COVID-19 curves: Compare Canada and other key nations
TORONTO -- Around the world, new COVID-19 infections and deaths continue to mount. From Canada to South Korea, every country has responded differently -- in some cases, quite significantly, resulting in vastly different outcomes.
Curious how different countries are faring? You can chart and compare the progression for jurisdictions that have reported more than 100 cases using our interactive graphs below.
A brief overview of a few select examples are highlighted below, along with a timeline focusing on key early containment measures and events up to the end of March. Economic measures are excluded.
- For more in-depth maps, check out our Project Pandemic page, and for complete coverage, visit CTVNews.ca/coronavirus
Provinces, territories and global jurisdictions with fewer than 100 cases are not included.
WORLD HEALTH ORGANIZATION (TOP)
- The World Health Organization is informed of several unusual cases of pneumonia in Wuhan
- Press release issued on pneumonia of unknown cause
- Outbreak declared a "public health event of international concern"
- Novel coronavirus disease named COVID-19
- WHO issues warning that window to contain outbreak is narrowing
- WHO declares the global outbreak a pandemic
For a long time, the messaging from Canadian health officials was that the novel coronavirus outbreak risk for Canadians was low and that efforts would be concentrated on containing the spread. Government officials were also guided by advice from the World Health Organization, which had initially discouraged travel restrictions, border closures and the wearing of masks, positions that were later criticized and reversed as the spread became increasingly dire in many countries. As the tally of cases grew in Canada, it became increasingly clear that many of the cases were linked to the United States. The level of movement between the two countries made containment impossible without drastic measures: On March 20, the 8,891-kilometre-long border was closed to non-essential travel and remains closed.
As infections rose in Canada, long-term care homes, especially in Ontario and Quebec, suffered a disproportionately devastating impact, with more than 80 per cent of the total deaths in Canada attributable to outbreaks at hundreds of these facilities.
Canada began turning a corner in early May, some three and a half months after its first case was identified. The number of new infections fell and the daily death toll dropped as low as the single digits from a peak of 177, prompting provinces to slowly reopen again.
For more background on Canada’s handling of COVID-19, read our report detailing the evolution of Canada’s plans to fight the virus, the response by each province, and track every case.
- Documents reveal glimpse into Canada’s early COVID-19 plans
- This is how each province is handling the pandemic
- Tracking every case of COVID-19 in Canada
Timeline of Key Early Events and Measures
- The Public Health Agency of Canada activates Emergency Operations Centre
- As more and more countries screen air travellers coming from China, Canada has yet to take similar screening measures
- Warning signs are added at major Canadian airports, raising awareness of the new virus
- New health screening requirements are implemented for all passengers coming from China to airports in Montreal, Toronto, and Vancouver.
- First case in Canada is confirmed in a patient returning from Wuhan, China
Jan. 29 - Feb. 2
- Airport screening requirements are expanded
- Canada confirms its first case related to travel outside China
- Minister of Health recommends stockpiling some food and medication “because things can change quickly”
Early to Mid-March
- B.C. confirms first case of community transmission in Canada on March 5 while Ontario sees first evidence of it mid-March
- As the WHO declares a pandemic, provinces and territories go into high alert
- State of emergencies declared across Canada; different regions implement different restrictions on the number of people allowed in a gathering
- Schools close across the country, along with daycares, non-essential businesses and cancelled events and activities involving large groups
- For a closer look at regional measures, please check out our story on how each province handled the pandemic
- Canadians are advised to avoid all non-essential travel outside Canada indefinitely
- Government advises Canadians returning from abroad to self-isolate for 14 days
- Government announces border closure set for after midnight on March 18; only Canadians, their families, residents, and Americans allowed
- Health Canada speeds up access to COVID-19 test kits
- Canadians are advised to practice physical distancing
- All international flights are redirected to airports in Vancouver, Calgary, Toronto and Montreal
- Canada-U.S. border closes to all non-essential travel
- Quarantine act is invoked; mandates all travellers must self-isolate
- All passengers flying in Canada are subject to a health check
The country was hit hard by COVID-19, but received attention early in the pandemic due to its low mortality rate of less than 1.5 per cent compared to other European countries at the time. In early April, Italy’s mortality rate stood at around 12 per cent, while Spain, France and Britain was roughly 9 to 10 per cent. Earlier during the pandemic, the testing rate for the latter three countries was also a fraction of Germany's, with some media reports indicating that Germany was able to ramp up extensive testing more quickly and earlier.
