Q&A: Malaria and COVID-19
Why is WHO particularly concerned about the spread of COVID-19 in malaria-affected areas?
Experience from previous disease outbreaks has shown the disruptive effect on
health service delivery and the consequences for diseases such as malaria. The
2014-2016 Ebola outbreak in Guinea, Liberia and Sierra Leone, for example,
undermined malaria control efforts and led to a massive increase in malaria-
related illness and death in the 3 countries.
A new modelling analysis from
WHO and partners, published on 23 April, found that the number of malaria deaths in
sub-Saharan Africa could double this year alone if there are severe
disruptions in access to insecticide-treated nets and antimalarial medicines
due to COVID-19. These projections reinforce the critical importance of
sustaining efforts to prevent, detect and treat malaria during the pandemic.
In all regions, protective measures should be utilized to minimize the risk of
COVID-19 transmission between patients, communities and health providers. WHO
and partners have developed guidance
on how to safely maintain malaria
prevention and treatment services in COVID-19 settings.


Q&A: Malaria and COVID-19
What is WHO doing to support malaria-affected countries in the context of COVID-19?
The WHO Global Malaria Programme is leading a cross-partner
effort to mitigate the negative impact of the coronavirus
in malaria-affected countries and, where possible, contribute towards a
successful COVID-19 response. The work is being carried out in close
collaboration with colleagues based at WHO headquarters, regional offices and
country level.
In March 2020, before the pandemic had secured a strong footing in Africa, WHO
sounded an urgent call for maintaining core malaria prevention and
treatment services while protecting health workers and communities against
COVID-19 transmission. The findings of a modelling
analysis from WHO and partners,
published in April, reinforced the WHO call for continuity of malaria services
during then pandemic.
In collaboration with partners, WHO developed technical guidance for countries
on how to safely maintain malaria prevention and treatment in COVID-19
settings. Tailoring malaria interventions in the COVID-19
response  is consistent with broader WHO
guidance on how
to maintain essential health services during the pandemic.


Q&A: Malaria and COVID-19
How many malaria-affected countries have reported cases of COVID-19?
Malaria-endemic countries in all WHO have **** regions have reported cases of
COVID-19. In the WHO African Region, which carries more than 90% of the global
malaria burden, 45 countries had reported approximately 25 000 cases of the
disease as of 30 April 2020. The latest situation
reports on
the COVID-19 pandemic are available on the WHO website.


Q&A: Malaria and COVID-19
What additional special measures may be needed in the context of COVID-19?
In addition to routine approaches to malaria control, there may be a case for
special measures in the context of the COVID-19 pandemic – such as a temporary
return to presumptive malaria treatment, or the use of mass drug
administration – which have proved useful in some previous emergencies. ****
Presumptive malaria treatment refers to treatment of a suspected malaria case
without the benefit of diagnostic confirmation (e.g. through a rapid
diagnostic test). This approach is typically reserved for extreme
circumstances, such as disease in settings where prompt diagnosis is no longer
possible.
Mass drug administration (MDA) is a WHO-recommended approach for rapidly
reducing malaria mortality and morbidity during epidemics and in complex
emergency settings. Through MDA, all individuals in a targeted population are
given antimalarial medicines – often at repeated intervals – regardless of
whether or not they show symptoms of the disease.
Such special measures should only be adopted after careful consideration of 2
key aims: lowering malaria-related mortality and keeping health workers and
communities safe. WHO is exploring concrete proposals for when and how to
activate such measures; guidance will be published in due course.


Q&A: Malaria and COVID-19
Should WHO-recommended preventive therapies be maintained in sub-Saharan Africa?
Yes, delivery of intermittent preventive treatment in pregnancy (IPTp),
seasonal malaria chemoprevention (SMC), and intermittent preventive treatment
in infants (IPTi) should be maintained provided that
best practices for protecting health
workers – and other front-line workers – from COVID-19 are followed. Ensuring
access to these and other core malaria prevention tools saves lives and is an
important strategy for reducing the strain on health systems in the context of
the COVID-19 response.
 Tailoring malaria interventions in the COVID-19
response , developed by WHO and partners
, includes guidance on how to deliver preventive therapies for pregnant
women and young children in ways that protect health workers and communities
against potential COVID-19 transmission.


Q&A: Malaria and COVID-19
What is WHO’s position on the use of Artemisia plant material for the prevention or treatment of malaria and/or COVID-19?
The most widely used antimalarial treatments, artemisinin-based combination
therapies (ACTs), are produced using the pure artemisinin compound extracted
from the plant Artemisia annua. In recent years, some news reports have
suggested that a range of non-pharmaceutical products made from Artemisia
plant material – such as herbal teas and tablets – may be effective in
preventing or treating malaria. Now, there are reports that products made from
Artemisia plant material may also have a preventive or curative effect on
COVID-19.
WHO urges extreme caution over reports touting the efficacy of such products.
As explained in a WHO position statement, there is no
scientific evidence base to support the use of non-pharmaceutical forms of
Artemisia for the prevention or treatment of malaria. There is also no
evidence to suggest that COVID-19 can be prevented or treated with products
made from Artemisia -based plant material.


Q&A: Malaria and COVID-19
Have there been disruptions in the global supply of key malaria-related commodities as a result of the COVID-19 pandemic?
Yes. In recent weeks, there have been reports of disruptions in the supply
chains of essential malaria commodities – such as long-lasting insecticidal
nets, rapid diagnostic tests and antimalarial medicines – resulting from
lockdowns and from a suspension of the importation and exportation of goods in
response to COVID-19. WHO and partners are working together to ensure the
availability of key malaria control tools, particularly in countries with a
high burden of the disease, and that efforts to limit the spread of COVID-19
do not compromise access to malaria prevention, diagnosis and treatment
services.


Q&A: Malaria and COVID-19
What are the key considerations for countries that are working to eliminate malaria or prevent re-establishment of transmission?
All of the considerations described above apply to malaria-eliminating
countries and those preventing re-establishment of the disease: efforts must
be sustained to prevent, detect and treat malaria cases while preventing the
spread of COVID-19 and ensuring the safety of those who deliver the services.
Countries that are nearing malaria elimination must protect their important
gains and avoid malaria resurgences. Countries that have eliminated malaria
must remain vigilant for any imported cases of malaria that may be occurring
to prevent reintroduction of the disease.


Q&A: Malaria and COVID-19
Are there any changes to WHO guidance with respect to malaria diagnosis and treatment?
WHO guidance remains the same. Countries should not scale back efforts to
detect and treat malaria; doing so would seriously undermine the health and
well-being of millions of people infected with a potentially life-threatening
disease.
As signs and symptoms of malaria and COVID-19 can overlap (such as a fever),
public health messages will need to be adapted in malaria-endemic settings so
that people who have a fever are encouraged to seek immediate treatment rather
than stay at home; without prompt treatment, a mild case of malaria can
rapidly progress to severe illness and death.


Q&A: Masks and COVID-19
How did WHO reach its scientific conclusions on mask use?
WHO convenes global teams of experts that collectively review the latest
studies. Throughout the COVID-19 pandemic, a group of more than 80 experts in
infection prevention and control from institutions worldwide participate in
weekly advisory calls to help inform WHO guidance documents. Advice on mask
use for healthy individuals in community settings was developed in
consultation with several senior experts.


Q&A: Masks and COVID-19
Does WHO recommend the use of gloves in the community to prevent transmission of COVID-19?
No, WHO does not recommend the regular use of gloves by people in the
community. The wearing of gloves may increase risks, since it can lead to
self-infection or transmission to others through touching contaminated
surfaces which is not followed by removal of gloves and hand hygiene.
Therefore, in public places such as supermarkets, in addition to physical
distancing, WHO recommends the installation of public hand hygiene stations at
the entrance and exit.
By widely improving hand hygiene practices, countries can help prevent the
spread of the COVID-19 virus.


Q&A: Masks and COVID-19
What are non-medical masks and what is their use?
Non-medical masks are often homemade of breathable fabrics and can be
commercially available as well. There are numerous designs for fabric masks,
but they generally cover the nose and mouth, are secured with ties or elastic
loops, include multiple layers of fabric, and can sometimes be washed and re-
used.
The evidence about the benefits of these masks is limited. One good quality
study showed that the risk of respiratory infection is increased (and not
reduced) in health care workers using cotton cloth masks when compared to
medical masks. Cloth masks are currently being recommended by some countries
as a means of source control in the general population. Although their
protective effectiveness to the wearer is unknown, they may protect others if
the wearer is a pre-symptomatic or asymptomatic carrier.
WHO is continuing to gather and review data as new studies become available
and will update guidance accordingly.


Q&A: Masks and COVID-19
Does WHO recommend the use of non-medical masks in the community?
Currently there is not enough evidence for or against the use of masks
(medical or other) for healthy individuals in the wider community. WHO
continues to recommend that medical masks be worn by individuals who are sick
or those caring for them. WHO is actively studying the rapidly evolving
science on masks and continuously updates its guidance.
In the interim, to support countries in their decision-making process WHO has
provided advice through a risk-based approach for the use of masks in the
context of COVID-19.


