94-473: William George Stern (born Vilmos György Stern , 2 July 1935 – 21 March 2020) was a British businessman most notable as the owner of the Stern Group of companies. When it collapsed in 1973, Stern became Britain's biggest bankrupt with debts of £118 million. The uninsured losses sustained by thousands of investors led directly to the creation of Britain's first Policyholders' Protection Act . He died during
188-625: A healthy diet are also recommended. Supportive care in severe cases includes treatment to relieve symptoms , fluid therapy , oxygen support and prone positioning , and medications or devices to support other affected vital organs. More severe cases may need treatment in hospital. In those with low oxygen levels, use of the glucocorticoid dexamethasone is recommended to reduce mortality. Noninvasive ventilation and, ultimately, admission to an intensive care unit for mechanical ventilation may be required to support breathing. Extracorporeal membrane oxygenation (ECMO) has been used to address
282-615: A variant of concern (VoC) or a variant of interest (VoI). Many of these variants have shared the more infectious D614G . As of May 2023, the WHO had downgraded all variants of concern to previously circulating as these were no longer detected in new infections. Sub-lineages of the Omicron variant (BA.1 – BA.5) were considered separate VoCs by the WHO until they were downgraded in March 2023 as no longer widely circulating. As of 24 September 2024 ,
376-590: A PHEIC at this stage", a notion that is not part of the PHEIC criteria laid down in the IHR. After confirmed cases of Ebola in neighbouring Uganda in June 2019, Tedros Adhanom , the director-general of the WHO, announced that the third meeting of a group of experts would be held on 14 June 2019 to assess whether the Ebola spread had become a PHEIC. The conclusion was that while the outbreak
470-691: A PHEIC would be an inappropriate way to raise money for the epidemic. Following a visit to the DRC in July 2019, Rory Stewart , the UK's DfID minister, called for the WHO to declare it an emergency. Acknowledging a high risk of spread to the capital of North Kivu, Goma , a call for a PHEIC declaration was published on 10 July 2019 in The Washington Post by Daniel Lucey and Ron Klain (the former United States Ebola response coordinator ). Their declaration stated that "in
564-441: A PHEIC, as the outbreak was considered over. On 30 January 2020, the WHO declared the outbreak of COVID-19 , centered on Wuhan in central China , a PHEIC. On 5 May 2023, the WHO ended the PHEIC declaration for COVID-19. On the date of the declaration, there were 7,818 cases confirmed globally, affecting 19 countries in five of the six WHO regions. Previously, the WHO had held EC meetings on 22 and 23 January 2020 regarding
658-501: A PHEIC, it had occurred in only three countries. Therefore, it was argued that the declaration of the H1N1 outbreak as a PHEIC, was fueling public fear. A 2013 study sponsored by the WHO estimated that, although similar in magnitude to seasonal influenza, it cost more life-years than seasonal flu, due to a shift toward mortality among persons less than 65 years of age. The second PHEIC was the 2014 polio declaration , issued on 5 May 2014 with
752-646: A PHEIC, the WHO Director-General is required to take into account factors that include the risk to human health and international spread as well as advice from an international committee of experts, the IHR Emergency Committee (EC), one of whom should be an expert nominated by the State within whose region the event arises. Rather than being a standing committee, the EC is created on an ad hoc basis. Until 2011,
846-540: A PHEIC, with six in favor and nine against. On 23 July 2022, the WHO director-general declared the outbreak a PHEIC. On 11 May 2023, the WHO ended the PHEIC declaration for Mpox, six days after doing so for COVID-19. On the date of the declaration, there were 17,186 cases reported globally, affecting 75 countries in all six WHO regions, with five deaths reported outside Africa and 72 deaths in African countries. The WHO had previously held an EC meeting on 23 June 2022 regarding
940-664: A PHEIC. As of November 2021, taking into account recent events in Afghanistan, a large number of unvaccinated children, increasing mobile people in Pakistan and the risks associated with the COVID-19 pandemic among others, polio remains a PHEIC. Confirmed cases of Ebola were being reported in Guinea in December 2013 and Liberia in March 2014 and Sierra Leone by May 2014. On 8 August 2014, following
