COVID-19 pandemic

Chinese medics in Huanggang, Hubei, in 2020.

The pandemic is known by several names. It is sometimes referred to as the "coronavirus pandemic"^[13] despite the existence of other human coronaviruses that have caused epidemics and outbreaks (e.g. SARS).^[14]

During the initial outbreak in Wuhan, the virus and disease were commonly referred to as "coronavirus", "Wuhan coronavirus",^[15] "the coronavirus outbreak" and the "Wuhan coronavirus outbreak",^[16] with the disease sometimes called "Wuhan pneumonia".^[17][18] In January 2020, the WHO recommended 2019-nCoV^[19] and 2019-nCoV acute respiratory disease^[20] as interim names for the virus and disease per 2015 international guidelines against using geographical locations (e.g. Wuhan, China), animal species, or groups of people in disease and virus names in part to prevent social stigma.^[21] WHO finalized the official names COVID-19 and SARS-CoV-2 on 11 February 2020.^[22] Tedros Adhanom Ghebreyesus explained: CO for corona, VI for virus, D for disease and 19 for when the outbreak was first identified (31 December 2019).^[23] WHO additionally uses "the COVID-19 virus" and "the virus responsible for COVID-19" in public communications.^[22]

WHO names variants of concern and variants of interest using Greek letters. The initial practice of naming them according to where the variants were identified (e.g. Delta began as the "Indian variant") is no longer common.^[24] A more systematic naming scheme reflects the variant's PANGO lineage (e.g., Omicron's lineage is B.1.1.529) and is used for other variants.^[25][26][27]

Discover more about Etymology related topics

Huanggang

Huanggang

Huanggang is a prefecture-level city in easternmost Hubei Province, China. It is situated to the north of the middle reaches of the Yangtze River and is bounded in the north by the Dabie Mountains and is named after Mount Huanggang. It borders Henan in the north, Anhui in the east and Jiangxi in the south.

2002–2004 SARS outbreak

2002–2004 SARS outbreak

The 2002–2004 outbreak of SARS, caused by severe acute respiratory syndrome coronavirus, infected over 8,000 people from 29 countries and territories, and resulted in at least 774 deaths worldwide.

COVID-19 pandemic in Hubei

COVID-19 pandemic in Hubei

The COVID-19 pandemic in Hubei was first manifested by a cluster of mysterious pneumonia in Wuhan, the provincial capital of Hubei, China. A Wuhan hospital notified the local center for disease control and prevention (CDC) and health commissions on December 27, 2019. On December 31, Wuhan CDC admitted that there was a cluster of unknown pneumonia cases related to the Huanan Seafood Wholesale Market after the unverified documents appeared on the Internet. The potential disease outbreak soon drew nationwide attention including that of the National Health Commission (NHC) in Beijing which sent experts to Wuhan on the following day. On January 8, a new coronavirus was identified as the cause of the pneumonia. The sequence of the virus was soon published on an open-access database. Measures taken by China have been controversial. They were praised by the World Health Organization (WHO) for improvements over SARS-CoV-2 responses, but maligned by many in the international community for being slow to publicly disclose key facts or deceptive about the outbreak and for aggressively censoring information relating to the outbreak and public discontent from citizens online.

Wuhan

Wuhan

Wuhan is the capital of Hubei Province in the People's Republic of China. It is the largest city in Hubei and the most populous city in Central China, with a population of over eleven million, the ninth-most populous Chinese city and one of the nine National Central Cities of China.

Pneumonia

Pneumonia

Pneumonia is an inflammatory condition of the lung primarily affecting the small air sacs known as alveoli. Symptoms typically include some combination of productive or dry cough, chest pain, fever, and difficulty breathing. The severity of the condition is variable.

Social stigma

Social stigma

Social stigma is the disapproval of, or discrimination against, an individual or group based on perceived characteristics that serve to distinguish them from other members of a society. Social stigmas are commonly related to culture, gender, race, socioeconomic class, age, sexual orientation, body image, physical disability, intelligence or lack thereof, and health. Some stigma may be obvious, while others are known as concealable stigmas that must be revealed through disclosure. Stigma can also be against oneself, stemming from negatively viewed personal attributes in a way that can result in a "spoiled identity".

Tedros Adhanom Ghebreyesus

Tedros Adhanom Ghebreyesus

Tedros Adhanom Ghebreyesus is an Ethiopian public health official, researcher, and Director-General of the World Health Organization since 2017. Tedros is the first African to become WHO Director-General, receiving an endorsement for the role by the African Union. He played a role in the response to the Ebola virus epidemic, the ongoing COVID-19 pandemic, and the ongoing 2022 monkeypox outbreak.

Variant of concern

Variant of concern

The term variant of concern (VOC) for SARS-CoV-2, which causes COVID-19, is a category used for variants of the virus where mutations in their spike protein receptor binding domain (RBD) substantially increase binding affinity in RBD-hACE2 complex, while also being linked to rapid spread in human populations.

Greek alphabet

Greek alphabet

The Greek alphabet has been used to write the Greek language since the late 9th or early 8th century BCE. It is derived from the earlier Phoenician alphabet, and was the earliest known alphabetic script to have distinct letters for vowels as well as consonants. In Archaic and early Classical times, the Greek alphabet existed in many local variants, but, by the end of the 4th century BCE, the Euclidean alphabet, with 24 letters, ordered from alpha to omega, had become standard and it is this version that is still used for Greek writing today.

SARS-CoV-2 Delta variant

SARS-CoV-2 Delta variant

The Delta variant (B.1.617.2) was a variant of SARS-CoV-2, the virus that causes COVID-19. It was first detected in India on 5 October 2020. The Delta variant was named on 31 May 2021 and had spread to over 179 countries by 22 November 2021. The World Health Organization (WHO) indicated in June 2021 that the Delta variant was becoming the dominant strain globally.

Phylogenetic Assignment of Named Global Outbreak Lineages

Phylogenetic Assignment of Named Global Outbreak Lineages

The Phylogenetic Assignment of Named Global Outbreak Lineages (PANGOLIN) is a software tool developed by Dr. Áine O'Toole and members of the Andrew Rambaut laboratory, with an associated web application developed by the Centre for Genomic Pathogen Surveillance in South Cambridgeshire. Its purpose is to implement a dynamic nomenclature to classify genetic lineages for SARS-CoV-2, the virus that causes COVID-19. A user with a full genome sequence of a sample of SARS-CoV-2 can use the tool to submit that sequence, which is then compared with other genome sequences, and assigned the most likely lineage. Single or multiple runs are possible, and the tool can return further information regarding the known history of the assigned lineage. Additionally, it interfaces with Microreact, to show a time sequence of the location of reports of sequenced samples of the same lineage. This latter feature draws on publicly available genomes obtained from the COVID-19 Genomics UK Consortium and from those submitted to GISAID. It is named after the pangolin.

SARS-CoV-2 Omicron variant

SARS-CoV-2 Omicron variant

Omicron (B.1.1.529) is a variant of SARS-CoV-2 first reported to the World Health Organization (WHO) by the Network for Genomics Surveillance in South Africa on 24 November 2021. It was first detected in Botswana and has spread to become the predominant variant in circulation around the world. Following the original B.1.1.529 variant, several subvariants of Omicron have emerged including: BA.1, BA.2, BA.3, BA.4, and BA.5. Since October 2022, two subvariants of BA.5 called BQ.1 and BQ.1.1 have emerged.

Background

SARS-CoV-2 is a virus closely related to bat coronaviruses,^[28] pangolin coronaviruses,^[29][30] and SARS-CoV.^[31] The first known outbreak (the 2019-2020 COVID-19 outbreak in mainland China) started in Wuhan, Hubei, China, in November 2019. Many early cases were linked to people who had visited the Huanan Seafood Wholesale Market there,^[32][33][34] but it is possible that human-to-human transmission began earlier.^[35][36]

The scientific consensus is that the virus is most likely of a zoonotic origin, from bats or another closely-related mammal.^[35][37][38] Controversies about the origins of the virus heightened geopolitical divisions, notably between the United States and China.^[39]

The earliest known infected person fell ill on 1 December 2019. That individual did not have a connection with the later wet market cluster.^[40][41] However, an earlier case may have occurred on 17 November.^[42] Two-thirds of the initial case cluster were linked with the market.^[43][44][45] Molecular clock analysis suggests that the index case is likely to have been infected between mid-October and mid-November 2019.^[46][47]

Cases

Official "case" counts refer to the number of people who have been tested for COVID-19 and whose test has been confirmed positive according to official protocols whether or not they experienced symptomatic disease.^[48][49] Due to the effect of sampling bias, studies which obtain a more accurate number by extrapolating from a random sample have consistently found that total infections considerably exceed the reported case counts.^[50][51] Many countries, early on, had official policies to not test those with only mild symptoms.^[52][53] The strongest risk factors for severe illness are obesity, complications of diabetes, anxiety disorders, and the total number of conditions.^[54]

In early 2020, a meta-analysis of self-reported cases in China by age indicated that a relatively low proportion of cases occurred in individuals under 20.^[55] It was not clear whether this was because young people were less likely to be infected, or less likely to develop symptoms and be tested.^[56] A retrospective cohort study in China found that children and adults were just as likely to be infected.^[57]

Among more thorough studies, preliminary results from 9 April 2020, found that in Gangelt, the centre of a major infection cluster in Germany, 15 per cent of a population sample tested positive for antibodies.^[58] Screening for COVID-19 in pregnant women in New York City, and blood donors in the Netherlands, found rates of positive antibody tests that indicated more infections than reported.^[59][60] Seroprevalence-based estimates are conservative as some studies show that persons with mild symptoms do not have detectable antibodies.^[61]

Initial estimates of the basic reproduction number (R₀) for COVID-19 in January 2020 were between 1.4 and 2.5,^[62] but a subsequent analysis claimed that it may be about 5.7 (with a 95 per cent confidence interval of 3.8 to 8.9).^[63]

In December 2021, the number of cases continued to climb due to several factors, including new COVID-19 variants. As of that 28 December, 282,790,822 individuals worldwide had been confirmed as infected.^[64] As of 14 April 2022^[update], over 500 million cases were confirmed globally.^[65] Most cases are unconfirmed, with the Institute for Health Metrics and Evaluation estimating the true number of cases as of early 2022 to be in the billions.^[66][67]

Semi-log plot of weekly new cases of COVID-19 in the world and the current top six countries (mean with deaths)

Deaths

Deceased in a refrigerated "mobile morgue" outside a hospital in Hackensack, New Jersey, U.S., in April 2020.

Gravediggers bury the body of a man suspected of having died of COVID-19 in the cemetery of Vila Alpina, east side of São Paulo, in April 2020.

Global excess and reported COVID-19 deaths and deaths per 100,000 according to the WHO study^[68]

As of 10 March 2023, more than 6.88 million^[3] deaths had been attributed to COVID-19. The first confirmed death was in Wuhan on 9 January 2020.^[69] These numbers vary by region and over time, influenced by testing volume, healthcare system quality, treatment options, government response,^[70] time since the initial outbreak, and population characteristics, such as age, sex, and overall health.^[71]

Multiple measures are used to quantify mortality.^[72] Official death counts typically include people who died after testing positive. Such counts exclude deaths without a test.^[73] Conversely, deaths of people who died from underlying conditions following a positive test may be included.^[74] Countries such as Belgium include deaths from suspected cases, including those without a test, thereby increasing counts.^[75]

Official death counts have been claimed to underreport the actual death toll, because excess mortality (the number of deaths in a period compared to a long-term average) data show an increase in deaths that is not explained by COVID-19 deaths alone.^[76] Using such data, estimates of the true number of deaths from COVID-19 worldwide have included a range from 16.5 to 26.8 million (≈20.2 million) by 3 February 2023 by The Economist,^[77][76] as well as over 18.5 million by 1 April 2023 by the Institute for Health Metrics and Evaluation^[78] and ≈18.2 million (earlier) deaths between 1 January 2020, and 31 December 2021, by a comprehensive international study.^[79] Such deaths include deaths due to healthcare capacity constraints and priorities, as well as reluctance to seek care (to avoid possible infection).^[80] Further research may help distinguish the proportions directly caused by COVID-19 from those caused by indirect consequences of the pandemic.^[79]

In May 2022, the WHO estimated the number of excess deaths by the end of 2021 to be 14.9 million compared to 5.4 million reported COVID-19 deaths, with the majority of the unreported 9.5 million deaths believed to be direct deaths due the virus, rather than indirect deaths. Some deaths were because people with other conditions could not access medical services.^[81][82]

A December 2022 WHO study estimated excess deaths from the pandemic during 2020 and 2021, again concluding ≈14.8 million excess early deaths occurred, reaffirming and detailing their prior calculations from May as well as updating them, addressing criticisms. These numbers do not include measures like years of potential life lost and may make the pandemic 2021's leading cause of death.^[83][84][68]

The time between symptom onset and death ranges from 6 to 41 days, typically about 14 days.^[85] Mortality rates increase as a function of age. People at the greatest mortality risk are the elderly and those with underlying conditions.^[86][87]

• 

  Semi-log plot of weekly deaths due to COVID-19 in the world and top six current countries (mean with cases)

• 

  Excess deaths relative to expected deaths (the patterns indicate the quality of the all-cause mortality data that were available for each respective country)^[68]

• 

  Excess deaths relative to expected deaths (global and WHO region)^[68]

• 

  The 25 countries with the highest total estimated COVID-19 pandemic excess deaths between January 2020 and December 2021^[68]

• 

  The 25 countries with the highest mean P-scores (excess deaths relative to expected deaths)^[68]

Infection fatality ratio (IFR)

The infection fatality ratio (IFR) is the cumulative number of deaths attributed to the disease divided by the cumulative number of infected individuals (including asymptomatic and undiagnosed infections and excluding vaccinated infected individuals).^[89][90][91] It is expressed in percentage points (not as a decimal).^[92] Other studies refer to this metric as the 'infection fatality risk'.^[93][94]

In November 2020, a review article in Nature reported estimates of population-weighted IFRs for various countries, excluding deaths in elderly care facilities, and found a median range of 0.24% to 1.49%.^[95]

IFRs rise as a function of age (from 0.002% at age 10 and 0.01% at age 25, to 0.4% at age 55, 1.4% at age 65, 4.6% at age 75, and 15% at age 85). These rates vary by a factor of ≈10,000 across the age groups.^[88] For comparison, the IFR for middle-aged adults is two orders of magnitude higher than the annualised risk of a fatal automobile accident and much higher than the risk of dying from seasonal influenza.^[88]

In December 2020, a systematic review and meta-analysis estimated that population-weighted IFR was 0.5% to 1% in some countries (France, Netherlands, New Zealand, and Portugal), 1% to 2% in other countries (Australia, England, Lithuania, and Spain), and about 2.5% in Italy. This study reported that most of the differences reflected corresponding differences in the population's age structure and the age-specific pattern of infections.^[88]

Case fatality ratio (CFR)

Another metric in assessing death rate is the case fatality ratio (CFR),^[a] which is the ratio of deaths to diagnoses. This metric can be misleading because of the delay between symptom onset and death and because testing focuses on symptomatic individuals.^[96]

Based on Johns Hopkins University statistics, the global CFR is 1.02 percent (6,881,955 deaths for 676,609,955 cases) as of 10 March 2023.^[3] The number varies by region and has generally declined over time.^[97]

Discover more about Epidemiology related topics

Investigations into the origin of COVID-19

Investigations into the origin of COVID-19

There are several ongoing efforts by scientists, governments, international organisations, and others to determine the origin of SARS-CoV-2, the virus responsible for the COVID-19 pandemic. Most scientists agree that as with other pandemics in human history, the virus is likely of zoonotic origin in a natural setting, and ultimately originated from a bat-borne virus. Many other explanations, including several conspiracy theories, have been proposed about the origins of the virus. Some scientists and politicians have speculated that SARS-CoV-2 was accidentally released from a laboratory, but this theory is unsupported by evidence. Another fringe theory about the origins of the virus, centered around an incident in the Mojiang mine in 2012 in which three miners fell ill and died, has also been found to have no supporting evidence.