Q&A: Masks and COVID-19
What individuals should wear medical masks to prevent the spread of COVID-19 according to WHO?
Medical masks are recommended in health care settings. However, it is
important to remember that the use of masks should be combined with other key
infection prevention and control measures such as hand hygiene and physical
distancing, as they do not serve all purposes to protect against COVID-19.
WHO recommends the use of medical masks for the following individuals:
Healthcare workers
Why? Medical masks and respirators such as N95, FFP2 or equivalent are
recommended for and should be reserved for, healthcare workers while giving
care to patients. Healthcare workers are the most exposed because they are in
close contact with people with suspected or confirmed COVID-19 and their
surrounding environment, which are the main routes of transmission.
People who are sick and exhibiting symptoms of COVID-19
Why? Anyone who is sick, even with mild symptoms such as muscle aches,
slight cough, sore throat or fatigue, should isolate at home and use a medical
mask as much as possible according to WHO’s recommendation on home care of
patients with suspected COVID-19. Coughing, sneezing or talking can generate
droplets that can spread the infection. These droplets can reach the face of
others nearby or land on the surrounding environment. If an infected person
coughs, sneezes, or talks wearing a medical mask, this helps to protect those
nearby from infection.
Anyone taking care of a person at home who is sick with COVID-19
Why? Those caring for individuals who are sick with COVID-19 should wear a
medical mask for protection. Close and frequent contact with someone with
COVID-19 can put those caring for them at high risk. National decision makers
may also choose to recommend medical mask use for certain individuals using a
risk-based approach. This approach takes into consideration the purpose of the
mask, risk of exposure and vulnerability of the wearer, the setting and
feasibility of use and the types of masks considered.
See “Advice on the use of masks in the context of COVID-19”.
WHO will continue to update guidance according to scientific findings.


Q&A: Masks and COVID-19
What types of masks are used against the spread of COVID-19?
Medical masks (also known as surgical masks): these are made from a
minimum of three layers of synthetic nonwoven materials, and configured to
have filtration layers sandwiched in the middle. These masks are available in
different thicknesses, have various levels of fluid-resistance and two levels
of filtration. These medical masks reduce the transfer of saliva or
respiratory droplets from the wearer to others and to the environment. They
also decrease the likelihood of potentially infectious droplets from others
reaching the mouth and nose of the mask wearer.
Hand hygiene should be performed before putting on a clean mask and after
removing the mask. These masks should be worn tightly around the chin and top
of the nose. The wearer should avoid touching the mask while it is on the face
and the mask should be immediately discarded if it becomes moist. Importantly,
wearing a mask must be combined with other preventive measures including
performing frequent and appropriate hand hygiene and physical distancing of at
least 1 metre (3 feet).
Respirators (also known as filtering facepiece respirators --FFR) and
available at different performance levels such as FFP2, FFP3, N95, N99):
these are specifically designed for healthcare workers who provide care to
COVID-19 patients in settings and areas where special medical procedures are
undertaken. Respirators are intended to protect the wearer when these medical
procedures aerosolize smaller particles than normal droplets into the air in
the health treatment area. Healthcare workers should be fit tested before
using a respirator to ensure that the respirator is sealed tightly on the
wearer’s face and is properly fitted. Respirators with valves should not be
used as the purpose of source control.


Q&A: Masks and COVID-19
What is WHO recommending to countries that are considering public mask use in community?
For countries that are currently considering the use of masks, WHO advises
decision makers to apply a risk-based approach and consider the following:
Purpose of mask use: if the intention is preventing the wearer
transmitting infection to others (that is source control) or to offer
protection to the wearer against infection (that is prevention).
Risk of exposure to COVID-19

due to epidemiology/number of cases in the population: if there is high community transmission and other measures such as contact tracing or ability to carry out testing are not possible.
depending on occupation: e.g., individuals working in close contact with public (e.g., community health worker, cashier).

Vulnerability of the mask wearer/population: for example, if supplies are
adequate medical masks could be used by people with comorbidities, such as
cardiovascular disease or diabetes mellitus, older people, immunocompromised
patients.
Setting in which the population lives: settings with high population
density (e.g. refugee camps, those living in cramped conditions) and settings
where individuals are unable to keep a safe distance (e.g. crowded buses or
other transport).
Feasibility: availability and costs of masks, access to clean water to
wash non-medical masks, and ability of mask wearers to tolerate adverse
effects of wearing a mask.
Type of mask: medical mask versus non-medical mask (prioritization of
medical masks for health care providers, symptomatic people and their
caregivers).
In addition to these factors, potential advantages of the use of masks by
healthy people in the community setting include reducing potential exposure
risk from an infected person during the ‘pre-symptomatic’ period or if an
infected person is asymptomatic.
There are potential risks and disadvantages that should be taken into account
in any decision-making process on the use of masks:

Non-medical or cloth masks could increase potential for COVID-19 to infect a person if the mask is contaminated by dirty hands and touched often, or kept on other parts of the face or head and then placed back over the mouth and nose
Depending on the type of mask used, could cause difficulty in breathing
They can lead to facial skin breakdown
They can lead to difficulty with communicating clearly
They can be uncomfortable to wear
It is possible that mask use, with unclear benefits, could create a false sense of security in the wearer, leading to diminished practice of recognized beneficial preventive measures such as physical distancing and hand hygiene.


Q&A: Masks and COVID-19
What is WHO’s view on masks?
WHO recognizes that there are many questions about the use of face masks to
prevent the transmission of COVID-19 in the community, and that many countries
are recommending that people wear them. Wearing a medical mask can limit the
spread of certain respiratory viral diseases, including COVID-19. However, the
use of a mask alone is not sufficient to provide an adequate level of
protection. Other measures such as physical distancing and hand hygiene should
be adopted.
WHO aims to provide the most scientifically sound yet practical
recommendations for the safety and wellbeing of individuals in all settings.
At present, WHO recommends a risk-based approach to be considered by decision
makers when deciding in which settings and circumstances non-medical masks
could be used in the community.
Please see: Advice on the use of masks.


Q&A: Mass gatherings and COVID-19
What are the risks arising from public transport to the venue(s)?
The extra risk from participants and spectators travelling on public transport
in a major city may not be significant compared to the ongoing risk to the
local population using the transport all the time if physical distancing is
not possible on public transport.


Q&A: Mass gatherings and COVID-19
Should event organizers arrange screening at venues beyond national government requirements for point of entry (PoE)?
Temperature screening alone, at exit or entry, is not an effective way to stop
international spread, since infected individuals may be in incubation period,
may not express apparent symptoms early on in the course of the disease, or
may dissimulate fever through the use of antipyretics; in addition, such
measures require substantial investments for what may bear little benefits. It
is more effective to provide prevention recommendation messages to travellers
and to collect health declarations at arrival, with travellers’ contact
details, to allow for a proper risk assessment and a possible contact tracing
of incoming
travellers.
Event organizers should also consider the capacity to undertake this and the
management of suspected cases. However, sporting organizations may have
criteria for participation that are stricter than government requirements for
Ports of Entry into the country that are based on event risk assessment,
including organizers' healthcare capacity.
Any additional screening questionnaires for participation in events need to be
aligned with public health agencies in the jurisdiction. There is a need to
consider how to manage different groups – athletes, officials and spectators,
and the large numbers of individuals likely to arrive at a sporting event from
many oversea countries – and to follow both host country and WHO travel
advice and to
assess whether there is difficulty in obtaining accurate information about the
travel history of those individuals.


Q&A: Mass gatherings and COVID-19
Are there additional safeguards event organizers can implement or recommend to athletes/officials/visitors in the context of COVID-19?
Follow standard preventative advice to the general public, including physical
distancing, in the athletes’ village.
Also promote:

signage, digital messaging to all participants and their entourages about COVID-19 and how to prevent infection
regular disinfection and cleaning of surfaces, in venues and in personal spaces
non-sharing of equipment and cleaning of equipment after each user.

Organizers are recommended to develop a checklist (include hand gels stations,
hygiene facilities, etc.). See the event mitigation recommendations checklist
for event organizers above.


Q&A: Mass gatherings and COVID-19
What should be the criteria for excluding an athlete or other accredited participant from competing?
Agreed health criteria are needed for the exclusion of athletes from competing
and for allowing them to return to competition wherever appropriate. These
should be consistent with public health guidelines for the general population,
with risk profiles based on recent travel to high-risk community transmission
zones, recent contact with individuals diagnosed with or suspected of having
COVID-19, current symptomatology, etc. Athletes who are feeling unwell should
not participate in events.
If testing of athletes has been agreed with the local public health service
there is a need to consider test availability, time taken for receipt of test
results and host-country health services capacity.
Criteria for exclusion of officials/judges from competition and for allowing
them to return to competition where appropriate should follow guidance and
criteria for the workplace.
Requirements for the attendance of all athletes and other accredited
participants should be put in place:
– health check: travel declaration and temperature screening
– contact tracing protocols ready (with all details of those present)
– allowing extra spacing (physical distancing)
– following all hygiene precautions.
Isolation procedures for athletes and other accredited participants (e.g.
field-of-play staff, medical teams, officials who have close contact with the
athletes) who feel unwell or become symptomatic should be clear and documented
and rehearsed prior to holding the event, especially for higher risk sports,
e.g. contact sports.


Q&A: Mass gatherings and COVID-19
How large does a meeting or event need to be in order to be a “mass gathering”?
High profile international sporting events such as the Olympics or World Cups
as well as international religious events such as the Hajj count as mass
gatherings. However, lower profile conferences and events can also meet WHO’s
definition of a mass gathering. An event counts as a “mass gatherings” if the
number of people it brings together is so large that it has the potential to
strain the planning and response resources of the health system in the
community where it takes place. You need to consider the location and duration
of the event as well as the number of participants. For example, if the event
takes place over several days in a small island state where the capacity of
the health system is quite limited then even an event with just a few thousand
participants could place a big strain on the health system and then be
considered a “mass gathering” event. Conversely, if the event is held in a big
city in a country with a large, well-resourced health system and lasts just a
few hours, the event may not constitute a “mass gathering” event.


Q&A: Mass gatherings and COVID-19
Should event organizers provide COVID-19 testing?
No, testing should be conducted in accordance with local health providers and
national guidance. Anyone unwell or symptomatic should not be allowed to
participate in the event. Establish close collaboration with local public
health authorities well before the event, to facilitate testing for athletes,
officials or spectators who meet pre-agreed suspect cases definitions.
Consider host-country health service capacity to manage any COVID-19 activity,
and other public health issues happening at the event over and above its own
national pandemic response.


