A new coronavirus was first reported in Wuhan, China, on December 31, 2019. This new virus presents particular dangers: there is no known pre-immunity, no vaccine, and no specific treatment. The virus is contagious, and everyone is presumed to be susceptible. Doctors Without Borders/Médecins Sans Frontières (MSF) teams are working in projects around the world to fight the spread of coronavirus, and to sustain other lifesaving medical aid for communities who are further threatened by this pandemic.
Coronaviruses are a large family of viruses, most of which are harmless for humans. Four types are known to cause colds, and two other types can cause severe lung infections: Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). The novel coronavirus is now known as SARS-CoV-2, because of its similarities to the virus that causes SARS.
This new coronavirus seems to target cells in the lungs, and possibly other cells in the respiratory system too. Cells infected by the virus will produce more virus particles, which can then spread to other people, for instance by coughing.
On February 11, the World Health Organization named the disease caused by the new coronavirus: COVID-19. Both the virus and the disease were unknown before the outbreak began in Wuhan. The overwhelming majority of cases were initially concentrated in China, however the disease has now spread worldwide. On March 11, the WHO declared the COVID-19 outbreak a pandemic. As of May 11, there were more than 4,116,767 cases of coronavirus in 213 countries, territories, or areas, and 282,872 people have lost their lives. There are now more cases in the United States (1,364,517) than in any other country.
Our understanding of this new coronavirus and COVID-19 is still evolving. The virus can spread from person to person, including by people who appear to have no symptoms. This makes it much harder to get a good picture of the way it’s spreading.
The WHO notes that coronavirus can be transmitted through small droplets from the nose or mouth which are spread when an infected person coughs or exhales. People can catch COVID-19 by touching objects or surfaces contaminated with the virus, and then touching their eyes, nose, or mouth. People can also be infected if they breathe in droplets from a person with coronavirus who coughs out or exhales droplets. The WHO recommends staying more than three feet away from a person who is sick.
The latest estimates are that 80 percent of the people who get infected with the new coronavirus will experience a mild or moderate form of disease. Roughly 15 percent will develop a severe form of the disease requiring hospitalization. Some 5 percent will become critically ill. Sophisticated health care systems may be able to cure some critically ill patients, but the danger is that even the most advanced systems may be overwhelmed by the large numbers of people who will need to be hospitalized.
The high level of supportive and intensive care required to treat patients with COVID-19 places real challenges to even the most advanced health care systems. MSF is very concerned about the potential consequences in countries with weak or fragile health care systems.
COVID-19 is more dangerous for elderly people or people suffering from other infections or ailments. Children so far seem to be less affected by the disease. The mortality rates vary significantly from place to place.
Public health measures such as isolation, quarantine, and social distancing are generally put in place to limit community transmission, reduce the number of new cases and severely ill patients, protect the most vulnerable people, and manage health resources.
It’s important to protect yourself and protect others too. As with other coronaviruses, droplet infection seems to be the main mode of transmission. The virus enters the human body through the mouth or nose. This can happen by breathing in infected droplets, or by touching with your hands a surface on which droplets have landed, and then touching your eyes, nose, or mouth later.
Simple infection control measures such as good handwashing and proper cough and sneeze etiquette are effective and important for prevention.
Hand hygiene is paramount, so wash your hands often with soap and water. Use enough soap, and make sure all parts of both your hands are washed. Spend at least 20 seconds washing your hands. If there is no visible dirt on your hands, an alcohol-based gel is also a good option.
Stay home when you are sick, and avoid contact with other people. If you cough or sneeze, cover your mouth and nose with a tissue or with the inside of your elbow. Throw used tissues into a wastebasket immediately and wash your hands.
Social distancing is advised in places with community transmission of the virus. Avoid crowded places and large gatherings, and generally keep some physical distance between you and other people.
Given the current problems with the supply of masks, gloves, and other personal protective equipment, the needs of health care staff should be prioritized.
