Coronavirus explained: what is a pandemic and could the coronavirus outbreak become one?


Gillian Duncan
  • English
  • Arabic

On Friday, the director general of the World Health Organisation warned time was running out to stop the spread of the new coronavirus.

Tedros Adhanom Ghebreyesus said containment was still possible, but that the window of opportunity was narrowing.

Since then, cases of Covid-19 have exploded in South Korea, which recorded 763 coronavirus infections and seven deaths as of Monday, up from just 156 cases on Friday.

Italy has also seen the number of its confirmed cases spiral, making it the worst affected country in Europe. As of Monday, it had 157 confirmed cases across the country and three deaths, with several towns in lockdown.

Cases have also rocketed in Iran, from none last Tuesday to 43 confirmed infections and 12 deaths as of Monday.

The virus also continues its inexorable spread in China, which has announced 409 new cases and 150 deaths, bringing the total number of confirmed infections to 77,345. Of them, 24,794 have so far recovered and 2,592 have died.

Covid-19 has now infected people in 33 countries and territories across multiple continents and experts say a pandemic is now looking increasingly likely.

But what does that mean? The National explains.

What is a pandemic?

Put simply, a pandemic is when epidemics are occurring in multiple countries and continents at the same time. The disease must also be infectious, which rules out conditions like cancer. And it must be transmitted locally with no clear link to the original source of the outbreak, which in this case is China.

Have there been pandemics before?

Yes, several. The first pandemic of the 21st century was the swine flu outbreak which occurred in 2009 and 2010. Most cases were mild but it killed an estimated 100,000 to 400,000 people in the first year alone.

  • Wahida Ghalayini, head of the nursing department, speaks to journalists at the quarantine department at Rafik Hariri University Hospital in Beirut, Lebanon. Lebanese Health Minister Hamad Hassan said all people traveling from Iran to Lebanon will be tested for the new virus that started in China before boarding flights to the Arab country after a woman tested positive earlier this week upon her return from Iran. AP
    Wahida Ghalayini, head of the nursing department, speaks to journalists at the quarantine department at Rafik Hariri University Hospital in Beirut, Lebanon. Lebanese Health Minister Hamad Hassan said all people traveling from Iran to Lebanon will be tested for the new virus that started in China before boarding flights to the Arab country after a woman tested positive earlier this week upon her return from Iran. AP
  • Kuwaitis coming back from Iran leave the air plane at Sheikh Saad Airport in Kuwait City before being taken to a hospital to be tested for coronavirus. AFP
    Kuwaitis coming back from Iran leave the air plane at Sheikh Saad Airport in Kuwait City before being taken to a hospital to be tested for coronavirus. AFP
  • Kuwaitis coming back from Iran wait at Sheikh Saad Airport in Kuwait City before being taken to a hospital to be tested for coronavirus. AFP
    Kuwaitis coming back from Iran wait at Sheikh Saad Airport in Kuwait City before being taken to a hospital to be tested for coronavirus. AFP
  • Kuwaiti policemen wearing protective masks wait at Sheikh Saad Airport in Kuwait City, before transferring Kuwaitis arriving from Iran to a hospital to be tested for coronavirus. AFP
    Kuwaiti policemen wearing protective masks wait at Sheikh Saad Airport in Kuwait City, before transferring Kuwaitis arriving from Iran to a hospital to be tested for coronavirus. AFP
  • Kuwaitis coming back from Iran wait at Sheikh Saad Airport in Kuwait City, before being taken to a hospital to be tested for coronavirus. AFP
    Kuwaitis coming back from Iran wait at Sheikh Saad Airport in Kuwait City, before being taken to a hospital to be tested for coronavirus. AFP
  • Kuwaiti health minister Sheikh Basel al-Sabah (R) speaks to the press at Sheikh Saad Airport in Kuwait City, as Kuwaitis returning from Iran wait before being taken to a hospital to be tested for coronavirus. AFP
    Kuwaiti health minister Sheikh Basel al-Sabah (R) speaks to the press at Sheikh Saad Airport in Kuwait City, as Kuwaitis returning from Iran wait before being taken to a hospital to be tested for coronavirus. AFP
  • Lebanese nurses wearing protective masks work at a ward where the first case of coronavirus in the country is being treated, at the Rafik Hariri University Hospital in the southern outskirts of the capital Beirut. AFP
    Lebanese nurses wearing protective masks work at a ward where the first case of coronavirus in the country is being treated, at the Rafik Hariri University Hospital in the southern outskirts of the capital Beirut. AFP
  • Medical staff check passengers arriving from Iran in the airport in Najaf, Iraq. AP
    Medical staff check passengers arriving from Iran in the airport in Najaf, Iraq. AP
  • Medical workers in protective suits at a coronavirus detection lab in Wuhan in central China's Hubei Province. AP
    Medical workers in protective suits at a coronavirus detection lab in Wuhan in central China's Hubei Province. AP
  • Nurses work at an ICU ward specialised for patients infected by coronavirus in Wuhan in central China's Hubei Province. AP
    Nurses work at an ICU ward specialised for patients infected by coronavirus in Wuhan in central China's Hubei Province. AP
  • Market workers wearing protective gear spray disinfectant at a market in the southeastern city of Daegu as a preventive measure after the COVID-19 coronavirus outbreak. AFP
    Market workers wearing protective gear spray disinfectant at a market in the southeastern city of Daegu as a preventive measure after the COVID-19 coronavirus outbreak. AFP
  • A woman is taken into an ambulance amid a coronavirus outbreak in northern Italy, in Casalpusterlengo. REUTERS
    A woman is taken into an ambulance amid a coronavirus outbreak in northern Italy, in Casalpusterlengo. REUTERS
  • British Diamond Princess evacuees arrive in coaches to Arrowe Park Hospital in Wirral, United Kingdom. Getty Images
    British Diamond Princess evacuees arrive in coaches to Arrowe Park Hospital in Wirral, United Kingdom. Getty Images
  • British Diamond Princess evacuees arrive at Arrowe Park Hospital in Wirral, United Kingdom. Getty Images
    British Diamond Princess evacuees arrive at Arrowe Park Hospital in Wirral, United Kingdom. Getty Images
  • Passengers of an aircraft are being taken to Arrowe Park Hospital, where passengers that have been repatriated to the UK from a cruise ship hit by the COVID-19 coronavirus in Yokohama, Japan, will be quarantined for 14 days to protect against the spread of the illness should any of them be infected, in Upton, England. AP
    Passengers of an aircraft are being taken to Arrowe Park Hospital, where passengers that have been repatriated to the UK from a cruise ship hit by the COVID-19 coronavirus in Yokohama, Japan, will be quarantined for 14 days to protect against the spread of the illness should any of them be infected, in Upton, England. AP

