It started as a seemingly perplexing case of pneumonia.
From a wet market in Wuhan, China, Covid-19 has spread to nearly every country on the globe in just under nine months. It's overturned daily lives, shuttered businesses and schools, and disrupted the world economy. It's infected more than 33 million people worldwide and has killed at least 1 million people — a toll that's likely to be far more than the official tallies show, global health officials say.
The coronavirus has laid bare public health shortcomings in even the most advanced countries on the planet that, up until 2020, hadn't witnessed a pandemic for more than 100 years. In the U.S., Covid-19 has tested hospital systems and their capacity to treat severely ill patients and has pushed drug companies to try to develop vaccines and therapeutics in record time.
The World Health Organization has warned, however, that the coronavirus pandemic is not over. According to a WHO situation report on Monday, there were nearly 2 million new Covid-19 cases reported the week ended Sept. 20, the highest number of reported cases in a week since the epidemic began. The Americas continue to report the bulk of new cases, representing half of all reported coronavirus infections across the globe so far.
"It has not burned out, it is not burning out, it is not going away," Dr. Mike Ryan, executive director of the WHO's health emergencies program, said of the coronavirus during a press briefing on Sept. 18.
This is the insidious path the coronavirus took to kill at least 1 million people. The number of reported deaths below come from WHO situation reports and data compiled by Johns Hopkins University released on the corresponding day.
Chinese health officials announced on Dec. 31 that they were investigating more than 20 cases of a viral pneumonia, rumored to be severe acute respiratory syndrome, or SARS, according to a Reuters report. The Wuhan Municipal Health Commission said an investigation and cleanup were underway at a local seafood market, which was suspected of being connected to the illness, the report said. The WHO requested information on the reported cluster from Chinese authorities the next day.
Chinese health authorities in Wuhan reported the first death linked to the pneumonia illness likely caused by a new, unknown virus, STAT News reported. The 61-year-old man died after being admitted to the hospital with respiratory failure and severe pneumonia, the report said, citing the Wuhan Municipal Health Committee, which had identified at least 41 cases of the illness.
The U.S. Centers for Disease Control and Prevention confirmed on Jan. 21 the first travel-related cases of the novel coronavirus in Washington state. In its report, the CDC said there were "growing indications" that the virus could be spreading from human-to-human contact compared with original reports of animal-to-human spread.
In a situation report from the day prior, the WHO found cases in Thailand, Japan and South Korea, the first handful of cases reported outside China.
After infecting more than 8,200 people around the world, mostly in mainland China, with thousands more suspected cases awaiting test results, the WHO declared the coronavirus a public health emergency, which is defined as an "extraordinary event" that is "serious, unusual or unexpected." The designation came only hours after the CDC confirmed the first person-to-person transmission in the U.S.
President Donald Trump announced on Jan. 31 that the United States would suspend entry to people who traveled to China in the past 14 days, excluding U.S. citizens or their immediate family members.
By that point, Chinese health officials had reported approximately 10,000 coronavirus cases and more than 200 deaths. However, other countries were beginning to report initial cases; there were at least 106 cases in 19 countries outside of China, according to a WHO situation report. Those nations included France, Germany, Italy, Canada, India and Australia.
Carnival's Princess Cruises announced on Feb. 4 that it was placing 3,700 passengers and crew under mandatory quarantine for two weeks after 10 people aboard the Diamond Princess in Yokohama, Japan, tested positive.
More than 700 people aboard the ship would ultimately test positive for Covid-19 and multiple people died. At least 25 other cruise ships across the globe detected coronavirus cases in the month following, according to Nature, including the Grand Princess that was moored off the cost of California in early March.
The WHO announced a name for the disease caused by the coronavirus: Covid-19. The CO stands for corona, the VI for virus and the D for disease. "Having a name matters to prevent the use of other names that can be inaccurate or stigmatizing," Tedros Adhanom Ghebreyesus, director-general of the WHO, told reporters at a news conference at the agency's headquarters in Geneva. "It also gives us a standard format to use for any future coronavirus outbreak."
Officials in Brazil confirmed on Feb. 26 that a 61-year-old man who traveled to Italy was Latin America's first case of Covid-19, according to The Associated Press. Brazil's national health agency said it would map the man's contacts, including people aboard his flight.
