Notes on the coronavirus

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Relatives contact the ward staff in urgent cases, e.g. to accompany the dying. Accompanying persons are only permitted in justified exceptional cases, e.g. accompanying a sick child or a relative suffering from dementia, as well as fathers when their own child is born.

The patient to be admitted may be accompanied by one person.

The Robert Koch Institute's current assessment of the situation in Germany can be found at www.rki.de/covid-19-risikobewertung

Like other pathogens of respiratory diseases, an infection with the novel coronavirus can lead to symptoms such as coughing, rhinitis, neck scratching and fever. Some sufferers also suffer from diarrhoea. In some patients, the virus appears to be associated with a more severe course, leading to respiratory problems and pneumonia. However, deaths have so far mainly occurred in patients who were older and/or who had previously suffered from underlying chronic diseases. Currently, the proportion of deaths in which the disease has been confirmed by laboratory tests is around 2 percent. However, it is likely that this proportion is actually lower because the data refer to patients who have been treated in hospital.

The novel coronavirus is transmissible from person to person. Cases have also been reported of people who have contracted the disease from people who had shown only mild or non-specific signs of the disease.

The novel coronavirus primarily causes respiratory diseases (see "What signs of disease are caused by the novel coronavirus?) It can be assumed that the transmission - as with other coronaviruses - occurs primarily via respiratory tract secretions. The novel coronaviruses were also found in stool samples of some affected individuals. Whether the novel coronavirus can also be spread via the stool has not yet been conclusively clarified.

See also "How to protect against infection" and "In what situations is it useful to wear a mouth and nose protector in the general population to protect against acute respiratory infections?

It is currently assumed that it can take up to 14 days before signs of disease appear after an infection.

As with influenza and other respiratory diseases, adherence to the coughing and sneezing etiquette, good hand hygiene, and distance from the sick (about 1 to 2 meters) also protect against transmission of the novel coronavirus. These measures are also advisable in view of the wave of influenza everywhere and at any time.

Not all diseases following infection with the novel coronavirus are severe. In the cases that have become known in Germany, cold symptoms have so far mostly been in the foreground. The treatment of the infection focuses on the optimal supportive measures according to the severity of the clinical picture. A specific therapy, i.e. one directed against the novel coronavirus itself, is currently not available.

Category II contact persons (lower risk of infection)

Exemplary constellations:

• Persons who were in the same room as a confirmed COVID-19 case, e.g. classroom, workplace, but did not have cumulative face-to-face contact with the COVID-19 case for at least 15 minutes.
• Family members who have not had face (or speech) contact for at least 15 minutes.
• Laboratory personnel working with replicable SARS-CoV-2, provided adequate protective measures are taken.
• Medical personnel who were in the same room as the COVID-19 case, but who were never within 2 meters of the case.
• Medical personnel with contact ≤ 2 m (e.g. during care or medical examination), if adequate protective clothing has been worn during the whole time of contact according to category I
• Persons who have stayed in a risk area defined by the RKI in the last 14 days

Recommended procedure for the management of category II contact persons:

• If considered appropriate according to the risk assessment of the public health department, optional are possible:

  • Identification and registration by name,
  • Information about COVID-19.
• No daily monitoring of symptoms; report to the public health department after 14 days from the last contact with the confirmed case.
• Reduce contact with other people, e.g. suggesting isolation at home
• Generally in the household, if possible, separation in time and space of the contact person from other household members. A "separation in time" can be achieved, for example, by taking meals not together but one after the other. Physical separation can be achieved, for example, by the contact person being in a different room from the other members of the household.
• Frequent hand washing, adherence to a coughing label.
• Medical personnel: in case of continued exposure to COVID-19, additional daily documentation of protective equipment used (e.g. divided into gowns, gloves, surgical mask, FFP2, FFP3 mask, protective goggles).

• Note that if symptoms consistent with SARS CoV-2 infection occur (especially respiratory symptoms), the contact person should immediately contact the public health department to discuss further action. According to the RKI case definition, this person is also considered a "patient for further diagnostic clarification".

Source:Robert Koch Institute

Currently there is no vaccine available. According to media reports, a first vaccine candidate will be tested in a clinical trial in China from the end of April 2020 It is currently not possible to foresee when a vaccine might be available.

