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{♫Intro♫}
This video was filmed on March 3 2020.
If we have a more up-to-date version of it,
it will be linked at the top of the description,
and right up there.
Let’s go over some terminology to start.
SARS-CoV-2 is a virus, specifically it is
a new kind of Coronavirus
that appeared suddenly in late 2019
in the city of Wuhan, China.
Coronaviruses are common,
you have likely had a coronavirus lots of times,
it’s one kind of virus that causes
the common cold.
But they can also cause SARS and MERS,
two diseases that have very high case mortality
rates.
They’re very dangerous,
and the disease that SARS-CoV-2 causes
has been named COVID-19
short for coronavirus disease 2019.
This disease spread very quickly in China
at first,
but new cases there are slowing,
and now the majority of new cases are
outside China.
This raises the question...do we have
a pandemic on our hands?
And the answer, yes, maybe,
also no, and also it doesn’t really matter
and it actually
matters a lot.
So...that’s why this video is here.
First of all, “Pandemic” sounds like an official term,
but there aren’t super hard rules
or numbers for when it can or should be used.
In general, we use the term epidemic
to describe a sudden, unexpected increase in cases
of a disease in a particular region.
A pandemic, on the other hand,
is sudden, unexpected worldwide spread
of a disease.
Why does the difference between those things matter?
Well, it’s not just whether we get
to use a scarier word in the headlines…
there’s also a difference in how we respond.
Epidemics you contain.
Pandemics you can only mitigate.
So, then how do we decide when something
is a pandemic?
Researchers have said they’d need to see
evidence of sustained, domestic transmission
in at least one more region outside of the
Pacific region that includes China, Japan,
and South Korea before using the term “pandemic”.
So the question is whether these cases outside
the Pacific are spreading on their own.
Not just new arrivals, but new spread.
And while we didn’t see any evidence of
that in the early months
of the COVID-19 outbreak,
we now have seen cases that aren’t directly
linked
to either travel, or exposure to people
who’ve traveled.
Instead, it looks like it might be
what’s known as community spread.
Community spread, or community cases,
are essentially when the source of the infection
is unknown.
In this case, that would mean people who
haven’t been to China
and also have’t been in direct contact with someone
who was recently in China are getting sick.
It’s spreading from person to person
in their own community
via droplets from coughing or sneezing or just, talking loudly.
As of February 29th, three states in the US
have reported community-acquired cases:
California, Oregon, and Washington.
And a preliminary genetic analysis of the
virus,
sampled from two separate patients in Washington state,
suggests that the virus was quietly spreading there for a while.
The virus in the two patients
had a particular genetic signature that only
a small fraction of samples from China had.
If the two cases were both new introductions
from abroad, it would be unlikely that they
both had that signature.
That suggests that there has been sustained transmission
in Washington state for several weeks --
though we’d need to find the sick people
who did that transmission to confirm this.
It seems likely that there are more cases
than outbreak responders are aware of,
probably because those people
simply aren’t sick enough to go to the doctor.
So does this make this a pandemic?
Again, there’s not a hard and fast rule,
but remember we’d need to see not just
domestic transmission, but sustained transmission.
So is that happening?
Well, many experts and scientists say yes,
but, as of this recording, the WHO (World Health Organization)
has chosen not to use the word pandemic.
And it so happens that the WHO
is having meetings between when we’re filming this
and when you’re seeing it.
They’re the ones who get to say,
although even if they say it, it’s not a formal term
-- just their assessment of things.
The formal use of the word “pandemic”
was actually retired in 2009!
If they decide at those meetings
that they’ve seen what they’re looking for,
they may switch from their current policy
of trying to contain the disease,
to naming it a pandemic and switching to a strategy
of mitigating the effects.
They’re looking for sustained, community-acquired transmission –
that is, many, many cases where no one knows
how someone got sick.
Now this might seem like splitting hairs,
but there are reasons why they might be
shy about making this call.
No one responds to news like “there’s a pandemic” lightly,
and they get that.
As for why we ended up in this situation in
the first place,
we do have some ideas about why COVID-19 has been able to spread.
As we mentioned, it’s spread from person to person
in droplets when a sick person coughs or sneezes.
