The 2020 coronavirus epidemic has become one of the worst global health emergencies in recent years. It has been compared more than once to the SARS outbreak in 2003 and the MERS one in 2012. Likewise in these earlier two cases, the world was faced with the spread of a coronavirus, which is a family of viruses responsible for various types of respiratory infections that can be associated with both the common cold and more serious illnesses like pneumonia. The epidemic that emerged between the end of 2019 and beginning of 2020 is that of a still-unknown branch of coronavirus called COVID-19.

Initial alarm from China

In December 2019, Chinese health officials began to realize that they were facing a rather unexpected situation. In Wuhan city in particular, the hospitalization of patients with a very contagious and unusual type of pneumonia kept popping up. There were suspicions that this was a new type of virus, still unknown and unclassified by the scientific community. The local authorities could be dealing with a repeat of the dramatic experience the country went through during the SARS epidemic of 2003, which developed in China and sparked a global health emergency within a few weeks. Fearing the backlash this could have on their image and economy, the Chinese government initially gave no clear sign of a problem.

However, the reports from hospitals in Hubei province, where Wuhan is the capital city, continued to speak of infections from an unknown virus for the entirety of the final month of 2019. The Chinese scientific community began to examine various cases, hoping to better understand what could potentially become a very grave situation. A doctor from Wuhan, Li Wenliang, set off a few alarms on social media about the danger of the unknown virus owing to the speed with which it could spread. The first official case came on December 8, 2019, with the virus infecting a group of people. These cases all pointed to a fish and animal market in Wuhan. It would seem that from there, according to initial reports, the virus was transmitted from animals to humans by an unspecified species, sparking the epidemic. On December 31, the first official communication from the Chinese government was sent to the World Health Organization about the possibility of a new virus.

Confirmation of the existence of a new virus

After the official report sent by Beijing to the WHO, health officials in the country began implementing certain measures. On January 1, 2020, the Wuhan market where the infection was thought to have started was closed while some patients were put in isolation. Local authorities imposed quarantines on those who had been in contact with people showing symptoms of the virus.

The first turning point from a scientific perspective came on January 7. Authorities in Beijing officially confirmed that they were dealing with a new type of virus from the coronavirus family. This initiated more extensive studies on various cases and illnesses, an essential part of better understanding the characteristics of the epidemic and the virus itself. On January 9, in light of the news from China and communication from Beijing, the WHO made the appearance of a new virus official. That same day, the first fatality from the epidemic was reported from Wuhan.

China’s draconian measures

After the second half of January, the characteristics of the infection became much clearer and much more serious. The virus proved to be highly contagious. The number of patients involved grew significantly both in Wuhan and in Hubei province. And the first cases from other areas of China were reported. In short, the invisible enemy demonstrated that it was much more powerful than expected, to the point that Beijing, after its initial measures at the beginning of the year, decided to implement a much more drastic approach aimed at containing the epidemic as much as possible. It started with the cancellation of events celebrating the Chinese New Year, the most important holiday for the Chinese population, during which millions of people travel to the country. On January 23, a full quarantine of the 11 million inhabitants of Wuhan was enforced a few days after the same measure was put in place for the entire Hubei province, where a total of 60 million people were isolated from the rest of China and the world.

The emergency then reached many other provinces, including that of the capital, Beijing, as well as Shanghai and other major cities in the country. By the end of January, the whole country had stopped: many factories halted activity, including those of foreign multinational companies; various production chains were stopped; and millions of students were sent home due to school and university closures. In all the most important cities, entry limits and checks were put in place, public transportation was suspended and rigid checks at airports were implemented. China decided to interrupt daily life as they waited for the expected peak in infected cases and to start, immediately after, decreasing that number. By January 31, the number of people affected by the virus had almost reached 10,000, including 203 fatalities. On January 25, the President of the People’s Republic of China, Xi Jinping, spoke about the emergency for the first time, admitting that the difficult situation had become a very serious danger for the country. On January 26, the WHO raised the global alert from “medium” to “high” and “very high” for China. In the meantime, to make room for the high number of hospitalized citizens in Wuhan, the government decided to build two hospitals in a week in order to provide more beds for infected patients since the existing ones had filled up due to the spread of the epidemic, in the hopes that this would prevent the collapse of the health system.

