Getting the news that you have cancer is overwhelming and frightening. The COVID-19 crisis adds another layer of anxiety. But know this: you can protect yourself from COVID-19 without compromising your cancer treatment. Don’t panic. In the vast majority of cases, a diagnosis of cancer is not an emergency even though it feels like one. There is time to learn about your options and sort out what is right for you.
For now, there will be changes to how we do things. Some of the changes will feel disruptive, but many will lead to better, more patient-centered care. Minimizing your chances of exposure to the virus doesn’t require sacrificing good care.
How you interact with your cancer care team will change during this period. In keeping with directives to shelter in place, whenever possible, your visits will be by phone or video. In-hospital appointments will be kept to a minimum to reduce your potential for exposure.
Your treatment/screening schedule may change. Your care team will reschedule or delay treatment when it is safe to do so, without compromising the effectiveness of your treatment.
Many oncology societies have issued guidance for care *. Your care team will know best about your particular situation. Your cancer care teams are still at work.
If you are newly diagnosed with invasive cancer
There are safe ways to postpone surgery. Systemic therapies (chemotherapy, hormone therapy, biologics and immuno-oncology treatments) are already a part of cancer care. Starting with that therapy before surgery (neoadjuvant therapy) is a great approach and is not only equally safe but allows us to learn how your tumor responds, if additional treatment will help, and whether aggressive surgical procedures or radiation can be avoided. We use this for breast cancer routinely. Switching the order of therapy helps tailor your treatments to response.
If you are in the middle of chemotherapy treatments, you should continue. Your doctors may take more precautions to support your blood counts. Stay home. Have others grocery shop for you. Your physicians may have you come in less often and have your caregivers/support accompany you by phone/video.
A new precancerous/high risk lesion (Ductal Carcinoma in situ (DCIS), atypical lesions, cervical neoplasia) is not an emergency. Waiting a few months is safe and active surveillance and prevention medications are possible alternatives.
If you are waiting to start radiation, your radiation oncologist will prioritize when to start. For some, waiting up to 12 weeks is safe. Shorter courses of treatment may be appropriate and just as safe.
If you are due for routine cancer screening, don’t go in now for mammograms, lung CT, or repeat imaging for low risk findings. Waiting 3 months will not change your outcome.
If you have recently learned that you areat VERY high risk, because you have inherited a mutation that increases your risk for developing cancer, you can get a video consult, learn about options for risk-reduction and screening, and schedule appropriate screening 3 months out.
If you are a cancer survivor, follow-ups and screening can be safely put off 3 months.
If you have a new mass or a new symptom that worries you, that may be reason to go in for imaging or an exam. Cancer clinics are open to care for you. You can always start with a video-visit.
Why it is important to triage surgical cases – We still need to put the infrastructure in place and scale up the tools we need to take care of everyone safely. This includes COVID testing, personal protective equipment, beds, blood supply, and ventilators in place for safe care of cancer patients in the operating rooms and hospitals. Postponing surgical procedures using multidisciplinary approaches can also allow combined reconstructive cases to proceed safely. If everyone stays home now, we prevent our health care system from being overwhelmed, so emergent and urgent cases can proceed. As COVID testing becomes widely available, we can safely resume surgical procedures, and allow loved ones to be present. When possible, facilities will be separated for COVID and non-COVID related care.
The silver lining is that a crisis drives innovation and patient centered care. We have a strong foundation of science and clinical studies upon which to build, more effective treatments, more options and a better understanding of how to personalize care. We can safely do less for those with very low risk tumors, and more for those that need it. Even without COVID, we should be tailoring treatment to risk, biology, and evolving clinical data. When it is safe to do less, that is actually a benefit. This is a time when acting on such data is particularly important.
Many cancer research studies have been put on hold, but not all, and COVID 19 studies are starting in earnest**. Once the worst of the crisis passes, and COVID testing is in place, we need to safely re-open research studies because finding new and better ways to treat cancer is essential.
If everyone helps to do their part, we will all get through this better as a community, making sure we do what is best for you and everyone going through this incredibly challenging health pandemic.
Stay home, help flatten the curve, and know that we are here for you.
