What is a pandemic and what happens when COVID-19 becomes one?

Kristine Sabillo, ABS-CBN News

Posted at Feb 26 2020 12:45 PM

A woman in a protective face mask walks out of a Hospital Clinic, where a case of novel coronavirus has been confirmed, in Barcelona, Spain February 25, 2020. Nacho Doce, Reuters

MANILA — Ask the World Health Organization (WHO) about the last time the world witnessed a pandemic and nothing in recent years comes to mind.

“There’s been changes in the classification in how we talk about pandemics. We haven’t recently had a global pandemic,” said Dr. Rabindra Abeyasinghe, World Health Organization representative to the Philippines, in an interview with ABS-CBN News on Tuesday.

According to Abeyasinghe, “A pandemic would be a disease that is spreading uncontrollably, affecting all continents, across the world.”

While the 2009 swine flu or H1N1 was called a pandemic, the WHO changed its classification of pandemic shortly afterwards. Using current definitions, H1N1 influenza is not considered a full-fledged pandemic reportedly because of its level of severity.

Regardless of a pandemic’s more technical definition, Abeyasinghe said COVID-19, a new strain of coronavirus, is still not considered a pandemic.

“It’s not uncontrolled transmission,” he said. “Containment efforts seem to be working in many of those places.”

"And in many of the countries the numbers of cases are still in double digits, not even a hundred cases," he added. "The respective governments are still in a containment phase…So this situation does not warrant a classification of a pandemic as yet."

More than 80,000 people have been infected and 2,700 have died because of COVID-19. Most of the cases are in China but there are now almost 900 cases in South Korea, more than 200 in Italy and 156 in Japan. There are also almost 700 COVID-19 patients from the Diamond Princess cruise ship docked in Japan.

As of Tuesday, other countries with COVID-19 cases are Singapore (90), Iran (61), United States (53), Thailand (35), Australia (22), Germany (16), Vietnam (16), United Arab Emirates (13), France (12), Canada (10), United Kingdom (9), Kuwait (5), India (3) and Philippines (3). Israel, Russia, Spain, Bahrain and Oman have two patients each. While the following countries have one case each: Belgium, Cambodia, Egypt, Finland, Iraq, Lebanon, Nepal, Sri Lanka, Sweden, and Afghanistan.

With local transmissions already detected in some of these countries, the World Health Organization is discussing with nations how to prepare for an actual pandemic.

“We already have more cases of COVID-19 than SARS,” Abeyasinghe pointed out.

He admitted that the situation has changed in the last weeks, especially with the spike in cases in countries like South Korea and Italy.

Currently, countries outside China are in a "containment phase," attempting to prevent the disease from spreading to communities.

"In a containment phase you need to make sure that anybody suspected of having the disease or is confirmed is excluded, isolated and managed,” the WHO official said.

Abeyasinghe said a pandemic would mean that there is “uncontrolled community transmission.”

"Isolation will no longer be the aim of the situation. The aim at that point would be to manage the severely ill patients and prevent the deaths (from happening)," he said. "This is a major strategic shift from a containment phase."

He emphasized the need to prepare for this in advance. "That would mean they (governments) would identify which facilities they are going to manage those severely ill patients."

Not everyone will also need to be tested and isolated.

"Naturally in that scenario, people who are mildly ill will be staying at home. They will not be boarded in hospitals," he said. "But if you are severe or critical you need to be managed in hospitals.”

He said some hospitals may need to be “repurposed” to accommodate that large number of patients.

Asked if the WHO agrees with experts claiming that it’s possible that COVID-19 will eventually become a seasonal pandemic like the common flu, he said: "That’s speculation."

Besides travel bans, countries have been making precautions to further contain the disease within their country. San Francisco in the United States has already declared an emergency while the Philippines’ Department of Health has asked for smaller gatherings in churches.