On March 11, the World Health Organization officially declared the Covid-19 coronavirus a global pandemic. The coronavirus outbreak originated in Wuhan, China, but it has now spread to most of the world and is surging in places like Italy, Iran, and South Korea. Global confirmed cases continue to rise, including in the US. In response, workers have been sent home, conferences have been canceled, store shelves have been emptied, a democratic country has been put under nationwide quarantine, and the global economy is under serious threat. It is safe to say this is one of the most serious public health crises in decades, if not a century.
It’s overwhelming — including for those of us covering it. But if you’re just getting up to speed, or you want to dig deeper, here’s a (not-comprehensive, but still expansive!) list of some of the articles, papers, podcasts, and interviews we’ve found most useful, from both Vox and elsewhere.
What is the coronavirus? What can I do to prevent getting it? What should I do if I think I have it? When will the outbreak end? This piece answers all of these questions and more, so if you’re short on time, start here.
For visual learners. This chart is particularly telling, and scary. As you’ll see in pieces throughout this guide, America’s failure to test aggressively enough and early enough has set the stage for a much more dangerous epidemic than was necessary:
Coronavirus 101: Symptoms, spread, and severity
You’ve probably heard a lot of different names for this new virus thrown around: “coronavirus,” “Covid-19,” maybe even “SARS-CoV-2.” This short post explains the subtle but important differences between these designations.
How Deadly Is Coronavirus? What We Know and What We Don’t, New York Times
This piece does a great job of breaking down how case fatality rate (CFR) is calculated, why the number is often inflated (and sometimes deflated) at the outbreak of a new disease, and where epidemiologists generally agree the actual CFR for Covid-19 stands (closer to 1 percent).
Coronavirus Disease (COVID-19) overview, Our World in Data
Visualizes the latest research and data on coronavirus total cases, growth rate, severity, symptoms, fatality risk, and more. OWD’s custom charts and graphs make the huge swaths of data easily accessible.
This interactive map from Johns Hopkins gives up-to-date counts of total confirmed Covid-19 coronavirus cases worldwide, country-by-country breakdowns, and death and recovery rates.
This piece looks at recent research on how the coronavirus spreads from person to person. Recent studies show that the virus transmits primarily via droplets from coughing or sneezing and can spread even when people don’t have any symptoms or are just beginning to feel sick.
Report: The WHO-China Joint Mission on Coronavirus Disease 2019, World Health Organization
This report is important for a variety of reasons. One is that it established the widely referenced baseline for Covid-19 symptoms. Based on 55,924 confirmed cases in China, the WHO established the two most common symptoms of those infected as a fever (88 percent) and a dry cough (67.7 percent). Less frequent symptoms include sputum, or thick mucus from coughs (33.4 percent), shortness of breath (18.6 percent), sore throat (13.9 percent), and headache (13.6 percent).
Study: On the origin and continuing evolution of SARS-CoV-2, National Science Review
This study performed population genetic analyses of SARS-CoV-2 genomes, finding two distinct strains of the virus. The first — a more aggressive and severe strain called the “L type” — was prevalent in the initial outbreak in China but has since decreased in frequency. The second, a more mild strain called the “S type,” was less prevalent in the early outbreak but has increased in relative frequency since. The existence of these two separate strains could potentially explain potential discrepancies in reported symptoms and case fatality rates between China and other countries.
Study: Children at similar risk of infection and transmission as general population, Cold Spring Harbor Laboratory
Preliminary data seemed to indicate that children were being infected by coronavirus at far lower rates than adults. However, this study in China of 391 cases and 1,286 of their close contacts concludes that “children are at similar risk of infection as the general population, though less likely to have severe symptoms.” Put another way, children may be experiencing less severe symptoms of the coronavirus, but they are still likely to be carriers and thus may act as asymptomatic transmitters.