On Monday, officials recorded a new daily record—more than 1,400 additional cases. The number of COVID-19 cases has increased more than two and a half times in the last week, with more than 8,000 total.
Experts say the surge, which began last week, is due largely to local officials underestimating the vulnerability of the city’s migrant workers, who live in cramped dormitories with up to 20 people to a room.
Just 16 of the new cases Monday were Singapore citizens or permanent residents. About three-quarters of all cases in Singapore are linked to the workers’ dormitories, according to official figures.
In the early months of the outbreak, Singapore’s response was praised—alongside those in Hong Kong and Taiwan—as a model for how to stop slow the spread of the coronavirus. The World Health Organization (WHO) commended Singapore, citing its widespread testing and comprehensive tracing of close contacts.
Singapore had also largely managed to quell a second wave of the virus, caused by students and other residents returning home from the U.S. and Europe. Authorities have only recorded one imported case since April 9.
But Hong Kong and Taiwan now appear to have a much better handle on the outbreak. Hong Kong recorded no new cases Monday, and Taiwan recorded just two. Both also have a fraction of the confirmed infections. (1,025 in Hong Kong and 422 in Taiwan), despite having larger populations.
‘A cognitive blindspot’
An estimated 200,000 migrants workers live in 43 dormitories in Singapore, according to figures from the Ministry of Manpower. Most are from less wealthy nations like India and China, and are employed in low-wage jobs like construction, shipyard work and cleaning.
Between 12 and 20 workers typically live in one room, according to TWC2, a non-profit organization that supports migrant workers in Singapore. They share common facilities, like bathrooms and kitchens.
“The dormitories and management of the migrant workers have been a cognitive blindspot,” says Jeremy Lim, a professor and the co-director of global health at the National University of Singapore’s Saw Swee Hock School of Public Health.
“The dorms are structurally not able to provide for the social distancing that is necessary,” Lim, who also works with a local NGO to provide medical care to migrant workers, adds.
Over the last week, authorities have worked to move workers out of their dorms and into vacant public housing blocks, military camps and other accommodations.
Even though the number of infected migrant workers has surged, community-transmitted cases among Singaporeans has been declining, a sign that tough new measures involving the closure of schools, mandatory masking and other policies implemented earlier this month could be working.
But Singapore’s hard-won early victories could easily be undone by the outbreak rampaging through the migrant worker community, Lim warns.
“We are at a critical juncture,” he says. “If we cannot contain the dormitory or the migrant worker outbreaks, it will inevitably spill back into the general population because Singapore is just so small and compact.”
Since the outbreak of Covid-19, a number of countries including Singapore have imposed increasingly stringent measures. Singapore announced that it will be further tightening its borders. All short-term visitors will no longer be allowed to enter or transit through Singapore from 11.59pm on March 23. This follows other measures including rigorous contact tracing, quarantine and home isolation orders, and stricter social distancing recommendations. In light of all these measures, how important is personal hygiene and cleanliness in dealing with Covid-19? #thebigstory#coronavirus#covid19 ——————– SUBSCRIBE ➤ http://bit.ly/FollowST ——————– WEBSITE ➤ http://www.straitstimes.com TWITTER ➤ https://www.twitter.com/STcom FACEBOOK ➤ https://www.facebook.com/TheStraitsTimes INSTAGRAM ➤ https://www.instagram.com/straits_times PODCASTS ➤ https://omny.fm/shows/st-bt/playlists The Straits Times, the English flagship daily of SPH, has been serving readers for more than a century. Launched on July 15, 1845, its comprehensive coverage of world news, East Asian news, Southeast Asian news, home news, sports news, financial news and lifestyle updates makes The Straits Times the most-read newspaper in Singapore.
Over seven years as a media executive living in Asia, Brian Lee has made the two-hour hop from Seoul to Shanghai more times than he can remember. But his last flight, on March 9, will be difficult to forget. On arrival at Shanghai’s Pudong International Airport, Lee was told that regulations had tightened while he was in the air and all passengers arriving from South Korea now had to submit to 14 days’ government quarantine due to the COVID-19 outbreak.