1034-448: A case of Ebola was confirmed in Goma, which has an international airport and a highly mobile population. Subsequently, the WHO announced a reconvening of a fourth EC meeting on 17 July 2019, when they officially announced it "a regional emergency, and by no means a global threat" and declared it as a PHEIC, without restrictions on trade or travel. In response to the declaration, the president of
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#17328518847601128-493: A comprehensive international study. Such deaths include deaths due to healthcare capacity constraints and priorities, as well as reluctance to seek care (to avoid possible infection). Further research may help distinguish the proportions directly caused by COVID-19 from those caused by indirect consequences of the pandemic. 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
1222-581: A global emergency. As of 17 August 2024, over 15,600 cases and 537 deaths have been reported in the current outbreak, with approximately 96% of cases occurring in the Democratic Republic of the Congo (DRC). 12 other African countries, some for the first time, have also reported cases. In 2018, an examination of the first four declarations (2009–2016) showed that the WHO was noted to be more effective in responding to international health emergencies, and that
1316-539: A large number of people". During the COVID-19 pandemic, as with other pandemics, the meaning of this term has been challenged. The end of a pandemic or other epidemic only rarely involves the total disappearance of a disease, and historically, much less attention has been given to defining the ends of epidemics than their beginnings. The ends of particular epidemics have been defined in a variety of ways, differing according to academic field, and differently based on location and social group. An epidemic's end can be considered
1410-529: A list of diseases that are always notifiable . SARS , smallpox , wild type poliomyelitis , and any new subtype of human influenza are always a PHEIC and do not require an IHR decision to declare them as such. Large scale health emergencies that attract public attention do not necessarily fulfill the criteria to be a PHEIC. ECs were not convened for the cholera outbreak in Haiti , chemical weapons use in Syria , or
1504-448: A median range of 0.24% to 1.49%. 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. 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
1598-815: A random sample have consistently found that total infections considerably exceed the reported case counts. Many countries, early on, had official policies to not test those with only mild symptoms. The strongest risk factors for severe illness are obesity, complications of diabetes , anxiety disorders, and the total number of conditions. During the start of the COVID-19 pandemic it was not clear whether young people were less likely to be infected, or less likely to develop symptoms and be tested. A retrospective cohort study in China found that children and adults were just as likely to be infected. Among more thorough studies, preliminary results from 9 April 2020 found that in Gangelt ,
1692-486: A rise in cases of wild polio and circulating vaccine-derived poliovirus. The status achieved, as global eradication, was deemed to be at risk by air travel and border crossing overland, with small numbers of cases in Afghanistan, Pakistan, and Nigeria. In October 2019, continuing cases of wild polio in Pakistan and Afghanistan, in addition to new vaccine-derived cases in Africa and Asia, was reviewed and polio continued to be
1786-466: A situation that is "serious, sudden, unusual, or unexpected", which may necessitate immediate international action. It can be seen as an "alarm system", a "call to action" and "last resort" measure. WHO Member States have 24 hours within which to report potential PHEIC events to the WHO. It does not have to be a member state that reports a potential outbreak, hence reports to the WHO may also be received informally, by non-governmental sources. Under
1880-457: A social phenomenon, not just a biological one. Time reported in March 2024 that expert opinions differ on whether or not COVID-19 is considered endemic or pandemic, and that the WHO continued to call the disease a pandemic on its website. During the initial outbreak in Wuhan , the virus and disease were commonly referred to as "coronavirus", "Wuhan coronavirus", "the coronavirus outbreak" and
1974-451: A test. Conversely, deaths of people who died from underlying conditions following a positive test may be included. Countries such as Belgium include deaths from suspected cases, including those without a test, thereby increasing counts. 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
