The Guardian (USA)

What is a pandemic and does it change the approach to coronaviru­s?

- Melissa Davey

Declaring a pandemic has nothing to do with changes to the characteri­stics of a disease, but is instead associated with concerns over its geographic spread. According to the World Health Organizati­on, 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 advice. It is still urging countries to “detect, test, treat, isolate, trace and mobilise their people”.

Dr Nathalie MacDermott, National

Institute for Health Research academic clinical lecturer King’s College London, says: “The change of term does not alter anything practicall­y as the world has been advised for the last few weeks to prepare for a potential pandemic, which has hopefully been taken seriously by all countries.

“The use of this term however highlights the importance of countries throughout the world working cooperativ­ely and openly with one another and coming together as a united front in our efforts to bring this situation under control.”

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