A woman who had recently traveled to Iran became the first recorded case of Covid-19 in the city and in New York state on March 1, officials reported. Then officials confirmed on March 4 that a family of four and their neighbor had tested positive for the virus.
Just over a week later the number of cases in New York began to spike to more than 400, the most of any state, though New York Gov. Andrew Cuomo warned there were likely "thousands and thousands" of cases already walking around the state. He told residents that New York officials expected the coronavirus to spread rapidly like it did in countries like China, South Korea and Italy.
On March 20, Cuomo ordered nonessential businesses to keep 100% of their workforce home, acknowledging the actions would cause businesses to shutter and people to lose their jobs. "When I talk about the most drastic action we can take, this is the most drastic action we can take," he said.
Italian Prime Minister Giuseppe Conte expanded the country's lockdown to the entire nation on March 9 as Italy's case count grew well above its European counterparts, reporting more than 1,000 new cases daily for the first time. The lockdown was seen as one of the most extensive efforts taken by a government outside of China to curb Covid-19.
The WHO declared the coronavirus a global pandemic after Covid-19 infected more than 121,000 people and killed at least 4,300. By that point, daily new cases in China and South Korea had significantly declined while Italy and Iran were reporting growing outbreaks.
That same day, Trump announced travelers from Europe to the U.S. would be banned for 30 days, applying only to countries in the Schengen economic and travel zone. The United Kingdom and Ireland were exempt from the restriction.
On March 13, the WHO's Tedros said Europe was the new epicenter for Covid-19 cases. "Europe has now become the epicenter of the pandemic, with more reported cases and deaths than the rest of the world combined, apart from China," Tedros said at a news briefing. "More cases are now being reported every day than were reported in China at the height of its epidemic."
By that point, coronavirus cases were accelerating in countries outside of China, which had managed to suppress its daily new case count, according to the WHO's situation report. Italy had the worst outbreak with more than 15,100 cases, followed by Spain with over 2,900 and France with more than 2,800. While other European countries were reporting less than 100 deaths, Italy's death toll had grown above 1,000.
Faced with a growing outbreak, France's president, Emanuel Macron, ordered the country to stay at home for up to 15 days, saying the nation was in "a health war." France's total number of cases had grown from 130 on March 1 to more than 6,600 by March 16. The country would later surpass China's total number of reported cases on April 3 with more than 83,000 cases.
Macron's order came the same day Canadian Prime Minister Justin Trudeau closed the country's borders to noncitizens with the exception of travelers from the U.S.
China reported no new domestic transmission for the first time since its outbreak began, a sign that its stringent lockdown measures helped curb the coronavirus's spread, according to Reuters. There were roughly 81,000 reported cases in China and at least 3,200 deaths.
The United States surpassed China and Italy in total number of Covid-19 cases, becoming the world's largest outbreak. The nation's total number of cases reached above 82,400, however, officials said that the cases were likely underreported since testing had been hampered by delays and strict limits over who could get a test. New York had the worst outbreak within the country, reporting nearly half of the nation's total cases.
U.K. Prime Minister Boris Johnson announced on March 27 that he'd tested positive for Covid-19, becoming one of the first world leaders infected with the virus. Johnson, who was 55 years old at the time, was later sent to the hospital on April 5 as a "precautionary step" after showing persistent symptoms, a Downing Street spokesperson said. As his symptoms worsened, he was sent to intensive care shortly after but later recovered.
Global cases doubled within a week to reach 1 million on April 2, with the U.S. reporting 20% of the total, and a death toll near 50,000. Tedros, the WHO's director general, warned that the world has "witnessed a near exponential growth in the number of new cases, reaching almost every country, territory and area."
Some countries in Africa were beginning to report initial cases, including more than 900 in Algeria, which alarmed officials concerned about the region's health systems.
New York state reported more cases than any other country beginning April 10 at more than 161,800 confirmed cases, overtaking Spain, Italy, France and Germany. The state had yet to report more deaths than those countries.
The WHO warned on May 2 that a delayed epidemic was taking place in Eastern European countries as Russia reported a spike in coronavirus deaths. Russia also surpassed Germany and France to become the world's fifth-most infected country.