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#17328518847602068-531: A villa in the south of France. He died on 21 March 2020 from COVID-19 . He was eulogised as a "titan" by relative-in-law Rabbi Pini Dunner . COVID-19 pandemic The COVID-19 pandemic (also known as the coronavirus pandemic and COVID pandemic ), caused by severe acute respiratory syndrome coronavirus 2 ( SARS-CoV-2 ), began with an outbreak of COVID-19 in Wuhan , China, in December 2019. It spread to other areas of Asia, and then worldwide in early 2020. The World Health Organization (WHO) declared
2162-478: Is a formal declaration by the World Health Organization (WHO) of "an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response", formulated when a situation arises that is "serious, sudden, unusual, or unexpected", which "carries implications for public health beyond
2256-518: Is associated with COVID-19 and is reported in as many as 88% of cases. 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. Infected people are more likely to transmit COVID-19 when they are physically close to other non-infected individuals. However, infection can occur over longer distances, particularly indoors. SARS‑CoV‑2 belongs to
2350-533: Is discouraged altogether by the World Health Organization (WHO), due to limited evidence of its efficacy. The severity of COVID-19 varies. It 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 hospitalisation. 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,
2444-439: 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
2538-485: Is not explained by COVID-19 deaths alone. Using such data, estimates of the true number of deaths from COVID-19 worldwide have included a range from 18.2 to 33.5 million (≈27.4 million) by 18 November 2023 by The Economist , as well as over 18.5 million by 1 April 2023 by the Institute for Health Metrics and Evaluation and ≈18.2 million (earlier) deaths between 1 January 2020, and 31 December 2021, by
2632-415: Is not only confined to infectious diseases, and may cover an emergency caused by exposure to a chemical agent or radioactive material. It can be seen as an "alarm system", a "call to action", and "last resort" measure. Multiple surveillance and response systems exist worldwide for the early detection and effective response to contain the spread of disease. Time delays occur for two main reasons. The first
2726-444: Is the delay between the first case and the confirmation of the outbreak by the healthcare system, allayed by good surveillance via data collection, evaluation, and organisation. The second is when there is a delay between the detection of the outbreak and widespread recognition and declaration of it as an international concern. The declaration is promulgated by an emergency committee (EC) made up of international experts operating under
2820-452: 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. Based on Johns Hopkins University statistics, the global CFR was 1.02 percent (6,881,955 deaths for 676,609,955 cases) as of 10 March 2023. The number varies by region and has generally declined over time. Several variants have been named by WHO and labelled as
2914-406: Is the seventh known coronavirus to infect people, after 229E , NL63 , OC43 , HKU1 , MERS-CoV , and the original SARS-CoV . The standard method of testing for presence of SARS-CoV-2 is a nucleic acid test , which detects the presence of viral RNA fragments. As these tests detect RNA but not infectious virus, its "ability to determine duration of infectivity of patients is limited." The test
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3008-614: Is typically done on respiratory samples obtained by a nasopharyngeal swab ; however, a nasal swab or sputum sample may also be used. The WHO has published several testing protocols for the disease. 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, practising good respiratory hygiene, and avoiding touching
3102-703: The 2009–2010 H1N1 (or swine flu) pandemic , the ongoing 2014 polio declaration , the 2013–2016 outbreak of Ebola in Western Africa , the 2015–16 Zika virus epidemic , the 2018–2020 Kivu Ebola epidemic , the 2020–2023 declaration for the COVID-19 pandemic , and the 2022–2023 and 2024 mpox outbreaks . The recommendations are temporary and require reviews every three months. Automatically, SARS , smallpox , wild type poliomyelitis , and any new subtype of human influenza are considered as PHEICs and thus do not require an IHR decision to declare them as such. A PHEIC
3196-651: The COVID-19 pandemic due to complications brought on by COVID-19 . He was born Vilmos György Stern or Ze’ev HaKohen Stern in Budapest, the youngest of three children of Chaim Stern, who owned a textile factory supplying goods to the Hungarian government. When Hungary was invaded by Nazi Germany in March 1944, Stern along with his family, escaped on the Kastner train , which carried 1,684 Jews to safety in Switzerland . During
