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COVID-19 pandemic — news, coverage & facts — IJR

Cases

Official "case" counts refer to the number of people who have been tested for COVID-19 and whose test has been confirmed positive according to official protocols whether they experienced symptomatic disease. Due to the effect of sampling bias, studies which obtain a more accurate number by extrapolating from a random sample have consistently found that total infections considerably exceed the reported case counts. Many countries, early on, had official policies to not test those with only mild symptoms. The strongest risk factors for severe illness are obesity, complications of diabetes, anxiety disorders, and the total number of conditions.

During the start of the COVID-19 pandemic, it was not clear whether young people were less likely to be infected, or less likely to develop symptoms and be tested. A retrospective cohort study in China found that children and adults were just as likely to be infected.

Among more thorough studies, preliminary results from 9 April 2020 found that in Gangelt, the centre of a major infection cluster in Germany, 15 per cent of a population sample tested positive for antibodies. Screening for COVID-19 in pregnant women in New York City, and blood donors in the Netherlands, found rates of positive antibody tests that indicated more infections than reported. Seroprevalence-based estimates are conservative as some studies show that persons with mild symptoms do not have detectable antibodies.

Initial estimates of the basic reproduction number (R0) for COVID-19 in January 2020 were between 1.4 and 2.5, but a subsequent analysis claimed that it may be about 5.7 (with a 95 per cent confidence interval of 3.8 to 8.9).

In December 2021, the number of cases continued to climb due to several factors, including new COVID-19 variants. As of that 28 December, 282,790,822 individuals worldwide had been confirmed as infected. As of 14 April 2022, over 500 million cases were confirmed globally. Most cases are unconfirmed, with the Institute for Health Metrics and Evaluation estimating the true number of cases as of early 2022 to be in the billions.

One measure that public health officials and policymakers have used to monitor the pandemic and guide decision-making is the test positivity rate ("percent positive"). According to Johns Hopkins in 2020, one benchmark for a "too high" per cent positive is 5%, which was used by the WHO in the past.

Deaths

As of 10 March 2023, more than 6.88 million deaths had been attributed to COVID-19. The first confirmed death was in Wuhan on 9 January 2020. These numbers vary by region and over time, influenced by testing volume, healthcare system quality, treatment options, government response, time since the initial outbreak, and population characteristics, such as age, sex, and overall health.

Multiple measures are used to quantify mortality. Official death counts typically include people who died after testing positive. Such counts exclude deaths without a test. Conversely, deaths of people who died from underlying conditions following a positive test may be included. Countries such as Belgium include deaths from suspected cases, including those without a test, thereby increasing counts.

Official death counts have been claimed to underreport the actual death toll, because excess mortality (the number of deaths in a period compared to a long-term average) data show an increase in deaths that is not explained by COVID-19 deaths alone. Using such data, estimates of the true number of deaths from COVID-19 worldwide have included a range from 18.5 to 35.2 million (≈27.4 million) by 25 January 2024 by The Economist, as well as over 18.5 million by 1 April 2023 by the Institute for Health Metrics and Evaluation and ≈18.2 million (earlier) deaths between 1 January 2020, and 31 December 2021, by a comprehensive international study. Such deaths include deaths due to healthcare capacity constraints and priorities, as well as reluctance to seek care (to avoid possible infection). Further research may help distinguish the proportions directly caused by COVID-19 from those caused by indirect consequences of the pandemic.

In May 2022, the WHO estimated the number of excess deaths by the end of 2021 to be 14.9 million compared to 5.4 million reported COVID-19 deaths, with the majority of the unreported 9.5 million deaths believed to be direct deaths due to the virus, rather than indirect deaths. Some deaths were because people with other conditions could not access medical services.

A December 2022 WHO study estimated excess deaths from the pandemic during 2020 and 2021, again concluding ≈14.8 million excess early deaths occurred, reaffirming and detailing their prior calculations from May as well as updating them, addressing criticisms. These numbers do not include measures like years of potential life lost and may make the pandemic 2021's leading cause of death.

The time between symptom onset and death ranges from 6 to 41 days, typically about 14 days. Mortality rates increase as a function of age. People at the greatest mortality risk are the elderly and those with underlying conditions.

The infection fatality ratio (IFR) is the cumulative number of deaths attributed to the disease divided by the cumulative number of infected individuals (including asymptomatic and undiagnosed infections and excluding vaccinated infected individuals). It is expressed in percentage points. Other studies refer to this metric as the infection fatality risk.