Germany also has more than double the number of hospital beds in Italy and Spain, according to OECD data, and a number of media reports cited Germany's "expensive and extensive" public health care system as a key reason for the lower mortality rate. Like many other countries, however, there was ongoing concern over a shortage of masks and other protective equipment during the height of the country’s outbreak.
Germany's outbreak also began mostly among young and healthy skiers who caught the virus at European ski resorts and the overall average age of infected patients early in the pandemic was more than a decade younger than its neighbouring countries. At first, the government appeared reluctant to impose physical distancing measures, travel restrictions, school and border closures, even as it advised against unnecessary travel and asked recent travellers from high-risk destinations to stay home.
The country began easing restrictions in May, with an “emergency brake” set-up for restrictions to be reinstituted locally if infections climbed above a threshold of 50 per 100,000 residents.
The outbreak there peaked in early April, when it was reporting more than 6,000 new cases a day. It has since steadily reported several hundred new cases each day. The overall number of infections in Germany remains among the top 20 globally, despite its comparatively low fatality and caseload per capita.
Timeline of Key Early Events and Measures
- Government considers the new disease a "very low threat", and far less dangerous than SARS; no need for a travel warning for the time being
- First case confirmed
- Lufthansa, Germany’s flagship airline, suspends all flights to China
- According to media reports, face masks are sold out, and measures to screen travellers from high-risk regions of China are in place at Frankfurt Airport, which has no direct flights to and from Wuhan
- German health minister believes any travel restrictions to and from China should be made across Europe, and not done unilaterally like in Italy; also rejects temperature screenings for inbound travellers
- Some regions of Germany begin closing schools and other public places
- Several sporting events are cancelled or suspended
- Travellers arriving from China, South Korea, Japan, Iran, and Italy are required to provide contact details in case they need to be tracked over possible infections
- The world’s largest travel trade fair, due to start the following week, is cancelled by organizers
- Rail passengers must fill exit cards with contact information in case they need to be reached; land border patrols are strengthened
- Government crisis team also decides to stockpile protective gear including masks and suits
- Robert Koch Institute (German public health institute) raises threat level for Germany to “moderate,” while the European Centre for Disease Prevention and Control raises threat level for Europe to “high” from “moderate”
- Border closures still discouraged by health minister
- A number of health organizations report shortage of protective gear and government discusses ordering more masks, gloves, suits
- Government recommends German states ban events involving more than 1,000 people
- Two seniors become the first deaths in Germany from COVID-19 as infections double
- Theatres, concert halls, opera houses close in Berlin
- Parts of Germany launch drive-through COVID-19 testing
- 14 of 16 German states close schools and kindergartens
- Germany closes its borders to surrounding countries
- Merkel announces other measures to limit physical contact, including closing non-grocery and cultural venues, and recommends cancelling all non-essential domestic and foreign travel
- Flights from Iran and China suspended
- Health institute raises threat risk to “high”
- European Union agrees on immediate travel ban into Europe for all non-EU citizens, Germany expands list to include citizens from Italy, Spain, and other EU countries
- National curfew enacted, which allows people to leave their home only to work, buy groceries, etc. gatherings are limited to no more than two people from different households
- Physical distancing required, restaurants and other services closed
- Health Institute changes its recommendation on masks to include people without symptoms
India has reported one of the highest number of total cases in the world. There was significant worry that COVID-19 could be devastating for the world’s second most populous country. Despite the high risk of spread due to its dense population, testing was extremely limited in the beginning and remains on the lower end compared with other many countries on a per capita basis.