3290-613: The Fukushima nuclear disaster in Japan , for example. Further assessment is required for diseases that are prone to becoming pandemics , including, but not limited to cholera , pneumonic plague , yellow fever , and viral hemorrhagic fevers. A declaration of a PHEIC may appear as an economic burden to the state facing the epidemic. Incentives to declare an epidemic are lacking and the PHEIC may be seen as placing limitations on trade in countries that already are struggling. In order to declare
3384-501: The Huanan Seafood Wholesale Market there, but it is possible that human-to-human transmission began earlier. Molecular clock analysis suggests that the first cases were likely to have been between October and November 2019. The scientific consensus is that the virus is most likely of a zoonotic origin, from bats or another closely related mammal. While other explanations such as speculations that SARS-CoV-2
3478-407: The Institute for Health Metrics and Evaluation estimating the true number of cases as of early 2022 to be in the billions. One measure that public health officials and policymakers have used to monitor the pandemic and guide decision-making is the test positivity rate ("percent positive"). According to Johns Hopkins in 2020, one benchmark for a "too high" per cent positive is 5%, which was used by
3572-476: The Lancet commission on COVID-19 published a report, calling the response to the pandemic "a massive global failure on multiple levels". The WHO responded by noting "several key omissions and misinterpretations in the report, not least regarding the public health emergency of international concern (PHEIC) and the speed and scope of WHO's actions." They stated that the report "offers the best opportunity to insist that
3666-506: The United States and the world . On 26 April 2009, more than one month after its first emergence, the initial PHEIC was declared when the H1N1 (or swine flu) pandemic was still in phase three . Within three hours on the same day, the WHO web site received almost two million visits, necessitating a dedicated web site for the swine influenza pandemic. At the time that H1N1 had been declared
3760-597: The basic reproduction number (R 0 ) for COVID-19 in January 2020 were between 1.4 and 2.5, 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). 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. As of 14 April 2022 , over 500 million cases were confirmed globally. Most cases are unconfirmed, with
3854-474: The variants of interest as specified by the World Health Organization are BA.2.86 and JN.1, and the variants under monitoring are JN.1.7, KP.2, KP.3, KP.3.1.1, JN.1.18, LB.1, and XEC. Symptoms of COVID-19 are variable, ranging from mild symptoms to severe illness. Common symptoms include headache, loss of smell and taste , nasal congestion and runny nose , cough, muscle pain , sore throat , fever, diarrhoea , and breathing difficulties . People with
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3948-429: The "Wuhan coronavirus outbreak", with the disease sometimes called "Wuhan pneumonia ". In January 2020, the WHO recommended 2019-nCoV and 2019-nCoV acute respiratory disease 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 . WHO finalised
4042-473: The 1960s, rising economic fortunes in Britain led to the creation of the first unitised property funds . Initially, only pension funds and charities were permitted to purchase units in these trusts, but these regulations were relaxed under the leadership of Prime Minister Edward Heath who came to power in 1970, after which time the general public could also invest via insurance companies . One such intermediary
4136-657: The 1990s with debts of £11 million. He was subsequently banned from serving as a company director for twelve years in April 2000, following the emergence of evidence that he had appropriated £1.5 million from the business despite his prior knowledge that it was on the brink of failure. In 1957 or 1958, he married Shoshana Stempel (Freshwater) . In 2000, Stern was living in a "£4m six-bedroom mansion" in West Heath Avenue, Hampstead, London, owned another home in Jerusalem, and
4230-431: The 2005 International Health Regulations (IHR), states have a legal duty to respond promptly to a PHEIC. PHEIC is defined as: an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response. This definition designates a public health crisis of potentially global reach and implies
4324-413: The DRC, together with an expert committee led by a virologist, took responsibility for directly supervising action, while in protest of the declaration health minister Oly Ilunga Kalenga resigned. A review of the PHEIC had been planned at a fifth meeting of the EC on 10 October 2019 and on 18 October 2019 it remained a PHEIC until 26 June 2020 when it was decided that the situation no longer constituted
