The New COVID-19 Disease (Coronavirus):
Summary of Risks, Prevention, Control
If you are concerned about your personal health, please contact your personal doctor, community doctor, health authorities or emergency services. This material is for information purposes, is based on public data and public domain images publicized by the World Health Organization WHO) and the Centers for Disease Control (CDC) in the United States, and was prepared by Methodist educators who are experts in Public Health. Writing & Editing Team (in alphabetical order): James K. Gray, PhD; Kristi McClellan, MPH; Richard A. Nisbett, PhD, MsPH; Martha Slay Wingate, DrPH.
For questions, contact the corresponding author: Richard A. Nisbett (firstname.lastname@example.org).
Opening Prayer: From the Iona Community, a prayer written for these COVID-19 times:
God our challenger and disturber,
help us to confront
all that makes for death and despair
in our lives, our communities, our world.
May we never lose sight
of the possibility of transformation
and be continually surprised
by people who believe in one another.
Gathered and scattered, God is with us
and so we are with one another.
The Social Community: Right to Health Care: Providing the care needed to maintain health, prevent disease, and restore health after injury or illness is a responsibility each person owes others and government owes to all, a responsibility government ignores at its peril. In Ezekiel 34:4a, God points out the failures of the leadership of Israel to care for the weak: “You don’t strengthen the weak, heal the sick, bind up the injured, bring back the strays, or seek out the lost.” As a result all suffer. It is unjust to construct or perpetuate barriers to physical or mental wholeness or full participation in community. We believe it is a governmental responsibility to provide all citizens with health care. We encourage hospitals, physicians, and medical clinics to provide access to primary health care to all people regardless of their health-care coverage or ability to pay for treatment (United Methodist Church Social Principles 2016).
Introduction. COVID-19 is the name for a new disease infecting people around the world. It is from a group of animal diseases called “coronaviruses.” To protect our loved ones and strangers, the world must cooperate to prevent unnecessary suffering and loss. Scientists believe it began late in 2019 and by early 2020 had caused much sickness and death in China. From there, this new disease has travelled around the world to virtually every country. As of this writing (27.3.2020), globally there have been about 580,000 confirmed cases with about 26,000 deaths in over 175 countries. The more tests that are conducted on people everywhere, the more cases that are found. It seems to be increasing rapidly. However, the control measures instituted by governments, particularly China and South Korea, have shown good success in slowing the epidemic and preventing new cases. Working together and making wise choices, people everywhere can help stop the transmission.
COVID-19 Summary Of risks
This is a new disease so virtually every one is susceptible to it. So far, studies have shown that of those infected, 8 out of 10 will have mild or no noticeable systems—in other words, many will not feel ill and so they will not seek medical care. While this is good news, it is also a dire warning because those who don’t feel ill or who ignore their symptoms as being a temporary inconvenience, still remain infective and can pass the disease to other, more vulnerable persons. Also, since the infection goes unnoticed, there may be many more people infected that we don’t even know about. For now, we only know about those who have been tested.
Of the 2 out of 10 who do have severe symptoms, the vast majority will need intensive care by hospitalization. Currently, medical doctors estimate that 4 or 5 out of 100 confirmed cases will die from COVID-19. All age groups are at risk of infection and serious illness, but so far those under aged 50 are more likely to have mild or no symptoms but they can still spread the disease. Only 1 in 20 children will have serious illness while 2 of 10 elderly will have a serious illness. Nevertheless, in Europe and the USA as many as 1 of 2 aged under 50 who are infected will require hospitalization. Studies suggest that men are more at risk for several complications than women, and this could be due to men having more underlying health conditions.
Those persons over aged 60 are most at risk, and this risk increases for every decade of age. For those over aged 80, 1 or 2 out of 10 infected will die. However, most of the deaths occur in older persons who have other serious health issues like heart disease, diabetes, high blood pressure, lung disease or other infections. Perhaps the biggest health risk factor is breathing and respiratory illness or prior damage to the lungs. This includes people with damaged lungs due to air pollution, cigarette smoking or vaping, and COPD (chronic obstructive pulmonary disease due to many causes, including occupational risk of having worked around inhaled substances like chemicals, petrol, asbestos, long-term exposure to charcoal smoke when cooking, etc.).
The cautious estimate is that 95-99 out of every 100 people are susceptible to COVID-19 so they need to take precautions. Taking precautions and changing behavior not only reduces one’s own risk of infection but protects many other people with whom an infected person may come in contact. It is estimated that every infected person infects 2 more people, so that the total infected in a society can double very rapidly (every few days).
Medical doctors call this type of disease a respiratory illness because the symptoms involve the upper respiratory system (mouth, nose, throat) and the lower respiratory system (lungs). Many illnesses we are familiar with like common colds and influenza (“flu”) are such diseases. The symptoms of all these diseases can be very similar. However, COVID-19 is typically presenting as a high temperature (sometimes with headache and chills), shortness of breath, and a dry cough. Each of us can respond differently to any such illness so there is a lot of variability in individual response. After one is exposed, it takes 1-14 days for symptoms to occur, but usually symptoms occur 5-6 days after exposure. New reports are suggesting that an early sign of infection is the reduced sense of smell and diminished sense of taste; and also that digestive symptoms occur in about 5 of 10 infected; such as lack of appetite and diarrhea. Figure 1 is a table comparing the symptoms of COVID-19 (coronavirus) with colds and flu.