What you can do
Preparing for Coronavirus to Strike the US, Scientific American
“We should prepare, not because we may feel personally at risk,” writes Zeynep Tufekci, “but so that we can help lessen the risk for everyone. We should prepare not because we are facing a doomsday scenario out of our control, but because we can alter every aspect of this risk we face as a society.”
This piece makes the case that the effort to “flatten the curve” through behavior changes such as social distancing is a moral and civic duty as well as a personal decision.
CDC guidelines on what to do if you’re sick, Centers for Disease Control and Prevention
If you have a confirmed case of the Covid-19 coronavirus disease but don’t need immediate medical attention, health professionals suggest self-isolation. According to the CDC, this self-isolation should include staying at home (except to get medical care), separating yourself from other people (and pets) in your home, cleaning all “high-touch” surfaces, and washing one’s hands often. This guide also includes a list of precautions for household members/partners/caregivers of infected individuals.
This outlines the six key steps that all of us should take to not only prevent ourselves from getting sick but prepare our lives for what is to come (and in many ways is already happening). It includes information on how to best wash your hands, whether or not to buy a face mask, and the importance of psychological preparation in the face of a pandemic.
This piece does a nice job outlining the critical role of time in the coronavirus response: We’re living in an exponential curve right now, and the difference of a few days can be the dividing line between a successful policy and an uncontrolled outbreak.
This 2018 meta-analysis looked at 15 studies of how the practice of workplace social distancing (e.g., increased use of telecommuting and remote-meeting options, staggered work hours, and spacing workers farther apart) impacted the spread of the H1N1 flu in 2009. The authors found that workplace social distancing measures alone “produced a median reduction of 23% in the cumulative influenza attack rate in the general population” (in addition to delaying and reducing the peak influenza attack rate). This outbreak occurred under different circumstances than the Covid-19 outbreak, but the general lesson is clear: Social distancing works.
The primary factor that will determine the severity of the coronavirus’s impact is the speed at which the outbreak occurs. The phrase “flatten the curve” has become a popular way to describe the importance of how we as a society can change our collective behavior to slow the rate of coronavirus cases and prevent our health care system from being overwhelmed. This piece explains the term itself, the chart behind it, and why it’s so important prevent an overwhelming burden on our health care system.
This study outlines the best practice strategies for diagnosing and treating Covid-19 from the point of view of hospitals and clinics, but can also be helpful for individuals experiencing symptoms. The two highest-concern symptoms are “dyspnea” (the feeling of shortness of breath) and “hypoxia” (having a low level of oxygen in your blood). The study notes that patients presenting with these symptoms should be immediately sent into isolation (and receive requisite medical care if needed); whereas for those exhibiting other symptoms, additional testing is needed to determine whether the patient has contracted Covid-19.
The global response to coronavirus
Following the initial outbreak of coronavirus in China, the experts agreed the way to end the outbreak was simple: containment. Now, with cases continuing to spread throughout the world, scientists think the containment scenario is unlikely. This piece gives an overview of various scenarios for how the outbreak could end, ranging from “nightmare” to “lucky.” One important takeaway is that the severity of Covid-19’s impact on our societies is a direct function of how we collectively choose to respond to it.
This interview with Bruce Aylward, WHO’s assistant director general who led the organization’s mission to China, explores the big takeaways from the mission’s report. Alyward and Vox’s Julia Belluz discuss the playbook China used to curb Covid-19 spread, why response speed to an outbreak is so crucial, whether China’s coronavirus data can be trusted and more.
Taiwan is an island of 23 million just 81 miles from mainland China and had 2.7 million visitors from China last year. Yet, as of March 10, the country had just 45 Covid-19 cases, and only one death, making Taiwan’s one of the most effective containment strategies in the world so far. This interview with Stanford health policy researcher Jason Wang explores what Taiwan did right, and how other countries, including the US, could put those lessons to use.