4418-518: The IHR (2005), which was developed following the SARS outbreak of 2002–2003. Between 2009 and 2016, there were four PHEIC declarations. The fifth was the 2018–2020 Kivu Ebola epidemic , declared in July 2019 and ended in June 2020. The sixth was the COVID-19 pandemic , declared in January 2020 and ended in May 2023. The seventh was the 2022–2023 mpox outbreak , declared in July 2022 and ended in May 2023. Under
4512-436: The IHR (2005), ways to detect, evaluate, notify, and report events were ascertained by all countries in order to avoid PHEICs. The response to public health risks also was decided. The IHR decision algorithm assists WHO Member States in deciding whether a potential PHEIC exists and whether the WHO should be notified. The WHO should be notified if any two of the four following questions are affirmed: The PHEIC criteria include
4606-481: The International Health Regulations as well as a new legally binding agreement (most likely a treaty) on pandemic prevention, preparedness, and response. Proposals include the possibility of issuing intermediate public health alerts (short of PHEICs) and determining public health emergencies of regional concern. Notably, although COVID-19 is routinely referred to as a pandemic, this word is not used in
4700-424: The International Health Regulations." With the emergency phase of the pandemic being regarded as having ended, more subtle and robust institutional responses and protocols are in the works for further iterations of this pandemic as well as global pandemics of whatever etiology . At the second IHR meeting for the 2022–2023 mpox outbreak on 21 July 2022, members of the emergency committee were divided about issuing
4794-466: The WHO declared its fourth PHEIC in response to clusters of microcephaly and Guillain–Barré syndrome in the Americas , which at the time were suspected to be associated with the ongoing 2015–16 Zika virus epidemic . Later research and evidence bore out these concerns; in April, the WHO stated that "there is scientific consensus that Zika virus is a cause of microcephaly and Guillain–Barré syndrome." This
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#17328518847604888-636: The WHO in the past. As of 10 March 2023, more than 6.88 million deaths had been attributed to COVID-19. The first confirmed death was in Wuhan on 9 January 2020. These numbers vary by region and over time, influenced by testing volume, healthcare system quality, treatment options, government response, time since the initial outbreak, and population characteristics, such as age, sex, and overall health. Multiple measures are used to quantify mortality. Official death counts typically include people who died after testing positive. Such counts exclude deaths without
4982-419: The WHO, US, European Union, and Australia. 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. On 14 November 2022, the first inhalable vaccine was introduced, developed by Chinese biopharmaceutical company CanSino Biologics , in
5076-474: The absence of a trajectory toward extinguishing the outbreak, the opposite path—severe escalation—remains possible. The risk of the disease moving into nearby Goma, Congo—a city of 1 million residents with an international airport—or crossing into the massive refugee camps in South Sudan is mounting. With a limited number of vaccine doses remaining, either would be a catastrophe". Four days later, on 14 July 2019,
5170-415: The affected state's national border" and "may require immediate international action". Under the 2005 International Health Regulations (IHR), states have a legal duty to respond promptly to a PHEIC. The declaration is publicized by an IHR Emergency Committee (EC) of international experts, which was developed following the 2002–2004 SARS outbreak . Since 2005, there have been eight PHEIC declarations:
5264-448: The broad family of viruses known as coronaviruses . 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. 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
5358-630: The centre of a major infection cluster in Germany, 15 per cent of a population sample tested positive for antibodies . 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. Seroprevalence -based estimates are conservative as some studies show that persons with mild symptoms do not have detectable antibodies. Initial estimates of
5452-746: The city of Shanghai, China. For the first two years of the pandemic, no specific and effective treatment or cure was available. 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 the HIV antiviral ritonavir ), to treat adult patients. FDA later gave it an EUA. Most cases of COVID-19 are mild. In these, supportive care includes medication such as paracetamol or NSAIDs to relieve symptoms (fever, body aches, cough), adequate intake of oral fluids and rest. Good personal hygiene and