"There are differences right now between Western Europe, which has been through that first big wave, and Eastern Europe, particularly Russian Federation, that is now experiencing higher numbers of disease," the WHO's Ryan said.
The European Union's agency for disease control warned on May 5 that five countries in the region — Poland, Romania, Sweden, Bulgaria and the U.K. — were not experiencing a decline in cases like other countries in the bloc. The U.K. eclipsed Italy and Spain, which were the worst-affected countries in Europe up until then, in the number of Covid-19 deaths that same week, according to a WHO situation report.
The U.K. government began to take its first steps to ease stringent coronavirus lockdown measures on May 10, encouraging people who can't work from home to return to work and and suggest children could go back to school in June.
Italy, Portugal and Belgium started to allow a handful of businesses to reopen with health precautions in early May after weeks of lockdown measures. Those countries followed others like Germany, Austria and Denmark, which began partial reopenings in late April.
Although every state in the U.S. began easing stringent lockdown restrictions set in place in the spring to curb the coronavirus spread, "not all states" met the White House criteria for reopening businesses, CDC Director Robert Redfield said. Crowds of people were reported over the Memorial Day weekend in late May on beaches from California to Florida and at protests over the police killing of George Floyd, an unarmed Black man, in Minneapolis.
While cases slowed in hot spots such as New York state, they were on the rise in places like Florida, Texas and Arizona that removed shelter-in-place orders much earlier.
The WHO's African regional office warned on June 11 that Covid-19 cases were accelerating in Africa after more than 200,000 cases were confirmed on the continent. Africa reported its first case in mid-February and took 100 days to reach 100,000 cases. However, it took less than 20 days to surpass 200,000, according to a WHO report.
There were at least 5,600 coronavirus deaths in the region with more than 70% occurring in five nations: Algeria, Egypt, Nigeria, South Africa and Sudan.
Nearly half of U.S. states reported growing coronavirus hospitalizations by early July after a summer of rising cases. Texas had reported a record of more than 8,000 people in its hospitals while Arizona, California and Georgia also reported growing Covid-19 hospitalizations as the outbreak spread across America's Sun Belt.
By mid-July, Texas officials and funeral home directors prepared for some of those hospitalizations to worsen and ordered body bags and trucks from the U.S. Federal Emergency Management Agency to serve as temporary mortuaries.
Roughly 9% of meatpacking facility employees in the U.S. across 14 states tested positive for Covid-19, according to a report from the CDC. The facilities, where employees work closely together for long shifts, operated through the worst of the pandemic earlier this year and became early hotspots for the nation's outbreak.
According the the nonprofit Food and Environment Reporting Network, which has been tracking the outbreaks, at least 59,000 U.S. meatpacking and farm workers have tested positive for Covid-19 and at least 250 have died as of mid-September.
The University of North Carolina at Chapel Hill announced on Aug. 17 that it would send its students home only weeks into the fall semester after the percentage of students and staff testing positive grew above 13%. UNC was among the first institutions to reverse its plans, though others have paused in-person instruction after spikes in coronavirus cases.
Following UNC's closure, more than 88,000 cases have been reported at colleges and universities across the country, according to data compiled by The New York Times last updated in early September.
Europe started to report a sharp rise in the number of new Covid-19 cases as many countries tried to reopen their economies and get people back to work while also achieving public health goals.
More than half of the new cases reported through the week ended Aug. 23 were from four countries: Spain (21%), Russia (16%), France (10%) and Ukraine (6%).
U.K. Prime Minister Johnson walked back some of the eased lockdown measures in England on Sept. 22, telling people to work from home again if possible and ordering pubs and restaurants to close at an earlier time. He warned that the measures could be in place for up to six months if conditions don't improve, saying the country was at a "perilous turning point."
London Mayor Sadiq Khan warned in a statement the day prior that Covid-19 is "spreading exponentially, in all age groups, across the U.K."
It took the coronavirus less than nine months to surpass yet another grim milestone: 1 million deaths. World leaders are struggling to contain the pandemic while reopening businesses and schools. The economic devastation has contributed to an increase in suicides, domestic abuse, violent crimes and mental health issues across America — making the economic fallout as big of a public health problem as the virus itself, government officials say.
Correction: On Sept. 1, the coronavirus death toll was 857,015. An earlier version misstated the figure.