From January to June, coronavirus disease 2019 (COVID-19) has evolved from an isolated disease in a region of China to a global pandemic that has brought countries to a standstill, pushed hospital systems to the brink, and dragged the global economy into a recession. Here, we take a look at how this pandemic evolved and progressed thus far in 2020.
In just 6 short months, the world has become a very different place as coronavirus disease 2019 (COVID-19) has brought countries to a standstill, pushed hospital systems to the brink, and dragged the global economy into what may be the worst recession since World War II.
At the end of June, the global death toll had reached 511,251, with 25% (127,251) from the United States alone. The number of global cases reached 10,475,817, and again, the United States accounted for 25% (2,627,584) of the total global number. But back in January, when the year was still young, COVID-19—and the virus that causes it, SARS-CoV-2—was just being introduced to the world.
Here’s a look back at how the pandemic has progressed in the first 6 months of the year.
January 9 — WHO Announces Mysterious Coronavirus-Related Pneumonia in Wuhan, China
At this point, the World Health Organization (WHO) still has doubts about the roots of what would become the COVID-19 pandemic, noting that the spate of pneumonia-like cases in Wuhan could have stemmed from a new coronavirus. There are 59 cases so far, and travel precautions are already at the forefront of experts’ concerns.
January 20 — CDC Says 3 US Airports Will Begin Screening for Coronavirus
Three additional cases of what is now the 2019 novel coronavirus are reported in Thailand and Japan, causing the CDC to begin screenings at JFK International, San Francisco International, and Los Angeles International airports. These airports are picked because flights between Wuhan and the United States bring most passengers through them.
January 21 — CDC Confirms First US Coronavirus Case
A Washington state resident becomes the first person in the United States with a confirmed case of the 2019 novel coronavirus, having returned from Wuhan on January 15, thanks to overnight polymerase chain reaction testing. The CDC soon after deploys a team to help with the investigation, including potential use of contact tracing.
January 21 — Chinese Scientist Confirms COVID-19 Human Transmission
At this point, the 2019 novel coronavirus has killed 4 and infected more than 200 in China, before Zhong Nanshan, MD, finally confirms it can be transmitted from person to person. However, the WHO is still unsure of the necessity of declaring a public health emergency.
January 23 — Wuhan Now Under Quarantine
In just 2 days, 13 more people died and an additional 300 were sickened. China makes the unprecedented move not only to close off Wuhan and its population of 11 million, but to also place a restricted access protocol on Huanggang, 30 miles to the east, where residents can’t leave without special permission. This means up to 18 million people are under strict lockdown.
January 31 — WHO Issues Global Health Emergency
With a worldwide death toll of more than 200 and an exponential jump to more than 9800 cases, the WHO finally declares a public health emergency, for just the sixth time. Human-to-human transmission is quickly spreading and can now be found in the United States, Germany, Japan, Vietnam, and Taiwan.
February 2 — Global Air Travel Is Restricted
By 5 pm on Sunday, those en route to the United States have to have left China or they can face a 2-week home-based quarantine if they had been in Hubei province. Mainland visitors, however, will need to undergo health screenings upon their return, and foreign nationals can even be denied admittance. Other countries beginning to impose similar air-travel restrictions at this point include Australia, Germany, Italy, and New Zealand.
February 3 — US Declares Public Health Emergency
The Trump administration declares a public health emergency due to the coronavirus outbreak. The announcement comes 3 days after WHO declared a Global Health Emergency as more than 9800 cases of the virus and more than 200 deaths had been confirmed worldwide.
February 10 — China’s COVID-19 Deaths Exceed Those of SARS Crisis
The COVID-19 death toll surpasses that of the severe acute respiratory syndrome (SARS) outbreak from 17 years ago, totaling 908 reported deaths in China in the last month compared with 774 deaths in the SARS crisis.
February 25 — CDC Says COVID-19 Is Heading Toward Pandemic Status
Explaining what would signify a pandemic, Nancy Messonnier, MD, director of the CDC's National Center for Immunization and Respiratory Diseases, says that thus far COVID-19 meets 2 of the 3 required factors: illness resulting in death and sustained person-to-person spread. Worldwide spread is the third criteria not yet met at the time.
See what happened in March on the next page.
March 6 — 21 Passengers on California Cruise Ship Test Positive
Twenty-one people of just 46 tested aboard a cruise ship carrying more than 3500 people off the California coast test positive for COVID-19, with 19 being crew members. The ship is held at sea instead of being allowed to dock in San Francisco while testing is conducted. Since the event, 60 passengers have sued the cruise line and parent company, Carnival Corp, for gross negligence in how passenger safety was handled.
March 11 — WHO Declares COVID-19 a Pandemic
In declaring COVID-19 a pandemic, Tedros Adhanom Ghebreyesus, director general of WHO, said at a briefing in Geneva the agency is “deeply concerned by the alarming levels of spread and severity” of the outbreak. He also expressed concern about “the alarming levels of inaction.”