COVID-19 pandemic in Hubei

COVID-19 pandemic in Hubei

The COVID-19 pandemic in Hubei was first manifested by a cluster of mysterious pneumonia in Wuhan, the provincial capital of Hubei, China. A Wuhan hospital notified the local center for disease control and prevention (CDC) and health commissions on December 27, 2019. On December 31, Wuhan CDC admitted that there was a cluster of unknown pneumonia cases related to the Huanan Seafood Wholesale Market after the unverified documents appeared on the Internet. The potential disease outbreak soon drew nationwide attention including that of the National Health Commission (NHC) in Beijing which sent experts to Wuhan on the following day. On January 8, a new coronavirus was identified as the cause of the pneumonia. The sequence of the virus was soon published on an open-access database. Measures taken by China have been controversial. They were praised by the World Health Organization (WHO) for improvements over SARS-CoV-2 responses, but maligned by many in the international community for being slow to publicly disclose key facts or deceptive about the outbreak and for aggressively censoring information relating to the outbreak and public discontent from citizens online.

Pangolin

Pangolin

Pangolins, sometimes known as scaly anteaters, are mammals of the order Pholidota. The one extant family, the Manidae, has three genera: Manis, Phataginus, and Smutsia. Manis comprises four species found in Asia, while Phataginus and Smutsia include two species each, all found in sub-Saharan Africa. These species range in size from 30 to 100 cm. A number of extinct pangolin species are also known.

Huanan Seafood Wholesale Market

Huanan Seafood Wholesale Market

The Wuhan Huanan Seafood Wholesale Market, simply known as the Huanan Seafood Market, was a live animal and seafood market in Jianghan District, Wuhan City, the capital of Hubei Province in Central China.

Molecular clock

Molecular clock

The molecular clock is a figurative term for a technique that uses the mutation rate of biomolecules to deduce the time in prehistory when two or more life forms diverged. The biomolecular data used for such calculations are usually nucleotide sequences for DNA, RNA, or amino acid sequences for proteins. The benchmarks for determining the mutation rate are often fossil or archaeological dates. The molecular clock was first tested in 1962 on the hemoglobin protein variants of various animals, and is commonly used in molecular evolution to estimate times of speciation or radiation. It is sometimes called a gene clock or an evolutionary clock.

Index case

Index case

The index case or patient zero is the first documented patient in a disease epidemic within a population, or the first documented patient included in an epidemiological study. It can also refer to the first case of a condition or syndrome to be described in the medical literature, whether or not the patient is thought to be the first person affected. An index case can achieve the status of a "classic" case study in the literature, as did Phineas Gage, the first known person to exhibit a definitive personality change as a result of a brain injury.

COVID-19 pandemic by country and territory

COVID-19 pandemic by country and territory

This is a general overview and status of places affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus which causes coronavirus disease 2019 (COVID-19) and is responsible for the COVID-19 pandemic. The first human cases of COVID-19 were identified in Wuhan, the capital of the province of Hubei in China in December 2019.

COVID-19 pandemic cases

COVID-19 pandemic cases

The article contains the number of cases of coronavirus disease 2019 (COVID-19) reported by each country, territory, and subnational area to the World Health Organization (WHO) and published in WHO reports, tables, and spreadsheets. As of 30 January 2023, 670,246,597 cases have been stated by government agencies from around the world to be confirmed. For more international statistics in table and map form, see COVID-19 pandemic by country and territory.

COVID-19 testing

COVID-19 testing

COVID-19 testing involves analyzing samples to assess the current or past presence of SARS-CoV-2. The two main types of tests detect either the presence of the virus or antibodies produced in response to infection. Molecular tests for viral presence through its molecular components are used to diagnose individual cases and to allow public health authorities to trace and contain outbreaks. Antibody tests instead show whether someone once had the disease. They are less useful for diagnosing current infections because antibodies may not develop for weeks after infection. It is used to assess disease prevalence, which aids the estimation of the infection fatality rate.

Complications of diabetes

Complications of diabetes

Complications of diabetes mellitus include problems that develop rapidly (acute) or over time (chronic) and may affect many organ systems. The complications of diabetes can dramatically impair quality of life and cause long-lasting disability. Overall, complications are far less common and less severe in people with well-controlled blood sugar levels. Some non-modifiable risk factors such as age at diabetes onset, type of diabetes, gender and genetics may influence risk. Other health problems compound the chronic complications of diabetes such as smoking, obesity, high blood pressure, elevated cholesterol levels, and lack of regular exercise. Complications of diabetes are a strong risk factor for severe COVID-19 illness.

Cohort study

Cohort study

A cohort study is a particular form of longitudinal study that samples a cohort, performing a cross-section at intervals through time. It is a type of panel study where the individuals in the panel share a common characteristic.

Impact of the COVID-19 pandemic on children

Impact of the COVID-19 pandemic on children

A systematic review notes that children with COVID-19 have milder effects and better prognoses than adults. However, children are susceptible to "multisystem inflammatory syndrome in children" (MIS-C), a rare but life-threatening systemic illness involving persistent fever and extreme inflammation following exposure to the SARS-CoV-2 virus.

Variants

Several variants have been named by WHO and labelled as a variant of concern (VoC) or a variant of interest (VoI). They share the more infectious D614G mutation:^{[98][99][100]} Delta dominated and then eliminated earlier VoC from most jurisdictions. Omicron's immune escape ability may allow it to spread via breakthrough infections, which in turn may allow it to coexist with Delta, which more often infects the unvaccinated.^[101]

Signs and symptoms

Symptoms of COVID-19

Symptoms of COVID-19 are variable, ranging from mild symptoms to severe illness.^[104][105] Common symptoms include headache, loss of smell and taste, nasal congestion and runny nose, cough, muscle pain, sore throat, fever, diarrhoea, and breathing difficulties.^[106] People with the same infection may have different symptoms, and their symptoms may change over time. Three common clusters of symptoms have been identified: one respiratory symptom cluster with cough, sputum, shortness of breath, and fever; a musculoskeletal symptom cluster with muscle and joint pain, headache, and fatigue; a cluster of digestive symptoms with abdominal pain, vomiting, and diarrhoea.^[107] In people without prior ear, nose, and throat disorders, loss of taste combined with loss of smell is associated with COVID-19 and is reported in as many as 88% of cases.^{[108][109][110]}

Transmission

The disease is mainly transmitted via the respiratory route when people inhale droplets and small airborne particles (that form an aerosol) that infected people exhale as they breathe, talk, cough, sneeze, or sing.^{[111][112][113][114]} Infected people are more likely to transmit COVID-19 when they are physically close. However, infection can occur over longer distances, particularly indoors.^[111][115]

Cause

Illustration of SARS-CoV-2 virion

SARS‑CoV‑2 belongs to the broad family of viruses known as coronaviruses.^[116] It is a positive-sense single-stranded RNA (+ssRNA) virus, with a single linear RNA segment. Coronaviruses infect humans, other mammals, including livestock and companion animals, and avian species.^[117]

Human coronaviruses are capable of causing illnesses ranging from the common cold to more severe diseases such as Middle East respiratory syndrome (MERS, fatality rate ≈34%). SARS-CoV-2 is the seventh known coronavirus to infect people, after 229E, NL63, OC43, HKU1, MERS-CoV, and the original SARS-CoV.^[118]

Diagnosis

A nurse at McMurdo Station sets up the polymerase chain reaction (PCR) testing equipment, in September 2020.

The standard methods of testing for presence of SARS-CoV-2 are nucleic acid tests,^[119] which detects the presence of viral RNA fragments.^[120] As these tests detect RNA but not infectious virus, its "ability to determine duration of infectivity of patients is limited."^[121] The test is typically done on respiratory samples obtained by a nasopharyngeal swab; however, a nasal swab or sputum sample may also be used.^[122][123] The WHO has published several testing protocols for the disease.^[124]

Prevention

Preventive measures to reduce the chances of infection include getting vaccinated, staying at home or spending more time outdoors, avoiding crowded places, keeping distance from others, wearing a mask in public, ventilating indoor spaces, managing potential exposure durations, washing hands with soap and water often and for at least twenty seconds, practicing good respiratory hygiene, and avoiding touching the eyes, nose, or mouth with unwashed hands.^[125][126]

Those diagnosed with COVID-19 or who believe they may be infected are advised by the CDC to stay home except to get medical care, call ahead before visiting a healthcare provider, wear a face mask before entering the healthcare provider's office and when in any room or vehicle with another person, cover coughs and sneezes with a tissue, regularly wash hands with soap and water and avoid sharing personal household items.^[127][128]

Vaccines

A doctor at Walter Reed National Military Medical Center receiving a COVID-19 vaccination

A COVID-19 vaccine is intended to provide acquired immunity against severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2), the virus that causes coronavirus disease 2019 (COVID-19). Prior to the COVID-19 pandemic, an established body of knowledge existed about the structure and function of coronaviruses causing diseases like severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). This knowledge accelerated the development of various vaccine platforms during early 2020.^[129] The initial focus of SARS-CoV-2 vaccines was on preventing symptomatic, often severe illness.^[130] On 10 January 2020, the SARS-CoV-2 genetic sequence data was shared through GISAID, and by 19 March, the global pharmaceutical industry announced a major commitment to address COVID-19.^[131] The COVID-19 vaccines are widely credited for their role in reducing the severity and death caused by COVID-19.^[132][133]

As of late-December 2021, more than 4.49 billion people had received one or more doses^[134] (8+ billion in total) in over 197 countries. The Oxford-AstraZeneca vaccine was the most widely used.^[135]

On 8 November 2022, Novavax's COVID-19 vaccine booster was authorized for use in adults in the United Kingdom.^[136] On 12 November 2022, the WHO released its Global Vaccine Market Report. The report indicated that "inequitable distribution is not unique to COVID-19 vaccines"; countries that are not economically strong struggle to obtain vaccines.^[137]

On 14 November 2022, the first inhalable vaccine was introduced, developed by Chinese biopharmaceutical company CanSino Biologics, in the city of Shanghai, China.^[138]

Treatment

A critically ill patient receiving invasive ventilation in the intensive care unit of the Heart Institute, University of São Paulo in July 2020. Due to a shortage of mechanical ventilators, a bridge ventilator is being used to automatically actuate a bag valve mask.

For the first two years of the pandemic, no specific and effective treatment or cure was available.^[139][140] In 2021, the European Medicines Agency's (EMA) Committee for Medicinal Products for Human Use (CHMP) approved the oral antiviral protease inhibitor, Paxlovid (nirmatrelvir plus AIDS drug ritonavir), to treat adult patients.^[141] FDA later gave it an EUA.^[142]

Most cases of COVID-19 are mild. In these, supportive care includes medication such as paracetamol or NSAIDs to relieve symptoms (fever,^[143] body aches, cough), adequate intake of oral fluids and rest.^[140][144] Good personal hygiene and a healthy diet are also recommended.^[145]

Supportive care includes treatment to relieve symptoms, fluid therapy, oxygen support and prone positioning, and medications or devices to support other affected vital organs.^[146] More severe cases may need treatment in hospital. In those with low oxygen levels, use of the glucocorticoid dexamethasone is recommended, to reduce mortality.^[147] Noninvasive ventilation and, ultimately, admission to an intensive care unit for mechanical ventilation may be required to support breathing.^[148] Extracorporeal membrane oxygenation (ECMO) has been used to address the issue of respiratory failure.^[149][150]

Existing drugs such as hydroxychloroquine, lopinavir/ritonavir, ivermectin and so-called early treatment are not recommended by US or European health authorities, as there is no good evidence they have any useful effect.^{[139][151][152]} The antiviral remdesivir is available in the US, Canada, Australia, and several other countries, with varying restrictions; however, it is not recommended for use with mechanical ventilation, and is discouraged altogether by the World Health Organization (WHO),^[153] due to limited evidence of its efficacy.^[139]

Prognosis

The severity of COVID-19 varies. The disease may take a mild course with few or no symptoms, resembling other common upper respiratory diseases such as the common cold. In 3–4% of cases (7.4% for those over age 65) symptoms are severe enough to cause hospitalization.^[154] Mild cases typically recover within two weeks, while those with severe or critical diseases may take three to six weeks to recover. Among those who have died, the time from symptom onset to death has ranged from two to eight weeks. Prolonged prothrombin time and elevated C-reactive protein levels on admission to the hospital are associated with severe course of COVID-19 and with a transfer to intensive care units (ICU).^[155][156]

Between 5% and 50% of COVID-19 patients experience long COVID,^[157] a condition characterized by long-term consequences persisting after the typical convalescence period of the disease.^[158][159] The most commonly reported clinical presentations are fatigue and memory problems, as well as malaise, headaches, shortness of breath, loss of smell, muscle weakness, low fever and cognitive dysfunction.^{[5][160][161][162]}

Discover more about Disease related topics

COVID-19

COVID-19

Coronavirus disease 2019 (COVID-19) is a contagious disease caused by a virus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first known case was identified in Wuhan, China, in December 2019. The disease quickly spread worldwide, resulting in the COVID-19 pandemic.

Variants of SARS-CoV-2

Variants of SARS-CoV-2

There are many variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19). Some are believed, or have been stated, to be of particular importance due to their potential for increased transmissibility, increased virulence, or reduced effectiveness of vaccines against them. These variants contribute to the continuation of the COVID-19 pandemic.