In November 2020, a review article in Nature reported estimates of population-weighted IFRs for various countries, excluding deaths in elderly care facilities, and found a median range of 0.24% to 1.49%. IFRs rise as a function of age (from 0.002% at age 10 and 0.01% at age 25, to 0.4% at age 55, 1.4% at age 65, 4.6% at age 75, and 15% at age 85). These rates vary by a factor of ≈10,000 across the age groups. For comparison, the IFR for middle-aged adults is two orders of magnitude higher than the annualised risk of a fatal automobile accident and much higher than the risk of dying from seasonal influenza.

In December 2020, a systematic review and meta-analysis estimated that population-weighted IFR was 0.5% to 1% in some countries (France, Netherlands, New Zealand, and Portugal), 1% to 2% in other countries (Australia, England, Lithuania, and Spain), and about 2.5% in Italy. This study reported that most of the differences reflected corresponding differences in the population's age structure and the age-specific pattern of infections. There have also been reviews that have compared the fatality rate of this pandemic with prior pandemics, such as MERS-CoV.

For comparison the infection mortality rate of seasonal flu in the United States is 0.1%, which is 13 times lower than COVID-19.

Another metric in assessing death rate is the case fatality ratio (CFR), which is the ratio of deaths to diagnoses. This metric can be misleading because of the delay between symptom onset and death and because testing focuses on symptomatic individuals.

Based on Johns Hopkins University statistics, the global CFR was 1.02 percent (6,881,955 deaths for 676,609,955 cases) as of 10 March 2023. The number varies by region and has generally declined over time.

Prevention

Preventive measures to reduce the chances of infection include getting vaccinated, staying at home, or spending more time outdoors, avoiding crowded places, keeping distance from others, wearing a mask in public, ventilating indoor spaces, managing potential exposure durations, washing hands with soap and water often and for at least twenty seconds, practising good respiratory hygiene, and avoiding touching the eyes, nose, or mouth with unwashed hands.

Those diagnosed with COVID-19 or who believe they may be infected are advised by healthcare authorities to stay home except to get medical care; call ahead before visiting a healthcare provider; wear a face mask before entering the healthcare provider's office; when in any room or vehicle with another person, cover coughs and sneezes with a tissue; regularly wash hands with soap and water; and avoid sharing personal household items.

A COVID-19 vaccine is intended to provide acquired immunity against SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) (SARS‑CoV‑2), the virus that causes coronavirus disease 2019 (COVID-19). Prior to the COVID-19 pandemic, an established body of knowledge existed about the structure and function of coronaviruses causing diseases like severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). This knowledge accelerated the development of various vaccine platforms during early 2020.

The initial focus of SARS-CoV-2 vaccines was on preventing symptomatic and severe illness. The COVID-19 vaccines are widely credited for their role in reducing the severity and death caused by COVID-19.

As of August 2024, more than 5.6 billion people had received one or more doses (13.7 billion in total). The Oxford-AstraZeneca vaccine was the most widely used. According to a June 2022 study, COVID-19 vaccines prevented an additional 14.4 million to 19.8 million deaths in 185 countries and territories from 8 December 2020 to 8 December 2021.

In 2022, the first recombinant protein-based COVID-19 vaccine (the Novavax vaccine) was authorised for use in adults in the United Kingdom. It has subsequently received endorsement/authorisation from the WHO, US, European Union, and Australia. That same year also saw the first inhalable vaccine, developed by Chinese biopharmaceutical company CanSino Biologics.

High-income countries rapidly bought up vaccines at the start of the pandemic, leading to concerns about vaccine equity. By April 2021, one in 500 people in low and middle-income countries had been vaccinated, compared with one in four in high-income countries.

Mitigation

Should containment fail, efforts focus on mitigation: measures taken to slow the spread and limit its effects on the healthcare system and society.

Successful mitigation delays and decreases the epidemic peak, known as "flattening the epidemic curve". This decreases the risk of overwhelming health services and provides more time for developing vaccines and treatments. Individual behaviour changed in many jurisdictions. Many people worked from home instead of at their traditional workplaces.

Non-pharmaceutical interventions that may reduce spread include personal actions such as wearing face masks, self-quarantine, and hand hygiene; community measures aimed at reducing interpersonal contacts such as closing workplaces and schools and cancelling large gatherings; community engagement to encourage acceptance and participation in such interventions; as well as environmental measures such as surface cleaning.