Our teams are responding to the coronavirus emergency on multiple fronts—caring for patients, offering health education and mental health support, and providing training for vital infection control measures in health facilities around the world. MSF is working with local authorities in many of the countries where we have medical projects to help prepare for the impact of COVID-19. A key priority is to keep our regular medical programs running for the tens of thousands of patients and extremely vulnerable communities we help support. This pandemic threatens the lives of people around the world, and presents even greater risks in countries with weak or fragile health systems.
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Note: MSF teams are responding to the coronavirus pandemic in the more than 70 countries where we run existing programs, as well as opening projects in other countries that have become outbreak hotspots.This is a selective list of projects specifically related to MSF’s COVID-19 response, as of May 7, 2020. Our activities are evolving on a daily basis, and teams are working on epidemic preparedness in practically all our medical projects. Preparedness may include a range of activities, such as how we reorganize triage and waiting areas; strengthen infection prevention and control (IPC) measures; and provide technical advice and training on IPC to other health workers and national ministries of health staff.
Highlights of our global response so far include:
USA: In response of the outbreak of COVID-19 in the United States, we are working with local authorities in key locations around the country and partner organizations that serve vulnerable populations that are normally excluded from healthcare, such as migrants and the homeless, and communities that are especially likely to be left behind during a health emergency.
In New York City, the current epicenter of the global pandemic, MSF is helping reduce the spread of COVID-19 by partnering with local organizations to improve IPC measures for vulnerable populations. MSF has opened a temporary relief station in Manhattan, offering free showers, toiletries, clean socks and undergarments, and information on additional services for people who currently lack access to hygiene facilities. We’ve also donated more than 140 handwashing stations to facilities like soup kitchens and supportive housing facilities, and we are distributing 1,000 mobile phones to vulnerable New Yorkers who lack the essential technology needed to contact emergency and support services. We are supporting New York City’s Department of Homeless Services in developing a webinar training on COVID-19 and IPC practices.
In Immokalee, Florida, where some 10,000 to 20,000 migrant farmworkers have continued to labor during the pandemic with minimal access to health care and testing, we are working closely with the Coalition of Immokalee Workers, the Department of Health, and local organizations and health care providers to implement a multifaceted COVID-19 response. MSF is running a public health education campaign and mobile “virtual” clinics, which provide COVID-19 testing and remote medical consultations for COVID-19 and other health issues.
MSF teams are also on the ground assessing local needs and our capacity to offer support to organizations and health care providers serving vulnerable communities in Puerto Rico, including persons affected by the recent earthquakes in the Southwestern part of the island, and Native American populations in the American Southwest. We also are providing remote support—such as advising on IPC and hospital triage set up and providing informational materials on COVID-19 best practices—to organizations helping vulnerable populations in various other geographic areas of the US. Learn more.
MSF’s international medical programs are impacted by the current travel restrictions, which limit our ability to move staff between countries. We also are dealing with the consequences of global shortages of medical supplies, in particular personal protective equipment for health care staff. Our regular health care programs are also preparing to deal with potential cases of COVID-19, especially making sure infection prevention measures are respected. We must be able to receive people with COVID-19, while making sure that no one is consequently infected in our structures, including other patients as well as staff.
We need to ensure that we can continue to provide lifesaving medical care in our ongoing projects. So far, teams are able to continue medical activities, but securing future supplies of key items—such as surgical masks, swabs, gloves, and chemicals used to diagnose COVID-19—is a matter of concern. There is also a risk of supply shortages due to a lack of production of generic drugs and difficulties to import essential drugs due to lockdowns, reduced production of basic products, exportation stops, or the repurposing and stocking of drugs and material for COVID-19.
MSF also seeks to ensure that any new treatments or vaccines developed to respond to COVID-19 are accessible, affordable, and available to all.
Teams are also preparing for potential cases of COVID-19 in our projects. Protecting patients and health care workers affected by the pandemic is essential. In places where there is a higher chance of cases, this means ensuring that infection prevention and control measures are in place, setting up screening at triage, maintaining isolation areas, and providing health education. In most countries where MSF works, we are coordinating with the WHO and the respective Ministries of Health to see how MSF could help in case of a high load of COVID-19 patients. We are also providing training on infection control for health facilities