Expressing alarm both about mounting infections and slow government responses, the World Health Organisation has declared that the global coronavirus crisis is now a pandemic but also said it's not too late for countries to act.
By reversing course and using the charged word "pandemic" that it had previously shied away from, the UN health agency appeared to want to shock lethargic countries into pulling out all the stops.
A pandemic is defined as the uncontrolled worldwide spread of a new disease – the last crisis to be given the official label was the 2009 swine flu outbreak, which killed hundreds of thousands of people.
"The WHO has been assessing this outbreak around the clock and we are deeply concerned both by the alarming levels of spread and severity, and by the alarming levels of inaction," WHO chief Dr Tedros Adhanom Ghebreyesus said at a press conference early on Thursday morning.
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"We have called every day for countries to take urgent and aggressive action. We have rung the alarm bell loud and clear," said Ghebreyesus.
But Ghebreyesus warned against "unreasonable fear" and said more than 90 per cent of the world's 118,000 cases were still in just four countries.
"Pandemic is not a word to use lightly or carelessly. It is a word that, if misused, can cause unreasonable fear, or unjustified acceptance that the fight is over, leading to unnecessary suffering and death," he said.
The WHO added that Iran and Italy are the new front lines of the battle against the virus that started in China.
"They're suffering but I guarantee you other countries will be in that situation soon," said Dr Mike Ryan, the WHO's emergencies chief.
Italy weighed imposing even tighter restrictions on daily life and announced billions in financial relief on Wednesday to cushion economic shocks from the coronavirus, its latest efforts to adjust to the fast-evolving health crisis that silenced the usually bustling heart of the Catholic faith, St. Peter's Square.
In Iran, by far the hardest-hit country in the Middle East, the senior vice president and two other Cabinet ministers were reported to have been diagnosed with Covid-19, the illness caused by the virus. Iran reported another jump in deaths, by 62 to 354 — behind only China and Italy.
In Italy, Premier Giuseppe Conte said he would consider requests from Lombardy, Italy's hardest-hit region, to toughen the already extraordinary anti-virus lockdown that was extended nationwide on Tuesday. Lombardy wants to shut down nonessential businesses and reduce public transportation.
These additional measures would be on top of travel and social restrictions that imposed an eerie hush on cities and towns across the country from Tuesday. Police enforced rules that customers stay 1m apart and ensured that businesses closed by 6pm.
Milan shopkeeper Claudia Sabbatini said she favoured stricter measures. Rather than run the risk of customers possibly infecting each other in her children's clothing store, she decided to close it.
"I cannot have people standing at a distance. Children must try on the clothes. We have to know if they will fit,'' she said.
Conte said fighting Italy's more than 10,000 infections — the biggest outbreak outside of China — must not come at the expense of civil liberties. His caution suggested that Italy is unlikely to adopt the draconian quarantine measures that helped China push down new infections from thousands per day to a trickle now and allowed its manufacturers to restart production lines.
China's new worry is that the coronavirus could re-enter from abroad. Beijing's city government announced that all overseas visitors will be quarantined for 14 days. Of 24 new cases that China reported on Wednesday, five arrived from Italy and one from the United States. China has had over 81,000 virus infections and over 3000 deaths.
For most, the coronavirus causes only mild or moderate symptoms, such as fever and cough. But for a few, especially older adults and people with existing health problems, it can cause more severe illnesses, including pneumonia. More than 121,000 people have been infected worldwide and over 4300 have died.
But the vast majority of people recover. According to the World Health Organization, people with mild illness recover in about two weeks, while those with more severe illness may take three to six weeks to recover.
In the Mideast, the vast majority of the nearly 10,000 cases are in Iran or involve people who travelled there. Iran announced another increase in cases Wednesday to 9000. Iran's semiofficial Fars news agency said they include Vice President Eshaq Jahangiri, who had not been seen in photos of recent top-level meetings. Fars said Iran's ministers for cultural heritage, handcrafts and tourism, and for industry, mines and business were also infected.
Cases in Qatar jumped from 24 to 262. Kuwait announced a two-week shutdown of the country.
For the global economy, virus repercussions were profound, with increasing concerns of wealth- and job-wrecking recessions. US stocks sank again in early trading on Wednesday, wiping out most of a huge rally from a day earlier as Wall Street continues to reel from worries about the coronavirus.
The Wall Street plunge followed a steep decline by markets across Asia, where governments there and elsewhere have announced billions of dollars in stimulus funds, including packages revealed in Japan on Tuesday and Australia on Wednesday.
Italy's government announced Wednesday it was earmarking €25 billion (nearly $44 billion) to boost anti-virus efforts and soften economic blows, including delaying tax and mortgage payments by families and businesses.
Britain's government announced a £30 billion ($61 billion) economic stimulus package and the Bank of England slashed its key interest rate by half a percentage point to 0.25 per cent.
Normal life was increasingly being upended.
With police barring access to St. Peter's Square, emptying it of tens of thousands of people who usually come on Wednesdays for the weekly papal address, Pope Francis instead live-streamed prayers from the privacy of his Vatican library.
In France, the government's weekly Cabinet meeting was moved to a bigger room so President Emmanuel Macron and his ministers could sit at least 1 metre apart.
Athletes who usually thrive on crowds grew increasingly wary of them. Spanish soccer club Getafe said it wouldn't travel to Italy to play Inter Milan, preferring to forfeit their Europa League match rather than risk infections.
Olympic champion skier Mikaela Shiffrin said she would be limiting contact with fans and fellow competitors, tweeting that "this means no selfies, autographs, hugs, high fives, handshakes or kiss greetings."
In the US, the caseload passed 1000, and outbreaks on both sides of the country stirred alarm.
Former US Vice President Joe Biden and Bernie Sanders, who are vying to take on President Donald Trump in the presidential election, abruptly cancelled rallies Tuesday and left open the possibility that future campaign events could be impacted, too. Trump's campaign insisted it would proceed as normal, although Vice President Mike Pence conceded future rallies would be evaluated "on a day to day basis."
In Europe, deaths soared among Italy's ageing population. Authorities said Italy has suffered 631 deaths, with an increase of 168 fatalities recorded Tuesday. In Spain, the number of cases surged past the 2000-mark on Wednesday. Belgium, Bulgaria, Sweden, Albania and Ireland all announced their first virus-related deaths.
"If you want to be blunt, Europe is the new China," said Robert Redfield, the head of the US Centers for Disease Control and Prevention.
In Germany, Chancellor Angela Merkel said that if the virus is not halted by vaccines and cures, up to 70 per cent of the country's 83 million people could ultimately become infected, citing estimates that epidemiologists have been putting forward for several weeks. Germany has some 1300 confirmed infection. Merkel's comments fit a pattern of government officials using sobering warnings to try to get people to protect themselves, most notably by washing their hands and not gathering in large numbers.