Q&A: Adolescents, youth and COVID-19
Since there are few known cases of adolescents getting seriously ill with COVID-19, should I go to a health facility if I develop symptoms of the disease?
If you have minor symptoms, such as a slight cough or a mild fever, there is
generally no need to seek medical care. Stay at home, self-isolate and monitor
your symptoms. Follow national guidance on self-isolation.
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.
Seek medical care if your health gets worse, or if there is no one in your
family that can take care of you at home. It is important that you follow the
procedures put in place by your country. Ask a family member or another
trusted adult how you can find out what these procedures are where you live.
Read more:
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-
public
https://apps.who.int/iris/rest/bitstreams/1272288/retrieve


Q&A: Adolescents, youth and COVID-19
Is it safe to have sex at this time?
There is no evidence that COVID-19 is transmitted through semen or vaginal
fluids. However, having sex with someone means that you are very close to
them. This puts one person at risk if the other person has COVID-19.
Masturbation does not involve another person, and carries no risk of COVID-19.
Also, having sex with a partner whom you are living with does not carry this
risk if both of you are taking steps to protect yourself from the virus. Make
sure to use condoms and contraception to avoid sexually transmitted infections
and unintended pregnancy.
Read more:
https://www.who.int/news-room/q-a-detail/contraception-family-planning-and-
covid-19
https://www.unfpa.org/resources/adolescents-and-young-people-coronavirus-
disease-covid-19


Q&A: Adolescents, youth and COVID-19
I am missing out on my education because of the COVID-19 pandemic. What should I do?
Your school or place where you are studying are likely to make arrangements
for you to catch up or to do exams at another time. Follow the procedures that
your school has put in place to reduce the immediate impact of school
closures, and to facilitate the continuity of education. If you have access to
internet, you can also consult your teachers and other trusted adults to
identify and access reliable online learning opportunities and resources,
including those included in the distance learning solutions recommended by
UNESCO, the United
Nations agency that helps countries improve their education systems. In
addition, UNESCO is collecting stories from students, teachers and
parents
about how they are coping and continuing to learn during school closures.
Access those stories, they might inspire you. You can also contact UNESCO and
share your story! Find out how to share it
here.
In places where internet connectivity is a problem, many governments have
started to broadcast educational programmes on TV and radio channels during
school closures. If you live in such a place, look out for educational
programmes on your local TV and radio channels.
Read more:
https://en.unesco.org/covid19/educationresponse/solutions
https://www.voicesofyouth.org/campaign/studying-home-due-coronavirus-how-
young-people-around-world-are-keeping-their-mood__


Q&A: Adolescents, youth and COVID-19
I am on medication for a chronic health condition. Should I change anything?
It is important to continue with any medication you may be using for chronic
and other conditions, such as asthma, diabetes, HIV infection and TB, and
attend recommended check-ups. Check with your health authorities and health
provider if these check-ups should be done differently during the COVID-19
outbreak. Some services, such as counselling, may be available remotely. For
treatment of clinically stable adolescents with HIV and adolescents with TB
and/or other chronic conditions, your health provider should consider multi-
month prescriptions and dispensing which will reduce the frequency of your
visits to the clinic and ensure continuity of treatment, if movements are
disrupted during the pandemic. Adherence to treatment is just as important
during this period.
Read more:
https://www.who.int/news-room/q-a-detail/q-a-on-covid-19-hiv-and-
antiretrovirals


Q&A: Adolescents, youth and COVID-19
I am feeling really anxious about COVID-19 and its impact on my life. What should I do?
In situations like a pandemic it is very normal to feel anxious and powerless,
and that is ok. Here are a few suggestions on things that could help you
proactively manage your anxiety:
Think about how you are feeling. Don’t ignore your feelings, especially if
you don’t feel well. When your life is disrupted, it is normal to have many
different feelings: worry, frustration, sad, stress, anger, anxiety - this can
happen to everyone. Draw on skills and strategies you have used in the past
that have helped you to manage life challenges, and skills to help you manage
your emotions. Here are a few examples:

Keep a diary
Express your feelings through art, like writing a poem, drawing, dancing, or playing music
Talk about your feelings and concerns with someone you trust
Try some breathing exercises. You may find guided breathing exercises online if you have access to internet.

Do something active every day : Any exercise will help, as it reduces
levels of the body's stress hormones, which can help your body and mind relax.
Exercise also produces a “feel good hormone” called endorphins which can help
to improve your mood. Try taking a walk, running, or any physical activity
outdoors while keeping a distance from others. For those who are unable to
leave the house, you could open the window for fresh air and do some indoor
exercises to stay active.
Don’t use smoking, eating, alcohol or other drugs to deal with your
emotions.
Stay connected with friends and family either by communicating with them
by phone or internet if you can., If you live close to them and the local
rules allow you to, you could also talk to them in person while keeping your
distance.
Keep a daily routine as much as possible. Try to go to bed and wake up at
the same times every day, making sure you get enough sleep. Plan ahead and try
to have a balance of activities such as keeping up with schoolwork, physical
exercise, connecting with friends and family, doing things you enjoy, and
eating regular meals.
Talk to a health worker or counsellor if you, or someone you care about:

feel overwhelmed with emotions like sadness, fears and worries
feel like stress gets in the way of your daily routines, or
feel like you want to harm yourself or others.

At this time, you may find it easier to speak to a counsellor than a health
worker, given that there may be restrictions on movement and health facilities
may be busy caring for those with COVID-19.
Read more:
https://www.who.int/docs/default-source/coronaviruse/coping-with-
stress.pdf
https://www.who.int/docs/default-source/coronaviruse/helping-children-cope-
with-stress-print.pdf
https://www.who.int/docs/default-source/coronaviruse/mental-health-
considerations.pdf
https://www.un.org/youthenvoy/2020/04/copingwithcovid-a-webinar-series-on-
young-people-and-mental-health/
https://www.voicesofyouth.org/campaign/covid-19-and-youth-mental-health


Q&A: Adolescents, youth and COVID-19
I am bored staying home. Since I am very unlikely to get severely ill even if I was to get COVID-19, why is it important that I follow the guidelines to prevent transmission such as keeping physical distance from other people?
Staying at home is difficult and can get boring, but it may help to do
something you enjoy. This could be reading a book, playing games or listening
to music. Try to stay connected with friends and family every day either by
communicating with them by phone or internet if you can, or, if you live close
to them and the local rules allow you to, by talking in-person while keeping
your distance.
At the same time, it is still really important that you reduce your chances of
being infected or spreading COVID-19 by washing your hands with soap and water
or alcohol-based hand rub as often as possible, keeping at least 1 metre (3
feet) from other people, and avoiding crowded places. You might be one of the
unlucky adolescents who does get severely ill if you catch COVID-19, or you
could spread it to others and be responsible for them getting really ill or
even dying. You have the power to make choices that could save lives and
together young people can play an important part in fighting COVID-19.
Read more:
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-
public


Q&A: Adolescents, youth and COVID-19
COVID-19 is everywhere in the news, and I am finding it difficult to know what is true and what is false. What should I do?
A near-constant stream of news, sometimes contradictory, can cause anyone to
feel lost and distressed. Make sure to use reliable sources such as the
UNICEF and the World Health
Organization’s sites to get
information, or to check any information you might be getting through less
reliable channels.
If you have a phone, you can use the WHO Health Alert on WhatsApp to get the latest information about the
pandemic. This is a new service, which is free to use, designed to give
prompt, reliable and official information 24 hours a day, worldwide. Start by
clicking WHO Health
Alert,
then simply text the word ‘Hi’ in a WhatsApp message to get started. Keep in
mind that overloading yourself with information about the COVID-19 pandemic
can also be stressful, so seek information updates and practical guidance at
specific times during the day and avoid listening to or following rumours that
make you feel uncomfortable.
Read more:
https://www.who.int/docs/default-source/coronaviruse/mental-health-
considerations.pdf


Q&A: Adolescents, youth and COVID-19
I know there is a risk of getting COVID-19 at the moment, but I feel fine. Can I still play sports?
Yes. You can still play sports that are in line with the physical distancing
measures and movement restrictions that are in place in your country. Being
physically active is good for your health, both physical and mental. Set up a
regular routine to practice activities or sports that do not require close
contact with others every day for 1 hour. You can do individual sports, like
jogging, walking, dancing or yoga. There are many options to try. You can set
up playground games indoors, such as jump rope and hop-scotch, play with your
brothers and sisters, and practice some strength training activities, using
improvised weights like bottles full of water or sand. If you have access to
the internet, you can also join in online active games or fitness classes, or
set up your own online physical exercises with your friends or classmates.
Find an activity that is fun, can be done within the restrictions that are in
place in your country, and makes you feel good.