Q&A: Mass gatherings and COVID-19
What if my organization does not have the expertise to assess the risks COVID-19 poses for our planned mass gathering?
The national and local public health authorities in the country where you plan
to hold the mass gathering will most likely know how to conduct a health risk
assessment. If there is a WHO Country Office there they may also be able to
provide some expert support. So too might the WHO Regional Office in your part
of the world. You can find the names and contact details of the WHO Regional
Offices at https://www.who.int/about/who-we-are/regional-offices


Q&A: Mass gatherings and COVID-19
Where can I find more advice on assessing and managing health risks around international mass gatherings?
WHO has produced guidance and also a training course on how to plan for a mass
gathering. The guidance and the course both look at how to conduct a risk
assessment, plan for and manage health risks in partnership with the local
authorities: https://www.who.int/emergencies/diseases/novel-
coronavirus-2019/technical-guidance/points-of-entry-and-mass-
gatherings You can find advice to give
individual participants on how to protect themselves and their loved ones from
COVID-19 at: https://www.who.int/emergencies/diseases/novel-
coronavirus-2019/advice-for-public


Q&A: Mass gatherings and COVID-19
What factors should organizers and health authorities look at when assessing whether the risks are acceptable or not?
For countries not currently known to be experiencing community transmission of
COVID-19, the priority consideration will be whether the planned mass
gathering event substantially increases the risk of the virus entering the
country and becoming established, as well as the risk for participants to
importing infection back to their home country and further increasing global
spread. In making this assessment, the organizers and their national or local
health authorities should recognize that the risk of imported cases of
COVID-19 is naturally linked to international travel. They should also
recognize that it is neither realistic or desirable to aim for zero risk. When
organizers and health authorities are determining whether to hold a mass
gathering, they should determine what is an acceptable risk and what
additional measures should be implemented to mitigate the risks.
For countries where COVID-19 has already started to spread in the community,
key consideration will be:

aiming at containing or at least slowing down the spread of the virus in the local community/country.
preventing participants from other countries being infected with COVID-19

In each case the risk should be considered in the context of the known
features of COVID-19, its severity, its transmissibility and the effectiveness
of measures to prevent or reduce transmission. The strain already placed on
the local health system in responding to COVID-19 outbreak(s), and the
additional strain the mass gathering might place on the system also need to be
taken into account.
You can find more advice on what to look at in the WHO document Key planning
recommendations for Mass Gatherings in the context of the current COVID-19
outbreak of 14 February 2020. See: https://www.who.int/publications-
detail/key-planning-recommendations-for-mass-gatherings-in-the-context-of-the-
current-covid-19-outbreak


Q&A: Mass gatherings and COVID-19
Does WHO recommend that all international mass gatherings be cancelled because of COVID-19?
No. As each international mass gathering is different, the factors to consider
when determining if the event should be cancelled may also differ. Any
decision to change a planned international gathering should be based on a
careful assessment of the risks and how they can be managed, and the level of
event planning. The assessment should involve all stakeholders in the event,
and in particular the health authorities in the country or community where the
event is due to take place. These authorities and stakeholders are in the best
position to assess the level of stress the event might place on the local
health system and emergency services – and whether this level of stress is
acceptable in the current situation.
It is WHO’s view that all countries with community transmission should
seriously consider postponing or reducing mass gatherings that bring people
together and have the potential to amplify disease and support the recommended
best practice of physical distancing. Any decision will be supported through
the use of WHO tools, in particular the Risk Assessment for Mass Gatherings
during COVID-19.
If movement restrictions and further national measures have been established
in the country, the WHO RA does not apply. However, when the process of re-
opening/conducting mass gatherings is being considered post movement
restrictions, it will be key to ensure any decisions are based on a risk
assessment, such as the WHO Mass gatherings COVID-19 risk assessment.


Q&A: Mass gatherings and COVID-19
If we go ahead with an international mass gathering, what can we do to reduce the risk of participants catching COVID-19?
Promote hand washing, respiratory hygiene and social distancing at the event.
Make sure you have emergency contact details for all participants, including
where they are staying during the event. You should make it clear to them that
this information will be shared with the local public health authorities to
enable rapid contact tracing if a participant at the event becomes ill with
COVID-19. The event organisers need to have an agreed preparedness plan in
case one or more participants become ill with COVID-19 symptoms. This should
include rapid isolation of the ill person and their safe transfer to a local
health facility. You should consider whether the number of participants at the
event could be reduced, making available participation by video or
teleconference and possibly screening participants for COVID-19 symptoms
(cough, fever, malaise) at points of entry to the venue. You can find advice
on how individual participants can protect themselves and their loved ones
from COVID-19 at: https://www.who.int/emergencies/diseases/novel-
coronavirus-2019/advice-for-public


Q&A: Older people and COVID-19
What should I do if I have symptoms of COVID-19?

If you present symptoms related to COVID-19, seek medical advice. __ Call by phone first if possible and give information about pre-existing health conditions and medicines that you are taking. Follow the instructions of the health-care worker and monitor your symptoms regularly.

If you have difficulty breathing, contact health emergencies immediately as this may be due to a respiratory infection. Call by phone first if possible to learn what to do next.

If you live with others, make sure that you isolate yourself __ as soon as you suspect infection  __by using the space that you identified in advance. You and other members of the household should also wear a medical mask as much as possible if these are available. You can learnhow to wear a mask here.

__

If you live with others and home care for COVID-19 is advised by your health-care worker , other household members should follow available guidance on home care for patients with COVID-19 presenting with mild symptoms and management of their contacts (guidance here __ ) . See related flyers for people who are ill , for household members _andfor caregivers  ._

__

If you live alone and home care for COVID-10 is advised by your health-care worker , ask your family, friends, neighbours, health-care worker or a local volunteer organisation to check in on you regularly and to provide support as needed following existing guidance for caregivers (guidance here __ ) .


Q&A: Older people and COVID-19
What can I do to prevent infection?
To prevent infection, there are a five things that you can do.
1. Wash your hands frequently and thoroughly with soap and wate r and
dry them thoroughly.
You can also use alcohol-based hand rub if your hands are not visibly dirty
and if this product is available. Cleaning your hands frequently will remove
the virus if it is on your hands. You can learn how to wash your hands hands
in this video (or this
visual). If an alcohol-based hand rub or soap is not
available, then using chlorinated water (0.05%) for handwashing is an option,
but it is not ideal because frequent use may irritate your skin.
2. **Cover your mouth and nose with a flexed elbow or tissue when
coughing and sneezing**.
And remember to throw away the used tissue immediately in a bin with a lid and
to wash your hands. This way you protect others from any virus released
through coughs and sneezes.
3. Avoid touching your eyes, nose and mouth.
****Hands touch many surfaces which can be contaminated with the virus. If
you touch your eyes, nose or mouth with unclean hands, you can transfer the
virus from the surface to yourself.
4. Keep physical distance from others.
If your national or local authorities have put in place confinement measures,
it is important to respect them. Taking exercise outside is good for your
physical and mental health, but should only be undertaken if regulations for
your area allow it. When you do go out, avoid crowded spaces and maintain at
least 1 metre distance (3 feet or arms-length) from others. Avoid unnecessary
visits to your house. If visits are necessary (e.g. caregiver to support with
activities of daily living), ask your visitor to regularly check for symptoms
to ensure that they are symptom free when visiting you. Ask them to also
follow these five key actions, including washing their hands when they first
enter your home.
5. Clean and disinfect frequently touched surfaces every day.
This includes tables, doorknobs, light switches, countertops, handles, desks,
phones, keyboards, toilets, taps, and sinks. If surfaces are dirty, use
detergent or soap and water prior to disinfection. Learn more by clicking
here.


Q&A: Older people and COVID-19
How is COVID-19 transmitted?
People can catch COVID-19 from others who have the virus. The disease can
spread from person to person through small droplets from the nose or mouth,
which are spread when a person with COVID-19 coughs or exhales. These droplets
land on objects and surfaces around the person. Other people then catch
COVID-19 by touching these objects or surfaces, and then touching their eyes,
nose or mouth. People can also catch COVID-19 if they breathe in droplets from
a person with COVID-19 who coughs out or exhales droplets.


Q&A: Older people and COVID-19
Is there a vaccine, drug or treatment for COVID-19?
While some western, traditional or home remedies may provide comfort and
alleviate symptoms of mild COVID-19, there are no medicines that have been
shown to prevent or cure the disease. WHO does not recommend self-medication
with any medicines, including antibiotics, as a prevention or cure for
COVID-19. However, there are several ongoing clinical trials of both western
and traditional medicines. WHO is coordinating efforts to develop vaccines and
medicines to prevent and treat COVID-19 and will continue to provide updated
information as soon as research results become available.


Q&A: Older people and COVID-19
I have recently lost someone I care about. What advice do you have to help me cope?
Losing someone close to you is always hard, whatever the cause. During these
extraordinary circumstances, when your usual routine may be disrupted and when
funerals may not be permitted, it may be even harder. Following this advice
may help.

Do not criticise yourself for how you feel. When you lose a family member or friend to COVID-19, you may experience a range of emotions. You may also have difficulty sleeping or low levels of energy. All these feelings are normal and there is no right or wrong way to feel grief.

Allow yourself time to process your emotions in response to your loss. You may think that the sadness and pain that you feel will never go away, but in most cases, these feelings lessen over time.

Talk regularly with people that you trust about your feelings.

Keep to your routines as much as you feel able and try to focus on activities that bring you joy.