The New Yorker was driven to a specially requisitioned three-star hotel, where nurses in hazmat suits handed him a mercury thermometer, to self-check his temperature twice daily, and a single plastic trash bag. Meals are left outside his door at 8:30 a.m., 12 noon and 6 p.m. each day. Other than opening his door to pick up his food, he has not seen beyond the drab confines of his room since. “I’m trying to stay active and positive,” says Lee, 27, a business manager for Shanghai-based media platform Radii. “I’ve been doing pushups and trying to do all the reading and writing that I haven’t had time for.”
As cases of COVID-19 stabilize in China and soar across the U.S., Middle East and Europe, the Beijing government has been busy recasting China as a sanctuary from the deadly virus, which has so far sickened 169,000 and killed at least 7,000 across the world. China’s strongman President Xi Jinping even visited the central city of Wuhan, the epicenter of the outbreak, on March 10. China’s strongest leader since Mao Zedong declared that the virus was “basically curbed” across Hubei province, where Wuhan is the capital.
Virus Expert on the Wuhan Coronavirus Outbreak: ‘Don’t Be Complacent. We Must Treat It Extremely Seriously’
Hong Kong infectious disease expert Yuen Kwok-yung discussed the situation of the Wuhan coronavirus outbreak with TIME in an exclusive interview. He warns that the disease is very infectious and control measures must be followed.
When TIME visited Wuhan in the early days of the outbreak on Jan. 22, students were still gossiping in cafes, while shoppers browsed for meat and fish for Lunar New Year festivities. But the city that Xi toured was a ghostly relic after seven weeks of bruising quarantine that has decimated the local economy. Still, China’s official press agency Xinhua has already announced a forthcoming book on how Xi’s “outstanding leadership as a great power leader” defeated the virus. The Great Power War will be available in six languages. State media has engaged in unabashed triumphalism while describing the U.S. response as “floundering.”
But even as Chinese Communist Party (CCP) propaganda ramps up, the experiences of people like Lee show that life across the Asian superpower remains far from normal. Offices are slowly reopening but central heating banned for fear of spreading germs. Taxi drivers hang sheets of plastic behind the front seats of their cabs to cocoon themselves from passengers. One friend in Beijing returned to work to find “the receptionist in a full white hazmat suit.” Another complained that the incessant spraying of germ-killing bleach had murdered all the office plants. The guy who installed my cable TV has also begun hawking medical masks, which are de rigueur for entering any supermarket. Grabbing noodles with my wife means sitting diagonally across a four-person table to comply with social distancing rules. When I tried to book an appointment with a lawyer, it had to be in Starbucks—her office had banned visitors—and even then the barista chastised her for standing closer than four feet while witnessing me signing documents.
More than anything, suspicion has shifted outward. Whereas ethnic Asians have faced prejudice around the globe due to the virus, inside China the tables have turned, with foreigners now the target of suspicion as cases rise overseas. This has been catalyzed by state propaganda leaping on China’s apparent success in stemming the virus as evidence that its political system is superior to Western-style democracy.
It would be “impossible for European countries to adopt the extreme measures that China has implemented” to fight the virus, the CCP mouthpiece Global Timesargued in a recent editorial. Sure enough, Robert Redfield, director the U.S. Centers for Disease Control and Prevention, told American lawmakers March 10 that [in terms of infections] “the new China is Europe.”
Security guards bark inquisitions when they see a foreign face—“what’s your nationality? where have you been for the last two weeks?”—so that many outsiders limit their social interactions to where they feel best known. My local barber says he not longer serves foreign customers.
Suspicion is especially pronounced for Italians, given their homeland’s rise to second in COVID-19 cases after China, with 25,000 infected. Ambra Schiliro, president of the Sicily Association in China, says that one Italian under self-quarantine in her Shanghai apartment had angry neighbors call the police to demand she move to a hotel. Andrea Fenn, a member of the Italian Chamber of Commerce in China, says that after some clients came to his office his Chinese partner discretely asked him, “Were they Italian? Where had they come from? Could I vouch for them?” Still, “It was an understandable reaction,” he says, “and nothing compared to the discrimination Asian people experienced in Italy at the beginning of the crisis.”
