The World Health Organization (WHO) declared COVID-19 a pandemic on 11 March 2020.
We are deeply concerned about how COVID-19 might affect people living in precarious environments such as the homeless, those living in refugee camps, or conflict-affected groups.
The high level of supportive and intensive care required has placed a heavy burden on some of the world’s most advanced healthcare systems.
MSF has been opening new projects in response to COVID-19 and adapting existing ones to help cope if cases are identified. On any given day, our staff treats tens of thousands of patients for a variety of illnesses in our medical programmes around the world. In many areas where we work, there are few medical organisations in a position to respond to an overload of patients.
Find out how we are responding to the pandemic around the world.
For comprehensive information, including how to protect yourself against the disease, please visit the World Health Organization's (WHO) COVID-19 webpage. For updated technical information and details on the evolution of the pandemic please see WHO's COVID-19 situational report page.
About the coronavirus disease (COVID-19)
- What is coronavirus disease (COVID-19)
COVID-19 (short for "coronavirus disease") is caused by a virus discovered in early January in China. It appears to be transmitted through droplets spread by coughing.
The virus affects the respiratory system. The main symptoms include general weakness and fever; coughing; and in later stages sometimes pneumonia and difficulty breathing.
Identified by Chinese scientists, the virus is now called SARS-CoV-2 because of its similarities to the virus that causes Severe Acute Respiratory Syndrome (SARS).
The coronaviruses are a large family of viruses, most of which are harmless to humans. Four types are known to cause colds, while two other types can cause severe lung infections (SARS and MERS – Middle East Respiratory Syndrome), similar to COVID-19.
Like all viruses, SARS-CoV-2 needs the cells of living beings to multiply. This virus 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, by coughing for instance.
- How is coronavirus transmitted?
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 one metre away from a person who is sick.
- How dangerous is coronavirus?
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.
- How can I prevent myself from being infected?
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.
- What are the symptoms of COVID-19?
The main symptoms are weakness and fever; dry cough and sore throat, which can lead to breathing problems - very similar to a cold or the flu.
These symptoms often get worse. Fevers become higher, there is increased pain in the chest and breathing can become very difficult. When this happens, some people might need to get oxygen or other breathing support from a healthcare facility.
People who have existing health problems like chronic lung diseases, asthma, heart disease and diabetes may find that the symptoms of that disease become more severe.
Access to healthcare
- Access to healthcare during COVID-19 pandemic
Preserving access to healthcare, both for COVID-19 patients as well as for any other patient, is paramount. This means ensuring that hospitals don’t become overwhelmed and that health staff can cope with the number of patients requiring intensive care and continue providing treatment to other patients who need it too.
- Protecting healthcare workers
Protecting healthcare workers from contracting the virus is paramount for ensuring the continuity of care for general and COVID-19-related health needs. However, global shortages of personal protective equipment (PPE) pose a great threat. Healthcare workers must have access to the equipment they need to do their jobs safely and effectively.
As research and development is underway to find effective treatment for coronavirus COVID-19, we are closely tracking the trials and evidence concerning the potential medicines in the pipeline.
Any drugs, tests and vaccines for COVID-19 should be made available to all those who need them. It is crucial that governments prepare to suspend or override patents for COVID-19 medical tools by issuing compulsory licences. Removing patents and other barriers will be essential in helping ensure that suppliers can sell tests and treatments at prices everyone can afford.
- Protecting people living in precarious settings
People living in overcrowded conditions, on the streets, in makeshift camps or in substandard housing are at particular risk. Many are already in poor health, often as a result of their poor living conditions and the virus thrives in such settings, without adequate water or sanitation. In addition, many of these marginalised groups are excluded from the formal healthcare system. In some places this means that hundreds of thousands if not millions of people are vulnerable, living in slums or in camp settings, in precarious living conditions without a social safety net to help them.
- Ensuring access to medicines, vaccines, and diagnostics
MSF seeks to ensure that the medical tools urgently needed to respond to COVID-19 are accessible, affordable, and available. All concerned stakeholders—including governments, pharmaceutical corporations, and other research organisations developing treatments, diagnostics, and vaccines—should take the necessary measures to:
- Prevent patents and monopolies from limiting production and affordable access;
- Establish a global coordination mechanism to ensure that there is a sufficient supply of COVID-19 medicines, vaccines, and diagnostics for people in low-resource settings and that all COVID-19 resources are allocated based on outbreak control needs; and guarantee access to repurposed drugs for patients suffering from diseases that are the original indication for use to ensure continuation of care;
- Prioritise the availability of the medical tools for protection and treatment of frontline healthcare workers; and
- Improve transparency and coordination by making sure an evidence-based approach is put in place to continuously monitor the risk of any supply chain vulnerabilities – and their impact on access to all essential medicines, vaccines and diagnostics – and to adopt measures to mitigate supply chain risks through international collaboration.