Figure 1. Symptoms of COVID-19 Coronavirus, Colds and Flu
As the chart shows, a key difference is that many of the upper respiratory symptoms (running nose, sneezing) are usually absent with COVID-19. If a person has the combination of symptoms for COVID-19, the best course of action is to go to a medical facility and get a test if the medical professionals so advise.
One of the features that makes COVID-19 so infective is that there are several ways it can be transmitted. First, the virus can become airborne (often called “aerosols transmission”) and survive in the air for several hours. In this way it can be inhaled—even when the infected person has left the area. Second, when people cough or touch their faces and then other objects, the virus can come in contact with the surfaces of objects around us. Early research suggests that the virus can remain infective for hours or days depending on the type of surface. Figure 2 shows how long scientists believe the virus can live on different types of surfaces. It has been found to survive on cruise ships for over 17 days.
Figure 2. How Long COVID-19 Remains Infective on Different Types of Surfaces
Finally, COVID-19 can also be transmitted by the fecal-oral route. This is why hygiene, and handwashing in particular, is so important. Below, in Section 5 we discuss how to prevent transmission, protect ourselves and our loved ones.
Presently, there are few specific treatments. If the patient requires hospitalization, then “aggressive supportive care” is begun and most people will respond favorably. Scientists are working on several treatments which may become available very soon. Most of these are prescription drugs that have been designed for other illnesses but medical doctors are finding they are also effective against COVID-19.
Your medical professionals will know about these treatments and they should only be administered under the care of a medical professional. Should you have more questions or wish for updates on the unfolding scientific evidence, please use the online system to request more information. Many research teams at laboratories around the world are working on treatments and on vaccine development so we will be continually updating our database with the latest information. There are concerns that ibuprofen makes COVID-19 worse and should be avoided.
There are many common prevention strategies for infectious diseases that individuals can take personally to prevent COVID-19. Every strategy requires changes in behavior and routines to some extent and will vary according to local customs and traditions. Many are difficult to accomplish but every effort should be made. It is important to emphasize that no single protection will be complete and that to reduce risk and exposure, it is essential to use all the strategies to the extent possible. Additionally, each country may mandate control measures by law and those should be obeyed—we cover group-control strategies in Section 6 below. On the personal level, here are the common ways to prevent transmission (See Figure 3):
Figure 3. Common Ways to Prevent COVID-19 Transmission
1. Basic hygiene & handwashing. Since viruses can live on surfaces and objects for some time (See Figure 2), frequent handwashing prevents infections. Maintain good hygiene practices like covering your face when coughing or sneezing but also handwashing much more frequently than usual—especially when you feel you’ve been exposed to objects, or are touching or caring for others (like children or the elderly), and after sneezing or coughing; before preparing and serving food; after contact with animals or pets. Proper handwashing requires vigorous scrubbing with soap and water of the palms, back of hands and fingers, between fingers and under fingernails. It should last for 20-30 seconds. Tip: To go the required time, sing a verse of your favorite hymn, popular song or national anthem while washing. Hand sanitizers are inferior to proper handwashing but if you use them, make certain the label indicates an alcohol content of 60% alcohol. Proper Handwashing technique
2. Face masks and Hand gloves. Some countries require by law the wearing of facemasks in public. The effectiveness of these masks will vary by the material used to make them and by the fit on an individual’s face. Typically, masks are more effective at preventing the spread of virus to surroundings from an infected wearer than protecting an uninfected person wearing a mask. The highest quality masks are recommended but often expensive and in short supply. Global companies are working overtime to produce and distribute more masks. During the shortfall, there are poorer quality masks that can still be effective. For instance, the USA Centers for Disease Control and Prevention website has tutorials on sewing homemade masks. The CDC recommends 100% cotton and even materials like pillow cases can be used. These masks will have limited effectiveness and need to be discarded more often and cleaned by washing frequently but can prevent some infections. On our website we have links to the CDC instructions and a pattern for making these homemade masks
Using latex hand gloves is important if your work or job requires contact with many persons, or handling objects. If latex gloves are in short supply, some protection can be had with vinyl, nitrile, plastic or rubber gloves. Disposable gloves of any type should be changed often and disposed of so that other surfaces and spaces do not become contaminated. All gloves, even Latex, can be contaminated like any other object and need to be replaced often. These latex gloves may be in short supply due to the huge needs of health professionals who are working with many people and handling infectious materials. Gloves made of other materials like cloth can be protective but must be cleaned thoroughly and often as some fabrics allow the COVID-19 virus to live in the glove material.