5546-480: The cumulative number of infected individuals (including asymptomatic and undiagnosed infections and excluding vaccinated infected individuals). It is expressed in percentage points. Other studies refer to this metric as the infection fatality risk . 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
5640-441: The development of various vaccine platforms during early 2020. The initial focus of SARS-CoV-2 vaccines was on preventing symptomatic and severe illness. The COVID-19 vaccines are widely credited for their role in reducing the severity and death caused by COVID-19. As of March 2023, more than 5.5 billion people had received one or more doses (11.8 billion in total) in over 197 countries. The Oxford-AstraZeneca vaccine
5734-709: The emergencies did not coincide with holidays. PHEIC was not invoked with the Middle Eastern Respiratory Syndrome (MERS) outbreak in 2013. Originating in Saudi Arabia, MERS reached more than 24 countries and resulted in 876 deaths by May 2020, although most cases were in hospital settings rather than sustained community spread. As a result, what constitutes a PHEIC has been unclear. PHEIC are not confined to only infectious diseases or biological ones. It may cover events caused by chemical agents or radioactive materials. Debate exists regarding whether
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#17328518847605828-470: The event. Upon declaration, the EC then makes recommendations on what actions the director-general and member states should take to address the crisis. The recommendations are temporary and require review every three months while in place. Summary of PHEIC declarations In the spring of 2009, a novel influenza A (H1N1) virus emerged. It was detected first in Mexico , North America . It spread quickly across
5922-513: The eyes, nose, or mouth with unwashed hands. Those diagnosed with COVID-19 or who believe they may be infected are advised by healthcare authorities 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. A COVID-19 vaccine
6016-468: The failures and lessons from the past 3 years are not wasted but are constructively used to build more resilient health systems and stronger political systems that support the health and wellbeing of people and planet during the 21st century." The formal end of the COVID-19 PHEIC is a matter of much nuance which carries its own risks, and as of March 2023, "WHO member states are negotiating amendments to
6110-474: The general public beginning in December 2020, made available through government and international programs such as COVAX , aiming to provide vaccine equity . Treatments include novel antiviral drugs and symptom control. Common mitigation measures during the public health emergency included travel restrictions , lockdowns , business restrictions and closures, workplace hazard controls , mask mandates , quarantines, testing systems, and contact tracing of
6204-657: The infected. The pandemic caused severe social and economic disruption around the world, including the largest global recession since the Great Depression . Widespread supply shortages , including food shortages , were caused by supply chain disruptions and panic buying . Reduced human activity led to an unprecedented temporary decrease in pollution . Educational institutions and public areas were partially or fully closed in many jurisdictions, and many events were cancelled or postponed during 2020 and 2021. Telework became much more common for white-collar workers as
6298-410: The international system in dealing with these emergencies was "robust". Another review of the first four declarations, with the exception of wild polio, demonstrated that responses were varied. Severe outbreaks, or those that threatened larger numbers of people, did not receive a swift PHEIC declaration, and the study hypothesized that responses were quicker when American citizens were infected and when
6392-484: The issue of respiratory failure. Existing drugs such as hydroxychloroquine , lopinavir/ritonavir , and ivermectin are not recommended by US or European health authorities, as there is no good evidence they have any useful effect. 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
6486-576: 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 . 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