Q&A: Adolescents, youth and COVID-19
Can adolescents catch COVID-19?
Yes. All age groups can catch COVID-19. While we are still learning about how
COVID-19 affects people, older persons (e.g. persons over 60 years) and
persons with pre-existing medical conditions, like high blood pressure, heart
disease, lung disease, cancer or diabetes, appear to develop serious illness
more often than others. As this is a new virus, we are still learning about
how it affects children and adolescents. Evidence to date suggests that
children and adolescents are less likely to get severe disease, but severe
cases and death can still happen in these age groups.
Read more:
https://www.who.int/docs/default-source/coronaviruse/key-messages-and-
actions-for-covid-19-prevention-and-control-in-schools-
march-2020.pdf?sfvrsn=baf81d52_4
https://www.who.int/news-room/q-a-detail/q-a-coronaviruses


Q&A: Adolescents, youth and COVID-19
I was due to get vaccinated for HPV, meningitis or tetanus, but immunization services have been disrupted. Should I be concerned?
WHO recommends that all vaccination in schools and mass campaigns should be
postponed during the COVID-19 pandemic. However, vaccines provided to
adolescents have sufficiently flexible schedules to make sure you can get the
vaccine in time when vaccination services start again. For example, the HPV
vaccine that requires two doses can be started any time between 9 and 14 years
of age and the interval between the two doses can be longer. The minimum
interval between doses is 6 months, but it can be 12 or 15 months and, if
necessary, even longer. It is most important hat you receive the t second dose
at some point in time to be fully protected.
Decisions to continue routine vaccination services are made by each country.
Ask a family member or another trusted adult how you can get information about
vaccination services where you live. It is important you get the vaccines you
are supposed to get, even if they have to be delayed due to the COVID-19
pandemic.
Read more:
https://apps.who.int/iris/bitstream/handle/10665/331590/WHO-2019-nCoV-
immunization_services-2020.1-eng.pdf
https://apps.who.int/iris/bitstream/handle/10665/331818/WHO-2019-nCoV-
immunization_services-FAQ-2020.1-eng.pdf


Q&A: Adolescents, youth and COVID-19
Schools are reopening in some areas of my country. Is it safe to go back to school?
A decision to reopen schools in every country and area is made based on
careful assessment of the situation, with consensus among all the key parties
involved, including the health and education policy-makers, teachers and other
school staff, parents and health and community workers. In addition, the
reopening of schools are carefully planned and prepared, with all necessary
measures in place to protect the safety and health of everyone in the school
community.
Therefore, if your school reopens, you should feel assured it is safe for you
to go back to school – provided that you strictly follow the guidelines and
rules that will be provided by your school.
Of course, if you have any concerns with going back to school, do not hesitate
to speak out to your teachers and parents or guardians.
Read more:
School reopening, UNESCO COVID-19 Education Response Education Sector Issue
Note 7.1, April 2020
Prepare for school reopening, IIEP-UNESCO's COVID response
brief,
April 2020


Q&A: Adolescents, youth and COVID-19
I heard I can be hurt by online contacts. What are my risks and how I can protect myself online.
Since you might be spending even more time online than before, it is wise to
be aware of some of the risks. First, be careful what content you share
online. Risky behaviour, such as sexting or sharing of sexualized content, can
expose you to risks of blackmail, harassment and humiliation. Second, spending
more time online may increase the chances that you could come into contact
with online predators who seek to sexually exploit young people. When in front
of webcams wear appropriate clothing and do not connect with teachers or
virtual classrooms from a bedroom. In addition, it’s important to note that
some adolescents – for example those with disabilities and those perceived to
be different or at greater risk of catching or spreading COVID-19 - may be at
increased risk of cyberbullying and discrimination. Hurtful, discriminatory or
inappropriate online contact is never okay. If in doubt, or if you feel
uncomfortable or distressed about some interactions you have online, tell a
parent or another trusted adult immediately.
Read more:
https://www.unicef.org/media/67396/file/COVID-19%20and%20Its%20Implications%20for%20Protecting%20Children%20Online.pdf


Q&A: Adolescents, youth and COVID-19
What should I do if someone in my family gets really ill with COVID-19?
Seek medical care, if members of your family get seriously ill. If possible,
either you or an adult should phone the local or national COVID-19 emergency
number for advice on where and how you could get care. If your family member
is confirmed as having COVID-19, you must be prepared that you and other known
contacts will need to monitor your symptoms, and continue to self-quarantine
for 14 days, even if you feel healthy.
Read more:
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-
public


Q&A: Adolescents, youth and COVID-19
I don’t like the way someone touches me at home and we are both at home all the time because of the pandemic. What should I do?
It is wrong for anyone to do this. And it is not your fault in any way. If you
are staying in the same house as the person and/or are dependent on him (it
will usually be a man), that may make some of the things that you could do
difficult, especially during stay-at-home restrictions due to COVID-19. Here
are some things that you can consider doing to improve your safety while in
the house.

You could tell him politely but firmly that you do not want him to touch you and ask him to please stop.

You could inform your parents or other caregivers or trusted adult in the house about what is happening.

You could inform a trusted adult outside your home such as a neighbour or a teacher or family friend or relative.

If you have access to a phone, you could call or text for help and support. This includes calling hotlines/helplines for children and women who are in need of help or feeling distressed or subjected to abuse, or calling a child protection service in your area. Be careful not to leave your phone calls or text messages where anyone else could access them.

If you need to leave the house immediately because he is hurting or harming you, think of discretely (without him overhearing) pre-arranging with a neighbour or trusted relative or family friend to help you leave the house and stay with them until it is safe for you to return home.

If you have been sexually abused or raped and need urgent medical help or care, go as soon as possible to the nearest hospital or clinic to ask for medical care.

Read more:
https://apps.who.int/iris/bitstream/handle/10665/331699/WHO-
SRH-20.04-eng.pdf


Q&A: Be Active during COVID-19
How much physical activity is recommended?
WHO has detailed recommendations on the amount of physical activity people of
all ages should do to benefit their health and wellbeing. (available
here for children under age
of 5 and
here
for youth, adults and olders) Here are the minimum levels we recommend:
Infants under the age of 1 year need to

be physically active several times a day.

Children under 5 years of age

should spend at least 180 minutes a day in physical activities, with 3-4 year-olds being moderately or vigorously active for an hour a day.

Children and adolescents aged 5-17years ****

all children and adolescents should do at least 60 minutes a day of moderate to vigorous-intensity physical activity, including activities that strengthen muscle and bone, at least 3 days per week. ****

Adults aged over 18 years ****

should do a total of at least 150 minutes of moderate-intensity physical activity throughout the week, or at least 75 minutes of vigorous-intensity physical activity throughout the week, including muscle-strengthening activities 2 or more days per week.
older adults with poor mobility should do physical activity to enhance balance and prevent falls on 3 or more days per week.

But any physical activity is better than none. Start with small amounts and
gradually increase duration, frequency and intensity over time.
Being active during the COVID-19 pandemic is challenging for us all. Because
the opportunities to be physically active seem to be more restricted, it is
even more important to plan in every day the ways to be active and to reduce
the time spent sitting for long periods. Put simply, it is a critical time to
ensure we all move more and sit less.


Q&A: Be Active during COVID-19
Why do we need it?
Regular physical activity benefits both the body and mind. It can reduce high
blood pressure, help manage weight and reduce the risk of heart disease,
stroke, type 2 diabetes, and various cancers. It also improves bone and muscle
strength and increases balance, flexibility and fitness. For older people,
activities that improve balance help to prevent falls and injuries. For
children, regular physical activity helps support healthy growth and
development and reduce the risk of disease in later life, and through regular
activity, children can develop fundamental movement skills and build social
relationships.
Regular physical activity also improves mental health and can reduce the risk
of depression, cognitive decline and delay the onset of dementia - and improve
overall feelings of wellbeing.


Q&A: Be Active during COVID-19
What is physical activity?
Physical activity includes all forms of active recreation, sports
participation, cycling and walking, as well as activities you do at work and
around the home and garden. It doesn’t have to be exercise or sport – play,
dance, gardening, and even house cleaning and carrying heavy shopping is all
part of being physically active.
During the COVID-19 pandemic, when so many of us are very restricted in our
movements, it is even more important for people of all ages and abilities to
be as active as possible. Even a short break from sitting, by doing 3-5
minutes of physical movement, such as walking or stretching, will help ease
muscle strain, relieve mental tension and improve blood circulation and muscle
activity. Regular physical activity can also help to give the day a routine
and be a way of staying in contact with family and friends.
EndFragment


Q&A: Be Active during COVID-19
So how do I stay safe while exercising in COVID-19?
Do not exercise if you have a fever, cough and difficulty breathing. Stay
home and rest, seek medical attention and call in advance. Follow the
directions of your local health authority.
If you are able to go for a walk or bicycle ride always practice
physical distancing and wash your hands with water and soap before you leave,
when you get to where you are going, and as soon as you get home. If water and
soap are not immediately available, use alcohol-based hand rub.
If you go to a park or public open space to walk, run or exercise always
practice physical distancing and wash your hands with water and soap, before
you leave, when you get to where you are going, and as soon as you get home.
If water and soap are not immediately available, use alcohol-based hand rub.
Follow the directions of your local health authority in regards to any
restrictions on the number of people with you and/or restrictions on the use
of public outdoor play or exercise equipment.
If you are not regularly active start slowly and with low intensity
activities , like walking and low impact exercises. Start with shorter
amounts, like 5-10 minutes, and gradually build up to 30 minutes or more
continuously over a few weeks. It is better and safer to be active for short
periods more frequently than to try and be active for long periods when you
are not used to it.
Choose the right activity so that you reduce the risk of injury and that
you enjoy the activity. Choose the right intensity according to your health
status and fitness level. You should be able to breath comfortably and hold a
conversation while you do light- and moderate-intensity physical activity.


Q&A: Be Active during COVID-19
How do I stay active in and around the home?
Try and reduce long periods of time spent sitting , whether for work,
studying, watching TV, reading, or using social media or playing games using
screens. Reduce sitting for long periods by taking short 3-5 minute breaks
every 20-30 minutes. Simply stand up and stretch or even better, take a walk
around the house, up and down the stairs, or into the garden. By just moving
around and stretching you can improve your health and wellbeing. For more
ideas and illustrations of healthy stretches see
here.
Set up a regular routine to be active every day , by planning a physical
activity or exercise break either by yourself, by joining an online class, or
by setting up a time to be active online with your friends or colleagues.
Making a specific time to be active helps ensure you get your daily physical
activity. Put the time in your diary, and it will help remind you. Stick with
it, as this will help you build a regular routine, and help you adjust to new
ways of working, study and family life under COVID-19 restrictions
Be active with your family and friends , **** connecting with others
can help you and your family in the home and elsewhere spend time together and
be active. Planning time to be active with your children with active games at
home, walks in the parks, or cycling can be a way the whole family can relax,
be together and be active and healthy whilst at home.
Set yourself and your family Be Active goals, by choosing a specific type
of activity, time of day and/or number of minutes you will do every day. Get
each family member to choose their own goal which sets a bit of a challenge
but is realistic with help from family or friends and motivation. Record your
progress on a weekly activity chart and, if you think it would help, reward
yourself with something you value.
http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-
covid-19/novel-coronavirus-2019-ncov-technical-guidance/stay-physically-
active-during-self-
quarantine/_recache?fbclid=IwAR2RQYVYBnmpDCMjBwqmoz0hZxzmit_9yKzXu6ZhjGNywRTEzWOUQefU8V0
More physical activity ideas to help you stay active
For Infants under 1 year of age ****

Spend regular time doing floor-based play with your baby in a prone position (‘tummy time’) and spread this throughout the day while baby is awake.