Variant of concern

Variant of concern

The term variant of concern (VOC) for SARS-CoV-2, which causes COVID-19, is a category used for variants of the virus where mutations in their spike protein receptor binding domain (RBD) substantially increase binding affinity in RBD-hACE2 complex, while also being linked to rapid spread in human populations.

Breakthrough infection

Breakthrough infection

A breakthrough infection is a case of illness in which a vaccinated individual becomes infected with the illness, because the vaccine has failed to provide complete immunity against the pathogen. Breakthrough infections have been identified in individuals immunized against a variety of diseases including mumps, varicella (Chickenpox), influenza, and COVID-19. The characteristics of the breakthrough infection are dependent on the virus itself. Often, infection of the vaccinated individual results in milder symptoms and shorter duration than if the infection were contracted naturally.

World Health Organization

World Health Organization

The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. Headquartered in Geneva, Switzerland, it has six regional offices and 150 field offices worldwide.

SARS-CoV-2 Alpha variant

SARS-CoV-2 Alpha variant

The Alpha variant (B.1.1.7) was a SARS-CoV-2 variant of concern. It was estimated to be 40–80% more transmissible than the wild-type SARS-CoV-2. Scientists more widely took note of this variant in early December 2020, when a phylogenetic tree showing viral sequences from Kent county in the United Kingdom looked unusual. The variant began to spread quickly by mid-December, around the same time as infections surged.

SARS-CoV-2 Beta variant

SARS-CoV-2 Beta variant

The Beta variant, (B.1.351), was a variant of SARS-CoV-2, the virus that causes COVID-19. One of several SARS-CoV-2 variants initially believed to be of particular importance, it was first detected in the Nelson Mandela Bay metropolitan area of the Eastern Cape province of South Africa in October 2020, which was reported by the country's health department on 18 December 2020. Phylogeographic analysis suggests this variant emerged in the Nelson Mandela Bay area in July or August 2020.

SARS-CoV-2 Delta variant

SARS-CoV-2 Delta variant

The Delta variant (B.1.617.2) was a variant of SARS-CoV-2, the virus that causes COVID-19. It was first detected in India on 5 October 2020. The Delta variant was named on 31 May 2021 and had spread to over 179 countries by 22 November 2021. The World Health Organization (WHO) indicated in June 2021 that the Delta variant was becoming the dominant strain globally.

SARS-CoV-2 Gamma variant

SARS-CoV-2 Gamma variant

The Gamma variant (P.1) was one of the variants of SARS-CoV-2, the virus that causes COVID-19. This variant of SARS-CoV-2 has been named lineage P.1 and has 17 amino acid substitutions, ten of which in its spike protein, including these three designated to be of particular concern: N501Y, E484K and K417T. This variant of SARS-CoV-2 was first detected by the National Institute of Infectious Diseases (NIID) of Japan, on 6 January 2021 in four people who had arrived in Tokyo having visited Amazonas, Brazil, four days earlier. It was subsequently declared to be in circulation in Brazil. Under the simplified naming scheme proposed by the World Health Organization, P.1 has been labeled Gamma variant, and is currently considered a variant of concern.

SARS-CoV-2 Lambda variant

SARS-CoV-2 Lambda variant

Lambda variant, also known as lineage C.37, is a variant of SARS-CoV-2, the virus that causes COVID-19. It was first detected in Peru in August 2020. On 14 June 2021, the World Health Organization (WHO) named it Lambda variant and designated it as a variant of interest. It has spread to at least 30 countries around the world and is known to be more resistant to neutralizing antibodies compared to other strains. There is evidence that suggests the Lambda variant is both more infectious and resistant to vaccines than the Alpha and/or Gamma variant.

SARS-CoV-2 Mu variant

SARS-CoV-2 Mu variant

The Mu variant, also known as lineage B.1.621 or VUI-21JUL-1, is one of the variants of SARS-CoV-2, the virus that causes COVID-19. It was first detected in Colombia in January 2021 and was designated by the WHO as a variant of interest on August 30, 2021. The WHO said the variant has mutations that indicate a risk of resistance to the current vaccines and stressed that further studies were needed to better understand it. Outbreaks of the Mu variant were reported in South America and Europe. The B.1.621 lineage has a sublineage, labeled B.1.621.1 under the PANGO nomenclature, which has already been detected in more than 20 countries worldwide.

SARS-CoV-2 Omicron variant

SARS-CoV-2 Omicron variant

Omicron (B.1.1.529) is a variant of SARS-CoV-2 first reported to the World Health Organization (WHO) by the Network for Genomics Surveillance in South Africa on 24 November 2021. It was first detected in Botswana and has spread to become the predominant variant in circulation around the world. Following the original B.1.1.529 variant, several subvariants of Omicron have emerged including: BA.1, BA.2, BA.3, BA.4, and BA.5. Since October 2022, two subvariants of BA.5 called BQ.1 and BQ.1.1 have emerged.

Goals of mitigation include delaying and reducing peak burden on healthcare (flattening the curve) and lessening overall cases and health impact.^[163][164] Moreover, progressively greater increases in healthcare capacity (raising the line) such as by increasing bed count, personnel, and equipment, help to meet increased demand.^[165]

Many countries attempted to slow or stop the spread of COVID-19 by recommending, mandating or prohibiting behaviour changes, while others relied primarily on providing information. Measures ranged from public advisories to stringent lockdowns. Outbreak control strategies are divided into elimination and mitigation. Experts differentiate between elimination strategies (known as "zero-COVID") that aim to completely stop the spread of the virus within the community,^[166] and mitigation strategies (commonly known as "flattening the curve") that attempt to lessen the effects of the virus on society, but which still tolerate some level of transmission within the community.^[167] These initial strategies can be pursued sequentially or simultaneously during the acquired immunity phase through natural and vaccine-induced immunity.^[168]

Nature reported in 2021 that 90 per cent of immunologists who responded to a survey "think that the coronavirus will become endemic".^[169]

Containment

Containment is undertaken to stop an outbreak from spreading into the general population. Infected individuals are isolated while they are infectious. The people they have interacted with are contacted and isolated for long enough to ensure that they are either not infected or no longer contagious. Screening is the starting point for containment. Screening is done by checking for symptoms to identify infected individuals, who can then be isolated or offered treatment.^[170] The Zero-COVID strategy involves using public health measures such as contact tracing, mass testing, border quarantine, lockdowns and mitigation software to stop community transmission of COVID-19 as soon as it is detected, with the goal of getting the area back to zero detected infections and resuming normal economic and social activities.^[166][171] Successful containment or suppression reduces Rt to less than 1.^[172]

Mitigation

Should containment fail, efforts focus on mitigation: measures taken to slow the spread and limit its effects on the healthcare system and society. Successful mitigation delays and decreases the epidemic peak, known as "flattening the epidemic curve".^[163] This decreases the risk of overwhelming health services and provides more time for developing vaccines and treatments.^[163] Individual behaviour changed in many jurisdictions. Many people worked from home instead of at their traditional workplaces.^[173]

Non-pharmaceutical interventions

The CDC and WHO advise that masks (such as worn here by Taiwanese president Tsai Ing-wen) reduce the spread of SARS-CoV-2.

Non-pharmaceutical interventions that may reduce spread include personal actions such as wearing face masks, self-quarantine, and hand hygiene; community measures aimed at reducing interpersonal contacts such as closing workplaces and schools and cancelling large gatherings; community engagement to encourage acceptance and participation in such interventions; as well as environmental measures such as surface cleaning.^[174]

Other measures

More drastic actions, such as quarantining entire populations and strict travel bans have been attempted in various jurisdictions.^[175] China and Australia's lockdowns have been the most strict. New Zealand implemented the most severe travel restrictions. South Korea introduced mass screening and localised quarantines, and issued alerts on the movements of infected individuals. Singapore provided financial support, quarantined, and imposed large fines for those who broke quarantine.^[176]

Contact tracing

Contact tracing attempts to identify recent contacts of newly infected individuals, and to screen them for infection; the traditional approach is to request a list of contacts from infectees, and then telephone or visit the contacts.^[177] Contact tracing was widely used during the Western African Ebola virus epidemic in 2014.^[178]

Another approach is to collect location data from mobile devices to identify those who have come in significant contact with infectees, which prompted privacy concerns.^[179] On 10 April 2020, Google and Apple announced an initiative for privacy-preserving contact tracing.^[180][181] In Europe and in the US, Palantir Technologies initially provided COVID-19 tracking services.^[182]

Health care

WHO described increasing capacity and adapting healthcare as a fundamental mitigation.^[183] The ECDC and WHO's European regional office issued guidelines for hospitals and primary healthcare services for shifting resources at multiple levels, including focusing laboratory services towards testing, cancelling elective procedures, separating and isolating patients, and increasing intensive care capabilities by training personnel and increasing ventilators and beds.^[183][184] The pandemic drove widespread adoption of telehealth.^[185]

Improvised manufacturing

A patient in Ukraine in 2020 wearing a scuba mask in the absence of artificial ventilation.

Due to capacity supply chains limitations, some manufacturers began 3D printing material such as nasal swabs and ventilator parts.^[186][187] In one example, an Italian startup received legal threats due to alleged patent infringement after reverse-engineering and printing one hundred requested ventilator valves overnight.^[188] Individuals and groups of makers created and shared open source designs, and manufacturing devices using locally sourced materials, sewing, and 3D printing. Millions of face shields, protective gowns, and masks were made. Other ad hoc medical supplies included shoe covers, surgical caps, powered air-purifying respirators, and hand sanitizer. Novel devices were created such as ear savers, non-invasive ventilation helmets, and ventilator splitters.^[189]

Herd immunity

In July 2021, several experts expressed concern that achieving herd immunity may not be possible because Delta can transmit among vaccinated individuals.^[190] CDC published data showing that vaccinated people could transmit Delta, something officials believed was less likely with other variants. Consequently, WHO and CDC encouraged vaccinated people to continue with non-pharmaceutical interventions such as masking, social distancing, and quarantining if exposed.^[191]

Discover more about Strategies related topics

Public health mitigation of COVID-19

Public health mitigation of COVID-19

Speed and scale are key to mitigation of COVID-19, due to the fat-tailed nature of pandemic risk and the exponential growth of COVID-19 infections. For mitigation to be effective, (a) chains of transmission must be broken as quickly as possible through screening and containment, (b) health care must be available to provide for the needs of those infected, and (c) contingencies must be in place to allow for effective rollout of (a) and (b).

Flattening the curve

Flattening the curve

Flattening the curve was a public health strategy to slow down the spread of the SARS-CoV-2 virus during the early stages of the COVID-19 pandemic. The curve being flattened is the epidemic curve, a visual representation of the number of infected people needing health care over time. During an epidemic, a health care system can break down when the number of people infected exceeds the capability of the health care system's ability to take care of them. Flattening the curve means slowing the spread of the epidemic so that the peak number of people requiring care at a time is reduced, and the health care system does not exceed its capacity. Flattening the curve relies on mitigation techniques such as hand washing, use of face masks and social distancing.

COVID-19 vaccine

COVID-19 vaccine

A COVID‑19 vaccine is a vaccine intended to provide acquired immunity against severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2), the virus that causes coronavirus disease 2019 (COVID‑19).

Endemic (epidemiology)

Endemic (epidemiology)

In epidemiology, an infection is said to be endemic in a specific population or populated place when that infection is constantly maintained at a baseline level without extra infections being brought into the group as a result of travel or similar means. An endemic disease always has a steady, predictable number of people getting sick, but that number can be high (hyperendemic) or low (hypoendemic), and the disease can be severe or mild. Also, a disease that is usually endemic can become epidemic.

Contact tracing

Contact tracing

In public health, contact tracing is the process of identifying persons who may have been exposed to an infected person ("contacts") and subsequent collection of further data to assess transmission. By tracing the contacts of infected individuals, testing them for infection, and isolating or treating the infected, this public health tool aims to reduce infections in the population. In addition to infection control, contact tracing serves as a means to identify high-risk and medically vulnerable populations who might be exposed to infection and facilitate appropriate medical care. In doing so, public health officials utilize contact tracing to conduct disease surveillance and prevent outbreaks. In cases of diseases of uncertain infectious potential, contact tracing is also sometimes performed to learn about disease characteristics, including infectiousness. Contact tracing is not always the most efficient method of addressing infectious disease. In areas of high disease prevalence, screening or focused testing may be more cost-effective.

COVID-19 testing

COVID-19 testing

COVID-19 testing involves analyzing samples to assess the current or past presence of SARS-CoV-2. The two main types of tests detect either the presence of the virus or antibodies produced in response to infection. Molecular tests for viral presence through its molecular components are used to diagnose individual cases and to allow public health authorities to trace and contain outbreaks. Antibody tests instead show whether someone once had the disease. They are less useful for diagnosing current infections because antibodies may not develop for weeks after infection. It is used to assess disease prevalence, which aids the estimation of the infection fatality rate.

Travel during the COVID-19 pandemic

Travel during the COVID-19 pandemic

During the COVID-19 pandemic, many countries and regions imposed quarantines, entry bans, or other travel restrictions for citizens of or recent travelers to the most affected areas. Some countries and regions imposed global restrictions that apply to all foreign countries and territories, or prevent their own citizens from travelling overseas.

COVID-19 lockdowns

COVID-19 lockdowns

Due to the COVID-19 pandemic, a number of non-pharmaceutical interventions colloquially known as lockdowns have been implemented in numerous countries and territories around the world. These restrictions were established with the intention to reduce the spread of SARS-CoV-2, the virus that causes COVID-19. By April 2020, about half of the world's population was under some form of lockdown, with more than 3.9 billion people in more than 90 countries or territories having been asked or ordered to stay at home by their governments. Although similar disease control measures have been used for hundreds of years, the scale of those implemented in the 2020s is thought to be unprecedented.

Transmission of COVID-19

Transmission of COVID-19

The transmission of COVID-19 is the passing of coronavirus disease 2019 from person to person. COVID-19 is mainly transmitted when people breathe in air contaminated by droplets/aerosols and small airborne particles containing the virus. Infected people exhale those particles as they breathe, talk, cough, sneeze, or sing. Transmission is more likely the more physically close people are. However, infection can occur over longer distances, particularly indoors.

Epidemic curve

Epidemic curve

An epidemic curve, also known as an epi curve or epidemiological curve, is a statistical chart used in epidemiology to visualise the onset of a disease outbreak. It can help with the identification of the mode of transmission of the disease. It can also show the disease's magnitude, whether cases are clustered or if there are individual case outliers, its trend over time, and its incubation period. It can give outbreak investigators an idea as to whether an outbreak is likely to be from a point source, a continuous common source, or a propagated source.

Tsai Ing-wen

Tsai Ing-wen

Tsai Ing-wen is a Taiwanese politician who has served as the president of the Republic of China (Taiwan) since 2016. A member of the Democratic Progressive Party (DPP), Tsai is the first female president of Taiwan. She served as chair of the DPP from 2020 to 2022, and also previously from 2008 to 2012 and 2014 to 2018.

