MSF steps up COVID-19 response in Europe
20 March 2020
Médecins Sans Frontières (MSF) has expanded activities in response to COVID-19 in Italy, Spain, Switzerland, France, Norway, Greece and Belgium.
Describing our COVID-19 response in Europe, Dr Christos Christou, MSF international president said:
“As an emergency humanitarian organisation, MSF provides medical assistance to vulnerable people in a moment of crisis and societal disruption. Today, in Europe some of the most advanced health systems in the world are buckling under the pressure of the COVID-19 pandemic. Responding to epidemics is at the core of what we do – intervening when the system is overrun and where we can put our expertise in managing emergencies to good use.”
MSF activities across Europe
Helping the elderly
Elderly people are among the most vulnerable to severe infection from COVID-19. In Italy, Belgium and Spain, we have extended activities to support nursing homes for the elderly. People often live close contact in these facilities, which do not usually have specialised medical equipment.
In the Marche region of Italy, MSF doctors, nurses and hygiene experts are supporting staff and local municipalities to set up infection prevention and control (IPC) measures. In Spain, we are advising nursing homes on case management, risk assessment and the implementation of IPC. In Belgium, we are carrying out health promotion and IPC measures in nursing homes in and around Brussels.
Supporting migrants, refugees and the homeless
In Belgium, France and Switzerland, we are assisting vulnerable groups, such as the homeless and migrants, living in precarious conditions, People living in overcrowded conditions, on the streets, in makeshift camps or in substandard housing are at particular risk.
Many are already in poor health, often as a result of their poor living conditions. Viruses thrive in areas with poor water and sanitation. In addition, many of these marginalised groups are excluded from the formal healthcare system.
In Brussels, we have set up a 50-bed facility, with the capacity to increase to 150 beds. The centre provides a space in which migrants and homeless people can isolate, receive medical care and be transferred to hospital.
In Paris and surrounding areas, our teams are intervening in emergency shelters, helping detect those who are potentially ill with COVID-19, in the coming days the team plans to expand activities to provide consultations to people living on the street.
In Geneva, we are providing logistical and health support for vulnerable groups living in precarious conditions, and training to staff and volunteers working with these groups.
Supporting hospitals and keeping healthcare workers safe
In Spain, MSF has set up two health units with a capacity of more than 200 beds to support hospitals in Madrid. The units support the hospitals’ emergency services by taking moderate patient cases, so that the emergency rooms and intensive care units can focus on those who are most severely affected by COVID-19.
Managed by the medical staff of the hospitals, MSF is providing logistical support and a monitoring team for each. MSF is also advising health authorities as they develop temporary units to expand hospital capacity in Madrid and Catalonia – including two hospitals in Barcelona and in Vitoria.
In Belgium, we are supporting five hospitals in Hainaut and Antwerp provinces, providing technical advice and training, and we are ready to increase admission capacity.
In Switzerland, we are supporting the Geneva University Hospital (HUG), sharing expertise to help with the management of patients who have contracted COVID-19, and with the organisation of medical teams and services in the hospital.
Under the coordination of the HUG, we have a mobile medical team ready to provide home-based care to people with COVID-19, who do not meet the criteria for hospital admission. In collaboration with the City of Geneva, we have made recommendations to public and private mortuary services on procedures to avoid any post-mortem transmission of the disease.
We are also providing strategic advice and IPC support to a hospital close to Oslo, Norway, in an area that is home to one of the main clusters of cases in the country.
In Greece, teams are supporting isolation in Samos camp and evaluating the support that hospitals need.
In Lesbos, we have prepared an emergency plan for the Moria refugee camp, should the epidemic spread.
MSF teams are also supporting COVID-19 activities in conjunction with health authorities from Afghanistan to Libya to Nigeria to Syria to Hong Kong.
We have seen how this virus has crippled some of the most advanced health systems in countries that have a social safety net and where most people have access to running water and space to self-isolate.
This is simply not possible for people in many of the countries where we typically work. Our greatest concern is that the virus takes hold in places with weaker health systems, where vulnerable people can’t protect themselves. International solidarity will be crucial, while the response to COVID-19 will have to be tailored to every setting and community, as well as to local capacities.
