Misplaced Pages

#132867

84-443: Established in 1975, Cruise Lines International Association (CLIA) is the world's largest cruise industry trade association based on the number of passenger cruise ships operated by its members. However, there is a significant proportion of the wider cruise industry which does not subscribe to CLIA's member body and which transports a considerable volume of passengers. There is no regulatory requirement for cruise operators to subscribe to

168-625: A healthy diet are also recommended. Supportive care in severe cases includes treatment to relieve symptoms , fluid therapy , oxygen support and prone positioning , and medications or devices to support other affected vital organs. More severe cases may need treatment in hospital. In those with low oxygen levels, use of the glucocorticoid dexamethasone is recommended to reduce mortality. Noninvasive ventilation and, ultimately, admission to an intensive care unit for mechanical ventilation may be required to support breathing. Extracorporeal membrane oxygenation (ECMO) has been used to address

252-627: A variant of concern (VoC) or a variant of interest (VoI). Many of these variants have shared the more infectious D614G . As of May 2023, the WHO had downgraded all variants of concern to previously circulating as these were no longer detected in new infections. Sub-lineages of the Omicron variant (BA.1 – BA.5) were considered separate VoCs by the WHO until they were downgraded in March 2023 as no longer widely circulating. As of 24 September 2024 ,

336-493: A comprehensive international study. Such deaths include deaths due to healthcare capacity constraints and priorities, as well as reluctance to seek care (to avoid possible infection). Further research may help distinguish the proportions directly caused by COVID-19 from those caused by indirect consequences of the pandemic. In May 2022, the WHO estimated the number of excess deaths by the end of 2021 to be 14.9 million compared to 5.4 million reported COVID-19 deaths, with

420-474: A free resource, the IBCC . Taking over-the-counter drugs such as paracetamol or ibuprofen , drinking fluids, taking honey to ease a cough, and resting may help alleviate symptoms. In the early months of the pandemic, many ICU doctors faced with the virus ventured to prescribe conjectured treatments because of the unprecedented circumstances. However, the standard of care for most intractable illnesses

504-432: A growing list of approved medications. Highly effective vaccines have reduced mortality related to SARS-CoV-2; however, for those awaiting vaccination, as well as for the estimated millions of immunocompromised persons who are unlikely to respond robustly to vaccination, treatment remains important. Some people may experience persistent symptoms or disability after recovery from the infection, known as long COVID , but there

588-595: A large number of people". During the COVID-19 pandemic, as with other pandemics, the meaning of this term has been challenged. The end of a pandemic or other epidemic only rarely involves the total disappearance of a disease, and historically, much less attention has been given to defining the ends of epidemics than their beginnings. The ends of particular epidemics have been defined in a variety of ways, differing according to academic field, and differently based on location and social group. An epidemic's end can be considered

672-517: A large randomized, controlled trial. In general there is no good evidence that anticoagulants have any benefit in the treatment of COVID-19, other than poor quality evidence suggesting a possible effect on all-cause mortality. People seriously ill with COVID-19 may require respiratory support. Depending on the severity, oxygen therapy , mechanical ventilation, and intravenous fluids may be required. Most cases of COVID-19 are not severe enough to require mechanical ventilation or alternatives, but

756-549: A life-threatening stage of the illness and in the presence of poor prognostic predictors, early antiviral treatment is essential. As of 2020, several treatments had been investigated and found to be ineffective or unsafe, and are thus were not recommended for use; these include baloxavir marboxil , lopinavir/ritonavir , ruxolitinib , chloroquine , hydroxychloroquine , interferon β-1a , and colchicine . As of 2021, favipiravir and nafamostat had shown mixed results but were still in clinical trials in some countries. During

840-451: A median range of 0.24% to 1.49%. IFRs rise as a function of age (from 0.002% at age 10 and 0.01% at age 25, to 0.4% at age 55, 1.4% at age 65, 4.6% at age 75, and 15% at age 85). These rates vary by a factor of ≈10,000 across the age groups. For comparison, the IFR for middle-aged adults is two orders of magnitude higher than the annualised risk of a fatal automobile accident and much higher than

924-587: A percentage of cases are. Some of the people acutely ill with COVID-19 experience deterioration of their lungs and acute respiratory distress syndrome (ARDS) and/or respiratory failure. Due to the high risk of death, urgent respiratory support including mechanical ventilation is often required in these people. Mechanical ventilation becomes more complex as ARDS develops in COVID-19 and oxygenation becomes increasingly difficult. People who undergo mechanical ventilation are at risk of ventilator-associated lung injury or of worsening an existing lung injury, this damage

