A new coronavirus first reported in the Chinese city of Wuhan in late 2019 has spread worldwide, reaching nearly all countries by spring 2020. More than half a million people have been diagnosed with the new coronavirus disease, known as COVID-19, and over twenty thousand have died.
The World Health Organization (WHO) declared the crisis a pandemic, and governments around the globe have taken drastic measures to limit the virus’s spread, including national lockdowns, border closures, and ramped-up medical research. Many economies are under extreme stress as measures to contain the virus disrupt supply chains, bring businesses to a halt, and drive up unemployment. Societies are also strained: schools have been forced to close, religious gatherings have been canceled, and major events including the Olympics have been postponed.
What are coronaviruses?
They are a family of viruses common in animals, including bats, camels, and cows, and can sometimes be transmitted to humans. They are named for the crown-like spikes on their surface, which scientists believe the virus uses to enter cells and delay the immune system’s response. Common symptoms of coronaviruses, including the new virus, are fever, cough, and shortness of breath; in more severe cases coronaviruses can cause kidney failure, acute respiratory illnesses such as pneumonia, and even death.
Have they caused outbreaks before?
Several coronaviruses have spread from animals to humans, leading to outbreaks in recent years. Middle East Respiratory Syndrome (MERS) was first transmitted to humans from camels in 2012 in Saudi Arabia. It has been fatal in one-third of patients, and has led to more than 850 deaths.
Until 2019, the most widespread coronavirus outbreak was that of Severe Acute Respiratory Syndrome (SARS). It was first reported in southern China in late 2002 and is believed to have been transferred to humans from civets, a cat-like species. An epidemic of SARS swelled across four continents in the months after its discovery, ultimately killing close to eight hundred before the virus was contained in July 2003.
On December 30, 2019, Chinese officials notified the WHO of an outbreak of a new coronavirus that was first detected in the city of Wuhan, in the central province of Hubei. The virus rapidly spread across China, and within a few months, it reached more than 160 countries. By late March, the death toll surpassed twenty thousand, far higher than the number of people killed during the SARS epidemic.
Think Global Health, a CFR website, offers research and analysis on the coronavirus outbreak.
How is the new virus transmitted?
Like other coronaviruses, it is transmitted primarily through close contact with an infected person. Droplets generated by coughing or sneezing, saliva, mucus, and fecal matter can carry the virus and transfer it to nearby people. Health experts believe contact within about six feet is typically required for transmission. They estimate that the virus can survive on surfaces for a few hours to several days.
Health experts have not yet confirmed some crucial aspects of the virus’s spread, including:
- the time it takes for an infected person to show symptoms, known as the incubation period;
- to what extent the virus can be spread by people showing no symptoms;
- whether animal-to-human transmission is ongoing;
- what animal the virus was first transmitted from; and
- whether the virus can be passed down from pregnant mothers to their babies.
Older people and those with preexisting health conditions are believed to be more at risk of developing severe symptoms. However, younger people are still susceptible. A March report by the U.S. Centers for Disease Control and Prevention (CDC) found that 29 percent of early cases in the United States were aged twenty to forty-four, and one-fifth of those were hospitalized.
Is there a vaccine?
No medicines to prevent or treat the virus are currently available, though researchers in both the public and private sectors have started clinical trials of possible vaccines and other medications. Officials at the U.S. National Institutes of Health said a vaccine would likely be ready to be administered to the public by mid-2021.
To lower the chances of getting sick, the WHO has urged people to wash their hands frequently, cover their noses and mouths when sneezing, and avoid anyone who appears sick. It advises anyone who is feeling sick or who was in close contact with someone who has the virus to call their medical providers. Wearing a medical mask is not recommended unless a person is suspected to have the coronavirus or is caring for someone suspected to have the virus. The CDC has also urged people to get flu shots and take similar precautionary measures, as a particularly deadly U.S. flu season has coincided with the coronavirus outbreak.
How deadly is the new coronavirus?
Scientists say it’s too soon to tell how deadly the virus is. They believe that a large number of cases worldwide likely have not been reported, which could lead to an artificially high or inaccurate fatality rate, the percentage of people who die after contracting the disease. WHO Director-General Tedros Adhanom Ghebreyesus said the global fatality rate was about 3.4 percent as of early March. In comparison, the fatality rate from the seasonal flu, which is in a different family of viruses, is about 0.1 percent, according to WHO estimates.