6580-485: The names of IHR EC members were not publicly disclosed; in the wake of reforms, now they are. These members are selected according to the disease in question and the nature of the event. Names are taken from the IHR Experts Roster . The director-general takes the advice of the EC, following their technical assessment of the crisis using legal criteria and a predetermined algorithm after a review of all available data on
6674-471: The occurrence of Ebola in the United States and Europe and with the already intense transmission ongoing in three other countries for months, the WHO declared its third PHEIC in response to the outbreak of Ebola in Western Africa . Later, one review showed that a direct impact of this epidemic on America escalated a PHEIC declaration. It was the first PHEIC in a resource-poor setting. On 1 February 2016,
6768-495: The official names COVID-19 and SARS-CoV-2 on 11 February 2020. 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). WHO additionally uses "the COVID-19 virus" and "the virus responsible for COVID-19" in public communications. WHO named variants of concern and variants of interest using Greek letters . The initial practice of naming them according to where
6862-534: The outbreak a public health emergency of international concern (PHEIC) on 30 January 2020, and assessed the outbreak as having become a pandemic on 11 March. COVID-19 symptoms range from asymptomatic to deadly, but most commonly include fever, sore throat , nocturnal cough , and fatigue. Transmission of the virus is often through airborne particles . Mutations have produced many strains (variants) with varying degrees of infectivity and virulence . COVID-19 vaccines were developed rapidly and deployed to
6956-665: The outbreak, but it was determined at that time that it was too early to declare a PHEIC, given the lack of necessary data and the then-scale of global impact. The WHO recognized the spread of COVID-19 as a pandemic on 11 March 2020. The emergency committee convened its third meeting on 30 April 2020, fourth on 31 July, fifth on 29 October, sixth on 14 January 2021, seventh on 15 April 2021, ninth in October 2021, tenth in January 2022, eleventh in April 2022, twelfth in July 2022, thirteenth in October 2022, fourteenth in January 2023, and fifteenth in May 2023. In September 2022,
7050-471: The outbreak, which had more than 2,100 cases in over 42 countries at that point; it did not reach the criteria for a PHEIC alert at the time. It was re-classified a PHEIC in August 2024. After an IHR meeting on 14 August 2024, the WHO declared an mpox outbreak in parts of Africa , of a new variant of the disease, a PHEIC. This marks the second time in three years that the WHO has classified an mpox outbreak as
7144-407: The pandemic 2021's leading cause of death . The time between symptom onset and death ranges from 6 to 41 days, typically about 14 days. Mortality rates increase as a function of age. People at the greatest mortality risk are the elderly and those with underlying conditions. The infection fatality ratio (IFR) is the cumulative number of deaths attributed to the disease divided by
7238-443: The pandemic evolved. Misinformation circulated through social media and mass media , and political tensions intensified . The pandemic raised issues of racial and geographic discrimination , health equity , and the balance between public health imperatives and individual rights . The WHO ended the PHEIC for COVID-19 on 5 May 2023. The disease has continued to circulate, but as of 2024, experts were uncertain as to whether it
7332-415: The population's age structure and the age-specific pattern of infections. There have also been reviews that have compared the fatality rate of this pandemic with prior pandemics, such as MERS-CoV. For comparison the infection mortality rate of seasonal flu in the United States is 0.1%, which is 13 times lower than COVID-19. Another metric in assessing death rate is the case fatality ratio (CFR), which
7426-458: The risk of dying from seasonal influenza . 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
7520-496: 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. In people without prior ear, nose, and throat disorders, loss of taste combined with loss of smell
7614-484: The situation as "an Ebola gas can sitting in DRC that's just waiting for a match to hit it", while the WHO panel were unanimous in their decision that declaring it a PHEIC would not give any added benefit. The advice against declaring a PHEIC in October 2018 and April 2019, despite the criteria for doing so appearing to be met on both occasions, has led to the transparency of the IHR EC coming into question. The language used in
7708-563: The spread of the virus within the community, 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. These initial strategies can be pursued sequentially or simultaneously during the acquired immunity phase through natural and vaccine-induced immunity . Public health emergency of international concern A public health emergency of international concern ( PHEIC / f eɪ k / FAYK )
