What the decision to call the COVID-19 outbreak a pandemic means for Canada and the world

The World Health Organization's decision to classify the coronavirus outbreak as a pandemic has implications for every country in the world, but experts say Canada is well positioned to respond to the crisis. 

"In the days and weeks ahead, we expect to see the number of COVID-19 cases, the number of deaths, and the number of affected countries climb even higher," WHO Director-General Tedros Adhanom Ghebreyesus told a news conference on Wednesday.

"We are deeply concerned both by the alarming levels of spread and severity, and by the alarming levels of inaction. We have therefore made the assessment that COVID-19 can be characterized as a pandemic."

Some countries such as China, South Korea and Singapore have been able to control outbreaks. But other countries need to act more aggressively, he cautioned.  

When asked which countries aren't doing enough to control the outbreak, Dr. Mike Ryan, head of WHO's health emergencies program, would not specify.  

"You know who you are," he said. 

What is a pandemic?

WHO defines a pandemic as the consistent spread around the world of a new disease to which the population has not yet gained immunity. The definition does not take into account the severity of illness — just how common it is now.  

Tedros said describing the situation as a pandemic does not change the WHO's assessment of the threat posed by the coronavirus, or how countries or the WHO should respond.

What sets this apart from previous pandemics, such as the one caused by 2009 H1N1 flu, is that it was sparked by a coronavirus.

Ryan said health officials take the pandemic characterization seriously. 

"The fact is right now in countries, we have front-line health workers who need our help," he said. "We have hospitals who need our support."

'Glad they finally did it'

Dr. Michael Gardam, an infectious disease physician and chief of staff at Humber River Hospital in Toronto, welcomed the pandemic call.

"Truthfully, I'm glad they finally did it," Gardam said on CBC News Network. "We've been seeing this spread around the world and clearly it's not being stopped."

On Wednesday evening, U.S. President Donald Trump suspended all travel from Europe for 30 days, beginning Friday at midnight in an effort to combat the pandemic.

As well, the NBA suspended its entire season indefinitely after a Utah Jazz player tested positive Wednesday for the coronavirus. 

And actors Tom Hanks and Rita Wilson say they both have COVID-19.

Gardam said for anyone in Canada who's been living in a "wishful bubble," thinking the outbreak is happening elsewhere, the WHO's decision bursts that bubble.

"This is really something which is a real threat to Canadians and we need to be thinking that way," he said.

While travel from other affected regions accounted for all cases here at the beginning, Canadians "really need to think about control measures here at home now," said Gardam. 

"Now it's a matter of symptoms or not. If you don't have symptoms — go about your life. If you are feeling flu-like symptoms, then stay away from people."

Gardam cited the example of Italy, where weeks ago there were just a handful of cases that have since exploded. 

"By the time you start to get an inkling that you have spread in the broader general public, you need to act now if you're going to slow this down," he said. "It's not a matter of stopping it, but it's about slowing it down."

'U.S. probably the tipping point'

Jason Kindrachuk, an assistant professor and Canada Research Chair in emerging viruses at the University of Manitoba, said the reason the WHO made the decision Wednesday was because of the spread of the pandemic in Italy, Iran and the U.S. 

"I think the U.S. was probably the tipping point in a lot of ways," he said, adding there was a belief that their health care systems would be able to contain the outbreak. 

"And we've seen that obviously that that is not been the case in the U.S." 

What changes for Canada? 

Chief Public Health Officer Dr. Theresa Tam said late last month that Canada's pandemic response plan is already in motion, and that Canada's course of action would be much the same whether the WHO declared a pandemic or not.  

Gardam says Canadians need to shift their thinking about the outbreak and focus on what's known as "social distancing," by avoiding large gatherings, cancelling conferences and staying away from others who may be ill — without going overboard and hoarding supplies.

"I'm definitely avoiding larger crowds now because I cannot afford to get sick in my work here," he said. 

"But I also haven't run out to the store and bought four month supplies of water and toilet paper." 

Kindrachuk says that if each person is in close contact with fewer people, then the virus has fewer opportunities to spread.

We're going to see a lot more conversation about what do we do about things like concerts or sporting events or even university classes.- Jason Kindrachuk, emerging viruses researcher, University of Manitoba

"Once we see large groups of people kind of conglomerating, that creates a perfect incubator for disease spread," he said. 

"We're going to see a lot more conversation about what do we do about things like concerts or sporting events or even university classes. I think all these things are going to be on the table very quickly for discussion." 

One area that experts agree on, is that Canada's health care system needs to stay alert and prepared for the spread of the outbreak domestically. 

"I think we're very early on in the course of the epidemic in Canada and we will certainly be seeing more and more cases in the days and weeks ahead," Dr. Isaac Bogoch, an infectious disease physician at Toronto General Hospital. 

"We're likely going to see more cases imported from a growing number of countries and then we're also going to see more locally-acquired cases here in the country as well."