For Children under 5 years of age ****

Active play in and around the home – invent games which involve being active and can develop skills in throwing, catching, kicking, as well as developing posture and balance.
Active play and games where children get out of breath, such as running around, skipping and jumping.

For Children and adolescents aged 5-17 years ****

Active games and active play with family. ****
Join in online active games or activity classes, also look for online physical education classes as well as exercise routines suitable for adolescents.
Set up playground games indoors such as Jump rope and hop-scotch – make up new games and challenges that involve being active.
Learn a new skill – for example try an learn to juggle.
Encourage doing some muscle strength training activities such as lifting weights or use improvised weight such as bottles full of water or sand.

For Adults ****

Climb up the stairs as much as you can, think of it as an opportunity to be active.
Use household chores as a way to be more physical activity.
Join in an online exercise class or make up your own routine to music you enjoy that uses the major muscle groups and raises you heart rate.
Do some muscle strengthening activities such as lifting weights or improvise using full bottles of water or simply use your own body weight and do sets of press ups, sit ups and squats.
Make time for fun, such as dancing to music.

Where to get more help and information
For more ideas use internet search platforms and check out social media for
suggestions and access to free resources suitable for children of all ages and
adults of all fitness and abilities.


Q&A: Breastfeeding and COVID-19
I have confirmed or suspected COVID-19 and am too unwell to breastfeed my baby directly. What can I do?
If you are too unwell to breastfeed your baby due to COVID-19 or other
complications, you should be supported to safely provide your baby with breast
milk in a way possible, available, and acceptable to you. This could include:

Expressing milk;
Donor human milk.

If expressing breast milk or donor human milk are not feasible then consider
wet nursing (another woman breastfeeds the child) or infant formula milk with
measures to ensure that it is feasible, correctly prepared, safe and
sustainable.


Q&A: Breastfeeding and COVID-19
I have confirmed or suspected COVID-19, is it safer to give my baby infant formula milk?
No. There are always risks associated with giving infant formula milk to
newborns and infants in all settings. The risks associated with giving infant
formula milk are increased whenever home and community conditions are
compromised, such as reduced access to health services if a baby becomes
unwell, reduced access to clean water and/or access to supplies of infant
formula milk are difficult or not guaranteed, affordable and sustainable.
The numerous benefits of breastfeeding substantially outweigh the potential
risks of transmission and illness associated with the COVID-19 virus.


Q&A: Breastfeeding and COVID-19
Can COVID-19 be passed through breastfeeding?
Transmission of active COVID-19 (virus that can cause infection) through
breast milk and breastfeeding has not been detected to date. There is no
reason to avoid or stop breastfeeding.


Q&A: Breastfeeding and COVID-19
Following delivery, should a baby still be immediately placed skin-to-skin and breastfed if the mother is confirmed or suspected to have COVID-19?
Yes. Immediate and continued skin-to-skin care, including kangaroo mother
care, improves the temperature control of newborns and is associated with
improved survival among newborn babies. Placing the newborn close to the
mother also enables early initiation of breastfeeding which also reduces
mortality.
The numerous benefits of skin-to-skin contact and breastfeeding substantially
outweigh the potential risks of transmission and illness associated with
COVID-19.


Q&A: Breastfeeding and COVID-19
I had confirmed or suspected COVID-19 and was unable to breastfeed, when can I start to breastfeed again?
You can start to breastfeed when you feel well enough to do so. There is no
fixed time interval to wait after confirmed or suspected COVID-19. There is no
evidence that breastfeeding changes the clinical course of COVID-19 in a
mother. Health workers or breastfeeding counsellors should support you to
relactate.


Q&A: Breastfeeding and COVID-19
Can women with confirmed or suspected COVID-19 breastfeed?
Yes. Women with confirmed or suspected COVID-19 can breastfeed if they wish to
do so. They should:

Wash hands frequently with soap and water or use alcohol-based hand rub and especially before touching the baby;
Wear a medical mask during any contact with the baby, including while feeding;
Sneeze or cough into a tissue. Then dispose of it immediately and wash hands again;
Routinely clean and disinfect surfaces that mothers have touched.

It is important to replace medical masks as soon as they become damp and
dispose of them immediately. Masks should not be reused or touched in the
front.


Q&A: Breastfeeding and COVID-19
If a mother confirmed or suspected to have COVID-19 does not have a medical face mask should she still breastfeed?
Yes. Breastfeeding unquestionably reduces mortality in newborns and infants
and provides numerous lifelong health and brain development advantages to the
child.
Mothers with symptoms of COVID-19 are advised to wear a medical mask, but even
if this is not possible, breastfeeding should be continued. Mothers should
follow other infection prevention measures, such as washing hands, cleaning
surfaces, sneezing or coughing into a tissue.
Non-medical masks (e.g. home-made or cloth masks) have not been evaluated. At
this time, it is not possible to make a recommendation for or against their
use.


Q&A: Breastfeeding and COVID-19
In communities where COVID-19 is prevalent, should mothers breastfeed?
Yes. In all socio-economic settings, breastfeeding improves survival and
provides lifelong health and development advantages to newborns and infants.
Breastfeeding also improves the health of mothers.


Q&A: Considerations for the cleaning and disinfection of environmental surfaces in the context of COVID-19 in non-health care settings
What areas should be prioritized for disinfection in non-health care settings?
Disinfection practices are important to reduce the potential for COVID-19
virus contamination in non-healthcare settings, such as in the home, office,
schools, gyms, publicly accessible buildings, faith-based community centres,
markets, transportation and business settings or restaurants. High-touch
surfaces in these non-health care settings should be identified for priority
disinfection such as door and window handles, kitchen and food preparation
areas, counter tops, bathroom surfaces, toilets and taps, touchscreen personal
devices, personal computer keyboards, and work surfaces.


Q&A: Considerations for the cleaning and disinfection of environmental surfaces in the context of COVID-19 in non-health care settings
Are public systems for disinfecting individuals such as spraying via tunnel or chambers safe to use?
No. Spraying of individuals with disinfectants (such as in a tunnel, cabinet,
or chamber) is not recommended under any circumstances. This practice could be
physically and psychologically harmful and would not reduce an infected
person’s ability to spread the virus through droplets or contact. Even if
someone who is infected with COVID-19 goes through a disinfection tunnel or
chamber, as soon as they start speaking, coughing or sneezing they can still
spread the virus.
The toxic effect of spraying with chemicals such as chlorine on individuals
can lead to eye and skin irritation, bronchospasm due to inhalation, and
potentially gastrointestinal effects such as nausea and vomiting. In addition
to health safety concerns, the use of chlorine in large-scale spraying
practices may prevent this resource from being used for important
interventions such as drinking water treatment and environmental disinfection
of health care facilities.


Q&A: Considerations for the cleaning and disinfection of environmental surfaces in the context of COVID-19 in non-health care settings
What protection measures should people take when using disinfectants?
It is important to reduce your risk when using disinfectants:

The disinfectant and its concentration should be carefully selected to avoid damaging surfaces and to avoid or minimize toxic effects on household members (or users of public spaces).
Avoid combining disinfectants, such as bleach and ammonia, since mixtures can cause respiratory irritation and release potentially fatal gases.
Keep children, pets and other people away during the application of the product until it is dry and there is no odour.
Open windows and use fans to ventilate. Step away from odours if they become too strong. Disinfectant solutions should always be prepared in well-ventilated areas.
Wash your hands after using any disinfectant, including surface wipes.
Keep lids tightly closed when not in use. Spills and accidents are more likely to happen when containers are open.
Do not allow children to use disinfectant wipes. Keep cleaning fluids and disinfectants out of the reach of children and pets.
Throw away disposable items like gloves and masks if they are used during cleaning. Do not clean and re-use.
Do not use disinfectant wipes to clean hands or as baby wipes.
The minimum recommended personal protective equipment when disinfecting in non-health care settings is rubber gloves, waterproof aprons and closed shoes. Eye protection and medical masks may also be needed to protect against chemicals in use or if there is a risk of splashing.

Note: Where cleaning and disinfection are not possible on a regular basis
due to resource limitations, frequent hand washing and avoiding touching the
face should be the primary prevention approaches to reduce any potential
transmission associated with surface contamination.


Q&A: Considerations for the cleaning and disinfection of environmental surfaces in the context of COVID-19 in non-health care settings
How should I clean food items from the grocery store, for example fruit, vegetables or packaged items?
There is no evidence to date of viruses that cause respiratory illnesses being
transmitted via food or food packaging. Coronaviruses cannot multiply in food;
they need an animal or human host to multiply.
The COVID-19 virus is generally thought to be spread from person to person
through respiratory droplets. Currently, there is no evidence to support
transmission of the COVID-19 virus associated with food.
Before preparing or eating food it is important to always wash your hands with
soap and water for at least 40-60 seconds. Regular food safety and handling
guidance should be followed.
See: https://www.who.int/activities/promoting-safe-food-
handling.
For food service businesses, please see the below guidance on COVID-19 and
Food Safety: https://www.who.int/teams/risk-communication/food-and-
agriculture-sectors.