7802-458: The statements for the Kivu Ebola epidemic has been noted to be different. In October 2018, the EC stated "a PHEIC should not be declared at this time". In the 13 previously declined proposals for declaring a PHEIC, the resultant statements quoted "the conditions for a PHEIC are not currently met" and "does not constitute a PHEIC". In April 2019, they stated that "there is no added benefit to declaring
7896-411: 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). Between 5% and 50% of COVID-19 patients experience long COVID , a condition characterised by long-term consequences persisting after
7990-408: The time there was no compensation scheme in place to protect them. As a direct consequence of Nation Life's failure, the 1975 Policyholders' Protection Act was introduced, which mandates investors' insurance be paid for by a one per cent levy on investment premiums. After being discharged in 1987, Stern resumed his business activities, until a second commercial empire under his control collapsed in
8084-694: The typical convalescence period of the disease. 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 . 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
8178-543: The variants were identified (e.g. Delta began as the " Indian variant") is no longer common. 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. SARS-CoV-2 is a virus closely related to bat coronaviruses , pangolin coronaviruses, and SARS-CoV . The first known outbreak (the 2019–2020 COVID-19 outbreak in mainland China ) started in Wuhan , Hubei, China, in December 2019. Many early cases were linked to people who had visited
8272-509: Was Nation Life Insurance , part of the Stern Group. As a result of the stock market crash and secondary bank crisis of 1973–74 , property prices in Britain tumbled dramatically. Investment fund customers attempted to liquidate their rapidly devaluing bonds, but the funds had insufficient cash to meet their redemption obligations, leading to their collapse. Nation Life, and its parent company, were forced into administration , and William Stern
8366-425: Was a health emergency in the Democratic Republic of the Congo (DRC) and the region, it did not meet all the three criteria for a PHEIC. Despite the number of deaths reaching 1,405 by 11 June 2019 and 1,440 by 17 June 2019, the reason for not declaring a PHEIC was that the overall risk of international spread was deemed to be low, and the risk of damaging the economy of the DRC high. Adhanom also stated that declaring
8460-443: Was accidentally released from a laboratory have been proposed, as of 2021 these were not supported by evidence. 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. Due to the effect of sampling bias , studies which obtain a more accurate number by extrapolating from
8554-521: Was declared bankrupt. Renowned lawyer and longtime business partner Winston Held ensured that himself, Stern and other investors in Stern Group managed to keep almost all of the personal wealth that they had accrued through many years of directorship at the company. The scandal was raised in the British Parliament on several occasions, and a BBC documentary on the subject aired in 1974. Thousands of private investors lost their life savings, since at
8648-457: Was still a pandemic. Pandemics and their ends are not well-defined, and whether or not one has ended differs according to the definition used. As of 24 November 2024, COVID-19 has caused 7,075,455 confirmed deaths. The COVID-19 pandemic ranks as the fifth- deadliest pandemic or epidemic in history . In epidemiology , a pandemic is defined as "an epidemic occurring over a very wide area, crossing international boundaries, and usually affecting
8742-477: Was the first time a PHEIC was declared for a mosquito‐borne disease . This declaration was lifted on 18 November 2016. In October 2018 and then later in April 2019, the WHO did not consider the 2018–2020 Kivu Ebola epidemic to be a PHEIC. The decision was controversial, with Michael Osterholm , director of the Center for Infectious Disease Research and Policy (CIDRAP) responding with disappointment and describing
8836-502: Was the most widely used. According to a June 2022 study, COVID-19 vaccines prevented an additional 14.4 million to 19.8 million deaths in 185 countries and territories from 8 December 2020 to 8 December 2021. On 8 November 2022, the first recombinant protein-based COVID-19 vaccine (Novavax's booster Nuvaxovid ) was authorised for use in adults in the United Kingdom. It has subsequently received endorsement/authorisation from
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