More drastic actions, such as quarantining entire populations and strict travel bans have been attempted in various jurisdictions. The Chinese and Australian government approaches have included many lockdowns and are widely considered the most strict. The New Zealand government response included the most severe travel restrictions. As part of its K-Quarantine programme, South Korea introduced mass screening and localised quarantines, and issued alerts on the movements of infected individuals. The Singaporean government's response included so-called "circuit breaker lockdowns" and financial support for those affected while also imposing large fines for those who broke quarantine.

Contact tracing attempts to identify recent contacts of newly infected individuals, and to screen them for infection; the traditional approach is to request a list of contacts from infectees, and then telephone or visit the contacts. Contact tracing was widely used during the Western African Ebola virus epidemic in 2014.

Another approach is to collect location data from mobile devices to identify those who have come in significant contact with infectees, which prompted privacy concerns. On 10 April 2020, Google and Apple announced an initiative for privacy-preserving contact tracing. In Europe and in the US, Palantir Technologies initially provided COVID-19 tracking services.

2020

On 11 January, WHO was notified by the Chinese National Health Commission that the outbreak was associated with exposures in the market, and that China had identified a new type of coronavirus, which it isolated on 7 January.

Initially, the number of cases doubled approximately every seven and a half days. In early and mid-January, the virus spread to other Chinese provinces, helped by the Chinese New Year migration. Wuhan was a transport hub and major rail interchange. On 10 January, the virus' genome was shared publicly. A retrospective study published in March found that 6,174 people had reported symptoms by 20 January. A 24 January report indicated human transmission was likely occurring, and recommended personal protective equipment for health workers. It also advocated testing, given the outbreak's "pandemic potential". On 30 January, 7,818 infections had been confirmed, leading WHO to declare the outbreak a Public Health Emergency of International Concern (PHEIC), upgrading it to a pandemic on 11 March. On 31 January, the first published modelling study warned of inevitable "independent self-sustaining outbreaks in major cities globally" and called for "large-scale public health interventions".

By 31 January, Italy indicated its first confirmed infections had occurred, in two tourists from China. On 19 March, Italy overtook China as the country with the most reported deaths.

By 26 March, the United States had overtaken China and Italy as the country with the highest number of confirmed infections. Genomic analysis indicated that the majority of New York's confirmed infections came from Europe, rather than directly from Asia. Testing of prior samples revealed a person who was infected in France on 27 December 2019 and a person in the United States who died from the disease on 6 February.

In October, WHO reported that one in ten people around the world may have been infected, or 780 million people, while only 35 million infections had been confirmed.

On 9 November, Pfizer released trial results for a candidate vaccine, showing a 90 per cent effectiveness in preventing infection. That day, Novavax submitted an FDA Fast Track application for their vaccine. On 14 December, Public Health England reported that a variant had been discovered in the UK's southeast, predominantly in Kent. The variant, later named Alpha, showed changes to the spike protein that could make the virus more infectious. As of 13 December, 1,108 infections had been confirmed in the UK. On 4 February 2020, US Secretary of Health and Human Services Alex Azar waived liability for vaccine manufacturers in all cases except those involving "willful misconduct".

2022

On 1 January, Europe passed 100 million cases amid a surge in the Omicron variant. Later that month, the WHO recommended the rheumatoid arthritis drug baricitinib for severe or critical patients. It also recommended the monoclonal antibody sotrovimab in patients with non-severe disease, but only those who are at highest risk of hospitalisation.

On 24 January, the Institute for Health Metrics and Evaluation estimated that about 57% of the world's population had been infected by COVID-19. By 6 March, it was reported that the total worldwide death count had surpassed 6 million people. By 6 July, Omicron subvariants BA.4 and BA.5 had spread worldwide. WHO Director-General Tedros Ghebreyesus stated on 14 September 2022, that "[The world has] never been in a better position to end the pandemic", citing the lowest number of weekly reported deaths since March 2020. He continued, "We are not there yet. But the end is in sight—we can see the finish line".

On 21 October, the United States surpassed 99 million cases of COVID-19, the most cases of any country. By 30 October, the worldwide daily death toll was 424, the lowest since 385 deaths were reported on 12 March 2020. 17 November marked the three-year anniversary since health officials in China first detected COVID-19.