SECTION 10

#1732772734133

1008-1489: A perfect storm to harm people's mental health and wellbeing." Early in the pandemic, theoretical concerns were raised about ACE inhibitors and angiotensin receptor blockers . However, later research in March 2020 found no evidence to justify stopping these medications in people who take them for conditions such as high blood pressure . One study from April 2020 found that people with COVID-19 and hypertension had lower all-cause mortality when on these medications. Similar concerns were raised about non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen; these were likewise not borne out, and NSAIDs may both be used to relieve symptoms of COVID-19 and continue to be used by people who take them for other conditions. People who use topical or systemic corticosteroids for respiratory conditions such as asthma or chronic obstructive pulmonary disease should continue taking them as prescribed even if they contract COVID-19. The principal for obstetric management of COVID-19 include rapid detection, isolation, and testing, profound preventive measures, regular monitoring of fetus as well as of uterine contractions, peculiar case-to-case delivery planning based on severity of symptoms, and appropriate post-natal measures for preventing infection. Patients with simultaneous SARS CoV2 and Influenza infection are more than twice as likely to die and more than four times as likely to need ventilation as patients with only COVID. It

1092-824: A random sample have consistently found that total infections considerably exceed the reported case counts. Many countries, early on, had official policies to not test those with only mild symptoms. The strongest risk factors for severe illness are obesity, complications of diabetes , anxiety disorders, and the total number of conditions. During the start of the COVID-19 pandemic it was not clear whether young people were less likely to be infected, or less likely to develop symptoms and be tested. A retrospective cohort study in China found that children and adults were just as likely to be infected. Among more thorough studies, preliminary results from 9 April 2020 found that in Gangelt ,

1176-461: A social phenomenon, not just a biological one. Time reported in March 2024 that expert opinions differ on whether or not COVID-19 is considered endemic or pandemic, and that the WHO continued to call the disease a pandemic on its website. During the initial outbreak in Wuhan , the virus and disease were commonly referred to as "coronavirus", "Wuhan coronavirus", "the coronavirus outbreak" and

1260-451: A test. Conversely, deaths of people who died from underlying conditions following a positive test may be included. Countries such as Belgium include deaths from suspected cases, including those without a test, thereby increasing counts. Official death counts have been claimed to underreport the actual death toll, because excess mortality (the number of deaths in a period compared to a long-term average) data show an increase in deaths that

1344-518: Is associated with COVID-19 and is reported in as many as 88% of cases. The disease is mainly transmitted via the respiratory route when people inhale droplets and small airborne particles (that form an aerosol ) that infected people exhale as they breathe, talk, cough, sneeze, or sing. Infected people are more likely to transmit COVID-19 when they are physically close to other non-infected individuals. However, infection can occur over longer distances, particularly indoors. SARS‑CoV‑2 belongs to

1428-426: Is called ventilatory-induced lung injury (VILI). The mechanism of this injury is thought to be due to trauma to the lungs caused by aerated regions of the lungs being over swollen (overdistension of the aerated alveoli ) and atelectrauma (force on the alveolar that could lead to lung collapse). Ventilators capable of pressure control modes and optimal PEEP are needed to maximise oxygen delivery while minimising

1512-611: Is discouraged altogether by the World Health Organization (WHO), due to limited evidence of its efficacy. The severity of COVID-19 varies. It may take a mild course with few or no symptoms, resembling other common upper respiratory diseases such as the common cold . In 3–4% of cases (7.4% for those over age 65) symptoms are severe enough to cause hospitalisation. Mild cases typically recover within two weeks, while those with severe or critical diseases may take three to six weeks to recover. Among those who have died,

1596-434: Is either beneficial or detrimental for the person's recovery. Other approaches to mechanical ventilation including avoiding intubation using a high flow nasal cannula or bi-level positive airway pressure are under investigation, however, the effectiveness of these approaches compared to intubation are not clear. Some doctors prefer staying with invasive mechanical ventilation when available because this technique limits

1680-439: Is intended to provide acquired immunity against severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2), the virus that causes coronavirus disease 2019 ( COVID-19 ). Prior to the COVID-19 pandemic, an established body of knowledge existed about the structure and function of coronaviruses causing diseases like severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). This knowledge accelerated