3. Cleaning and Disinfecting surfaces and objects, doing laundry. The USA Centers for Disease Control and Prevention has issued these guidelines for cleaning and disinfecting:
- When disinfecting space that was used by someone has been infected:
- close off the areas used by the sick person
- open outside doors and windows to increase air circulation
- wait 24 hours before cleaning and disinfecting:
- When cleaning and disinfecting:
- wear disposable gloves and gowns for all tasks, including the handling of trash
- when removing the gloves and gowns take care to avoid recontamination
- wash your hands often, especially immediately after removing gloves
- clean all surfaces with soap and water, especially “high touch” surfaces like door handles, light switches, faucets, toilets, countertops, phones, etc.
- disinfect with diluted household bleach solutions appropriate for the surface material
- make a bleach solution by mixing 5 tablespoons (1/3rd cup) bleach per gallon of water
- use alcohol solutions with at least 70% alcohol
- follow the instructions on the label of household cleaners and disinfectants
- for soft surfaces like rugs, carpets and drapes, use soap and water and launder when possible
- for electronics such as touchscreens, keyboards, phones, remote controls follow manufacturers instructions; usually, an alcohol-based wipe or spray is effective
- for doing laundry, wear disposable gloves, don’t shake out dirty laundry, use warm or hot water temperature (take due care not to scald/expose skin to high temperatures).
4. Avoiding Direct Contact. This protective behavior is often the most difficult. Typical social greetings like hand-shaking, kissing the cheeks, hugging can transmit infections. It is better to substitute other forms of greeting like “elbow bumping,” or other nods and gestures of civility.
Often local and national governments will implement laws and regulations to prohibit gatherings in order to reduce public contact in hopes of reducing transmission. Other organizations should ask their members to voluntarily reduce their contact with other people even if those other persons don’t appear to be ill. Below are some common group strategies:
- Quarantine. Typically, a quarantine is used to separate infectious people from the uninfected by physically constraining the infected person or persons to space not shared with others. Sometimes a government may require infected people, for example, involuntarily to remain in their homes and refrain from going out in public.
- Self-isolation. Self-isolation generally refers to person intentionally reducing their risk of exposure by limiting or eliminating social contact. This is very difficult, especially in crowded households, for the differently-abled, small children, the ill, the elderly.
- Social Distancing. Social distancing is intentionally reducing one’s risk of exposure by increasing the space between people, whether inside or outside in public. Most experts recommend a minimum of 1-2 meters (3-6 feet) away from the other person. See Figure 4.
Figure 4. Social Distancing Guidelines
- Avoiding groups. Most experts recommend avoiding or prohibiting large gatherings at all, and severely limiting group sizes to fewer than 10 people.
Figure 5. Five Key Reminders
Please see the Frequently Asked Questions (FAQ) Section for more specific information.
Item #11 at the end of the FAQ section gives recommendations for steps which should be taken immediately.
Please make every effort to share this information with other faith communities and civil society organizations. This disease attacks everyone without preference and you cannot protect your loved ones and your communities unless everyone is informed and working together to reduce exposures and stop the spread.
1.1. Where did this virus come from? Coronaviruses infect many different mammals, but especially bats. The animals may not be sickened by the virus but when it gets into humans it can cause severe illness and even death. This new coronavirus has been named SARS CoV2 because it is very closely related to an earlier type that caused the disease SARS. Both of these are found in Asian fruit bats and may have passed through another animal like the civet or pangolin from which humans likely got the disease. The new disease caused by SARS CoV2 is called COVID-19.
1.2. Can humans become infected from an animal source? The short answer is “yes” because that is how this virus got into the human population. Nonetheless, these “crossover” or “spillover” viral events are relatively rare.
1.3. Can I eat wild meat? It is always best to avoid eating wild animals from the bush, forest or outback. Sometimes even domestic animals or livestock can be infected by wild animals when they come into contact. You should avoid eating the meat or even touching any dead animal or a live one acting strangely or that appears to be ill. Likewise, you should avoid meat acquired from live, or “wet,” markets where animals are kept in confinement close to one another or where butchered meat of different types of animals are displayed together, touching one another.
1.4. How long is the incubation period for COVID-19? The period between when someone is exposed to when they begin to display symptoms is called the “incubation period.” For this disease, the range is 1-14 days, but the typical incubation period for most people is 5-6 days. These ranges support the CDC/WHO recommendations for self-isolation/quarantine and monitoring of symptoms for at least 14 days after being exposed.
1.5. Can I catch COVID-19 from domestic livestock or pets? If domestic livestock has become contaminated, it can spread this virus. There are two reports of companion pets—dogs—in Asia which appear to have caught the virus but do not appear infected. It is not known if pets can become infected or if so, whether or not they can spread the virus. For now, we believe the dogs were infected by humans and that they did not become sick. One should practice appropriate hygiene and handwashing when dealing with all animals and pets.
1.6. How long does the virus survive in the air and on surfaces? The virus can “live” and remain infective in the air for 3-5 hours, it can be infective on the surfaces of objects or furniture for 3-5 days. On certain objects like paper it can live only about 1 day or so. Scientists believe that while the virus can be found on money (coins and currency) it does not last long on those surfaces. However, most of our objects, furniture, utensils and possessions are plastic or metal and the virus can live on these for 3-5 days. For this reason, care should be taken to disinfect regularly if an infected source or person is in frequent contact with these objects. See Section also Section 5 in the COVID-19 Summary for cleaning and disinfecting.