On 11 November, the WHO reported that deaths since the month of February had dropped 90 per cent. Director-General Tedros said this was "cause for optimism". On 3 December, the WHO indicated that, "at least 90% of the world's population has some level of immunity to Sars-CoV-2". In early December, China began lifting some of its most stringent lockdown measures. Subsequent data from China's health authorities revealed that 248 million people, nearly 18 per cent of its population, had been infected in the first 20 days of that month. On 29 December, the US joined Italy, Japan, Taiwan, and India in requiring negative COVID-19 test results from all people travelling from China due to the new surge in cases. The EU refused similar measures, stating that the BF7 omicron variant had already spread throughout Europe without becoming dominant.

2023

On 4 January 2023, the WHO said the information shared by China during the recent surge in infections lacked data, such as hospitalisation rates. On 10 January, the WHO's Europe office said the recent viral surge in China posed "no immediate threat." On 16 January, the WHO recommended that China monitor excess mortality to provide "a more comprehensive understanding of the impact of COVID-19".

On 30 January, the three-year anniversary of the original declaration, the WHO determined that COVID-19 still met the criteria for a public health emergency of international concern (PHEIC).

On 19 March, WHO Director-General Tedros indicated he was "confident" the COVID-19 pandemic would cease to be a public health emergency by the end of the year. On 5 May, the WHO downgraded COVID-19 from being a global health emergency, though it continued to refer to it as a pandemic. The WHO does not make official declarations of when pandemics end. The decision came after Tedros convened with the International Health Regulations Emergency Committee, wherein the Committee noted that due to the decrease in deaths and hospitalisations, and the prevalence of vaccinations and the level of general immunity, it was time to remove the emergency designation and "transition to long-term management". Tedros agreed, and the WHO reduced the classification to an "established and ongoing health issue". In a press conference, Tedros remarked that the diminishing threat from COVID-19 had "allowed most countries to return to life as we knew it before COVID-19".

In September the WHO said it had observed "concerning" trends in COVID-19 case numbers and hospitalisations, although analysis was hampered because many countries were no longer recording COVID-19 case statistics.

In November 2023, in response to viral mutations and changing characteristics of infection, the WHO adjusted its treatment guidelines. Among other changes, remdesivir and molnupiravir were now recommended only for the most severe cases, and deuremidevir and ivermectin were recommended against.

Asia

As of the end of 2021, Asia's peak had come at the same time and at the same level as the world as a whole, in May 2021. However, cumulatively they had experienced only half of the global average in cases.

China opted for containment, instituting strict lockdowns to eliminate viral spread. The vaccines distributed in China included the BIBP, WIBP, and CoronaVac. It was reported on 11 December 2021, that China had vaccinated 1.162 billion of its citizens, or 82.5% of the total population of the country against COVID-19. China's large-scale adoption of zero-COVID had largely contained the first waves of infections of the disease. When the waves of infections due to the Omicron variant followed, China was almost alone in pursuing the strategy of zero-Covid to combat the spread of the virus in 2022. Lockdown continued to be employed in November to combat a new wave of cases; however, protests erupted in cities across China over the country's stringent measures, and in December that year, the country relaxed its zero-COVID policy. On 20 December 2022, the Chinese State Council narrowed its definition of what would be counted as a COVID-19 death to include solely respiratory failure, which led to scepticism by health experts of the government's total death count at a time when hospitals reported being overwhelmed with cases following the abrupt discontinuation of zero-COVID.

The first case in India was reported on 30 January 2020. India ordered a nationwide lockdown starting 24 March 2020, with a phased unlock beginning 1 June 2020. Six cities accounted for around half of reported cases—Mumbai, Delhi, Ahmedabad, Chennai, Pune and Kolkata. Post-lockdown, the Government of India introduced a contact tracking app called Aarogya Setu to help authorities manage contact tracing and vaccine distribution. India's vaccination programme was considered to be the world's largest and most successful with over 90% of citizens getting the first dose and another 65% getting the second dose. A second wave hit India in April 2021, straining healthcare services. On 21 October 2021, it was reported that the country had surpassed 1 billion vaccinations.