An international emergency

In January, the situation in China was critical, with active epicenters across the country, in addition to the most widespread and problematic one in Hubei province. The Chinese government aimed to prevent even more epicenters from forming out of Wuhan by enforcing countermeasures to limit the spread to even more provinces. Between the end of January and beginning of February, the problem became an international issue. This was not only due to the registered cases in those going abroad from China during the explosion of the epidemic but also because, according to the WHO, there was a high risk that the virus could spread around the globe.

Many countries began to adopt restrictive measures in their ties to China starting at the end of January: Russia closed its borders, many European countries imposed very strict checks in airports for passengers arriving from Asian countries, and Italy decided to completely stop all flights to and from China. These types of measures were set by other governments around the world with the intention of isolating the epicenters in China as much as possible.

The first infections in other countries

On January 21, a traveler who had landed in the US from China tested positive. This incident aroused a lot of media attention because it confirmed that the emergency concerning the coronavirus, which had been given the official name of COVID-19, was of international importance. In Europe, the first two cases were reported in France on January 24. Once again, the infected patients had recently been to China. That same day, the first case was found in Singapore, whereas on the 27, both China and Germany reported their first cases. The presence of COVID-19 arrived in Italy on January 30 in the positive tests of a Chinese couple on vacation in the country. They were then hospitalized and isolated at the Spallanzani hospital in Rome.

The first serious concerns outside of China came from Thailand, where 14 cases had been confirmed by January 28. Because the country’s health system is considerably weaker than that of other affected countries, all eyes were worriedly focused on Bangkok. January also saw outbreaks in South Korea and Japan. On February 5, there was a major outbreak on the Diamond Princess cruise ship, which anchored in Yokohama after some cases were discovered on it. The Japanese authorities quarantined all passengers on board, a choice that generated much criticism as the cases on board significantly increased. By mid-February, 54 percent of the COVID-19 cases confirmed outside of China were on the Diamond Princess.

On February 14, the first case of infection is discovered in Africa in a person who had returned from China to Egypt. Authorities in Cairo managed to isolate the patient and prevent further problems on the African continent, which has been under close observation due to the fragile health systems and close ties to China in many countries. On February 15, the first coronavirus death in Europe was reported from France. The victim was an 80-year-old Chinese tourist. On February 19, Iran reported its first cases.

Initial economic damage caused by the coronavirus

Activity in China has almost completely ceased since the end of January. From factories to offices, the international headquarters of multinational companies to the businesses that produce vehicles for the West, a significant part of the country waits with crossed arms following the government’s severe measures put in place to combat the virus. This has very negative effects on the economy not only for China but for the whole international community. Many car manufacturers, for example, had to stop production not only because certain factories are shut down in the Asian country but also because those in Europe receives important parts that are produced only in China. The same problem applies to other important sectors, which has had adverse effects on the most important international stock markets and global economic growth.

It’s also noteworthy that the closing of many businesses in China has caused, among other things, a drastic drop in consumption. This has impacted the demand of oil more than anything, which has been noticeably decreasing since January with increasingly lower prices. It’s possible that the economic consequences of the epidemic will be felt around the world throughout all of 2020 – even longer if the virus were to persist.

Infections in South Korea and Japan

Starting in mid-February, China began to see the initial effects of Xi Jinping’s measures. According to several experts, the country had started to descend from the peak of the outbreak, with the number of new cases presenting the first slight decrease.

