Coronavirus Disease 2019 (COVID-19)

(Presentation adapted from slides prepared by WHO colleagues)

Dr N. Paranietharan
WHO Representative to Indonesia

Townhall meeting, UN Indonesia

06 March 2020
Disclaimer: Information presented is valid as of 04 March and may change with time

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Epidemiology
• Coronaviruses can infect both animals and humans.
• Human coronaviruses can cause:
- mild disease (common cold); or
- severe disease (MERS - Middle East Respiratory
Syndrome and SARS – Severe Acute Respiratory
Syndrome).
• an animal source seems the most likely primary source.
• There is clear evidence of human-to-human
transmission.
• Incubation period can be from 1-12.5 days with median
estimates of 5-6 days.

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14/02/2020

The latest science on Author Most likely value Plausible range

the incubation period Liu et al. 4.8 days (±2.6 2–11 days
days)
Backer & 6.4 days (95%CI: 2.1 – 11.1 days (2.5 & 97.5
Wallinga 5.6-7.7) percentile)
Linton 4-5 days 2-9 days
Current estimates of the Zheng 5.174 days (CI: 4.46-6.037)
incubation period range Li et al. 5.2 days (95% CI, 4.1 to 7.0)
Lauer 5.2 days - median (95% CI 4.4-6.0)
from 1-12.5 days with (mean: 5.5)
median estimates of 5-6 Guan 3 days Range: 0–24 days
Yang Yang et 4.75 days IQR: 3.0-7.2 days
days. al.

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Clinical features
• Patients present with flu like symptoms: fever, cough,
shortness of breath
• Severity ranges from mild/moderate (80%) to severe
disease (15%) and critical cases (5%)

• Chinese authorities report 3 - 4% of people infected with

the virus have died
• People of all ages can be infected however persons over
60 years and those with pre-existing conditions (Diabetes,
heart disease, respiratory disease and hypertension) are
at higher risk of severe disease
• Children tend to have milder disease
• No known effective antiviral therapy for COVID-19 so far
• NO Vaccines so far
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14/02/2020
COVID-19 estimates on clinical severity

5%
critical

15% severe

80% mild

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Transmission of COVID-19
The spread of COVID-19 between humans is being driven by droplet transmission

• The virus is transmitted from a sick person to a healthy person through respiratory
droplets when the sick person coughs or talks close to another person.
• Current diagnostic tests have yielded positive results from a variety of specimens
including throat swabs from asymptomatic people and feces.

• These positive results are not a conclusive indication that people are contagious.
People may have been exposed and infected but are NOT necessarily transmitting
the disease. More investigations into potential other routes of transmission are
ongoing.
• What has been reported so far is that the main driver of transmission is droplet
transmission from people with symptoms.

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Protecting your community and family
members
 Advice for public: Basic Protective measures
• Wash your hands frequently with an alcohol-based hand rub or soap and water.
• Practice respiratory hygiene
When coughing and sneezing, cover mouth and nose with flexed elbow or tissue – discard tissue immediately
into a closed bin and clean your hands with alcohol-based hand rub or soap and water.

• Maintain social distancing

at least 1 metre (3 feet) distance between yourself and other people, , particularly those who are coughing,
sneezing and have a fever.

• Avoid touching eyes, nose and mouth

• If you have fever, cough and difficulty breathing, seek medical care early
• Avoiding unprotected contact with farm or wild animals.
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public
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Reduce your risk of coronavirus infection:
Frequently clean hands by
using alcohol-based hand
rub or soap and water. When coughing and sneezing
cover mouth and nose with flexed
elbow or tissue – throw tissue away
Thoroughly cook meat immediately and wash hands.
and eggs

Avoid close contact with anyone

that has fever and cough
Avoid unprotected
contact with live wild or
farm animals

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 Current guidance on Masks
 Masks to be used by:
- People with respiratory symptoms, e.g. cough or difficulty breathing. Including when seeking
medical attention;
- People providing care to individuals with respiratory symptoms;
- Health workers, when entering a room with patients or treating an individual with
respiratory symptom
 A medical mask is not required for members of the general public who do
not have respiratory symptoms
- However, masks might be worn in some countries according to local cultural habits. If masks
are used, best practices should be followed on how to wear, remove, and dispose of them
and on hand hygiene action after removal.
https://www.who.int/docs/default-source/coronaviruse/advice-on-the-use-of-masks-2019-ncov.pdf

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When you need to wear a mask and how to use it
Wash hands with alcohol-based hand rub
or soap and water

Cover mouth and nose and make sure

there are no gaps

Avoid touching the mask while using it

Do not re-use single-use masks

Remove it from behind (do not touch the

front of mask); discard immediately in a
closed bin; wash hands with alcohol-
based hand rub or soap and water
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While Travelling
Avoid travel if Avoid close contact
you have a with people suffering from a
fever and fever and cough
cough

If you have a fever, cough and difficulty

breathing seek medical care early and share
previous travel history with your health care Frequently clean hands by using
provider alcohol-based
hand rub or soap and water

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While Travelling
If you become sick while
travelling, inform crew
and seek medical care
early

If you seek medical attention, share

travel history with your health care
provider

Avoid touching
eyes,
nose or Avoid close contact and
mouth travel with animals that
are sick

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While Travelling
When coughing or sneezing cover
mouth and nose with flexed elbow
or tissue - throw tissue away
immediately and wash hands

Avoid spitting
in public

Immediately discard single-use If you choose to wear a mask, be

mask after each use and wash hands sure to cover mouth and nose –
after removing masks avoid touching mask once it’s on

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 Accelerating priority research and innovation
• Address crucial unknowns regarding clinical severity
extent of transmission and infection, laboratory,
treatment options and Vaccines
• Enhance global coordination of all relevant R&D
stakeholders through existing mechanisms
• Support a clear and transparent global research and
innovation priority setting process
• Key asks from the field:
- Point of care diagnostic test
- Evidence based treatment regime
- Vaccines

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 THANK YOU

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Medical staff members carry a patient into the Jinyintan hospital, where patients infected by a mysterious SARS-like
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virus are being treated, in Wuhan in China's central Hubei province on January 18, 2020. (AFP photo)