What is the new coronavirus? The 2019-nCoV Coronavirus (presently designated SARS-CoV-2) is a new variant of the coronaviruses family , initially detected at the end of 2019, in patients associated with a fish market in the city of Wuhan (Hubei Province, China). It results from a mutation apparently originating in animals and subsequently transmitted to humans, not being known for sure how that happened. The SARS-CoV-2 is similar to other coronaviruses, such as SARS (Severe Acute Respiratory Syndrome, identified in China) and MERS-CoV (Middle East Respiratory Syndrome, identified in Saudi Arabia and other Middle East countries). How is it transmitted? It is not yet known how the virus was transmitted to humans. However, we do know that the transmission between humans is made through droplets associated with coughing and expectoration , as well as through contact with contaminated surfaces or objects . Transmission occurs between individuals even before the onset of the disease. There is also the possibility of transmission by aerosol (airborne particles of very small dimension), essentially at the time of particular procedures in health units. Most cases existing in Europe and all cases diagnosed in Portugal result from transmission originated in China or from people who contacted cases originating from that country. How does the disease manifest itself? As in other viral infections, the number of people that carry the virus, without developing the disease (asymptomatic carriers) is unknown. The disease caused by SARS-CoV-2 is designated COVID-19 (Coronavirus Infectious Disease 2019) and its symptomatology is essentially respiratory, s imilar to flu syndrome, consisting in fever, coughing, expectoration and respiratory difficulty . Not all symptoms are simultaneously present. The disease is more severe in older people, people with chronic diseases or under medication suppressing immune defenses . Most occur as a disease with no complications. About 20% of cases develop a severe situation. Mortality ranges from 2 to 3.5% of known cases of disease. How can you protect yourself? The main preventive measure is not to travel to those areas with active infection . Given the evolution of the situation, it is advisable to consult the updated information available in DGS site or ECDC site . According to DGS instructions the active communitarian transmission areas of COVID-19 are China, South Korea, Japan, Singapore, Iran, and the regions of Emiglia-Romagna, Lombardia, Piemonte and Veneto, in Italy. This information was forwarded by DGS on February 27, 2020. Therefore, avoidable travelling to those regions is strongly advised against . If absolutely necessary, the use of face mask is recommended in the presence of people with respiratory symptoms or in enclosed spaces, also being recommended frequent hand washing with water and soap or with alcohol-based solutions , after contact with surfaces or objects of common use. Given the rapid evolution of the situation, covering increasingly larger areas and involving more restrictions to mobility, travels abroad not necessary are globally not recommended . Health professionals must strictly comply with the instructions provided locally and nationwide. In daily life, washing hands with water and soap after contact with common use surfaces and avoiding to touch the face and the eyes with uncleaned hands, are essential measures. How to proceed when returning from an infected area? If you returned from an active communitarian transmission area of COVID-19 in the last two weeks… AND/OR … if you contacted in the last two weeks with one or more cases of confirmed or probable cases of COVID-19, determined by the health system… AND/OR … if you have fever (>38ºC) or other respiratory symptoms (coughing, expectoration, shortness of breath)… … you must contact Emergency Line SNS 24 (808 24 24 24) and follow the instructions provided. In the Região Autónoma da Madeira, contact Emergency Line SRS 24 Madeira (800 24 24 20). What is a suspicious case? A suspicious case refers to a person presenting a fever higher than 38oC, coughing, expectoration or respiratory difficulty , and: coming from an area of active communitarian transmission; and / or having contacted with a probable or confirmed case of asymptomatic carrier or presenting the disease (COVID-19). What is a situation of low risk of contagion? This is a situation where there was only occasional contact : a person who remained in an enclosed environment with a confirmed case of COVID-19 up to 15 minutes or at a distance of over two meters; a person who had contact with a confirmed case of COVID-19 up to 15 minutes or at a distance of over two meters. What is a situation of high risk of contagion? This is a situation where there was close contact : A person living in the same house as a confirmed case of COVID-19 . A person who had direct physical contact with a confirmed case of COVID-19 (example: greeting). A person with direct unprotected contact with infectious secretions of a confirmed case of COVID-19 (example: exposure to coughing, handling paper tissues with unprotected hands). A person with unprotected contact at a distance of less than two meters and for at least 15 minutes with a confirmed case of COVID-19 . A person who remained without protection in an enclosed environment with a confirmed case of COVID-19, during at least 15 minutes and at a distance of less than two meter s (example: classroom, meeting room, waiting room of a health unit). A health professional or other direct caretaker in unprotected contact with a confirmed case of COVID-19 , or laboratory workers involved in the manipulation of biological products of a confirmed case of COVID-19, without protection or with possible breach in the protection equipment. Contact in an aircraft with a confirmed case of COVID-19 , in the two adjacent seats (in any direction) and members of the crew involved in the assistance in the area of a confirmed case of COVID-19 (if the seriousness of the symptoms or movements of the confirmed case of COVID-19 inside the aircraft point to a higher risk of exposure, all the passengers in that area and even the whole aircraft could be considered proximal contacts).