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Suspicion may be quite natural given Chinese state media’s self-serving tactic of highlighting the number of new COVID-19 cases that have arrived from overseas. On March 16, state media reported that 12 of the day’s 16 new COVID-19 infections were imported. On March 17, it was 20 out of 21. As such, in glaring doublespeak, Beijing’s own travel restrictions are deemed “essential measures,” even as countries that have closed borders with China are denounced.
Stefen Chow was lucky that he was permitted to self-quarantine in his own home upon arriving in Beijing after visiting his family home in Singapore. Only he was allowed to venture outside to collect deliveries, however, while his wife and two young children—aged four and six—couldn’t leave their front door for 14 days.
But much like what’s currently unfolding in the U.S., regulations for each Chinese city differ, and the lack of clarity regarding containment protocols has a chilling effect on business. Currently, even those traveling from Shanghai to the neighboring city of Suzhou for a meeting are technically required to submit to 14 days quarantine, perhaps even at a government facility, meaning few take the risk of venturing beyond the city limits. Those who have stayed at home must also self-quarantine if a roommate or family member returns from overseas or another province.
But in practice, implementation is largely at the discretion of CCP neighborhood committees, known as ju wei hui, or individual security guards — some of whom use their new power to shamelessly flirt with passers-by. “It has been frustratingly confusing,” says Ker Gibbs, president of the American Chamber of Commerce in Shanghai. “People don’t know if they can access their own apartment building, let alone their office.”
Returning to some semblance of normalcy is imperative for the Chinese and global economies. According to official data, China’s manufacturing and services sectors sank to record lows in February, car sales plunged by 80%, and China’s exports dropped 17.2% overall in January and February. As of March 18, China’s economy was operating at 71.% of typical output, according to policy research firm Trivium. Factories are being inspected one-by-one before getting the green light to reopen, but the pace of revival will depend on the nature of business; services can recover much faster than manufacturing, for example, given the latter’s reliance on knotty supply chains. High-tech and highly automated manufacturing also has a greater capacity to bounce back, being less labor-focused.
But with demand expected to crater across every sector, especially as the virus goes global, all anticipate lean times ahead. More than 100 real estate firms across the country filed for bankruptcy in January and February. Officials have been encouraging both state and private landlords to waive rents to prevent more firms going under. “I would still give [the government] reasonably high marks for communication and being proactive with business community,” says Gibbs.
Still, the state is keeping a very close eye on those attempting to re-energize the world’s number two economy. Across China, officials outside office buildings and residential compounds note visitors’ names, contact information, ID numbers and travel history in order to feed to a police database. People in some cities must register phone numbers with an app in order to take public transport. Online retail giant Alibaba has rolled out its Health Code App across 200 Chinese cities that rates users green, yellow or red dependent on travel history and possible contact with infected people. Anyone who has left the city in the past two weeks is liable to get a yellow code, and with green mandatory for access to most malls and office buildings in big cities, few book frivolous travel lest they jeopardize their score. A red code requires 14 day quarantine.
Apart from privacy concerns across what is already the world’s most surveilled state, the app has sparked consternation among those suddenly ordered to quarantine themselves with no explanation why.
There is growing weariness about measures that are little more than box-ticking. Masks are mandatory outside the home despite huge doubts over their efficacy. A temperature test is required to enter any shop, restaurant building, or even pass certain street corners. But these are so casually administered that people with readings so low as to indicate clinical hypothermia are routinely waved by. On countless occasions I’ve been rudely accosted by a supercilious doorman only for him to point the temperature gun at my coat sleeve. It’s especially frustrating since COVID-19 can spread while asymptomatic, rendering these tests ultimately pointless.
Bosses unused to employees working from home are putting them under extreme pressure, believing only increasing workload can ensure productivity at home. Miss Li, who works for Beijing start-up Bytedance and asked that TIME only uses one name as she was not permitted to speak with the media, says that she used to work 9 am to 9 pm, 6 days a week, commonly known by the shorthand “996” in China. “But now we joke that has become 007—midnight to midnight, 7 days a week,” she says.
And despite official efforts to spin the disaster, initial bungling and attempts to coverup the crisis mean the Party’s legitimacy will take a hit. A campaign to ensure the people of Hubei express “gratitude” to the CCP for containment efforts received short shrift. “The government should end its arrogance and humbly express gratitude to its masters—the millions of people in Wuhan,” wrote noted blogger Fang Fang in a post of remarkable bravery given China’s strict censorship.