1.7. Will warm weather stop the virus? It appears that this disease can be spread anywhere in the world. Some scientists have found that the virus cannot live in hot and humid climates. These scientists speculate that COVID-19 will diminish in the warm, rainy season. However, we simply do not have sufficient information at his time since this is a new disease. All precautions need to be maintained until scientists and medical doctors tell us we can return to our normal routines.
2.1. How does the virus spread? This virus is highly contagious and spreads person-to-person. It can be infective as a particle in the air if you are standing 1 meter from an infected person who coughs, sneezes or speaks; it can be picked up from a surface or object, or direct skin contact when droplets land on a surface. It can be spread by contaminated fecal material. It may be that other bodily fluids are infectious as well (urine, breastmilk, etc.). Much remains unknown.
2.2. How long can someone who has had the virus give it to others? It is not precisely known how long people can give it to others. Scientists believe that a person who is infected can give the virus to others for a period of 5-6 weeks. However, only time will allow us to know the answer completely for COVID-19.
2.3. What is “community spread”? The virus that causes COVID-19 seems to be spreading easily and sustainably in the community. Community spread means people have been infected with the virus in an area, including some who are not sure how or where they became infected and others who may not even feel ill or show symptoms.
Whenever certain groups become infected early or have many infected persons, it is a human trait to blame them, and even stigmatize those groups as a whole. This virus will infect anyone without regard to their group, race/ethnicity, income, religion, etc. Counter stigma by learning and sharing facts from trusted sources. Communicating the facts that viruses do not target specific racial or ethnic groups and how COVID-19 actually spreads can help stop stigma.
The CDC informs us: “Stigma is discrimination against an identifiable group of people, a place, or a nation. Stigma is associated with a lack of knowledge about how COVID-19 spreads, a need to blame someone, fears about disease and death, and gossip that spreads rumors and myths.
Stigma hurts everyone by creating more fear or anger towards ordinary people instead of the disease that is causing the problem.” We will need to work together to stop the spread.
4.1. What are the key symptoms of COVID-19? This disease has many of the symptoms of other respiratory diseases. See the Figure 1 in the Symptoms Section of the COVID-19 Summary. The symptoms which seem most common to COVID-19 are a high fever, shortness of breath, and dry cough. Other symptoms like headache, chills, aches and pains may be present. Generally, a runny nose and sneezing are not common symptoms of COVID-19. Some new reports suggest that diminished sense of taste and smell may be noticed very early in the infection.
4.2. How can I protect myself? For general guidelines, please see Section 5 of the COVID-19 Summary. It is important to know that studies have shown that you can become infected by being around an infected person who has no symptoms and with whom you have no touching or sharing of objects. Many governments are calling for people to try to stay 6 feet (2 meters) apart whenever possible. This is called “social distancing” and it is one of the most effective ways we have to reduce exposure and transmission.
4.3. Who is at risk of infection? Everyone is at risk of infection. In China the average age of a patient was about 46; elsewhere the average is nearly 60. Here are the groups at higher-risk for severe complications from infection:
- Elderly with underlying health conditions (other diseases, diabetes, infections, heart problems, high blood pressure)
- Young people with underlying health conditions (same as elderly)
- Those with prior poor lung health or lung damage (COPD, occupations where chemicals are inhaled, those exposed to heavy smoke or pollution such as cooking charcoal)
- Cigarette/cigar/pipe smokers or electronic vapers
- Healthcare workers and care providers
4.4. What should I do if I am at higher risk? Here is the advice from the CDC:
“If you are at higher risk of getting very sick from COVID-19, you should: stock up on supplies; take everyday precautions to keep space between yourself and others; when you go out in public, keep away from others who are sick; limit close contact and wash your hands often; and avoid crowds, cruise travel, and non-essential travel. If there is an outbreak in your community, stay home as much as possible. Watch for symptoms and emergency signs. If you get sick, stay home and call your doctor.”
4.5. What are the 7 key steps to remember to prevent the spread of COVID-19?
- Wash your hands with soap and water for 20-30 seconds
- Avoid touching your face, eyes, mouth, nose
- Avoid contact with people who are vulnerable. If you can’t wear a mask
- Cover your cough with the bend of your elbow
- Disinfect surfaces you frequently use
- If you feel unwell, stay at home and call your healthcare provider
- Only share information from trusted sources and do not blame or stigmatize others
4.6. What should I do if I need to care for someone who is infected or have been in contact with someone who was infected?