March 13 — Trump Declares COVID-19 a National Emergency
President Donald Trump declares the novel coronavirus a national emergency, which unlocks billions of dollars in federal funding to fight the disease’s spread.
March 13 — Travel Ban on Non-US Citizens Traveling From Europe Goes Into Effect
The Trump administration issues a travel ban on non-Americans who visited 26 European countries within 14 days of coming to the United States. People traveling from the United Kingdom and the Republic of Ireland are exempt.
March 17 — University of Minnesota Begins Testing Hydroxychloroquine
The University of Minnesota launches a clinical trial to investigate whether hydroxychloroquine can prevent an individual exposed to COVID-19 from becoming ill or reduce the severity of the infection. The trial is limited to those at high risk of exposure and aims to enroll 1500 individuals.
March 17 — CMS Temporarily Expands Use of Telehealth
CMS expands its telehealth rules, permitting use during the COVID-19 pandemic as a means to protect older patients from potential exposure. The relaxation allows Medicare to cover telehealth visits the same as it would regular in-person visits.
March 17 — Administration Asks Congress to Send Americans Direct Financial Relief
President Trump asks Congress to expediate emergency relief checks to Americans as part of an economic stimulus package. The proposal comes just as the United States reports its 100th death from COVID-19.
March 19 — California Issues Statewide Stay-at-Home Order
California becomes the first state to issue a stay-at-home order, mandating all residents to stay at home except to go to an essential job or shop for essential needs. The order also instructs health care systems to prioritize services to those who are the sickest.
March 24 — With Clinical Trials on Hold, Innovation Stalls
Overwhelmed hospitals are keeping out everyone who does not need to be there, and that means delaying the start of new clinical trials, according to an interview. The Center for Biosimilars® reported that drugs with fresh FDA approvals are not likely to launch, as their chances of making it into circulation are dim with hospitals struggling just to find enough personal protective equipment.
March 25 — Reports Find Extended Shutdowns Can Delay Second Wave
Mathematical models based on social distancing measures implemented in Wuhan, China, show keeping tighter measures in place for longer periods of time can flatten the COVID-19 curve.
March 26 — Senate Passes CARES Act
The Senate passes the Coronavirus Aid, Relief, and Economic Security (CARES) Act, providing $2 trillion in aid to hospitals, small businesses, and state and local governments, while including an elimination of the Medicare sequester from May 1 through December 31, 2020.
March 27 — President Trump Signs CARES Act Into Law
The House of Representatives approves the CARES act, the largest economic recovery package in history, and President Trump signs it into law. The bipartisan legislation provides direct payments to Americans and expansions in unemployment insurance.
March 30 — FDA Authorizes Use of Hydroxychloroquine
FDA issues an emergency use authorization (EUA) for “hydroxychloroquine sulfate and chloroquine phosphate products” to be donated to the Strategic National Stockpile and donated to hospitals to treat patients with COVID-19. The EUA would be rescinded June 15, except for patients in clinical trials, in the wake of reports of heart rhythm problems among some patients.
March 31 — COVID-19 Can Be Transmitted Through the Eye
A report in JAMA Ophthalmology creates a stir with the finding that patients can catch the virus that causes COVID-19 through the eye, despite low prevalence of the virus in tears. The coverage of the study involving 38 patients from Hubei Province, China, drew some of AJMC.com’s highest readership of 2020, as the findings contradicted assumptions by leading professional societies.
See what happened in April and May on the next page.
April 8 — Troubles With the COVID-19 Cocktail
“What do you have to lose?” Trump asks when touting the malaria drug hydroxycholorquine or the related chloroquine as possible treatments for COVID-19. With a common antibiotic, azithromycin, the drug cocktail becomes an early candidate to prevent hospitalization or death. But Trump’s promotion of the combination, despite known heart risks for some patients, prompts the American Heart Association, the American College of Cardiology, and the Heart Rhythm Society to warn in a joint guidance that the drugs are not for everyone.
April 16 — “Gating Criteria” Emerge as a Way to Reopen the Economy
After Trump briefly entertains the idea of reopening the US economy in time for Easter Sunday, the White House releases broad guidelines for how people could return to work, to church, and to restaurants and other venues. The plan outlines the concept of “gating criteria,” which call for states or metropolitan areas to achieve benchmarks in reducing COVID-19 cases or deaths before taking the next step toward reopening.
April 28 — Young, Poor Avoid Care for COVID-19 Symptoms
As the pandemic lingers, the term “deferred care” caught fire in health care circles—referring to the fact that many would avoid a doctor’s office or hospital for any procedure that could wait. But a Gallup poll finds a darker side to this phenomenon: 1 in 7 Americans report they would not seek care for a fever or dry cough—the classic symptoms of COVID-19. The reason? Cost concerns. Those most likely to avoid medical treatment for symptoms are younger than age 30 and make less than $40,000 a year. By the end of April, 26.5 million Americans have filed for unemployment since mid-March.
