More than 9,300 people have died as a result of COVID-19 since Dec. 31, 2019, when a “pneumonia of unknown cause detected in Wuhan, China” was first reported to the World Health Organization (WHO). By Mar. 7 there were 100,000 confirmed cases around the world. WHO officially declared the outbreak a pandemic four days later on Mar. 11.
The situation evolved rapidly, as governments and health experts scrambled to contain the spread of the virus, ramp up testing, reinforce or prepare healthcare facilities and equipment, and try to develop a vaccine.
The number of new cases in China has fallen as the number of new international cases is rising, indicating the epicenter of the problem has shifted from China to new places like Europe and the U.S.
In Europe, Italy was on lockdown, experiencing some of the worst mortality statistics outside of China. On Mar. 15 the country announced a 25% spike in its coronavirus death toll, reporting 368 fatalities in the deadliest 24-hour span anywhere in the world to that point. Spain and France had also initiated lockdowns, and Germany estimated as many as two-thirds of its population could contract the virus.
In the U.S., COVID-19 cases were reported in nearly all 50 states but testing capabilities were slow to roll out nationwide. Consumers were panic-buying/stockpiling face masks, hand sanitizer, shelf-stable food, and toilet paper. Around the country, public events were canceled, schools closed, and businesses initiated telecommuting protocols.
Health experts were calling for “social distancing” to “flatten the curve,” or slow the spread of the virus so not to overwhelm the healthcare system with a spike in sick people seeking treatment all at once. The Centers for Disease Control and Prevention (CDC) recommended halting gatherings of more than 50 people for eight weeks.
The global supply of personal protective equipment for healthcare workers was rapidly depleting. A shortage of gloves, medical masks, respirators, goggles, face shields, gowns, and aprons could leave frontline workers ill-prepared to handle the crisis.
The U.S. declared a national emergency and the government was working to develop and implement a relief package. Overall, a rattled global economy was blinking red and teetering toward recession.
Much like influenza, COVID-19 is spread via small droplets of fluid from the nose and mouth of someone who is sick, so health authorities have encouraged people to exercise preventive measures like proper hand hygiene and good respiratory etiquette. Fever, dry cough, fatigue, sputum production, and shortness of breath were among the most common symptoms.
In terms of those at greatest risk, so far, the elderly and people with pre-existing health conditions like heart disease, diabetes, and respiratory issues seem particularly vulnerable.
The median incubation period was estimated to be 5.1 days, according to research published in the Annals of Internal Medicine. The vast majority (97.5%) of people who develop symptoms will do so within 11.5 days. Containment efforts have emphasized quarantine as the most effective measure to limit spread.
Health experts and epidemiologists were still analyzing data to determine the R-nought (R0), or reproduction number, which is the average number of people who will catch the disease from a single infected person. The R0 for seasonal flu is typically around 1.3, and infects millions of people every year. Estimates from preliminary data suggested an R0 for COVID-19 between 2 and 3.11.
The mortality rate was equally hard to determine based on limited epidemiological data, but WHO estimated the case fatality rate was 3.4% for all age groups. For comparison, seasonal flu generally kills far fewer than 1% of those infected.
The outbreak began in December 2019 in Wuhan, the capital city of Hubei province in central China that’s home to 11 million people. Two-thirds (27) of 41 admitted hospital patients had been exposed to the Huanan Seafood Wholesale Market, according to analysis published in the Lancet in February. One family cluster was found.
While there were still major gaps in knowledge about the origin, experts noted loosely-regulatory “wet” markets that trade wild animals in close proximity to people present the circumstances for zoonotic diseases to jump from animals to humans.
The natural reservoir host for SARS-CoV-2 still hasn’t been confirmed, but bats or pangolins have been suspected as potential sources. In terms of genetic code, SARS-CoV-2 appears very closely related to SARS, which was caused by another coronavirus that spread in China in 2002-2003, infecting about 8,000 people and killing nearly 800. Researchers eventually linked the origin of SARS to bats, which passed through civets before reaching humans.
The Huanan Seafood market was closed in early January. By the end of February, China announced a permanent ban on wildlife trade and consumption. The decision on “Comprehensively Prohibiting the Illegal Trade of Wild Animals, Eliminating the Bad Habits of Wild Animal Consumption, and Protecting the Health and Safety of the People,” banned all trade and eating of non-aquatic wild animals.
However, according to the Wildlife Conservation Society (WCS), the ban did not extend to the trade of wildlife for non-food uses such as fur, medicine, pets, or biomedical research. In those cases, the ban calls for strict approvals and quarantine of wild animals.
Pangolins for example, are the most trafficked animal in the world. The scaly anteaters have long been prized in China for both meat and also their signature keratin scales, which have been used for a range of health purposes in Traditional Chinese Medicine (TCM).
News about the virus emerged just as China’s busiest travel season was beginning, with over 600 million people traveling to their hometowns to celebrate the Lunar New Year, one of the country’s biggest public holidays, during which basically everything shuts down for days.
As the virus continued to spread and the situation worsened, China’s government took unprecedented action to initiate a lockdown in late January.
“China—as a country that has both the political power and the authority to lockdown a country like no one else can do—is attempting to restrict movement of peoples in order to restrict movement of the virus. So far that seems to have worked to some degree,” Loren Israelsen, president of the United Natural Products Alliance (UNPA), said during a Feb. 27 webinar hosted by TraceGains.
For weeks, there was virtually no movement in most parts of the country with a population of 1.3 billion people. However, given the timing of the outbreak around the New Year, about 600 million people were locked down in the wrong place, away from their homes, offices, and factories.
“The government is now carefully trying to relocate people back to where they live and work,” Israelsen said. “This is partly why the factory shutdown problems have been so severe. The next big task you will see China doing—whether they do so publicly or not—is to, bit by bit, get people back to where they live and then begin to get them back to work—a monumental task under the best of circumstances, and these are not good circumstances.”
Global & Local Impact
China’s experience provides a case study on how COVID-19 could affect the U.S. economy, according to Wilson Lau, vice president of Nuherbs, a major importer of botanicals from China. “Travel, tourism, and trade will be significantly disrupted, if not shut down. The airlines and hotel chains are already grappling with cancellations. People are beginning to stock up on non-perishable foods like fruit snacks, canned goods, frozen produce and beans, as well as antibacterial products. They are also buying more pet medications and supplements. For some reason people are apparently hoarding toilet paper and bottled water, which indicates this is panic buying driven more by fear and less by what circumstances are likely to be. The grocery industry and trade associations are working to anticipate and respond to these shifts.”
Lau also urged companies to be prepared for major disruptions for a few months and make contingency plans. “Workers won’t be able to get to their jobs if they are sick or quarantined, and if schools and daycare centers close, parents will have to stay home with their children and work fewer hours. The service industry will be hit hard. This is a good time to donate to food banks.”
“With things changing every day, people are naturally worried,” he continued. “We like to bring certainty into uncertain situations whenever possible, so we think things through and make decisions, rather than waiting to see what happens. We encourage you to make plans and be prepared. And take your herbs.”