Iran reported its first confirmed cases on 19 February 2020, in Qom. Early measures included the cancellation/closure of concerts and other cultural events, Friday prayers, and school and university campuses. Iran became a centre of the pandemic in February 2020. More than ten countries had traced their outbreaks to Iran by 28 February, indicating a more severe outbreak than the 388 reported cases. The Iranian Parliament closed, after 23 of its 290 members tested positive on 3 March 2020. At least twelve sitting or former Iranian politicians and government officials had died by 17 March 2020. By August 2021, the pandemic's fifth wave peaked, with more than 400 deaths in 1 day.

COVID-19 was confirmed in South Korea on 20 January 2020. Military bases were quarantined after tests showed three infected soldiers. South Korea introduced what was then considered the world's largest and best-organised screening programme, isolating infected people, and tracing and quarantining contacts. Screening methods included mandatory self-reporting by new international arrivals through mobile application, combined with drive-through testing, and increasing testing capability to 20,000 people/day. Despite some early criticisms, South Korea's programme was considered a success in controlling the outbreak without quarantining entire cities.

Europe

The COVID-19 pandemic arrived in Europe with its first confirmed case in Bordeaux, France, on 24 January 2020, and subsequently spread widely across the continent. By 17 March 2020, every country in Europe had confirmed a case, and all had reported at least one death, with the exception of Vatican City. Italy was the first European nation to experience a major outbreak in early 2020, becoming the first country worldwide to introduce a national lockdown. By 13 March 2020, the WHO declared Europe the epicentre of the pandemic and it remained so until the WHO announced it had been overtaken by South America on 22 May. By 18 March 2020, more than 250 million people were in lockdown in Europe. Despite deployment of COVID-19 vaccines, Europe became the pandemic's epicentre once again in late 2021.

The Italian outbreak began on 31 January 2020, when two Chinese tourists tested positive for SARS-CoV-2 in Rome. Cases began to rise sharply, which prompted the government to suspend flights to and from China and declare a state of emergency. On 22 February 2020, the Council of Ministers announced a new decree-law to contain the outbreak, which quarantined more than 50,000 people in northern Italy. On 4 March, the Italian government ordered schools and universities closed as Italy reached a hundred deaths. Sport was suspended completely for at least one month. On 11 March, Italian Prime Minister Giuseppe Conte closed down nearly all commercial activity except supermarkets and pharmacies. On 19 April, the first wave ebbed, as 7-day deaths declined to 433. On 13 October, the Italian government again issued restrictive rules to contain the second wave. On 10 November, Italy surpassed 1 million confirmed infections. On 23 November, it was reported that the second wave of the virus had led some hospitals to stop accepting patients.

The virus was first confirmed to have spread to Spain on 31 January 2020, when a German tourist tested positive for SARS-CoV-2 on La Gomera in the Canary Islands. Post-hoc genetic analysis has shown that at least 15 strains of the virus had been imported, and community transmission began by mid-February. On 29 March, it was announced that, beginning the following day, all non-essential workers were ordered to remain at home for the next 14 days. The number of cases increased again in July in a number of cities including Barcelona, Zaragoza, and Madrid, which led to reimposition of some restrictions but no national lockdown. By September 2021, Spain was one of the countries with the highest percentage of its population vaccinated (76% fully vaccinated and 79% with the first dose). Italy is ranked second at 75%.

Sweden differed from most other European countries in that it mostly remained open. Per the Swedish constitution, the Public Health Agency of Sweden has autonomy that prevents political interference and the agency favoured remaining open. The Swedish strategy focused on longer-term measures, based on the assumption that after lockdown the virus would resume spreading, with the same result. By the end of June, Sweden no longer had excess mortality.

Devolution in the United Kingdom meant that each of its four countries developed its own response. England's restrictions were shorter-lived than the others. The UK government started enforcing social distancing and quarantine measures on 18 March 2020. On 16 March, Prime Minister Boris Johnson advised against non-essential travel and social contact, praising work from home and avoiding venues such as pubs, restaurants, and theatres. On 20 March, the government ordered all leisure establishments to close, and promised to prevent unemployment. On 23 March, Johnson banned gatherings and restricted non-essential travel and outdoor activity. Unlike previous measures, these restrictions were enforceable by police through fines and dispersal of gatherings. Most non-essential businesses were ordered to close. On 24 April 2020, it was reported that a promising vaccine trial had begun in England; the government pledged more than £50 million toward research. On 16 April 2020, it was reported that the UK would have first access to the Oxford vaccine, due to a prior contract; should the trial be successful, some 30 million doses would be available. On 2 December 2020, the UK became the first developed country to approve the Pfizer vaccine; 800,000 doses were immediately available for use. In August 2022 it was reported that viral infection cases had declined in the UK.

