What are coronaviruses?
What does "novel" mean?
Who is at risk for infection?
What are the symptoms of COVID-19?
What does cough etiquette mean?
Is there a vaccine?
Where is the outbreak predicted to spread?
Where does International SOS get its information?
TransmissionHow does COVID-19 spread?
Does COVID-19 spread through the air or air-conditioning?
Can the virus be transmitted through packages shipped from an area with COVID-19?
TreatmentCan COVID-19 be treated?
Is Tamiflu useful?
If I am sick in China, can I choose which clinic to go to?
What about alternative treatments?
What can I do to protect myself?
Should I wear a face mask?
What is the difference between quarantine and isolation?
What environmental measures can be taken?
A traveller has recently returned from Wuhan. What should they do?
Coronaviruses are a large family of viruses, some of which can infect people. Some cause mostly mild illness, such as the strains responsible for some common colds. Others can potentially also lead to severe, or even fatal, disease - such as Middle East Respiratory Syndrome Coronavirus (MERS-CoV), which continues to circulate in some parts of the world. The Severe Acute Respiratory Syndrome (SARS) outbreak was caused by a coronavirus. It caused severe and fatal disease, however, is no longer in circulation. The natural reservoir for coronaviruses is thought to be animal hosts. New strains emerge from this reservoir, infect an 'intermediate' host, and from there infect people. The viruses may then be capable of being transmitted from one person to another. Some are efficient at human-to-human transmission, while others are not.
Novel means new. In this case, the 2019-novel coronavirus was given a new name SARS-CoV-2 as of 12 February, reflecting that the new virus is related to the SARS coronavirus seen in 2002. The virus is a previously-unidentified strain of coronavirus. It is responsible for the outbreak of pneumonia which began in Wuhan, China in December 2019. The disease caused by the virus has been called COVID-19, or Coronavirus Disease-2019.
The disease can move from person to person, but it is not yet known how easily or sustainably it spreads. Scientists are studying the data as it becomes available. The initial cases reported having visited a seafood/animal market, which may have been a source of exposure. However now the main way the disease is spreading is from person to person.
Some people have had a mild illness and recovered. Others have had more severe infections. Critical and fatal cases have occurred. Preliminary evidence indicates that people with underlying medical conditions, elderly people and those with compromised immune systems may be at higher risk for severe illness.
The illness is still being studied. So far, we know that common symptoms include fever, cough, sore throat, shortness of breath and difficulty breathing. These symptoms are not limited to COVID-19. Respiratory illnesses and pneumonia caused by other organisms (including bacteria) and other viruses (such as influenza) can also cause these symptoms. Other less common symptoms of COVID-19 include muscle aches, headache, nausea and diarrhoea. It is capable of causing severe illness, and some infected people have died. It is possible that people with underlying health conditions are at higher risk for severe disease.
Cough etiquette, or respiratory hygiene, is a measure taken to reduce person-to-person transmission of infected droplets. Individuals should distance themselves, cover their mouth and nose with a tissue when coughing and sneezing. It is important that tissues are disposed of correctly (in nearest waste bin) after use and that hands are washed immediately with soap and water or alcohol based hand sanitizer (containing 60-85% alcohol).
No. It may take months or years for a vaccine to be developed. Research and testing is underway.
Further imported cases into any location that has travellers from is occurring. Wherever there is an infected person, there is the potential for the virus to spread to people in close contact with them and local outbreaks can occur.
There is the possibility that a pandemic (global outbreak) may occur, and every location may eventually be affected.
The European Centre for Disease Prevention and Control (ECDC) has assessed the risk within the EU / EEA and UK population in Europe as low, while the risk of people in areas with "presumed ongoing community transmission" as high.
The United States Centers for Disease Control and Prevention in their 25 February update advised "The potential public health threat posed by COVID-19 virus is high, both globally and to the United States", however " For the general American public, who are unlikely to be exposed to this virus, the immediate health risk from COVID-19 is considered low".
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While the first cases in Wuhan may have 'jumped' from an animal or environmental source to people, the spread now is from a sick person to others who are in close contact. In general, coronaviruses spread through infected respiratory droplets, just like other respiratory infections, including colds and influenza. A sick person expels these droplets when they cough, sneeze, or talk. Others can get the disease via contact (direct or indirect) with these contaminated droplets.
The World Health Organization states as at 21 February 2020, "The spread of COVID-19 between humans is being driven by droplet transmission The virus is transmitted from a sick person to a healthy person through respiratory droplets when the sick person coughs or talks close to another person. Current diagnostic tests have yielded positive results from a variety of specimens including throat swabs from asymptomatic people and feces. These positive results are not a conclusive indication that people are contagious. People may have been exposed and infected but are NOT necessarily transmitting the disease. More investigations into potential other routes of transmission are ongoing. What has been reported so far it that the main driver of transmission is droplet transmission from people with symptoms."