“Today, all levels of MSF are impacted, bringing new challenges, and requiring even more collaboration and creativity to find solutions. We’re adapting as quick as we can to prepare for COVID-19 in our projects around the world, despite the travel restrictions and supply shortages,” concludes Dr Christou.
Wherever we are in the world we are working to maintain healthcare activities in an increasingly challenging context of travel restrictions and constraints on the movement of goods.
MSF provides relief items and adapts response for COVID-19 in Idlib
28 March 2020
Deir Hassan camp in Idlib province, northwestern Syria, hosts more than 164,000 people in settlements scattered over the hills and, as is the case across northwest Syria, it lacks basic services. It is now also threatened by the potential spread of COVID-19.
On 16 March, after assessing the needs in Deir Hassan camp, Médecins Sans Frontières (MSF) distributed essential items to 180 families in the Latamneh and Al-Habeet settlements, including family tents, mats, plastic sheeting, blankets, cooking sets and hygiene kits.
“We witnessed people living in the open; we also saw ...
Preparation is key to cope with the COVID-19 pandemic in Côte d'Ivoire
27 March 2020
We are concerned about the measures that are being taken in West African countries and the potentially negative consequences they will have on people.
Abdoul-Aziz Mohamed, Executive Director for MSF West and Central Africa
MSF has been working to respond to the coronavirus COVID-19 pandemic recently declared in Côte d'Ivoire.
While Côte d'Ivoire is now registering 80 cases (as of 26 March, according to WHO) of COVID-19 and has not yet reached the stage of local transmission, the Ivorian authorities have quickly taken measures to restrict ...
“Medical staff working beyond limits, in the first Covid-19 epicentre in Italy”
27 March 2020
Everybody here is working beyond their limits. It’s been incredible to see people working around the clock, trying to adapt, trying to learn, trying to collaborate to save as many lives as possible, all while working in the face of so much death.
Dr Chiara Lepora, project coordinator in Lodi, northern Italy
The new coronavirus disease, COVID-19, had spread to more than 190 countries across the world. MSF medical teams are assisting in numerous affected areas. In Italy, we are supporting three hospitals at the first epicentre of the outbreak in the North – with teams working on infection control, remote patient care and outreach – and facilities for the elderly in central Italy. Dr Chiara Lepora is the project coordinator in Lodi, northern Italy.
“We have a team of around 25 people working here in the Lombardy region, particularly around the hospitals in Lodi, Codogno and Sant'Angelo. The health system here is very advanced, but the virus ...
MSF steps up COVID-19 response with activities in Spain
25 March 2020
We are seeking to share our experience so we can act in the interest of those who are most vulnerable.
Dr David Noguera, president of MSF Spain
MSF is stepping up our response to the coronavirus COVID-19 pandemic by starting medical, logistical and strategic support activities in Spain. We will be leveraging our experience and expertise in managing epidemics ...
MSF “deeply surprised” that Iranian authorities put a stop to our COVID-19 response
25 March 2020
We are deeply surprised to learn that the approval for the deployment of our treatment unit has been revoked.
Michel Olivier Lacharité, manager of the MSF emergency programmes in Paris
MSF expresses incomprehension following yesterday’s declarations by officials of the Iranian Ministry of Health stating that the approval for our intervention to manage severe COVID-19 cases in Isfahan, central Iran, has been rescinded. Ministry of Health officials said that the country does not need ...
MSF provides support with response in second worst affected province in Iran
22 March 2020
Iran is by far the hardest hit country in the region, and Isfahan the second worst affected province. We hope our assistance will relieve at least some of the pressure on the local health system.
Julie Reversé, MSF’s representative in Iran
MSF has sent a 50-bed inflatable treatment unit and an emergency team of nine people to Isfahan, the second worst affected province in Iran, to increase hospital capacity for treating...
“Our priority is to protect hospital staff” where COVID-19 began in Italy
21 March 2020
With all that the hospital staff must do to care for the patients, they have little time to think about themselves. Today we’re helping them to fight the pandemic safely, so they can continue their work taking care of all patients.
Carlotta Berutto, nurse and MSF project coordinator, Codogno
One week ago, MSF started to support the COVID-19 pandemic response at Codogno hospital, where the first Italian case was detected, in the region of Lombardy, northern Italy. Half of the 100 beds in this hospital are...