The global HIV/AIDS outbreak is also considered a pandemic, having killed more than 36 million people since 1981.

But the most famous and deadly pandemic in modern history was the Spanish flu outbreak, which infected a third of the world’s population in 1918 and killed as many as 50 million people in just 18 months.

Did experts see this coming?

Many experts and organisations believed the next pandemic would probably result from an as yet unidentified strain of influenza.

But some, like the Johns Hopkins Centre for Health Security, correctly identified the pandemic potential of a coronavirus.

The centre ran a computer simulation in late 2019 involving a strain of coronavirus that emerged from Brazil’s pig farms.

Nearly every country in the world would have had cases within 18 months in the simulation. In total, 65 million people died. That coronavirus was deadlier than Sars, but about as easy to catch as the flu.

The good news is scientists believe the new coronavirus is less deadly than Sars, but on the other hand that it is still highly contagious - much more so than flu.

On average, each person with flu goes on to infect around 1.3 others. With Covid-19, it is thought to be two to three people, with some studies describing cases with a much higher transmission rate.

"I have thought for a long time that the most likely virus that might cause a new pandemic would be a coronavirus," Eric Toner, a scientist at the centre was quoted as saying by Business Insider.

Why did the virus spread so quickly?

There are several aspects of Covid-19 which have fuelled its especially rapid spread. First, it is entirely new to the human population, having jumped from an animal - believed to be a bat - through an as yet unidentified intermediary.

That means no one has had any immunity to the virus, putting everybody at greater risk of catching it.

Travellers in Suvarnabhumi Airport in Bangkok wear protective facemasks amid concerns of the spread of COVID-19. AFP / Romeo GACAD
Travellers in Suvarnabhumi Airport in Bangkok wear protective facemasks amid concerns of the spread of COVID-19. AFP / Romeo GACAD

Second, the virus appears to be highly transmissible and third, because the virus has a long incubation period of between 0 to 14 days, people can pass it on others before they develop symptoms themselves.

These factors combined have made efforts to contain Covid-19 practically impossible, even with the best infection control measures in place.

What changes in a pandemic?

The WHO will require governments to mobilise their entire health system, distributing “personal protective equipment” and “antivirals and other medical supplies in accordance with national plans”.

Experts say quarantines, travel restrictions and contact tracing may also end as the focus moves from preventing the spread from outside the country to limiting transmissions as much as possible inside.