Story at a glance

  • The COVID-19 outbreak is not a pandemic, says WHO Director General.
  • There is no official scientific definition of a pandemic.
  • In the U.S., each state has protocols for reporting infectious diseases.

The World Health Organization (WHO) disease reporting procedure involves government health officials submitting reports of disease cases. The WHO provides resources for setting up disease surveillance systems with specific recommendations for known diseases. For new diseases, the individual government’s health agencies may determine when to report cases of unknown causes.

In the U.S., individual states have their own systems and protocols for disease reporting. For example, New York states that reporting communicable diseases is the responsibility of physicians but also school nurses, laboratory directors, health care facilities and others. Nationally, the Centers for Disease Control and Prevention (CDC) maintains a list of notifiable diseases that health institutions are recommended to report new cases of regularly. The numbers from these diseases go into the CDC’s Morbidity and Mortality Weekly Report.

There are also specialists whose jobs are to analyze data about disease cases reported and look for trends. Experts use statistical models to detect potential patterns that could find outbreaks at their early stages. For example, for foodborne pathogens there is a national network of laboratories that share data about things like salmonella and E. coli. There are other national networks in the U.S. that are focused on other issues like antimicrobial resistance.

Coordination of information forms the basis of disease surveillance. Once that information is pulled together, it’s up to health officials at the top to make decisions about what should be done or recommended to be done about a potential outbreak, if anything. In the U.S., that’s the CDC. Globally, that’s WHO, which normally forms a committee for a specific task like the current novel coronavirus outbreak.

Regarding COVID-19, the China CDC is heading the response within China, and WHO coordinates all the information from countries reporting new cases. The outbreak has expanded out of China with a recent increase in new cases in South Korea and Iran.

In a news briefing on Feb. 24, WHO Director General Tedros Adhanom Ghebreyesus, who goes by Dr. Tedros, says that the COVID-19 outbreak is not yet considered to be a pandemic. Dr. Tedros warns that it’s not important what we label the outbreak because that will not prevent new cases.

“Our decision about whether to use the word 'pandemic' to describe an epidemic is based on an ongoing assessment of the geographical spread of the virus, the severity of disease it causes and the impact it has on the whole society,” he adds.

Their decision not to use the word ‘pandemic’ has to do with how it is currently spreading.

“For the moment, we are not witnessing the uncontained global spread of this virus and we are not witnessing large-scale severe disease or deaths,” says Dr. Tedros.

But that could change, like how the WHO committee at first decided not to make the COVID-19 outbreak a public health emergency of international concern (PHEIC) and then later did make it a PHEIC. WHO has stressed that the situation in China is severe, but at the moment the disease hasn’t reached pandemic levels. It has pandemic potential, but there’s still opportunity to prevent it from getting there.

Historically, the word ‘pandemic’ has only been used for two worldwide influenza outbreaks in 1918 and in 2009. Dr. Tedros notes that WHO and the health community in general understands much more about flu viruses and can make the call on whether an outbreak is a pandemic at an earlier stage than for this coronavirus.

The use of ‘pandemic’ is a word choice, not a scientific one since there is no official scientific definition.

“It really is borderline semantics, to be honest with you," says Anthony Fauci of the US National Institute of Allergy and Infectious Diseases, according to CNN. “I think you could have people arguing each end of it.”

Published on Feb 25, 2020