The coronavirus is officially a pandemic. Here's what that means, and 8 other outbreaks that got the designation - or should have.

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The coronavirus is officially a pandemic. Here's what that means, and 8 other outbreaks that got the designation - or should have.

FILE PHOTO: Members of a Servpro cleanup crew wearing hazardous material suits prepare to enter Life Care Center of Kirkland, the Seattle-area nursing home at the epicenter of one of the biggest coronavirus outbreaks in the United States, in Kirkland, Washington, U.S. March 11, 2020.  REUTERS/Jason Redmond

Jason Redmond/Reuters

Members of a Servpro cleanup crew wearing hazardous material suits prepare to enter Life Care Center of Kirkland, the Seattle-area nursing home at the epicenter of one of the biggest coronavirus outbreaks in the United States, on March 11, 2020.

Ten weeks after the first reported case of the new coronavirus, the World Health Organization (WHO) declared the outbreak a pandemic. The last time it used the designation was in 2009, when H1N1 flu spread to nearly every corner of the globe.

In 2010, the organization defined a pandemic as "the worldwide spread of a new disease." The determination is based on the geographic spread of a disease, the severity of illnesses it causes, and its effects on society.

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"WHO has been assessing this outbreak around the clock, and we're deeply concerned both by the alarming levels of spread and severity and by the alarming levels of inaction," the organization's director-general, Tedros Adhanom Ghebreyesus, told reporters on Wednesday.

"Pandemic is not a word to use lightly or carelessly," Tedros added. "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."

 

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The pandemic designation is a bit ambiguous

Director-General of the WHO Tedros Adhanom Ghebreyesus, attends a news conference on the coronavirus (COVID-2019) in Geneva, Switzerland February 24, 2020. REUTERS/Denis Balibouse

Denis Balibouse/Reuters

Director-General of the WHO Tedros Adhanom Ghebreyesus, attends a news conference on the new coronavirus (COVID-19) in Geneva, Switzerland on February 24, 2020.

"There's no numerical definition of a pandemic - like beauty, it's in the eye of the beholder," William Schaffner, an infectious-disease specialist at the Vanderbilt University School of Medicine, previously told Business Insider.

Until Wednesday, the coronavirus outbreak had been classified as an epidemic. The WHO defines that as the  occurrence of an illness "clearly in excess of normal expectancy" in a community or region.

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But a definition for pandemic is absent from the WHO dictionary of emergency terms. The organization instead lumps pandemic and epidemic diseases together in the same list, which includes everything from cholera to the Spanish flu.

 

In epidemiology, however, a pandemic is an epidemic that reaches a global scale, crossing many international boundaries and usually affecting a very large number of people.

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By that definition, the SARS outbreak and HIV/AIDS are both pandemics, though the WHO does not label them as such. SARS spread to 29 countries between 2002 and 2003 and infected more than 8,000 people. Many experts called SARS "the first pandemic of the 21st century."

FILE PHOTO: A nurse wearing protective gear walks outside a Severe Acute Respiratory Syndrome Clinic (SARS) in suburban Toronto, April 24, 2003. REUTERS/Mike Cassese/File Photo

Mike Cassese/Reuters

A nurse wearing protective gear walks outside a SARS clinic in suburban Toronto, Canada, April 24, 2003.

HIV/AIDS is an ongoing pandemic that affects 37.9 million people across the globe. It is a leading cause of death worldwide.

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The definition of a pandemic also means that the Black Death, or bubonic plague, probably deserves the label. It killed an estimated 25 million people the 14th century. About 60% of Europe's population was wiped out.

The Spanish flu, which infected about 500 million people between 1918 and 1919, is labeled an influenza pandemic by the Centers for Disease Control and Prevention (CDC). The virus, a variant of H1N1 flu, impacted one-third of the world's population at the time. The CDC lists three other flu waves - in 1958, 1968, and 2009 - as influenza pandemics. 

The last time the WHO declared a pandemic was in 2009

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mask swine flu sick disease hospital doctor

Chung Sung-Jun/Getty Images

A nurse wears a protective mask during the 2009 H1N1 pandemic.

The word "pandemic" comes from the Greek "pan" and "demos," meaning "all the people," but using it does not change that much from a pragmatic, disease-fighting perspective.

The WHO's hesitation in using the term may have to do with its experience during the H1N1 outbreak in 2009 (the last time the organization designated a severe outbreak as a pandemic). The H1N1 flu infected one in every five people on the planet that year, killing about 0.02% of infected patients. But after its first year circulating the globe, the virus "petered out," according to CBS medical contributor Dr. David Agus.

So Agus suggested that the WHO may have waited to declare the coronavirus a pandemic due to its premature use of the word during the H1N1 outbreak - and the resulting panic it caused.

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Read more:

World Health Organization declares the coronavirus a pandemic

One key indicator will tell us when the coronavirus outbreak is winding down - but we're not seeing it yet

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One chart shows 11 countries' coronavirus death rates, based on the known number of cases and deaths

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