Another comment appended to the profile of a whistleblower doctor quickly went viral: “The doctor risks her job to take interview, the reporter risks being charged with fabricating rumors to write the article, the media risks being shut down to publish the article, and people on WeChat risk having their accounts blocked to share the article. Today we need this ridiculous level of tacit cooperation just for a word of truth.”
Of course, truth in China is whatever the Party deems it to be. One recent afternoon, I noticed four medical personnel in hazmat suits loitering outside my apartment building. After a few minutes a neighbor pulls up with airport tags on her luggage. The medical staff check her temperature, make her sign various papers and escort her home. She won’t reappear for 14 days. Suddenly alarmed, I opened my Health Code App to check my rating is still green. China may spy victory over the virus, but normal lies a long way off, if it ever returns at all.
Mar.12 — The faltering return of China’s oil refineries, power plants and gas importers shows it’s too soon to count on the world’s biggest energy user to revive beleaguered global prices. Meanwhile, while corporate-debt markets shut down for issuers in the U.S. and Europe for a stretch in February, with investors spooked by the economic hit from the coronavirus, China had its busiest month on record. Bloomberg’s Selina Wang reports on “Bloomberg Markets: Asia.”
On Monday, Italy placed its 60 million residents under lockdown, as the number of cases of the COVID-19 virus throughout the country continues to rise.
In less than a month, Italy has gone from having only three cases of the coronavirus to having the highest number of cases and deaths outside of China, with 463 deaths and at least 9, 172 of people infected throughout all 20 regions of the country. The number of cases rose by 50% on March 8 alone. Italy also faces an above average mortality rate of 4%.
“We all must give something up for the good of Italy,” Italian Prime Minister Giuseppe Conte said in a televised address on Monday while announcing the nationwide lockdown. “There is no more time.”
The nationwide lockdown is expected to have major economic repercussions on the country, where growth was already stagnating. While the government has not specified exactly how long the ban will last, it says it will remain in place until April 3.
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Here is how the virus spread across the country — and why it is so much worse in Italy than any other European country:
How did coronavirus start spreading in Italy?
Officially it began in Feb. 20, when a 38-year-old man checked himself into a local hospital in the town of Codogno in Lombardy. He tested positive with the virus, becoming the first recorded patient with the COVID-19 virus in Italy.
Yet some health officials believe that the virus arrived in Italy long before the first case was discovered. “The virus had probably been circulating for quite some time,” Flavia Riccardo, a researcher in the Department of Infectious Diseases at the Italian National Institute of Health tells TIME. “This happened right when we were having our peak of influenza and people were presenting with influenza symptoms.”
Before the first case was reported, there was an unusually high number of pneumonia cases recorded at a hospital in Codogno in northern Italy, the head of the emergency ward Stefano Paglia told the newspaper La Repubblica, suggesting it is possible patients with the virus were treated as if they had a seasonal flu. Health facilities hosting these patients could have become sites for infection, helping proliferate the spread of the virus.
The northern regions of Lombardy, Veneto and Emilia-Romagna, have been most affected by the outbreak. 85% of infected patients are in the region which is home to 92% of deaths so far. But the virus has been confirmed in all 20 regions of the country.
Why does Italy have such a high number of cases and deaths?
Because the virus spread undetected, some officials believe this is the reason for such a high number of cases in the country. “This started unnoticed which means by the time we realized it, there were a lot of transmission chains happening,” Riccardo says, noting that this may be why Italy has seen such a high number of cases.
Some officials also believe Italy, which has already tested over 42, 000 people, may have a higher number of cases as a result of performing more rigorous tests than their European counterparts.
Italy, however, is also reporting an above average mortality rate at 4%. The average age of coronavirus patients who have died because of the virus in Italy is 81, according to the National Health Institute. Italy, which has one the world’s oldest populations, could be facing a higher mortality rate as a result of its above-average elderly population. “Italy is the oldest country in the oldest continent in the world,” says Lorenzo Casani, the health director of a clinic for elderly people in Lombardy told TIME. “We have a lot of people over 65.”
