Health

When Will We Know If the Coronavirus Is a Global Pandemic? – Healthline

Published

5 years ago

February 26, 2020

There are different levels of disease, based on how widespread it is and how often it occurs within a community.
A pandemic is an epidemic (a sudden increase in the number of cases of a disease) that’s spread over several countries or continents. It usually affects a large number of people.
The World Health Organization (WHO) has said we’re not yet in a pandemic, but it’s possible that will change.

The last couple of months have seen the COVID-19 crisis grow into a worldwide emergency, but the Centers for Disease Control and Prevention (CDC) report it’s still too early to declare COVID-19 a worldwide pandemic.

“We are taking and will continue to take aggressive action to reduce the impact of this virus, that it will have on the communities in the U.S. We are working with state, local, and territorial health departments to ready our public health workforce to respond to local cases and the possibility this outbreak could become a pandemic,” said Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, in a statement.

But what is a “pandemic,” and what are the implications?

According to the CDC, there are different levels of disease, based on how widespread it is and how often it occurs within a community.

The first level is called “endemic.” This is the amount of disease usually present in a community; the constant presence or usual occurrence of a disease or infectious agent in a population. It’s also referred to as the “baseline level” of a disease.

An “epidemic” is a sudden increase in the number of cases of a disease above the endemic level for that area.

However, the term “outbreak,” although having the same definition as epidemic, is typically when the disease occurs in a relatively small area.

Finally, a “pandemic” is an epidemic that’s spread over several countries or continents. It usually affects a large number of people.

“A pandemic is person-to-person spread of a disease causing significant illness and death on an exceptionally broad worldwide scale. As opposed to an epidemic, which would be the spread of a disease to an area such as a community, nation, or portions of the world, as well as tending to be a non-exceptional occurrence,” Dr. Charles Bailey, medical director of infection prevention at St. Joseph Hospital in Orange County, California, told Healthline.

The CDC further separates outbreaks of disease by the source.

Disease outbreaks can come from a “common source,” like when a group of people with food poisoning all ate at the same restaurant.

Then there’s a “propagated outbreak.” This occurs when a disease is passed from one person to another. It can result from person-to-person contact, sharing needles, or as in the case of Lyme disease, by deer ticks.

“So, it’s not enough to say that somebody that was in, for example, Hubei province has COVID-19, and then they travel somewhere else or somebody who was staying with them goes back to their home country and they’re found to have it,” said Dr. Carl Fichtenbaum of the division of infectious diseases at the University of Cincinnati College of Medicine.

He explains that that doesn’t make it a pandemic. What makes a difference is when you start to have people, such as within Italy or South Korea, “who are transmitting it to other people in that area.”

He emphasizes that it typically starts out with family members.

“Currently, as reported, there are 79,553 people infected and about 2,628 deaths in 29 countries. The WHO will need input from multiple health partners across the world prior to deeming this a pandemic,” said Dr. Vidya Mony, FAAP, associate hospital epidemiologist of infection prevention at Santa Clara Valley Medical Center.

Mony points out that the last pandemic was the 2009 H1N1 influenza pandemic, and neither SARS, MERS, nor Ebola qualified as a pandemic despite differing severity, case counts, and death rates.

“As always, we will await guidance from CDC, WHO as to our next steps. But, as a hospital system, it is important that we prepare ourselves for this potential,” Mony said. “The most important aspect is that everyone remains calm and has an emergency preparedness plan in the event of a pandemic.”

Just over 100 years ago, an incredibly dangerous strain of H1N1 spread across the world.

It’s been largely forgotten, but the Spanish flu of 1918 ultimately infected between 25 to 30 percent of the world population and killed an estimated 40 million people.

Fichtenbaum believes the government is taking COVID-19 seriously.

“I think that the preparedness in the United States is starting to change already, and I think we’re starting to see those directives. We’re seeing language coming from the Centers for Disease Control and Prevention showing that they’re starting to think about what happens if we have epidemic levels of COVID-19 and how do we contain its spread and protect people,” he said. “And so very much like some of the early discussions with the Ebola virus, we’re now starting to see this, so the interest is very high.”

Fichtenbaum says that part of the U.S. strategy would be for healthcare facilities in each city, and each locale, to begin planning:

where they’ll care for people with the virus
who would be tested
what would be the criteria they use to decide what actions to take

He added, “Of course, this time of year, is very much complicated by influenza, which is virtually indistinguishable from a clinical perspective, so you’d have to be testing people for COVID-19 as well as influenza and also quarantining people so that you could contain the spread of it.”

“It’s a matter of time, but I think that it’s only days or weeks from the World Health Organization calling this [COVID-19] a pandemic,” Fichtenbaum said.

A pandemic involves local people transmitting an infection that affects a significant portion of the population. The CDC hasn’t determined that the situation with COVID-19 meets those criteria — yet.

New diseases have regularly appeared and caused widespread sickness, disruption, and deaths. COVID-19 is one of a long line of health challenges the world has had to deal with.

The United States is preparing to deal with a potential pandemic situation, and experts say it’s only a matter of time before the WHO declares COVID-19 a global pandemic.

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Health

Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

Published

1 day ago

September 13, 2024

Anne Joseph

The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.

It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.

Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”

Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.

Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.

A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.

On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.

Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”

But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”

“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.

Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.

Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.

Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.

“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.

“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”

This report by The Canadian Press was first published Sept. 13, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

Published

3 days ago

September 11, 2024

Anne Joseph

HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

Published

4 days ago

September 10, 2024

Anne Joseph

ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

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