1764-490: Is not explained by COVID-19 deaths alone. Using such data, estimates of the true number of deaths from COVID-19 worldwide have included a range from 18.2 to 33.5 million (≈27.4 million) by 18 November 2023 by The Economist , as well as over 18.5 million by 1 April 2023 by the Institute for Health Metrics and Evaluation and ≈18.2 million (earlier) deaths between 1 January 2020, and 31 December 2021, by

SECTION 20

#1732772734133

1848-405: Is recommended that patients admitted to hospital with COVID should be routinely tested to see if they also have Influenza. The public are advised to get vaccinated against both Influenza and COVID. Severe cases are most common in older adults (those older than 60 years, and especially those older than 80 years). Many developed countries do not have enough hospital beds per capita , which limits

1932-520: Is removed from the body via large cannulae, moved through a membrane oxygenator that performs the lung functions of oxygen delivery and carbon dioxide removal, and then returned to the body. The Extracorporeal Life Support Organization (ELSO) maintains a registry of outcomes for this technology, and as of September 2020 it has been used in less than 120,000 patients over 435 ECMO centers worldwide with 40% mortality for adult respiratory patients. Initial use of ECMO in COVID-19 patients from China early in

2016-556: Is similar to many other respiratory diseases treated with ECMO. The mortality is also similar to the 35% mortality seen in the EOLIA trial, the largest randomized controlled trial for ECMO in ARDS. This registry based, multi-center, multi-country data provide provisional support for the use of ECMO for COVID-19 associated acute hypoxemic respiratory failure. Given that this is a complex technology that can be resource intense, guidelines exist for

2100-508: Is still limited information on the best management and rehabilitation for this condition. Most cases of COVID-19 are mild. In these, supportive care includes medication such as paracetamol or NSAIDs to relieve symptoms (fever, body aches, cough), proper intake of fluids, rest, and nasal breathing . Good personal hygiene and a healthy diet are also recommended. As of April 2020 the U.S. Centers for Disease Control and Prevention (CDC) recommended that those who suspect they are carrying

2184-417: Is that, as it develops over years, doctors build a body of research that tests various theories, compares and contrasts dosages, and measures one drug's power against another. Antiviral development for SARS-CoV-2 has been disappointing. In January 2020, research into potential treatments started, and several antiviral drugs were in clinical trials. In February 2020 with 'no known effective' treatments,

2268-452: Is the ratio of deaths to diagnoses. This metric can be misleading because of the delay between symptom onset and death and because testing focuses on symptomatic individuals. Based on Johns Hopkins University statistics, the global CFR was 1.02 percent (6,881,955 deaths for 676,609,955 cases) as of 10 March 2023. The number varies by region and has generally declined over time. Several variants have been named by WHO and labelled as

2352-406: Is the seventh known coronavirus to infect people, after 229E , NL63 , OC43 , HKU1 , MERS-CoV , and the original SARS-CoV . The standard method of testing for presence of SARS-CoV-2 is a nucleic acid test , which detects the presence of viral RNA fragments. As these tests detect RNA but not infectious virus, its "ability to determine duration of infectivity of patients is limited." The test

2436-614: Is typically done on respiratory samples obtained by a nasopharyngeal swab ; however, a nasal swab or sputum sample may also be used. The WHO has published several testing protocols for the disease. Preventive measures to reduce the chances of infection include getting vaccinated, staying at home or spending more time outdoors, avoiding crowded places, keeping distance from others, wearing a mask in public, ventilating indoor spaces, managing potential exposure durations, washing hands with soap and water often and for at least twenty seconds, practising good respiratory hygiene, and avoiding touching

2520-514: The Huanan Seafood Wholesale Market there, but it is possible that human-to-human transmission began earlier. Molecular clock analysis suggests that the first cases were likely to have been between October and November 2019. The scientific consensus is that the virus is most likely of a zoonotic origin, from bats or another closely related mammal. While other explanations such as speculations that SARS-CoV-2

2604-407: The Institute for Health Metrics and Evaluation estimating the true number of cases as of early 2022 to be in the billions. One measure that public health officials and policymakers have used to monitor the pandemic and guide decision-making is the test positivity rate ("percent positive"). According to Johns Hopkins in 2020, one benchmark for a "too high" per cent positive is 5%, which was used by