In Hubei province, the situation has always been described as serious, but in Wuhan, the lines in hospitals have begun to dwindle. On February 23, the government in Beijing eliminated many precautionary measures in at least six provinces and permitted residents of Wuhan to leave the quarantine and return to their home cities. In recent weeks, the virus has become less mysterious: COVID-19 is being studied in China as well as in the rest of the world, and its main characteristics have been identified, including its highly contagious nature – higher than that of the 2003 SARS – and the fact that it can be transmitted even by asymptomatic patients. After that, data supporting the possibility of an incubation period of up to 14 days was discovered as well as the possibility of a mortality rate between 2 and 3 percent. On the other hand, a large number of patients have been cured, and many have been discharged from hospitals.

Starting in February, the coronavirus began to hit outside China. In Japan, the authorities have still not actually put an emergency system in place, possibly intended to not compromise the country’s image ahead of the 2020 Olympics in Tokyo. But the epicenters in some major cities, and especially the one on the island of Hokkaido, are worried. On February 29, the cases reported in Japan reached 241, including 4 victims. There are additionally the numbers from the Diamond Princess, the cruise ship anchored in Yokohama. The situation provoked certain controversy for the Japanese government over the way it was managed: the epicenter on board contained at least 705 infected people and caused six deaths. The last passengers left the ship on February 29 after spending a month on board.

After China, however, the most worrying country is South Korea, where the first case was detected in a woman who had returned from China on January 20. From there, the authorities began to carefully watch the evolution of the virus. But on February 19, South Korean officials reported at least 20 more cases within 24 hours and 70 the following day. The sudden hike in numbers was attributed to the so-called “Patient 31”, a 61-year-old woman belonging to the sect of the Shincheonji Church of Jesus. She was supposedly the one to have infected many people in the city of Daegu, where she participated in the church’s convention and attended several masses and at least one funeral. At these events, the woman became a super-spreader, managing to spread the coronavirus in Daegu in a short amount of time. Cases in the country grew, especially in Daegu, and by February 29, the total number of affected people had reached 3,150, including 16 victims.

The coronavirus in Italy

During the night of February 20 in Codogno, in the Lodi province of Northern Italy, a 38-year-old man was hospitalized for respiratory problems at a local hospital. Given his symptoms, a few tests were done to check for the possible presence of COVID-19. The tests came back positive. Up until this point, there were only three confirmed cases in Italy: the Chinese couple on vacation and a boy hospitalized in Rome who had contracted the virus in Wuhan. Since the 38-year-old had not been to China recently, he was the first case of direct infection in Italy. He was put under intensive care and became “Patient 1”. Initially, it was thought that this man, who unfortunately found himself in the spotlight of an outbreak, had contracted the virus from a friend, a businessman who had recently returned from China; however, this friend’s tests came back negative. Still today, no one knows who the Italian “Patient 0” is. In addition to the 38-year-old from Codogno, his wife and a friend had been infected. On February 21, another two cases were discovered in the Padua province.

From then on, the Italian authorities saw exponential growth in the number of confirmed cases, reaching more than a hundred in 48 hours. This situation incited panic within the country, especially in Northern Italy. In Milan, supermarkets were mobbed over fears of possible quarantines and measures similar to those in China. Across Italy, masks flew off the shelves, along with hand sanitizer and other hygiene products. From February 24, a “red zone” was declared in Lodi province, which isolated ten towns. In Lombardy, where Lodi province is located, as well as in Veneto, Emilia Romagna and Piedmont, many new cases were discovered, causing school closures and the postponement of several Serie A football matches and other sporting events. Within 10 days of the discovery of the first case in Italy, the main epicenters were still only those in Veneto and Lombardy, even though there were cases in at least ten regions. With more than a thousand confirmed cases and 29 deaths, Italy had become the third most affected country, after China and South Korea, by February 29. One statistic revealed that the epicenters in Northern Italy had sparked infections in 17 other countries around the world, thanks also to travel abroad by residents from the affected areas.

