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MSF update on COVID-2019 coronavirus outbreak

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MSF’s epidemiologists and infectious disease experts are following the fast-evolving development of the outbreak of the novel coronavirus (COVID-2019). As of 11 February, there are more than 43,000 cases worldwide, more than 99 per cent of which are in mainland China.

We have offered support to the health authorities in mainland China and Hong Kong, who are leading the respective response efforts, and offering support similar to what we did in 2003 during the outbreak of Severe Acute Respiratory Syndome (SARS), caused by a related type of coronavirus. These activities included training of healthcare staff on methods to prevent and control infections, and health education for vulnerable and at-risk groups.

An MSF team is being sent to Hong Kong with an initial focus on health education for vulnerable groups, such as the elderly and other at-risk groups.

Because the COVID-2019 virus is new, much remains to be understood. However, as with other coronaviruses, droplet infection seems to be the main mode of transmission. Infection control measures such as hand-washing and cough etiquette (cover coughs with disposable tissues or clothing) are therefore very important to help prevent new cases.

Questions and answers - COVID-2019 coronavirus

WHAT IS THE DISEASE?

The disease is caused by a virus, called COVID-2019, which was discovered in early January in China and has been identified as a member of the family of coronaviruses. COVID-2019 seems to be transmitted through droplets, spread by coughing.

The main symptoms include general weakness and fever; coughing and sometimes difficulty of breathing in a later stage. In 20 per cent of the reported cases, it has led to pneumonia. The early symptoms of some patients are mild and the disease ranges in severity.

HOW DANGEROUS IS THE DISEASE?

Since it is new, much remains to be understood about the virus. Our understanding of the virus and the disease is still evolving. Some people that are infected with COVID-2019 have become very sick, others were only mildly sick.

The disease is likely more dangerous for elderly people or people suffering from other infections or ailments, as often is the case with infectious diseases. Most cases reported to date have been mild or moderate, with around 20 per cent of those infected experiencing severe illness. At the end of January, around 2-3 per cent of the patients have died of the disease.

HOW CONTAGIOUS IS THE DISEASE?

Our understanding of the virus and the disease is still evolving. It seems the virus can spread by sick people coughing. But how efficiently the virus is transmitted from one person another is not fully understood yet.

WHAT IS THE LINK TO SARS/MERS?

SARS (Severe Acute Respiratory Syndrome) and MERS (Middle Eastern Respiratory Syndrome) are both infections of the respiratory system. They are caused by types of coronavirus (SARS-CoV and MERS-CoV respectively) related to COVID-2019.

SARS was discovered in 2002 in mainland China and spread to a number of other countries. More than 8,000 people fell sick, and 774 of them died of the disease. Since 2004, no new cases of SARS have been recorded. MSF intervened in mainland China, Hong Kong, and Vietnam for the outbreak of SARS.

MERS was discovered in 2012, when an epidemic started in Saudi Arabia. More than 1,200 people fell sick, and 449 of them died. MERS still infects people every now then, primarily in Middle Eastern countries. MSF has not intervened during outbreaks of MERS.

WHAT CAN BE DONE TO RESPOND TO THE OUTBREAK?

For now, the health authorities are leading the response efforts including diagnosis of the virus, patient care, contact tracing, and investigations into a better understanding of the disease. Since it is a new virus, there is currently no vaccine or specific treatment (though supportive care is given to treat symptoms), and the understanding of the virus and the disease are still evolving.

We do know that in a respiratory disease outbreak, it is important to apply hand hygiene, coughing etiquette, avoid close contact with people showing symptoms of respiratory diseases, and inform a doctor when feeling sick. Public awareness of the virus and enhanced prevention measures such as these are key components for prevention.

WHAT DID MSF DO DURING THE SARS OUTBREAK? MERS?

During the outbreak of SARS, MSF supported the Bach Mai Hospital in Vietnam with an isolation ward. In mainland China, we gave support with training of healthcare staff in Infection Prevention and Control in the city of Guangzhou.

In Hong Kong we provided support with training of healthcare staff in infection prevention and control, healthcare education for people, and donated protection equipment.

MSF did not intervene for MERS outbreaks.

HOW CAN I PREVENT MYSELF FROM BEING INFECTED?

As with other coronaviruses, droplet infection seems to be the main mode of transmission, so infection prevention control measures such as hand-washing, and cough and sneeze etiquette are important for prevention.

Hand hygiene is paramount, so wash your hands often with soap and water. Use enough soap, and make sure all parts of both your hands are washed. Spend at least 20 seconds washing your hands. If there’s no visible dirt on your hands, an alcohol-based gel is also a good option.

If you cough or sneeze, cover your mouth and nose with a tissue, or with the inside of your elbow. Put used tissues in the bin immediately, just like used masks, and wash your hands.

A mask is a good preventive measure to protect from breathing in the virus or transmitting it if you are sick. Only touch the strings of the mask when you take it off. Put it directly in the bin and wash your hands.