What has been China’s response?
Wuhan officials were initially slow to respond when the first cases appeared in early December. They silenced doctors who warned of the new virus, and did not alert the public of a possible outbreak. (One of those doctors, Li Wenliang, later died from the virus.) By the time authorities issued warnings and alerted the WHO on December 31, the virus had already spread to an unmanageable level, experts say. The central government later admitted to “shortcomings and deficiencies,” vowing to improve the emergency management system. CFR’s Elizabeth C. Economy described the outbreak as “the worst humanitarian and economic crisis of [Chinese President Xi Jinping’s] tenure.”
Beijing, as well as local and provincial governments, then took dramatic steps. Dozens of cities were locked down, affecting the movement of an estimated 170 million people, and public transit systems were closed. Factories stopped production, and economic activity largely came to a halt. As hard-hit cities, such as Wuhan, faced shortages of medical workers and supplies, the central government sent thousands of medical personnel, including military doctors, to help. Thousands of health-care workers contracted the disease and several died.
In March, the outbreak appeared to be slowing, with China reporting its fewest number of new cases since tracking began in January. China closed several makeshift hospitals in Wuhan, ended lockdowns in Hubei Province, and started reopening schools. Beijing has since sent teams of medical experts and supplies to other countries with major outbreaks.
How is the rest of the world responding?
There has been a wide variety of responses by countries dealing with severe outbreaks. Here are several measures they have implemented to prevent or limit the virus’s spread:
Travel restrictions. Nearly one hundred countries placed travel restrictions on China, including closing their land borders and banning entry by Chinese nationals. As outbreaks worsened outside of China, many countries expanded their restrictions to include other hot spots, such as Iran, Italy, and South Korea. The European Union has temporarily barred travelers from outside the bloc. Airports worldwide have ramped up screenings of travelers, including temperature checks, and many citizens returning home from abroad have been encouraged to self-quarantine. Cruise ships with infected patients on board were denied docking at ports.
Social distancing. Public health experts have encouraged people to practice social distancing, or increasing the physical space between oneself and other people. For the new coronavirus, experts recommend a distance of six feet. They say this can help “flatten the curve” of the outbreak [see graph], meaning it can spread out the number of cases over time and prevent health-care systems from becoming overwhelmed. Government, business, and religious leaders have all canceled large public gatherings to encourage social distancing. Buddhist New Year celebrations were called off, and the Roman Catholic Church has livestreamed masses. Months ahead of the annual Hajj pilgrimage, Saudi Arabia suspended entry visas for foreigners planning to travel to the holy city of Mecca and other religious sites. The 2020 Summer Olympics in Tokyo were postponed, while professional sports leagues, including the U.S. National Basketball Association, suspended their seasons.
Lockdowns. Some governments have gone beyond social distancing measures to order their populations to stay at home, close all nonessential businesses, and shut down schools. In late March, India implemented the world’s largest lockdown, telling its population of 1.3 billion to stay home for twenty-one days. Italy was one of the first to issue a nationwide lockdown, but experts say the move came too late after the virus was already widespread. Spain, which had one of the highest death tolls in late March, faced similar criticism for failing to quickly stop large gatherings and enforce a lockdown. Several U.S. states, including California and New York, have imposed lockdowns. Lagos, Nigeria—Africa’s most populous city—instituted a lockdown as the number of cases started to rise there and elsewhere on the continent.
Testing. Countries with early outbreaks sought to quickly develop diagnostic tests for the virus, and some have focused on mass testing of their populations. South Korea, which earlier in the year had the highest number of cases outside of China, has tested ten thousand people per day on average, created drive-through testing centers, and empowered companies to mass-produce tests. Experts believe the high rate of testing has kept the country’s death toll low and helped it flatten the curve.
Ramping up health capabilities. In places where the number of cases is surging, governments are taking efforts to ensure public health systems do not become overwhelmed as in Italy. With the world’s highest number of cases and more than six thousand deaths by late March, the European nation has faced severe shortages of health-care workers and critical supplies, such as hospital beds and life-saving ventilators. Major brands, including in the automotive and fashion industries, have started producing ventilators, masks, and other equipment to augment medical stockpiles.