Seek advice and comfort from people that you trust __ (e.g. religious/faith leaders, mental health workers or other trusted members of your community) while maintaining physical distance (e.g. attending virtual mass) . ****

Think of alternative ways to say goodbye to the person who passed away __ such as writing a letter or dedicating a drawing to your loved one. These are small actions that can help you cope with grief and loss, particularly in situations where funeral services are not permitted


Q&A: Older people and COVID-19
What is COVID-19?
COVID-19 is a disease caused by a new coronavirus, which has not been
previously identified in humans. In most cases, COVID-19 causes mild symptoms
including dry cough, tiredness and fever, though fever may not be a symptom
for some older people. Other mild symptoms include aches and pains, nasal
congestion, runny nose, sore throat or diarrhoea. Some people become infected
but don’t develop any symptoms and don't feel unwell. Most people recover from
the disease without needing special treatment. Around 1 out of every 6 people
who gets COVID-19 becomes seriously ill and has difficulty breathing.


Q&A: Older people and COVID-19
Who is at risk of developing severe disease?
Older people, and people of all ages with pre-existing medical conditions
(such as diabetes, high blood pressure, heart disease, lung disease, or
cancer) appear to develop serious illness more often than others.


Q&A: Older people and COVID-19
How can I keep healthy on a daily basis during the COVID-19 pandemic?
You can follow these 10 steps to keep healthy during the COVID-19 pandemic.
__

Keep to your regular routines as much as possible and maintain a daily schedule for yourself including sleeping, meals and activities.

Stay socially connected. Speak to loved ones and people you trust every day or as much as possible, using the telephone, video-calls or messaging, through writing letters, etc. Use this time to share your feelings and to do common hobbies together.

__

Be physically active every day. Reduce long periods of sitting and set up a daily routine that includes at least 30 minutes of exercise. Make sure to do activities that are safe and appropriate for your level of physical fitness as indicated by your health-care worker. You can use household chores as a way to keep physically active, follow an on-line class (e.g. Tai Chi, yoga) or choose your favourite music and dance to that. __

__

Drink water and eat healthy and well-balanced meals. This will keep you hydrated, help strengthen your immune system and lower the risk of chronic illnesses and infectious diseases. __For nutrition advice click here.

 __

Avoid smoking and drinking alcohol . Smokers are likely to be more vulnerable to COVID-19 because smoking can affect lung capacity and because the act of smoking increases the possibility of transmission of virus from hand to mouth. Drinking alcohol not only disturbs your sleep but may also increase your risk of falls, weaken your immune system, and interact with any prescription medicines that you are taking. Limit the amount of alcohol you drink or don’t drink alcohol at all.

Take breaks from news coverage about COVID-19 as prolonged exposure can cause feelings of anxiety and despair. Seek updates at specific times of the day from a reliable source like the WHO website click here or national or local channels in order to help you distinguish facts from rumours or scams. ****

__

Engage in hobbies and activities that you enjoy or learn something new. Cognitive exercise such as reading a book or doing crosswords/sudoku will keep your mind active and distract you from worrying. You can also use this time to keep a well-being diary (click here for an example.)

 __

If you have ongoing health conditions , take your prescribed medicines and follow the advice of your health-care worker  __regarding any health visits or phone consultations.

 __

If you have an emergency medical condition that is not related to COVID-19 , contact health emergencies immediately and ask what you should do next. Follow the instructions of the health-care worker. ****

__

If stress, worry, fear or sadness get in the way of your daily activities for several days in a row, seek psychosocial support __ from available services in your community. If you are subject to abuse or violence from others, tell someone you trust and report this to the relevant authorities. You can also seek support from dedicated helplines that may be available in your country. ****


Q&A: Older people and COVID-19
What can older people do to prepare for COVID-19 in their community?
There is a lot that you can do to prepare for COVID-19 in your community.

Inform yourself of the special measures taken in your community as well as the services and the sources of reliable information __ that are availableduring the health emergency (e.g. home deliveries, psychosocial support, health ministry website, alternative access to your pension).

Create a list of the basic supplies that you will need for at least two weeks and try to get these delivered where possible __ (e.g. **** non-perishable food items, household products, batteries for assistive devices you may use, and prescription medicines). Alternatively, ask family members, caregivers, neighbours or community leaders to help with ordering and/or delivery of groceries or prescription medicines. Make sure that your mobile phone credit is topped up and identify a safe place to charge your phone regularly so that you can keep in contact with family and friends and reach emergency services if needed.

Make a list of emergency numbers (e.g. COVID-19 local helpline, nearby hospital and health emergencies numbers, hotline for victims of abuse, psychosocial support hotline) and support contacts (e.g. family members and friends, main caregiver, community care worker, associations of older persons). If you live alone, you may wish to share this list and ask your neighbours, family or caregiver to be in touch regularly, for example, by phone or video chat.

Discuss with your health-care worker __ how your health needs can be addressed during COVID-19. This may involve postponing non-urgent appointments, talking to your doctor or health-care worker by phone or video chat instead of in person and/or revising your vaccination schedule.

If you rely on the support provided by a caregiver , identify with him or her another person that you trust __ to support your daily living and care needs in case your caregiver is unable to continue to provide care. Together, you can note down all the personal care and assistance that you require and how it should be provided and share it with this trusted person so that they can be ready to provide care in case of need. ****

If you are the primary caregiver of another person who is care dependent (e.g. grandchild, older spouse, child with a disability), identify a person that you and the person that you care for trust to take on your caregiving responsibilities in case you fall sick. Local authorities or volunteer organizations that provide support in these situations in your community might be able to help.

If multiple people live in your home, if possible prepare a separate room or space in your home so that anyone showing symptoms compatible with COVID-19 can be isolated from others. If you do not have space for self-isolation, contact your community leaders or local health authorities to see if there is community space that could help you or other household members self-isolate.

Think about what matters most to you regarding care and support, including medical treatment, in case something happens to you and you are unable to make your own decisions. If you want to develop an advanced care plan to record your treatment and care wishes, you can talk about it with your health-care worker or someone that you trust. You can write down your wishes and share them with people you trust.


Q&A: Pregnancy, childbirth and COVID-19
Do pregnant women with suspected or confirmed COVID-19 need to give birth by caesarean section?
No. WHO advice is that caesarean sections should only be performed when
medically justified.
The mode of birth should be individualized and based on a woman’s preferences
alongside obstetric indications.


Q&A: Pregnancy, childbirth and COVID-19
Should pregnant women be tested for COVID-19?
Testing protocols and eligibility vary depending on where you live.
However, WHO recommendations are that pregnant women with symptoms of COVID-19
should be prioritized for testing. If they have COVID-19, they may need
specialized care.


Q&A: Pregnancy, childbirth and COVID-19
Can I touch and hold my newborn baby if I have COVID-19?
Yes. Close contact and early, exclusive breastfeeding helps a baby to thrive.
You should be supported to

Breastfeed safely, with good respiratory hygiene;
Hold your newborn skin-to-skin, and
Share a room with your baby

You should wash your hands before and after touching your baby, and keep all
surfaces clean.


Q&A: Pregnancy, childbirth and COVID-19
I’m pregnant. How can I protect myself against COVID-19?
Pregnant women should take the same precautions to avoid COVID-19 infection as
other people. You can help protect yourself by: ****

Washing your hands frequently with an alcohol-based hand rub or soap and water.
Keeping space between yourselves and others and avoiding crowded spaces.
Avoiding touching your eyes, nose and mouth.
Practicing respiratory hygiene. This means covering your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose of the used tissue immediately.

If you have fever, cough or difficulty breathing, seek medical care
early. Call before going to a health facility, and follow the directions of
your local health authority. ****
Pregnant women and women who have recently delivered – including those
affected by COVID-19 - should attend their routine care appointments.


Q&A: Pregnancy, childbirth and COVID-19
Can COVID-19 be passed from a woman to her unborn or newborn baby?
We still do not know if a pregnant woman with COVID-19 can pass the virus to
her foetus or baby during pregnancy or delivery. To date, the active virus has
not been found in samples of amniotic fluid or breastmilk.


Q&A: Pregnancy, childbirth and COVID-19
Are pregnant women at higher risk from COVID-19?
Research is currently underway to understand the impacts of COVID 19 infection
on pregnant women. Data are limited, but at present there is no evidence that
they are at higher risk of severe illness than the general population.
However, due to changes in their bodies and immune systems, we know that
pregnant women can be badly affected by some respiratory infections. It is
therefore important that they take precautions to protect themselves against
COVID-19, and report possible symptoms (including fever, cough or difficulty
breathing) to their healthcare provider.
WHO will continue to review and update its information and advice as more
evidence becomes available.


Q&A: Pregnancy, childbirth and COVID-19
What care should be available during pregnancy and childbirth?
All pregnant women, including those with confirmed or suspected COVID-19
infections, have the right to high quality care before, during and after
childbirth. This includes antenatal, newborn, postnatal, intrapartum and
mental health care.
A safe and positive childbirth experience includes:

Being treated with respect and dignity;
Having a companion of choice present during delivery;
Clear communication by maternity staff;
Appropriate pain relief strategies:
Mobility in labour where possible, and birth position of choice.

If COVID-19 is suspected or confirmed, health workers should take all
appropriate precautions to reduce risks of infection to themselves and others,
including hand hygiene, and appropriate use of protective clothing like
gloves, gown and medical mask.


Q&A: Self-care interventions for sexual and reproductive health and rights (SRHR) and COVID-19
Who is self care for?
Self care can be practiced by everyone and evidence-based self-care
interventions have the potential to benefit even the most vulnerable
populations. For individuals who may need to access information, counselling
or a health services before, during or after accessing a self-care
intervention, links with existing health services remains important. Examples
of providing access to referrals and health facilities for non-COVID-19
related SRH conditions may include ensuring antenatal care visits, delivery
and postpartum care; retesting and HIV treatment if an individual’s HIV self-
test is positive along with other STI diagnostic and treatment as required. In
addition, crisis centers, shelters, legal aid, and protection services for
individuals subject to violence.