Q&A: Considerations for the cleaning and disinfection of environmental surfaces in the context of COVID-19 in non-health care settings
Which surface disinfectants are effective against COVID-19 in non-health care setting environments?
In non-health care settings, sodium hypochlorite (bleach / chlorine) may be
used at a recommended concentration of 0.1% or 1,000ppm (1 part of 5% strength
household bleach to 49 parts of water). Alcohol at 70-90% can also be used for
surface disinfection. Surfaces must be cleaned with water and soap or a
detergent first to remove dirt, followed by disinfection. Cleaning should
always start from the least soiled (cleanest) area to the most soiled
(dirtiest) area in order to not spread the dirty to areas that are less
soiled.
All disinfectant solutions should be stored in opaque containers, in a well-
ventilated, covered area that is not exposed to direct sunlight and ideally
should be freshly prepared every day.
In indoor spaces, routine application of disinfectants to surfaces via
spraying is not recommended for COVID-19. If disinfectants are to be applied,
these should be via a cloth or wipe which is soaked in the disinfectant.


Q&A: Considerations for the cleaning and disinfection of environmental surfaces in the context of COVID-19 in non-health care settings
What is the guidance for the disinfection of outdoor spaces such as open markets, roads?
In outdoor spaces, large-scale spraying or fumigation in areas such as streets
or open market places for the COVID-19 virus or other pathogens is not
recommended. Streets and sidewalks are not considered as routes of infection
for COVID-19. Spraying disinfectants, even outdoors, can be noxious for
people’s health and cause eye, respiratory or skin irritation or damage.
This practice will be ineffective since the presence of dirt or rubbish for
example, inactivates the disinfectant, and manual cleaning to physically
remove all matter is not feasible. This is even less effective on porous
surfaces such as sidewalks and unpaved walkways. Even in the absence of dirt
or rubbish, it is unlikely that chemical spraying would adequately cover
surfaces allowing the required contact time to inactivate pathogens.


Q&A: Considerations for the cleaning and disinfection of environmental surfaces in the context of COVID-19 in non-health care settings
What are the recommended practices once back home after outdoor activities?
Thorough hand hygiene: washing hands with soap and water or using alcohol-
based hand gel, should be performed before touching surfaces, items, pets, and
people within the household environment. Please see:
https://www.who.int/gpsc/clean_hands_protection/en/.
While outside, people should always follow physical distancing measures,
staying at least one metre from another person; perform hand hygiene by
washing hands frequently with soap and water or using alcohol-based hand rub;
follow good respiratory hygiene by covering your mouth and nose with your bent
elbow or tissue when coughing or sneezing; avoid touching your eyes, nose and
mouth; and avoid crowded places.


Q&A: Considerations for the cleaning and disinfection of environmental surfaces in the context of COVID-19 in non-health care settings
Are gloves recommended for the community in public spaces to protect against COVID-19, for example when going to the grocery store supermarket?
No. The use of gloves by the public in public spaces is not a recommended or
proven prevention measure. Wearing gloves in public spaces does not replace
the need for hand hygiene, nor does it offer any additional measure of
protection against the COVID-19 virus than hand hygiene. Gloves do not provide
complete protection against hand contamination, as pathogens may gain access
to the hands via small defects in gloves or by contamination of the hands
during glove removal. People can also transfer pathogens from one surface to
another by touching with gloved hands, or even transfer pathogens to the
mouth, nose, or eyes if they touch their face with gloved hands.


Q&A: Contraception/Family planning and COVID-19
What is the best contraceptive method to use during the COVID-19 pandemic?
All modern methods of contraception help to prevent pregnancy. Women and their
partners can choose any modern contraceptive method that is acceptable to and
safe for them. The best method of contraception is the one that works well for
you.
There is a wide variety of modern methods, one of which may suit you best. For
more information see here.
Condoms, when they are used consistently and correctly, are the only method of
contraception that help to prevent unintended pregnancy and protect against
sexually transmitted infections, including HIV. They can be used together with
other methods of contraception to protect against both unintended pregnancy
and sexually transmitted infections.
Emergency contraceptive pills can prevent up to 95% of pregnancies when taken
within 5 days after intercourse, and they can be taken by anyone with or
without a health condition


Q&A: Contraception/Family planning and COVID-19
I am a policy maker. What can I do to make sure people can access contraception and family planning information and services?

Plan and develop innovative strategies to ensure as many eligible people as possible can access information and contraception during this period.

Increase use of mobile phones and digital technologies to help people make decisions about which contraceptive methods to use, and how they can be accessed.

Enable health care workers to provide contraceptive information and services as per national guidelines to the full extent possible. This is particularly important where pregnancy poses a high risk to health.

Expand availability of contraceptive services (including both information and methods) through places other than healthcare facilities, such as pharmacies, drug shops, online platforms and other outlets. This can be with or without prescription depending on national guidelines and contraceptive method.

Relax restrictions on the number of repeat issues of prescription-only hormonal contraceptives that can be issued.

Ensure access to emergency post-coital contraception, including consideration of over the counter provision.

Enable access to contraception for women and girls in the immediate post-partum and post abortion periods when they may access health services.


Q&A: Contraception/Family planning and COVID-19
Why is providing contraception/ family planning, as well as family planning services and information, important during the COVID-19 pandemic?
Contraception and family planning information and services are life-saving and
important at all times. Sexual activity does not cease with the COVID-19
pandemic, it is therefore crucial to ensure that people are able to access
rights-based services and information to initiate and / or continue use of
contraception.
By preventing unintended pregnancies, contraception helps to protect girls and
women from the negative health consequences of unintended pregnancies, which
can save their lives. Contraception reduces the need for abortion, meaning
that women and girls are less at risk of unsafe abortion, which again can be
lifesaving.
Condoms, when used consistently and correctly, help to prevent both unintended
pregnancies and sexually transmitted infections (including HIV).
In addition, by preventing the negative health consequences associated with
unintended pregnancies, unsafe abortion and sexually transmitted infections
(including HIV), contraception can help alleviate additional pressure on
already-stretched health systems which are working hard to address COVID-19.


Q&A: Contraception/Family planning and COVID-19
I want to remove or replace my implant or IUD – can I do this during COVID-19 pandemic?
Removal of long acting methods such as implants or IUDs, after the recommended
period of use (and routine follow up appointments) may not be prioritized by
your country’s health system during this health emergency. Seek advice from
your health provider. If you are experiencing side effects or desire urgent
removal for other reasons, contact a provider to find out what options suit
you best, and which are available and feasible.
If, due to restrictions on movement due to the COVID-19 pandemic you cannot
have your long acting method removed straight away, it is important to use
another method of contraception to avoid pregnancy at this time.
There are no medical problems caused by delaying removal of long acting
methods such as implants or IUDs. Do not try to remove the contraception
method yourself; wait until you are able to access health care from a trained
provider.


Q&A: Contraception/Family planning and COVID-19
Is contraception/ family planning safe to use during the COVID-19 pandemic?
Yes. All modern methods of contraception are safe to use, including during the
COVID-19 pandemic.
If you have had a baby in the last six months or have a health condition, such
as diabetes, high blood pressure, or breast cancer – or if you smoke – seek
advice from a health care professional to ensure you are using a method of
contraception which is suitable and safe for you.


Q&A: Contraception/Family planning and COVID-19
I can’t access my contraceptive method of choice. What do you advise?
If you cannot access your contraceptive method of choice – perhaps because it
requires a prescription, or because it can only be given to you by a health
worker – consider using condoms, fertility awareness-based methods,
lactational amenorrhea (if you are exclusively breastfeeding), or other
contraceptive methods that are recommended for self-care in your country.
Depending on the situation in your country, methods recommended for self-care
could include the pill or mini-pill, emergency contraception pills, and DMPA-
SC (Sayana Press®).


Q&A: Contraception/Family planning and COVID-19
I want to avoid getting pregnant during the COVID-19 pandemic. What can I do?
If you do not want to become pregnant, you should start or continue to use
your contraceptive method of choice. You may be able to access information and
contraceptive services from a healthcare provider by phone or online.
If you cannot access these services you may opt for a method that is available
without a prescription (such as condoms, spermicides, pills, or emergency
contraceptive pills) from a nearby pharmacy or drug shop.


Q&A: Contraception/Family planning and COVID-19
I am a programme manager. What can I do to help people access contraception and family planning information and services?

Increase use of telehealth for counselling and sharing of messages related to safe and effective use of contraception and for selection and initiation of contraceptives.

Ensure adequate inventory to avoid potential stock outs at all levels of the health system.

Prepare advisories for users on how they can access contraceptive information, services and supplies.

Monitor contraceptive consumption in your area to identify any potential pitfall and shortage.

Increase availability and access to the contraceptives which can be used by the client without service provider support.


Q&A: Contraception/Family planning and COVID-19
I want to change my contraceptive method – is this possible?
Yes. It may be difficult however, to access all the methods of contraception
that are normally available in your country due to restrictions on movement,
lack of supply, as well as increased demands on health providers and services.
If you have a pre-existing health condition, consult a provider to find out
what options suit you best, and which are available and feasible. Seek advice
and information from your health provider and consider using methods that do
not have medical restrictions like minipills, condoms, fertility awareness-
based methods, diaphragm, spermicides or lactational amenorrhea if you are
exclusively breastfeeding.


Q&A: Ethics and COVID-19: resource allocation and priority setting
What conclusions can we draw about the fair allocation of scarce resources within countries during the COVID-19 outbreak?

