Event background

On 31 December 2019, the Wuhan Municipal Health Commission in Wuhan City, Hubei province, China, reported a cluster of pneumonia cases (including seven severe cases) of unknown aetiology, with a common reported link to Wuhan’s Huanan Seafood Wholesale Market, a wholesale fish and live animal market [1].

On 1 January 2020, the market was closed down. According to the Wuhan Municipal Health Commission, samples from the market tested positive for a novel coronavirus. Cases showed symptoms such as fever, dry cough and dyspnoea; radiological findings showed bilateral lung infiltrates [2].

On 9 January 2020, China’s CDC reported that a novel coronavirus (later named SARS-CoV-2, the virus causing COVID-19) had been detected as the causative agent for 15 of the 59 cases of pneumonia [3]. 

On 9 January 2020, ECDC published a Threat Assessment Brief on the cluster of pneumonia possibly associated with a novel coronavirus in Wuhan, China [4].

On 10 January 2020, the first novel coronavirus genome sequence was made publicly available [5]. The sequence was deposited in the GenBank database (accession number MN908947) and uploaded to the Global Initiative on Sharing All Influenza Data (GISAID).

On 17 January 2020, ECDC published its first risk assessment on the novel coronavirus [6].

By 20 January 2020, there were reports of confirmed cases from three countries outside China: Thailand, Japan and South Korea [7]. These cases had all been exported from China.

On 23 January 2020, Wuhan City was locked down – with all travel in and out of Wuhan prohibited – and movement inside the city was restricted [8].

On 24 January 2020, the first European case was reported in France. This case had a travel history to China [9]. On 28 January 2020, Germany, also reported cases, related to a person visiting from China [10].

On 30 January 2020, the World Health Organization (WHO) declared this first outbreak of novel coronavirus a ‘public health emergency of international concern’ [11]. On 22 February 2020, and over the following days, the Italian authorities reported clusters of cases in several regions (Lombardy, Piedmont, Veneto etc). During the following week, several European countries reported cases of COVID-19 in travellers from the affected areas in Italy, as well as cases without epidemiological links to Italy, China or other countries with ongoing transmission [12]. 

On 8 March 2020, Italy issued a decree to install strict public health measures including social distancing, starting in the most affected regions and on 11 March 2020 extending these measures at national level. Following this, Spain, France and many other European countries installed similar public health measures [13].

On 11 March 2020, the Director General of the WHO declared COVID-19 a ‘global pandemic’ [14].

As of 25 March 2020, all EU/EEA countries and more than 150 countries worldwide had been affected.

On 3 April 2020, the number of confirmed COVID-19 cases reported worldwide surpassed one million.

On 8 April 2020, ECDC provided its expert opinion on the use of face masks in public by individuals who are not ill to reduce potential pre-symptomatic or asymptomatic transmission of COVID-19. This opinion was translated into 26 languages [15].

On 14 April 2020, the European Commission, in cooperation with the President of the European Council, put forward a European roadmap towards lifting coronavirus containment measures [16].

During the course of April 2020, many EU/EEA countries started to adjust their response measures (i.e., the gradual opening of schools, small shops and other businesses) [17].

On 23 April 2020, the number of confirmed cases of COVID-19 in the EU/EAA and the United Kingdom (UK) surpassed one million.

On 27 April 2020, health authorities in the UK warned of a number of seriously ill children with multisystem inflammatory syndrome associated with COVID-19, presenting with signs of circulatory shock and hyperinflammatory state, with features consistent with toxic shock or Kawasaki disease [18].

On 13 May 2020, the European Commission presented guidelines and recommendations to help Member States gradually lift travel restrictions, with all the necessary safety and precautionary means in place [19].

On 21 May 2020, the European Union Aviation Safety Agency (EASA) and ECDC jointly published guidance for the management of airline passengers in relation to the COVID-19 pandemic [20].

On 17 June 2020, the European Commission presented a European strategy to accelerate the development, manufacture and deployment of vaccines against COVID-19 [21]. 

On 29 June 2020, the number of confirmed cases of COVID-19 worldwide surpassed 10 million.

On 9 July 2020, the WHO’s Director-General announced the initiation of the Independent Panel for Pandemic Preparedness and Response (IPPR) to evaluate the world’s response to the COVID-19 pandemic [22].

