COVID-19: COVID-19 is the disease caused by the new coronavirus that emerged in China in December 2019. COVID-19 symptoms include cough, fever, and shortness of breath, muscle aches, sore throat or unexplained loss of taste or smell. COVID-19 can be severe, and some cases have caused death. The new coronavirus can be spread from person to person. It is diagnosed with a laboratory test. There is no coronavirus vaccine yet. Prevention involves frequent hand-washing, coughing into the bend of your elbow and staying home when you are sick.
Who is most at risk for the coronavirus disease?
People of all ages can be infected by the new coronavirus (2019-nCoV). Older people and people with pre-existing medical conditions (such as asthma, diabetes, and heart disease) appear to be more vulnerable to becoming severely ill with the virus.
WHO advises people of all ages to take steps to protect themselves from the virus, for example by following good hand hygiene and good respiratory hygiene.
What is the incubation period of the coronavirus disease?
The “incubation period” means the time between catching the virus and beginning to have symptoms of the disease. Most estimates of the incubation period for COVID-19 range from 1-14 days, most commonly around five days. These estimates will be updated as more data become available.
Can the coronavirus disease spread through air?
The virus that causes COVID-19 is mainly transmitted through droplets generated when an infected person coughs, sneezes, or speaks. These droplets are too heavy to hang in the air. They quickly fall on floors or surfaces. You can be infected by breathing in the virus if you are within 1 meter of a person who has COVID-19, or by touching a contaminated surface and then touching your eyes, nose or mouth before washing your hands.
Basic protective measures against the new coronavirus:
Stay aware of the latest information on the COVID-19 outbreak, available on the WHO website and through your national and local public health authority. Most people who become infected experience mild illness and recover, but it can be more severe for others. Take care of your health and protect others by doing the following:
- Wash your hands frequently: Regularly and thoroughly clean your hands with an
alcohol-based hand rub or wash them with soap and water.
- Why? – Washing your hands with soap and water or using alcohol-based hand rub kills viruses that may be on your hands.
- Maintain social distancing: Maintain at least 1 meter (3 feet) distance between yourself and anyone who is coughing or sneezing.
- Why? – When someone coughs or sneezes they spray small liquid droplets from their nose or mouth which may contain virus. If you are too close, you can breathe in the droplets, including the COVID-19 virus if the person coughing has the disease.
- Avoid touching eyes, nose and mouth:
- Why? – Hands touch many surfaces and can pick up viruses. Once contaminated, hands can transfer the virus to your eyes, nose or mouth. From there, the virus can enter your body and can make you sick.
- Practice respiratory hygiene: Make sure you, and the people around you, follow good respiratory hygiene. This means covering your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose of the used tissue immediately.
- Why? – Droplets spread virus. By following good respiratory hygiene you protect the people around you from viruses such as cold, flu and COVID-19.
- If you have fever, cough and difficulty breathing, seek medical care early: Stay home if you feel unwell. If you have a fever, cough and difficulty breathing, seek medical attention and call in advance. Follow the directions of your local health authority.
- Why? – National and local authorities will have the most up to date information on the situation in your area. Calling in advance will allow your health care provider to quickly direct you to the right health facility. This will also protect you and help prevent spread of viruses and other infections.
- Stay informed and follows advice given by your healthcare provider: Stay informed on the latest developments about COVID-19. Follow advice given by your healthcare provider, your national and local public health authority or your employer on how to protect yourself and others from COVID-19.
- Why? – National and local authorities will have the most up to date information on whether COVID-19 is spreading in your area. They are best placed to advise on what people in your area should be doing to protect themselves.
Protection measures for persons who are in or have recently visited (past 14 days) areas where COVID-19 is spreading:
- Follow the guidance outlined above.
- Stay at home if you begin to feel unwell, even with mild symptoms such as headache and slight runny nose, until you recover. Why? Avoiding contact with others and visits to medical facilities will allow these facilities to operate more effectively and help protect you and others from possible COVID-19 and other viruses.
- If you develop fever, cough and difficulty breathing, seek medical advice promptly as this may be due to a respiratory infection or other serious condition. Call in advance and tell your provider of any recent travel or contact with travelers. Why? Calling in advance will allow your health care provider to quickly direct you to the right health facility. This will also help to prevent possible spread of COVID-19 and other viruses.
Simple ways to prevent the spread of COVID-19 in your workplace:
- Make sure your workplaces are clean and hygienic: Surfaces (e.g. desks and tables) and objects (e.g. telephones, keyboards) need to be wiped with disinfectant regularly.
- Why? – Because contamination on surfaces touched by employees and customers is one of the main ways that COVID-19 spreads.