Cruise Lines International Association - Misplaced Pages Continue

2688-602: The basic reproduction number (R 0 ) for COVID-19 in January 2020 were between 1.4 and 2.5, but a subsequent analysis claimed that it may be about 5.7 (with a 95 per cent confidence interval of 3.8 to 8.9). In December 2021, the number of cases continued to climb due to several factors, including new COVID-19 variants. As of that 28   December, 282,790,822 individuals worldwide had been confirmed as infected. As of 14 April 2022 , over 500 million cases were confirmed globally. Most cases are unconfirmed, with

2772-479: The coronavirus pandemic and COVID pandemic ), caused by severe acute respiratory syndrome coronavirus 2 ( SARS-CoV-2 ), began with an outbreak of COVID-19 in Wuhan , China, in December 2019. It spread to other areas of Asia, and then worldwide in early 2020. The World Health Organization (WHO) declared the outbreak a public health emergency of international concern (PHEIC) on 30 January 2020, and assessed

2856-474: The variants of interest as specified by the World Health Organization are BA.2.86 and JN.1, and the variants under monitoring are JN.1.7, KP.2, KP.3, KP.3.1.1, JN.1.18, LB.1, and XEC. Symptoms of COVID-19 are variable, ranging from mild symptoms to severe illness. Common symptoms include headache, loss of smell and taste , nasal congestion and runny nose , cough, muscle pain , sore throat , fever, diarrhoea , and breathing difficulties . People with

2940-429: The "Wuhan coronavirus outbreak", with the disease sometimes called "Wuhan pneumonia ". In January 2020, the WHO recommended 2019-nCoV and 2019-nCoV acute respiratory disease as interim names for the virus and disease per 2015 international guidelines against using geographical locations (e.g. Wuhan, China), animal species, or groups of people in disease and virus names in part to prevent social stigma . WHO finalised

3024-534: The City of Dubrovnik, Corfu and Heraklion to collaborate and identify best practices for long-term destination management to the benefit of residents and visitors alike. While it is unclear what level of support is delivered, CLIA is also a corporate sponsor of the Mercy Ship program. The trade body's marketing and education activities may be considered activities more closely related to influence or lobbying, however

3108-505: The European Union, the use of dexamethasone and remdesivir were authorized. Corticosteroids like dexamethasone have shown clinical benefit in treating COVID-19. As of February 2021, the monoclonal antibody therapies bamlanivimab/etesevimab and casirivimab/imdevimab were found to reduce the number of hospitalizations, emergency room visits, and deaths. and both combination drugs received emergency use authorization by

3192-456: The U.S., Canada, Australia, and several other countries, with varying restrictions; however, it is not recommended for people needing mechanical ventilation, and has been discouraged altogether by the World Health Organization (WHO), due to limited evidence of its efficacy. In November 2021, the UK approved the use of molnupiravir as a COVID treatment for vulnerable patients recently diagnosed with

3276-525: The US Food and Drug Administration (FDA). As of February 2021 there were Emergency Use Authorizations for baricitinib , bamlanivimab , bamlanivimab/etesevimab , and casirivimab/imdevimab . As of July 2021, outpatient drugs budesonide and tocilizumab showed promising results in some patients but remained under investigation. As of July 2021, a large number of drugs had been considered for treating COVID-19 patients. As of November 2022, there

3360-528: The United States, only remdesivir had FDA approval for certain COVID-19 patients, and while early research had suggested a benefit in preventing death and shortening illness duration, this was not borne out by subsequent trials. On 16 April 2021, the FDA revoked the emergency use authorization (EUA) for the investigational monoclonal antibody therapy bamlanivimab , when administered alone, to be used for

3444-640: The WHO in the past. As of 10 March 2023, more than 6.88   million deaths had been attributed to COVID-19. The first confirmed death was in Wuhan on 9 January 2020. These numbers vary by region and over time, influenced by testing volume, healthcare system quality, treatment options, government response, time since the initial outbreak, and population characteristics, such as age, sex, and overall health. Multiple measures are used to quantify mortality. Official death counts typically include people who died after testing positive. Such counts exclude deaths without

Cruise Lines International Association - Misplaced Pages Continue

3528-660: The WHO recommended volunteers take part in trials of the effectiveness and safety of potential treatments. Antiviral medications were tried in people with severe disease. As of March 2020 several medications were already approved for other uses or were already in advanced testing. As of April 2020 trials were investigating whether existing medications could be used effectively against the body's immune reaction to SARS-CoV-2 infection. As of May 2020 several antiviral drugs were under investigation for COVID-19, though none had been shown to be clearly effective on mortality in published randomized controlled trials. As of February 2021, in