The Coronavirus in Iran

As was previously noted, the first cases of infection reported by Tehran occurred on February 19. However, something about the government’s data didn’t fully make sense. More specifically, there was a significant gap in the number of infected people and the number of deaths. At the end of February, the coronavirus in Iran had killed almost 20 percent of the infected patients, a percentage that is unusually high, given that it had never reached more than 3 percent globally. A statement from the conservative parliament member Ahmad Amirabadi Farahani, who said that Qom alone had reported at least 50 victims, confirmed that the situation had potentially gotten out of hand. The Iranian government initially minimized it, claiming that everything was under control. But then the deputy health minister, Iraj Harirchi, tested positive for COVID-19. This incident made it clear that the situation in Iran was potentially very serious. A few days after the political official reported that he had the virus, Iranian TV began to show images of holy sites in Qom, the city the epidemic spread from, being disinfected while the parliamentary elections of February 21 were influenced by fears of an increase in cases.

Many voters were checked for fevers, and most people showed up to the ballot box wearing masks. In the following days, four members of parliament tested positive for coronavirus. On February 29, there were almost a thousand cases, and 49 people had died. The highest number after China.

The situation in Iran is worrying for two reasons: on one hand, because of the national health system that has been tested by Western sanctions for years and worsened by the US under Donald Trump’s presidency; on the other hand, because a spread within the country could be problematic for the whole Middle East region. Lebanon, Oman, Iraq, Kuwait, Bahrain and the UAE have all reported cases in people who came from Iran.

Positive signs in China

A month after the emergency in Wuhan, China has “woken up” from the nightmare to serious difficulties and major economic repercussions due to their fight against the virus. On February 29, there were 79,000 confirmed cases, with more than 2,500 fatalities. This is a heavy toll for a nation forced to fight one of the most significant epidemics of recent years. A symbol of that battle was Li Wenliang, the young doctor who was one of the first to speak up about the presence of a potentially new virus in the city of Wuhan and who, on February 6, died because of it.

The government in Beijing sent doctors and military members to Hubei province, where at least ten new hospitals had been built and work and recreational activities had been suspended. In the second half of February, the trend of new daily cases began to decrease, with fewer infected citizens, especially in the provinces least affected by the virus.

The Chinese government has not declared the emergency over, but it spoke of the first positive signs. With an increasingly lower number of patients in hospitals, both due to fewer new infections and a greater number of discharged people who have been cured, the health system has slowly become less burdened, especially in the bigger cities outside the red zone of Hubei province. The goal of the government, which admitted it was initially unprepared in dealing with the emergency and which removed the heads of the communist party in Wuhan in February, is to end the first phase of the emergency by spring and allow the Chinese economy to resume business gradually.

Studying the virus around the world

Beyond the Chinese situation, all eyes are on the development of the epidemic in the rest of the world. In March, the WHO could declare this an official pandemic, which means an epidemic has spread to all corners of the globe, and therefore, is an emergency that involves all international parties. Since February, COVID-19 has become an emergency for not only China but all countries exposed to the virus and those who could become involved in the future. Scientists are busy studying the virus, and more importantly, are in search of a vaccine. In Australia, China, the US, Israel, Italy and other European countries, researchers are trying to speed up the possibility of making a vaccine available. Optimistic observers estimate it will be ready within three to six months, whereas others say it will take up to 12 to 18 months.

Various studies have come up with a few hypotheses regarding both the origin of the virus and its future development. One Italian study, in particular, has brought attention to the fact that the virus already existed in September and October, before the number of cases unexpectedly grew in December. It’s difficult to identify which animal could have transmitted the virus to humans. The fact that Chinese authorities initially pointed fingers at the Wuhan market makes it seem that the coronavirus originated in bats, snakes or other wild animals that are sold in more rural areas of China.

In terms of the future development of the virus, a few distinct directions have been hypothesized: either COVID-19 will be completely eradicated thanks to containment measures enacted by highly impacted countries, as was the case with SARS in 2003; or, in the opposite case, we will have to coexist with the virus for the next few years. In the latter possibility, COVID-19 could turn up in the future as a flu-like virus and continue to infect thousands of people around the world, only in a weaker way, one that wouldn’t debilitate global health systems.