The world is not ready for global outbreak of the coronavirus, the World Health Organization warned on Monday, but amid major spikes of confirmed COVID-19 cases in three countries over the past week, many experts have begun acknowledging that a pandemic is now all but inevitable. Authorities are currently struggling to contain — and understand — escalating outbreaks in South Korea, Iran, and Italy, while all over the world, governments and public health officials scramble to prepare for more coronavirus outbreaks.
Below is a look at the scope and scale of these new outbreaks, and what the spike in global cases could mean.
The big picture, by the numbers
“We have all got to look at our systems, because none of them work fast enough,” WHO epidemiologist Bruce Aylward cautioned Monday after reviewing China’s unprecedented efforts to slow the original and largest outbreak of COVID-19. According to Monday’s WHO report on the outbreaks, more than 79,000 confirmed cases of the novel coronavirus have been reported globally. Nearly 2,600 people have died from the illness, mostly in China, where more than 77,000 of the confirmed cases have been reported. There have been welcome signs that the spread of the virus in China has temporarily slowed. Outside of China, if you subtract the cases contracted on the Princess Diamond cruise ship, more than 1,300 COVID-19 cases have been reported across 29 countries on every inhabited continent except South America.
The numbers reported by health officials do not offer the complete picture of the virus’ spread, however, despite how often those numbers lead coverage of the crisis. The WHO only reports cases that have been confirmed with laboratory tests. The total number of infections in any given country — including cases which have, for various reasons, gone undetected, untested, and/or unreported — is far from clear. That doesn’t mean the whole world is already infected and health officials haven’t figured it out, but it most likely means that there are many more cases yet to discover, including in countries like the U.S.
As the below graph of the global cases as of Sunday reveals, efforts to prevent the global spread of COVID-19 have not succeeded. Now the world waits to find out how bad it will get, and how fast.
Red alert in South Korea
South Korea continues to face the largest known outbreak outside of China. As of Monday, 893 cases of the Covid-19 novel coronavirus have been confirmed in the country, resulting in 8 deaths. On Sunday, President Moon Jae-in instituted the highest possible alert level over the virus, giving the government the power to impose draconian measures, including lockdowns, in an effort to contain the outbreak.
Cases have reportedly been confirmed in every major city and province in the country, but hardest hit are the cities of Cheongdo and Daegu, the nation’s fourth largest city. In Daegu, a single person is believed to have potentially exposed thousands of people to the virus at a branch of a secretive religious sect called the Shincheonji Church of Jesus — where more than half of the COVID cases in the country originated. It’s still not clear how that woman became infected, but the government says it has ordered self-quarantines and coronavirus tests for some 9,500 members of the church who may have been exposed at the Daegu branch.
South Korea has an excellent national health-care system and valuable experience containing outbreaks of other diseases, but health officials have acknowledged they will not be able to contain the virus in Daegu, which along with Cheongdo has been designated a “special care area.” Residents of the cities have been asked to remain in their homes and avoid public places and gatherings, but long lines for supplies have been reported, including this line for face masks on Monday:
Iran’s outbreak may be even worse, endangering the entire Middle East
Since last Tuesday, Iran’s government has reported 61 confirmed COVID-19 cases and 12 deaths — the highest death toll outside of China. But there is reason to believe the real size of the outbreak is much larger, and that Iran’s government has not only mismanaged its response, but may have hid the escalating epidemic from both Iranians and the world.
All of Iran’s neighbors have closed their borders with the country, but it appears to have been too late to contain the outbreak. On Monday, Iraq, Afghanistan, Bahrain, Oman, and Kuwait all announced their first reported cases of coronavirus — all reportedly linked to travel from Iran.
And it’s still not clear how widely COVID-19 has been transmitted inside Iran, while some reports have indicated the entire country has been exposed. The Iranian regime claims it has a handle on the outbreak and that it has been transparent about the outbreak, but the new crisis comes little more than a month after Iran’s Revolutionary Guard shot down a passenger jet near Tehran killing all 176 people aboard, then lied about its responsibility for days.
Medical staff inside Iran have reported a shortage of supplies and lack of preparation by the government. Iran was also slow to restrict air travel from China, possibly because the country’s reliance on China amid crippling U.S.-led sanctions. It was still allowing air travel within the country as of Monday.
The holy city of Qom has been the hardest hit, with at least 26 reported cases of the coronavirus. On Monday, a semi-official news agency in the country reported that a member of Iran’s parliament from Qom had announced that at least 50 people had already died in the outbreak — more than four times what Iran has reported. He also claimed that 250 people were already quarantined in Qom and that the outbreak started six days before Iran says it did. The Islamic Republic has denied the report.
Also on Monday, one of the top medical officials managing the outbreak in Qom said on state television that the situation was “very dire” and warned that the virus had “spread across the city.” The doctor also claimed that Iran’s health ministry had ordered officials in the city not to publish statistics about the outbreak.
Meanwhile, thanks to the constant traffic of Shia pilgrims in and out of Iran — often traveling to Qom — it’s quite possible countless people in the region have been exposed to the coronavirus. Iran’s outbreak may quickly become the Middle East’s disaster.
Italy’s outbreak leaves Europe on edge
In Italy, 229 Covid-19 cases have been confirmed, leading to six deaths. The country’s outbreak is the now the third largest in the world, as well as the biggest in Europe.
More than 50,000 Italians are now living under lockdown in the northern Lombardy region, where 90 percent of the cases have occurred, primarily near the town of Cordogno, where the region’s outbreak seems to have begun with a single case. Health officials still don’t know how that man was infected, having not traveled to China.
Police are patrolling the streets of 11 towns and issuing fines to anyone caught leaving or entering the locked-down areas. Mass has been cancelled in Milan, some 45 miles north of the epicenter of the outbreak, as well as other cities in Northern Italy.
Meanwhile, dozens of cases have been confirmed in the Veneto region, including cases in Venice, where 20,000 people attended the city’s annual Carnival event on Sunday morning before authorities canceled the two remaining days of the celebration.
Schools and universities across the country have been closed. Prime Minister Giuseppe Conte has urged Italians to “have faith in the political and scientific institutions, which are doing everything possible,” while health officials have asked people to avoid crowds and isolate themselves if they’ve been exposed to anyone with the coronavirus. 27 million people live in the parts of the country where the government has restricted public activities.
Across Europe, EU members are trying to figure out how to handle travel from Italy while bracing for outbreaks of their own.
This post has been updated throughout.