Non-pharmaceutical intervention

Non-pharmaceutical intervention

A non-pharmaceutical intervention or non-pharmacological intervention (NPI) is any type of health intervention which is not primarily based on medication. Some examples include exercise, sleep improvement, or dietary habits.

2019

Map of Wuhan, China

The outbreak was discovered in Wuhan in November 2019. It is possible that human-to-human transmission was happening before the discovery.^[35][36] Based on a retrospective analysis starting from December 2019, the number of cases in Hubei gradually increased, reaching 60 by 20 December and at least 266 by 31 December.^[192]

A pneumonia cluster was observed on 26 December and treated by Doctor Zhang Jixian. She informed the Wuhan Jianghan CDC on 27 December.^[193] Vision Medicals reported the discovery of a novel coronavirus to the China CDC (CCDC) on 28 December.^[194][195]

On 30 December, a test report from CapitalBio Medlab addressed to Wuhan Central Hospital reported an erroneous positive result for SARS, causing doctors there to alert authorities. Eight of those doctors, including Li Wenliang (who was also punished on 3 January),^[196] were later admonished by the police for spreading false rumours; and Ai Fen was reprimanded.^[197] That evening, Wuhan Municipal Health Commission (WMHC) issued a notice about "the treatment of pneumonia of unknown cause".^[198] The next day, WMHC made the announcement public, confirming 27 cases^[199][200]—enough to trigger an investigation.^[201]

On 31 December, the WHO office in China was informed of cases of the pneumonia cases^[202][199] and immediately launched an investigation.^[201]

Official Chinese sources claimed that the early cases were mostly linked to the Huanan Seafood Wholesale Market, which also sold live animals.^[203] However, in May 2020, CCDC director George Gao indicated the market was not the origin (animal samples had tested negative).^[204]

2020

A highway sign discouraging travel in Toronto in March 2020

On 11 January, WHO was notified by the Chinese National Health Commission that the outbreak was associated with exposures in the market, and that China had identified a new type of coronavirus, which it isolated on 7 January.^[202]

Initially, the number of cases doubled approximately every seven and a half days.^[205] In early and mid-January, the virus spread to other Chinese provinces, helped by the Chinese New Year migration. Wuhan was a transport hub and major rail interchange.^[206] On 10 January, the virus's genome was shared through GISAID.^[207] A retrospective study published in March found that 6,174 people had reported symptoms by 20 January.^[208] A 24 January report indicated human transmission, recommended personal protective equipment for health workers, and advocated testing, given the outbreak's "pandemic potential".^[43][209] On 31 January the first published modelling study warned of inevitable "independent self-sustaining outbreaks in major cities globally" and called for "large-scale public health interventions."^[210]

On 30 January, 7,818 infections had been confirmed, leading WHO to declare the outbreak a Public Health Emergency of International Concern (PHEIC).^[211][212] On 11 March, WHO elevated it to a pandemic.^[213][214]

By 31 January, Italy had its first confirmed infections, in two tourists from China.^[215] On 19 March, Italy overtook China as the country with the most reported deaths.^[216] By 26 March, the United States had overtaken China and Italy as the country with the highest number of confirmed infections.^[217] Genomic analysis indicated that the majority of New York's confirmed infections came from Europe, rather than directly from Asia.^[218] Testing of prior samples revealed a person who was infected in France on 27 December 2019^[219][220] and a person in the United States who died from the disease on 6 February.^[221]

An exhausted anesthesiologist physician in Pesaro, Italy, March 2020

In October, WHO reported that one in ten people around the world may have been infected, or 780 million people, while only 35 million infections had been confirmed.^[222]

On 9 November, Pfizer released trial results for a candidate vaccine, showing a 90 per cent effectiveness against infection.^[223] That day, Novavax entered an FDA Fast Track application for their vaccine.^[224]

On 14 December, Public Health England reported that a variant had been discovered in the UK's southeast, predominantly in Kent. The variant, later named Alpha, showed changes to the spike protein that could be more infectious. As of 13 December, 1,108 infections had been confirmed.^[225]

On 4 February 2020, US Secretary of Health and Human Services Alex Azar waived liability for vaccine manufacturers.^[226]

2021

On 2 January, the Alpha variant, first discovered in the UK, had been identified in 33 countries.^[227] On 6 January, the Gamma variant was first identified in Japanese travellers returning from Brazil.^[228] On 29 January, it was reported that the Novavax vaccine was 49 per cent effective against the Beta variant in a clinical trial in South Africa.^[229][230] The CoronaVac vaccine was reported to be 50.4 per cent effective in a Brazil clinical trial.^[231]

A temporary hospital for COVID-19 patients in Brazil in March 2021

On 12 March, several countries stopped using the Oxford-AstraZeneca COVID-19 vaccine due to blood clotting problems, specifically cerebral venous sinus thrombosis (CVST).^[232] On 20 March, the WHO and European Medicines Agency found no link to thrombus, leading several countries to resume the vaccine.^[233] In March WHO reported that an animal host was the most likely origin, without ruling out other possibilities.^[2][34] The Delta variant was first identified in India. In mid-April, the variant was first detected in the UK and two months later it had metastasized into a third wave there, forcing the government to delay reopening that was originally scheduled for June.^[234]

On 10 November, Germany advised against the Moderna vaccine for people under 30.^[235] On 24 November, the Omicron variant was detected in South Africa; a few days later the World Health Organization declared it a VoC (variant of concern).^[236] The new variant is more infectious than the Delta variant.^[237]

2022

TEM of an Omicron variant coronavirus

On 1 January, Europe passed 100 million cases amidst a surge in the Omicron variant.^[238] Later that month on 14 January, the World Health Organization recommended two new treatments, Baricitinib, and Sotrovimab (although conditionally).^[239] Later on 24 January, it was reported that about 57% of the world had been infected by COVID-19, per the Institute for Health Metrics and Evaluation Model.^[66][67]

On 6 March, it was reported that the total worldwide death count had surpassed 6 million people since the start of the pandemic.^[240] Some time later, on 6 July, it was reported that Omicron subvariants BA.4 and BA.5 had spread worldwide.^[241]

On 21 October the United States surpassed 99 million cases of COVID-19, the most cases of any country.^[242]

On 30 October, it was reported that worldwide 424 deaths occurred due to the virus, the lowest since 385 deaths were reported on 12 March 2020.^[243] 17 November marked the three-year anniversary since health officials in China first detected COVID-19.^[244] Ghebreyesus of the WHO stated on 14 September 2022, that "[The world has] never been in a better position to end the pandemic", citing the lowest number of weekly reported deaths since March 2020. He continued, "We are not there yet. But the end is in sight—we can see the finish line".^{[245][246][247][248]}

On 11 November, the World Health Organization reported that deaths since the month of February have dropped 90 percent. Director-General Tedros Adhanom Ghebreyesus said this was "cause for optimism".^[249] On 3 December, the World Health Organization indicated that, "at least 90% of the world's population has some level of immunity to Sars-CoV-2".^[250] On 21 December, data from China's health authorities revealed that 248 million people, nearly 18 percent of its population, had been infected within just the first 20 days of December, as China abruptly halted its stringent lockdown measures.^[251]

On 29 December 2022, the U.S. joined Italy, Japan, Taiwan and India in requiring negative COVID-19 test results from all people traveling from China due to the new surge in cases, while the EU refused similar measures, stating that the BF7 omicron variant had already spread throughout Europe without becoming dominant.^[252][253]

2023

On 4 January 2023, the World Health Organization indicated that the information being shared by China during its latest virus surge lacks data, such as hospitalization rates.^[254] On 10 January, the World Health Organization’s Europe office indicated that there was no current threat from China's recent viral surge for the aforementioned region.^[255] On January 16, the WHO recommended, "the monitoring of excess mortality, which provides us with a more comprehensive understanding of the impact of COVID-19", in regards to the current surge in China.^[256]

On 27 January, the World Health Organization met to decide if COVID-19 still met the criteria of a public health emergency of international concern (PHEIC).^[257] Its decision was announced on 30 January, exactly 3 years to the day when it was first declared;^[258] it was decided it was still a PHEIC.^[259] On 8 February, it was reported that a recent study aimed at China's case surge indicated no new COVID-19 variants have emerged as a result.^[260][261]

On 19 March, WHO director Dr. Tedros Adhanom Ghebreyesus indicated that he is "confident" the COVID-19 pandemic would come to an end this year.^[262]

Discover more about History related topics

Timeline of the COVID-19 pandemic

Timeline of the COVID-19 pandemic

The timeline of the COVID-19 pandemic lists the articles containing the chronology and epidemiology of SARS-CoV-2, the virus that causes the coronavirus disease 2019 (COVID-19) and is responsible for the COVID-19 pandemic.

Pandemic prevention

Pandemic prevention

Pandemic prevention is the organization and management of preventive measures against pandemics. Those include measures to reduce causes of new infectious diseases and measures to prevent outbreaks and epidemics from becoming pandemics.

Pandemic predictions and preparations prior to the COVID-19 pandemic

Pandemic predictions and preparations prior to the COVID-19 pandemic

Planning and preparing for pandemics has happened in countries and international organizations. The World Health Organization writes recommendations and guidelines, though there is no sustained mechanism to review countries' preparedness for epidemics and their rapid response abilities. National action depends on national governments. In 2005–2006, before the 2009 swine flu pandemic and during the decade following it, the governments in the United States, France, UK, and others managed strategic health equipment stocks, but they often reduced stocks after the 2009 pandemic in order to reduce costs.

Timeline of the COVID-19 pandemic in 2019

Timeline of the COVID-19 pandemic in 2019

This article documents the chronology and epidemiology of SARS-CoV-2 in 2019, the virus that causes coronavirus disease 2019 (COVID-19) and is responsible for the COVID-19 pandemic. The first human cases of COVID-19 known to have been identified were in Wuhan, Hubei, China, in December 2019. It marked the beginning of the 2019-2020 COVID-19 outbreak in mainland China.

Pneumonia

Pneumonia

Pneumonia is an inflammatory condition of the lung primarily affecting the small air sacs known as alveoli. Symptoms typically include some combination of productive or dry cough, chest pain, fever, and difficulty breathing. The severity of the condition is variable.

Novel coronavirus

Novel coronavirus

Novel coronavirus (nCoV) is a provisional name given to coronaviruses of medical significance before a permanent name is decided upon. Although coronaviruses are endemic in humans and infections normally mild, such as the common cold, cross-species transmission has produced some unusually virulent strains which can cause viral pneumonia and in serious cases even acute respiratory distress syndrome and death.

Chinese Center for Disease Control and Prevention

Chinese Center for Disease Control and Prevention

The Chinese Center for Disease Control and Prevention is an institution directly under the National Health Commission, based in Changping District, Beijing, China.

SARS

SARS

Severe acute respiratory syndrome (SARS) is a viral respiratory disease of zoonotic origin caused by the severe acute respiratory syndrome coronavirus, the first identified strain of the SARS coronavirus species, severe acute respiratory syndrome–related coronavirus (SARSr-CoV). The first known cases occurred in November 2002, and the syndrome caused the 2002–2004 SARS outbreak. In the 2010s, Chinese scientists traced the virus through the intermediary of Asian palm civets to cave-dwelling horseshoe bats in Xiyang Yi Ethnic Township, Yunnan.

Li Wenliang

Li Wenliang

Li Wenliang was a Chinese ophthalmologist who warned his colleagues about early COVID-19 infections in Wuhan. On 30 December 2019, Wuhan CDC issued emergency warnings to local hospitals about a number of mysterious "pneumonia" cases discovered in the city in the previous week. On the same day, Li, who worked at the Central Hospital of Wuhan, received an internal diagnostic report of a suspected severe acute respiratory syndrome (SARS) patient from other doctors which he in turn shared with his Wuhan University alumni through a WeChat group. He was dubbed a whistleblower when that shared report later circulated publicly despite his requesting confidentiality from those with whom he shared the information. Rumors of a deadly SARS outbreak subsequently spread on Chinese social media platforms; Wuhan police summoned and admonished him and seven other doctors on 3 January for "making false comments on the Internet about unconfirmed SARS outbreak."

Ai Fen

Ai Fen

Ai Fen is a Chinese doctor and director of the emergency department of Central Hospital of Wuhan. In December 2019, she was one of the first doctors to encounter pneumonia patients infected with the then-unknown virus, SARS-CoV-2. On 30 December 2019, Ai Fen received a diagnostic report of suspected "Severe Acute Respiratory Syndrome cases". An image of the diagnostic report was shared on WeChat by an ophthalmologist at the hospital, Li Wenliang. The image was then circulated on the internet, leading Ai Fen to be questioned by hospital superiors. She was given the nickname "The Whistle-Giver" (发哨子的人) in an article in the Chinese Renwu magazine which was censored by the Chinese government but was reposted on the Chinese internet using emojis, Morse code and pinyin to circumvent censorship.

George F. Gao

George F. Gao

Gao Fu, also known as George Fu Gao, is a Chinese virologist and immunologist. He has served as Director of the Chinese Center for Disease Control and Prevention from August 2017 to July 2022 and Dean of the Savaid Medical School of the University of Chinese Academy of Sciences since 2015.

Timeline of the COVID-19 pandemic in April 2020

Timeline of the COVID-19 pandemic in April 2020

This article documents the chronology and epidemiology of SARS-CoV-2 in April 2020, the virus which causes the coronavirus disease 2019 (COVID-19) and is responsible for the COVID-19 pandemic. The first human cases of COVID-19 were identified in Wuhan, China, in December 2019.

National reactions ranged from strict lockdowns to public education campaigns.^[263] WHO recommended that curfews and lockdowns should be short-term measures to reorganise, regroup, rebalance resources, and protect the health care system.^[264] As of 26 March 2020, 1.7 billion people worldwide were under some form of lockdown.^[265] This increased to 3.9 billion people by the first week of April—more than half the world's population.^[266][267]

Asia

As of the end of 2021, Asia's peak had come at the same time and at the same level as the world as a whole, in May 2021.^[268] However, cumulatively they had experienced only half the world average.^[269]

A temporary hospital constructed in Wuhan in February 2020.