- Promote regular and thorough hand-washing by employees, contractors, and customers: Put sanitizing hand rub dispensers in prominent places around the workplace. Make sure these dispensers are regularly refilled. Display posters promoting hand-washing – ask your local public health authority for these. Combine with other communication measures such as offering guidance from occupational health and safety officers, briefings at meetings, and information on intranet sites to promote hand-washing. Make sure that staff, contractors, and customers have access to places where they can wash their hands with soap and water.
- Why? – Because washing kills the virus on your hands and prevents the spread of COVID19.
- Promote good respiratory hygiene in the workplace: Display posters promoting respiratory hygiene. Combine this with other communication measures such as guidance from occupational health and safety officers, briefing at meetings, and information on the intranet, etc. Ensure that face masks1 or paper tissues are available at your workplaces, for those who develop a runny nose or cough at work, along with closed bins for hygienically disposing of them.
- Why? – Because good respiratory hygiene prevents the spread of COVID-19.
- Brief your employees, contractors, and customers that if COVID-19 starts spreading in your community anyone with even a mild cough or low-grade fever (37.3 C or more) needs to stay at home. They should also stay home (or work from home) if they have had to take simple medications, such as paracetamol/acetaminophen, ibuprofen or aspirin, which may mask symptoms of infection.
Remember:
Now is the time to prepare for COVID-19. Simple precautions and planning can make a big difference. Action now will help protect your employees and your business.
Burial:
People who have died from COVID-19 can be buried or cremated.
- Confirm national and local requirements that may dictate the handling and disposition of the remains.
- Family and friends may view the body after it has been prepared for burial, in accordance with customs. They should not touch or kiss the body and should wash hands thoroughly with soap and water after the viewing;
- Those tasked with placing the body in the grave, on the funeral pyre, etc., should wear gloves and wash hands with soap and water after removal of the gloves once the burial is complete.
Environmental cleaning and control:
Human coronaviruses can remain infectious on surfaces for up to 9 days.7 COVID-19 virus has been detected after up to 72 hours in experimental conditions.8 Therefore, cleaning the environment is paramount.
- The mortuary must be kept clean and properly ventilated at all times.
- Lighting must be adequate. Surfaces and instruments should be made of materials that can be easily disinfected and maintained between autopsies.
- Instruments used during the autopsy should be cleaned and disinfected immediately after the autopsy, as part of the routine procedure.
- Environmental surfaces, where the body was prepared, should first be cleaned with soap and water, or a commercially prepared detergent solution.
- After cleaning, a disinfectant with a minimum concentration of 0.1% (1000 ppm) sodium hypochlorite (bleach), or 70% ethanol should be placed on a surface for at least 1 minute.7 Hospital-grade disinfectants may also be used as long as they have a label claim against emerging viruses and they remain on the surface according to manufacturer’s recommendations.
- Personnel should use appropriate PPE, including respiratory and eye protection, when preparing and using the disinfecting solutions.
- Items classified as clinical waste must be handled and disposed of properly according to legal requirements.
Health work rights, roles and responsibilities:
Health worker rights include the expectation that employers and managers in health facilities:
- Assume overall responsibility to ensure that all necessary preventive and protective measures are taken to minimize occupational safety and health risks.
- Provide information, instruction, and training on occupational safety and health, including; refresher training on infection prevention and control (IPC); use, putting on, taking off and disposal of personal protective equipment (PPE).
- Provide adequate IPC and PPE supplies (masks, gloves, goggles, gowns, hand sanitizer, soap and water, cleaning supplies) in sufficient quantity to those caring for suspected or confirmed COVID-19 patients, such that workers do not incur expenses for occupational safety and health requirements.
- Familiarize personnel with technical updates on COVID-19 and provide appropriate tools to assess, triage, test, and treat patients, and to share IPC information with patients and the public.
- Provide appropriate security measures as needed for personal safety.
- Provide a blame-free environment in which health workers can report on incidents, such as exposures to blood or bodily fluids from the respiratory system, or cases of violence, and adopt measures for immediate follow up, including support to victims.
- Advise health workers on self-assessment symptom reporting, and staying home when ill.
Quarantine of persons:
The quarantine of persons is the restriction of activities of or the separation of persons who are not ill but who may been exposed to an infectious agent or disease, with the objective of monitoring their symptoms and ensuring the early detection of cases. Quarantine is different from isolation, which is the separation of ill or infected persons from others to prevent the spread of infection or contamination.