• Persons who have had personal contact (regardless of travel) with a person where the novel coronavirus has been detected in the laboratory and persons who have stayed in a risk area should generally avoid contact with other persons and contact the competent public health authority immediately. The contact data can be queried, for example, via a database of the Robert Koch Institute (RKI). If you need medical help, call and tell them you are in contact with a person who has been diagnosed with the novel coronavirus, or tell them about your trip, a doctor.

• For travellers from regions that are not risk areas but where transmissions are more frequent (e.g. China, Italy, Iran, South Korea), the following applies: If you develop a fever, cough or shortness of breath within 14 days of returning home, you should - after making an appointment by telephone and giving information about the trip - consult a doctor. You should also avoid unnecessary contact and stay at home if possible. Keep your distance when coughing and sneezing or turn away and hold the crook of your arm or a handkerchief in front of your mouth and nose. Dispose of used tissues immediately. You should wash your hands regularly and thoroughly with soap and water.

• Since 15.2.2020, a special procedure has been in force for all air travellers from China (see press release of the Federal Ministry of Health). Among other things, they will be asked whether they have had contact with people infected with coronavirus or have stayed in the infected area. Persons on board who are obviously ill or could have a contagious disease must be reported.

During your journey

• If you suffer from signs of illness such as fever, cough or shortness of breath during the flight, inform the flight crew immediately.

• If you are at the airport when signs of illness appear, inform the airport staff immediately.

• Since 15.2.2020, a special procedure has been in force for all air travellers from China (see press release of the Federal Ministry of Health). Among other things, they will be asked whether they have had contact with people infected with coronavirus or have stayed in the infected area. Persons on board who are obviously ill or could have a contagious disease must be reported.

If you have stayed in a risk area within the last 14 days

Avoid unnecessary contact with others and, regardless of any signs of illness, contact the responsible health office immediately by telephone and make reference to your trip. This will discuss necessary behavioural measures with you. You will find your responsible health office in a database of the Robert Koch Institute (RKI)

Coronaviruses, which can cause respiratory diseases, are usually transmitted via secretions of the respiratory tract. If these infectious secretions reach the hands, which then touch the face for example, transmission could also take place in this way. Therefore, good hand hygiene is an important part of prevention.

On the other hand, transmission via inanimate surfaces has not yet been documented. An infection with the novel coronavirus via surfaces that do not belong to the direct environment of a diseased person, such as imported goods, mail or luggage, therefore seems unlikely. In general, thorough hand washing is an important part of personal hygiene and can protect against a variety of other infectious diseases such as gastrointestinal disorders.

Irrespective of this, the Federal Centre for Health Education does not have any tasks in the field of evaluating foodstuffs or objects. Questions on this topic are the responsibility of the Federal Institute for Risk Assessment (BfR), while the Federal Institute for Occupational Safety and Health (BAuA) is responsible for the topic of occupational safety.

The most important and effective measures for personal protection as well as for the protection of other persons from infection with respiratory pathogens are correct coughing and sneezing etiquette, good hand hygiene and keeping a distance (approx. 1 to 2 metres) from persons suspected of being ill. However, these measures are advisable everywhere and at all times in view of the wave of influenza.

If a person suffering from an acute respiratory tract infection has to move around in public places, it may be advisable for this person to wear a mouth-nose protection (e.g. a surgical mouthguard) to reduce the risk of infecting other people with droplets produced by coughing or sneezing (foreign protection).

For optimum effectiveness, it is important that the mouth and nose protector is correctly positioned. This must be worn close fitting and must be changed when it becomes steam. It should not be moved (even unconsciously) while being worn. Ask a medical professional to advise you whether this measure is advisable in your particular case, which mask is suitable for you and how to put on or change the mask correctly.

On the other hand, there is not sufficient evidence that wearing a mouthguard reduces the risk of infection for a healthy person wearing it. According to the WHO, wearing a mask in situations where it is not recommended can create a false sense of security. This can lead to central hygiene measures such as good hand hygiene being neglected.

Health recommendations for trips abroad are given by the Federal Foreign Office. Up-to-date information on the security situation in individual affected countries can be found on the country pages of the Federal Foreign Office.

Further (technical) information on the novel coronavirus can be found on the website of the Robert Koch Institute.

The Federal Foreign Office provides an up-to-date assessment of the safety of travellers to affected regions.

In addition, you will find current assessments of the situation on the World Health Organization website.

The Federal Ministry of Health (BMG), some federal states and health insurance companies have set up hotlines for citizens.