April 29 — NIH Trial Shows Early Promise for Remdesivir
National Institutes of Health (NIH) trial data, which are not peer reviewed, show that remdesivir, made by Gilead Sciences, is better than placebo in treating COVID-19. Patients with advanced COVID-19 and lung involvement who received the antiviral had a 31% faster recovery time, or about 4 days.
May 1 — Remdesivir Wins EUA
Shortly after the trial data are published, FDA grants an EUA to remdesivir after preliminary data from an NIH trial found the treatment accelerated recovery in individuals with advanced COVID-19 and lung involvement.
May 9 — Saliva-Based Diagnostic Test Allowed for At-Home Use
The FDA broadens authorization of a saliva-based test to detect COVID-19 infection; the EUA is granted to Rutgers Clinical Genomics Laboratory. The test makes it possible for those who cannot get to a collection center to get tested, including those who are home because they are ill, quarantined, or at high risk of infection due to their age or comorbidities.
May 12 — Death Toll Likely Underestimated, Fauci Testifies
Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, testifies before the US Senate that the US death toll of 80,000 is likely an underestimate. He warns against the relaxation of social distancing and says he is “cautiously optimistic” that a vaccine will be effective and achieved within 1 or 2 years.
May 21 — United States and AstraZeneca Form Vaccine Deal
The Trump administration and AstraZeneca announce a collaboration to speed development of a COVID-19 vaccine called AZD1222. HHS says it expects the first doses to be available as early as October 2020; phase 3 clinical studies are underway this summer.
May 28 — US COVID-19 Deaths Pass the 100,000 Mark
The CDC says surpassing 100,000 deaths is a “sobering development and a heart-breaking reminder of the horrible toll of this unprecedented pandemic.” It asks that Americans continue following local and state guidance on prevention strategies, such as social distancing, good hand hygiene, and wearing a face mask while in public.
See what happened in June on the next page.
June 4 — Lancet, NEJM Retract COVID-19 Studies on Hydroxychloroquine
On the same day, The New England Journal of Medicine and The Lancet both retract 2 studies on the use of hydroxychloroquine in COVID-19, after the authors said they could not vouch for the data used. A private database of medical records compiled by a little-known firm called Surgisphere was used in both studies. The retractions bring to light the difficulty of publishing vital COVID-19 research while ensuring accuracy.
June 10 — US COVID-19 Cases Reach 2 Million
The number of confirmed cases of COVID-19 hits 2 million in the United States as new infections continue to rise in 20 states. Cases begin to spike as states ease social distancing restrictions.
June 16 — HHS Announces COVID-19 Vaccine Doses Will Be Free for Some
Officials associated with the United States’ Operation Warp Speed, a project to rapidly develop and deploy a COVID-19 vaccine, explain that the vaccine would be provided for free to elderly patients and other vulnerable populations who cannot afford it.
June 18 — WHO Ends Study Into Hydroxychloroquine
WHO announces it will stop testing hydroxychloroquine as a treatment for COVID-19. The data from the Solidarity Trial show the drug did not reduce mortality. According to WHO, patients who were previously administered the drug would finish their course or stop based on a supervisor’s discretion.
June 20 — NIH Halts Trial of Hydroxychloroquine
Just days after WHO ended its own trial, the NIH announces it is halting a clinical trial examining the safety and effectiveness of hydroxychloroquine as a treatment for COVID-19. The study indicates that the treatment does no harm, but also provides no benefit.
June 22 — Study Suggests 80% of Cases in March Went Undetected
A study in Science Translation Medicine suggests that as many as 80% of Americans who sought care for flu-like illnesses in March were actually infected with the virus that causes COVID-19. According to the research, if one-third of these patients sought COVID-19 testing, it may have amounted to 8.7 million infections.
June 26 — White House Coronavirus Task Force Addresses Rising Cases in the South
For the first time in 2 months, the White House Coronavirus Task Force holds a briefing. The focus of the discussion is the rising number of cases and growing positive test rate in some states. As cases rise, Texas and Florida both decide to halt the reopenings as each state records growing numbers of cases.
June 29 — Gilead Sets Price for Remdesivir at $3120
Gilead Sciences sets a price for remdesivir, which can shorten hospitalization stays for patients with COVID-19, at $520 a vial. With a treatment course of 6 vials, the typical treatment course will be $3120 per patient for people covered with private insurance. Critics of the price point are quick to point out that taxpayers funded the COVID-19 remdesivir trial through the National Institute of Allergy and Infectious Diseases.
June 30 — Fauci Warns New COVID-19 Cases Could Hit 100,000 a Day
In his appearance before the Senate Health, Education, Labor, and Pensions Committee, Fauci warns that while the current daily number of new cases in the United States is hovering around 40,000, that could reach as high as 100,000 new cases per day given the outbreak’s current trajectory.