Q&A: Self-care interventions for sexual and reproductive health and rights (SRHR) and COVID-19
Why are self-care interventions important during a pandemic like COVID-19?
With the major disruptions to the normal functioning of national health
systems caused by the need to respond to people who have or are affected by
the virus, evidence-based, high-quality self-care interventions can provide an
important alternative to the usual health facility- or health worker-based
services. Self-care is a valuable part of a well-functioning health system and
can be particularly useful when physical distancing measures make it more
difficult for people to access their normal health care services and
medications.
More information can be found here:


Q&A: Self-care interventions for sexual and reproductive health and rights (SRHR) and COVID-19
What is self care?
WHO’s definition of self care is the ability of individuals, families and
communities to promote health, prevent disease, maintain health, and to cope
with illness and disability with or without the support of a health worker.


Q&A: Self-care interventions for sexual and reproductive health and rights (SRHR) and COVID-19
What self care actions can I take to protect my sexual and reproductive health?
In 2019, WHO issued a new guideline that brought together 32 existing or new
recommendations on a range of sexual and reproductive health self-care
interventions. The guideline has recommendations on pregnancy and newborn
care, contraception, abortion, sexually transmitted infections including HIV
and HPV, and for sexual health more broadly. The full list of recommendations
can be found here:


Q&A: Self-care interventions for sexual and reproductive health and rights (SRHR) and COVID-19
What are self-care interventions?
Self-care interventions recommended by WHO are evidence-based and can include
information about a sexual or reproductive health issue as well as ways in
which individuals can obtain drugs, devices, diagnostics and/or digital
products fully or partially separate from formal health services that can be
used with or without the direct supervision of a health worker. For example,
self-injectable contraception, HPV self-sampling kits or HIV self-tests.


Q&A: Self-care interventions for sexual and reproductive health and rights (SRHR) and COVID-19
Is self care safe?
For all of the recommendations on self-care interventions on sexual and
reproductive health issued by WHO, the evidence to date suggests that self
care is safe, with the right level of support by the health service as needed.
Self-care can also benefit health workers, by allowing them to serve a greater
number of patients and deploying their clinical skills where greatest need
exists. During a pandemic such as COVID-19, adopting self-care as part of the
healthcare system can also reduce the exposure of health workers to infection
as self-care will reduce the number of in-person contacts with a health
worker.


Q&A: Self-care interventions for sexual and reproductive health and rights (SRHR) and COVID-19
How can I get healthcare support during the COVID-19 pandemic for a self-care intervention?
There are a number of ways in which support can be provided:
Digital technologies and platforms, such as helplines through the phone or
online or websites of organizations with recognized expertise may be available
for consultation or follow up. Such information sources could enable you to
then proceed with obtaining and self-administering an injectable contraceptive
or self-testing for HIV, for example.
It may also be possible to get over the counter medical devices, medicines,
information and diagnostics through pharmacies or drug stores. Menstrual
hygiene products, pregnancy tests, condoms and emergency contraception pills
are usually available over-the-counter and depending on where you live,
contraceptive pills and drugs that protect you from getting HIV if you think
you have been exposed to risk.
You may also be able to receive communications in a variety of ways that can
help keep you healthy. Examples include notifications and reminders about
taking medicines sent by SMS or email.


Q&A: Self-care interventions for sexual and reproductive health and rights (SRHR) and COVID-19
Do I need to see a health worker for self care actions?
Self-care interventions provide individuals, families and communities with a
way to manage their own health at home. Some self-care actions, such as
washing your hands and practicing good respiratory hygiene measures that
protect you from COVID-19, do not need you to meet with a health worker. Other
self-care interventions, such as obtaining a prescription for hormonal
contraception and abortion medications or counselling during pregnancy, will
need interaction with a health worker. Such support can be provided in
different ways during this pandemic and will depend on the healthcare
arrangements in place where you live; for example, some medicines are
available over-the-counter without a prescription in a pharmacy, or counseling
and important information during pregnancy and when caring for a newborn can
be provided over the phone or online.


Q&A: Tobacco and COVID-19
As a smoker, is my risk of getting the COVID-19 virus higher than that of a non-smoker?
At the time of preparing this Q&A, there are no peer-reviewed studies that
have evaluated the risk of SARS-CoV-2 infection associated with smoking.
However, tobacco smokers (cigarettes, waterpipes, bidis, cigars, heated
tobacco products) may be more vulnerable to contracting COVID-19, as the act
of smoking involves contact of fingers (and possibly contaminated cigarettes)
with the lips, which increases the possibility of transmission of viruses from
hand to mouth. Smoking waterpipes, also known as shisha or hookah, often
involves the sharing of mouth pieces and hoses, which could facilitate the
transmission of the COVID-19 virus in communal and social settings.


Q&A: Tobacco and COVID-19
As a vaper, am I more likely to be infected or to have more severe symptoms if infected?
There is no evidence about the relationship between e-cigarette use and
COVID-19. However, existing evidence indicates that electronic nicotine
delivery systems (ENDS) and electronic non-nicotine delivery systems (ENNDS),
more commonly referred to as e-cigarettes, are harmful and increase the risk
of heart disease and lung disorders. Given that the COVID-19 virus affects the
respiratory tract, the hand-to-mouth action of e-cigarette use may increase
the risk of infection.


Q&A: Tobacco and COVID-19
What does WHO recommend for tobacco users?
Given the risks to health that tobacco use causes, WHO recommends quitting
tobacco use. Quitting will help your lungs and heart to work better from the
moment you stop. Within 20 minutes of quitting, elevated heart rate and blood
pressure drop. After 12 hours, the carbon monoxide level in the bloodstream
drops to normal. Within 2-12 weeks, circulation improves and lung function
increases. After 1-9 months, coughing and shortness of breath decrease.
Quitting will help to protect your loved ones, especially children, from
exposure to second-hand smoke.
WHO recommends the use of proven interventions such as toll-free quit lines,
mobile text-messaging cessation programmes, and nicotine replacement therapies
(NRTs), among others, for quitting tobacco use.


Q&A: Tobacco and COVID-19
What can I do to protect people from the risks associated with smoking, smokeless tobacco use and vaping?

If you smoke, use e cigarettes or use smokeless tobacco, now is a good time to quit completely.

Do not share devices like waterpipes and e-cigarettes.

Spread the word about the risks of smoking, using e-cigarettes and using smokeless tobacco.

Protect others from the harms of second-hand smoke.

Know the importance of washing your hands, physical distancing, and not sharing any smoking or e -cigarette products.

Do not spit in public places


Q&A: Tobacco and COVID-19
What about using smokeless tobacco, like chewing tobacco?
Using smokeless tobacco often involves some hand to mouth contact. Another
risk associated with using smokeless tobacco products, like chewing tobacco,
is that the virus can be spread when the user spits out the excess saliva
produced during the chewing process. * *


Q&A: Tobacco and COVID-19
As a smoker, am I likely to get more severe symptoms if infected?
Smoking any kind of tobacco reduces lung capacity and increases the risk of
many respiratory infections and can increase the severity of respiratory
diseases. COVID-19 is an infectious disease that primarily attacks the lungs.
Smoking impairs lung function making it harder for the body to fight off
coronaviruses and other respiratory diseases. Available research suggests that
smokers are at higher risk of developing severe COVID-19 outcomes and death.


Q&A: Tobacco and COVID-19
Does nicotine use affect my chances in the context of COVID-19?
There is currently insufficient information to confirm any link between
tobacco or nicotine in the prevention or treatment of COVID-19. WHO urges
researchers, scientists and the media to be cautious about amplifying unproven
claims that tobacco or nicotine could reduce the risk of COVID-19. WHO is
constantly evaluating new research, including that which examines the link
between tobacco use, nicotine use, and COVID-19.


Q&A: Tuberculosis and COVID-19
Does the BCG vaccine protect people from COVID-19?
There is no evidence at this point that the Bacille Calmette-Guérin vaccine
(BCG) protects people against infection with COVID-19 virus. Clinical trials
addressing this question are underway, and WHO will evaluate the evidence when
it is available. In the absence of evidence, WHO does not recommend BCG
vaccination for the prevention of COVID-19. WHO continues to recommend
reserving BCG for neonatal vaccination in settings with a high risk of
tuberculosis.

More information


Q&A: Tuberculosis and COVID-19
What should health authorities do to provide sustainability of essential tuberculosis services during the COVID-19 pandemic?
People-centred delivery of tuberculosis (TB) prevention, diagnosis, treatment
and care services should be ensured in tandem with the COVID-19 response.
Prevention: Measures must be implemented to limit transmission of TB and
COVID-19 in congregate settings and health care facilities. Administrative,
environmental and personal protection measures apply to both (e.g. basic
infection prevention and control, cough etiquette, patient triage).
Provision of TB preventive treatment should be maintained as much as possible.
Diagnosis : Tests for TB and COVID-9 are different and both should be
made available for individuals with respiratory symptoms, which may be similar
for the two diseases.
Treatment and care : People-centred outpatient and community-based care
should be strongly preferred over hospital treatment for TB patients (unless
serious conditions require hospitalization) to reduce opportunities for
transmission.
Anti-TB treatment, in line with the latest WHO guidelines, must be provided
for all TB patients, including those in quarantine and those with confirmed
COVID-19 disease. Adequate stocks of TB medicines should be provided to all
patients to reduce trips to collect medicines.
Use of digital health technologies for patients and programmes should be
intensified. In line with WHO recommendations, technologies like electronic
medication monitors and video-supported therapy can help patients complete
their TB treatment.


