COVID-19: the first 100 days

I have begun work on my new book to be published by Routledge, entitled COVID Societies: Theorising the Coronavirus Crisis. Part of the Introduction chapter will present an overview of the emergence of the COVID-19 pandemic over its first one hundred days. Things moved very quickly over that time. Here is an except from this chapter outlining key events during this period.

Sign outside an Australian shop, April 2020

The time elapsing from the first reporting of a cluster of cases of a new respiratory disease that was later to be named ‘COVID-19’ to the first million confirmed cases worldwide was slightly less than one hundred days. The World Health Organization (WHO) has published a timeline of how events unfolded from the very beginning of the first observation of a cluster of unusual cases of atypical pneumonia in the Chinese city of Wuhan, Hubei province (World Health Organization, 2020). The Independent Panel for Pandemic Preparedness & Response (2021) also put together a chronological account of the events unfolding between late 2019 and the end of March 2020, by which time the virus had spread extensively around the world. The Panel concluded that these months were characterised by some evidence of early and rapid action by nations and global health authorities. However, delay, hesitation to act decisively and denial of the threat were also prevalent in their responses. The events and developments outlined below in these first one hundred days of the COVID crisis are synthesised from these two valuable chronologies.

On 30 December 2019, the first cases of ‘atypical viral pneumonia of unknown cause’ who had been admitted to hospitals in Wuhan were reported in two urgent notices to hospital networks in the city by officials from the Wuhan Municipal Health Commission. Wuhan clinicians noted that several of these atypical pneumonia patients had visited the same ‘wet market’ in the city selling live sea creatures and other animals for human consumption, suggesting it was a key source of transmission. On 31 December, a Chinese business publication published a report about one of these notices, which in turn was picked up by several disease surveillance systems operating in the region. WHO’s Headquarters office in Geneva was alerted to the report. Later that day, the Wuhan Municipal Health Commission sent out a bulletin for public notice, reporting that 27 cases of this disease had been identified. By the end of December, it seemed likely from the epidemiology of these Wuhan cases that human-to-human transmission of this as yet un-identified and unnamed pathogen was likely.

The WHO Country Office in China requested further information from the Wuhan officials on 1 January 2020, activating its Incident Management Support Team as part of its emergency response framework. By 2 January, the Wuhan Institute of Virology had sequenced almost the entire genome of the novel virus. There were 44 reported cases by 3 January. WHO released a tweet about this Wuhan pneumonia cluster (which had not yet caused any deaths) on 4 January, noting the investigations to determine the cause were underway. It released its first Disease Outbreak News report on 5 January about these cases. All countries were warned to take precautions against the spread of this new virus. On 9 January, Chinese authorities had determined that the pathogen was a novel coronavirus, similar to a previous virus (SARS-CoV) that had caused SARS disease (Severe Acute Respiratory Syndrome) in a previous outbreak between 2003 and 2007. Chinese scientists had developed a first test for the virus by 10 January.

The first death from infection with the novel coronavirus was reported by the China media on 11 January. The first case outside China was reported in Thailand on 13 January and a second case in Japan on 16 January: both cases had travelled from Wuhan. Chinese health experts publicly confirmed on 20 January that the virus was transmissible between humans and that healthcare workers had become infected. Wuhan officials had instituted a city-wide lockdown on 23 January in the attempt to control the spread. At this point in the outbreak, 830 cases and 25 deaths had been reported. The first case outside Asia was recorded in the USA on 21 January and the first European cases (a total of three) were reported by France on 24 January.

WHO’s first mission to Wuhan to investigate the outbreak took place on 20-21 January. It declared a ‘public health emergency of international concern’ on 30 January, its highest level of alarm. At this point in the outbreak, the novel coronavirus had begun to spread quickly around the world. A total of 98 cases had been detected in 18 countries. By 4 February, over 20 000 confirmed cases and 425 deaths had been reported in China, and 176 cases in 24 other countries. On 11 February, WHO announced that the novel coronavirus would be named SARS-CoV-2 and the disease it caused as COVID-19 (a contraction of ‘coronavirus disease 2019’). This naming followed best practice, which avoids linking titles of new microbes or diseases to specific regions, nationalities, individuals or animals because of the possibility of inaccuracy or stigma.

By 7 March, over 100 000 confirmed cases of COVID-19 had been reported globally. The outbreak was officially declared as a pandemic by WHO on 11 March 2020, when reported cases globally had reached over 118 000 across 114 countries. By 13 March, Europe had become the epicentre of the pandemic, with more reported cases and deaths than the rest of the world combined, apart from China. By 4 April, almost 100 days after the first Wuhan cases having been reported, WHO reported that over 1 million confirmed cases had been reported worldwide, with the pace of infection rapidly increasing.

Even at that stage, many countries’ governments worldwide had not yet taken decisive action to contain the spread of the virus. WHO’s declaration on 30 January of a ‘public health emergency of international concern’ was largely ignored. Only a minority of countries began comprehensive prevention and response strategies. Many countries did very little throughout the month of February, even while cases were rapidly spreading and climbing globally. Most governments either did not appreciate the seriousness of the threat posed by COVID-19 or wanted to take a ‘wait-and-see’ approach rather than implement significant action. Due to their previous experiences with the SARS pandemic, several eastern and south-eastern Asian countries were among the earlier responders, while African countries who had been through the Ebola threat also learned from this and put measures into place quickly. Many other countries did not spring into action until they noted the exponential rise in cases and rapid spread of the virus. Serious actions that could have contained such a huge expansion in cases and deaths were implemented too late.

References

The Independent Panel for Pandemic Preparedness & Response. (2021). COVID-19: Make It The Last Pandemic. https://theindependentpanel.org/wp-content/uploads/2021/05/COVID-19-Make-it-the-Last-Pandemic_final.pdf

World Health Organization. (2020). Timeline: WHO’s COVID-19 response. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/interactive-timeline?gclid=CjwKCAiA17P9BRB2EiwAMvwNyGWSa7LCiCAgb9r1TIgGmjmcYnZzOj7_zVA80ZeeVZyUsfqM35BvrhoCofQQAvD_BwE#event-7

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