They’ve Contained the Coronavirus. Here’s How., New York Times
Taiwan isn’t the only place to stave off a massive Covid-19 outbreak despite close ties to China. As of March 12, Hong Kong had only 131 confirmed cases of coronavirus, including four deaths. Singapore is even more impressive. It has managed to limit its coronavirus outbreak to 187 cases confirmed and no deaths — all without closing public schools. How did they do it? What lessons can we learn from their efforts? Two epidemiologists from the University of Hong Kong explain.
If Taiwan, Hong Kong, and Singapore are models for how to contain coronavirus, Iran is a warning of what could happen if the outbreak is handled poorly. Iran has only officially reported around 11,000 cases of the virus as of March 13, but many suspect the actual number to be much higher. On Friday, these suspicions were confirmed when new satellite photos were released purporting to show three large burial trenches. This piece, by two Iranian doctors now living in the US, documents how government cover-ups and malfeasance left the country woefully unprepared for what was to come. “The most important lesson of the coronavirus crisis in Iran,” the authors write, “is that health policy must never be politicized.”
The most obvious way to end the coronavirus outbreak would be to develop a vaccine for it. But what is required to actually make a vaccine? When could a Covid-19 vaccine reasonably be ready by? And can governments do anything to speed up this process? This piece has the answers.
The American government’s response so far
As of March 11, only around 7,000 Covid-19 tests had been performed in the US — a number well short of other developed countries, many of whom have far smaller populations. This piece explores the important story behind the testing delays, what those delays could mean for public response to the outbreak, and why it is so important that testing gets on track.
How much worse the coronavirus could get, in charts, New York Times
“The answers depend on the actions we take — and, crucially, on when we take them,” write Nicholas Kristof and Stuart Thompson. This interactive model will help you get a sense of how much the outcomes could vary depending on how fast we get our act together. “Play with it, and you see the benefits of acting aggressively and early,” Kristof tweeted.
Trump Has Sabotaged America’s Coronavirus Response, Foreign Policy
This piece, written in late January, documents how, under Donald Trump’s leadership, the US government “has intentionally rendered itself incapable” of responding effectively to a pandemic. In 2018, the Trump administration fired the government’s entire pandemic response chain of command and slashed the CDC’s budget and staff. Thus, this piece argues, the US government’s blundered response to the coronavirus outbreak isn’t an accident — it is the culmination of key decisions by the Trump administration.
I ran the White House pandemic office. Trump closed it. Washington Post
After the 2014 Ebola crisis, the Obama administration established the National Security Council Directorate for Global Health Security and Biodefense, under the leadership of Beth Cameron. ”I was mystified when the White House dissolved the office, leaving the country less prepared for pandemics like covid-19,” she writes.
“For six weeks behind the scenes, and now increasingly in public, Trump has undermined his administration’s own efforts to fight the coronavirus outbreak,” reports Dan Diamond, “resisting attempts to plan for worst-case scenarios, overturning a public-health plan upon request from political allies and repeating only the warnings that he chose to hear.”
A chilling lesson in what happens when a president who refuses to hear bad news is faced with a crisis full of it.
Report: 2017 Pandemic Influenza Plan, US Department of Health and Human Services (HHS)
This 2017 report from HHS outlines the US government’s planning strategy for a potential flu pandemic in the United States. While the coronavirus is certainly a unique challenge, the report is worth reading just to get a sense of how the US government thinks about the threat of pandemics and responses to them. In particular, some of the planning assumptions themselves are worth grappling with. According to the chart on page 44, in a “moderate” flu pandemic scenario, HHS expected around 64 million Americans to contract the illness and 32 million to require outpatient medical care.
How coronavirus will impact the global economy
This piece overviews the potential macroeconomic impact of the coronavirus outbreak. The key finding: Coronavirus will likely lead to an economic recession, but — unlike in 2008 — many governments will not have the primary tool for stimulating their economies (cutting interest rates) at their disposal. Instead, governments will have to stimulate demand via fiscal policy — a process that could run into some serious legislative roadblocks.