Casani also suggests the mortality rate might be higher than average because Italy is testing only the critical cases. “We are not doing enough,” he said.
Casani says that pollution in northern Italy could be a factor in higher death rates. According to a report by the Swiss air monitoring platform IQAir, 24 of Europe’s 100 most polluted cities are in Italy. “Studies have shown a high correlation between mortality rates from viral respiratory conditions and pollution,” Casani says. “This could be a factor.”
Was the Italian government prepared for the outbreak?
The outbreak in Italy has come as a surprise to some, given the stringent measures Italy imposed to protect itself from the virus. A month before the first case was reported, the Italian Health Ministry created a task force to manage coronavirus. Italy was the first European Union country to ban flights to and from China.
The travel ban, however, may have encouraged travellers to come in on connecting flights without disclosing their country of departure. Some experts also believe the virus could have entered the country before the government took action, spreading undetected throughout the country.
How is the government responding now?
The Italian government has taken the biggest steps outside of China to curb the spread of the disease.
Under the new lockdown legislation, people can be issued fines for traveling within or outside the country without a permit, though foreigners still can travel to Italy. All public events are banned and schools have been cancelled throughout the country. Public spaces, such as gyms, theatres and cinemas, have also been closed by the government. Individuals who defy the lockdown could face up to three months in jail or a fine of $234. The new rules prohibit inmates from having visitors or day releases, which set off protests at 27 prisons throughout the country.
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Many have applauded Italy’s actions. In a tweet, the Director-General of the World Health Organization commended Italy for its “bold, courageous steps” and for “making genuine sacrifices.”
The government & the people of 🇮🇹 are taking bold, courageous steps aimed at slowing the spread of the #coronavirus & protecting their country & 🌍. They are making genuine sacrifices. @WHO stands in solidarity with 🇮🇹 & is here to continue supporting you.https://t.co/Y2rkgUihtA
— Tedros Adhanom Ghebreyesus (@DrTedros) March 8, 2020
Some infectious disease and public health experts, however, have concerns about the effectiveness of the lockdown.
“These measures will probably have a short-term impact,” John Edmunds, a professor at the London School of Hygiene & Tropical Medicine told Reuters, noting that the measures were “almost certainly unsustainable.” He added, “if they can’t be sustained for the long term, all they are likely to do is delay the epidemic for a while.”
How is the Italian healthcare system handling it?
Italy’s current national health service, known as Servizio Sanitario Nazionale (SSN), provides free universal care to patients yet remains under-funded. Investments in public healthcare make up only 6.8% of the country’s gross domestic product (GDP), which is lower than other countries in the European Union including France and Germany.
“The continuous cuts—to care and to research—are obviously a problem right now,” Casani says. “We were not prepared. We do not have enough doctors for the people. We do not have an organized plan for pandemics.”
With the number of coronavirus cases on the rise, the Italian health ministry has doubled the number of hospital beds in infectious disease wards. The Governor of Lombardy Attilio Fontana has requested that universities grant degrees earlier this school year in order to increase the number of nurses in Italy. Yet some health officials fear these efforts will not be enough.
“Right now in Lombardy, we do not have free beds in intensive care units,” Casani says. He added that doctors “have to make this horrible choice and decide who is going to survive and who is not going to survive…who is going to get a monitor, a respirator and the attention they need.”
What impact will the lockdown have on the Italian economy?
The lockdown could push Italy into a recession. Berenberg bank, which before the outbreak estimated that Italy’s GDP would contract by 0.3%, now forecasts it will fall by 1.2% this year.
Lombardy, the region most affected by the outbreak, account for one-fifth of Italy’s GDP. The Italian tourism sector, which makes up 13% of the country’s GDP, is projected to lose $8.1 billion, according to the Associated Press, as a result of 32 million fewer foreign travelers.
Conte said on March 9 that the government would deploy a “massive shock therapy” in order to protect the economy. Italy’s Deputy Economy Minister, Laura Castelli said in an interview with Rai Radio 1 today that “mortgages, taxes, everything is suspended” as a result of the lockdown. The government has also created a support package of $8.5 billion for families and businesses affected by virus.
