COVID-19 pandemic

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COVID-19 pandemic

Confirmed deaths per 1,000,000 population

as of 20 December 2020

show
Cases per capita

show
Daily new cases
 Clockwise from top:

 Nurse treating a COVID-19 patient in an intensive care unit

aboard USNS  Comfort, a U.S. hospital ship

 Disinfection of public spaces in Taiwan

 Donated medical supplies received in the Philippines

 Burial in Iran

 Italian government task force

Disease Coronavirus disease 2019 (COVID-19)

Virus strain Severe acute respiratory syndrome

coronavirus 2 (SARS-CoV-2)[a]

Source Possibly via bats, pangolins, or both[1][2]

Location Worldwide

First outbreak Wuhan, China[3]

Index case Wuhan, Hubei, China

30°37′11″N 114°15′28″E

Date December 2019[3] – present

(1 year, 1 month, 1 week and 2 days)

Confirmed cases 89,718,548[4]

Suspected cases‡ Possibly 10% of the global population (WHO

 estimate as of early October 2020)[5]

Deaths 1,928,136[4]

Territories 191[4]

‡
Suspected cases have not been confirmed by laboratory tests as being

due to this strain, although some other strains may have been ruled

out.

The COVID-19 pandemic, also known as the coronavirus pandemic, is an

ongoing pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first identified in December
2019 in Wuhan, China. The World Health Organization declared the outbreak a Public
Health Emergency of International Concern in January 2020 and a pandemic in March
2020. As of 10 January 2021, more than 89.7 million cases have been confirmed,
with more than 1.92 million deaths attributed to COVID-19.
Symptoms of COVID-19 are highly variable, ranging from none to severe illness. The
virus spreads mainly through the air when people are near each other. [b] It leaves an
infected person as they breathe, cough, sneeze, or speak and enters another person
via their mouth, nose, or eyes. It may also spread via contaminated surfaces. People
remain infectious for up to two weeks, and can spread the virus even if they do not
show symptoms.[9]
Recommended preventive measures include social distancing, wearing face masks in
public, ventilation and air-filtering, hand washing, covering one's mouth when sneezing
or coughing, disinfecting surfaces, and monitoring and self-isolation for people exposed
or symptomatic. Several vaccines are being developed and distributed.
Current treatments focus on addressing symptoms while work is underway to develop
therapeutic drugs that inhibit the virus. Authorities worldwide have responded by
implementing travel restrictions, lockdowns, workplace hazard controls, and facility
closures. Many places have also worked to increase testing capacity and trace
contacts of the infected.
The responses to the pandemic have resulted in global social and economic disruption,
including the largest global recession since the Great Depression.[10] It has led to the
postponement or cancellation of events, widespread supply shortages exacerbated
by panic buying, agricultural disruption and food shortages, and decreased emissions of
pollutants and greenhouse gases. Many educational institutions have been partially or
fully closed. Misinformation has circulated through social media and mass media. There
have been incidents of xenophobia and discrimination against Chinese people and
against those perceived as being Chinese or as being from areas with high infection
rates.[11]

Contents
 1Epidemiology
o 1.1Background
o 1.2Cases
o 1.3Deaths
 2Disease
o 2.1Signs and symptoms
o 2.2Transmission
o 2.3Cause
o 2.4Diagnosis
o 2.5Prevention
o 2.6Vaccines
o 2.7Treatment
o 2.8Prognosis
 3Mitigation
o 3.1Screening, containment and mitigation
o 3.2Health care
 4History
o 4.12019
o 4.22020
o 4.32021
 5National responses
o 5.1Asia
o 5.2Europe
o 5.3North America
o 5.4South America
o 5.5Africa
o 5.6Oceania
o 5.7Antarctica
 6International responses
o 6.1Travel restrictions
o 6.2Evacuation of foreign citizens
o 6.3United Nations response measures
o 6.4Protests against governmental measures
 7Impact
o 7.1Economics
o 7.2Culture
o 7.3Politics
o 7.4Agriculture and food systems
o 7.5Education
o 7.6Other health issues
o 7.7Environment and climate
o 7.8Xenophobia and racism
 8Information dissemination
o 8.1Misinformation
 9See also
 10Notes
 11References
  12Further reading
 13External links
o 13.1Health agencies
o 13.2Directories
o 13.3Data and graphs
o 13.4Medical journals

Epidemiology
For country-level data, see:

COVID-19 pandemic by country and territory

Cases
89,718,548

Deaths
1,928,136

As of 10 January 2021[4]

Africa · Asia · Europe · North America

Oceania · South America

Background
Although it is still unknown exactly where the outbreak first started, many early cases of
COVID-19 have been attributed to people who have visited the Huanan Seafood
Wholesale Market, located in Wuhan, Hubei, China.[12] On 11 February 2020, the World
Health Organization (WHO) named the disease "COVID-19", which is short
for coronavirus disease 2019.[13][14] The virus that caused the outbreak is known as severe
acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a newly discovered virus
closely related to bat coronaviruses,[15] pangolin coronaviruses,[16][17] and SARS-CoV.
[18]
 Scientific consensus is that COVID-19 likely originated naturally, probably from bats. [19]
[20]

The earliest known person with symptoms was later discovered to have fallen ill on
1 December 2019, and that person did not have visible connections with the later wet
market cluster.[21][22] However, an earlier case of infection could have occurred on 17
November.[23] Of the early cluster of cases reported that month, two thirds were found to
have a link with the market.[24][25][26] There are several theories about when and where the
very first case (the so-called patient zero) originated.[27] It is possible that the virus first
emerged in October 2019.[28]
Cases
Main articles: COVID-19 pandemic by country and territory and COVID-19 pandemic
cases

Total confirmed cases per country as of 9 January 2021.