Public information campaigns. Informing the public of risks and best practices is critical during outbreaks, experts say. Singapore’s government has been a model for such efforts, writes CFR’s Joshua Kurlantzick, with top officials providing consistent messaging, holding regular news conferences, and launching public awareness campaigns. In a broader effort, the WHO worked with FIFA, the international governing body for soccer, to produce videos of famous players describing best practices in more than a dozen languages. By contrast, Iran, which has had one of the highest death tolls has been challenged by public mistrust and an uncoordinated government response.
Funding for vulnerable countries. After the WHO declared the outbreak a public health emergency of international concern in late January, it shepherded a global preparedness and response plan that asks for $675 million in funding to last through April and is aimed at supporting nations with weak health systems. But by March 25, the WHO had received less than half of that. The United Nations later launched a separate $2 billion plan to protect the world’s most vulnerable populations, including refugees and migrants, and support affected countries. Additionally, the International Committee of the Red Cross appealed for more than $800 billion to help vulnerable communities amid the pandemic.
This video by CFR’s World101 library lays out what international health organizations and individual countries can do to fight the next pandemic.
What has been the U.S. public health response?
The United States declared the coronavirus outbreak a public health emergency in late January as person-to-person spread was detected in other countries. In February, President Donald J. Trump’s administration banned travelers and non-U.S. citizens who recently visited mainland China from entering the United States. Still, by March, the virus had reached every state, and the United States surpassed China as the country with the highest number of cases; more than eighty-five thousand people had been infected and more than 1,200 had died, according to the CDC.
The CDC has led the U.S. public health response, which has included screening travelers at airports, quarantining sick patients, regularly sharing guidance with the public on its website, and deploying hundreds of personnel to assist state and local health departments. A coronavirus task force, overseen by Vice President Mike Pence, has coordinated the Trump administration’s response. The administration has faced criticism from some health experts for initial inaction and failing to consistently communicate the risks of the virus to the public. Additionally, widespread testing was delayed after the first diagnostic test developed by the CDC sometimes produced inconclusive results.
Early in the outbreak, the administration implemented travel bans for hot spots, and eventually advised Americans to avoid all international travel. The task force has urged people to practice social distancing, avoid gatherings of more than ten people, and not to visit nursing homes and retirement communities. Meanwhile, state and local leaders have announced different emergency measures based on the severity of their outbreaks. This has sparked tensions between local officials and the president, who announced in late March a hope to “reopen” the country and resume business by Easter in mid-April.
What are the economic consequences?
The pandemic has brought an unprecedented stop to economic activity in many countries as governments have ordered businesses to close and people to stay home and avoid travel. It has ravaged the hospitality and tourism industries, disrupted global supply chains, and affected markets for commodities such as oil. The economic turmoil has sparked fears of a global recession, with Bloomberg analysts warning that the global economy could lose up to $2.7 trillion. For comparison, the SARS crisis caused the global economy to lose an estimated $40 billion in 2003.
With travel restrictions in place in more than one hundred countries, the tourism industry, including hotels and air and cruise lines, has been devastated. Moreover, city shutdowns have dealt crushing blows to eateries: by late March, U.S. local restaurant revenue was down by more than 60 percent. The cancellation of conferences, concerts, sporting events around the world has driven up financial and job losses.
The monthslong closure of factories and shipping ports in China, the world’s manufacturing hub and largest exporter of goods, has disrupted the supply chains for vehicles, jets, smartphones, and pharmaceuticals, among other products. A March survey of more than six hundred U.S. companies found that around three-quarters of them suffered supply chain disruptions because of the pandemic. Meanwhile, oil prices have plummeted as the global demand has fallen.
To counter the economic shocks, central banks around the world have cut interest rates. The U.S. Federal Reserve has taken additional dramatic measures, including extending loans to private companies and increasing purchases of government debt. Some governments are issuing cash handouts, providing vouchers for childcare or groceries, and expanding paid sick leave. In early March, the U.S. Congress approved more than $8 billion in emergency funding for health agencies. Later that month, lawmakers passed a $2 trillion stimulus package that would give $1,200 checks to many Americans, create a loan program for small businesses, and establish a $500 billion lending fund for industries, cities, and states. EU member states have largely acted unilaterally as finance ministers have failed to reach an agreement on how to respond to the economic crisis as a bloc.