Q&A: Tuberculosis and COVID-19
How can we protect people seeking tuberculosis care during the COVID-19 pandemic?
In a context of widespread restriction of movement of the population in
response to the pandemic and isolation of COVID-19 patients, communication
with the healthcare services should be maintained so that people with
tuberculosis (TB), especially those most vulnerable, get essential services.
This includes management of adverse drug reactions and co-morbidities,
nutritional and mental health support, and restocking of the supplies of
medicines.
Enough TB medicines will need to be dispensed to the patient or caregiver to
last until the next visit. This will limit interruption or unnecessary visits
to the clinic. Mechanisms to deliver medicines at home and even to collect
specimens for follow-up testing may become expedient. Home-based TB treatment
is bound to become more common. Alternative arrangements to reduce clinic
visits may involve limiting appointments to specific times to avoid exposure
to other clinic attendees; using digital technologies to maintain treatment
support. Community health workers become more critical as treatment is more
decentralized.
More TB patients will probably start their treatment at home and therefore
limiting the risk of household transmission of TB during the first few weeks
is important.
Vulnerable populations who have poor access to healthcare should not get
further marginalized during the pandemic.


Q&A: Tuberculosis and COVID-19
Can tuberculosis and COVID-19 be tested on the same type of specimen?
The diagnostic methods for tuberculosis (TB) and COVID-19 are quite distinct
and commonly require different specimens.
Sputum, as well as many other biological specimens, can be used to diagnose TB
using culture or molecular techniques.
Tests for COVID-19 are done most commonly by nasopharyngeal or oropharyngeal
swab or wash in ambulatory patients, but sputum or endotracheal aspirate or
bronchoalveolar lavage may be used in patients with severe respiratory
disease. Molecular testing is the currently recommended method for the
identification of infectious COVID-19 and just as for TB, serological assays
are not recommended for the routine diagnosis of COVID-19.
The pipeline for COVID-19 diagnostics has flourished impressively within a few
months. Amongst these is the Xpert® Xpress SARS-CoV-2 cartridge for use on
GeneXpert machines, which are machines used in TB diagnosis. WHO is currently
evaluating this cartridge as well as other tests. Additional resources to roll
out COVID-19 testing should be mobilized rather than relying only on existing
resources that are used for TB, to ensure that the diagnostic coverage for TB
is maintained as necessary.


Q&A: Tuberculosis and COVID-19
Do COVID-19 and tuberculosis spread in the same way?
While both tuberculosis (TB) and COVID-19 spread by close contact between
people the exact mode of transmission differs, explaining some differences in
infection control measures to mitigate the two conditions.
TB bacilli remain suspended in the air in droplet nuclei for several hours
after a TB patient coughs, sneezes, shouts, or sings, and people who inhale
them can get infected. The size of these droplet nuclei is a key factor
determining their infectiousness. Their concentration decreases with
ventilation and exposure to direct sunlight.
COVID-19 transmission has primarily been attributed to the direct breathing of
droplets expelled by someone with COVID-19 (people may be infectious before
clinical features become apparent). Droplets produced by coughing, sneezing,
exhaling and speaking may land on objects and surfaces, and contacts can get
infected with COVID-19 by touching them and then touching their eyes, nose or
mouth . Handwashing, in addition to respiratory precautions, are thus
important in the control of COVID-19.


Q&A: Tuberculosis and COVID-19
Is tuberculosis treatment different in people who have both TB and COVID-19?
In most cases tuberculosis (TB) treatment is not different in people with or
without COVID-19 infection.
Experience on joint management of both COVID-19 infection and TB remains
limited. However, suspension of TB treatment in COVID-19 patients should be
exceptional. TB preventive treatment, treatment for drug-susceptible or drug-
resistant TB disease should continue uninterrupted to safeguard the patient’s
health, reduce transmission and prevent the development of drug-resistance.
While treatment trials are ongoing, no medication is currently recommended for
COVID-19 and therefore no cautions on drug-drug interactions are indicated at
present. TB patients on treatment should nonetheless be asked if they are
taking any medicines, including traditional cures, that may interact with
their medication.
Effective treatments to prevent TB and to treat active TB have been scaled up
and are in use worldwide. The risk of death in TB patients approaches 50% if
left untreated and may be higher in the elderly or in the presence of
comorbidity. It is critical that TB services are not disrupted during the
COVID-19 response.
Gathering evidence as this pandemic unfolds will be very important, while
upholding the norms of professional conduct and patient confidentiality when
handling clinical details.


Q&A: Tuberculosis and COVID-19
How can health authorities ensure supplies of tuberculosis medicines and diagnostics?
Appropriate planning and monitoring are essential to ensure that procurement
and supply of tuberculosis (TB) medicines and diagnostics are not interrupted.
WHO is monitoring medicine supply at the global level, while The Global Fund,
the Stop TB Partnership Global Drug Facility (GDF), USAID, Unitaid and other
donors play an essential role in supporting countries to secure adequate and
sustainable supplies of TB medicines, drugs and diagnostics.
Countries are advised to place their orders for 2020 delivery as soon as
possible given anticipated delays in transport and delivery mechanisms.


Q&A: Tuberculosis and COVID-19
What measures should be in place to protect staff working in tuberculosis laboratories and healthcare facilities, and community health workers, from COVID-19 infection?
Health care facilities, including those that diagnose and care for
tuberculosis (TB) and lung diseases, are bound to receive patients with
COVID-19, many of whom may be undiagnosed. Additional measures may be needed
to avoid that staff in these centres are exposed to COVID-19 infection.
The Information Note includes additional, temporary measures
that should be considered. These include alternative arrangements to reduce
visits for TB follow-up, precautions for sputum collection, transportation and
testing. The note also includes a description of ethical obligations in this
setting.
Existing WHO recommendations for infection prevention and control for TB and
for COVID-19 should be strictly implemented, including personal protection
equipment.
Lessons learnt over many years of TB infection prevention and control, contact
tracing, investigation and management can benefit efforts to stop the spread
of COVID-19.


Q&A: Tuberculosis and COVID-19
Should all people being evaluated for tuberculosis also be tested for COVID-19 and vice-versa?
Testing of the same patient for both tuberculosis (TB) and COVID-19 would
generally be indicated for three main reasons, subject to the specific setting
in each country:

clinical features that are common to both diseases; or
simultaneous exposure to both diseases; or
presence of a risk factor

As the pandemic advances, more people of all ages, including TB patients, will
be exposed to COVID-19. The Information Note
contains
further considerations for simultaneous testing for the two diseases.


Q&A: Tuberculosis and COVID-19
What services can be leveraged across both diseases?
The response to COVID-19 can benefit from the capacity building efforts
developed for tuberculosis (TB) over many years of investment by national
authorities and donors. These include infection prevention and control,
contact tracing, household and community-based care, and surveillance and
monitoring systems.
Although modes of transmission of the two diseases are slightly different,
administrative, environmental and personal protection measures apply to both
(e.g. basic infection prevention and control, cough etiquette, patient
triage).
TB laboratory networks have been established in countries with the support of
WHO and international partners. These networks as well as specimen
transportation mechanisms could also be used for COVID-19 diagnosis and
surveillance.
Respiratory physicians, pulmonology staff of all grades, TB specialists and
health workers at the primary health care level may be points of reference for
patients with pulmonary complications of COVID-19. They should familiarize
themselves with the most current WHO recommendations for the supportive
treatment and containment of COVID-19.
TB programme staff with their experience and capacity, including in active
case finding and contact tracing, are well placed to support the COVID-19
response.
Various digital technologies used in TB programmes can support the COVID-19
response, including adherence support, electronic medical records and
eLearning.


Q&A: Tuberculosis and COVID-19
What is the potential impact of COVID-19 pandemic on essential tuberculosis services?
Modelling work suggests that if the COVID-19 pandemic led to a global
reduction of 25% in expected TB detection for 3 months – a realistic
possibility given the levels of disruption in TB services being observed in
multiple countries – then we could expect a 13% increase in TB deaths,
bringing us back to the levels of TB mortality that we had 5 years ago. This
may even be a conservative estimate as it does not factor in other possible
impacts of the pandemic on TB transmission, treatment interruptions and poorer
outcomes in people with TB and COVID-19 infection (Predicted impact of the
COVID-19 pandemic on global tuberculosis deaths in 2020, P.
Glaziou).
Between 2020 and 2025 an additional 1.4 million TB deaths could be registered
as a direct consequence of the COVID-19 pandemic (Stop TB Partnership
analysis).
All measures should be taken to ensure continuity of services for people who
need preventive and curative treatment for tuberculosis (TB).


Q&A: Tuberculosis and COVID-19
Are people with tuberculosis likely to be at increased risk of COVID-19 infection, illness and death?
While experience on COVID-19 infection in tuberculosis (TB) patients remains
limited, it is anticipated that people ill with both TB and COVID-19 may have
poorer treatment outcomes, especially if TB treatment is interrupted.
Older age, diabetes and chronic obstructive pulmonary disease (COPD) are
linked with more severe COVID-19 and are also risk factors for poor outcomes
in TB.
TB patients should take precautions as advised by health authorities to be
protected from COVID-19 and continue their TB treatment as prescribed.
People ill with COVID-19 and TB show similar symptoms such as cough, fever and
difficulty breathing. Both diseases attack primarily the lungs and although
both biological agents transmit mainly via close contact, the incubation
period from exposure to disease in TB is longer, often with a slow onset.