3612-419: The WHO, US, European Union, and Australia. On 12 November 2022, the WHO released its Global Vaccine Market Report. The report indicated that "inequitable distribution is not unique to COVID-19 vaccines"; countries that are not economically strong struggle to obtain vaccines. On 14 November 2022, the first inhalable vaccine was introduced, developed by Chinese biopharmaceutical company CanSino Biologics , in

3696-448: The broad family of viruses known as coronaviruses . It is a positive-sense single-stranded RNA (+ssRNA) virus, with a single linear RNA segment. Coronaviruses infect humans, other mammals, including livestock and companion animals, and avian species. Human coronaviruses are capable of causing illnesses ranging from the common cold to more severe diseases such as Middle East respiratory syndrome (MERS, fatality rate ≈34%). SARS-CoV-2

3780-411: The cases of severe disease course are caused by systemic hyper-inflammation, the so-called cytokine storm . Although several medications have been approved in different countries as of April 2022, not all countries have these medications. Patients with mild to moderate symptoms who are in the risk groups can take nirmatrelvir/ritonavir (marketed as Paxlovid) or remdesivir , either of which reduces

3864-648: The centre of a major infection cluster in Germany, 15 per cent of a population sample tested positive for antibodies . Screening for COVID-19 in pregnant women in New York City , and blood donors in the Netherlands, found rates of positive antibody tests that indicated more infections than reported. Seroprevalence -based estimates are conservative as some studies show that persons with mild symptoms do not have detectable antibodies. Initial estimates of

3948-760: The city of Shanghai, China. For the first two years of the pandemic, no specific and effective treatment or cure was available. In 2021, the European Medicines Agency's (EMA) Committee for Medicinal Products for Human Use (CHMP) approved the oral antiviral protease inhibitor , Paxlovid (nirmatrelvir plus the HIV antiviral ritonavir ), to treat adult patients. FDA later gave it an EUA. Most cases of COVID-19 are mild. In these, supportive care includes medication such as paracetamol or NSAIDs to relieve symptoms (fever, body aches, cough), adequate intake of oral fluids and rest. Good personal hygiene and

4032-598: The coronavirus to replicate inside the body and antibody therapies that mimic our own immune system to attack the virus" The WHO recommendations on which medications should or should not be used to treat Covid-19 are continuously updated. As of July 2022, WHO strongly recommended for non-severe cases nirmatrelvir and ritonavir , and recommended conditionally Molnupiravir , Sotrovimab and Remdesivir . For severe cases WHO strongly recommended corticosteroids, IL-6 receptor blockers or Baricitinib and conditionally recommended casirivimab and imdevimab . For patients in

4116-484: The cumulative number of infected individuals (including asymptomatic and undiagnosed infections and excluding vaccinated infected individuals). It is expressed in percentage points. Other studies refer to this metric as the infection fatality risk . In November 2020, a review article in Nature reported estimates of population-weighted IFRs for various countries, excluding deaths in elderly care facilities, and found

4200-441: The development of various vaccine platforms during early 2020. The initial focus of SARS-CoV-2 vaccines was on preventing symptomatic and severe illness. The COVID-19 vaccines are widely credited for their role in reducing the severity and death caused by COVID-19. As of March 2023, more than 5.5 billion people had received one or more doses (11.8 billion in total) in over 197 countries. The Oxford-AstraZeneca vaccine

4284-611: The disease. The WHO, the Chinese National Health Commission , the UK National Institute for Health and Care Excellence , and the United States' National Institutes of Health , among other bodies and agencies worldwide, have all published recommendations and guidelines for taking care of people with COVID-19. As of 2020 Intensivists and pulmonologists in the U.S. have compiled treatment recommendations from various agencies into

SECTION 50

#1732772734133

4368-414: The early part of 2020 convalescent plasma , plasma from persons who recovered from SARS-CoV-2 infection, was frequently used with anecdotal successes in reports and small case series. However subsequent trials found no consistent evidence of benefit. However, conflicting outcomes from trials could be understood by noting that they transfused insufficient therapeutic doses of CCP. As of February 2021, in

4452-513: The eyes, nose, or mouth with unwashed hands. Those diagnosed with COVID-19 or who believe they may be infected are advised by healthcare authorities to stay home except to get medical care, call ahead before visiting a healthcare provider, wear a face mask before entering the healthcare provider's office and when in any room or vehicle with another person, cover coughs and sneezes with a tissue, regularly wash hands with soap and water and avoid sharing personal household items. A COVID-19 vaccine