Italy’s Deputy Economy Minister, Laura Castelli @LaCastelliM5s from the Five Star Movement saying decree tomorrow will suspend mortgages and taxes:
“ Mortgages suspended? Mortgages, taxes, everything is suspended.
But we need to look at the situation of the municipalities” https://t.co/fR6vwMl9T0
Some experts are concerned about the long-term implications of this spending.
Before the coronavirus outbreak, Italy was already struggling with a public debt that is at 134% of the country’s GDP. In the Europe Union, countries are not supposed to have debt that is higher than 60% of their country’s GDP. “With the increased spending that comes with having to support people and businesses, the deficit might explode,” says Pepijn Bergsen, a Europe Research Fellow at Chatham House.
An economic slowdown in Italy, a country in the Eurozone, will have impacts on the rest of the continent.
“It is likely there will be a Eurozone wide recession this year,” Bergsen says, citing both an Italian recession and potential future lockdowns in other European Union countries as contributing factors. “It will be difficult for authorities to come up with any measures that would avoid a recession.”
Please send any tips, leads, and stories to virus@time.com.
(LONDON) — As cases of the coronavirus surge in Italy, Iran, South Korea, the U.S. and elsewhere, many scientists say it’s plain that the world is in the grips of a pandemic — a serious global outbreak.
The World Health Organization has so far resisted describing the crisis as such, saying the word “pandemic” might spook the world further and lead some countries to lose hope of containing the virus.
“Unless we’re convinced it’s uncontrollable, why (would) we call it a pandemic?” WHO director-general Tedros Adhanom Ghebreyesus said this week.
The U.N. health agency has previously described a pandemic as a situation in which a new virus is causing “sustained community-level outbreaks” in at least two world regions.
Many experts say that threshold has long been met: The virus that was first identified in China is now spreading freely in four regions, it has reached every continent but Antarctica, and its advance seems unavoidable. The disease has managed to gain a foothold and multiply quickly even in countries with relatively strong public health systems.
On Friday, the virus hit a new milestone, infecting more than 100,000 people worldwide, far more than those sickened by SARS, MERS or Ebola in recent years.
“I think it’s pretty clear we’re in a pandemic and I don’t know why WHO is resisting that,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
Experts acknowledge that declaring a pandemic is politically fraught because it can rattle markets, lead to more drastic travel and trade restrictions and stigmatize people coming from affected regions. WHO was previously criticized for labeling the 2009 swine flu outbreak a pandemic. But experts said calling this crisis a pandemic could also spur countries to prepare for the virus’s eventual arrival.
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WHO already declared the virus a “global health emergency’ in late January, putting countries and humanitarian organizations on notice and issuing a broad set of recommendations to curb its spread.
Even in countries that moved quickly to shut down their links to China, COVID-19 has managed to sneak in. Within a matter of weeks, officials in Italy, Iran and South Korea went from reporting single new cases to hundreds.
“We were the first country to stop flights to China and we were completely surprised by this disease,” said Massimo Galli, an infectious-diseases professor at the University of Milan. “It’s dangerous for the entire world that the virus is able to spread underground like this.”
With more than 3,800 cases, Italy is the epicenter of Europe’s outbreak and has shut down schools, closed sports stadiums to fans and urged the elderly not to go outside unless absolutely necessary. But it has still exported cases of the virus to at least 10 countries, including Austria, the Czech Republic, Spain, South Africa and Nigeria.
Devi Sridhar, a professor of global public health at the University of Edinburgh who co-chaired a review of WHO’s response to the 2014-16 Ebola outbreak in West Africa, said a pandemic declaration is long overdue.
“This outbreak meets all the definitions for a pandemic that we had pre-coronavirus,” she said.
At a news conference last month, Dr. Mike Ryan, WHO’s emergencies chief, said a pandemic is “a unique situation in which we believe that all citizens on the planet” will likely be exposed to a virus “within a defined period of time.”
Several experts said they hadn’t heard that definition. The U.S. Centers for Disease Control and Prevention, for its part, defines a pandemic as “an epidemic that has spread over several countries or continents, usually affecting a large number of people.”
The Associated Press receives support for health and science coverage from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