Health care workers (caring for patients) and first responders can justifiably be prioritized when allocating some resources because of their contribution to the health and well-being of the community. Their health helps preserve the health of others.
Participants of research aimed at developing vaccines, therapies or other critical resources should receive some priority in receiving those resources because they have also helped save others by their participation. This is not an absolute priority – for example, it should not take precedence over giving priority to those most at risk in the case of resources such as vaccines.
While the principle of first come, first served is often applied when allocating resources in health care settings, it is rarely appropriate in an emergency. In practice, it is very likely to favour certain groups, such as those closest to a distribution centre, those with access to better information, or those who are most well-off.
Younger populations appear to be at lower risk in the COVID-19 context. Consequently, the principle of youngest first should have low priority for vaccine, but perhaps may have more weight if they do become sick and need critical care resources.
The allocation of different resources may find ethical justification in different principles or values. For instance, if a novel vaccine is found to be safe and effective, a lottery-based allocation may be justified among those as highest risk, the old and those with co-morbidities, if they outnumber available vaccines.
Maximizing utility should be balanced with the principle of priority to the worst-off: centralizing the availability of resources in larger centres may extend their benefits to more people, but may exclude isolated populations and challenge our concern for those at highest risk.


Q&A: Ethics and COVID-19: resource allocation and priority setting
What are the key ethical considerations that governments, vaccine manufacturers and funders should take into account to ensure a fair distribution of vaccines globally?
Countries are equally vulnerable to COVID-19 and have a shared responsibility,
grounded in solidarity, to collaborate globally to mitigate the outbreak. Each
government has special obligations to its own citizens, but the fair
allocation of vaccines globally requires us not to simply appeal to self-
interest, claims of resource ownership and the prioritization of compatriots.
Vaccines should be allocated in a way that prioritizes those who fall into the
categories presented in the below table. (Where individuals or populations
fall into multiple categories, they should receive even higher priority.)
Priority populations, and rationale for prioritization
Priority population|  Rationale for prioritization
---|---
Those at greatest risk of becoming infected and seriously ill
| Maximize benefit of vaccine
Those who, if vaccinated, would prevent the greatest spread of the virus
| Maximize benefit of vaccine
Those who have volunteered to participate in research aimed at developing the
vaccine
|
Reciprocal obligation to those who were voluntarily put at risk to aid in this
effort
Those falling into each category may change over time.


Q&A: Ethics and COVID-19: resource allocation and priority setting
Are the ethical considerations the same for all medical countermeasures, including therapeutics, vaccines and personal protective equipment (PPE)?
Generally, the considerations may be different. The allocation of different
resources may find ethical justifications in different principles or values.
For instance, once a novel vaccine is found to be safe and effective, to
prioritize those at highest risk, as well as populations like health care
workers who may be more likely to serve as vectors for transmission, is
justified.
Within those subgroups, some suggest that a lottery-based (i.e., random)
allocation may be justified, given that resources will be limited and we can
assume nearly equal benefits will be derived from any recipient within that
group. This is not the case, however, for other resources such as ventilators,
where some individuals may derive significantly more benefit than others.


Q&A: Ethics and COVID-19: resource allocation and priority setting
What is the basis for deciding who should have priority access to scarce resources?
The ethical basis for deciding which individuals or groups might be
prioritized, including the principles to be applied, are presented in the
below table:
Ethical considerations when deciding who to prioritize
Principle|  Description|  Practice implication
---|---|---
Equality|
Each person’s interest should count equally unless there are good reasons that
justify the differential prioritization of resources.
Irrelevant characteristics of individuals, such as race, ethnicity, creed,
ability or gender, should not serve arbitrarily as the basis for the
differential allocation of resources.
This principle can be used to justify the allocation of resources by a lottery
– that is, randomly by chance – or by a system of first come, first served.
|
May be most appropriate to guide the allocation of scarce resources among
individuals or populations who can be expected to derive the same benefit from
the resource, for example, vaccines among high-risk populations, or
ventilators among those with similar clinical indicators for benefit.
Best outcomes (utility)|
This principle can be used to justify the allocation of resources according to
their capacity to do the most good or minimize the most harm, for example,
using available resources to save the most lives possible.
|
May be most appropriate to guide the allocation of scarce resources that
confer substantially different benefits to different individuals, for example,
ventilators to those expected to derive the most benefit.
Prioritize the worst off|
This principle can be used to justify the allocation of resources to those in
greatest medical need or those most at risk.
|
May be most appropriate to guide the allocation of resources that are designed
or intended to protect those at risk, for example, PPE for health care
workers, vaccines for those most at risk of infection and severe illness, or
those most in need, as in the case of provision of drugs in short supply to
those needing them most urgently.
Prioritize those tasked with helping others
|
This principle can be used to justify the allocation of resources to those who
have certain skills or talents that can save many other people, or because
something is owed to them on account of their participation in helping others.
|
May be most appropriate to guide the allocation of resources to health care
workers, first responders, etc.
Allocation principles may be relevant or justified at different stages of
resource scarcity (from less scarcity to more scarcity). For example, where
little scarcity exists, the allocation of resources such as ventilators may be
most justified by the principle of first come, first served (which promotes
the value of equality). When those resources become increasingly scarce, their
allocation may be justified according to a principle that prioritizes those
most in need. With even greater scarcity, a principle that aims to maximize
benefit from the resource may be most justified. At each stage, allocation
should aim to promote equality – that is, first come, first served, or random
allocation, when no relevant factors distinguish individuals within a
particular scheme of allocation (for example, among those with similar needs,
or among those who can be expected to benefit similarly from the resources, or
among those that are at similar levels of risk).
In addition, multiple principles may be combined within an allocation scheme.
For example, an allocation scheme for PPE might find its justification in a
principle prioritizing those most at risk as well as a principle prioritizing
those tasked with helping others, which would support priority allocation of
PPE to health care workers.


Q&A: Ethics and COVID-19: resource allocation and priority setting
Can I adapt previous frameworks for pandemic influenza to guide resource allocation for COVID-19?
Many ethical frameworks have been produced for resource allocation, some of
which have been included in pandemic plans. Those frameworks provide useful
guidance in the current scenario. Yet, when applying them, we must take into
account the type of health care resource, the context, and the stage of the
pandemic. That is, while the ethical principles that apply to resource
allocation might be the same in different pandemics, they can lead to
different decisions, given contextual circumstances. For example, this
pandemic appears to significantly impact older adults (those 60 years of age
or older), and such characteristics are relevant to shaping priorities for the
allocation of resources during COVID-19. As a result, it may be inappropriate
to use critical care triage guidelines that have age cut-offs that
deprioritize or exclude those aged over 60 years.
When applying ethical guidelines for resource allocation, we should consider
the extent to which resources are overwhelmed in the current context. It would
be inappropriate, for instance, to exclude population groups from being
allocated a resource (for example, ventilators) at the outset of a pandemic
when capacity remains. When resources are scarce, though – when there is an
insufficient supply to meet everyone’s needs – resource allocation should be
guided by well established, broadly applicable ethical principles, unless
there are characteristics of the outbreak that justify different courses of
action. Irrelevant characteristics of populations within countries, such as
ethnicity, race or creed, should play no role in any resource allocation in
any pandemic. This reflects our commitment to treating people with equal
respect.


Q&A: Ethics and COVID-19: resource allocation and priority setting
How should decision-makers make considered ethical judgements about these matters, given the likelihood that there will not be enough of a resource? Who should be involved in decision-making on scarce resources?
For most decisions, multiple ethical values and principles will be relevant to
deliberations about how to allocate resources. This is likely to generate some
disagreement, because different people may weigh the values differently. Some
may prioritize equality while others might put more emphasis on best outcomes
or prioritization of the worst-off. For this reason, it is imperative that the
different values be weighed and applied to specific allocation issues using a
fair process.
A fair process for allocating scarce resources must promote certain ethical
values:

Transparency. In a transparent process, the decisions and their justifications should be made public. This means that the population should be informed about the criteria guiding the decisions.
Inclusiveness. Those affected by allocation decisions – including individuals, communities or countries – should be able to exert at least some influence over the decision-making process as well as the decision itself. This also means that decisions 4 should be open to challenge and potentially revisable, perhaps through an appeal process.
Consistency. Decisions should be consistent so that all persons in the same categories are treated in the same way. This means that favouritism towards one’s own family, religious or political compatriots, or otherwise, is not appropriate. All forms of corruption that are at variance with this principle should be challenged and condemned.
Accountability. Those making decisions about allocation must be accountable for those decisions – that is, they should justify their decisions and be held responsible for them. A fair process means that allocation decisions should not be made by individuals, by individual pharmaceutical companies, or, in the case of allocation between countries, by a single country. Resources such as vaccines and therapies should not be stockpiled outside the system of fair allocation.

The fair allocation of resources is one that is valuable in itself precisely
because it is fair. However, it may also be valuable because a fair system
engenders solidarity and trust, which are vital to the successful and
sustained collective response necessary for dealing effectively with any
outbreak.


Q&A: HIV, antiretrovirals and COVID-19
How can programmes assure continued access to HIV services?
It is important to assure continuous access to essential HIV prevention,
testing and treatment services also where measurements of confinement are
implemented within the public health response to the COVID-19 pandemic. While
access to essential services should be maintained, adapted and evidence-based
measures to reduce possible transmission should be considered and implemented.
These include[12]:

Applying standard precautions for all patients (including ensuring that all patients cover their nose and mouth with a tissue or elbow when coughing or sneezing, offering a medical mask to patients with suspected COVID-19 infection while they are in waiting in the service, perform hand hygiene etc.)
Health care and outreach workers, as well as peer educators and clients should apply adapted hand hygiene measures
Ensuring triage, early recognition, and source control (isolating patients with suspected COVID-19 infection)
Ensure there is adequate ventilation in all areas in the healthcare facility
Spatial separation of at least 1 metre should ideally be maintained between all patients within all types of services
Cleaning and disinfection procedures should be followed consistently and correctly
Dispensing medicines (for treatment of HIV, TB and other chronic conditions such as opioid dependence) for longer periods allowing reduced frequency of patient visits
Consider reduction of services to the most critical ones (provision of essential treatment and prevention services; services such as counselling sessions may be reduced or adapted)

Generally, vulnerable populations, including members of key populations, as
well as homeless and/or displaced people may be at increased risk of infection
– because of additional comorbidities impacting on their immune system,
reduced ability to apply measures of confinement and social distancing, as
well as generally limited access to health services. It is critical that
services that reach these populations such as community-based services, drop-
in centres and outreach services can continue providing life-saving prevention
(distribution of condoms, needles and syringes), testing and treatment while
securing safety of staff and clients. Services can be adapted according to
above considerations where applicable.