   10,000,000+
   1,000,000–9,999,999
   100,000–999,999
   10,000–99,999
   1,000–9,999
   100–999
   1–99
   0

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. [29][30] Many
countries, early on, had official policies to not test those with only mild symptoms. [31][32] An
analysis of the early phase of the outbreak up to 23 January estimated 86 percent of
COVID-19 infections had not been detected, and that these undocumented infections
were the source for 79 percent of documented cases. [33] Several other studies, using a
variety of methods, have estimated that numbers of infections in many countries are
likely to be considerably greater than the reported cases. [34][35]
On 9 April 2020, preliminary results found that 15 percent of people tested in Gangelt,
the centre of a major infection cluster in Germany, tested positive for antibodies.
[36]
 Screening for COVID-19 in pregnant women in New York City, and blood donors in
the Netherlands, has also found rates of positive antibody tests that may indicate more
infections than reported.[37][38] Seroprevalence based estimates are conservative as some
studies shown that persons with mild symptoms do not have detectable antibodies.
[39]
 Some results (such as the Gangelt study) have received substantial press coverage
without first passing through peer review. [40]
Analysis by age in China indicates that a relatively low proportion of cases occur in
individuals under 20.[41] It was not clear whether this was because young people were
less likely to be infected, or less likely to develop serious symptoms and seek medical
attention and be tested.[42] A retrospective cohort study in China found that children and
adults were just as likely to be infected. [43]
Initial estimates of the basic reproduction number (R0) for COVID-19 in January were
between 1.4 and 2.5,[44] but a subsequent analysis concluded that it may be about 5.7
(with a 95 percent confidence interval of 3.8 to 8.9).[45] R0 can vary across populations
and is not to be confused with the effective reproduction number (commonly just called
R), which takes into account effects such as social distancing and herd immunity. By
mid-May 2020, the effective R was close to or below 1.0 in many countries, meaning the
spread of the disease in these areas at that time was stable or decreasing. [46]

Epidemic curve of daily new cases of COVID-19 (7 day rolling average) by continent
 

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

COVID-19 total cases per 100 000 population from selected countries [47]
 

COVID-19 active cases per 100 000 population from selected countries [47]

Deaths
Main articles: COVID-19 pandemic deaths and COVID-19 pandemic death rates by
country
Further information: List of deaths due to COVID-19
Deceased in a 16 m (53 ft) "mobile morgue" outside a hospital in Hackensack, New Jersey

Official deaths from COVID-19 generally refer to people who died after testing positive
according to protocols. This may ignore deaths of people who die without having been
tested.[48] Conversely, deaths of people who had underlying conditions may lead to over-
counting.[49] Comparison of statistics for deaths for all causes versus the seasonal
average indicates excess mortality in many countries.[50][51] This may include deaths due
to strained healthcare systems and bans on elective surgery.[52] The first confirmed death
was in Wuhan on 9 January 2020.[53] The first reported death outside of China occurred
on 1 February in the Philippines,[54] and the first reported death outside Asia was in the
United States on 6 February.[55]
More than 95 percent of the people who contract COVID-19 recover. Otherwise, the
time between symptoms onset and death usually ranges from 6 to 41 days, typically
about 14 days.[56] As of 10 January 2021, more than 1.92 million[4] deaths had been
attributed to COVID-19. People at the greatest risk from COVID-19 tend to be those
with underlying conditions, such as a weakened immune system, serious heart or lung
problems, severe obesity, or the elderly.[57]
On 24 March 2020, the Centers for Disease Control and Prevention (CDC) of the United
States, indicated the World Health Organization (WHO) had provided two codes for
COVID-19: U07.1 when confirmed by laboratory testing and U07.2 for clinically or
epidemiological diagnosis where laboratory confirmation is inconclusive or not available.
[58][59]
 The CDC noted that "Because laboratory test results are not typically reported on
death certificates in the U.S., [the National Center for Health Statistics (NCHS)] is not
planning to implement U07.2 for mortality statistics" and that U07.1 would be used "If
the death certificate reports terms such as 'probable COVID-19' or 'likely COVID-19'."
The CDC also noted "It Is not likely that NCHS will follow up on these cases" and while
the "underlying cause depends upon what and where conditions are reported on the
death certificate, ... the rules for coding and selection of the ... cause of death are
expected to result in COVID–19 being the underlying cause more often than not." [58]
On 16 April 2020, the World Health Organization (WHO), in its formal publication of the
two codes, U07.1 and U07.2, "recognized that in many countries detail as to the
laboratory confirmation... will not be reported [and] recommended, for mortality
purposes only, to code COVID-19 provisionally to code U07.1 unless it is stated as
'probable' or 'suspected'."[60][61] It was also noted that the WHO "does not distinguish"
between infection by SARS-CoV-2 and COVID-19.[62]
Multiple measures are used to quantify mortality. [63] These numbers vary by region and
over time, influenced by testing volume, healthcare system quality, treatment options,
government response,[64][65][66] time since the initial outbreak, and population
characteristics, such as age, sex, and overall health. [67] Countries like Belgium include
deaths from suspected cases of COVID-19, regardless of whether the person was
tested, resulting in higher numbers compared to countries that include only test-
confirmed cases.[68]
The death-to-case ratio reflects the number of deaths attributed to COVID-19 divided by
the number of diagnosed cases within a given time interval. Based on Johns Hopkins
University statistics, the global death-to-case ratio is 2.1 percent (1,928,136 deaths for
89,718,548 cases) as of 10 January 2021.[4] The number varies by region.[69]

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

COVID-19 deaths per 100 000 population from selected countries [47]
Infection fatality ratio (IFR)
A crucial metric in assessing the severity of a disease is the infection fatality ratio (IFR),
which is the cumulative number of deaths at