There were reports of outbreaks in slums, where families live in extreme poverty and crowded conditions. A sudden lockdown imposed across the country in March sparked a mass exodus of migrant labourers back to their home villages, spurring worries of possible outbreaks in regions poorly equipped to handle a health-care crisis. According to the OECD, India has just 0.5 hospital beds for every 1,000 people, for example -- China, by comparison, has 4.3 beds.
Despite these and other concerns, the number of reported deaths per capita and case fatality rate for India sits far below many other countries -- though the data has been called “sparse, and sporadic”. By mid-April, masks were mandatory across India. The country was reopening by early June amid concerns over the massive economic costs of staying closed, and despite worries that the move was too risky and too soon.
Timeline of Key Early Events and Measures
Jan. to Feb.
- India evacuates its citizens from China and citizens advised to refrain from going to China
- Travellers returning from China will be quarantined
Feb. to March
- Indian citizens evacuated through the months of February and March from various parts of the world, including China, Iran, Italy, and the UK
Early to Mid-March
- Compulsory screening for international passengers coming from a number of countries, restricts travel from Italy, South Korea, Japan, and Iran
- A growing number of schools across the country begin closing
- Citizens strongly advised not to travel to China, Italy, South Korea, Iran, Japan, France Spain, and Germany
- Travellers returning to India asked to self-monitor and isolate
- Quarantine required for passengers arriving from China, Korea, Iran, Italy, Spain, France, and Germany
- India closes international land borders
- Travellers from EU, U.K., Turkey - even Indian passport holders - are banned from entering
- More than 75 districts and major cities where cases have been identified are locked down except essential services
- Government announces immediate national lockdown
In March, Italy became the centre of the worst outbreak outside of China at the time, with deaths at one point doubling every few days. Within two short weeks, daily cases spiked to a high of more than 6,500 and daily death tolls hit as high as 971. The country instituted an unprecedented lockdown, considered by many to be the most drastic response outside China at the time.
The elderly were hit especially hard, a pattern that would be repeated later in places like Canada. The percentage of Italy’s population over 65 is the second highest in the world, second only to Japan, according to the world bank. “Dozens” were dying in nursing homes in the worst-affected areas, but were untested due to strict testing rules, according to media reports.
Testing ramped up slowly early in the pandemic, with the eligibility criteria varying between jurisdictions. In the small town of Vo, mass testing was said to help quickly contain the spread. Leaders, including the president, downplayed the outbreak in the early days, resulting in initial complacency.
While the country’s first case was identified in mid-February, a national waste water study in June found the virus was detected in samples collected in December, indicating that when doctors first reported cases in China, the virus was already present in Italy too.
Italy’s mortality in March was 41,329, roughly double that of the previous five years, according to a report published in July. This included 5,000 deaths not included in the toll attributed to COVID-19, suggesting how undercounted initial numbers likely were.
Italy turned a corner in April and by June, was steadily reporting roughly 200 to 300 new cases a day, with deaths generally falling to under 20 a day. The country began significantly easing restrictions in mid-May and by late July, also reopened its borders to tourists from more than two dozen countries.
Timeline of Key Early Events and Measures
- Air connections from Wuhan suspended
- Government suspends all flights to and from China
- Third country after Czech Republic and Greece to no longer receive and process visa applications in China
- State of emergency is declared
- 11 municipalities in Northern Italy are placed under quarantine, locking down 50,000+ people, penalties for violation include fines and prison
- Schools/universities close in the affected areas
- Public events, religious services, train service to affected areas, sporting events, carnivals including Venice are all cancelled or suspended
- 500 police officers added to patrol quarantined regions
- Key buildings, such as the Palazzo Madama, install thermal scanners for everyone entering premise
- Government shuts all schools and universities in Italy
- Quarantine expands to all of Lombardy and more than a dozen other northern provinces, putting 16 million people under lockdown
- Prime Minister Giuseppe Conte announces nationwide closure of commercial businesses, museums, entertainment venues, etc.