4536-457: The following lines: A-Rosa Cruises Lüftner Cruises Belmond Cruises CroisiEurope Hapag Lloyd Cruises Marella Cruises P&O Cruises UK Pullmantur Riviera Travel Saga Shearings Holiday APT Group Aqua Expeditions Coral Expeditions Dream Cruises Ganges Voyager P&O Cruises Australia Riviera Travel Star Cruises Travelmarvel COVID-19 pandemic The COVID-19 pandemic (also known as

4620-474: The general public beginning in December 2020, made available through government and international programs such as COVAX , aiming to provide vaccine equity . Treatments include novel antiviral drugs and symptom control. Common mitigation measures during the public health emergency included travel restrictions , lockdowns , business restrictions and closures, workplace hazard controls , mask mandates , quarantines, testing systems, and contact tracing of

4704-665: The infected. The pandemic caused severe social and economic disruption around the world, including the largest global recession since the Great Depression . Widespread supply shortages , including food shortages , were caused by supply chain disruptions and panic buying . Reduced human activity led to an unprecedented temporary decrease in pollution . Educational institutions and public areas were partially or fully closed in many jurisdictions, and many events were cancelled or postponed during 2020 and 2021. Telework became much more common for white-collar workers as

4788-487: The issue of respiratory failure. Existing drugs such as hydroxychloroquine , lopinavir/ritonavir , and ivermectin are not recommended by US or European health authorities, as there is no good evidence they have any useful effect. The antiviral remdesivir is available in the US, Canada, Australia, and several other countries, with varying restrictions; however, it is not recommended for use with mechanical ventilation, and

4872-576: The majority of the unreported 9.5 million deaths believed to be direct deaths due the virus, rather than indirect deaths. Some deaths were because people with other conditions could not access medical services . A December 2022 WHO study estimated excess deaths from the pandemic during 2020 and 2021, again concluding ≈14.8 million excess early deaths occurred, reaffirming and detailing their prior calculations from May as well as updating them, addressing criticisms. These numbers do not include measures like years of potential life lost and may make

4956-495: The official names COVID-19 and SARS-CoV-2 on 11 February 2020. Tedros Adhanom Ghebreyesus explained: CO   for corona , VI   for virus , D   for disease and 19 for when the outbreak was first identified (31 December 2019). WHO additionally uses "the COVID-19 virus" and "the virus responsible for COVID-19" in public communications. WHO named variants of concern and variants of interest using Greek letters . The initial practice of naming them according to where

5040-772: The organization holds no powers to set or enforce laws or regulations. In response to the COVID-19 pandemic , CLIA voluntarily suspended sailings out of US ports on 13 March 2020, one day before the Centers for Disease Control and Prevention issued a no-sail order. However, COVID-19 outbreaks continued on ships already at sea. Whilst CLIA had drafted a plan to hire a global rescue team to extract infected passengers, by 6 April this had not been realized and public health authorities had to intervene to evacuate critically ill people from ships. CLIA has several categories of membership: As of July 2020, CLIA Cruise Line Members are made up of

5124-427: The outbreak as having become a pandemic on 11 March. COVID-19 symptoms range from asymptomatic to deadly, but most commonly include fever, sore throat , nocturnal cough , and fatigue. Transmission of the virus is often through airborne particles . Mutations have produced many strains (variants) with varying degrees of infectivity and virulence . COVID-19 vaccines were developed rapidly and deployed to

SECTION 60

#1732772734133

5208-407: The pandemic 2021's leading cause of death . The time between symptom onset and death ranges from   6 to 41 days, typically about 14 days. Mortality rates increase as a function of age. People at the greatest mortality risk are the elderly and those with underlying conditions. The infection fatality ratio (IFR) is the cumulative number of deaths attributed to the disease divided by

5292-495: The pandemic evolved. Misinformation circulated through social media and mass media , and political tensions intensified . The pandemic raised issues of racial and geographic discrimination , health equity , and the balance between public health imperatives and individual rights . The WHO ended the PHEIC for COVID-19 on 5 May 2023. The disease has continued to circulate, but as of 2024, experts were uncertain as to whether it