Q&A: Violence against women during COVID-19
How does COVID-19 increase risks of violence for women?
Stress, the disruption of social and protective networks, loss of income and
decreased access to services all can exacerbate the risk of violence for
women.
In many countries, where people are encouraged or required to stay at home,
the risk of intimate partner violence is likely to increase. Please see the
following resource for more detail:
https://www.who.int/reproductivehealth/publications/emergencies/COVID-19-VAW-
full-text.pdf

In addition, access to sexual and reproductive health services will likely
become more limited. Other services, such as hotlines, crisis centers,
shelters, legal aid, and protection services, may also be reduced, making it
difficult for women to access the few sources of help that would usually be
available.


Q&A: Violence against women during COVID-19
Who is most vulnerable?
Women who are displaced, who are migrants or refugees, and those living in
conflict-affected areas, older women and women with disabilities are
particularly at risk of violence and are likely to be disproportionately
affected by violence during COVID-19.


Q&A: Violence against women during COVID-19
I run a health facility. What can I do to support women survivors of violence during COVID-19?

Identify information on local services for survivors, including on hotlines, shelters, rape crisis centers, and counselling.

Find out opening hours, contact details and whether these services can be offered remotely, and establish referral linkages.

Make these available to health care providers and easily accessible to patients/clients coming to your facility.

Support the health care providers in your facility to continue to support women survivors of violence during this time.

Be prepared to shift rapidly to providing care through alternative ways, by creating effective response plans; for example, by ensuring frontline healthcare workers have phones and can charge them.

Ensure there is a protocol in place to ensure continued safe document storage in case of sudden lockdown.

Inform survivors of ways they can protect themselves, and provide small credit card-size cards listing relevant phone numbers for support


Q&A: Violence against women during COVID-19
I am worried about someone I know. How can I help?
If you know of, or are concerned about, someone in an abusive relationship
there are some things you can do:

Keep regularly in touch with the person to check that they are safe, ensuring that it is safe for them to be in touch with you. Assume that a perpetrator of violence can see, hear and or monitor communications, so find out how best to communicate with the person that you are concerned about. Send them an SMS or message via email or social media, in a way that is safe for them. Be discrete in connecting with them when the abuser is present in the home so that they are not placed at risk of additional harm. Check each time, as this may change.

Find out what services for survivors of violence against women (e.g. shelters, hotlines, counselling services, women’s organizations) are functioning during the COVID-19 pandemic and make this information available through your networks and social media. Only provide this information directly if you can do so discretely without the abuser finding out.

If someone you know needs urgent help for whatever reason, be prepared to call emergency health services, the police, health centre, or hotline.


Q&A: Violence against women during COVID-19
I need medical attention because of violence. Who can help me and where should I go?
If you need urgent medical attention, call for an ambulance or contact your
country’s emergency health services. If you need any other support, contact a
specialized service if available or a health provider.


Q&A: Violence against women during COVID-19
I am safe, but I am suffering from mental / sexual / social / long-term physical health problems because of violence. Is there anyone who can help me during COVID-19?
As much as possible, reduce sources of stress:

Maintain contact with and seek support from family and friends via phone, email, text, etc.

Try to maintain daily routines and make time for physical activity and sleep.

Use relaxation exercises (e.g. slow breathing, meditation, progressive muscle relaxation, grounding exercises – see WHO Clinical handbook p.70) to relieve stressful thoughts and feelings.

Engage in activities that in the past have helped with managing adversity.

Seek information about COVID- 19 from reliable sources and reduce the time spent consuming news (for example, 1-2 times per day, rather than every hour).

Seek care from a trained health provider for symptoms and conditions including
injuries that need medical attention. Due to restrictions on movement, and
pressure on health systems, it may be difficult to access healthcare in person
at this time. In this case, find out what is available in your locality and
seek alternatives, including information and support offered by phone or
online.
If you are currently receiving healthcare and support for violence-related
issues this could continue during COVID-19 – this could even be by phone or
online if feasible and appropriate for your health needs.


Q&A: Violence against women during COVID-19
I am a health worker. How can I help women survivors of violence during COVID-19?
As a health worker, there are things you can do to help mitigate the impacts
of violence on women and children at any time, including during the COVID-19
pandemic.
Whilst your time and resources may be stretched during this health emergency,
you have a duty of care to women who may seek help from you – often to address
physical and mental hurt caused by violence.
You may need to adjust how you deliver services, if face-to-face care is not
possible. Depending on your resources consider mobile phone, WhatsApp or other
communication channels to deliver support, always ensuring you can do this in
a way that is safe for the survivor. Communicate openly with women about any
changes in service delivery.
If a woman with suspected or confirmed COVID-19 seeks your care because of
violence, your response should be the same as for any other survivor. You
should however ensure that you are protected from infection, by maintaining
distance where possible, wearing protective clothing, practicing respiratory
hygiene, and washing hands and surfaces with soap and water regularly and
after touching, to avoid infection.
In any circumstances, including during the COVID-19 pandemic, health workers
should provide first-line support, using the LIVES approach to help women
survivors of violence:
L isten closely, with empathy and no judgement
I nquire about women’s needs and concerns
V alidate women’s experiences. Show you believe and understand.
E nhance their safety.
S upport women to connect with additional services.


Q&A: Violence against women during COVID-19
I have harmed or am worried about harming or hurting my partner (and children) with my words or actions. How can I stop?

If you feel yourself getting angry or very annoyed, step away into another room if you can, or outside for a deep breath.

Count to ten and breathe in and out until you feel calmer. Count down from 10, or do anything else that may help you stay calm.

Talk to a trusted friend, relative, or religious leader and if necessary seek help from local health services or specialized services if available.

Recognize that everyone in your family is experiencing stress during this time.

Demonstrate kindness and patience in your words and actions.

Eliminate or reduce your alcohol consumption as much as possible.

The current measures to address the COVID-19 pandemic, such as restrictions on
movement, as well as financial instability caused by the crisis, are likely to
add to your stress. This is normal, and you can control how you react. Take
measures to ensure you manage your stress in a way that is respectful and safe
to you and your family. Try to be kind to yourself, your partner, children and
anyone else in the family.


Q&A: Violence against women during COVID-19
I am a policy maker. What can I do to prevent and address violence against women during COVID-19?

When making preparedness and response plans for the COVID-19 pandemic, include essential services for violence against women.

Allocate adequate resources for services for survivors and identify ways to make them accessible – particularly in the context of measures to restrict people’s movement.

Explore the use of telemedicine, digital health, or mhealth to enhance access to support and services for survivors, while ensuring this is safe for them.

Explore alternative shelters for women who may require this.

Ensure that lockdown measures do not penalize women for seeking support when experiencing violence, such as by going to the police or hospital to report violence.


Q&A: Violence against women during COVID-19
Home is not a safe place for me. What can I do?
If you are experiencing violence, it may be helpful to reach out to family,
friends and neighbors, to seek support from a hotline or, if safe, from online
service for survivors of violence. Find out if local services (e.g. shelters,
counselling) are open and reach out to them if available.
Make a safety plan in case the violence against you or your children
escalates. This includes:

Identifying a neighbour, friend, relative, colleague, or shelter to go to in case you need to leave the house immediately for safety.

Have a plan for how you will exit the house safely and how you will reach there (e.g. transport).

Keep a few essential items (e.g. identification documents, phone, money, medicines, and clothes) available, and a list of telephone numbers in case of an emergency.

If possible, develop a code with a trusted neighbour so they can come to your aid in case of an emergency.


Q&A: Violence against women during COVID-19
I want to report an incidence of violence during COVID-19. What should I do?
If you want to report an incidence of violence, you should follow your
country’s guidance on how to report violence and contact the service where you
are most likely to get a survivor-centred response.
Some countries are making exceptions to movement restrictions for reporting of
violence specifically. Remember that reporting may put you at risk, so ensure
you have a safety plan in place.
You may find making a report mentally or emotionally difficult. Seek the
support of friends, relations, neighbours or colleagues, or local support
services for survivors of violence.


Q&A: Violence against women during COVID-19
Why should I care about violence against women during COVID-19?
Violence against women is a grave violation of women’s human rights, no matter
when, where, or how it takes place. There are many forms of violence against
women, which have many potential negative health consequences for women and
their children.
Violence against women can result in injuries and serious physical, mental,
sexual and reproductive health problems, including sexually transmitted
infections, HIV, and unplanned pregnancies. In extreme cases, violence against
women can result in death.
The effects of violence are very often long-lived. Violence – in all its forms
– can have an impact on a woman’s well-being throughout the rest of her life.
This is unacceptable, and the risks of violence that women and their children
face during the current COVID-19 crisis cannot be ignored.
When we are able to prevent violence, or to support women survivors of
violence, we help to safeguard women’s human rights, and promote physical and
mental health and well-being for women throughout their lives. This also helps
to alleviate pressure on already stretched essential public services,
including the health system.


Q&A: Violence against women during COVID-19
Has violence against women increased since the beginning of the COVID-19 pandemic?
Violence against women is highly prevalent, and intimate partner violence is
the most common form of violence. During health emergencies, such as the
COVID-19 pandemic, violence against women tends to increase.
Whilst data are scarce, reports from across the world, including China, the
United Kingdom, the United States of America, and other countries suggest a
significant increase in domestic violence cases related to the COVID-19
pandemic. Reports from other countries suggest a reduction in survivors
seeking services due to a combination of lockdown measures and not wanting to
attend health services for fear of infection.


Questions relating to consumers
Can the virus live on the surface of food packaging? How long? Is it necessary to disinfect?
See question 10 of Questions relating to food businesses. It
is not necessary to disinfect food packaging materials, but hands should be
properly washed after handling food packages and before eating.


Questions relating to consumers
How long is it to cook food? To what temperature to kill the virus?
This virus is not more resistant to heat than the usual viruses and bacteria
found in food. As recommended for good hygiene practice, foods should be
thoroughly cooked to at least 70°C. It is recommended to follow the WHO
5-Keys to Safer
Food.


