday in the U.S. stood at 51.
People across the country are being urged to avoid crowds and even interpersonal contact as many workers begin working from home. Thousands of schools have been closed, concerts and sporting events canceled, and travel restricted. Mr. Trump and his Democratic rivals in the 2020 election have halted their political rallies.
Europe has become the epicenter of the pandemic, with countries imposing a cascade of restrictions in an effort to prevent their health systems from collapsing under the caseload.
COVID-19 cases in Italy rose by roughly 20% Saturday, as the already hard-hit country saw its biggest daily rise in infections yet.
Italian health officials reported 3,497 new cases, a little more than half of which came from the northern region of Lombardy, Europe’s most affected area. An additional 157 people also died between Friday and Saturday.
Italy now has reported 21,157 cases, with authorities predicting that the numbers will continue to rise despite a national lockdown in place since March 9. Only grocery stores, pharmacies and banks are allowed to operate.
At noon, people around Italy came out onto their balconies, terraces or gardens or simply leaned out from open windows to clap for several minutes in a gesture of thanks to medical staff.
An Italian couple tested positive for the virus late Friday, five days after they disembarked in San Juan, Puerto Rico, from the Costa Luminosa cruise ship. The couple apparently had been exposed to a 68-year-old woman on the ship who had the virus, but because Puerto Rico had no tests, her sample had to be sent to the U.S. Centers for Disease Control and Prevention in
Atlanta. It took five more days to confirm her diagnosis.
Gov. Wanda Vazquez of Puerto Rico called the delay “unacceptable.”
Spain has the fifth-highest number of cases, behind China, Italy, Iran and South Korea. Health authorities in Spain said the number of infections climbed past 5,700, half of them in the capital, Madrid. That represents a national increase of over 1,500 in 24 hours. The country had 136 deaths, up from 120.
The nation has responded, like Italy, with a lockdown: Effective Monday morning, people will be allowed to leave their homes only to buy food and medicine, commute to work, go to hospitals and banks, or take trips related to the care of the young and the elderly. All schools, universities, restaurants, bars and hotels nationwide, along with nonessential stores, will be closed.
France announced the closing of all “non-indispensable” businesses as of midnight, including restaurants, bars and movie theaters, after a sharp uptick in cases, which doubled over 72 hours to about 4,500. There have been 91 deaths, and 300 patients are in critical condition — half of them under 50 years of age.
In Britain, the death toll nearly doubled from the day before to 21, and the number of people infected rose to over 1,100.
Denmark closed its borders and halted passenger traffic to and from the country. Poland is denying all foreigners entry unless they lived in Poland or had personal ties there. Any noncitizens allowed in will be quarantined for 14 days. The Czech Republic and Slovakia took similar action. Lithuania said it was introducing border checks at the frontiers with Poland and Latvia for 10 days and was considering banning foreigners from entering.
Russia said its land borders with Norway and Poland will be closed to most foreigners beginning
Sunday.
Iran said Saturday the outbreak has killed another 97 people, pushing the death toll in the country to 611, as war-ravaged Syria announced a number of strict measures despite the government saying it has no confirmed cases.
Iran is suffering from the worst outbreak in the Middle East, with 12,729 cases and even senior officials testing positive. It is a close ally of the Syrian government in the civil war, with military advisers as well as Shiite pilgrims frequently traveling between the two countries.
As of Saturday, South Korea had confirmed more than 8,000 patients and 72 deaths — after having tested more than 240,000 in about a month and a half. The early detection, isolation and treatment has translated into a low mortality rate of about 0.7%, compared to more than 3% worldwide.
New Zealand announced that incoming passengers, including the nation’s own citizens, will be required to isolate themselves for 14 days with few exceptions. Philippine officials announced a night curfew in the capital and said millions of people in the densely populated region should leave their homes only during the daytime for work or urgent errands.
What to do
Health and government officials, as well as media outlets, have been doing their best to caution and advise the public about the best things to do — and what not to do. The following recommendations come from the Allegheny County Health Department, which provides information and updates at its website: alleghenycounty.us/healthdepartment.
You should cover coughs and sneezes with a tissue, then dispose of it. If you don’t have a tissue, cough into your elbow or sleeve.
Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom, before eating, and after blowing your nose, coughing or sneezing.
If soap and water are not readily available, use an alcohol-based hand sanitizer with 60%-95% alcohol.
Avoid shaking hands; consider touching elbows instead if you believe personal contact is necessary for a greeting.
Routinely clean frequently touched surfaces and objects. High-touch surfaces include counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets and bedside tables. Use a household cleaning spray or wipe, according to the label instructions.
For most people, COVID-19 causes only mild or moderate symptoms, such as fever, fatigue and coughing. Those who develop symptoms should stay home and call a health care provider. As much as possible, stay in a specific room and separate yourself from family. Although there have not been reports of pets or other animals becoming sick with COVID-19, it is still recommended that sick people limit contact with animals until more information is known. Avoid public transportation, ride-sharing and taxis.
What lies ahead
People everywhere already have taken steps such as stocking their cupboards and refrigerators with enough provisions to get them through as much as a week or more in self-isolation.
Experts say they do not expect the internet to get overloaded by spikes in traffic from the millions of Americans working from home. But connections could stumble for many if too many family members try to videoconference at the same time. Some may have to settle for audio, which is much less demanding of bandwidth.
Several major U.S. internet providers have taken measures — including the temporary suspension of data caps and free broadband for 60 days for households with children who lack it — designed to better accommodate remote access for students, workers and public health officials.
Italy’s internet saw a 30% spike in peak-hour traffic this past week after the government sent everyone home into isolation, said Matthew Prince, CEO of Cloudflare, which shapes and secures internet traffic for websites.
While people focus on care and prevention — and wait for the development of a vaccine — many wonder if warmer weather might help usher us away from the virus. The truth is, no one knows.
“We have to assume that the virus will continue to have the capacity to spread, and it’s a false hope to say, ‘Yes, it will just disappear in the summertime like influenza,’” said Dr. Michael Ryan, the World Health Organization’s emergencies chief.
Benjamin Cowling, head of the Epidemiology and Biostatistics Division at the School of Public Health at Hong Kong University, said that people’s behavior in winter environments is likely having an effect.
“People are more likely to spend time indoors in colder weather than they are in the summer,” he said. “More time indoors means that people are more likely to be in the same rooms together and thus get infected.”
But Dr. Cowling said higher temperatures are unlikely to fully stop the continued spread of the virus.
“I don’t think we can count on it stopping in the summer. It may slow down, but it won’t be stopped,” he said. “At this rate, we would expect every country in the world to have cases in about nine months — we’re headed toward that now. ”