5376-517: The pandemic produced long-term consequences. Deterioration of social networks and economies, survivor stigma , anger and aggression, and mistrust of official information are long-term consequences. In April 2020 The Lancet published a 14-page call for action focusing on the UK and stated conditions were such that a range of mental health issues was likely to become more common. BBC quoted Rory O'Connor in saying, "Increased social isolation, loneliness, health anxiety, stress, and an economic downturn are

5460-602: The pandemic suggested poor outcomes, with less than 90% mortality. In March 2020, the ELSO registry began collecting data on the worldwide use of ECMO for patients with COVID-19 and reporting this data on the ELSO website in real time. In September 2020, the outcomes of 1,035 COVID-19 patients supported with ECMO from 213 experienced centers in 36 different countries were published in The Lancet , and demonstrated 38% mortality, which

5544-542: The pandemic, such as hydroxychloroquine and lopinavir/ritonavir , but later research found them to be ineffective or even harmful, like fluvoxamine , a cheap and widely available antidepressant ; As of December 2020, there was not enough high-quality evidence to recommend so-called early treatment. In December 2020, two monoclonal antibody -based therapies were available in the United States, for early use in cases thought to be at high risk of progression to severe disease. The antiviral remdesivir has been available in

5628-415: The population's age structure and the age-specific pattern of infections. There have also been reviews that have compared the fatality rate of this pandemic with prior pandemics, such as MERS-CoV. For comparison the infection mortality rate of seasonal flu in the United States is 0.1%, which is 13 times lower than COVID-19. Another metric in assessing death rate is the case fatality ratio (CFR), which

5712-415: The risk of ventilator-associated lung injury and pneumothorax . An approach to enable the person to breath spontaneously while being mechanically ventilated by adjusting the level of sedation and the respirator settings has been suggested, with the goal of reducing atrophy of the diaphragm. There is no clear evidence to suggest that enabling spontaneous breathing early while being mechanically ventilated

5796-462: The risk of dying from seasonal influenza . In December 2020, a systematic review and meta-analysis estimated that population-weighted IFR was 0.5% to 1% in some countries (France, Netherlands, New Zealand, and Portugal), 1% to 2% in other countries (Australia, England, Lithuania, and Spain), and about 2.5% in Italy. This study reported that most of the differences reflected corresponding differences in

5880-652: The risk of serious illness or hospitalization. In the US, the Biden Administration COVID-19 action plan includes the Test to Treat initiative, where people can go to a pharmacy, take a COVID test, and immediately receive free Paxlovid if they test positive. Several experimental treatments are being actively studied in clinical trials . These include the antivirals molnupiravir (developed by Merck ), and nirmatrelvir/ritonavir (developed by Pfizer ). Others were thought to be promising early in

5964-496: The same infection may have different symptoms, and their symptoms may change over time. Three common clusters of symptoms have been identified: one respiratory symptom cluster with cough, sputum , shortness of breath, and fever; a musculoskeletal symptom cluster with muscle and joint pain, headache, and fatigue; a cluster of digestive symptoms with abdominal pain, vomiting, and diarrhoea. In people without prior ear, nose, and throat disorders, loss of taste combined with loss of smell

6048-476: The spread of aerosol particles compared to a high flow nasal cannula. The administration of inhaled nitric oxide to people being ventilated is not recommended, and evidence around this practice is weak. Extracorporeal membrane oxygenation (ECMO) is an artificial lung technology that has been used since the 1980s to treat respiratory failure and acute respiratory distress syndrome when conventional mechanical ventilation fails. In this complex procedure, blood

6132-634: The spread of the virus within the community, and mitigation strategies (commonly known as " flattening the curve ") that attempt to lessen the effects of the virus on society, but which still tolerate some level of transmission within the community. These initial strategies can be pursued sequentially or simultaneously during the acquired immunity phase through natural and vaccine-induced immunity . Treatment and management of COVID-19 The treatment and management of COVID-19 combines both supportive care , which includes treatment to relieve symptoms , fluid therapy , oxygen support as needed, and

6216-411: The time from symptom onset to death has ranged from two to eight weeks. Prolonged prothrombin time and elevated C-reactive protein levels on admission to the hospital are associated with severe course of COVID-19 and with a transfer to intensive care units (ICU). Between 5% and 50% of COVID-19 patients experience long COVID , a condition characterised by long-term consequences persisting after