China opted for containment, inflicting strict lockdowns to eliminate spread.^[270][271] The vaccines distributed in China included the BIBP, WIBP, and CoronaVac.^[272] It was reported on 11 December 2021, that China had vaccinated 1.162 billion of its citizens, or 82.5% of the total population of the country against COVID-19.^[273] China's large-scale adoption of zero-COVID had largely contained the first waves of infections of the disease.^{[274][275][276]} When the waves of infections due to the Omicron variant followed, China was almost alone in pursuing the strategy of zero-Covid to combat the spread of the virus in 2022.^[277] Lockdown continued to be employed in November to combat a new wave of cases;^[278][279] however, protests erupted in cities across China over the country's stringent measures,^[280][281] and in December that year, the country relaxed its zero-COVID policy.^[282] On 20 December 2022, the Chinese State Council narrowed its definition of what would be counted as a COVID-19 death to include solely respiratory failure, which led to skepticism by health experts of the government's total death count^[283][284] at a time when hospitals reported being overwhelmed with cases following the abrupt discontinuation of zero-COVID.^[285]

The first case in India was reported on 30 January 2020. India ordered a nationwide lockdown starting 24 March 2020,^[286] with a phased unlock beginning 1 June 2020. Six cities accounted for around half of reported cases—Mumbai, Delhi, Ahmedabad, Chennai, Pune and Kolkata.^[287] Post-lockdown, the Government of India introduced a contact tracking app called Arogya Setu to help authorities manage contact tracing. Later this app was also used for a vaccination management program.^[288] India's vaccination program was considered to be the world's largest and the most successful with over 90% of citizens getting the first dose and another 65% getting the second dose.^[289][290] A second wave hit India in April 2021, straining healthcare services.^[291] On 21 October 2021, it was reported that the country had surpassed 1 billion vaccinations.^[292]

Disinfection of Tehran Metro trains against COVID-19 transmission. Similar measures have also been taken in other countries.^[293]

Iran reported its first confirmed cases on 19 February 2020, in Qom.^[294][295] Early measures included the cancellation of concerts and other cultural events,^[296] Friday prayers,^[297] and education shutdowns.^[298] Iran became a centre of the pandemic in February 2020.^[299][300] More than ten countries had traced their outbreaks to Iran by 28 February, indicating a more severe outbreak than the 388 reported cases.^[300][301] The Iranian Parliament closed, after 23 of its 290 members tested positive on 3 March 2020.^[302] At least twelve sitting or former Iranian politicians and government officials had died by 17 March 2020.^[303] By August 2021, the pandemic's fifth wave peaked, with more than 400 deaths in 1 day.^[304]

COVID-19 was confirmed in South Korea on 20 January 2020. Military bases were quarantined after tests showed three infected soldiers.^[305] South Korea introduced what was then considered the world's largest and best-organised screening programme, isolating infected people, and tracing and quarantining contacts.^[306] Screening methods included mandatory self-reporting by new international arrivals through mobile application,^[307] combined with drive-through testing,^[308] and increasing testing capability to 20,000 people/day.^[309] Despite some early criticisms,^[310] South Korea's programme was considered a success in controlling the outbreak without quarantining entire cities.^{[306][311][312]}

Europe

Deaths per 100,000 residents

The global COVID-19 pandemic arrived in Europe with its first confirmed case in Bordeaux, France, on 24 January 2020, and subsequently spread widely across the continent. By 17 March 2020, every country in Europe had confirmed a case,^[313] and all have reported at least one death, with the exception of Vatican City. Italy was the first European nation to experience a major outbreak in early 2020, becoming the first country worldwide to introduce a national lockdown.^[314] By 13 March 2020, the World Health Organization (WHO) declared Europe the epicentre of the pandemic^[315][316] and it remained so until the WHO announced it had been overtaken by South America on 22 May.^[317] By 18 March 2020, more than 250 million people were in lockdown in Europe.^[318] Despite deployment of COVID-19 vaccines, Europe became the pandemic's epicentre once again in late 2021.^[319][320]

The Italian outbreak began on 31 January 2020, when two Chinese tourists tested positive for SARS-CoV-2 in Rome.^[215] Cases began to rise sharply, which prompted the government to suspend flights to and from China and declare a state of emergency.^[321] On 22 February 2020, the Council of Ministers announced a new decree-law to contain the outbreak, including quarantining more than 50,000 people in northern Italy.^[322] On 4 March the Italian government ordered schools and universities closed as Italy reached a hundred deaths. Sport was suspended completely for at least one month.^[323] On 11 March Conte stopped nearly all commercial activity except supermarkets and pharmacies.^[324][325] On 19 March Italy overtook China as the country with the most COVID-19-related deaths.^[326][327] On 19 April the first wave ebbed, as 7-day deaths declined to 433.^[328] On 13 October, the Italian government again issued restrictive rules to contain the second wave.^[329] On 10 November Italy surpassed 1 million confirmed infections.^[330] On 23 November, it was reported that the second wave of the virus had led some hospitals to stop accepting patients.^[331]

Vaccinations at a retirement home in Gijón, Spain, in December 2020.

The virus was first confirmed to have spread to Spain on 31 January 2020, when a German tourist tested positive for SARS-CoV-2 in La Gomera, Canary Islands.^[332] Post-hoc genetic analysis has shown that at least 15 strains of the virus had been imported, and community transmission began by mid-February.^[333] On 29 March, it was announced that, beginning the following day, all non-essential workers were ordered to remain at home for the next 14 days.^[334] The number of cases increased again in July in a number of cities including Barcelona, Zaragoza and Madrid, which led to reimposition of some restrictions but no national lockdown.^{[335][336][337][338]} By September 2021, Spain was one of the countries with the highest per centage of its population vaccinated (76% fully vaccinated and 79% with the first dose),^[339] while also being one of the countries more in favour of vaccines against COVID-19 (nearly 94% of its population were already vaccinated or wanted to be).^[340] However, as of 21 January 2022, this figure had only increased to 80.6%. Nevertheless, Spain leads Europe for per-capita full-vaccination rates. Italy is ranked second at 75%.^[339]

Sweden differed from most other European countries in that it mostly remained open.^[341] Per the Swedish Constitution, the Public Health Agency of Sweden has autonomy that prevents political interference and the agency favoured remaining open. The Swedish strategy focused on longer-term measures, based on the assumption that after lockdown the virus would resume spreading, with the same result.^[342][343] By the end of June, Sweden no longer had excess mortality.^[344]

Devolution in the United Kingdom meant that each of its four countries developed its own response. England's restrictions were shorter-lived than the others.^[345] The UK government started enforcing social distancing and quarantine measures on 18 March 2020.^[346][347] On 16 March, Prime Minister Boris Johnson advised against non-essential travel and social contact, praising work from home and avoiding venues such as pubs, restaurants, and theatres.^[348][349] On 20 March, the government ordered all leisure establishments to close,^[350] and promised to prevent unemployment.^[351] On 23 March, Johnson banned gatherings and restricted non-essential travel and outdoor activity. Unlike previous measures, these restrictions were enforceable by police through fines and dispersal of gatherings. Most non-essential businesses were ordered to close.^[352] On 24 April 2020, it was reported that a promising vaccine trial had begun in England; the government pledged more than £50 million towards research.^[353] On 16 April 2020, it was reported that the UK would have first access to the Oxford vaccine, due to a prior contract; should the trial be successful, some 30 million doses would be available.^[354] On 2 December 2020, the UK became the first developed country to approve the Pfizer vaccine; 800,000 doses were immediately available for use.^[355] In August 2022 it was reported that viral infection cases had declined in the UK.^[356]

North America

The virus arrived in the United States on 13 January 2020.^[357] Cases were reported in all North American countries after Saint Kitts and Nevis confirmed a case on 25 March, and in all North American territories after Bonaire confirmed a case on 16 April.^[358]

The hospital ship USNS Comfort arrives in Manhattan on 30 March 2020.

102,417,985^[359] confirmed cases have been reported in the United States with 1,113,229^[359] deaths, the most of any country, and the nineteenth-highest per capita worldwide.^[360] COVID-19 is the deadliest pandemic in U.S. history;^[361] it was the third-leading cause of death in the U.S. in 2020, behind heart disease and cancer.^[362] From 2019 to 2020, U.S. life expectancy dropped by 3 years for Hispanic Americans, 2.9 years for African Americans, and 1.2 years for white Americans.^[363] These effects have persisted as U.S. deaths due to COVID-19 in 2021 exceeded those in 2020.^[364] In the United States, COVID-19 vaccines became available in December 2020, under emergency use, beginning the national vaccination program, with the first vaccine officially approved by the Food and Drug Administration on 23 August 2021.^[365] On 18 November 2022, while cases in the U.S. have declined, COVID variants BQ.1/BQ.1.1 have become dominant in the country.^[366][367]

In March 2020, as cases of community transmission were confirmed across Canada, all of its provinces and territories declared states of emergency. Provinces and territories have, to varying degrees, implemented school and daycare closures, prohibitions on gatherings, closures of non-essential businesses and restrictions on entry. Canada severely restricted its border access, barring travellers from all countries with some exceptions.^[368] Cases surged across Canada, notably in the provinces of British Columbia, Alberta, Quebec and Ontario, with the formation of the Atlantic Bubble, a travel-restricted area of the country (formed of the four Atlantic provinces).^[369] Vaccine passports were adopted in all provinces and two of the territories.^[370][371] Per a report on 11 November 2022, Canada is facing a surge in influenza, while COVID-19 is expected to rise during winter.^[372]

South America

Disinfection of public area in Itapevi, Brazil, in April 2020.

The COVID-19 pandemic was confirmed to have reached South America on 26 February 2020, when Brazil confirmed a case in São Paulo.^[373] By 3 April, all countries and territories in South America had recorded at least one case.^[374] On 13 May 2020, it was reported that Latin America and the Caribbean had reported over 400,000 cases of COVID-19 infection with 23,091 deaths. On 22 May 2020, citing the rapid increase of infections in Brazil, the World Health Organization WHO declared South America the epicentre of the pandemic.^[375][376] As of 16 July 2021, South America had recorded 34,359,631 confirmed cases and 1,047,229 deaths from COVID-19. Due to a shortage of testing and medical facilities, it is believed that the outbreak is far larger than the official numbers show.^[377]

The virus was confirmed to have spread to Brazil on 25 February 2020,^[378] when a man from São Paulo who had traveled to Italy^[379] tested positive for the virus. The disease had spread to every federative unit of Brazil by 21 March. On 19 June 2020, the country reported its one millionth case and nearly 49,000 reported deaths.^[380][381] One estimate of under-reporting was 22.62% of total reported COVID-19 mortality in 2020.^{[382][383][384]} As of 22 March 2023, Brazil, with 37,085,520^[359] confirmed cases and 699,310^[359] deaths, has the third-highest number of confirmed cases and second-highest death toll from COVID-19 in the world, behind only those of the United States and of India.^[385]

Africa

US Air Force personnel unload a C-17 aircraft carrying medical supplies in Niamey, Niger, in April 2020.

The COVID-19 pandemic was confirmed to have spread to Africa on 14 February 2020, with the first confirmed case announced in Egypt.^[386][387] The first confirmed case in sub-Saharan Africa was announced in Nigeria at the end of February 2020.^[388] Within three months, the virus had spread throughout the continent, as Lesotho, the last African sovereign state to have remained free of the virus, reported a case on 13 May 2020.^[389][390] By 26 May, it appeared that most African countries were experiencing community transmission, although testing capacity was limited.^[391] Most of the identified imported cases arrived from Europe and the United States rather than from China where the virus originated.^[392] Many preventive measures have been implemented by different countries in Africa including travel restrictions, flight cancellations, and event cancellations.^[393]

In early June 2021, Africa faced a third wave of COVID infections with cases rising in 14 countries.^[394] By 4 July the continent recorded more than 251,000 new COVID cases, a 20% increase from the prior week and a 12% increase from the January peak. More than sixteen African countries, including Malawi and Senegal, recorded an uptick in new cases.^[395] The World Health Organization labelled it Africa's 'Worst Pandemic Week Ever'.^[396] In October 2022, it was reported by the World Health Organization that most countries on the African continent will miss the goal of 70 percent of their population being vaccinated by the end of 2022.^[397]

Oceania

Empty shelves at a Coles grocery store in Brisbane, Australia, in April 2020.

The COVID-19 pandemic was confirmed to have reached Oceania on 25 January 2020, with the first confirmed case reported in Melbourne, Australia.^[398] It has since spread elsewhere in the region.^[399] Australia and New Zealand were praised for their handling of the pandemic in comparison to other Western nations, with New Zealand and each state in Australia wiping out all community transmission of the virus several times even after re-introduction into the community.^{[400][401][402]}

As a result of the high transmissibility of the Delta variant, however, by August 2021, the Australian states of New South Wales and Victoria had conceded defeat in their eradication efforts.^[403] In early October 2021, New Zealand also abandoned its elimination strategy.^[404] In November and December, following vaccination efforts, the remaining states of Australia, excluding Western Australia, voluntarily gave up COVID-zero to open up state and international borders.^{[405][406][407]} The open borders allowed the Omicron Variant of COVID-19 to enter quickly and cases subsequently exceeded 120,000 a day.^[408] By early March, with cases exceeding 1000 a day Western Australia conceded defeat in its eradication strategy and opened the borders after previously delaying the re-opening due to the omicron variant.^[409] Despite record cases, Australian jurisdictions slowly removed restrictions such as close contact isolation, mask wearing and density limits by April.^[410]

On 9 September restrictions were significantly relaxed. The mask mandate on aircraft was scrapped nationwide.^[411] 9 September was also the last day cases were reported daily in Australia as the country transitioned to weekly reporting instead.^[412] On 14 September, COVID-19 disaster payment for people who had to isolate due to COVID-19 was extended so long as isolating was mandated by the government.^[413] By 22 September all states had ended mask mandates on public transport including in Victoria where the mandate had lasted some 800 days.^[414] On 30 September 2022, all Australian leaders declared the emergency response finished and announced the end of the requirement for people to isolate from 14 October if they have COVID-19 due in part to high levels of 'hybrid immunity' and very low case numbers.^[415]

Antarctica

Due to its remoteness and sparse population, Antarctica was the last continent to have confirmed cases of COVID-19 and was one of the last regions of the world affected directly by the pandemic.^{[416][417][418]} The first cases were reported in December 2020, almost a year after the first cases of COVID-19 were detected in China. At least 36 people are confirmed to have been infected.^[419]

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COVID-19 lockdowns

COVID-19 lockdowns

Due to the COVID-19 pandemic, a number of non-pharmaceutical interventions colloquially known as lockdowns have been implemented in numerous countries and territories around the world. These restrictions were established with the intention to reduce the spread of SARS-CoV-2, the virus that causes COVID-19. By April 2020, about half of the world's population was under some form of lockdown, with more than 3.9 billion people in more than 90 countries or territories having been asked or ordered to stay at home by their governments. Although similar disease control measures have been used for hundreds of years, the scale of those implemented in the 2020s is thought to be unprecedented.

COVID-19 pandemic by country and territory

COVID-19 pandemic by country and territory

This is a general overview and status of places affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus which causes coronavirus disease 2019 (COVID-19) and is responsible for the COVID-19 pandemic. The first human cases of COVID-19 were identified in Wuhan, the capital of the province of Hubei in China in December 2019.