Q&A: HIV, antiretrovirals and COVID-19
Can pregnant or postpartum women living with HIV transmit the COVID-19 virus to their unborn child or infant?
There are few data on the clinical presentation of COVID-19 in specific
populations, such as children and pregnant women[13] but findings from a small
published study suggest that there is currently no evidence for intrauterine
infection caused by vertical transmission in women who develop COVID-19
pneumonia in late pregnancy[14]. **** Although no vertical transmission has
been documented, transmission after birth via contact with infectious
respiratory secretions is a concern. Infants born to mothers with suspected,
probable, or confirmed COVID-19 should be fed according to standard infant
feeding guidelines[15], while applying necessary precautions for infection
prevention and control (IPC). As with all confirmed or suspected COVID-19
cases, symptomatic mothers who are breastfeeding or practicing skin-to-skin
contact or kangaroo mother care should practice respiratory hygiene, including
during feeding (for example, use of a medical mask when near a child if the
mother has respiratory symptoms), perform hand hygiene before and after
contact with the child, and routinely clean and disinfect surfaces with which
the symptomatic mother has been in contact[16].

Q&A on COVID-19, pregnancy, childbirth and breastfeeding


Q&A: HIV, antiretrovirals and COVID-19
What is WHO’s position on use of corticosteroids for the treatment of COVID-19?
The current interim guidance from WHO on clinical management of severe acute
respiratory infection when COVID-19 infection is suspected advises against the
use of corticosteroids unless indicated for another reason.[8]
This guidance is based on several systematic reviews that cite lack of
effectiveness and possible harm from routine treatment with corticosteroids
for viral pneumonia or acute respiratory distress syndrome.[9]


Q&A: HIV, antiretrovirals and COVID-19
Are people living with HIV at increased risk of being infected with the virus that causes COVID-19?
People living with HIV with advanced disease, those with low CD4 and high
viral load and those who are not taking antiretroviral treatment have an
increased risk of infections and related complications in general. It is
unknown if the immunosuppression of HIV will put a person at greater risk for
COVID-19, thus, until more is known, additional precautions for all people
with advanced HIV or poorly controlled HIV, should be employed[1],[2]. __
At present there is no evidence that the risk of infection or complications of
COVID-19 is different among people living with HIV who are clinically and
immunologically stable on antiretroviral treatment when compared with the
general population. Some people living with HIV may have known risk factors
for COVID-19 complications, such as diabetes, hypertension and other
noncommunicable diseases and as such may have increased risk of COVID-19
unrelated to HIV. We know that during the SARS and MERS outbreaks there were
only a few case reports of mild disease among people living with HIV.
To date, there is a case report of a person living with HIV who had COVID-19
and recovered[3] and a small study on risk factors and antiretrovirals used
among people living with HIV with COVID-19 from China. This study reported
similar rates of COVID-19 disease as compared to the entire population and
increased risk with older age, but not with low CD4, high viral load level or
antiretroviral regimen[4]. Current clinical data suggest the main mortality
risk factors are linked to older age and other comorbidities including
cardiovascular disease, diabetes, chronic respiratory disease, and
hypertension. Some very healthy people have also developed severe disease from
the coronavirus infection[5].
PLHIV are advised to take the same precautions as the general
population[6],[7]:

wash hands often

cough etiquette

physical distancing

seek medical care if symptomatic

self-isolation if in contact with someone with COVID-19 and

other actions per the government response

People living with HIV who are taking antiretroviral drugs should ensure that
they have at least 30 days and up to 6-month supply of medicines and ensure
that their vaccinations are up to date (influenza and pneumococcal vaccines).
Adequate supplies of medicines to treat co-infections and comorbidities and
addiction should also be ensured.


Q&A: HIV, antiretrovirals and COVID-19
What is WHO’s position on the use of antiretrovirals for the treatment of COVID-19?
Currently, there is insufficient data to assess the effectiveness of LPV/r or
other antivirals for treating COVID-19. Several countries are evaluating the
use of LPV/r and other antivirals and we welcome the results of these
investigations.
Again, as part of WHO’s response to the outbreak, the
WHO R&D Blueprint
has been activated to accelerate evaluation of diagnostics,
vaccines and therapeutics for this novel coronavirus. WHO has also designed a
set of procedures to assess the performance, quality and safety of medical
technologies during emergency situations.


Q&A: HIV, antiretrovirals and COVID-19
What studies on treatment and prevention of COVID-19 with antiretrovirals are being planned?
Several randomized trials are planned to assess the safety and efficacy of
using antiretroviral drugs – mainly LPV/r – for treating COVID-19, in
combination with other drugs. Results are expected from mid-2020 onwards.


Q&A: HIV, antiretrovirals and COVID-19
How do we ensure human rights and reduce stigma and discrimination?
As the world scales up public health responses to the COVID19 pandemic,
countries are being urged to take decisive action to control the epidemic. WHO
has urged all countries to ensure an appropriate balance between protecting
health, preventing economic and social disruption, and respecting human
rights.
WHO is working with partners including the UNAIDS Joint Programme and the
Global Network of People Living with HIV to ensure that human rights are not
eroded in the response to COVID-19 and to ensure that people living with or
affected by HIV are offered the same access to services as others and to
ensure HIV-related services continue without disruption.
To mitigate potential prison outbreaks of COVID19 and reduce morbidity and
mortality among people in prisons and other closed settings, it is crucial
that prisons and immigration detention centres are embedded within the broader
public health response. This requires close collaboration between health and
justice ministries and includes protocols for entry screening, personal
protection measures, physical distancing, environmental cleaning and
disinfection, and restriction of movement, including limitation of transfers
and access for non-essential staff and visitors. In the current context it is
of critical importance that countries work toward developing non-custodial
strategies to prevent overcrowding in closed settings[10]. Governance of
prison health by a ministry of health, rather than a ministry of justice or
similar, is likely to facilitate this[11]. __


Q&A: HIV, antiretrovirals and COVID-19
If countries use antiretrovirals for COVID-19, are there concerns about treatment shortages for people living with HIV?
Antiretrovirals are an efficacious and highly tolerable treatment for people
living with HIV. The antiretroviral LPV/r is currently being investigated as a
possible treatment for COVID-19.
If they are to be used for the treatment of COVID-19, a plan should be in
place to ensure there is adequate and continuous supply to cover the needs of
all people living with HIV already using LPV/r and those who will need to
begin treatment. However, a relatively small proportion of people are on
regimens which include LPV/r, since it is used as a second-line regimen
according to WHO’s HIV treatment guidelines. Any country that allows the use
of HIV medicines for the treatment of COVID-19 must ensure that an adequate
and sustainable supply is in place.


Q&A: HIV, antiretrovirals and COVID-19
Can antiretrovirals be used to treat COVID-19?
Several studies have suggested that patients infected with the virus causing
COVID-19, and the related coronavirus infections (SARS-CoV and MERS-CoV) had
good clinical outcomes, with almost all cases recovering fully. In some cases,
patients were given an antiretroviral drug: lopinavir boosted with ritonavir
(LPV/r). These studies were mostly carried out in HIV-negative individuals.
It is important to note that these studies using LPV/r had important
limitations. The studies were small, timing, duration and dosing for treatment
were varied and most patients received co-interventions/co-treatments which
may have contributed to the reported outcomes.
While the evidence of benefit of using antiretrovirals to treat coronavirus
infections is of very low certainty, serious side effects were rare. Among
people living with HIV, the routine use of LPV/r as treatment for HIV is
associated with several side effects of moderate severity. However, as the
duration of treatment in patients with coronavirus infections was generally
limited to a few weeks, these occurrences can be expected to be low or less
than that reported from routine use.


Q&A: HIV, antiretrovirals and COVID-19
Can antiretrovirals be used to prevent COVID-19 infection?
Two studies have reported the use of LPV/r as post-exposure prophylaxis for
SARS-CoV and MERS-CoV. One of these studies suggested that the occurrence of
MERS-CoV infection was lower among health workers receiving LPV/r compared to
those who did not receive any drugs; the other study found no cases of SARS-
CoV infection among 19 people living with HIV hospitalized in the same ward of
SARS patients, of whom 11 were on antiretroviral therapy. Again, the certainty
of the evidence is very low due to small sample size, variability in drugs
provided, and uncertainty regarding intensity of exposure.


Q&A: HIV, antiretrovirals and COVID-19
Should pregnant and breastfeeding women living with HIV with COVID-19 and their newborns be managed differently?
There is currently no known difference between the clinical manifestations of
COVID-19 or risk of severe illness or foetal compromise for pregnant and non-
pregnant women or adults of reproductive age. Pregnant and recently pregnant
women with suspected or confirmed COVID-19 should be treated with supportive
and management therapies, considering the immunologic and physiologic
adaptations during and after pregnancy which may overlap with COVID-19
symptoms. Data are limited but, until the evidence base provides clearer
information, special consideration should be given to pregnant women with
concomitant medical illnesses who could be infected with COVID-19. There are
no reported deaths in pregnant women at time of publishing this
information[17] however, COVID-19 testing of symptomatic pregnant women may
need to be prioritized to enable access to specialized care. All recently
pregnant women with COVID-19 or who have recovered from COVID-19 should be
provided with information and counselling on safe infant feeding and
appropriate IPC measures to prevent COVID-19 virus transmission[18].
With confirmed disease or under investigation, management is similar to non-
pregnant women, with appropriate isolation of confirmed or under
investigation. Obstetric facilities must be notified and prepared, noting that
each infant born to any mother with confirmed COVID-19 should be considered a
‘person under investigation’ and should be isolated according to the IPC
guidance. Currently, it is unknown whether newborns with COVID-19 are at
increased risk for severe complications.