COVID-19: A message from MSF International President Dr Christos Christou
19 March 2020
A key priority is to keep our regular medical programmes running for hundreds and thousands of patients we care for and for the extremely vulnerable communities we help around the world.
Dr Christos Christou, International President, MSF
As a medical humanitarian organisation with projects and teams around the world, we find ourselves in the midst of a pandemic, which will touch each and every one of us, our families, our friends, our communities...
As COVID-19 continues to spread, MSF prepares for action in France
19 March 2020
In the context of the coronavirus epidemic, we are particularly concerned about the fate of people in precarious situations.
Pierre Mendiharat, MSF’s Deputy Operations Director
Faced with the spread of the Covid-19 epidemic, the French health system is strengthening its capacity to prevent and treat cases. This week, in consultation with France’s health authorities, Médecins Sans Frontières (MSF) is setting up activities to help detect and manage COVID-19 cases among the most vulnerable populations...
Help and solidarity needed in Europe to protect medical staff
17 March 2020
European governments must ensure that supplies can then be shipped easily to the virus hotspots... this virus respects no borders and solidarity too must be extended beyond them.
Brice de le Vingne, head of MSF COVID-19 task force
As the number of people with COVID-19 continues to rise rapidly across many countries in Europe - now the epicentre of the pandemic - Médecins Sans Frontières (MSF) urges European Member States to demonstrate solidarity beyond their national borders. Essential medical supplies, including personal protective equipment starting...
Coronavirus: What is MSF doing?
16 March 2020
The Covid-19 epidemic has already spread to more than 100 countries around the world. These include countries whose health systems are fragile and where MSF teams have a long-standing presence, as well as regions such as Europe, where the capacities are more robust but where the epidemic is particularly virulent. Travel restrictions generated by the outbreak also directly affect MSF's work around the world.
What questions does MSF face in this context? An interview with Clair Mills, MSF’s medical director.
Several factors make this virus particularly worrying. Being a new virus, there is no acquired immunity; as many as 35 candidate vaccines are currently in the study phase, but experts agree that no widely usable vaccine will be available for at least 12 to 18 months. The case-fatality rate, which by definition is calculated only on the basis of identified patients and is therefore difficult to estimate accurately currently, appears to be around 1%.
It is known that at least some of those affected can transmit the disease before developing symptoms - or even in the absence of any symptoms. In addition, a very high proportion - around 80% - of people develop very mild forms of the disease, which makes it difficult to identify and isolate cases quickly. Confirmation of the diagnosis requires laboratory and/or medical imaging capabilities that are only available in reference structures. It is therefore not surprising that it has proved impossible to contain the spread of the virus, which is now present in more than 100 countries around the world. This epidemic is therefore very different from those - such as measles, cholera, or Ebola - in which Médecins Sans Frontières has developed its expertise over the last few decades.
Furthermore, it is estimated today that approximately 15-20% of patients with Covid-19 require hospitalization and 6% require intensive care for a duration of between 3 and 6 weeks. This can, of course, quickly saturate the healthcare system - this was the case in China at the beginning of the epidemic, and is currently the case in Italy. There are currently more than 1,100 patients in intensive care units in the country and the hospital system in the North, although well developed, has been overwhelmed by the rapid increase in the number of patients.
As is often the case during this type of epidemic, medical staff members themselves are particularly exposed to infection. Between mid-January and mid-February in China more than 2,000 health care workers were infected with the coronavirus (3.7% of all patients).
This epidemic is likely to lead to the disruption of basic medical services and emergency facilities, the de-prioritization of treatment for other life-threatening diseases and conditions and for other chronic infectious diseases everywhere... but especially in some developing countries, where the health system is already fragile.
Even though they cannot prevent the outbreak from spreading the measures currently being taken by many countries can slow it down by reducing the increase in cases and limiting the number of severe patients that health systems have to manage at the same time. The aim is not only to reduce the number of cases but also to spread them over time, avoiding congestion in emergency and intensive care units.
Priorities for intervention vary from one context to another.
In some areas that seem to be spared today, such as the Central African Republic, South Sudan and Yemen, where fragile or war-torn health systems are already struggling to meet the health needs of the population, it is necessary to protect healthcare personnel and to limit the risks of spreading the epidemic as much as possible. This is done by implementing prevention programmes - identifying areas or populations at risk; running health awareness and information activities; distributing soap and protective equipment for healthcare personnel; and reinforcing hygiene measures in medical structures - to prevent our hospitals and clinics from becoming places where the disease is transmitted. In these countries where MSF has a longstanding presence we want to contribute to these efforts against Covid-19 while ensuring continuity of care against malaria, measles, respiratory infections, etc.