- All of Italy (60 million people) goes under quarantine
- Sports events within the country are cancelled
- All non-essential commercial activities prohibited, restaurants, bars close
- Government enlists military help to enforce lockdown
- Parks and playground closed, additional restrictions added to limit movement throughout the country
- All non-essential businesses and factories close
NEW ZEALAND (TOP)
New Zealand, which reported its first case roughly a month after Europe and North America, may have benefited from seeing how its counterparts in Europe and North America fared. It is notable how quickly the country moved to mitigate the spread by closing its borders even when only a handful of cases were reported. At its peak, the country reported just 95 new cases. Since late April, New Zealand has maintained zero to less than five new cases a day and only a handful of deaths in total.
By mid-May, all lockdown measures had been lifted except size limits on social gatherings and physical distancing. Following the recovery of its final active case of COVID-19 at the time, all restrictions except for border closures were lifted by June 9. After more than three weeks without a new case, however, two travellers who had arrived from Britain tested positive in mid-June, prompting Prime Minister Jacinda Ardern to put the military in charge of its border quarantine operations.
Timeline of Key Early Events and Measures
- A national co-ordination centre is established to respond to the outbreak
- Any traveller who left from China or transited through the country would not be allowed to enter the country
- Only citizens and permanent residents allowed
- Travel advisory for all of mainland China has been raised to "do not travel"
- Ministry of Health advises people should self-isolate for 14 days if they’ve arrived from or via China
- Hong Kong, Iran, Italy, Japan, South Korea, Singapore and Thailand have been added to the list of countries and regions of concern when medical professionals are assessing patients
- First case detected in a citizen who recently returned from Iran
- Travel restrictions that include inbound travellers from Iran was enacted the same day
- All travellers returning are required to self-isolate for 14 days, including citizens
- Non-citizens who violate self-isolation rules must leave after quarantine
- Citizens urged to returned home
- Indoor events with more than 100 people are prohibited (excluding work, schools public transit)
- Borders close to all but citizens and residents
- Public facilities such as libraries, community centres, museums close in key cities
- All schools close
- With just over 100 cases, government decides to raise national alert level to 4 in two days, which triggers a highly restrictive four-week nationwide lockdown
- Bars, restaurants and other non-essential services ordered to close within two days
UNITED STATES (TOP)
Testing in the United States was severely hampered in the first several weeks according to medical journal articles and numerous media reports. Screening was “rationed” because only CDC – not public health or hospital labs – could run the tests initially, with a strict criteria for testing only those with known exposure. State labs also ran into verification problems with the CDC test kits, with results coming back “inconclusive or invalid due to failure of the negative control”. Under pressure by state labs to expand testing capacity, the FDA finally allowed them to develop and use their own tests by the end of February. But even when the testing criteria was loosened and testing capacity ramped up, the demand far exceeded availability.
Compounding the regulatory and technical problems with testing was the varying political response from all levels of government, with cities and states and the White House reacting with skepticism to urgency to conflict over the situation, despite warnings. Even prior to the outbreak in China, government reports and pandemic prep exercises as late as last year were not taken seriously. The world’s richest country “squandered” an entire month, a New York Times investigation said.
New York became the centre of the U.S. outbreak by late March, with more confirmed cases than any other country outside the U.S., according to one media report. Hospitals, health care workers, and the 911 emergency response system were all reportedly overwhelmed, with one doctor describing the situation at his hospital as “apocalyptic”.
By mid-April, all 50 U.S. states and Washington, D.C. were under a disaster declaration as the number of COVID-related deaths in the U.S. crossed the 20,000 mark and surpassed Italy, becoming the highest in the world. Many parts of the country issued stay-at-home orders, cancelled mass-gatherings like sporting and music events, and closed schools.
While the total number of cases still surged from about half a million to two million over the following two months and deaths soared past 100,000, the restrictions helped cap the rise in daily new infections and deaths during that period, with the curve marginally sloping downward.
