On January 30, 2020, the first imported case of COVID-19 (formerly referred to as Novel Coronavirus) was confirmed from a 38-year-old Chinese national who had arrived in the Philippines on January 21 from Wuhan, China via Hong Kong.

The Department of Health (DOH) in the Philippines has since reported three confirmed COVID-19 cases with over a hundred admitted patients under investigation (PUI) as of February 26.

As this health situation continues to rapidly evolve it is important for the public to know the right information on the virus and be equipped with ways to protect themselves and their families both at home and in the workplace.

The Coronavirus Disease (COVID-19)

The 2019-nCoV was identified in January 2020 as the cause of an outbreak of pneumonia originating in Wuhan, China, which initially started in December 2019. Around 25% of cases in China are severe and a growing number of fatalities have been recorded.

The virus was renamed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), and the disease that it causes was called Coronavirus Disease (COVID-19).

About Coronaviruses

Coronaviruses are a large family of viruses, some of which can infect people. Some cause mostly mild illness, such as the strains responsible for certain types of common cold. Others can potentially lead to severe, or even fatal disease - such as the Middle East Respiratory Syndrome Coronavirus (MERS-CoV), which continues to circulate in some parts of the world.

The Severe Acute Respiratory Syndrome (SARS) outbreak in 2003 was also caused by a coronavirus. It caused severe and fatal disease but is no longer in circulation.

The natural reservoir for coronaviruses is thought to be animal hosts. New strains that emerge from this reservoir infect an ‘intermediate’ host, and from there lead on to infect people. The viruses may then be capable of being transmitted from one person to another. Some viruses are efficient at human-to-human transmission, whilst others are not.

Symptoms of COVID-19

While the illness is still being studied it is known that the common symptoms include fever, cough, shortness of breath and difficulty of breathing. It is important to note however that these symptoms are not limited to COVID-19. Respiratory illnesses and pneumonia caused by other organisms (including bacteria) and other viruses (such as influenza) can also cause these symptoms.

COVID-19 can cause severe illness and a growing number of infected people have died. It is possible that people with underlying health conditions are at a higher risk for severe disease.

How does COVID-19 spread?

The transmission of the disease is from person to person, i.e. from a sick person to others who are in close contact. Although the exact way this happens is still being investigated it is probably occurring in the same way as other respiratory infections, including colds and flu, are transmitted, through infected respiratory droplets. The sick person expels these when they cough, sneeze, or talk. Others can get the disease via contact (direct or indirect) with these contaminated droplets.

Initially the virus may have 'jumped’ from the environment to humans. Preliminary information suggests that this coronavirus was “zoonotic” - transmitted from an animal source to humans. The initial group of cases appeared to have a common source of exposure - a live animal and seafood market in Wuhan, China.

What are some practical tips to protect ourselves?

• Avoid potential exposure. Practice good hygiene measures and safe food practices.
• Avoid direct contact with animals (live or dead) and their environment. Do not touch surfaces that may be contaminated with animal droppings.
• Keep some distance from people who are obviously sick.
• Maintain good personal hygiene. Wash your hands frequently. Carry a hand sanitiser for use when soap and water are not readily available. Avoid touching your face.
• Ensure food, including eggs, is thoroughly cooked.
• Do not travel if you are sick. Note that some locations have implemented screening and travellers may face quarantine and testing.

When do we use face masks?

There two types of face masks available in the market: surgical masks and respirators (i.e. N95 masks). The N95 mask is recommended for health professionals who work with patients for long periods of time. The surgical mask is the most commonly used mask that helps to prevent the spread of infection.

The World Health Organization (WHO) has provided a simple guideline when to use a face mask and the proper way to put on, use, take-off and dispose of a mask:

When to use a mask

• -       For healthy people wear a mask only if you are taking care of a person with suspected COVID-19 infection.
• -       Wear a mask, if you are coughing or sneezing.
• -       Masks are effective only when used in combination with frequent hand-cleaning with alcohol-based hand rub or soap and water.

How to put on, take off and dispose of a mask

• -       Before putting on a mask, clean your hands with alcohol-based hand rub or soap and water.
• -       Cover your mouth and nose with the mask and make sure there are no gaps between your face and the mask.
• -       Avoid touching the mask while using it; if you do, clean your hands with alcohol-based hand rub or soap and water.
• -       Replace the mask with a new one as soon as it is damp and do not re-use single use masks.
• -       To remove the mask: remove from behind (do not touch the front of mask); discard immediately in a closed bin; clean hands with alcohol-based hand rub or soap and water.

What is the treatment for COVID-19?

The treatment of the new coronavirus is supportive with medication to reduce fever and to support and improve respiratory function. There is no specific antiviral therapy against this disease however trials are underway.

Is there a vaccine against COVID-19?

There is no available vaccine against COVID-19, however research and development has commenced.

Can we still travel outside the Philippines?

As of January 30, 2020, several flight operators announced temporary suspension or the reduction of flights on routes serving China amid travel restrictions imposed in the country to contain the COVID-19 outbreak. We advise travelers to defer all travel to Hubei province in China due to official travel restrictions in place in some cities, plus the potential for further sudden restrictions on departure and the risk of quarantine at their next destination. Members should also defer travel to other areas of China as advised by their local national authorities. Even in the absence of such advisories, members should consider deferring non-essential travel to the rest of mainland China based on their own considerations and risk assessment.

Is it safe to travel within the Philippines?

While there has been no directive from the DOH that prohibits travel within the Philippines, caution must still be taken especially with non-essential travel. Screening measures in public establishments such as airports, hotels and resorts are in place with respective protocols on those who have recently traveled to countries with travel bans due to COVID-19.

On February 18 the DOH together with the Department of Interior and Local Government (DILG), and the Department of Tourism (DOT) issued a joint statement on public gatherings assuring everyone that it is “safe to organise and attend public gatherings, meetings, and festivals as long as all precautionary measures identified by the DOH are observed”.

The DOH further reminded the general public on proper hand hygiene and to seek medical attention when symptoms of cough, colds, sore throat and fever are present.

Dr. Irene Umayam, International SOS Philippines