North America

The virus arrived in the United States on 13 January 2020. Cases were reported in all North American countries after Saint Kitts and Nevis confirmed a case on 25 March, and in all North American territories after Bonaire confirmed a case on 16 April.

Per Our World in Data, 103,436,829 confirmed cases have been reported in the United States with 1,238,678 deaths, the most of any country, and the nineteenth-highest per capita worldwide. COVID-19 is the deadliest pandemic in US history; it was the third-leading cause of death in the US in 2020, behind heart disease and cancer. From 2019 to 2020, US life expectancy dropped by 3 years for Hispanic Americans, 2.9 years for African Americans, and 1.2 years for white Americans. These effects have persisted as US deaths due to COVID-19 in 2021 exceeded those in 2020. In the United States, COVID-19 vaccines became available under emergency use in December 2020, beginning the national vaccination programme. The first COVID-19 vaccine was officially approved by the Food and Drug Administration on 23 August 2021. By 18 November 2022, while cases in the U.S. had declined, COVID variants BQ.1/BQ.1.1 had become dominant in the country.

In March 2020, as cases of community transmission were confirmed across Canada, all of its provinces and territories declared states of emergency. Provinces and territories, to varying degrees, implemented school and daycare closures, prohibitions on gatherings, closures of non-essential businesses, and restrictions on entry. Canada severely restricted its border access, barring travellers from all countries with some exceptions. Cases surged across Canada, notably in the provinces of British Columbia, Alberta, Quebec and Ontario, with the formation of the Atlantic Bubble, a travel-restricted area of the country (formed of the four Atlantic provinces). Vaccine passports were adopted in all provinces and two of the territories. Per a report on 11 November 2022, Canadian health authorities saw a surge in influenza, while COVID-19 was expected to rise during winter.

Economics

The pandemic and responses to it damaged the global economy. On 27 February 2020, worries about the outbreak crushed US stock indexes, which posted their sharpest falls since 2008.

Tourism collapsed due to travel restrictions, closing of public places including travel attractions, and advice of governments against travel. Airlines cancelled flights, while British regional airline Flybe collapsed. The cruise line industry was hard hit, and train stations and ferry ports closed. International mail stopped or was delayed.

The retail sector faced reductions in store hours or closures. Retailers in Europe and Latin America faced traffic declines of 40 per cent. North America and Middle East retailers saw a 50–60 per cent drop. Shopping centres faced a 33–43 per cent drop in foot traffic in March compared to February. Mall operators around the world coped by increasing sanitation, installing thermal scanners to check the temperature of shoppers, and cancelling events.

Hundreds of millions of jobs were lost, including more than 40 million jobs in the US. According to a report by Yelp, about 60% of US businesses that closed will stay shut permanently. The International Labour Organization (ILO) reported that the income generated in the first nine months of 2020 from work across the world dropped by 10.7%, or $3.5 trillion.

Pandemic fears led to panic buying, emptying groceries of essentials such as food, toilet paper, and bottled water. Panic buying stemmed from perceived threat, perceived scarcity, fear of the unknown, coping behaviour, and social psychological factors (e.g. social influence and trust).

Supply shortages were due to disruption to factory and logistic operations; shortages were worsened by supply chain disruptions from factory and port shutdowns, and labour shortages.

Shortages continued as managers underestimated the speed of economic recovery after the initial economic crash. The technology industry, in particular, warned of delays from underestimates of semiconductor demand for vehicles and other products.

According to WHO Secretary-General Tedros Ghebreyesus, demand for personal protective equipment (PPE) rose one hundredfold, pushing prices up twentyfold. PPE stocks were exhausted everywhere.

In September 2021, the World Bank reported that food prices remained generally stable and the supply outlook remained positive. However, the poorest countries witnessed a sharp increase in food prices, reaching the highest level since the pandemic began. The Agricultural Commodity Price Index stabilised in the third quarter but remained 17% higher than in January 2021.

By contrast, petroleum products were in surplus at the beginning of the pandemic, as demand for gasoline and other products collapsed due to reduced commuting and other trips. The 2021 global energy crisis was driven by a global surge in demand as the world economy recovered. Energy demand was particularly strong in Asia.