So far there is no evidence that this virus is spread through the air or through air-conditioning systems. The patterns of spread are consistent with transmission through droplets from an infected person to someone who is in close unprotected contact. Nevertheless, in the hospital setting, patients are currently managed in special 'negative pressure' rooms if available, and healthcare workers will take 'airborne precautions' when performing certain procedures.
This coronavirus is primarily spreading to people who are in close unprotected direct contact with an infected person. The United States CDC advises "Currently there is no evidence to support transmission of COVID-19 associated with imported goods". The World Health Organization states "The likelihood of an infected person contaminating commercial goods is low and the risk of catching the virus that causes COVID-19 from a package that has been moved, travelled, and exposed to different conditions and temperature is also low. "
Not specifically. Patients receive supportive care, aimed at relieving their symptoms and preventing complications while they recover. This can include the use of mechanical ventilation if required. There is no specific antiviral therapy against this disease. Antibiotics are only effective against diseases caused by bacteria, not viral diseases like COVID-19.
Studies are underway in China to see if an antiviral medication, "remdesivir", and other experimental treatments may be effective.
The antiviral medication Tamiflu (oseltamivir) is not effective against COVID-19. Tamiflu is used to treat influenza.
Certain medical facilities in China have been designated by the Department of Health as “fever clinics”. These fever clinics manage any patients who suffer from fever and respiratory symptoms. Other facilities are mandated to refer any patients with fever and respiratory symptoms to these dedicated fever clinics.
If you are sick but do not have a fever or respiratory symptoms, then you can be treated in the non-fever clinic facilities.
International SOS advises its members in China who are suffering from symptoms of illness to call the Assistance Centre for advice before seeking care at a medical facility.
Some authorities have recommended alternative treatments for COVID-19. However, there is no evidence to confirm or disprove the effectiveness and safety of alternative treatments.
Avoid potential exposure. Practice good hygiene measures and safe food practices.
- Avoid direct contact with animals (live or dead) and their environment. Do not touch surfaces that may be contaminated with droppings.
- Keep some distance from people who are obviously sick.
- Maintain good personal hygiene. Wash your hands frequently with soap and water. Carry hand sanitiser for use when soap and water are not readily available. Some authorities are advising hand sanitisers containing 60-85% alcohol. Avoid touching your face.
- Ensure food, including eggs, is thoroughly cooked.
- Do not travel if you are sick. Note that some locations have implemented screening, and travellers may face quarantine and testing.
If your location has guidelines for the public, please follow them.
In some locations, authorities are requiring people to wear a mask when in public places. You must comply with any official directives.
In other locations, authorities are asking only people who are sick, or if they can't, those in close contact with them, to use a face mask to cover their coughs and sneezes while they are seeking medical attention. Other authorities encourage groups at higher risk for severe complications e.g. older adults or those with underlying illness, to consider wearing a mask. Some authorities have advised to use masks while travelling or working in public places to reduce the chances of droplet transmission.
While surgical face masks may stop people touching their mouth, they do not stop them breathing in the virus, nor the virus entering the eyes. They will also catch some of the droplets that are coughed and sneezed out.
Fitted respirators, such as ‘P2’, 'P3' or ‘N95’ masks, require training and fitting. These are generally not being recommended for use by the public. They may be recommended to be used by those in close contact with infected people, such as healthcare workers or family members caring for sick relatives.
Quarantine is the separation and monitoring of people who have been exposed to an infected person (or have been to an outbreak area) to see if they become ill. This separation helps reduce the risk that the quarantined person will spread the disease. Quarantine generally requires a person to remain in a nominated place or at home for a certain period of time after exposure to a disease. The duration of quarantine will vary depending on the estimated incubation period. For COVID-19, early estimates indicate a quarantine duration of 14 days.
Isolation is the separation of people who are ill with a potentially contagious disease from those who are healthy.
Environmental measures aim at reducing transmission of infection and include the routine cleaning of frequently used surfaces and objects; minimising shared objects; and good ventilation. Frequently touched surfaces and objects should be washed with water and detergent, followed by a dilute household bleach solution. These objects /surfaces may include desks, phones, keyboards, doorknobs and toilets. Laundry should be washed according to detergent manufacturer’s instructions at the warmest specified temperature. Shared objects should be kept to a minimum including such things as drinking glasses, eating utensils, towels and linen. Good air ventilation is important in rooms where people gather regularly.
A traveller has recently returned from Wuhan or an affected location. What should they do?
If there are local procedures in place from the local health authorities, these must be followed.
Anyone with a recent travel history to Wuhan or an affected location should monitor their health for at least 14 days. If symptoms develop, seek medical care. Inform your healthcare provider of your travel history before going to the facility in person.