National responses to the COVID-19 pandemic

National responses to the COVID-19 pandemic

National responses to the COVID-19 pandemic have been varied, and have included containment measures such as lockdowns, quarantines, and curfews. As of 3 January 2023, 661,019,881 cases of COVID-19 have been reported, resulting in 6,692,005 reported deaths. The most affected countries in terms of confirmed cases are the United States, Brazil, India, Russia, South Africa, Peru, Mexico, Chile, the United Kingdom, and Iran.

COVID-19 pandemic in Asia

COVID-19 pandemic in Asia

The COVID-19 pandemic began in Asia in Wuhan, Hubei, China, and has spread widely through the continent. As of 15 March 2023, at least one case of COVID-19 had been reported in every country in Asia except Turkmenistan.

CoronaVac

CoronaVac

CoronaVac, also known as the Sinovac COVID-19 vaccine, is a whole inactivated virus COVID-19 vaccine developed by the Chinese company Sinovac Biotech. It was Phase III clinical trialled in Brazil, Chile, Indonesia, the Philippines, and Turkey and relies on traditional technology similar to other inactivated-virus COVID-19 vaccines, such as the Sinopharm BIBP vaccine, another Chinese vaccine, and Covaxin, an Indian vaccine. CoronaVac does not need to be frozen, and both the final product and the raw material for formulating CoronaVac can be transported refrigerated at 2–8 °C (36–46 °F), temperatures at which flu vaccines are kept.

SARS-CoV-2 Omicron variant

SARS-CoV-2 Omicron variant

Omicron (B.1.1.529) is a variant of SARS-CoV-2 first reported to the World Health Organization (WHO) by the Network for Genomics Surveillance in South Africa on 24 November 2021. It was first detected in Botswana and has spread to become the predominant variant in circulation around the world. Following the original B.1.1.529 variant, several subvariants of Omicron have emerged including: BA.1, BA.2, BA.3, BA.4, and BA.5. Since October 2022, two subvariants of BA.5 called BQ.1 and BQ.1.1 have emerged.

2022 COVID-19 protests in China

2022 COVID-19 protests in China

A series of protests against COVID-19 lockdowns began in mainland China in November 2022. Colloquially referred to as the White Paper Protests or the A4 Revolution, the demonstrations started in response to measures taken by the Chinese government to prevent the spread of COVID-19 in the country, including implementing a zero-COVID policy. Discontent had grown since the beginning of the pandemic towards the policy, which confined many people to their homes without work and left some unable to purchase or receive daily necessities.

COVID-19 pandemic in Maharashtra

COVID-19 pandemic in Maharashtra

The first case of the COVID-19 pandemic in the Indian state of Maharashtra was confirmed on 9 March 2020.

COVID-19 pandemic in Delhi

COVID-19 pandemic in Delhi

The first case of the COVID-19 pandemic in the Indian capital of Delhi was reported on 2 March 2020. Delhi has the seventh-highest number of confirmed cases of COVID-19 in India. The total number of cases reported as of Apr 2022, is 1,867,572 consisting of 26,158 deaths and 1,840,342 who have recovered.

COVID-19 pandemic in Gujarat

COVID-19 pandemic in Gujarat

In Gujarat, the first two cases of the COVID-19 pandemic were confirmed on 19 March 2020 in Rajkot and Surat.

COVID-19 pandemic in Tamil Nadu

COVID-19 pandemic in Tamil Nadu

The first case of the COVID-19 pandemic in the Indian state of Tamil Nadu was reported on 7 March 2020.

COVID-19 pandemic in West Bengal

COVID-19 pandemic in West Bengal

The COVID-19 pandemic was first confirmed in the Indian state of West Bengal on 17 March 2020 in Kolkata. The Health and Family Welfare department of Government of West Bengal has confirmed a total of 13,43,442 COVID-19 positive cases, including 1,09,806 active cases, 15,120 deaths and 12,18,516 recoveries, as of 28 May 2021.

United Nations

In June 2020, the Secretary-General of the United Nations launched the UN Comprehensive Response to COVID-19.^[420] The United Nations Conference on Trade and Development (UNSC) was criticised for its slow response, especially regarding the UN's global ceasefire, which aimed to open up humanitarian access to conflict zones.^[421]

WHO

World Health Organization representatives holding joint meeting with Tehran city administrators in March 2020.

The WHO spearheaded initiatives such as the COVID-19 Solidarity Response Fund to raise money for the pandemic response, the UN COVID-19 Supply Chain Task Force, and the solidarity trial for investigating potential treatment options for the disease. The COVAX program, co-led by the WHO, GAVI, and the Coalition for Epidemic Preparedness Innovations (CEPI), aimed to accelerate the development, manufacture, and distribution of COVID-19 vaccines, and to guarantee fair and equitable access across the world.^[422]

Protests against governmental measures

In several countries, protests rose against restrictions such as lockdowns. A February 2021 study found that protests against restrictions were likely to directly increase spread.^[423]

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United Nations response to the COVID-19 pandemic

United Nations response to the COVID-19 pandemic

The United Nations response to the COVID-19 pandemic has been led by its Secretary-General and can be divided into formal resolutions at the General Assembly and at the Security Council (UNSC), and operations via its specialized agencies and chiefly the World Health Organization in the initial stages, but involving more humanitarian-oriented agencies as the humanitarian impact became clearer, and then economic organizations, like the United Nations Conference on Trade and Development, the International Labour Organization, and the World Bank, as the socioeconomic implications worsened.

Secretary-General of the United Nations

Secretary-General of the United Nations

The secretary-general of the United Nations is the chief administrative officer of the United Nations and head of the United Nations Secretariat, one of the six principal organs of the United Nations.

United Nations Conference on Trade and Development

United Nations Conference on Trade and Development

The United Nations Conference on Trade and Development (UNCTAD) is an intergovernmental organization within the United Nations Secretariat that promotes the interests of developing countries in world trade. It was established in 1964 by the United Nations General Assembly (UNGA) and reports to that body and the United Nations Economic and Social Council (ECOSOC). UNCTAD is composed of 195 member states and works with nongovernmental organizations worldwide; its permanent secretariat is in Geneva, Switzerland.

Global ceasefire

Global ceasefire

A global ceasefire is a temporary stoppage of war on a planetary scale, i.e., by every country. A global ceasefire was first proposed by United Nations Secretary-General António Guterres on Monday, 23 March 2020, as part of the United Nations' response to the COVID-19 pandemic. On 24 June 2020, 170 UN Member States and Observers signed a non-binding statement in support of the Appeal, and on 1 July 2020, the UN Security Council passed a resolution demanding a general and immediate cessation of hostilities for at least 90 days and requesting that the UN Secretary-General accelerate the international response to the coronavirus pandemic.

World Health Organization

World Health Organization

The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. Headquartered in Geneva, Switzerland, it has six regional offices and 150 field offices worldwide.

Tehran

Tehran

Tehran is the capital and largest city of Iran and the largest city in Tehran Province. With a population of around 9 million in the city and around 16 million in the larger metropolitan area of Greater Tehran, Tehran is the most populous city in Iran and Western Asia, and has the second-largest metropolitan area in the Middle East, after Cairo. It is ranked 24th in the world by metropolitan area population.

COVID-19 Solidarity Response Fund

COVID-19 Solidarity Response Fund

COVID-19 Solidarity Response Fund was a global fund for supporting the work of the World Health Organization (WHO) in containing the COVID-19 pandemic. It was launched on 13 March 2020 by the United Nations Foundation and the Swiss Philanthropy Foundation in support of WHO, and was announced by the Director-General of WHO in Geneva, Switzerland. The fund ceased its active fundraising activities at the end of 2021, with further donations to be directed to the WHO Foundation.

UN COVID-19 Supply Chain Task Force

UN COVID-19 Supply Chain Task Force

The UN COVID-19 Supply Task Force is a task force set up by the United Nations to coordinate the procurement and distribution of personal protective equipment, diagnostic tests and oxygen to countries with overstretched healthcare systems. This initiative will be run by the World Health Organization and the World Food Programme, along with the multiple partners of United Nations. The hubs of this supply chain system will be located in China, Belgium, Ethiopia, Panama, Malaysia, Ghana, South Africa and the United Arab Emirates. According to the WHO, the supply chain may need to cover more than 30% of the world's needs in the acute phase of the pandemic. WHO announced that the World Food Programme will need to deploy eight 747 aircraft, eight medium-sized cargo aircraft and several smaller passenger planes to move the equipment and staff.

Solidarity trial

Solidarity trial

The Solidarity trial for treatments is a multinational Phase III-IV clinical trial organized by the World Health Organization (WHO) and partners to compare four untested treatments for hospitalized people with severe COVID-19 illness. The trial was announced 18 March 2020, and as of 6 August 2021, 12,000 patients in 30 countries had been recruited to participate in the trial.

COVAX

COVAX

COVID-19 Vaccines Global Access, abbreviated as COVAX, is a worldwide initiative aimed at equitable access to COVID-19 vaccines directed by the GAVI vaccine alliance, the Coalition for Epidemic Preparedness Innovations (CEPI), and the World Health Organization (WHO), alongside key delivery partner UNICEF. It is one of the four pillars of the Access to COVID-19 Tools Accelerator, an initiative begun in April 2020 by the WHO, the European Commission, and the government of France as a response to the COVID-19 pandemic. COVAX coordinates international resources to enable low-to-middle-income countries equitable access to COVID-19 tests, therapies, and vaccines. UNICEF is the key delivery partner, leveraging its experience as the largest single vaccine buyer in the world and working on the procurement of COVID-19 vaccine doses, as well as logistics, country readiness and in-country delivery.

GAVI

GAVI

GAVI, officially Gavi, the Vaccine Alliance is a public–private global health partnership with the goal of increasing access to immunization in poor countries. In 2016, Gavi channeled more than half of total donor assistance for health, and most donor assistance for immunization, by monetary measure.

Coalition for Epidemic Preparedness Innovations

Coalition for Epidemic Preparedness Innovations

The Coalition for Epidemic Preparedness Innovations (CEPI) is a foundation that takes donations from public, private, philanthropic, and civil society organisations, to finance independent research projects to develop vaccines against emerging infectious diseases (EID).

Donated medical supplies received in the Philippines.

The pandemic shook the world's economy, with especially severe economic damage in the United States, Europe, and Latin America.^[424] A consensus report by American intelligence agencies in April 2021 concluded, "Efforts to contain and manage the virus have reinforced nationalist trends globally, as some states turned inward to protect their citizens and sometimes cast blame on marginalized groups." COVID-19 inflamed partisanship and polarisation around the world as bitter arguments exploded over how to respond. International trade was disrupted amid the formation of no-entry enclaves.^[425]

Travel restrictions

The pandemic led many countries and regions to impose quarantines, entry bans, or other restrictions, either for citizens, recent travellers to affected areas,^[426] or for all travellers.^[427] Travel collapsed worldwide, damaging the travel sector. The effectiveness of travel restrictions was questioned as the virus spread across the world.^[428] One study found that travel restrictions only modestly affected the initial spread, unless combined with other infection prevention and control measures.^[429] Researchers concluded that "travel restrictions are most useful in the early and late phase of an epidemic" and "restrictions of travel from Wuhan unfortunately came too late".^[430] The European Union rejected the idea of suspending the Schengen free travel zone.^[431][432]

Repatriation of foreign citizens

Ukraine evacuates Ukrainian citizens from Wuhan, China.

Several countries repatriated their citizens and diplomatic staff from Wuhan and surroundings, primarily through charter flights. Canada, the United States, Japan, India,^[433] Sri Lanka, Australia, France, Argentina, Germany, and Thailand were among the first to do so.^[434] Brazil and New Zealand evacuated their own nationals and others.^[435][436] On 14 March, South Africa repatriated 112 South Africans who tested negative, while four who showed symptoms were left behind.^[437] Pakistan declined to evacuate its citizens.^[438]

On 15 February, the US announced it would evacuate Americans aboard the Diamond Princess cruise ship,^[439] and on 21 February, Canada evacuated 129 Canadians from the ship.^[440] In early March, the Indian government began repatriating its citizens from Iran.^[441][442] On 20 March, the United States began to withdraw some troops from Iraq.^[443]

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Timeline of the COVID-19 pandemic

Timeline of the COVID-19 pandemic

The timeline of the COVID-19 pandemic lists the articles containing the chronology and epidemiology of SARS-CoV-2, the virus that causes the coronavirus disease 2019 (COVID-19) and is responsible for the COVID-19 pandemic.

International aid related to the COVID-19 pandemic

International aid related to the COVID-19 pandemic

Due to its severity, the COVID-19 pandemic has caused countries to send aid, as part of the international responses and management regarding the pandemic. Types of materials aided includes masks, medical supplies, personal protective equipment, money, and test kits. It started with aid to China as the virus spreads primarily there, and then internationally as it spreads globally. The destination of the aid ranges from hospitals, COVID-19 healthcare workers, research on the vaccine, to societies vulnerable. People donating includes the government of said country, notable people, organizations and institutions, charities, as well as regular people.

Infection prevention and control

Infection prevention and control

Infection prevention and control is the discipline concerned with preventing healthcare-associated infections; a practical rather than academic sub-discipline of epidemiology. In Northern Europe, infection prevention and control is expanded from healthcare into a component in public health, known as "infection protection". It is an essential part of the infrastructure of health care. Infection control and hospital epidemiology are akin to public health practice, practiced within the confines of a particular health-care delivery system rather than directed at society as a whole.

European Union

European Union

The European Union (EU) is a supranational political and economic union of 27 member states that are located primarily in Europe. The union has a total area of 4,233,255.3 km2 (1,634,469.0 sq mi) and an estimated total population of nearly 447 million. The EU has often been described as a sui generis political entity combining the characteristics of both a federation and a confederation.

Schengen Agreement

Schengen Agreement

The Schengen Agreement is a treaty which led to the creation of Europe's Schengen Area, in which internal border checks have largely been abolished. It was signed on 14 June 1985, near the town of Schengen, Luxembourg, by five of the ten member states of the then European Economic Community. It proposed measures intended to gradually abolish border checks at the signatories' common borders, including reduced-speed vehicle checks which allowed vehicles to cross borders without stopping, allowing residents in border areas freedom to cross borders away from fixed checkpoints, and the harmonisation of visa policies.

Evacuations related to the COVID-19 pandemic

Evacuations related to the COVID-19 pandemic

This article lists major evacuations conducted by several countries as a result of the COVID-19 pandemic.

Wuhan

Wuhan

Wuhan is the capital of Hubei Province in the People's Republic of China. It is the largest city in Hubei and the most populous city in Central China, with a population of over eleven million, the ninth-most populous Chinese city and one of the nine National Central Cities of China.

