Expressing alarm both about mounting infections and inadequate government responses, the World Health Organization declared Wednesday that the global coronavirus crisis is now a pandemic but added that 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 U.N. health agency sought to shock lethargic countries into pulling out all the stops.
"We have called every day for countries to take urgent and aggressive action. We have rung the alarm bell loud and clear," said Tedros Adhanom Ghebreyesus, the WHO chief.
"All countries can still change the course of this pandemic. If countries detect, test, treat, isolate, trace and mobilize their people in the response," he said. "We are deeply concerned by the alarming levels of spread and severity and by the alarming levels of inaction."
The WHO said 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.
He added that the agency thought long and hard about labeling the crisis a pandemic -- meaning a new virus causing sustained outbreaks in multiple regions of the world.
The risk of employing the term, Ryan said, is "if people use it as an excuse to give up."
But the benefit is "potentially of galvanizing the world to fight."
Underscoring the mounting challenge: The case count outside China has multiplied 13-fold over the last two weeks to over 118,000, with the disease now responsible for nearly 4,291 deaths, WHO said.
With officials saying that Europe has become the new epicenter, Italy's cases soared again, to 12,462 infections and 827 deaths -- numbers second only to China.
"If you want to be blunt, Europe is the new China," said Robert Redfield, the head of the U.S. Centers for Disease Control and Prevention.
Italy weighed imposing even tighter restrictions on daily life and announced billions in financial relief Wednesday to cushion economic shocks from the coronavirus, its latest efforts to adjust to the fast-evolving 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 Tuesday. Lombardy wants to shut down nonessential businesses and reduce public transportation.
These measures would be on top of travel and social restrictions that imposed an eerie hush on cities and towns across the country. Police enforced rules that customers stay 1 meter (3 feet) apart and ensured that businesses closed by 6 p.m.
Milan shopkeeper Claudia Sabbatini said she favored the stricter measures. Rather than risk customers possibly infecting each other in her children's clothing store, she closed 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.
Still, the effectiveness of such measures as travel restrictions and quarantines will likely drop substantially and be called into question as COVID-19 spreads globally, making it impossible for countries to keep the virus out. Health officials will also need to be more flexible in their coordinated response efforts, as the epicenters are likely to shift quickly and dramatically -- as the recent eruptions in Iran and Italy have demonstrated.
Conte emphasized fighting the outbreak must not come at the expense of civil liberties, suggesting 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 Wednesday, five arrived from Italy and one from the United States. China has had over 81,000 virus infections and over 3,000 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 4,300 have died.
But most people recover. People with mild illness recover in about two weeks, while those with more severe illness may take three to six weeks to recover, the WHO says.
In the Mideast, most of the nearly 10,000 cases are in Iran or involve people who traveled to the country. Iran's semiofficial Fars news agency said they include Vice President Eshaq Jahangiri. Iran's ministers for cultural heritage, handicrafts and tourism, and for industry, mines, and business were also infected, the agency said.
In Qatar, cases 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. U.S. stocks in afternoon trading wiped out more than all the gains from a huge rally a day earlier as Wall Street continues to reel.
Wall Street's 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 dedicating 25 billion euros (nearly $28 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-pound ($39 billion) economic stimulus package and the Bank of England slashed its key interest rate by half a percentage point to 0.25%.
Normal life was increasingly upended, with Pope Francis live-streaming prayers from the privacy of his Vatican library as police barred access to St. Peter's Square, emptying it of tens of thousands of people who attend the weekly papal address.
In the U.S., the caseload passed 1,000, and outbreaks on both sides of the country stirred alarm.
Former U.S. Vice President Joe Biden and Sen. Bernie Sanders, vying to take on President Donald Trump in the presidential election, canceled rallies Tuesday and left open the possibility that future campaign events could be impacted. 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, Spain's number of cases surged Wednesday past the 2,000 mark and Belgium, Bulgaria, Sweden, Albania, and Ireland all announced their first virus-related deaths.
And at a Congressional hearing in Washington Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease, sounded an alarm: "Bottom line, it's going to get worse."
In Germany, Chancellor Angela Merkel said that if the virus is not halted by vaccines and cures, up to 70% of the country's 83 million people could ultimately become infected.
Germany has about 1,300 confirmed infections and Merkel's comments fit a pattern of government officials using sobering warnings to convince people to protect themselves by washing their hands and not gathering in large numbers.
"It's terrifying," said Silvana Gomez, a student at Harvard University, where undergraduates were told to leave campus by Sunday. "I'm definitely very scared right now about what the next couple days, the next couple weeks look like"