But as states began reopening, that modest dip in new infections made a dramatic upward reversal that eclipsed what unfolded between March and April. The explosion of cases nearly doubled in just over a month, hitting Arizona, Florida and Texas the hardest. Meanwhile, leadership at all levels of government continued to be unco-ordinated, with mayors clashing with state governors over measures including wearing face masks, and reopenings of businesses and schools. Testing remained contentious. As other countries gird for the possibility of a “second wave,” experts including Dr. Anthony Fauci, said the U.S. never emerged from the first.
Timeline of Key Early Events and Measures
- First known case confirmed in Washington State
- White House Coronavirus Task Force established to “monitor, prevent, contain, and mitigate” the pandemic’s spread
- Government declares public health emergency, restrictions placed on travellers arriving from China
- U.S. issues a “do not travel” advisory for China
- Evidence of community spread as first U.S. case of unknown origin identified in California as CDC warns U.S. to prepare for outbreak.
- Tests developed by hospitals and other labs now permitted by FDA
- Washington state declares state of emergency
- Florida declares public health emergency, with several other states, including New York, following suit over the following days
- Testing restrictions are officially lifted, leaving it up to medical professionals to determine if a patient should be tested
- NBA first major sports league to suspend games as WHO formally declares a pandemic
- CDC recommends against non-essential travel to several countries and regions including China, most of Europe, and Iran
- Travel restrictions are also imposed for incoming visitors from Europe and elsewhere
- National emergency declared
- Flights from restricted countries must land at designated airports with enhanced screening
- White House advises against gatherings of more than 10 people
- Government issues a global “do not travel” advisory for its citizens
- Additional travel restrictions are imposed on foreign nationals who had visited Europe within the previous two weeks
- Additional quarantine and monitoring measures are added to earlier travel restrictions
- U.S.-Canada announces temporary restriction of all non-essential travel between the two countries
- Governors in NY, California, and other large states are ordering most businesses to close and for people to stay indoors, with varying exceptions
- 15 states impose lockdown orders in less than a week
- Only 2,250 tests per million have been performed, two-thirds of what South Korea was able to accomplish three weeks earlier, since regulations around testing were loosened four weeks earlier, according to the Washington Post
SOUTH KOREA (TOP)
South Korea initiated containment measures almost immediately after China reported the unknown pneumonia cases to the World Health Organization - even before the global health agency issued a press release. The first case was identified just weeks later, caught during heightened airport screening. Health officials quickly and aggressively ramped up their testing capacity, contact tracing, tracking, and quarantine measures in a national, co-ordinated, and detailed fashion, allowing for early mass testing.
A high-level of transparency -- at times seen as controversial and intrusive -- allowed for real-time anonymous information to be shared with the public and used for tracking. Taking information from phone GPS tracking, credit cards, and CCTV cameras, officials are able to trace the movements of an infected patient and alert those who were in contact or nearby. Officials are also alerted when an infected individual ventures outside their quarantine zone through a phone app.
“Patient 31” was identified around mid-February, and was the source of a major outbreak. Drive-through testing sites were established quickly, offering citizens an efficient way of getting tested while minimizing exposure to others, with results sent via text within three days.
The number of daily new infections peaked by the end of February before dropping sharply. Since the start of April, South Korea has reported less than 100 new cases daily. Since the first case was identified, daily deaths have yet to exceed the single digits.
South Korea never enacted strict nationwide lockdown measures like many other countries. Inbound travellers are subject to quarantine and depending on where they are coming from, may require automatic testing on arrival. Infected people are isolated and those who come in contact with them are put into quarantine. Mask wearing is extremely common everywhere. Physical distancing and staying home were highly encouraged in late March, and schools were closed, but much of the country otherwise operated and continues to operate under relatively minimal restrictions. Nightlife establishments in Seoul, however, were closed indefinitely in May after a number of cases were linked to an infected individual who visited nearly half a dozen nightclubs in one evening.
