What’s the Difference Between Pandemic, Epidemic and Outbreak?
By Rebecca S.B. Fischer
The coronavirus is on everyone's minds. As an epidemiologist, I find it interesting to hear people using technical terms – like quarantine or super spreader or reproductive number – that my colleagues and I use in our work every day.
But I'm also hearing newscasters and neighbors alike mixing up three important words: outbreak, epidemic and pandemic.
Simply put, the difference between these three scenarios of disease spread is a matter of scale.
Small, but unusual.
By tracking diseases over time and geography, epidemiologists learn to predict how many cases of an illness should normally happen within a defined period of time, place and population. An outbreak is a noticeable, often small, increase over the expected number of cases.
Imagine an unusual spike in the number of children with diarrhea at a daycare. One or two sick kids might be normal in a typical week, but if 15 children in a daycare come down with diarrhea all at once, that is an outbreak.
When a new disease emerges, outbreaks are more noticeable since the anticipated number of illnesses caused by that disease was zero. An example is the cluster of pneumonia cases that sprung up unexpectedly among market-goers in Wuhan, China. Public health officials now know the spike in pneumonia cases there constituted an outbreak of a new type of coronavirus, now named SARS-CoV-2.
As soon as local health authorities detect an outbreak, they start an investigation to determine exactly who is affected and how many have the disease. They use that information to figure out how best to contain the outbreak and prevent additional illness.
Bigger and spreading.
An epidemic is an outbreak over a larger geographic area. When people in places outside of Wuhan began testing positive for infection with SARS-CoV-2 (which causes the disease known as COVID-19), epidemiologists knew the outbreak was spreading, a likely sign that containment efforts were insufficient or came too late. This was not unexpected, given that no treatment or vaccine is yet available. But widespread cases of COVID-19 across China meant that the Wuhan outbreak had grown to an epidemic.
International and out of control.
In the most classical sense, once an epidemic spreads to multiple countries or regions of the world, it is considered a pandemic. However, some epidemiologists classify a situation as a pandemic only once the disease is sustained in some of the newly affected regions through local transmission.
To illustrate, a sick traveler with COVID-19 who returns to the U.S. from China doesn't make a pandemic, but once they infect a few family members or friends, there's some debate. If new local outbreaks ensue, epidemiologists will agree that efforts to control global spread have failed and refer to the emerging situation as a pandemic.
Terms Are Political, Not Just Medical
As of this writing, the World Health Organization classifies the risk of global COVID-19 spread as "very high," the highest level in their risk classification scheme and one step below an official pandemic declaration. This means that the WHO remains hopeful that, by taking aggressive steps now, containment of localized outbreaks may still be possible.
But I and other scientists and public health officials are already calling this a pandemic. The official numbers count an excess of 100,000 cases in almost 100 countries, and community spread has been documented in the U.S. and elsewhere. By the classical definition, it's a pandemic.
A formal declaration of COVID-19 or any other infectious disease as pandemic tells governments, agencies and aid organizations worldwide to shift efforts from containment to mitigation. It has economic, political and societal impacts on a global scale.
Formal declaration needn't incite fear or cause you to stockpile surgical masks. It doesn't mean the virus has become more infectious or more deadly, nor that your personal risk of getting the disease is greater. But it will be a historical event.
Reposted with permission from The Conversation.
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By Joe Roman and Taylor Ricketts
The COVID-19 pandemic in the United States is the deepest and longest period of malaise in a dozen years. Our colleagues at the University of Vermont have concluded this by analyzing posts on Twitter. The Vermont Complex Systems Center studies 50 million tweets a day, scoring the "happiness" of people's words to monitor the national mood. That mood today is at its lowest point since 2008 when they started this project.