On 27 July 2020, the European Maritime Safety Agency (EMSA) and ECDC jointly published guidance for cruise ship operations in relation to the COVID-19 pandemic [23].

On 12 August 2020, the number of confirmed COVID-19 cases worldwide surpassed 20 million.

On 28 August 2020, ECDC launched a tutorial on ‘how to wear a face mask properly’ [24].

On 4 September 2020, the European Commission adopted a proposal for a European Council recommendation to ensure that any measures taken by Member States that restrict free movement due to the coronavirus pandemic are coordinated and clearly communicated at the EU level [25].

On 18 September 2020, ECDC published its testing strategies and objectives of populations in various epidemiological situations [26].

On 18 September 2020, the European Medicines Agency endorsed the use of dexamethasone for COVID-19 patients on oxygen or mechanical ventilation [27].

On 18 September 2020, the number of confirmed COVID-19 cases worldwide surpassed 30 million.

On 21 September 2020, ECDC published a Threat Assessment Brief on re-infection, following reports of cases with suspected or possible reinfection with SARS-CoV-2 [28].

On 24 September, ECDC published the 12th update of its risk assessment on COVID-19 in the EU/EEA and the UK, evaluating the risk of COVID-19 in coming weeks and months with particular attention to the impact on healthcare services due to the increase of COVID-19 cases observed following the summer and the lifting of some control and preventive measures. This was a reminder that the pandemic is far from over [29]. 



1. Wuhan City Health Committee (WCHC). Wuhan Municipal Health and Health Commission’s briefing on the current pneumonia epidemic situation in our city, 2019 [updated 31 December 2019, 14 January 2020]. Available from: https://epaper.hubeidaily.net/pc/content/202001/01/content_15040.html

2. European Centre for Disease Prevention and Control (ECDC). Risk assessment: Outbreak of acute respiratory syndrome associated with a novel coronavirus, Wuhan, China; first update 2020 [updated 22 January 2020]. Stockholm: ECDC; 2020. Available from: https://www.ecdc.europa.eu/en/publications-data/rapid-risk-assessment-cluster-pneumonia-cases-caused-novel-coronavirus-wuhan

3. News X. Experts claim that a new coronavirus is identified in Wuhan 2020 [14 January 2020]. Available from:  http://www.xinhuanet.com/2020-01/09/c_1125438971.htm

4. European Centre for Disease Prevention and Control (ECDC). Threat Assessment Brief: Pneumonia cases possibly associated with a novel coronavirus in Wuhan, China. Stockholm: ECDC; 2020. Available from: https://www.ecdc.europa.eu/en/publications-data/pneumonia-cases-possibly-associated-novel-coronavirus-wuhan-china

5. Holmes E. Initial genome release of novel coronavirus 2020 [14 January 2020]. Available from: http://virological.org/t/initial-genome-release-of-novel-coronavirus/319

6. European Centre for Disease Prevention and Control (ECDC). Rapid Risk Assessment: Cluster of pneumonia cases caused by a novel coronavirus, Wuhan, China, 2020. Stockholm: ECDC; 2020. Available from: https://www.ecdc.europa.eu/en/publications-data/rapid-risk-assessment-cluster-pneumonia-cases-caused-novel-coronavirus-wuhan

7. World Health Organization. Novel Coronavirus (2019-nCoV) SITUATION REPORT – 1, 20 January 2020. Geneva: WHO; 2020. Available from:  https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200121-sitrep-1-2019-ncov.pdf?sfvrsn=20a99c10_4

8. Du Z, Wang L, Chauchemez S, Xu X, Wang X, Cowling BJ, et al. Risk for transportation of 2019 novel coronavirus disease from Wuhan to other cities in China. Emerg Infect Dis. 2020 May. Available from:  https://doi.org/10.3201/eid2605.200146

9. Santé publique France. Epidémie de coronavirus Covid-19 au départ de Wuhan, Chine. Paris: Santé publique France; 2020. Available from : https://www.santepubliquefrance.fr/dossiers/coronavirus-covid-19

10. Bayerisches Staatsministerium für Gesundheit und Pflege. Bestätigter Coronavirus-Fall in Bayern – Infektionsschutzmaßnahmen laufen. Munich: BSfGuP; 2020. Available from: https://www.stmgp.bayern.de/presse/bestaetigter-coronavirus-fall-in-bayern-infektionsschutzmassnahmen-laufen

