COVID-19 Crisis Info - 13 March 2020
More than 100 countries have now reported cases, and on 11 March, the WHO declared COVID-19 as a pandemic. Most countries still have only sporadic cases or defined clusters. 90% of the 118K cases are being reported from four countries: cases in China are now decreasing, but there are major outbreaks in Italy, Iran and South Korea. In other countries, including Europe, the numbers are growing exponentially.
This is a new contagious virus and much remains to be understood. Unlike influenza, there is no known pre-immunity, no vaccine, no specific treatment and everyone is presumed to be susceptible.
This will be a mild or moderate respiratory illness for the vast majority (estimated 80% of confirmed cases) but it has a higher rate of quite severe complications for vulnerable people (elderly and people with comorbidities) than other viruses such as flu.
Based on current data (WHO joint mission report from China) 20% of the confirmed cases will be severe and require hospitalisation for sustained monitoring and supportive treatment. 6% of the total confirmed cases will require critical care provision (about 30% of those hospitalised).
The high level of supportive and intensive care required has placed a heavy burden on some of the world’s most advanced hospital systems.
Public measures such as isolation, quarantine and social distancing are generally put in place to limit uncontrolled community transmission, slow down the number of cases and severely ill patients and protect the most vulnerable and manage the collective health resources. However, these measures should not lead to an increased risk of transmission within a household and particularly for the more vulnerable family members.
Please note that this data is based on what is available so far and may vary somewhat in each scenario. (Countries have different policies for testing, so the proportion of confirmed cases with complications will also vary according to how much testing is done of non- complicated cases for example) WHO’s interim guidance and other information on coronaviruses can be found here
Epidemiologic Situation – as of 12 March
- Total cases since the declaration of the epidemic: 162.443 – 90% of which from China, Italy, Iran and South Korea
- Total number of deaths: 4641
- Countries and regions affected: more than 100
- These numbers change regularly – one website to check for the latest numbers is here
What are MSF’s main concerns?
MSF is extremely concerned about how COVID-19 might affect populations living in precarious environments such as the homeless, those living in refugee camps in Greece or Bangladesh, or conflict-affected populations in Yemen or Syria. These people are already living under harsh and often unhygienic conditions and their access to health care is already severely compromised. They may have more difficulty to implement the preventive measures and face obstacles to access healthcare.
It is very important to inform people on what protective measures to take and that they have the means to protect themselves(washing hands and self-isolation in case of high-risk contact with COVID-19 patients). Generally, we are very concerned about how COVID-19 outbreaks will affect countries with already fragile health systems, such as in CAR or Yemen. In many areas where we work, there are few medical actors in a position to respond to an overload of patients. We want to make sure that we continue to ensure care for all patients where we work today, and that our medical teams are prepared to manage potential cases of COVID-19.
It is clear that we must do everything to prevent and delay further spreading of the virus. It is already straining some of the world’s most advanced healthcare systems. 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.
Infections of healthcare staff can happen easily in structures that are overwhelmed by large numbers of patients, and that have to deal with limited supplies of personal protective equipment for staff and probably reduced workforce (as healthcare staff will also be part of confirmed cases through transmission in the community).
Infected healthcare staff will further reduce the capacity to admit and treat patients. Safety for healthcare workers should be a top priority in every healthcare facility. We know from our experience that trust in the response and in health authorities is an essential component for outbreak control. Clear, timely, measured and honest communication and guidance is needed.
People need to be empowered to protect themselves. In order to ensure that the medical tools urgently needed to respond to COVID-19 are accessible, affordable, and available; concerned stakeholders including governments, pharmaceutical corporations and other research organizations developing treatments, diagnostics, and vaccines should take the necessary measures to
- prevent patents and monopolies from limiting production and affordable access;
- guarantee access to repurposed drugs for patients suffering from diseases that are the original indication for use to ensure the continuation of care;
- prioritise the availability of the medical tools for the protection and treatment of front-line healthcare workers; and
- Improve transparency and coordination, making sure an evidence-based approach is put in place to continuously monitor the risk of the potential supply chain vulnerability on essential medical tools and to adapt mitigate measures when needed through international collaboration.