The Hedonometer measures happiness through analysis of key words on Twitter, which is now used by one in five Americans. This chart covers 18 months from early 2019 to July 2020, showing major dips in 2020. hedonometer.org<p>These same tweets also indicate a potential salve. Before pandemic lockdowns began, doctoral student <a href="https://scholar.google.com/citations?user=0P0ZYbIAAAAJ&hl=en" target="_blank">Aaron Schwartz</a> <a href="https://doi.org/10.1002/pan3.10045" target="_blank">compared tweets before, during, and after visits to 150 parks, playgrounds and plazas</a> in San Francisco. He found that park visits corresponded with a spike in happiness, followed by an afterglow lasting up to four hours.</p><p>Tweets from parks contained fewer negative words such as "no," "not" and "can't," and fewer first-person pronouns like "I" and "me." It seems that nature makes people more positive and less self-obsessed.</p><p>Parks keep people happy in times of global crisis, economic shutdown and public anger. Research has also shown that transmission rates for COVID-19 are <a href="https://www.sfchronicle.com/news/article/Is-risk-of-coronavirus-transmission-lower-15287602.php" target="_blank">much lower outdoors than inside</a>. As scholars who study <a href="https://scholar.google.com/citations?user=yFzb2EUAAAAJ&hl=en" target="_blank">conservation</a> and how nature <a href="https://scholar.google.com/citations?user=CCnUeN8AAAAJ&hl=en" target="_blank">contributes to human well-being</a>, we see opening up parks and creating new ones as a straightforward remedy for Americans' current blues.</p>
Park Visits Are Up During the Pandemic<p>According to the Hedonometer, sentiments expressed online started trending lower in mid-March as the impacts of the pandemic became clear. As lockdowns continued, they registered the lowest sentiment scores on record. Then in late May, effects from George Floyd's death in police custody and the following protests and police response once again could be seen on Twitter. May 31, 2020 was the saddest day of the project.</p><p>Recent surveys of park visitors around the University of Vermont have shown people <a href="https://osf.io/preprints/socarxiv/sd3h6" target="_blank">using green spaces more</a> since COVID-19 lockdowns began. Many people reported that parks were highly important to their well-being during the pandemic.</p>
<div id="4c7e4" class="rm-shortcode" data-rm-shortcode-id="bc0ac146ab2a94228f32d973fc2ab272"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1289428912879964160" data-partner="rebelmouse"><div style="margin:1em 0">#Goldengatepark #sf #quarantinemood https://t.co/9l3ufnbkt6</div> — Suvd (@Suvd)<a href="https://twitter.com/Suvd19486406/statuses/1289428912879964160">1596258783.0</a></blockquote></div><p>The powerful effects of nature are strongest in large parks with more trees, but smaller neighborhood parks also provide a significant boost. Their impact on happiness is real, measurable and lasting.</p><p>Twitter records show that parks increase happiness to a level similar to the bounce at Christmas, which typically is the happiest day of the year. Schwartz has since expanded his <a href="https://arxiv.org/pdf/2006.10658.pdf" target="_blank">Twitter study</a> to the 25 largest cities in the U.S. and found this bounce everywhere.</p><p>Parks and public spaces won't cure COVID-19 or stop police brutality, but they are far more than playgrounds. There is growing evidence that parks contribute to mental and physical health in a range of communities.</p><p>In a 2015 study, for example, Stanford researchers sent people out for one of two walks: through a local park or on a busy street. Those who walked in nature showed <a href="https://doi.org/10.1016/j.landurbplan.2015.02.005" target="_blank">improved moods and better memory performance</a> compared to the urban group. And a team led by <a href="https://penniur.upenn.edu/people/eugenia-gina-south" target="_blank">Gina South</a> of the University of Pennsylvania showed in a 2018 study that greening and cleaning up blighted vacant lots in Philadelphia <a href="http://dx.doi.org/10.1001/jamanetworkopen.2018.0298" target="_blank">reduced local residents' feelings of depression, worthlessness and poor mental health</a>.</p>