“At this point, this feels much worse than 2008,” says Jason Furman, who served as Obama’s chief economist and helped coordinate the response to the financial crisis. “Lehman Brothers was quite bad, but it was the culmination of a sequence of things that had happened over 14 months. This hit all at once.”
Report: COVID-19: Implications for business, McKinsey & Co.
In this report, McKinsey outlines three potential scenarios for the coronavirus outbreak worldwide — quick recovery, global slowdown, and global pandemic and recession — and how each would impact the global economy. “Quick recovery” is extremely unlikely, as it would have required a global public health response equivalent to China’s. But reading through the difference between the latter two scenarios is enlightening.
From McKinsey’s perspective, the difference between a “global slowdown” (global GDP growth for 2020 would be cut in half, to between 1 and 1.5 percent) and “global pandemic and recession” (global growth in 2020 falling to between –1.5 percent and 0.5 percent) hinges largely on a single question: Is the virus is seasonal, or will it persist consistently through the summer?
Study: The Global Macroeconomic Impacts of COVID-19: Seven Scenarios, Australian National University
Building on modeling of the economic impact of 2002–2003 SARS and 2006 flu pandemics, this paper models seven possible global economic scenarios in the wake of coronavirus. In the paper’s “low severity scenario,” the estimated loss to global GDP is $2.4 trillion. But the costs rise sharply as the level of severity increases, with the highest potential cost to global GDP rising to $9 trillion.
The social impact of coronavirus
The thrust of this piece can be summed up in one key passage: “Make no mistake: The rapid implementation of social distancing is necessary to flatten the coronavirus curve and prevent the current pandemic from worsening. But just as the coronavirus fallout threatens to cause an economic recession, it’s also going to cause what we might call a ‘social recession’: a collapse in social contact that is particularly hard on the populations most vulnerable to isolation and loneliness — older adults and people with disabilities or preexisting health conditions.”
Amid COVID-19 outbreak, the workers who need paid sick days the most have the least, Economic Policy Institute
This piece documents a disquieting paradox at the heart of the coronavirus outbreak: the workers who are the most public-facing — namely those who work in leisure and hospitality — have the least access to paid sick days. This means that the workers who are most likely to get sick (and thus spread the coronavirus) are also the least likely to be able to take time off work to self-quarantine or seek medical testing.
This week, at least a dozen states and a number of large urban school districts decided to shut down all K-12 schools in response to the growing coronavirus outbreak, As this piece reports, the effects of these closures could be massive: Kids across America will go without lunch, families will be left scrambling for child care, and, in many situations, parents will have to choose between keeping their jobs and leaving their kids alone.
The coronavirus outbreak isn’t happening in any year — it’s happening in a presidential election year. According to this piece, the impact of coronavirus on voting could be stark: “A presidential election unfolds over months in crowded campaign rallies and nominating conventions, and culminates in November when more than 130 million voters and nearly a million poll workers come together in firehouses and gymnasiums, swiping fingers on touch screens or opening up those aforementioned licked envelopes. The effects of a socially transmitted respiratory virus, if it were to spread unabated through campaign season, would be almost endless.”
As this piece reports, the 550,000 homeless individuals across the US have a “double vulnerability” to the coronavirus. Not only are they “more susceptible to contracting the disease” due to cramped shelters, inability to self-quarantine and unsanitary street conditions, but “once infected the chronically homeless are more likely to get much sicker or die because of underlying medical conditions and a lack of reliable health care.” As a result, the experts expect the coronavirus outbreak to result in a “disaster” for America’s homeless population.
Podcasts to help you understand the coronavirus
Covid-19, explained by Carl (who has it), Today, Explained
Coronavirus: Fears and Facts, Science Vs.
Behind the Covid-19 curve, The Weeds
Mr. Chen Goes to Wuhan, This American Life