Air charter

Air charter

Air charter is the business of renting an entire aircraft as opposed to individual aircraft seats.

Cruise ship

Cruise ship

Cruise ships are large passenger ships used mainly for vacationing. Unlike ocean liners, which are used for transport, cruise ships typically embark on round-trip voyages to various ports-of-call, where passengers may go on tours known as "shore excursions". On "cruises to nowhere" or "nowhere voyages", cruise ships make two- to three-night round trips without visiting any ports of call.

Economics

A stock index chart shows the 2020 stock market crash.

The pandemic and responses to it damaged the global economy. On 27 February 2020, worries about the outbreak crushed US stock indexes, which posted their sharpest falls since 2008.^[444]

Tourism collapsed due to travel restrictions, closing of public places including travel attractions, and advice of governments against travel. Airlines cancelled flights, while British regional airline Flybe collapsed.^[445] The cruise line industry was hard hit,^[446] and train stations and ferry ports closed.^[447] International mail stopped or was delayed.^[448]

The retail sector faced reductions in store hours or closures.^[449] Retailers in Europe and Latin America faced traffic declines of 40 per cent. North America and Middle East retailers saw a 50–60 per cent drop.^[450] Shopping centres faced a 33–43 per cent drop in foot traffic in March compared to February. Mall operators around the world coped by increasing sanitation, installing thermal scanners to check the temperature of shoppers, and cancelling events.^[451]

Hundreds of millions of jobs were lost.^[452][453] including more than 40 million Americans.^[454] According to a report by Yelp, about 60% of US businesses that closed will stay shut permanently.^[455] The International Labour Organization (ILO) reported that the income generated in the first nine months of 2020 from work across the world dropped by 10.7 per cent, or $3.5 trillion.^[456]

Supply shortages

COVID-19 fears led to panic buying of essentials across the world, including toilet paper, instant noodles, bread, rice, vegetables, disinfectant, and rubbing alcohol (picture taken in February 2020).

The outbreak was blamed for panic buying, emptying groceries of essentials such as food, toilet paper, and bottled water. Panic buying stemmed from perceived threat, perceived scarcity, fear of the unknown, coping behaviour and social psychological factors (e.g. social influence and trust).^[457]

Supply shortages were due to disruption to factory and logistic operations; shortages were worsened by supply chain disruptions from factory and port shutdowns, and labour shortages.^[458]

Shortages continued as managers underestimated the speed of economic recovery after the initial economic crash. The technology industry, in particular, warned of delays from underestimates of semiconductor demand for vehicles and other products.^[459]

According to WHO's Adhanom, demand for personal protective equipment (PPE) rose one hundredfold, pushing prices up twentyfold.^[460][461] PPE stocks were exhausted everywhere.^[462]

In September 2021, the World Bank reported that food prices remain generally stable and the supply outlook remains positive. However, the poorest countries witnessed a sharp increase in food prices, reaching the highest level since the pandemic began. The Agricultural Commodity Price Index stabilized in the third quarter but remained 17% higher than in January 2021.^[463]

By contrast, petroleum products were in surplus at the beginning of the pandemic, as demand for gasoline and other products collapsed due to reduced commuting and other trips.^[464] The 2021 global energy crisis was driven by a global surge in demand as the world economy recovered. Energy demand was particularly strong in Asia.^{[465][466][467]}

Culture

An American Catholic military chaplain prepares for a live-streamed Mass in an empty chapel at Offutt Air Force Base in March 2020.

The performing arts and cultural heritage sectors have been profoundly affected by the pandemic, impacting organisations' operations as well as individuals – both employed and independent – globally. By March 2020, across the world and to varying degrees, museums, libraries, performance venues, and other cultural institutions had been indefinitely closed with their exhibitions, events and performances cancelled or postponed.^[468] A UNESCO report estimated ten million job losses worldwide in the culture and creative industries.^[469] Some services continued through digital platforms,^{[470][471][472]} such as live streaming concerts^[473] or web-based arts festivals.^[474]

Politics

The pandemic affected political systems, causing suspensions of legislative activities,^[475] isolations or deaths of politicians,^[476] and rescheduled elections.^[477] Although they developed broad support among epidemiologists, NPIs (non-pharmaceutical interventions) were controversial in many countries. Intellectual opposition came primarily from other fields, along with heterodox epidemiologists.^[478]

On 23 March 2020, United Nations Secretary-General António Manuel de Oliveira Guterres appealed for a global ceasefire;^[479][480] 172 UN member states and observers signed a non-binding supporting statement in June,^[481] and the UN Security Council passed a resolution supporting it in July.^[482][483]

China

Multiple provincial-level administrators of the Chinese Communist Party were dismissed over their handling of quarantine measures. Some commentators claimed this move was intended to protect CCP general secretary Xi Jinping.^[484] The US intelligence community claimed that China intentionally under-reported its COVID-19 caseload.^[485] The Chinese government maintained that it acted swiftly and transparently.^[486] Journalists and activists in China who reported on the pandemic were detained by authorities,^[487][488] including Zhang Zhan, who was arrested and tortured.^{[489][490][491]}

Italy

An Italian government task force meets to discuss COVID-19 in February 2020.

In early March 2020, the Italian government criticised the EU's lack of solidarity with Italy.^{[492][493][494]} On 22 March 2020, after a phone call with Italian Prime Minister Giuseppe Conte, Russian president Vladimir Putin ordered the Russian army to send military medics, disinfection vehicles, and other medical equipment to Italy.^[495][496] In early April, Norway and EU states like Romania and Austria started to offer help by sending medical personnel and disinfectant,^[497] and Ursula von der Leyen offered an official apology to the country.^[498]

United States

Anti-lockdown protesters rallied at Ohio Statehouse 20 April 2020.^[499]

Beginning in mid-April 2020, protestors objected to government-imposed business closures and restricted personal movement and association.^[500] Simultaneously, essential workers protested in the form of a brief general strike.^[501] Some political analysts claimed that the pandemic contributed to President Donald Trump's 2020 defeat.^[502][503]

The outbreak prompted calls for the United States to adopt social policies common in other wealthy countries, including universal health care, universal child care, paid sick leave, and higher levels of funding for public health.^{[504][505][506]} The Kaiser Family Foundation estimated the cost of preventable hospitalizations (of unvaccinated people) for COVID-19 in the United States between June and November 2021 at US$13.8 billion.^[507]

There were also protest in regards to vaccine mandates in the United States. One matter that was taken before the Supreme court which had to do with enforcing said mandates on private companies, resulted in OSHA losing the case.^[508][509]

Other countries

The number of journalists imprisoned or detained increased worldwide, with some related to the pandemic.^[510][511] The planned NATO "Defender 2020" military exercise in Germany, Poland, and the Baltic states, the largest NATO war exercise since the end of the Cold War, was held on a reduced scale.^[512][513]

The Iranian government was heavily affected by the virus, which infected some two dozen parliament members and political figures.^[301][514] Iran President Hassan Rouhani wrote a public letter to world leaders asking for help on 14 March 2020, due to a lack of access to international markets.^[515] Saudi Arabia, which launched a military intervention in Yemen in March 2015, declared a ceasefire.^[516]

Diplomatic relations between Japan and South Korea worsened.^[517] South Korea criticised Japan's "ambiguous and passive quarantine efforts" after Japan announced travellers from South Korea must quarantine for two weeks.^[518] South Korean society was initially polarised on President Moon Jae-in's response to the crisis; many Koreans signed petitions calling for Moon's impeachment or praising his response.^[310]

Some countries passed emergency legislation. Some commentators expressed concern that it could allow governments to strengthen their grip on power.^[519][520] In the Philippines, lawmakers granted President Rodrigo Duterte temporary emergency powers.^[521] In Hungary, the parliament voted to allow prime minister Viktor Orbán to rule by decree indefinitely, suspend parliament and elections, and punish those deemed to have spread false information.^[522] In countries such as Egypt,^[523] Turkey,^[524] and Thailand,^[521] opposition activists and government critics were arrested for allegedly spreading fake news.^[525] In India, journalists criticising the government's response were arrested or issued warnings by police and authorities.^[526]

Food systems

The pandemic disrupted food systems worldwide,^[527] hitting at a time when hunger and undernourishment were rising (an estimated 690 million people lacked food security in 2019).^[528] Food access fell – driven by falling incomes, lost remittances, and disruptions to food production. In some cases, food prices rose.^[527][528] The pandemic and its accompanying lockdowns and travel restrictions slowed movement of food aid. Per the World Health Organization, 811 million individuals were undernourished in 2020, "likely related to the fallout of COVID-19".^[529]

Education

Students take end-of-year exams in Tabriz, Iran, during the pandemic.

The pandemic impacted educational systems in many countries. Many governments temporarily closed educational institutions, often replaced by online education. Other countries, such as Sweden, kept their schools open. As of September 2020, approximately 1.077 billion learners were affected due to school closures. School closures impacted students, teachers, and families with far-reaching economic and societal consequences.^[530] They shed light on social and economic issues, including student debt, digital learning, food insecurity, and homelessness, as well as access to childcare, health care, housing, internet, and disability services. The impact was more severe for disadvantaged children.^[531] The Higher Education Policy Institute reported that around 63% of students claimed worsened mental health as a result of the pandemic.^[532]

Health

The pandemic impacted global health for many other conditions. Hospital visits fell. Visits for heart attack symptoms declined by 38% in the US and 40% in Spain.^[533] The head of cardiology at the University of Arizona said, "My worry is some of these people are dying at home because they're too scared to go to the hospital."^[534] People with strokes and appendicitis were less likely to seek treatment.^[534] Medical supply shortages impacted many people.^[535] The pandemic impacted mental health,^[536][537] increasing anxiety, depression, and post-traumatic stress disorder, affecting healthcare workers, patients and quarantined individuals.^[538][539]

In late 2022, during the first Northern Hemisphere autumn and winter seasons following the widespread relaxation of global public health measures, North America and Europe experienced a surge in respiratory viruses and coinfections in both adults and children. This formed the beginnings of the 2022–2023 pediatric care crisis and what some experts have termed a "tripledemic" of seasonal influenza, Respiratory Syncytial Virus (RSV), and SARS-CoV-2 throughout North America.^[540][541] In the United Kingdom, pediatric infections also began to spike beyond pre-pandemic levels, albeit with different illnesses, such as Group A streptococcal infection and resultant scarlet fever.^[542] As of mid-December 2022, 19 children in the UK had died due to Strep A and the wave of infections had begun to spread into North America and Mainland Europe.^[543][544]

Environment

Images from the NASA Earth Observatory show a stark drop in pollution in Wuhan, when comparing NO₂ levels in early 2019 (top) and early 2020 (bottom).^[545]

The pandemic and the reaction to it positively affected the environment and climate as a result of reduced human activity. During the "anthropause", fossil fuel use decreased, resource consumption declined, and waste disposal improved, generating less pollution.^[546] Planned air travel and vehicle transportation declined. In China, lockdowns and other measures resulted in a 26% decrease in coal consumption, and a 50% reduction in nitrogen oxides emissions.^[546]

A wide variety of largely mammalian species, both captive and wild, have been shown to be susceptible to SARS-CoV-2, with some encountering particularly fatal outcomes. In particular, both farmed and wild mink have developed symptomatic COVID-19 infections, leading to a 35–55% mortality rate in one study.^[547][548] Other animals, such as white-tailed deer, have not exhibited as high mortality numbers but have effectively become natural reservoirs of the virus, with large numbers of free-ranging deer infected throughout the US and Canada, including approximately 80% of Iowa's wild deer herd.^[549][550]

Discrimination and prejudice

A socially distanced homeless encampment in San Francisco, California, in May 2020^[551]

Heightened prejudice, xenophobia, and racism toward people of Chinese and East Asian descent were documented around the world.^{[552][553][554]} Reports from February 2020 (when most confirmed cases were confined to China) cited racist sentiments about Chinese people 'deserving' the virus.^{[555][556][557]} Chinese people and other Asian peoples in the United Kingdom and United States reported increasing levels of abuse and assaults.^{[558][559][560]} Former US President Trump was criticised for referring to SARS-CoV-2 as the "Chinese Virus" and "Kung Flu", which others condemned as racist and xenophobic.^{[561][562][563]}

Age-based discrimination against older adults increased. This was attributed to their perceived vulnerability and subsequent physical and social isolation measures, which, coupled with their reduced social activity, increased dependency on others. Similarly, limited digital literacy left the elderly more vulnerable to isolation, depression, and loneliness.^[564]

Correspondence published in The Lancet on 20 November 2021, suggested the "inappropriate stigmatisation of unvaccinated people, who include our patients, colleagues, and other fellow citizens", noting vaccinated individuals' high rates of infection, high viral loads, and therefore their relevant role in transmission.^[565]

In January 2022, Amnesty International urged Italy to change their anti-COVID-19 restrictions to avoid discrimination against unvaccinated people, saying that "the government must continue to ensure that the entire population can enjoy its fundamental rights." The restrictions included mandatory vaccination over the age of 50, and mandatory vaccination to use public transport.^[566]

Lifestyle changes

The "Wee Annie" statue in Gourock, Scotland, was given a face mask during the pandemic.

The pandemic triggered massive changes in behaviour, from increased Internet commerce to cultural changes in the job market. Online retailers in the US posted US$791.70 billion in sales in 2020, an increase of 32.4% from $598.02 billion from the year before.^[567] Home delivery orders increased, while indoor restaurant dining shut down due to lockdown orders or low sales.^[568][569] Hackers, cybercriminals, and scammers took advantage of the changes to launch new attacks.^[570] Education in some countries temporarily shifted from physical attendance to video conferencing.^[571] Massive layoffs shrank the airline, travel, hospitality, and other industries.^[572][573] Despite most corporations implementing measures to address COVID-19 in the workplace, a poll from Catalyst found that as many as 68% of employees around the world felt that these policies were only performative and "not genuine".^[574]

Historiography

A 2021 study noted that the COVID-19 pandemic had increased interest in epidemics and infectious diseases among both historians and the general public. Prior to the pandemic, these topics were usually overlooked by "general" history and only received attention in the history of medicine.^[575]

Religion

According to the Pew Research Center, amid the COVID-19 pandemic some religious groups defied public health measures and stated "the rules [during COVID-19] were a violation of religious freedom".^[576]

Discover more about Impact related topics

Impact of the COVID-19 pandemic

Impact of the COVID-19 pandemic

As of 2022, the COVID‑19 pandemic is an ongoing global pandemic of coronavirus disease 2019 (COVID‑19) caused by severe acute respiratory syndrome coronavirus 2 (SARS CoV‑2). Its impact has been broad, affecting general society, the global economy, culture, ecology, politics, and other areas. These aspects are discussed across many articles:

Economic impact of the COVID-19 pandemic

Economic impact of the COVID-19 pandemic

The COVID-19 pandemic has had far-reaching economic consequences including the COVID-19 recession, the second largest global recession in recent history, decreased business in the services sector during the COVID-19 lockdowns, the 2020 stock market crash, which included the largest single-week stock market decline since the financial crisis of 2007–2008 and the impact of COVID-19 on financial markets, the 2021–2022 global supply chain crisis, the 2021–2022 inflation surge, shortages related to the COVID-19 pandemic including the 2020–present global chip shortage, panic buying, and price gouging. It led to governments providing an unprecedented amount of stimulus. The pandemic was also a factor in the 2021–2022 global energy crisis and 2022 food crises.

