Twenty years after SARS (Severe Acute Respiratory Syndrome) and a decade after MERS (Middle East Respiratory Syndrome), a new health crisis is wreaking havoc globally.

In early December 2019, a patient was diagnosed with an unusual pneumonia in Wuhan - a city with 11 million citizens and capital of the Hubei region in central China. On December 31st the WHO regional office in Beijing received notification of a cluster of pneumonia cases of unknown cause from the same city. Response to the new emergency was then rapid and efficient, and after a few days researchers at the Wuhan Institute of Virology  performed metagenomics analysis on a sample collected from a bronchoalveolar lavage, identifying the novel coronavirus as the potential etiology.

It is speculated that SARS-CoV-2 originated in bats and transmitted to humans through yet unknown intermediary animals. A recurring hypothesis is that they originated in a live animal market in Wuhan. Despite the efforts of Chinese authorities to contain the epidemic, COVID-19 rapidly spread throughout China, with hundreds of cases in Wuhan in the first weeks of January 2020.

When the first WHO report on 2019-nCoV was released on January 21st, 282 cases of Covid-19 had been reported from China (278 cases), Thailand (2 cases), Japan (1 case) and the Republic of Korea (1 case).

All cases outside China appeared to originate from Wuhan. By mid-January, several countries had instituted measures for screening passengers and airline personnel  coming from affected zones, for respiratory symptoms and febrile illness. All over the world quarantine measures for people arriving from China were put into effect, while in Wuhan and the Hubei region, strict rules for limiting human-human transmission were applied.

However, the outbreak in China persisted, with almost 8,000 cases confirmed one month after the first cluster was identified. Most were limited to the Hubei region and a few cases were declared in 19 countries all over the world, all exported from China.

Accordingly, on January 30th, the WHO declared a Public Health Emergency of International Concern. On February 28th, the WHO Risk Assessment confirmed that the situation was high risk on a global level. In late February, while new infections in China had stabilised, Iran and Italy were experiencing a sharp increase in cases.

The contagion spread like a wild fire to at least 67 countries across 6 continents causing the WHO to declare Covid-19 a pandemic on Mar 11th, 2020.

Europe became the “new epicentre” of the disease soon after China. Italy, Spain and France have experienced a colossal increase in Covid-19 fatalities and thousands continue to die every day in Europe.

The situation in Italy is the most grievous with April 7th confirming 135,586 total cases and 17,127 deaths. The country's northern region of Lombardy has been hit the hardest, with 52,325 total cases and almost 10,000 dead on April 7th. Lombardy is also where the first resident case was officially reported on February 20th (WHO Covid-19 daily reports).

In the last two weeks, the United States of America has surpassed every other country in the number of Covid-19 infections and their national tally of fatalities is steadily mounting.

The evolution of the epidemic in Europe (most affected countries) and the USA, compared to global data, is depicted in the chart below.

Italy was the next country to see a significant spike in the spread of the contagion. Unprecedented measures for limiting the outbreak were applied, first in Lombardy and then across the nation, almost freezing social, economic and political life.

The most frightening concern of the Covid-19 spread is the capacity of intensive care units (ICU) to manage critical cases requiring ventilation. Covid-19 is associated with severe respiratory illness requiring ICU in approximately 5% of proven infections. Ventilation is generally needed for weeks. This critical issue highlights how quickly health systems can be challenged to provide adequate care and emphasises the importance of maintaining robust capacity that could respond quickly in times of crisis.

Thus, the epidemic has triggered a staggering demand for Covid-19 testing facilities, life-support and other medical equipment, personal protective gear such as masks, face shields, gloves and gowns. Governments all over the world (including the USA), have openly expressed their lack of preparedness and the enormous deficiencies in their health care systems which hamper their ability to effectively care for the large numbers who become ill from the disease. Governments are feverishly adopting preventive measures to stem the spread of contagion and “flatten the curve” so that their health systems do not become further overwhelmed.

Several Research centres and universities around the world are working on a vaccine for Covid-19 and 35 candidate vaccines for Covid-19 are currently in pre-clinical trials (WHO 2020).

Until such time however, non-medical interventions are the most important response strategy to delay the spread of the virus and reduce the impact of disease.

Three-quarters of the world’s population is now under “lock down”, staying at home, physically distancing and, where appropriate, self-isolating. Quarantine, washing hands often, avoiding touching one’s face and covering the mouth when sneezing / coughing have become the norm. As highlighted by governments globally, until a vaccine is officially developed, the responsibility of halting the spread of this contagion lies in the hands of the public as they safeguard themselves, and each other, through non-therapeutic measures.