Understanding the COVID-19 pandemic, globally and locally

Influenza epidemic in United States. St. Louis, Missouri, Red Cross Motor Corps on duty, October 1918. (National Archives)

Pandemics

A pandemic (from Greek πᾶν, pan, “all” and δῆμος, demos, “people”) is an epidemic of an infectious disease that has spread across a large region, for instance multiple continents or worldwide, affecting a substantial number of people. Throughout human history, there have been a number of pandemics of diseases such as influenza, smallpox and tuberculosis.

The most fatal pandemic in recorded history was the Black Death (also known as “The Plague”), which killed an estimated 75–200 million people in the 14th century, including 10-60% of the population of Europe. The term pandemic was not used yet but was for later pandemics including the 1918 influenza pandemic, commonly known as the “Spanish flu,” which was a variant of the H1N1 virus and resulted in somewhere between 50-100 million deaths worldwide, roughly 3-5% of the entire world’s population.

Current pandemics include COVID-19 (SARS-CoV-2), and while not the only current pandemic, it is the most critical one at present. We are still in the midst of the HIV/AIDS pandemic, which has claimed somewhere between 23 and 43.8 million lives since 1981. The current 2019–20 coronavirus outbreak, of COVID-19, was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. COVID-19 is caused by the SARS-CoV-2 coronavirus, the third zoonotic coronavirus to be identified, after SARS-CoV and MERS-CoV.

Beds with patients in an emergency hospital in Camp Funston, Kansas, in the midst of the influenza epidemic. The flu struck while America was at war, and was transported across the Atlantic on troop ships. (OHA 250: New Contributed Photographs Collection, Otis Historical Archives, National Museum of Health and Medicine)

Coronaviruses

Corona is derived from Latin corōna, meaning “crown” or “garland.” Virus also comes from Latin, where it means “slimy liquid” or “poison.” Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV-1). A new (thus the term “novel”) strain of coronavirus (SARS-CoV-2) causes Coronavirus disease 2019, abbreviated COVID-19, which was declared a pandemic by the WHO on March 11, 2020.

Some coronaviruses are zoonotic, meaning they are transmitted between animals and people. Coronavirus disease was first discovered in humans in the 1930s. The virus, Human coronavirus 229E (HCoV-229E) was first isolated in 1965. In November 2002 an outbreak of Severe Acute Respiratory Syndrome (SARS) was discovered. This disease originated in China and subsequently spread to Vietnam, Hong Kong, Taiwan, Singapore and Canada. A new coronavirus was identified in 2012 with a SARS like illness, called the Middle East Respiratory Syndrome (MERS) CoV resulted in a limited number of outbreaks, mostly in Saudi Arabia and other middle eastern countries. In December 2019, a novel coronavirus (nCoV) was identified in Wuhan, China, which was isolated on January 7, 2020.

The 2019-2020 COVID-19 pandemic is expected to have a profound negative effect on the global economy, potentially for years to come, with substantial drops in GDP (gross domestic product) accompanied by increases in unemployment noted around the world. The COVID-19 recession is a major ongoing global economic crisis which has caused both a recession in some nations, and in others a depression. It is currently the worst global economic crisis since the Great Depression. The slowdown of economic activity during the COVID-19 pandemic has also had a profound effect on emissions of pollutants and greenhouse gases.

As of October 5, 2020 there were 35,346,526 confirmed cases worldwide, with 7,546,065 in the US; with 1,039,199 deaths globally, including 213,408 in the US.

Disinfectant being sprayed in Taiwan. (Source: Military News Agency Zhou Lihang)

Coronavirus Cases in Nashville

As of October 1, 2020, Metro Public Health Department (MPHD) officials announced 28,867 confirmed cases of coronavirus disease (COVID-19) in Nashville/Davidson County. Including both confirmed and probable cases, MPHD officials announced a total of 29,065 cases. The cases range in age from 1 month to 103 years. 27,812 individuals are now labeled inactive/recovered after having the virus previously. Cases by sex reveal 14,300 of those are males and 14,475 are female, with 290 unknown. A total of two-hundred sixty-five (265) people in Davidson County had died after a confirmed case of COVID-19. Including both confirmed and probable cases, 276 deaths have been attributed to COVID-19, and as many as 316 including suspected cases.

Probable cases refer to those that have supporting epidemiological and clinical evidence that a COVID-19 infection has occurred, regardless of test result. If a person is a close contact of a COVID-19 case and has a clinically compatible illness, he or she can meet the criteria to be a probable case. Additionally, a positive result of an antigen test from a respiratory specimen can meet the criteria to be a probable case. If a health care provider diagnoses a person with clinically compatible illness with COVID-19, this person meets the probable case criteria. When the health care provider who signs the death certificate determines COVID-19 disease was the cause of death or a significant condition contributing to death, this person meets the probable case criteria and would be considered a probable death.

Coronavirus Prevention

A total of 389,664 tests have been conducted through October 1, with 36,445 positive/probable results and 353,219 negative results. 9.35% of the tests administered yielded positive results.

There are no definitive cures for coronavirus disease. There are no vaccines proven to work. Treatments may or may not be effective in alleviating symptoms in individuals. The only way to ensure your personal safety is to not get the virus. Health officials remind everyone to take steps to stop the spread of germs like COVID-19.

These include the following prevention strategies:

Practice social distancing as defined by the CDC (a minimum 6 feet of distance from others).

Gatherings are recommended to be kept at 25 people or fewer, to the extent possible, because intimate gatherings are the most high-risk setting for transmission of COVID-19.

Wear a cloth face covering when in a community setting, especially in situations where you may be near people; however, these face coverings are not a substitute for social distancing.

Stay at home as much as possible, especially people over 65 years of age or those whose health is at risk should remain at home if possible.

Wash your hands often with soap and water; use alcohol-based hand sanitizer if soap and water are not available.

Cover your mouth and nose with a tissue when coughing or sneezing.

Avoid touching your eyes, nose, or mouth.

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