In May 2026, the US charged seven Chinese executives and four major container manufacturers, Singamas Container Holdings, China International Marine Containers, Shanghai Universal Logistics Equipment, and CXIC Group Containers, with conspiring to restrict shipping container production and fix prices from 2019 to 2024, contributing to global supply chain disruptions and higher consumer costs during the pandemic.

Politics

The pandemic affected political systems, causing suspensions of legislative activities, isolations or deaths of politicians, and rescheduled elections. Although they developed broad support among epidemiologists, NPIs (non-pharmaceutical interventions) were controversial in many countries. Intellectual opposition came primarily from other fields, along with heterodox epidemiologists.

The pandemic (and the response of Brazilian politicians to it) led to widespread panic, confusion, and pessimism in Brazil. When questioned regarding record deaths in the country in April 2020, Brazilian president Jair Bolsonaro said "So what? I'm sorry. What do you want me to do about it?" Bolsonaro disregarded WHO-recommended mitigation techniques and instead downplayed the risks of the virus, promoted increased economic activity, spread misinformation about the efficacy of masks, vaccines, and public health measures, and distributed unproven treatments including hydroxychloroquine and ivermectin. A series of federal health ministers resigned or were dismissed after they refused to implement Bolsonaro's policies.

Disagreements between federal and state governments led to a chaotic and delayed response to the rapid spread of the virus, exacerbated by preexisting social and economic disparities in the country. Employment, investment, and valuation of the Brazilian real plummeted to record lows. Brazil was also heavily affected by the Delta and Omicron variants. At the height of the outbreak in the spring of 2021, 3,000+ Brazilians were dying per day. Bolsonaro's loss to Lula da Silva in the 2022 presidential election is widely credited to the former's mishandling of the pandemic.

Multiple provincial-level administrators of the Chinese Communist Party (CCP) were dismissed over their handling of quarantine measures. Some commentators claimed this move was intended to protect CCP General Secretary Xi Jinping. The US intelligence community claimed that China intentionally under-reported its COVID-19 caseload. The Chinese government maintained that it acted swiftly and transparently. Journalists and activists in China who reported on the pandemic were detained by authorities, including Zhang Zhan, who was arrested and tortured.

In early March 2020, the Italian government criticised the EU's lack of solidarity with Italy. On 22 March 2020, after a phone call with Italian Prime Minister Giuseppe Conte, Russian president Vladimir Putin ordered the Russian army to send military medics, disinfection vehicles, and other medical equipment to Italy. In early April, Norway and EU states like Romania and Austria started to offer help by sending medical personnel and disinfectant, and European Commission president Ursula von der Leyen offered an official apology to the country.

Beginning in mid-April 2020, protestors objected to government-imposed business closures and restrictions on personal movement and assembly. Simultaneously, essential workers protested unsafe conditions and low wages by participating in a brief general strike. Some political analysts claimed that the pandemic contributed to US President Donald Trump's 2020 defeat to former Vice President Joe Biden and Senator Kamala Harris.

The COVID-19 pandemic in the United States prompted calls for the United States to adopt social policies common in other wealthy countries, including universal health care, universal child care, paid sick leave, and higher levels of funding for public health. The Kaiser Family Foundation estimated that preventable hospitalisations of unvaccinated Americans in the second half of 2021 cost US$13.8 billion.

There were also protest in regard to vaccine mandates in the United States. In January 2022, the US Supreme Court struck down an OSHA rule that mandated vaccination or a testing regimen for all companies with greater than 100 employees.

The number of journalists imprisoned or detained increased worldwide; some detentions were related to the pandemic. The planned NATO "Defender 2020" military exercise in Germany, Poland, and the Baltic states, the largest NATO war exercise since the end of the Cold War, was held on a reduced scale.

The Iranian government was heavily affected by the virus, which infected some two dozen parliament members and political figures. Iranian president Hassan Rouhani wrote a public letter to world leaders asking for help on 14 March 2020, due to a lack of access to international markets. Saudi Arabia, which had launched a military intervention in Yemen in March 2015, declared a ceasefire.

Diplomatic relations between Japan and South Korea worsened. South Korea criticised Japan's "ambiguous and passive quarantine efforts" after Japan announced travellers from South Korea must quarantine for two weeks. South Korean society was initially polarised on president Moon Jae-in's response to the crisis; many Koreans signed petitions calling for Moon's impeachment or praising his response.