The CDC says:
- Make sure you understand how to care for an infected person based on your healthcare providers advice and instructions
- Monitor the patient’s symptoms and be in touch with your healthcare provider
- Household members should stay in a separate room and prohibit nonessential visitors
- Don’t let infected persons handle pets or animals; those caring for animals need to wash hands regularly
- Make sure shared spaces for noninfected persons have good air flow
- Perform hand hygiene (washing with soap and water or using a hand sanitizer) frequently. Be sure hand sanitizer contains at least 60% alcohol
- Avoid touching your eyes, nose, mouth with unwashed hands
- Insist the patient wears a facemask and that the caregiver wears a mask while providing care
- Wear disposable facemask and gloves when you know you will come in contact with the patient’s bodily fluids (blood, stool, saliva, mucous, vomit, urine)
- When removing protective gear, remove gloves first and wash hands, then facemask and wash hands again, then other gear like gowns and wash hands again. Dispose of all used gear properly to avoid contamination and wash hands again
- Avoid sharing household items and objects with the infected (plates, glasses, cups, utensils, towels, bedding, etc.)
- Clean regularly all “high-touch” surfaces (door knobs or handles, counters, tabletops, fixtures, toilets, phones, keyboards, tablets and screens, bedside tables, etc.)
- Use a household cleanser appropriate for the surface type or a diluted bleach solution (5 tablespoons, or 1/3rd cup, or 3.8 ounces) of bleach for each gallon of water. (1 gallon = 3.8 liters)
- Wash laundry thoroughly with as warm or hot water as possible
- Place all disposable items, discarded clothing or waste, etc. in a container lined with a plastic bag; remember to wash hands thoroughly after disposing
- Always consult your healthcare providers about these instructions
4.7. Can an object or package from a highly-infected area of country carry the virus? There is very low chance of the virus surviving over a period of one week during shipping or transportation at normal ambient temperatures. Heat, humidity, drying (desiccation), sunlight typically inactivate most viruses. There is still a lot to learn about his virus but the greatest transmission potential thus far has been as droplets or aerosols in the air or landing on surfaces nearby.
5.1. What is the risk of my child becoming sick with COVID-19? Based on available evidence, children do not appear to be at higher risk for developing severe complications from COVID-19 than compared to adults. While some children and infants have been sick with COVID-19, adults make up most of the known cases to date. For children, be aware of the symptoms and changes in behavior (but their risk is low). However, children can have severe and even fatal outcomes.
5.2. How can I protect my child? The precautions to prevent infection in child are the same as for adults. What you can do as a parent is to teach them good hygiene behavior:
- Clean hands often using soap and water or alcohol-based hand sanitizer
- Avoid people who are sick (coughing and sneezing)
- Clean and disinfect high-touch surfaces daily in household common areas (e.g. tables, hard-backed chairs, doorknobs, light switches, remotes, handles, desks, toilets, sinks)
- Launder items including washable plush toys as appropriate in accordance with the manufacturer’s instructions. If possible, launder items using the warmest appropriate water setting for the items and dry items completely. Dirty laundry from an ill person can be washed with other people’s items
5.3. Are the symptoms of COVID-19 different in children than in adults? No. The symptoms of COVID-19 are similar in children and adults. However, children with confirmed COVID-19 have generally presented with mild symptoms. Reported symptoms in children include cold-like symptoms, such as fever, runny nose, and cough. Vomiting and diarrhea have also been reported. It’s not known yet whether some children may be at higher risk for severe illness, for example, children with underlying medical conditions and special healthcare needs. There is much more to be learned about how the disease impacts children
5.4. Should children wear masks? No. If your child is healthy there is no reason to wear a mask. People who are infected or caring for infected people are the ones who should wear masks. Naturally, if the local or national governments makes it mandatory then please comply.
5.5. While school is out, can my children hang out with their friends? Here are the CDC recommendations for children dismissed from school:
- The key to slowing the spread of COVID-19 is to limit social interactions as much as possible. Parents should minimize play dates, and if held, parents should keep the groups small. Advise older children to hang out in a small group (less than 10) and to meet up outside rather than inside. It’s easier to keep and maintain space between others in outdoor settings, like parks
- If you have small meetups, consider hanging out with another family or friend who is also taking extra measures to put distance between themselves and others (i.e. social distancing). Make sure children practice good hygiene everyday, such as cleaning and then disinfecting frequently touched surfaces. Remember, if children meet outside of school in bigger groups, it can put everyone at risk
- This includes spring break and other group travel. Parents should help their older children revise spring break plans that included non-essential travel to crowded areas
5.6. How can I keep my children healthy and intact if we have relatives in high-risk groups or with chronic medical conditions?
- If others in your home are at particularly high risk for COVID-19, consider extra precautions to separate your child from those individuals
- If you are unable to stay home with your child during school dismissals, carefully consider who might be best positioned to provide childcare. If someone at higher risk for COVID-19 will be providing care (e.g., older adult, such as a grandparent or someone with a chronic medical condition), limit your children’s contact with those people
- Consider postponing visits or trips to see older family members and grandparents; Connect virtually or by writing letters and sending via mail
5.7. Am I more at risk if I am pregnant? The number of pregnant women studied has been very small, but in China pregnant women did not seem to be affected differently than other infected adults. Because of changes in their bodies, pregnant women can be at higher risk for severe complications from other respiratory diseases so it is important for pregnant women to protect themselves. Medical doctors and scientists are continuing to gather more information on the risks to mothers, fetuses, newborns, and caregivers.
