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Advice and information to the public about novel coronavirus COVID-19

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The novel coronavirus COVID-19 was discovered in January 2020. How can we prevent infection? What should people who have been to the outbreak areas do if they become sick? Which measures are not recommended and why? The information and advice will be updated based on how the outbreak develops and current knowledge about the disease.

Foto: Colourbox.com
Foto: Colourbox.com

The novel coronavirus COVID-19 was discovered in January 2020. How can we prevent infection? What should people who have been to the outbreak areas do if they become sick? Which measures are not recommended and why? The information and advice will be updated based on how the outbreak develops and current knowledge about the disease.


Preventing infection

As with colds and influenza, the virus is transmitted from the respiratory tract of a sick person.

To prevent infection, people should keep at least one metre away from people with respiratory symptoms and those who are ill should avoid coughing or sneezing directly onto others. Try to cough / sneeze into a paper tissue (disposed carefully afterwards) or into the crook of the elbow.

Good hand hygiene, both among the sick and the healthy, is important to prevent transmission of infection. Wash hands frequently and thoroughly with soap and lukewarm water, especially when you have been in contact with other people. Hand disinfection is a good alternative if hand washing is unavailable. If your hands are visibly dirty or wet, hand disinfection has a limited effect so hands should be cleaned with soap and water.

There is no vaccine against the disease.

Cough etiquette and good hand hygiene reduce the risk of respiratory infections, including coronavirus infections

There are a variety of respiratory infections, with colds and influenza being the most prevalent. Good respiratory hygiene/cough etiquette and hand hygiene help to prevent transmission of all respiratory infections, including the novel coronavirus. If you are coughing and sneezing, try to have tissues and hand cleaning facilities available, otherwise use the crook of your elbow.

How are respiratory infections transmitted?

Respiratory infections spread when viruses or bacteria from the respiratory tract of a sick or infected person are transmitted to another person, often via the mouth and mucous membranes of the eyes and nose.

When a sick or infected person speaks, coughs or sneezes, droplets of infectious agents are thrown into the air. Anyone nearby can breathe in air with infectious agents, or get them on their face or hands and then transfer them to their mouth, nose or eyes. This type of infection is called droplet infection. The droplets will usually fall to the ground within a metre of the person coughing / sneezing if they do not land on anyone or anything. In some respiratory infections, the infectious agent is so tiny that it can stay suspended in the air for long periods and may be transported over longer distances. This is airborne transmission, and makes the infectious agent more contagious.

Contact transmission is also a common route for respiratory infections. The infectious agent is transmitted by physical contact between the sick person and other people, or indirectly when objects become contaminated, for example by coughing and sneezing on them. If others touch the contaminated objects, they will then get the infectious agents on their hands and potentially transfer them to their mouth or mucous membranes.

Respiratory hygiene/ cough etiquette - important for preventing droplet infection

Simple measures can reduce the risk of droplet infection. If you have a respiratory infection, try to stay away from other people. Cough and sneeze into tissues and dispose of them into a waste bin immediately after use. Always perform hand hygiene (hand washing or hand disinfection) before touching objects that others may touch. If tissues are unavailable, cough or sneeze into the crook of your elbow. These measures will limit both the spread of infection in the air and to nearby objects.

Cough and sneezes often come unexpectedly and we often do not have tissues or hand washing facilities available. Since infectious agents may be carried in the respiratory tract without us being ill, avoid coughing on others even when you are feeling well. It is a good habit to avoid coughing out in the air when someone is nearby. If you are near others, cough or sneeze into the crook of your elbow. If you cough directly into your hands, it is easy to transmit infectious agents to your hands and then directly to others or indirectly via objects. Always perform hand hygiene if coughing or sneezing directly into the hands.

Good hand hygiene - important to prevent contact transmission

Hand hygiene is an effective measure to prevent disease. People who are sick should perform hand hygiene when there is a risk of having an infectious agent on their hands (for example, after wiping their noses), before touching nearby objects. Hand washing with soap and lukewarm water is recommended, but hand disinfection is a good alternative and can also be performed while in bed. It is also important that family members and others who come into contact with the sick are vigilant about hand hygiene after contact with the sick person or with contaminated items (such as used tissues).

Face masks not recommended

This is not recommended for healthy people. This does not apply if you work in the healthcare service or are in contact with a person with confirmed or suspected infection with COVID-19. They are often used incorrectly and people who use face masks tend to touch their face more often which can increase the risk of infection. People who are sick can use face masks to prevent infection to others.

Import of goods and receipt of parcels from China

Currently, there is no indication that there is any risk associated with the purchase of goods and receipt of parcels from China, as long as this does not involve import of live or dead animals. This also applies to parcels that have been sent via China on their way to Norway.

People who have been in areas with ongoing transmission

Healthy people who have stayed in areas with an ongoing spread of COVID-19 (currently mainland China) during the last 14 days and develop symptoms of respiratory disease (fever, cough and other respiratory symptoms) within 14 days of their return, should seek medical attention (by phone) if they arise.

If they have not been in contact with a confirmed case and do not have symptoms they can be in contact with others. Good hand and respiratory hygiene/cough etiquette is advised.

Healthy people who have been in close contact with a confirmed case (person diagnosed with the virus) during the last 14 days should seek medical advice and will be followed up.

When should you seek medical attention?

People who develop signs of respiratory infection during the first 14 days after returning from an affected area, or after close contact with someone who has tested positive for the virus, should seek medical attention. Symptoms of respiratory infection include cough, fever, sore throat, chest pain and breathing difficulties. Contact the doctor’s office by telephone before the consultation. Tell the doctor where and when you have been travelling. Examination of healthy people returning from China is generally not recommended. 

Airports and other entry points

China has initiated screening of travellers by plane from China (exit screening). This includes health checks, questions about possible exposure to infection and information material. People with symptoms or who report contact with others who were sick should not board the aircraft and should be followed up locally. If implemented effectively, this is an important intervention to prevent further spread.

There are no direct flights from Wuhan and Hubei Province to Norway. Screening, for example through taking temperatures on arrival by plane to Norway is not considered to be effective (partly because infected people may be in the incubation phase) and is not recommended. At the major airports, information is provided to travellers who have been in affected areas about what to do and who to contact in case of symptoms of respiratory infection.

Quarantine

When considering preventive measures, any anticipated benefits are weighed against costs, feasibility, ethical considerations, public attitudes and the Infectious Disease Control Act. With the current situation, quarantine of everyone who has been to outbreak areas is considered inappropriate. It is an infringement of civil liberty, and during earlier epidemics, quarantine on arrival was not shown to be particularly effective.

However, the Norwegian Institute of Public Health does recommend a form of quarantine for those at high risk of infection. This applies to people who have been in close contact with someone diagnosed with the COVID-19 infection. Quarantine at home is recommended for healthy people who are at high risk of infection. They will be followed up by healthcare personnel to see if they develop symptoms within 14 days of their last possible exposure. They should avoid unnecessary travel and social contact, including going to work, school or shops.

Healthy people who have been in areas with outbreaks without being in close contact with a confirmed case are informed that they should be alert for symptoms of respiratory disease within 14 days of their return, but they do not need to be quarantined. If they become ill, they should seek medical attention by telephone.

Much is still unknown about the disease, but it appears that it is not very contagious before symptoms develop. Our advice is aligned with the other Nordic countries, the World Health Organization (WHO) and the European Centre for Disease Control (ECDC).

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Facts

Coronavirus

SARS-CoV-2 is the name of the virus that is causing the outbreak of COVID-19 disease.

The virus is related to another coronavirus that caused the SARS outbreak in 2002/2003 but is not the same virus.