GloHSA Rapid Brief – CoronaVirus

https://glohsa.com/wp-content/uploads/2020/01/Rapid-Brief-Corona-Virus-25.01.2020.pdf

GloHSA recommendations to promote basic health security advice in light of current events in Wuhan, China: 

1) Containment measures are relevant regarding what is known and what remains to be known regarding the Wuhan outbreak and its development.

2) Containment measures should combine relevant population protection with as little as possible impact on worldwide socio-economic activity & flux.

3) Every doctor (with a special focus on dispensaries, hospitals, other healthcare facilities and assets) should be asked worldwide to carefully determine the travel history of their patients with a fever or an Influenza like syndrome. These patients should be triaged and considered a potential case if a coronavirus identified area has been visited until clinically and diagnostically proven otherwise. The travel history could be enhanced by the addition of the “dietary history” given that the wildlife host is still unclear and people are likely to have eaten bats, drunk cobra blood, and alike.

4) Post mortem immunohistochemical stains of victims’ organs are needed to understand the tropism of the virus (upper or lower respiratory tract, other organs?).

5) More data regarding the virus behavior should be documented such as the respective proportion of contaminated and exposed people without symptoms as well as the rate of spread of those asymptomatic cases, for those data may contribute to herd immunity and change the strategic response.

6) Data on healthcare worker infections, severity of infection, and mortality should be better documented and anticipated for it is of utmost importance not to weaken healthcare system under the potential coming pandemic pressure. To that respect, reasons why healthcare workers are contaminated despite personal protective equipment (PPE) is critical because it either highlight an unknown behavior of the 2019-nCoV or a lack of preparedness.

7) The emergency department-intensive care unit axis integrity is essential therefore the bigger issue is protection of highly specialized healthcare staff for whom the facility has no or limited backup.

8) Maintaining integrity of the global healthcare system is integral for maintaining social integration and order for any given community.

Because the basic reproduction number (Rt) is estimated to be 1.4 – 2.5 and the current case fatality rate is 3% (comparable to clinically recognized seasonal influenza (2%) and substantially less than SARS (10%) and MERS (35%)), the interest of the followings is still under scrutiny:

• Any patient with a fever or Influenza like symptoms should be delayed or denied boarding any collective transportation assets (aircraft, ships, trains, buses, timeshare services…).
• Any patient with a fever or Influenza like symptoms should not be granted entry into a territory where no coronavirus cases have been declared.
• Any patient with a fever or Influenza like symptoms will benefit from quarantine, isolation or a sound diagnosis including virus identification (depending on the local resources/assets).