This continuity is now weakened by the restrictions (a ban on entering the country, preventive isolation for 14 days, etc.) imposed by governments on staff from certain countries, such as Italy, France and Japan,, where some of our international staff come from, as well as the closure of borders and the suspension of certain air links. Despite these constraints, our strength lies in the fact that we can rely on locally recruited staff in our countries of intervention. They represent 90% of our employees in the field.
In countries where health systems are more robust but where the epidemic is particularly active, such as Italy or Iran, the main challenge is to avoid overloading hospital care capacities. In these contexts we can contribute to the efforts of national medical teams by making MSF staff available to support or relieve them when needed. We can also help by sharing our experiences in triage and control procedures for infections acquired during epidemics. We have provided teams to support four hospitals in northern Italy and have also offered support to the Iranian authorities to support them in caring for severe patients. Depending on the evolution of the epidemic in France, we will make available to the response our experience, our logistics and the know-how of our staff, if they can be useful.
One of the keys of the fight against Covid-19 is the availability of protective equipment, in particular masks and gloves used for medical examinations. The anticipation of shortages leads to requisitions by many states, which can in turn become a reflex on the part of states to monopolise these precious resources. In the current context such equipment should on the contrary be considered as a common good to be used rationally and appropriately and therefore to be allocated as a priority to health workers exposed to the virus, wherever they are in the world.
Generally speaking, this pandemic requires solidarity not only between states but at all levels, based on mutual aid, cooperation, transparency, the sharing of resources, and, in the affected areas, towards the most vulnerable populations and towards caregivers.
MSF starts COVID-19 response activities in four northern Italian hospitals
14 March 2020
Teams from Médecins Sans Frontières (MSF) in Italy are providing support to Italian health authorities in response to the COVID-19 coronavirus pandemic. MSF staff are based in four hospitals in the northern Italian province of Lodi, part of the Lombardy region, the epicentre of the outbreak in the country.
The MSF team in Lodi province is composed of Italian infectious disease specialists, anaesthetists, nurses and logisticians, who bring their global experience in managing epidemics from the countries where MSF works to support Italian hospitals. The MSF staff are working in collaboration with local health authorities and personnel of hospitals in the cities of Lodi, Codogno, Casalpusterlengo, and Sant’Angelo Lodigiano, on a number of activities, including disease prevention and care for patients.
We are providing support to help with the huge needs and workload of local hospital staff in responding to this pandemic, to help care for patients.
Dr Claudia Lodesani, President of MSF Italy
The addition of MSF staff at Codogno hospital will allow for around 20 existing beds to re-open, which had been unused due to a lack of staff. The MSF team will work alongside doctors and nurses from other departments of the facility and together will provide care to COVID-19 patients.
“We’ve met doctors and nurses in Lodi province who have been working tirelessly for weeks in an extraordinary situation,” says Dr Claudia Lodesani, infectious disease specialist and President of MSF Italy, who is coordinating MSF’s COVID-19 response in Italy. “We are providing support to help with the huge needs and workload of local hospital staff in responding to this pandemic, to help care for patients.”
The infectious disease support activities will reinforce prevention and control actions already implemented within the hospitals, to avoid the transmission of the virus and guarantee the safety of health workers.
“In an epidemic like this, stopping the transmission of the virus is crucial. In hospitals it is key to reduce the risks for frontline staff, a key factor to fight the epidemic,” says Dr Lodesani. “Outside, everyone must respect the instructions of the Ministry of Health, to curb the infection and avoid further burdening hospitals, which need to continue to treat people for other illnesses and injuries.”
MSF has offered our support to the response in Italy as one of the most affected countries by the COVID-19 pandemic. Our teams are working in solidarity with Italian people and the healthcare professionals working on the frontline to stop the epidemic. MSF is also in contact with health authorities in other countries where we work, on the COVID-19 pandemic. Given the scale of the pandemic, MSF’s ability to support further countries will depend on the nature of the outbreak but also on its capacity to deploy.