5.8. What plans should I make if I am to delivery during the COVID-19 crisis? Families with infected mothers-to-be should prepare for how to protect other caregivers in their household, using the recommended methods to prevent spread, practice social hygiene, and clean/disinfect regularly. Stay in regular communication with your care provider.
5.9. What risk is there for passing COVID-19 from the infected mother to her baby? What preparations should the pregnant woman and her family discuss ahead of deliver? An NPR report states: “Early research has not shown any evidence that the virus can be transmitted in utero, during delivery or through breast milk. But transmission can occur after birth when infants are in close contact with someone who has the illness.”
This means that some normal hospital practices like keeping the mom and baby together, and allowing guests, need to be revised by healthcare staff to protect the infant and others to reduce the risk of the newborn and other family members from becoming infected. Pregnant women and their families should plan with their healthcare provider or midwife about how to protect the uninfected baby and other family members and care providers.
5.10 What precautions can I take if I am going to breastfeed my newborn child? CDC recommends that infected women who would like to provide breast milk for their infant use a breast pump, being sure to practice good pumping hygiene. Direct breastfeeding could also be possible if the infected mother wears a mask, but it is not currently the CDC’s first choice.
6.1. How can we prepare as a family? Here are some planning ideas:
- Create a household plan of action to help protect your health and the health of those you care about in the event of an outbreak of COVID-19 in your community
- Talk with the people who need to be included in your plan, and discuss what to do in your community; seek community resources and share to have food security
- Plan ways to care for those who might be at greater risk for serious complications, particularly older adults and those with underlying chronic medical conditions like heart, lung or kidney disease
- Create a list of local organizations that you and your household can contact in the event you need access to information, healthcare services, support, and resources.
- Create an emergency contact list of family, friends, neighbors, drivers, healthcare providers, teachers, employers, health department, and other community resources
6.2. What should I do if someone in my household becomes infected? The CDC suggests: Most people who get COVID-19 will be able to recover at home. Here are some guidelines:
- Stay home when you are sick, except to get medical care
- Use a separate room and bathroom for sick household members (if possible)
- Clean hands regularly by handwashing with soap and water or using an alcohol-based hand sanitizer with at least 60% alcohol
- Provide your sick household member with clean disposable facemasks to wear at home, if available, to help prevent spreading COVID-19 to others
- Clean the sick room and bathroom, as needed, to avoid unnecessary contact with the sick person
- Avoid sharing personal items like utensils, food, and drinks
If you develop emergency warning signs for COVID-19 get medical attention immediately. Emergency warning signs include:
- Trouble breathing
- Persistent pain or pressure in the chest
- New confusion or inability to arouse
- Bluish lips or face
6.3. What cleaning materials should I have on hand? Typical household cleansers and hygiene products will be sufficient: hand soap, laundry soap, bleach, etc. See the cleaning and disinfecting instructions in Item 4.6.
6.4. Can the virus be spread through food, refrigerated or frozen food items? Currently there is little evidence to support transmission of COVID-19 associated with food. However, before preparing or eating food it is important to always wash your hands with soap and water for 20 seconds for general food safety. Throughout the day wash your hands after blowing your nose, coughing or sneezing, or going to the bathroom. It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.
In general, because of poor survivability of these coronaviruses on surfaces, there is likely very low risk of spread from food products or packaging that are shipped over a period of days or weeks at ambient, refrigerated, or frozen temperatures. As a precaution, it is always good to practice good hygiene like washing all fruits and vegetables, especially if they may have been handled by many people, such as in a community market or a supermarket store.
7.1. What should I do if there is an outbreak in my community?
- Put your household preparedness plan to work (see item 6.1)
- Stay informed from trusted sources about the local situation
- Practice good hygiene and preventative practices
- Stay in touch with others
- Practice social distancing and reduce personal gestures like touching, kissing, hugging
7.2. What should parents do to protect their children during a community outbreak?
- Review and start activities under Section 5 above
- Stay calm, reassure your children, work cooperatively with them, tell them you will protect them
- Explain that the illness is usually mild and that children are less likely to have serious illness
- Do discourage children and teens from gathering to play or socialize as they normally do
- Find alternative activities and recreation opportunities that reduce exposure
7.3. Should I go to work in my community if there is an outbreak? Keep in touch with your workplace, co-workers and public notifications and restrictions.
8.1. When should I be tested? If you have the symptoms or have been in close contact with someone known to have COVID-19, contact or visit your healthcare provider. They will determine if you should be tested. For those with underlying conditions, or otherwise poor health, it is best to test as early as possible. Even if the symptoms are very mild, make sure these at-risk persons seek healthcare immediately. See the list in item 4.3 for those at high risk.