When to use quarantine:
Introducing quarantine measures early in an outbreak may delay the introduction of the disease to a country or area or may delay the peak of an epidemic in an area where local transmission is ongoing, or both. However, if not implemented properly, quarantine may also create additional sources of contamination and dissemination of the disease. In the context of the current COVID-19 outbreak, the global containment strategy includes the rapid identification of laboratory-confirmed cases and their isolation and management either in a medical facility3 or at home. WHO recommends that contacts of patients with laboratory-confirmed COVID-19 be quarantined for 14 days from the last time they were exposed to the patient.
Minimum infection prevention and control measures:
The following IPC measures should be used to ensure a safe environment for quarantined persons.
- Early recognition and control:
- Any person in quarantine who develops febrile illness or respiratory symptoms at any point during the quarantine period should be treated and managed as a suspected case of COVID-19.
- Standard precautions apply to all persons who are quarantined and to quarantine personnel.
- Environmental controls:
- Clean and disinfect frequently touched surfaces.
- Clean and disinfect bathroom and toilet surfaces at least once daily with regular household disinfectant.
- Clean clothes, bed linens, and bath and hand towels using regular laundry soap.
- Countries should consider implementing measures to ensure that waste is disposed of in a sanitary landfill and not in an unmonitored open area.
- Cleaning personnel should wear disposable gloves when cleaning surfaces or handling clothing or linen soiled with body fluids, and they should perform hand hygiene before putting on and after removing their gloves.
Home care:
For COVID-19 patients with mild illness, hospitalization may not be required. All patients cared for outside hospital (i.e. at home or non-traditional settings) should be instructed to follow local/regional public health protocols for home isolation and return to designated COVID-19 hospital if they develop any worsening of illness.
Home care may also be considered when inpatient care is unavailable or unsafe (e.g. capacity is limited, and resources are unable to meet the demand for health care services). Specific IPC guidance for home care should be followed.
Persons with suspected COVID-19 or mild symptoms should:
- Self-isolate if isolation in a medical facility is not indicated or not possible.
- Perform hand hygiene frequently, using an alcohol-based hand rub if hands are not visibly dirty or soap and water when hands are visibly dirty.
- Keep a distance of at least 1 m from other people.
- Wear a medical mask as much as possible; the mask should be changed at least once daily.
- Avoid contaminating surfaces with saliva, phlegm, or respiratory secretions.
- Improve airflow and ventilation in their living space by opening windows and doors as much as possible.
Caregivers or those sharing living space with persons suspected of COVID-19 or with mild symptoms should:
- Perform hand hygiene frequently, using an alcohol-based hand rub if hands are not visibly dirty or soap and water when hands are visibly dirty.
- Keep a distance of at least 1 meter from the affected person when possible.
- Wear a medical mask when in the same room as the affected person.
- Dispose of any material contaminated with respiratory secretions (disposable tissues) immediately after use and then perform hand hygiene.
- Improve airflow and ventilation in the living space by opening windows as much as possible.
System and service coordination to provide long-term care:
- Coordinate with relevant authorities (e.g. Ministry of Health, Ministry of Social Welfare, Ministry of Social Justice, etc.) should be in place to provide continuous care in LTCFs.
- Activate the local health and social care network to facilitate continuous care (clinic, acute-care hospital, day-care center, volunteer group, etc.).
- Facilitate additional support (resources, health care providers) if any older person in LTCFs is confirmed with COVID19.
Prevention:
- Provide COVID-19 IPC training to all employees.
- Provide information sessions for residents on COVID-19 to inform them about the virus, the disease it causes and how to protect themselves from infection.
- Regularly audit IPC practices (hand hygiene compliance) and provide feedback to employees.
- Increase emphasis on hand hygiene and respiratory etiquette.
Physical distancing in the facility:
Physical distancing in the facility should be instituted to reduce the spread of COVID-19:
- Restrict the number of visitors.
- For group activities ensure physical distancing, if not feasible cancel group activities.
- Stagger meals to ensure physical distance maintained between residents or if not feasible, close dining halls and serve residents individual meals in their rooms.
- Enforce a minimum of 1 meter distance between residents.
- Require residents and employees to avoid touching.
Precautions and personal protective equipment (PPE):
When providing routine care for a resident with suspected or confirmed COVID-19, contact precaution and droplet precautions should be practiced. Detailed instructions on precautions for COVID-19 are available.
- PPE should be put on and removed carefully following recommended procedures to avoid contamination.
- Hand hygiene should always be performed before putting on and after removing PPE.
- Contact and droplet precautions include the following PPE: medical mask, gloves, gown, and eye protection (goggles or face shield).
- Employees should take off PPE just before leaving a resident’s room.
- Discard PPE in medical waste bin and preform hand hygiene.
Reporting: Any suspected or confirmed COVID-19 cases should be reported to relevant authorities as required by law or mandate.