Questions relating to consumers
Is it still safe to go to food markets? Animal markets? Wet markets?
It should be safe provided it is possible to maintain a safe physical distance
of at least one metre from all other shoppers and staff, it is possible to
wash/sanitize hands, and that Good Manufacturing Practices and Good Hygienic
Practices (GMP/GHP) standards are maintained in the market. For more
recommendations on how to minimise the risk of transmission of emerging
pathogens in wet markets, see the WHO recommendations to reduce risk of
transmission of emerging pathogens from animals to humans in live animal
markets or animal product markets.


Questions relating to consumers
Is food/grocery delivery safe?
Yes, if the provider follows good personal and food hygiene practices. After
accepting food/grocery deliveries, hands should be washed with soap and water.


Questions relating to consumers
Can the virus live on the surface of foods (including fruits and vegetables, frozen foods, pre-packaged foods)?
Coronaviruses cannot multiply in food – they need a live animal or human host
to multiply and survive (see question 10 of Questions relating to food
businesses).


Questions relating to consumers
How to wash fruits and vegetables? Just with water, or something else?
Washing fruit and vegetables with potable water is sufficient: it is
recommended to follow the WHO 5-Keys to Safer
Food.


Questions relating to consumers
Can I get COVID-19 from food?
There is currently no evidence that people can catch COVID-19 from food or
food packaging. COVID-19 is a respiratory illness and the transmission route
is through person-to-person contact and through direct contact with
respiratory droplets generated when an infected person coughs or sneezes.


Questions relating to consumers
What is the best household disinfectant for surfaces?
Regular household cleaning and disinfection products will effectively
eliminate the virus from household surfaces. For cleaning and disinfecting
households with suspected or confirmed COVID19 illnesses - surface virucidal
disinfectants, such as 0.05% sodium hypochlorite (NaClO) and products based on
ethanol (at least 70%), should be used.


Questions relating to consumers
What precautions should consumers take in grocery stores?
Consumers should maintain a safe physical distance of at least one metre from
all other shoppers and staff while queuing before entering the store and while
shopping in the store. If a trolley or basket is used while shopping, sanitize
the handle before and after use. Hands should be sanitized before entering the
store. Practice good coughing/sneezing etiquette while in the store. Avoid
touching mouth, nose or eyes during shopping. Minimise direct hand contact
with food by using available tongs and serving utensils. Use contactless
payment rather than cash/notes (where feasible).


Questions relating to food businesses
What measures should be taken to ensure safe transport of food during this pandemic?
The general guidelines outlined in the Codex Code of Hygienic Practice for
the Transport of Food in Bulk and Semi-Packed Food.1
should be followed, in addition to ensuring that employees delivering foods
are free from COVID-19, coughing/sneezing etiquette is practiced by all
involved in food transport and that frequent hand washing/sanitizing is
practiced and staff practice physical distancing.
See also other Codes of Hygienic Practice for various groups of
food.


Questions relating to food businesses
How should shopping trolleys or carts be disinfected?
The handles of shopping trolleys or carts should be frequently cleaned using
either alcohol-based sanitizers or chlorine-based disinfectants (sodium
hypochlorite). Sanitizers, paper towels and trash bins should be placed
outside the retail premises close to the trolley park for customers to use.


Questions relating to food businesses
Should grocery store workers wear gloves? Masks?
Disposable Gloves
Gloves may be used by food workers but must be changed frequently and hands
must be washed between glove changes and when gloves are removed. Gloves must
be changed after carrying out non-food related activities such as
opening/closing doors by hand, and emptying bins. Food workers should be aware
that wearing gloves can allow bacteria to build up on the surface of the
hands, so hand washing is extremely important when gloves are removed to avoid
subsequent contamination of food. Food workers should not touch their mouth,
nose and eyes when wearing gloves.
Disposable gloves can give a false sense of safety and should not be used in
the food work environment as a substitute for hand washing. The COVID-19 virus
can contaminate disposable gloves in the same way it can get onto workers
hands and contact surfaces. Removal of disposable gloves can lead to
contamination of hands. Wearing disposable gloves can give you a false sense
of security and may result in staff not washing hands as frequently as
required.
Handwashing is a greater protective barrier to infection than wearing of
disposable gloves. Food businesses need to ensure adequate sanitary facilities
are provided and ensure food workers thoroughly and frequently wash their
hands. Soap and water is adequate for hand washing. Hand sanitisers can be
used as an additional measure but should not replace hand washing.
Wearing of Face Masks
WHO advice on the use of masks in the context of COVID-19
should be followed. Face Masks do not have to be routinely used by food
workers to protect against transmission of COVID-19. However, for some food
processing activities, such as working in abattoirs or handling cooked, ready-
to-eat foods, wearing face masks is a usual practice.
WHO recommends that face masks should be used if a person is sick with
symptoms of COVID-19 (especially coughing) or looking after someone with
suspected or confirmed COVID-19.
However, a food worker who is sick or who has symptoms of COVID-19 should not
be allowed to work in grocery stores or other food businesses and should be
excluded from work until free of symptoms or deemed fit for work by a medical
doctor.


Questions relating to food businesses
What measures should be taken to ensure safe water is used in food production during this pandemic?
There is no evidence that COVID-19 is transmitted by water used in food
processing. The WHO guidelines for drinking-water
quality should be followed.


Questions relating to food businesses
How can food businesses remain safe from virus contamination?
The main priority is to keep the virus out of the food environment. Several
key measures are required including upgrading of cleaning and sanitation
measures, disinfecting surfaces and high-touch points, educating staff on the
virus and how to protect themselves and others, reinforcing protocols such as
physical distancing, hand washing, and improved security with people staying
in their vehicles/sanitizing hands when handing out documents and other
material. ****


Questions relating to food businesses
How should food premises be cleaned/disinfected during this pandemic?
The general guidelines outlined in the General Principles of Food
Hygiene
for food processing and manufacture premises should be followed. If a
suspected or confirmed case of COVID-19 is identified in a food premises then
there is a requirement to completely clean the area with a neutral detergent,
followed by decontamination of surfaces using a disinfectant effective against
viruses. All surfaces that the infected employee has come into contact with
must be cleaned, including all surfaces and objects which are visibly
contaminated with body fluids/respiratory secretions, and all potentially
contaminated high-contact areas such as toilets, door handles, telephones.
Alcohol based sanitizers/surface disinfectants should be used for cleaning
purposes. In general, alcohol-based disinfectants (ethanol, propan-2-ol,
propan-1-ol) have been shown to significantly reduce infectivity of enveloped
viruses like SARS-CoV-2, in concentrations of 70-80% with one-minute exposure
time. Chlorine-based disinfectants (sodium hypochlorite) are effective for
surface decontamination, as are disinfectants with active ingredients based on
quaternary ammonium compounds (QUATS).
All staff should wash their hands thoroughly for 20 seconds after any contact
with someone who is unwell with symptoms consistent with coronavirus
infection. Staff engaged in environmental cleaning should wear PPE when
performing cleaning activities, such as overalls or uniform, single-use
plastic aprons, gloves and a face mask. Protective clothing (e.g. uniforms,
overalls, etc.) should be frequently washed at 60°C or above.


Questions relating to food businesses
What is known about various conditions affecting survivability of the virus?
Very little is known about how the SARS-CoV-2 virus survives outside the human
body. Probably the most up-to-date summary of scientific information we have
on survival in the environment is from the European Centre for Disease control
(ECDC) and the following is extracted from their recent technical
report:
Recent publications have evaluated the survival of SARS-CoV-2 on different
surfaces. According to van Doremalen et al., the environmental stability of
SARS-CoV-2 is up to three hours in the air post-aerosolization, up to four
hours on copper, up to 24 hours on cardboard and up to two to three days on
plastic and stainless steel, albeit with significantly decreased titres [3].
These findings are comparable with results obtained for environmental
stability of SARS-CoV-1. These findings resulted from experiments in a
controlled environment and should be interpreted with caution in the real-life
environment. Moreover, different levels of environmental contamination have
been detected in rooms of COVID-19 patients, ranging from 1 out of 13 to 13
out of 15 samples testing positive for SARS-CoV-2 before cleaning. No air
samples were positive in these studies, but one sample from an air exhaust
outlet was positive indicating that virus particles may be displaced by air
and deposited on surfaces [4,5]. In a study of environmental contamination in
a Chinese hospital during the COVID-19 outbreak, SARS-CoV-2 was detected in
environmental samples from the COVID-19 dedicated intensive care units (ICU),
the COVID-19 dedicated obstetric isolation ward and the COVID-19 dedicated
isolation ward. SARS-CoV-2 was also detected on objects such as the self-
service printers used by patients to self-print the results of their exams,
desktop keyboards and doorknobs. Virus was detected most commonly on gloves
(15.4% of samples) and rarely on eye protection (1.7%) [6]. This evidence
shows the presence of SARS-CoV-2 in the environment of a COVID-19 patient,
therefore reinforcing the belief that fomites play a role in transmission of
SARS-CoV-2; however, the relative importance of this route of transmission
compared to direct exposure to respiratory droplets is still unclear.


Questions relating to food businesses
What is the most appropriate sanitizer to use on surfaces in a food production environment?
In general, alcohol-based disinfectants (ethanol, propan-2-ol, propan-1-ol)
have been shown to significantly reduce infectivity of enveloped viruses like
SARS-CoV-2, in concentrations of 70-80% with one-minute exposure time.
Chlorine-based disinfectants (sodium hypochlorite) are effective for surface
decontamination, as are disinfectants with active ingredients based on
quaternary ammonium compounds (QUATS).