Timeline of Key Early Events and Measures
- Quarantine and screening measures placed for all travellers coming from Wuhan, China (WHO issued a press release on Jan. 5)
- Health authorities strengthen national surveillance of pneumonia cases in hospitals
- First case of COVID-19 is identified in a traveller from Wuhan through thermal screening during entry at Incheon International Airport
- Infectious disease alert is raised to from blue to yellow (level 2)
- Public told to continue hand washing, cough etiquette, and mask-wearing if they have respiratory symptoms
- National hotline available for public to report symptoms within 14 days of travel
- Government issues travel recommendations and advisories for travellers to China
- Inbound travellers who visited Wuhan within 14 days are asked to submit health questionnaire and to report to health officials if fever or respiratory symptoms develop
- Concerned that the novel coronavirus could become a pandemic, health officials and more than 20 medical companies meet to discuss urgency of developing effective test, promising “swift regulatory approval,” according to a Reuters investigation
- The first diagnostic test from a company is approved within a week (Feb. 4) and a second company is ready by Feb. 12
- All inbound travellers (Korean and foreign) coming from anywhere in China subject to tougher screening and quarantine measures, including a health questionnaire at the point of entry; false information subject to a fine of up to US$10,000
- Infectious disease alert raised to “orange” - level 3
- Additional staff added to the KCDC’s national call centre to deal with an influx in calls for consultation
- Additional law enforcement and health staff added to airport quarantine checkpoints
- Occupational safety and health agency to provide 720,000 masks to industries and workplaces considered more vulnerable to infectious diseases due to the large number of foreign employees or visitors. These include construction, manufacturing and service industries
- Anyone with contact with patients who tested positive must self-isolate for 14 days
- Foreigners arriving from Hubei province are barred from entering the country
- A separate airport arrival hall is created for travellers from China
- Visitors must provide domestic contact information that is verified prior to entry
- Daycare centres, nursing and long-term care facilities asked to temporarily close if anyone, including visitors, test positive or is a contact of a positive case
- Strict quarantine measures for arrivals expand to include Hong Kong and Macao
- The number of diagnostic test kits available, which have increased dramatically from 200 to 3,000 per day, continues to ramp up (goal is capacity for 10,000 a day, which they eventually exceed)
- Confirmed cases jump, attributed to “Patient 31,” identified two days earlier, who participated in a large church gathering in Daegu
- Government announces plans to designate certain hospitals as national infectious disease hospitals with orders to transfer all existing patients to other healthcare facilities by Feb 28
- Infectious disease alert raised to "red" or level 4, the highest threat level
- All citizens in the city of Daegu asked to self-isolate for two weeks and those with symptoms to get tested
- First drive-through testing site is launched
- South Korea to test tens of thousands of members of the Shincheonji Church of Jesus, a key point of exposure by "Patient 31" and the main cluster
- KCDC advises "social distancing" until early March and maintain good hygiene practices
- Businesses allowed to stay open, but many check temperatures before at the door, and offices, hotels, etc. have thermal cameras to screen for fevers
- Public libraries, museums, churches, daycare in Daegu closed
- Government launches a smartphone GPS-based app to track people violating quarantine orders
- Similar to those coming from China, all inbound travellers (both citizens and foreigners) from Japan, Italy, Iran, and within days - rest of Europe - must undergo special immigration screening, including installing a Self-Diagnosis Mobile App where they must submit daily results for 14 days (authorities will follow-up in person if travellers fail to comply with self-checks) and advised to “minimize movement”
- Government declares several cities including Daegu "special disaster zones"
- Reopening of daycare centres and new school semester postponed to April 5 and 6 respectively
- Government advises South Koreans to cancel all non-urgent international travel
- All travellers entering Korea must undergo special screening, including a health questionnaire, contact information, and install the Self-Diagnosis Mobile App
- Every person at high-risk facilities in Daegu are being tested with almost 95 per cent tested already
- All travellers arriving from Europe will automatically be tested
- Public urged to practice social distancing until April 5 and stay home as much as possible aside from work and getting essentials
- Restrictions placed for high-risk places such as churches, entertainment and sports facilities
- All travellers arriving from the U.S. will be tested at the airport