Evacuation of squalid Greek camps more urgent than ever over COVID-19 fears
13 March 2020
Families of five or six have to sleep in spaces of no more than 3m2. This means that recommended measures such as frequent hand washing and social distancing to prevent the spread of the virus are just impossible.
Dr Hilde Vochten, MSF’s Medical Coordinator in Greece
The overcrowded and horrific living conditions in the camps - or hotspots - on the Greek islands provide the perfect storm for a COVID-19 outbreak...
COVID-19: 3 questions
13 March 2020
This epidemic, in terms of scale and global spread and rapidity, has a huge effect on health care systems in the countries affected. Hospitalising so many people for such a long time at such a high level of care poses a real challenge to even the most advanced healthcare systems.
More than 100 countries have now reported cases, and on 11 March, the WHO declared COVID-19 as a pandemic. Most countries still have only sporadic cases or defined clusters. 90% of the 118K cases are being reported from four countries: cases in China are now decreasing, but there are major outbreaks in Italy, Iran and South Korea. In other countries, including Europe, the numbers are growing exponentially.
Unlike influenza, there is no known pre-immunity, no vaccine, no specific treatment and everyone is presumed to be susceptible. This will be a mild respiratory illness for the vast majority (estimated 80% of confirmed cases) but it has a higher rate of quite severe complications for vulnerable people (elderly and people with comorbidities), than other viruses such as flu.
Public measures such as isolation, quarantine and social distancing are generally put in place to limit uncontrolled community transmission, slow down number of cases and severely ill patients and protect the most vulnerable and manage the collective health resources.
This epidemic, in terms of scale and global spread and rapidity, has a huge effect on health care systems in the countries affected. Hospitalising so many people for such a long time at such a high level of care poses a real challenge to even the most advanced healthcare systems. We are very concerned about the consequences in countries with weaker healthcare systems, who will struggle even more if they have to deal with a large number of patients with COVID-19.
A) Ensuring continuity of medical care
MSF supports extremely vulnerable communities with our medical programmes around the world. In any given day we are treating hundreds of thousands of patients for a variety of ailments. We need to ensure we can continue to provide adequate and live saving medical care in our ongoing projects. This is challenging because current travel restrictions are limiting our ability to move staff between different countries. There is also global pressure on the production of some medical supplies, in particular specialised personal protective equipment for healthcare workers.
Our projects are still able to continue medical activities, but ascertaining future supplies of certain key items, such as surgical masks, swabs, gloves and chemicals for diagnosis of COVID-19 is of concern. There is also a risk of supply shortages due to lack of production of generic drugs and difficulties to import essential drugs (such as antibiotics and antiretroviral drugs) due to lockdowns, reduced production of basic products, exportation stops or repurposing/stocking of drugs and material for COVID-19.
B) Protecting our patients and healthcare workers
Protecting patients and healthcare workers is essential, so our medical teams are also preparing for potential cases of COVID-19 in our projects. In places where there is a higher chance of cases, this means ensuring infection control measures are in place, setting up screening at triage, isolation areas, and health education. In most countries where MSF works, we are coordinating with the WHO and the Ministries of Health to see how MSF could help in case of a high load of COVID-19 patients and are providing training on infection control for health facilities.
C) Our actions against the epidemic
In Italy, which is now the second-most affected country (after China), this week MSF has begun supporting four hospitals in the epicentre of the outbreak with infection control, as well as patient care.
In Hong Kong, we are providing health education and mental health support for vulnerable groups.
In Iran, MSF has submitted a proposal to the authorities to help caring for patients with COVID-19. Whether we’ll be able to make similar offers to other countries will depend on the nature of the outbreak but also on our capacity to deploy.
MSF is extremely concerned how COVID-19 might affect populations living in precarious environments such as the homeless, those living in refugee camps in Greece or Bangladesh, or conflict affected populations in Yemen or Syria. These people are already living under harsh and often unhygienic conditions and their access to health care is already severely compromised.
Generally, we are very concerned how COVID-19 outbreaks will affect countries with already fragile health systems, such as in Central African Republic (CAR) or Yemen.
Infections of healthcare staff can happen easily in structures that are overwhelmed by large numbers of patients, and that have to deal with limited supplies of personal protective equipment for staff and probable reduced workforce. Infected healthcare staff will further reduce the capacity to admit and treat patients. Safety for healthcare workers should be a top priority in every healthcare facility.