Creative Strategies<p>It isn't easy to create new parks on the scale of San Francisco's Golden Gate Park or the Washington Mall, but smaller projects can expand outdoor space. Options include greening vacant lots, closing streets and investing in existing parks to make them safer, greener and shadier and support wildlife.</p><p>These initiatives don't have to be capital-intensive. In the University of Pennsylvania study, for example, renovating a vacant lot by removing trash, planting grass and trees and installing a low fence cost only about US$1,600.</p><p>Urban green space is most needed in neighborhoods that have lacked funding for parks, especially given <a href="https://www.nytimes.com/2020/04/08/nyregion/coronavirus-race-deaths.html" target="_blank">COVID-19's disproportionate impact on Black and Latinx people</a>.</p><p>Cities can also create parklike spaces by <a href="https://theconversation.com/with-fewer-cars-on-us-streets-now-is-the-time-to-reinvent-roadways-and-how-we-use-them-140408" target="_blank">closing streets to cars</a>. Many cities worldwide are currently retooling their transportation systems for the post-COVID-19 world in order to <a href="https://thecityfix.com/blog/bicycles-slower-speeds-livable-city-paris-mayor-anne-hidalgo-plans-ambitious-second-term-dario-hidalgo/" target="_blank">reallocate public space</a>, widen sidewalks and make more space for nature.</p><p>Urban designers, artists, ecologists and other citizens can play a direct role, too, creating pop-up parks and green spaces. Some advocates <a href="https://www.bloomberg.com/news/articles/2017-09-15/a-brief-history-of-park-ing-day" target="_blank">transform parking spaces into mini-parks</a> with grass, potted trees and seating for just the time on the meter, to make a larger point about turning so much public space over to cars.</p><p>Or cities can invest a little more. Minneapolis, Cincinnati and Arlington, Virginia, have won <a href="https://www.tpl.org/parkscore" target="_blank">national recognition</a> for their ambitious investments in public park systems. These areas could serve as models for neighborhoods that lack access to parks.</p>
<div id="25fd0" class="rm-shortcode" data-rm-shortcode-id="383f0d2df0237e9359c30dcce6cd6c42"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1276558744835379201" data-partner="rebelmouse"><div style="margin:1em 0">Looking to safely get outside? Check out the best parks for social distancing in this year's top ten ParkScore citi… https://t.co/HJjEtDsrTD</div> — The Trust for Public Land (@The Trust for Public Land)<a href="https://twitter.com/tpl_org/statuses/1276558744835379201">1593190296.0</a></blockquote></div>
A New Park Deal?<p>The United States has historically driven economic recovery with major infrastructure investments, like the New Deal in the 1930s and the 2009 <a href="https://www.investopedia.com/terms/a/american-recovery-and-reinvestment-act.asp" target="_blank">American Reinvestment and Recovery Act</a>. Such investments could easily include nature-positive spaces.</p><p>Parks are not panaceas, as evidenced by the widely publicized <a href="https://www.nytimes.com/2020/07/06/nyregion/amy-cooper-false-report-charge.html" target="_blank">racist confrontation between a white woman and a Black birder</a> in New York's Central Park in early July. But Hedonometer data add to a <a href="https://advances.sciencemag.org/content/5/7/eaax0903?utm_source=miragenews&utm_medium=miragenews&utm_campaign=news" target="_blank">growing body of evidence</a> that they provide <a href="https://doi.org/10.1073/pnas.1807504116" target="_blank">clear mental health benefits</a>. Creating and expanding parks also <a href="https://www.nrpa.org/contentassets/f568e0ca499743a08148e3593c860fc5/economic-impact-study-summary.pdf" target="_blank">generates jobs and economic activity</a>, with much of the money spent locally.</p><p>We believe investments in nature are well worth it, offering both short-term solace in difficult times and long-term benefits to health, economies and communities.</p>
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By Gianna-Carina Grün
While the first countries are easing their lockdowns, others are reporting more and more new cases every day. Data for the global picture shows the pandemic is far from over. DW has the latest statistics.
What's the Current Global Trend?<p>The goal for all countries is to make it to the blue part of the chart and stay there. Countries and territories in this section reported zero new cases both this week (past seven days) and the week before.</p><p>Currently, that is the case for 14 out of 209 countries and territories. </p>
How Has the Covid-19 Trend Evolved Over the Past Weeks?<p>The situation has improved slightly: 87 countries report more cases this week than last week. </p>
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