6300-508: The trade body, each year a significant number of cruise passengers are transported on a growing number of non-member vessels. The trade body has no representation across the entirety of Africa, for example. CLIA works with the Global Sustainable Tourism Council (GSTC) to help port cities analyze how to manage tourism flows and map out a road map for a sustainable future. To date, the industry has partnered with

6384-723: The treatment of mild-to-moderate COVID-19 in adults and certain pediatric patients. As of July 2022, WHO strongly recommended against treating non-severe cases with convalescent plasma, hydroxychloroquine, lopinavir-ritonavir or colchicine and recommended conditionally against corticosteroids or ivermectin or fluvoxamine or nirmatrelvir and ritonavir WHO also strongly recommended against treating severe cases with hydroxychloroquine or lopinavir-ritonavir or Baricitinib and conditionally recommended against ruxolitinib or tofacitinib , ivermectin or convalescent plasma. As of September 2022, oral treatment of outpatients with metformin , ivermectin , and fluvoxamine were found to be ineffective in

6468-694: The typical convalescence period of the disease. The most commonly reported clinical presentations are fatigue and memory problems, as well as malaise , headaches, shortness of breath , loss of smell, muscle weakness , low fever and cognitive dysfunction . Many countries attempted to slow or stop the spread of COVID-19 by recommending, mandating or prohibiting behaviour changes, while others relied primarily on providing information. Measures ranged from public advisories to stringent lockdowns. Outbreak control strategies are divided into elimination and mitigation. Experts differentiate between elimination strategies (known as " zero-COVID ") that aim to completely stop

6552-623: The use of ECMO during the COVID-19 pandemic. Individuals may experience distress from quarantine, travel restrictions, side effects of treatment, or fear of the infection itself. To address these concerns, the National Health Commission of China published a national guideline for psychological crisis intervention on 27 January 2020. According to the Inter-Agency Standing Committee (IASC) Guidelines on Mental Health and Psychosocial Support,

6636-543: The variants were identified (e.g. Delta began as the " Indian variant") is no longer common. A more systematic naming scheme reflects the variant's PANGO lineage (e.g., Omicron 's lineage is B.1.1.529) and is used for other variants. SARS-CoV-2 is a virus closely related to bat coronaviruses , pangolin coronaviruses, and SARS-CoV . The first known outbreak (the 2019–2020 COVID-19 outbreak in mainland China ) started in Wuhan , Hubei, China, in December 2019. Many early cases were linked to people who had visited

6720-550: The virus isolate themselves at home and wear a face mask. As of November 2020 use of the glucocorticoid dexamethasone had been strongly recommended in those severe cases treated in hospital with low oxygen levels, to reduce the risk of death. Noninvasive ventilation and, ultimately, admission to an intensive care unit for mechanical ventilation may be required to support breathing. Extracorporeal membrane oxygenation (ECMO) has been used to address respiratory failure, but its benefits are still under consideration. Some of

6804-443: Was accidentally released from a laboratory have been proposed, as of 2021 these were not supported by evidence. Official "case" counts refer to the number of people who have been tested for COVID-19 and whose test has been confirmed positive according to official protocols whether or not they experienced symptomatic disease. Due to the effect of sampling bias , studies which obtain a more accurate number by extrapolating from

6888-560: Was moderate-certainty evidence suggesting that dexamethasone, and systemic corticosteroids in general, probably cause a slight reduction in all-cause mortality (up to 30 days) in hospitalized patients with COVID‐19, the evidence was very uncertain at 120 days. In March 2022, the BBC wrote, "There are now many drugs that target the virus or our body in different ways: anti-inflammatory drugs that stop our immune system overreacting with deadly consequences, anti-viral drugs that make it harder for

6972-457: Was still a pandemic. Pandemics and their ends are not well-defined, and whether or not one has ended differs according to the definition used. As of 24 November 2024, COVID-19 has caused 7,075,455 confirmed deaths. The COVID-19 pandemic ranks as the fifth- deadliest pandemic or epidemic in history . In epidemiology , a pandemic is defined as "an epidemic occurring over a very wide area, crossing international boundaries, and usually affecting

7056-509: Was the most widely used. According to a June 2022 study, COVID-19 vaccines prevented an additional 14.4 million to 19.8 million deaths in 185 countries and territories from 8 December 2020 to 8 December 2021. On 8 November 2022, the first recombinant protein-based COVID-19 vaccine (Novavax's booster Nuvaxovid ) was authorised for use in adults in the United Kingdom. It has subsequently received endorsement/authorisation from

#132867