11. World Health Organization. Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV). Geneva: WHO; 2020. Available from: https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov)

12. European Centre for Disease Prevention and Control. Outbreak of novel coronavirus disease 2019 (COVID19): situation in Italy – 23 February 2020. ECDC: Stockholm; 2020. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/novel-coronavirus-threat-assessment-brief-23-feb-2020.pdf

13. Ministero della salute. Notizie dal Minististero. Covid-19, nuove regole: evitare ogni spostamento nelle zone colpite. Available from: http://www.salute.gov.it/portale/news/p3_2_1_1_1.jsp?lingua=italiano&menu=notizie&p=dalministero&id=4173

14. WHO Director-General’s opening remarks at the media briefing on COVID-19 – 11 March 2020. Available from: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19—11-march-2020

15. European Centre for Disease Prevention and Control. Using face masks in the community. Stockholm: ECDC; 2020. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/COVID-19-use-face-masks-community.pdf

16. European Commission. Joint European Roadmap towards lifting COVID-19 containment measures. Available from: https://ec.europa.eu/info/sites/info/files/communication_-_a_european_roadmap_to_lifting_coronavirus_containment_measures_0.pdf

17. Coronavirus disease 2019 (COVID-19) in the EU/EEA and the UK – ninth update, 23 April 2020. Stockholm: ECDC; 2020. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-rapid-risk-assessment-coronavirus-disease-2019-ninth-update-23-april-2020.pdf

18. Riphagen S, Gomez X, Gonzalez-Martinez C, Wilkinson N, Theocharis P. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet. 2020 06/05/2020. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204765

19. European Commission. Travel and transportation during the coronavirus pandemic. Available from: https://ec.europa.eu/info/live-work-travel-eu/health/coronavirus-response/travel-and-transportation-during-coronavirus-pandemic_en

20. COVID-19 Aviation Health Safety Protocol: Guidance for the management of airline passengers in relation to the COVID-19 pandemic. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/EASA-ECDC_COVID-19_Operational-guidelines-for-management-of-passengers.pdf

21. European Commission. EU Strategy for COVID-19 vaccines. Available from: https://ec.europa.eu/info/sites/info/files/communication-eu-strategy-vaccines-covid19_en.pdf

22. World Health Organization. News release on independent evaluation of global COVID-19 response. Available from: https://www.who.int/news-room/detail/09-07-2020-independent-evaluation-of-global-covid-19-response-announced

23. COVID-19 EU guidance for cruise ship operations: Guidance on the gradual and safe resumption of operations of cruise ships in the European Union in relation to the COVID-19 pandemic. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/COVID-19-cruise-guidance-27-07-2020.pdf

24. European Centre for Disease Prevention and Control. Do you know how to wear a face mask properly? Stockholm: ECDC; 2020. Available from: https://www.ecdc.europa.eu/en/publications-data/video-covid-19-do-you-know-how-wear-face-mask-properly-long-version

25. European Commission. Proposal for a Council recommendation on a coordinated approach to the restriction of free movement in response to the COVID-19 pandemic. Available from: https://ec.europa.eu/info/sites/info/files/council-proposal-coordinated-approach-restriction-movement_en.pdf

26. European Centre for Disease Prevention and Control. COVID-19 testing strategies and objectives. Stockholm: ECDC; 2020. Available from: https://www.ecdc.europa.eu/en/publications-data/covid-19-testing-strategies-and-objectives 

27. European Medicines Agency. EMA endorses use of dexamethasone in COVID-19 patients on oxygen or mechanical ventilation. Amsterdam: EMA; 2020. Available from: https://www.ema.europa.eu/en/news/ema-endorses-use-dexamethasone-covid-19-patients-oxygen-mechanical-ventilation

28. European Centre for Disease Prevention and Control. European Centre for Disease Prevention and Control. COVID-19 testing strategies and objectives. Stockholm: ECDC; 2020. Available from: https://www.ecdc.europa.eu/en/publications-data/threat-assessment-brief-reinfection-sars-cov-2

29 European Centre for Disease Prevention and Control. Increased transmission of COVID-19 in the EU/EEA and the UK – 24 September 2020. ECDC: Stockholm; 2020.Available from: https://www.ecdc.europa.eu/en/publications-data/covid-19-risk-assessment-increased-transmission-twelfth-update

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