COVID-19 is a contagious new 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.
MSF is very concerned how the COVID-19 pandemic will affect people in countries with already fragile health systems. 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.
Of particular concern is 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 and overcrowded conditions and their access to health care is already compromised.
People in these areas may have more difficulty to implement the recommended preventive measures and face obstacles to access healthcare. It is very important to inform people on what protective measures to take (such as often washing their hands) and that they have the means to protect themselves (including self-isolation in case of contact with a person infected with COVID-19).
Challenges in ensuring continuous care in MSF projects
We want to ensure continuous care for all patients where we work today, and that our medical teams are prepared to manage potential cases of COVID-19. Protecting patients and healthcare workers is essential, so our medical teams are also preparing for potential cases of COVID-19 coronavirus in our projects.
More research and information is needed on COVID-19 in patients co-infected with other diseases such as malaria, dengue, TB or measles. that are hugely prevalent in many areas where we work.
In places where there is a high chance of seeing a number of cases, this means ensuring infection prevention and control measures are in place, including setting up screening at triage zones, creating isolation areas, and providing health education.
In most countries where MSF works, we are coordinating with the World Health Organization (WHO) and local ministries of health to see how MSF could help in a situation with a high number of COVID-19 patients. We are also providing training on infection prevention and control for health facilities in a number of countries.
Our projects are still able to continue medical activities, but ascertaining future supplies of certain key items, such as surgical masks, swabs, gloves and chemicals for diagnosis of COVID-19, is of concern. There is also a risk of supply shortages for other diseases due to a lack of production of generic drugs and difficulties to import essential drugs (such as antibiotics, antimalarial and antiretroviral drugs), caused by community lockdowns, reduced production of active pharmaceutical ingredients, and reduction in export movements.
We face additional challenges because current travel restrictions linked to COVID-19 are limiting our ability to move staff between different countries.
MSF response to COVID-19 coronavirus
It is clear that healthcare workers need support and patients need care. Given the size of this pandemic, MSF’s ability to respond on the scale required will be limited.
In Italy, which is now the second-most affected country (after China), we have begun supporting four hospitals in the epicentre of the outbreak, in the country’s north, with infection prevention and control measures, as well as providing care to patients.
In Hong Kong, we are providing health education and mental health support for vulnerable groups. Staff in health facilities in Cambodia and Papua New Guinea have received training.
In Iran, MSF has submitted a proposal to the authorities to help care for patients with COVID-19.
Whether we’ll be able to make similar offers to other countries will depend on the nature of the outbreak but also on our capacity to send staff.
About COVID-19
COVID-19 will be a mild respiratory illness for the vast majority of people (estimated 80 per cent 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 from WHO, 20 per cent of confirmed COVID-19 cases will be severe and those people will require hospitalisation for sustained monitoring and supportive treatment. Six per cent of total confirmed cases will require critical care provision (about 30 per cent 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, protect the most vulnerable, and manage the collective health resources.
However, these measures should not lead to an increase risk of transmission within a household and particularly for more vulnerable family members. They should also not hinder or delay medical care for patients suffering from any other disease.
As the research and development is underway for effective treatment for COVID-19, we are closely tracking the trials and evidences concerning the potential medicines in the pipeline.
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.