Some countries passed emergency legislation. Some commentators expressed concern that it could allow governments to strengthen their grip on power. In Hungary, the parliament voted to allow Prime Minister Viktor Orbán to rule by decree indefinitely, suspend parliament and elections, and punish those deemed to have spread false information. In countries such as Egypt, Turkey, and Thailand, opposition activists and government critics were arrested for allegedly spreading fake news. In India, journalists criticising the government's response were arrested or issued warnings by police and authorities.

Health

The pandemic impacted global health for many conditions. Hospital visits fell. Visits for heart attack symptoms declined by 38% in the US and 40% in Spain. The head of cardiology at the University of Arizona said, "My worry is some of these people are dying at home because they're too scared to go to the hospital". People with strokes and appendicitis were less likely to seek treatment. Medical supply shortages impacted many people. The pandemic impacted mental health, increasing anxiety, depression, and post-traumatic stress disorder, affecting healthcare workers, patients, and quarantined individuals.

In late 2022, during the first northern hemisphere autumn and winter seasons following the widespread relaxation of global public health measures, North America and Europe experienced a surge in respiratory viruses and coinfections in both adults and children. This formed the beginning of the 2022–2023 paediatric care crisis and what some experts termed a "tripledemic" of seasonal influenza, respiratory syncytial virus (RSV), and SARS-CoV-2 throughout North America. In the United Kingdom, paediatric infections also began to spike beyond pre-pandemic levels, albeit with different illnesses, such as Group A streptococcal infection and resultant scarlet fever. As of mid-December 2022, 19 children in the UK had died due to Strep A and the wave of infections had begun to spread into North America and Mainland Europe.

The B/Yamagata lineage of influenza B might have become extinct in 2020/2021 due to COVID-19 pandemic measures. There have been no naturally occurring cases confirmed since March 2020. In 2023, the WHO concluded that protection against the Yamagata lineage was no longer necessary in the seasonal flu vaccine, reducing the number of lineages targeted by the vaccine from four to three.

Preventative measures taken during the COVID-19 pandemic may have impacted the number of bronchiolitis cases, with observed decreases in cases during the pandemic followed by an increase when preventative measures were rolled back.

Transition to later phases

A March 2022 review declared a transition to endemic status to be "inevitable". In June 2022, an article in Human Genomics said that the pandemic was still "raging", but that "now is the time to explore the transition from the pandemic to the endemic phase". Another review that month predicted that the virus that causes COVID-19 would become the fifth endemic seasonal coronavirus, alongside four other human coronaviruses. A February 2023 review of the four common cold coronaviruses concluded that the virus would become seasonal and, like the common cold, cause less severe disease for most people. Another 2023 review stated that the transition to endemic COVID-19 may take years or decades.

On 5 May 2023, the WHO declared that the pandemic was no longer a public health emergency of international concern. This led several media outlets to incorrectly report that this meant the pandemic was "over". The WHO commented to Full Fact that it was unlikely to declare the pandemic over "in the near future" and mentioned cholera, which it considers to have been a pandemic since 1961 (i.e., continuously for the last 65 years). The WHO does not have an official category for pandemics or make declarations of when pandemics start or end. In June 2023, Hans Kluge, director of the WHO in Europe, commented that "While the international public health emergency may have ended, the pandemic certainly has not".

Epidemics and pandemics usually end when the disease becomes endemic, and when the disease becomes "an accepted, manageable part of normal life in a given society". As of March 2024, there was no widely agreed definition of when a disease is or is not a pandemic, though efforts at a formal definition were underway. Experts asked by Time that month noted that COVID-19 continued to circulate and cause disease, but expressed uncertainty as to whether it should still be described as a pandemic. In December 2024, Director-General of the World Health Organization Tedros Adhanom Ghebreyesus stated that COVID should not be referred to in past tense as it is "still with us, still causes acute disease and Long COVID and still kills... The world might want to forget about COVID-19, but we cannot afford to."

By 2025, five years after the start of the pandemic, experts asked by The Independent and The Washington Post generally considered COVID-19 to have become endemic. Cases and deaths from COVID-19 still remained high; in the United States, the only two infectious diseases causing more than 10,000 deaths a year were flu and COVID, according to an expert in The Washington Post.

COVID-19 pandemic

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COVID-19 pandemic

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COVID-19 pandemic across IJR

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