Q&A: HIV, antiretrovirals and COVID-19
What is the role multi-month prescriptions and dispensing for antiretrovirals and other medicines?
Clinically stable adults, children, adolescents and pregnant and breastfeeding
women as well as members of key populations (people who inject drugs, sex
workers, men who have sex with men, transgender people and people living in
prisons and closed settings) can benefit from simplified antiretroviral
therapy delivery models which include multi-month prescriptions and dispensing
(3-6 month supply) which will reduce the frequency of visits to clinical
settings and ensures continuity of treatment during possible disruption of
movements during the coronavirus outbreak. Similar consideration should be
given to providing people who are clinically stable on methadone or
buprenorphine substitution therapy with an increased possibility for take-home
medications to reduce additional burden on the health sector.


Q&A: Infection prevention and control for health care workers caring for patients with suspected or confirmed COVID-19
Why does WHO recommend contact and droplet precautions and not routine use of airborne precautions for healthcare workers providing care to patients with suspected/confirmed 2019-nCoV infection?
WHO developed its rapid guidance based on the consensus of international
experts who considered the currently available evidence on the modes of
transmission of 2019-nCoV. This evidence demonstrates viral transmission by
droplets and contact with contaminated surfaces of equipment; it does not
support routine airborne transmission. Airborne transmission may happen, as
has been shown with other viral respiratory diseases, during aerosol-
generating procedures (e.g., tracheal intubation, bronchoscopy), thus WHO
recommends airborne precautions for these procedures.
Click here for more information about healthcare worker protection for
2019-nCoV.


Q&A: Infection prevention and control for health care workers caring for patients with suspected or confirmed COVID-19
How long the 2019-nCoV can survive on a dry surface?
There is currently no data available on stability of 2019-nCoV on surfaces.
Data from laboratory studies on SARS-CoV and MERS-
CoV
have shown that stability in the environment depends on several factors
including relative temperature, humidity, and surface type. WHO continues to
monitor existing evidence around nCoV and will update when such evidence is
available.


Q&A: Infection prevention and control for health care workers caring for patients with suspected or confirmed COVID-19
What are the recommendation regarding disinfection of vehicles, goods and products coming from China or other COVID-19 affected countries?
To date there is no epidemiological information to suggest that contact with
goods, products or vehicles shipped from COVID-19 affected countries have been
the source of COVID-19 in humans.
For these reasons, there is no disinfection recommendations for any goods and
products coming from COVID-19 affected countries given that there is no
available evidence that these products pose a risk to public health. WHO will
continue to closely monitor the evolution of COVID-19, and will update the
recommendations as needed.


Q&A: Infection prevention and control for health care workers caring for patients with suspected or confirmed COVID-19
Can chlorine solutions also be used?
Chlorine solutions are strongly discouraged as they carry a higher risk of
hand irritation and ill health effects from making and diluting chlorine
solutions, including eye irritation and respiratory problems. In addition,
there is a risk of loss of antimicrobial effect if exposed to sunlight or
heat. Preparing chlorine solutions requires training to reach the correct dose
of 0.05% with varying strengths of bleach available in the private sector.
Even if stored at a cool dry place with a lid away from sunlight, they have to
be renewed daily. In comparison simple soapy water solution do not have any of
the above-mentioned health risks and complications including loss of antiviral
effect due to heat or sunlight. The antiviral effect of soapy water is due to
the oily surface membrane of the COVID-virus that is dissolved by soap,
killing the virus.


Q&A: Infection prevention and control for health care workers caring for patients with suspected or confirmed COVID-19
Does WHO recommend routine wearing masks for healthy people during the 2019 nCoV outbreak?
No. WHO does not recommend that asymptomatic individuals (i.e., who do not
have respiratory symptoms) in the community should wear medical masks, as
currently there is no evidence that routine use of medical masks by healthy
individuals prevents 2019-nCoV transmission. Masks are recommended to be used
by symptomatic persons in the community. Misuse and overuse of medical masks
may cause serious issues of shortage of stocks and lack of mask availability
for those who actually need to wear them.
In health care facilities where health care workers are directly taking care
of suspect or confirmed 2019-nCoV acute respiratory disease patients, masks
are an important part of containing 2019-nCoV spread between people, along
with other PPE and hand hygiene.
Click here for more information on medical mask use.


Q&A: Infection prevention and control for health care workers caring for patients with suspected or confirmed COVID-19
Are there special procedures for the management of bodies of persons who have died from 2019-nCoV?
No, there are no special procedures for the management of bodies of persons
who have died from 2019-nCoV. Authorities and medical facilities should
proceed with their existing policies and regulations that guide post-mortem
management of persons who died from infectious diseases.


Q&A: Infection prevention and control for health care workers caring for patients with suspected or confirmed COVID-19
Is there a model for setting up an isolation ward and types and products and health requirements?
A model for setting up an isolation ward is currently under development. PPE
specifications for healthcare workers caring for nCoV patients can be found in
the disease commodity package at: https://www.who.int/publications-
detail/disease-commodity-package---novel-coronavirus-(ncov)


Q&A: Infection prevention and control for health care workers caring for patients with suspected or confirmed COVID-19
Can patients with suspected and confirmed nCoV infection be cohorted in the same room?
Ideally, suspected and confirmed 2019-nCoV acute respiratory disease patients
should be isolated in single rooms. However, when this is not feasible (e.g.,
limited number of single rooms), cohorting is an acceptable option. Some
patients with suspected 2019-nCoV infection may actually have other
respiratory illnesses, hence they must be cohorted separately from patients
with confirmed 2019-nCoV infection. A minimum of 1-meter distance between beds
should be maintained at all times.


Q&A: Infection prevention and control for health care workers caring for patients with suspected or confirmed COVID-19
How can you clean soiled bedding, towels and linens from patients with COVID-19?
All individuals dealing with soiled bedding, towels and clothes from patients
with COVID-19 should:

Wear appropriate personal protective equipment, which includes heavy duty gloves, mask, eye protection (face shield/goggles), long-sleeved gown, apron (if gown is not fluid resistant), boots or closed shoes before touching any soiled linen.
Never carry soiled linen against body; place soiled linen in a clearly labelled, leak-proof container (e.g. bag, bucket)
If there is any solid excrement on the linen, such as feces or vomit, scrape it off carefully with a flat, firm object and put it in the commode or designated toilet/latrine before putting linen in the designated container. If the latrine is not in the same room as the patient, place soiled excrement in covered bucket to dispose of in the toilet or latrine;
Wash and disinfect linen: washing by machine with warm water (60-90°C) and laundry detergent is recommended for cleaning and disinfection of linens. If machine washing is not possible, linen can be soaked in hot water and soap in a large drum, using a stick to stir, avoiding splashing. If hot water not available, soak linen in 0.05% chlorine for approximately 30 minutes. Finally, rinse with clean water and let linen dry fully in the sunlight.

Additional resources for best practices for environmental cleaning can be
found in the following two documents:
1)Infection prevention and control of epidemic-and pandemic prone acute
respiratory infections in health
care

2)Best Practices for Environmental Cleaning in Healthcare Facilities in
Resource-Limited Settings which was developed by CDC and ICAN
in collaboration with WHO


Q&A: Infection prevention and control for health care workers caring for patients with suspected or confirmed COVID-19
Are boots, impermeable aprons, or coverall suits required as routine personal protective equipment (PE) for healthcare workers (HCW) caring for patients with suspected or confirmed 2019-nCoV infection?
No. Current WHO guidance for HCW caring for suspected or confirmed 2019-nCoV
acute respiratory disease patients recommends the use of contact and droplet
precautions, in addition to standard precautions which should always be used
by all HCW for all patients. In terms of PPE, contact and droplet precautions
include wearing disposable gloves to protect hands, and clean, non-sterile,
long-sleeve gown to protect clothes from contamination, medical masks to
protect nose and mouth, and eye protection (e.g., goggles, face shield),
before entering the room where suspected or confirmed 2019-nCoV acute
respiratory disease patients are admitted. Respirators (e.g. N95) are only
required for aerosol generating procedures.
Click here for more information on PPE for HCW caring for suspected or
confirmed nCoV patients.


Q&A: Infection prevention and control for health care workers caring for patients with suspected or confirmed COVID-19
Is there a special procedure regarding waste produced by patients with suspected or confirmed 2019-nCoV?
No. Waste produced during the health care or home care of patients with
suspected or confirmed 2019-nCoV infection should be disposed of as infectious
waste.
Click here for more information on disposing of infectious
waste.
Click here to visit the CDC website.


Q&A: Infection prevention and control for health care workers caring for patients with suspected or confirmed COVID-19
What are the disinfectants recommended for environmental cleaning in healthcare facilities or homes housing patients with suspected or confirmed 2019-nCoV infection?
Environmental cleaning in healthcare facilities or homes housing patients with
suspected or confirmed 2019-nCoV infection should use disinfectants that are
active against enveloped viruses, such as 2019-nCoV and other coronaviruses.
There are many disinfectants, including commonly used hospital disinfectants,
that are active against enveloped viruses. Currently WHO recommendations
include the use of:

70% Ethyl alcohol to disinfect reusable dedicated equipment (e.g., thermometers) between uses
Sodium hypochlorite at 0.5% (equivalent 5000ppm) for disinfection of frequently touched surfaces in homes or healthcare facilities

Click here for the guidance on clinical management of severe acute
respiratory infection when novel coronavirus (nCoV) infection is
suspected.
Click here for the guidance on infection prevention and control during health
care when novel coronavirus (nCoV) infection is suspected.
Click here for more information about environmental
cleaning.