8.3. Can a person test negative and later test positive for COVID-19? Yes. If your healthcare provider has determined a person’s symptoms warrant testing, they will arrange for a test. If a test comes back negative, usually it means that person does not have COVID-19 and their illness is being caused by something else. However, if it is very early in the COVID-19 infection some people will test negative and sometimes must be tested several times. Especially if someone belongs to a high-risk group, even if they test negative, continue to monitor their symptoms and if they continue or worsen, be prepared to retest.
8.4. Can someone get COVID-19 more than once? Possibly. Typically, when a person is exposed to a disease and survives, that person builds protection (immunity) against that specific disease. However, sometimes the virus (or other infectious agent) will change and can cause a new infection (like the winter flu which changes every flu season). When a disease builds protection in a person, it can be long-lasting (“acquired immunity”) or short-lasting protection (“waning immunity”). Some early reports suggest to medical scientists that COVID-19 may only provoke short-term protection but other studies suggest it prompts long-lasting protection. Since there are no definite answers yet, people need to continue to be aware of the symptoms as re-infection is a possibility.
8.5. Am I at risk if I go to a funeral, wake, or visitation for someone who died of COVID-19? Am I at risk if I touch or kiss a person after they have passed away from COVID-19? This is a new disease so there is much to learn. While there have been no reports of people becoming infected from touching a person who has passed away, it is a good idea to refrain from doing so or practicing other local death rituals or burial customs that might be an opportunity for spread of the virus. This includes touching, kissing, washing/preparing/shrouding the body of the deceased, sharing food utensils or dinnerware, etc. Work with your faith and religious leaders to pay respects and honor your loved ones in accordance with protective behaviors.
9.1. “Masks don’t work.” It is true that masks are not guaranteed to stop illness. It depends on the material from which its made, the goodness of fit to a person’s face, how consistently it is used, etc. Viruses as aerosols are tiny and can indeed penetrate most types of masks. However, some studies show that using a mask is a 3-to 5-fold improvement over no barrier at all. A mask does help prevent spread from an infected person who is wearing one and therefore some protection for the person who is not wearing one. They are critical for healthcare workers, and home healthcare providers who are most at risk from caring for a large number of ill people. For uninfected people, using a mask in open spaces in public will make little difference. If the local or national government requires mask wearing by law, of course, as a public health strategy then wearing a mask can become mandatory.
9.2. “It is mutating into a more deadly strain.” Viruses like the coronavirus can indeed mutate very easily and sometimes become more deadly and sometimes less deadly. The factor that determines this is how easily is the virus transmitted to others. If we make it hard to transmit by our changes in personal and social behavior, the virus will become less deadly. Early in this epidemic, Chinese scientists discovered two strains of this virus, with one being more deadly than the other. One of the forms that has emerged more recently may indeed be more aggressively in infecting people. The honest answer is that we just don’t have enough information to know if and how this virus is changing.
9.3. “It is no more dangerous than the typical winter flu.” It is true that many people who get this virus will not feel ill or show symptoms. Overall, though, given how infective this virus is and how easily it is spread and with a death rate of perhaps 10 times that of the winter flu, COVID-19 is likely to be far more dangerous than the winter flu.
9.4. “It kills only the elderly, so younger people can relax and don’t need to use precautions.” Actually, most elderly people without underlying health conditions will not become critically ill with COVID-19. ALL persons can become infected—even young children—and small numbers of these will have a serious illness requiring hospitalization. The young and healthy who work in healthcare are at high risk due to higher levels of exposure in their work settings. The actions of young people in following health instructions, reporting mild illnesses, reducing their own exposure and protecting the more vulnerable will determine the overall infection rate and extent of sickness and death around the world. With 50% of those under aged 50 infected with COVID-19 in Europe requiring hospitalization, clinics and hospitals are in danger of running out of beds, equipment, and supplies. Younger people can help prevent this strain on health facilities.
9.5. “You need to be with an infected person for 10 minutes.” For winter flu, some hospital guidelines define exposure as being within 6 feet of infected person who sneezes or coughs for a period of 10 minutes or longer. We know a great deal more about this seasonal flu than we do this new coronavirus. It is important to note that one can become infected with shorter interactions and from objects on which the virus has survived.
9.6. “Pharmaceutical treatments (drugs designed for COVID-19) and a vaccine could be available within a few months.” Scientists are working overtime to discover effective drugs and to design a vaccine. However, the discovery, prove of effectiveness (“efficacy”), manufacturing, shipping and distribution are all time-consuming steps. The entire process is lengthy because the drug or vaccine must be shown to be safe and effective for humans. It is doubtful that a vaccine can be delivered in the next 12 months. However, medical doctors are studying some drugs already approved for other diseases and some of these preliminary studies show great promise. The best-case scenario is that a drug currently available will be shown to be safe and effective. Even this outcome will take several more months.
9.7. “This virus was made in a bioterror weapons lab either in China or elsewhere.” With every emerging infectious disease there is speculation and rumors that some military medical research unit has manufactured and released a virus either on purpose or by accident. These rumors have circulated about COVID-19 as well. The available evidence (from molecular epidemiology) argues against this hypothesis. While intentional manufacture is possible, it is not going to be known for some time and, at any rate, we as an interdependent, connected global community have to deal with this disease on practical terms no matter where it came from.