In order to ensure that the medical tools urgently needed to respond to COVID-19 are accessible, affordable, and available; concerned stakeholders including governments, pharmaceutical corporations and other research organizations developing treatments, diagnostics, and vaccines should take the necessary measures to:
- prevent patents and monopolies from limiting production and affordable access;
- guarantee access to repurposed drugs for patients suffering from diseases that are the original indication for use to ensure continuation of care;
- prioritise the availability of the medical tools for protection and treatment of front-line healthcare workers; and
- Improve transparency and coordination, making sure an evidence-based approach is put in place to continuously monitor the risk of the potential supply chain vulnerability on essential medical tools, and to adapt mitigate measures when needed through international collaboration.
We are very concerned about the consequences in countries with weaker healthcare systems, who will struggle even more if they have to deal with a large number of patients with COVID-19.
Providing materials, engaging communities in the COVID-19 coronavirus outbreak
14 February 2020
Specialised medical protective equipment from Médecins Sans Frontières (MSF) is on its way to Wuhan Jinyintan hospital in the capital city of Hubei province, China, the epicentre of the current coronavirus COVID-19 outbreak.
“As of 14 February, there are more than 64,000 COVID-19 cases, 99 per cent of which are in China,” says Gert Verdonck, MSF’s Emergency Coordinator for COVID-19. “Medical protective equipment is key. So, we want to contribute to supporting frontline health workers with the specialised protection they need to work safely in an outbreak of this magnitude.”
MSF sending supplies to China, engaging communities in Hong Kong
Weighing 3.5 tonnes, these supplies are being dispatched from MSF Supply in Brussels, Belgium through the Hubei Charity Federation, to reach Wuhan Jinyintan hospital, one of the hospitals on the forefront of treating patients with COVID-19.
An MSF team in Hong Kong opened a project at the end of January focusing on health education for vulnerable people. Community engagement is a crucial activity of any outbreak response and in Hong Kong, this focuses on groups who are less likely to have access to important medical information, such as the socio-economically disadvantaged.
Our teams have already conducted face-to-face sessions with street cleaners, refugees and asylum seekers and the visually impaired in recent weeks.
Karin Huster, MSF project coordinator, Hong Kong
The team is also targeting those who are more vulnerable to developing severe disease if they are infected, such as the elderly.
“Our teams have already conducted face-to-face sessions with street cleaners, refugees and asylum seekers and the visually impaired in recent weeks,” says Karin Huster, who is in charge of MSF’s project in Hong Kong. “We share up-to-date, evidence-based medical information, but perhaps even more crucially, we’re there to listen and answer the many questions that this new disease has generated.”
“Fear can often spread faster than a virus, so helping people manage their stress and anxiety is a key focus for us.”
MSF donates equipment, prepares to support and respond across Asia
In addition, MSF is sending a donation of one tonne of personal protective equipment to the Hong Kong St John Ambulance service to help them carry over until their stocks can be replenished. The staff are transporting high-risk patients, and therefore, it is important to ensure that they have the specialised protection they need to work safely.
We want to contribute to supporting frontline health workers with the specialised protection they need to work safely in an outbreak of this magnitude.
Gert Verdonck, MSF Emergency Coordinator for COVID-19
Further afield, in other countries where MSF is working, teams are preparing in case of an outbreak of COVID-19. In several countries, predominantly in south and southeast Asia, MSF is in contact with the health authorities and offering support should it be needed.
This includes training of health workers on infection prevention and control measures and health education for vulnerable and at-risk groups, similar to MSF’s activities in 2003 during the outbreak of Severe Acute Respiratory Syndrome (SARS), caused by a related type of coronavirus.
January 30, 2020
MSF’s epidemiologists and infectious disease experts are following the fast-evolving development of the outbreak of the novel coronavirus (2019-nCoV). As of 30 January, there are more than 7,900 cases, more than 98 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 2019-nCoV 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 - 2019-nCoV coronavirus
The disease is caused by a virus, currently called 2019-nCoV, which was discovered in early January in China and has been identified as a member of the family of coronaviruses. 2019-nCoV 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.
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 2019-nCoV 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.
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.
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 2019-nCoV.
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.
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.
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.
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.