It’s also been suggested that a number of
cases
are being spread by folks without any symptoms at all.
That’s called asymptomatic transmission.
But on Tuesday, the WHO said that,
at least in China,
only one percent of reported cases
had no symptoms -
and most of those developed symptoms within days.
So it looks like asymptomatic transmission
is really rare,
and that’s unlikely to be
the main driver of new cases, which is very
good news.
Pandemic or no pandemic,
it’s important to remember that this designation
has nothing to do with how deadly a disease is.
The term only describes where the disease
is spreading.
It doesn’t tell you anything else.
And we’re not really sure what the mortality
rate of COVID-19 is.
It’s changing so fast it’s hard to even
pick a number to cite.
For one thing, it’s been different so far in China
than in the rest of the world,
and different in some parts of China than
in other parts of China.
For another, the actual rate might be much lower,
since mild cases may very well be going unrecognized.
You may have heard a figure around two percent
cited in the news, and that’s backed up
by the published literature so far,
but it’s probably not going to be the number
we have when the dust settles.
And the number’s gonna be very different in places
with more robust healthcare systems
than in places that don’t have lots of respirators.
We’re planning a whole other episode for you
on how we understand and compare
fatality rates, so keep an eye out for that.
In the end, whether something’s an epidemic
or pandemic may have as much to do with
our response to the disease as the disease itself.
If it’s an epidemic, the nation or region
where it’s happening
may try to contain it and prevent it from getting out.
But with a pandemic, the focus may be
more on mitigation efforts,
like surveillance, treatment, and protecting
vulnerable populations.
They may also focus on
slowing the spread of the disease
through what’s called social distancing:
things like dismissing school
or postponing mass gatherings,
rather than just trying to keep it out of the community.
And there are also things we as individuals
can do
to help prevent the spread of the disease.
People should be aware of the symptoms of this disease,
which include fever, dry cough, and tiredness.
Those are the main COVID specific things
to watch out for.
People might also get aches and pains,
a sore throat,
a runny or congested nose…
and I realize now I’m just listing
symptoms of a cold or flu!
That's why it's really important
to contact your doctor if you start having any
difficulty breathing --
which is more indicative of this disease.
And when I say contact a doctor,
I mean call them, don’t go in to sit in a waiting room
with a bunch of strangers.
The US Centers for Disease Control
recommends avoiding touching your face,
avoiding close contact with people who are sick,
and staying home if you yourself are sick.
You should also wash your hands with soap and water for at least 20 seconds.
That’s not just some empty platitude.
Coronaviruses are surrounded
by an envelope of oily material.
And soap is really, really good at disrupting
and dissolving oily stuff.
So washing your hands with soap and water
for 20 seconds -- about the time it takes
to sing Twinkle, Twinkle, Little Star,
or the chorus from Toto’s “Africa,”
whichever you prefer -- is a genuinely effective way
of destroying virus particles.
And you should also get your flu shot. We
mean this. Now, the flu shot isn’t gonna
protect you from COVID-19, but the flu and
COVID-19 have similar symptoms. Which means
one could be confused for the other, placing
an extra burden of testing and treatment on
health providers.
Plus, you’re less likely to get the flu,
and the flu sucks. Also if you do get it,
it’ll probably be less severe, meaning you’re
less likely to need treatment from a potentially
overworked healthcare system.
They also want people to stop buying face
masks. Surgical masks are good at keeping
your stuff in, not necessarily the world out.
So unless you’re a healthcare worker or
already sick, or you are in a specific situation
where your doctor has recommended a mask,
they won’t do much.
And we should leave them for the people who
need them.
In sum, it’s understandable that the word
“pandemic” is being thrown around, whether
COVID-19 is one by definition or assignation
by the WHO or not.
It’s okay to be concerned. After all, events
like this are uncertain, and we can give you
some facts here on SciShow, but we can’t
eliminate that uncertainty.
There are many people who’ve been affected,
families who’ve lost loved ones and we should
keep them in our hearts.
But when you see the whole story from a thousand
feet up, it’s relatively mild compared to
what we’d feared.
There are clear things we can all do to reduce
the risk of transmission, both for our own
benefit and for those around us;
And there are a lot of smart people working
really hard to make this better.
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