Impact of the COVID-19 pandemic on aviation

Impact of the COVID-19 pandemic on aviation

The COVID-19 pandemic has had a significant impact on the airline industry due to travel restrictions and a decimation in demand among travelers.

Impact of the COVID-19 pandemic on science and technology

Impact of the COVID-19 pandemic on science and technology

The COVID-19 pandemic has affected many scientific and technical institutions globally, resulting in lower productivity in a number of fields and programs. However, the impact of the pandemic has led to the opening of several new research funding lines for government agencies around the world.

Financial market impact of the COVID-19 pandemic

Financial market impact of the COVID-19 pandemic

Economic turmoil associated with the COVID-19 pandemic has had wide-ranging and severe impacts upon financial markets, including stock, bond, and commodity markets. Major events included a described Russia–Saudi Arabia oil price war, which after failing to reach an OPEC+ agreement resulted in a collapse of crude oil prices and a stock market crash in March 2020. The effects upon markets are part of the COVID-19 recession and are among the many economic impacts of the pandemic.

2020 stock market crash

2020 stock market crash

On 20 February 2020, stock markets across the world suddenly crashed after growing instability due to the COVID-19 pandemic. It ended on 7 April 2020.

COVID-19 recession

COVID-19 recession

The COVID-19 recession is an ongoing global economic recession caused by the COVID-19 pandemic. The recession began in most countries in February 2020.

Flybe (1979–2020)

Flybe (1979–2020)

Flybe, styled as flybe, was a British airline based in Exeter, England. Until its sale to Connect Airways in 2019, it was the largest independent regional airline in Europe. Flybe once provided more than half of UK domestic flights outside London.

International Labour Organization

International Labour Organization

The International Labour Organization (ILO) is a United Nations agency whose mandate is to advance social and economic justice by setting international labour standards. Founded in October 1919 under the League of Nations, it is the first and oldest specialised agency of the UN. The ILO has 187 member states: 186 out of 193 UN member states plus the Cook Islands. It is headquartered in Geneva, Switzerland, with around 40 field offices around the world, and employs some 3,381 staff across 107 nations, of whom 1,698 work in technical cooperation programmes and projects.

Panic buying

Panic buying

Panic buying occurs when consumers buy unusually large amounts of a product in anticipation of, or after, a disaster or perceived disaster, or in anticipation of a large price increase, or shortage.

Shortage

Shortage

In economics, a shortage or excess demand is a situation in which the demand for a product or service exceeds its supply in a market. It is the opposite of an excess supply (surplus).

Personal protective equipment

Personal protective equipment

Personal protective equipment (PPE) is protective clothing, helmets, goggles, or other garments or equipment designed to protect the wearer's body from injury or infection. The hazards addressed by protective equipment include physical, electrical, heat, chemicals, biohazards, and airborne particulate matter. Protective equipment may be worn for job-related occupational safety and health purposes, as well as for sports and other recreational activities. Protective clothing is applied to traditional categories of clothing, and protective gear applies to items such as pads, guards, shields, or masks, and others. PPE suits can be similar in appearance to a cleanroom suit.

Some news organizations removed their online paywalls for some or all of their pandemic-related articles and posts.^[577] Some scientific publishers made pandemic-related papers available with open access.^[578][579] The share of papers published on preprint servers prior to peer review increased dramatically.^[580] Research is indexed and searchable in the NIH COVID-19 Portfolio.^[581]

Misinformation

Misinformation and conspiracy theories about the pandemic are widespread. They travelled through mass media, social media, and text messaging.^[582] WHO declared an "infodemic" of incorrect information.^[583] Cognitive biases, such as jumping to conclusions and confirmation bias, were linked to conspiracy beliefs, including COVID-19 vaccine hesitancy.^[584]

Discover more about Information dissemination related topics

Media coverage of the COVID-19 pandemic

Media coverage of the COVID-19 pandemic

Media coverage of the COVID-19 pandemic has varied by country, time period and media outlet. News media has simultaneously kept viewers informed about current events related to the pandemic, and contributed to misinformation or fake news.

Impact of the COVID-19 pandemic on social media

Impact of the COVID-19 pandemic on social media

During a time of social distance and limited contact with others, social media became an important place to interact during the COVID-19 pandemic. Social media platforms helped the world remain connected, largely increasing in usage. Individuals isolated at home turned to social media to maintain their relationships and to access entertainment to pass the time.

Impact of the COVID-19 pandemic on journalism

Impact of the COVID-19 pandemic on journalism

The COVID-19 pandemic has strongly impacted the journalism industry and affected journalists' work. Many local newspapers have been severely affected by losses in advertising revenues from COVID-19; journalists have been laid off, and some publications have folded. Many newspapers with paywalls lowered them for some or all of their COVID-19 coverage. The pandemic was characterized as a potential "extinction event" for journalism as hundreds of news outlets closed and journalists were laid off around the world, advertising budgets were slashed, and many were forced to rethink how to do their jobs amid restrictions on movement and limited access to information or public officials. Journalists and media organizations have had to address new challenges, including figuring out how to do their jobs safely and how to navigate increased repression and censorship brought on by the response to the pandemic, with freelancers facing additional difficulties in countries where press cards or official designations limit who can be considered a journalist.

Paywall

Paywall

A paywall is a method of restricting access to content, with a purchase or a paid subscription, especially news. Beginning in the mid-2010s, newspapers started implementing paywalls on their websites as a way to increase revenue after years of decline in paid print readership and advertising revenue, partly due to the use of ad blockers. In academics, research papers are often subject to a paywall and are available via academic libraries that subscribe.

Open access

Open access

Open access (OA) is a set of principles and a range of practices through which research outputs are distributed online, free of access charges or other barriers. Under some models of open access publishing, barriers to copying or reuse are also reduced or removed by applying an open license for copyright.

Preprint

Preprint

In academic publishing, a preprint is a version of a scholarly or scientific paper that precedes formal peer review and publication in a peer-reviewed scholarly or scientific journal. The preprint may be available, often as a non-typeset version available free, before or after a paper is published in a journal.

COVID-19 misinformation

COVID-19 misinformation

False information, including intentional disinformation and conspiracy theories, about the scale of the COVID-19 pandemic and the origin, prevention, diagnosis, and treatment of the disease has been spread through social media, text messaging, and mass media. False information has been propagated by celebrities, politicians, and other prominent public figures. Many countries have passed laws against "fake news", and thousands of people have been arrested for spreading COVID-19 misinformation. The spread of COVID-19 misinformation by governments has also been significant.

Misinformation

Misinformation

Misinformation is incorrect or misleading information. It differs from disinformation, which is deliberately deceptive. Rumors are information not attributed to any particular source, and so are unreliable and often unverified, but can turn out to be either true or false. Even if later retracted, misinformation can continue to influence actions and memory. People may be more prone to believe misinformation because they are emotionally connected to what they are listening to or are reading. The role of social media has made information readily available to society at anytime, and it connects vast groups of people along with their information at one time. Advances in technology has impacted the way people communicate information and the way misinformation is spread. Misinformation has impacts on societies' ability to receive information which then influences our communities, politics, and medical field.

Conspiracy theory

Conspiracy theory

A conspiracy theory is an explanation for an event or situation that asserts the existence of a conspiracy by powerful and sinister groups, often political in motivation, when other explanations are more probable. The term generally has a negative connotation, implying that the appeal of a conspiracy theory is based in prejudice, emotional conviction, or insufficient evidence. A conspiracy theory is distinct from a conspiracy; it refers to a hypothesized conspiracy with specific characteristics, including but not limited to opposition to the mainstream consensus among those who are qualified to evaluate its accuracy, such as scientists or historians.

Confirmation bias

Confirmation bias

Confirmation bias is the tendency to search for, interpret, favor, and recall information in a way that confirms or supports one's prior beliefs or values. People display this bias when they select information that supports their views, ignoring contrary information, or when they interpret ambiguous evidence as supporting their existing attitudes. The effect is strongest for desired outcomes, for emotionally charged issues, and for deeply entrenched beliefs. Confirmation bias cannot be eliminated, but it can be managed, for example, by education and training in critical thinking skills.

In June 2022, an article in Human Genomics said that the pandemic was still "raging", but that "now is the time to explore the transition from the pandemic to the endemic phase. The latter will require worldwide vigilance and cooperation, especially in emerging countries", and suggested that developed countries should assist in boosting vaccination rates worldwide.^[585]

As of 4 November 2022, health officials in some countries have said that COVID-19 is endemic or that the country was beginning to transition to an endemic phase. These include Cambodia,^[586] Indonesia,^[587] Lebanon,^[588] Malaysia,^[589] Mexico,^[590] Philippines,^[591] Singapore,^[592] South Korea,^[12] Spain^[11] and Vietnam.^[593]

On 3 December 2022, Tedros Adhanom Ghebreyesus, WHO Director-General indicated, "We are much closer to being able to say that the emergency phase of the pandemic is over".^[594][595]

The pandemic has been included in the narratives of ongoing pre-pandemic TV shows and made a focus in new ones, with mixed results.^[596] Writing about the then-upcoming BBC sitcom Pandemonium on 16 December 2020, The New York Times asked, "Are we ready to laugh about Covid-19? Or rather, is there anything amusing, or recognizable in a humorous way, about life during a plague, with all of its indignities and setbacks, not to mention its rituals and rules."^[597]

In films and television:

• South Park: Post Covid, a 2021 animated comedy film depicting the main characters of South Park forty years after the COVID-19 pandemic broke out.^[598]
• Songbird, 2020 science-fiction thriller film inspired by the COVID-19 pandemic, with an exaggerated twist of COVID-19 mutating into COVID-23 in 2024.^[599]
• The sixth season of Queen Sugar, a 2016 drama series focusing on a pair of siblings who are forced to cope with their new life of taking over the sugarcane farm after a loved one's death; in this season, the story is predominantly about the COVID-19 pandemic and some of the characters catching the virus, such as Charley.^[600]
• Social Distance, a 2020 television series focusing on individuals who are forced to cope with the COVID-19 pandemic, the effects of quarantine, and the subsequent George Floyd protests.^[601]

Discover more about Culture and society related topics

COVID-19 pandemic in popular culture

COVID-19 pandemic in popular culture

References to the COVID-19 pandemic in popular culture began in the first few months of the pandemic.

BBC

BBC

The British Broadcasting Corporation (BBC) is the national broadcaster of the United Kingdom, based at Broadcasting House in London, England. It is the world's oldest national broadcaster, and the largest broadcaster in the world by number of employees, employing over 22,000 staff in total, of whom approximately 19,000 are in public-sector broadcasting.

The New York Times

The New York Times

The New York Times, also referred to as the Gray Lady, is a daily newspaper based in New York City with a worldwide readership reported in 2022 to comprise 740,000 paid print subscribers, and 8.6 million paid digital subscribers. It also is a producer of popular podcasts such as The Daily. Founded in 1851, it is published by The New York Times Company. The Times has won 132 Pulitzer Prizes, the most of any newspaper, and has long been regarded as a national "newspaper of record". For print, it is ranked 18th in the world by circulation and 3rd in the United States. The newspaper is headquartered at The New York Times Building in Times Square, Manhattan.

South Park: Post Covid

South Park: Post Covid

"South Park: Post Covid" is a 2021 American adult animated comedy television special episode written and directed by Trey Parker. It is the first in a series of South Park television specials for the streaming service Paramount+ and premiered on November 25, 2021. It is also considered to be the 310th episode overall of the television series.

South Park

South Park

South Park is an American animated sitcom created by Trey Parker and Matt Stone and developed by Brian Graden for Comedy Central. The series revolves around four boys—Stan Marsh, Kyle Broflovski, Eric Cartman, and Kenny McCormick—and their exploits in and around the titular Colorado town. South Park became infamous for its profanity and dark, surreal humor that satirizes a substantial amount of subject matter.

Songbird (2020 film)

Songbird (2020 film)

Songbird is a 2020 American dystopian science fiction thriller film based on the COVID-19 pandemic. It was directed by Adam Mason, who wrote the screenplay with Simon Boyes. Produced by Michael Bay, Adam Goodman, Andrew Sugerman and Eben Davidson, the film stars KJ Apa, Sofia Carson, Craig Robinson, Bradley Whitford, Peter Stormare, Alexandra Daddario, Paul Walter Hauser and Demi Moore.

Queen Sugar

Queen Sugar

Queen Sugar is an American drama television series created and executive produced by Ava DuVernay, with Oprah Winfrey serving as an executive producer. DuVernay also directed the first two episodes. The series is based on the 2014 novel of the same name by American writer Natalie Baszile. Queen Sugar centers on the lives of three siblings in rural Louisiana who must deal with the aftermath of their father's sudden death and decide the fate of his 800-acre sugarcane farm. The mainstream themes in the series often accompany episodes centered on racial profiling, the long reach of chattel slavery in American history and the inequities in the criminal justice system, and other issues related to African Americans.

Social Distance (TV series)

Social Distance (TV series)

Social Distance is an American streaming television anthology series created by Hilary Weisman Graham that premiered on October 15, 2020 on Netflix. The series was "conceived, cast and executed entirely remotely during quarantine". The eight-part series, set during the first months of the COVID-19 pandemic, focuses on how families, friends, and couples were forced to cope with the effects of quarantine as well as the Black Lives Matter protests following the murder of George Floyd. Each episode tells a different story and shows "the power of the human spirit in the face of uncertainty and isolation," and how technology was used to stay connected during quarantine.

George Floyd protests

George Floyd protests

The George Floyd protests were a series of both peaceful protests and riots against police brutality and racism that began in Minneapolis on May 26, 2020, and largely took place during 2020. The civil unrest and protests began as part of international reactions to the murder of George Floyd, a 46-year-old African American man who was murdered during an arrest after Derek Chauvin, a Minneapolis Police Department officer, knelt on Floyd's neck for 9 minutes and 29 seconds as three other officers looked on and prevented passers-by from intervening. Chauvin and the other three officers involved were later arrested. In April 2021, Chauvin was found guilty of second-degree unintentional murder, third-degree murder, and second-degree manslaughter. Chauvin was sentenced to 22.5 years in prison with possibility of supervised release after 15 years for second-degree murder in June 2021.