Q&A: Infection prevention and control for health care workers caring for patients with suspected or confirmed COVID-19
Can disposable medical face masks be sterilized and reused?
No. Disposable medical face masks are intended for a single use only. After
use they should be removed using appropriate techniques (i.e. do no touch the
front, remove by pulling the elastic ear straps or laces from behind) and
disposed of immediately in an infectious waste bin with a lid, followed by
hand hygiene.
Click here for more information on using masks in the context of the nCoV
outbreak.


Q&A: Infection prevention and control for health care workers caring for patients with suspected or confirmed COVID-19
Do patients with suspected or confirmed 2019-nCoV need to be hospitalized if they have mild illness?
No. For patients who have mild illness, e.g., low-grade fever, cough, malaise,
rhinorrhoea, sore throat without any warning signs, such as shortness of
breath or difficulty in breathing, increased respiratory (i.e. sputum or
haemoptysis), gastro-intestinal symptoms such as nausea, vomiting, and/or
diarrhoea and without changes in mental status, hospitalization may not be
required unless there is concern for rapid clinical deterioration. All
patients discharged home should be instructed to return to hospital if they
develop any worsening of illness.
Click here for more information on admission criteria.
Click here for more information on caring for mildly symptomatic 2019-nCoV
patients at home.


Q&A: Infection prevention and control for health care workers caring for patients with suspected or confirmed COVID-19
What personal protective equipment (PPE) should be used by healthcare workers (HCW) performing nasopharyngeal (NP) or oropharyngeal (OP) swabs on patients with suspected or confirmed COVID-19?
Health care workers collecting NP and OP swab specimens from suspected or
confirmed COVID-19 patients should be well-trained on the procedure and should
wear a clean, non-sterile, long-sleeve gown, a medical mask, eye protection
(i.e., googles or face shield), and gloves. Procedure should be conducted in a
separate/isolation room, and during NP specimen collection health care workers
should request the patients to cover their mouth with a medical mask or
tissue. Although collection of NP and OP swabs have the potential to induce
fits of coughing from the patient undergoing the procedure, there is no
currently available evidence that cough generated via NP/OP specimen
collection leads to increased risk of COVID-19 transmission via aerosols.


Q&A: Infection prevention and control for health care workers caring for patients with suspected or confirmed COVID-19
Are specialized or referral hospitals required for patients with suspected or confirmed 2019-nCoV infection when hospitalization is needed?
No. Current WHO recommendations do not include a requirement for exclusive use
of specialized or referral hospitals to treat suspected or confirmed 2019-nCoV
acute respiratory disease patients. However, countries or local jurisdictions
may choose to care for patients at such hospitals if those are deemed the most
likely to be able to safely care for patients with suspected or confirmed
2019-nCoV infection or for other clinical reasons (e.g., availability of
advanced life support). Regardless, any healthcare facility treating patients
with suspected or confirmed 2019-nCoV patients should adhere to the WHO
infection prevention and control recommendations for healthcare to protect
patients, staff and visitors. Click here for the
guidance.


Q&A: Infection prevention and control for health care workers caring for patients with suspected or confirmed COVID-19
Should blood centers routinely screen blood products for COVID-19 virus?
No, although RNA fragments of SARS-CoV-2 were detected in blood of symptomatic
COVID-19 patients, this does not mean that the virus is viable/infectious. In
general, respiratory viruses are not known to be transmitted by blood
transfusion. Blood centers should have routine blood donor screening measures
in place to prevent individuals with respiratory symptoms or fever from
donating blood. As precautionary measures, blood centers might encourage self-
deferral of those with travel history to an COVID-19 affected country in the
previous 14 days, or of those who have been diagnosed with COVID-19 or are
close contact with a confirmed COVID-19 case.


Q&A: Influenza and COVID-19 - similarities and differences
How are COVID-19 and influenza viruses different?
The speed of transmission is an important point of difference between the two
viruses. Influenza has a shorter median incubation period (the time from
infection to appearance of symptoms) and a shorter serial interval (the time
between successive cases) than COVID-19 virus. The serial interval for
COVID-19 virus is estimated to be 5-6 days, while for influenza virus, the
serial interval is 3 days. This means that influenza can spread faster than
COVID-19.
Further, transmission in the first 3-5 days of illness, or potentially pre-
symptomatic transmission –transmission of the virus before the appearance of
symptoms – is a major driver of transmission for influenza. In contrast, while
we are learning that there are people who can shed COVID-19 virus 24-48 hours
prior to symptom onset, at present, this does not appear to be a major driver
of transmission.
The reproductive number – the number of secondary infections generated from
one infected individual – is understood to be between 2 and 2.5 for COVID-19
virus, higher than for influenza. However, estimates for both COVID-19 and
influenza viruses are very context and time-specific, making direct
comparisons more difficult.
Children are important drivers of influenza virus transmission in the
community. For COVID-19 virus, initial data indicates that children are less
affected than adults and that clinical attack rates in the 0-19 age group are
low. Further preliminary data from household transmission studies in China
suggest that children are infected from adults, rather than vice versa.
While the range of symptoms for the two viruses is similar, the fraction with
severe disease appears to be different. For COVID-19, data to date suggest
that 80% of infections are mild or asymptomatic, 15% are severe infection,
requiring oxygen and 5% are critical infections, requiring ventilation. These
fractions of severe and critical infection would be higher than what is
observed for influenza infection.
Those most at risk for severe influenza infection are children, pregnant
women, elderly, those with underlying chronic medical conditions and those who
are immunosuppressed. For COVID-19, our current understanding is that older
age and underlying conditions increase the risk for severe infection.
Mortality for COVID-19 appears higher than for influenza, especially seasonal
influenza. While the true mortality of COVID-19 will take some time to fully
understand, the data we have so far indicate that the crude mortality ratio
(the number of reported deaths divided by the reported cases) is between 3-4%,
the infection mortality rate (the number of reported deaths divided by the
number of infections) will be lower. For seasonal influenza, mortality is
usually well below 0.1%. However, mortality is to a large extent determined by
access to and quality of health care.


Q&A: Influenza and COVID-19 - similarities and differences
How are COVID-19 and influenza viruses similar?
Firstly, COVID-19 and influenza viruses have a similar disease presentation.
That is, they both cause respiratory disease, which presents as a wide range
of illness from asymptomatic or mild through to severe disease and death.
Secondly, both viruses are transmitted by contact, droplets and fomites. As a
result, the same public health measures, such as hand hygiene and good
respiratory etiquette (coughing into your elbow or into a tissue and
immediately disposing of the tissue), are important actions all can take to
prevent infection.


Q&A: Influenza and COVID-19 - similarities and differences
What medical interventions are available for COVID-19 and influenza viruses?
While there are a number of therapeutics currently in clinical trials in China
and more than 20 vaccines in development for COVID-19, there are currently no
licensed vaccines or therapeutics for COVID-19. In contrast, antivirals and
vaccines available for influenza. While the influenza vaccine is not effective
against COVID-19 virus, it is highly recommended to get vaccinated each year
to prevent influenza infection.


Q&A: Malaria and COVID-19
What is WHO’s position on the use of chloroquine and hydroxychloroquine in the context of the COVID-19 response?
WHO is actively following the ongoing clinical trials that are being conducted
in response to COVID-19, including studies looking at the use of chloroquine
and its derivative, hydroxychloroquine, for treatment and/or prevention.
Currently, there is insufficient data to assess the efficacy of either of
these medicines in treating patients with COVID-19, or in preventing them from
contracting the coronavirus.
In the context of the COVID-19 response, hydroxychloroquine was one of the
potential treatment options that was being assessed as part of the Solidarity
clinical trial. However, on 25 May 2020, the WHO Director-General
announced that the Executive Group of the Solidarity Trial had put a
temporary pause on the hydroxychloroquine arm
of the trial while the safety data are reviewed. This decision follows the
publication of a recent Lancet study focusing on the effects of
hydroxychloroquine on COVID-19 patients who have been hospitalized; authors of
the study reported a higher mortality rate among patients who received the
drug. The Director-General made clear in his announcement that
hydroxychloroquine continues to be a safe drug for use in patients with
malaria and autoimmune diseases.
For public health emergencies, WHO has a systematic and transparent process
for research and development (R&D), including for clinical trials of drugs.
The WHO “R&D Blueprint” for COVID-19,
initiated on 7 January 2020, aims to fast-track the availability of effective
tests, vaccines and medicines that can be used to save lives and avert large-
scale crises. WHO has also designed a set of procedures to assess the
performance, quality and safety of medical technologies during emergency
situations.


Q&A: Malaria and COVID-19
Should core malaria vector control interventions be maintained in view of the rapid global spread of COVID-19?
As of March 2020, there have been reports of the suspension of insecticide-
treated net (ITN) and indoor residual spraying (IRS) campaigns in several
African countries due to concerns around exposure to COVID-19. Suspending such
campaigns will leave many vulnerable populations at greater risk of malaria,
particularly young children and pregnant women.
WHO strongly encourages countries not to suspend the planning **** for –
or implementation of – vector control activities, including ITN and IRS
campaigns, while ensuring these services are delivered using best practices
to protect health workers and communities from
COVID-19 infection. Modifications of planned distribution strategies may be
needed to minimize exposure to the coronavirus.
WHO commends the leaders of Benin, Chad, the Central African Republic, the
Democratic Republic of the Congo, Mali, Niger, Sierra Leone and Uganda for
committing to move forward with ITN campaigns during the pandemic. Other
countries are adapting their net distribution strategies to ensure households
receive the nets as quickly and safely as possible.
Together with partners, WHO has developed guidance to ensure that those
suffering from malaria can safely receive the care they need in COVID-19
settings. Tailoring malaria interventions in the COVID-19
response includes guidance on the
prevention of infection through vector control and chemoprevention, testing,
treatment of cases, clinical services, supply chain and laboratory activities.
The document is consistent with broader WHO
guidance on how
to maintain essential health services during the pandemic.