SOUTHERN CAPE NEWS - In a press briefing on 24 February, World Health Organisation (WHO) Director General, Dr Tedros Ghebreyesus, said the Covid-19 outbreak has the "potential" of becoming a global pandemic, "but we are not there yet".

"For the moment we are not witnessing the uncontained global spread of this virus and we are not witnessing larger scale severe diseases or death. Does this virus have pandemic potential? Absolutely it has. Are we there yet? From our assessment, not yet."

He said a report compiled by a WHO-China joint mission highlights questions for which there are still not answers, but "the key message that should give all countries hope, courage and confidence is that this virus can be contained". He said the team estimates that the measures taken in China have averted a significant number of cases. 

There are many countries that have managed to contain the virus, but the sudden increase in cases in Italy, the Islamic Republic of Iran and the Republic of Korea are "deeply concerning". 

Yet, the decision about whether to use the word pandemic is based on an ongoing assessment of the geographical spread of the virus, the severity of disease it causes and the impact it has on the whole society.

Fatality rate
The WHO-China mission found that there has been no significant change in the DNA of the virus, and the fatality rate is between 2% and 4% in Wuhan and 0,7% outside Wuhan.

The team also found that for people with mild disease, recovery time is about two weeks while people with severe or critical disease, recovery is within three to six weeks. 

Furthermore, their research showed that the Covid-19 epidemic in China peaked and plateaued between 23 January and 2 February and has been declining steadily since then, "which is encouraging", said Ghebreyesus.

Families, individuals must also focus on preparing
“So how should we describe the current situation?” he asked.

“What we see are epidemics in different parts of the world affecting countries in different ways and requiring a tailored response. The sudden increase in new cases is certainly very concerning ... This is a time for all countries, communities, families and individuals to focus on preparing ... We must focus on containment while doing everything we can to prepare for a potential pandemic.”

He stressed that all countries must prioritise protecting their health workers first, and then engage their communities to protect people who are most at risk of severe disease, particularly the elderly and people with underlying health conditions. 

"And thirdly, we must protect countries that are the most vulnerable by doing our utmost to contain epidemics in countries with the capacity to do it.”

NICD: how to prevent transmission
Prof Cheryl Cohen, head of respiratory diseases and meningitis at South Africa's National Institute for Communicable Diseases (NICD), says regular hand-washing and coughing or sneezing into your sleeve or into tissues and disposing of these carefully, are the best way to prevent the spread of any respiratory virus. 

Keep hand sanitiser on hand at all times. When travelling to China, don't visit any live animal markets. If you feel safer when travelling, use a face mask, although there is no evidence of the prevention capability of this measure.

She said South Africa is ready for the coronavirus. Routine screening is being done at all the ports of entry and the staff is aware of what to do should any suspected case be reported. 

The necessary information has been made available to all health care workers and the health department is ready to detect, manage and contain any case of Covid-19.

In the United States, the Centre for Disease Control and Prevention has issued the following strategies for employers:

Actively encourage sick employees to stay home:

• Employees who have symptoms of acute respiratory illness are recommended to stay home and not come to work until they are free of fever (37,8° C or greater using an oral thermometer), signs of a fever, and any other symptoms for at least 24 hours, without the use of fever-reducing or other symptom-altering medicines (e.g. cough suppressants).

• Ensure that sick leave policies are flexible and that employees are aware of these policies.

• Talk with companies that provide your business with contract or temporary employees about the importance of sick employees staying home and encourage them to develop non-punitive leave policies.

• Do not require a healthcare provider’s note for employees who are sick with acute respiratory illness to validate their illness or to return to work, as healthcare provider offices and medical facilities may be extremely busy and not able to provide such documentation in a timely way.

• Employers should maintain flexible policies that permit employees to stay home to care for a sick family member. Employers should be aware that more employees may need to stay at home to care for sick children or other sick family members than is usual.

Separate sick employees:
• Employees who appear to have acute respiratory illness symptoms (i.e. coughing, shortness of breath) upon arrival at work, or who become sick during the day, should be separated from other employees and be sent home immediately. Sick employees should cover their noses and mouths with a tissue when coughing or sneezing (or an elbow or shoulder if no tissue is available).

Emphasise the importance of staying home when sick, respiratory etiquette and hand hygiene by all employees:

• Place posters that encourage staying home when sick, cough and sneeze etiquette, and hand hygiene in workplace areas where they are likely to be seen.

• Provide tissues and no-touch disposal receptacles for use by employees.

• Instruct employees to clean their hands often with an alcohol-based hand sanitiser that contains 60 to 95% alcohol, or wash their hands with soap and water for at least 20 seconds. Soap and water should be used preferentially if hands are visibly dirty.

• Provide soap and water and alcohol-based hand rubs in multiple locations or conference rooms in the workplace. Maintain adequate supplies.

Perform routine environmental cleaning:

• Routinely clean all frequently touched surfaces, such as workstations, countertops and doorknobs.

• Provide disposable wipes so that commonly used surfaces (for example doorknobs, keyboards, remote controls, desks) can be wiped down by employees before each use.

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