9.8. “This disease is a punishment from God for our sins or the deficiencies of those who are sickened.” As with the rumors of a bioterror weapon, this is a common response to the fear and panic of an unknown disease. This myth of God’s displeasure has surfaced throughout human history whenever we are confronted by a threat to our health and loved ones. The fact is that infectious diseases can affect all equally—the strong and the weak, the good and the bad, the rich and the poor, the faithful and the unfaithful, one faith vs. another, one race/ethnicity vs. another, the righteous and the sinful, the lucky and the unlucky. Our protective behaviors, our capacity for love and caring, enable us all and protect the most vulnerable among us. Diseases do not show bias or prejudice, only humans sometimes do.
9.9. “This disease can be spread by mosquitoes.” There is no evidence to suggest that COVID-19 can be spread by mosquitoes. Because it is a respiratory virus, it is spread primarily through droplets in the air or living on contaminated objects or surfaces.
[And from WHO myth busters page: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters]
9.10. “Antibiotics can prevent and treat COVID-19.” Antibiotics do not work against viruses, only bacterial infections. Antibiotics should not be used as a means of prevention or treatment. However, if you are hospitalized, you may receive antibiotics because of a co-occurring bacterial infection.
9.11. “Eating garlic can help prevent infection.” Garlic is a healthy food and may have some antimicrobial properties, but there is no evidence that it protects against COVID-19 infection. However, good nutrition is important in helping keep you healthy against any type of infection.
9.12. “Vaccines against pneumonia or influenza protect against COVID-19.”
Currently, there is not a vaccine for COVID-19. Vaccines against pneumonia, such as pneumococcal and Haemophilus influenza type B (Hib) vaccines, do not provide protection against the new virus. However, vaccination against these respiratory illnesses is highly recommended to protect your health and prevent co-infection.
9.13. “Spraying alcohol or chlorine or bleach all over your body kill COVID-19.”
Spraying alcohol or chlorine all over your body will not kill viruses that have already entered your body. Spraying these and other type substances can be harmful to clothes and can cause damage is swallowed or if they get into your eyes. Alcohol and chlorine can be used to disinfect surfaces, but they should be used appropriately.
The following measures ARE NOT effective against COVID-19 and can be harmful:
- Smoking or vaping
- Wearing multiple masks
- Taking antibiotics
- Relying on herbal remedies (except those known to improve nutrition and immune function generally)
- Drinking alcohol to excess
- Blaming others
- Self-medicating or taking powerful drugs when not under the care of a medical doctor
- Losing hope. God will never abandon you
The information in these materials can help towards developing a local plan. Planning needs to begin immediately. People are smart, tough, resourceful loving. The natural ingenuity and resilience of people can meet the task at hand. While public forums may be unwise, small steering committees should be formed immediately. The steering committee should have maximum diversity: females, males, youth, various occupations. They should use the information presented here to develop a plan for their church and for the community in which it is located. If several churches, mosques, temples, synagogues can work together that should prioritized. At any rate all materials and plans should be shared with other faith communities. COVID-19 in one group will affect other groups—the virus is not prejudiced or bigoted. That plan should be a single, clear, simple document. It should be communicated by a trusted leader.
- Churches and entire communities should have a plan
- For communities it should be down to the block-captain level (“quarter” of community)
- The churches and community leadership should integrate into any multi-sectoral, multi-stakeholder planning organization the government promotes (Ministry? NGO? CSO? etc.)
- Communicate regularly with government authorities
- Organize a registry to keep a list of all probable and confirmed cases by block
- Ask non-essential businesses to close
Those key areas that need to be addressed in the plan include:
- Establish a communications team and enable them to prepare print, digital and other forms of communications to the general public; post flyers and contact information for team Chairpersons and designated Community Health Workers
- Develop a transportation plan to take people to clinics and to testing facilities
- Organize community tailors and seamstresses to begin mask and gown production
- Acquire plastic shopping bags to modify into “handmitts” which allow maximum movement of fingers (minimally, this requires the bag and duct tape)
- Hold fundraisers and tap into economic cooperatives and local associations to purchase sewing supplies, cleaning and hygiene supplies.
- Distribute the completed products without prejudice through the churches
- Begin working with the church health committees and Community Health Workers to prepare education materials and presentations
- Begin conducting health awareness/health promotion activities
- Organize hand-washing stations at key locations in the community and create a team keep them stocked with soap and water
- Create a team to monitor & oversee the hygienic cleaning of communal hand pumps/
standpipes/spigots/faucets, community latrines
- Train CHWs to be watchful for early signs of infection
- Identify the “intrinsic resources” available (what skills, materials, labor pools are within the community already) and the “extrinsic resources” (those funds, supplies, materials that must come from outside)
- Create youth groups to prepare and deliver skits on good hygiene
- Emphasize the importance of social distancing and self-isolation
- Create an elder-care team to reach out to and provide food and supplies to elderly
- How to share this information with other faith communities and civil society organizations.