Coronavirus disease (COVID-19) advice for the public

Wash your hands frequently

Regularly and thoroughly clean your hands with an alcohol-based hand rub or wash them with soap and water.

Why? Washing your hands with soap and water or using alcohol-based hand rub kills viruses that may be on your hands.

Maintain social distancing

Maintain at least 1 metre (3 feet) distance between yourself and anyone who is coughing or sneezing.

Why? When someone coughs or sneezes they spray small liquid droplets from their nose or mouth which may contain virus. If you are too close, you can breathe in the droplets, including the COVID-19 virus if the person coughing has the disease.

Avoid touching eyes, nose and mouth

Why? Hands touch many surfaces and can pick up viruses. Once contaminated, hands can transfer the virus to your eyes, nose or mouth. From there, the virus can enter your body and can make you sick.

Practice respiratory hygiene

Make sure you, and the people around you, follow good respiratory hygiene. This means covering your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose of the used tissue immediately.

Why? Droplets spread virus. By following good respiratory hygiene you protect the people around you from viruses such as cold, flu and COVID-19.

If you have fever, cough and difficulty breathing, seek medical care early

Stay home if you feel unwell. If you have a fever, cough and difficulty breathing, seek medical attention and call in advance. Follow the directions of your local health authority.

Why? National and local authorities will have the most up to date information on the situation in your area. Calling in advance will allow your health care provider to quickly direct you to the right health facility. This will also protect you and help prevent spread of viruses and other infections.

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Credit: WHO

WHO declares Coronavirus a Global Health Emergency

The World Health Organization has declared Coronavirus a global health emergency with 82 cases so far identified in 18 countries.

There are now 7711 confirmed and 12167 suspected cases throughout China. Of the confirmed cases, 1370 are severe and 170 people have died. 124 people have recovered and been discharged from hospital.

The WHO Secretariat provided an overview of the situation in other countries. There are now 82 cases in 18 countries. Of these, only 7 had no history of travel in China. There has been human-to-human transmission in 3 countries outside China. One of these cases is severe and there have been no deaths.

The Committee welcomed the leadership and political commitment of the very highest levels of Chinese government authorities, their commitment to transparency, and the efforts made to investigate and contain the current outbreak. China quickly identified the virus and shared its sequence, so that other countries could diagnose it quickly and protect themselves, which has resulted in the rapid development of diagnostic tools.

The Committee emphasized that the declaration of a PHEIC should be seen in the spirit of support and appreciation for China, its people, and the actions China has taken on the frontlines of this outbreak, with transparency, and, it is to be hoped, with success. In line with the need for global solidarity, the committee felt that a global coordinated effort is needed to enhance preparedness in other regions of the world that may need additional support for that.

World Bank Mobilizes US$300 Million to Finance the Ebola Response in Democratic Republic of Congo

The World Bank Group on Wednesday announced that it is mobilizing up to US$300 million to scale up support for the global response to the Ebola epidemic in the Democratic Republic of Congo (DRC).

A World Health Organization (WHO) worker prepares to administer a vaccination during the launch of a campaign aimed at beating an outbreak of Ebola in the port city of Mbandaka, Democratic Republic of Congo May 21, 2018. REUTERS/Kenny Katombe

The announcement follows the declaration by the World Health Organization (WHO) that the current outbreak constitutes a Public Health Emergency of International Concern.

“Together, we must take urgent action to stop the deadly Ebola epidemic that is destroying lives and livelihoods in the Democratic Republic of Congo”, said World Bank Chief Executive Officer Kristalina Georgieva. “The communities and health workers on the front line of this outbreak urgently need more support and resources from the international community to prevent this crisis from worsening inside the country and from spreading across borders.”

The US$300 million in grants and credits will be largely financed through the World Bank’s International Development Association (IDA) and its Crisis Response Window, which is designed to help countries respond to severe crises and return to their long-term development paths. The financing package will cover the Ebola-affected health zones in DRC and enable the government, WHO, UNICEF, WFP, IOM and other responders to step up the frontline health response, deliver cash-for-work programs to support the local economy, strengthen resilience in the affected communities, and contain the spread of this deadly virus.

This amount is approximately half of the anticipated financing needs of the Fourth Strategic Response Plan (SRP4), which is expected to be finalized in the coming week by the Government and the international consortium of partners working on the response. The World Bank has been supporting programs to combat DRC’s ongoing battle with Ebola since May 2018, with resources going to the frontline response, health system strengthening, and preparedness to reduce the risk of spread.

The US $300 million in World Bank financing announced today comes in addition to the US$100 million disbursed by the World Bank and the Pandemic Emergency Financing Facility (PEF) in response to the current Ebola Outbreak in DRC since August 2018. Details on the Bank’s total financing for the DRC Ebola response to date are available here. 

Ebola has spread across communities already beset by the severe hardships of extreme poverty and insecurity. The World Bank’s engagement in DRC is focused on investing in people, supporting communities, strengthening services and systems, which are all critical steps to stamping out this crisis—and to tackle the underlying sources of poverty and inequity that have helped fuel this deadly outbreak.

Tuberculosis Diagnosis in People with HIV Increases Risk of Death Within 10 Years

NIH-Supported Analysis Identified Elevated Mortality in Large Latin American Cohort

Dr. Samuel Pierre examines a patient at the GHESKIO clinic in Port-au-Prince, Haiti. 
Credit: NIAID

Among people with HIV in Latin America, those diagnosed with tuberculosis (TB) at an initial clinic visit were about twice as likely to die within 10 years as people not initially diagnosed with TB, according to findings from a large observational study. This increased risk persisted despite the availability of TB treatment and mirrored patterns seen previously in HIV-negative populations, according to research supported by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. Investigators from the NIAID-supported Caribbean, Central and South America Network for HIV Epidemiology (CCASAnet) presented the findings today at the Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle.

People with HIV are at greater risk of TB disease than HIV-negative people without HIV due to HIV-related immune system damage as well as geographical and behavioral risk factors shared by both diseases. In 2017, the World Health Organization estimates there were 920,000 new TB cases among individuals with HIV globally, and approximately 300,000 people with HIV died from TB. Due to this large burden of HIV and TB co-infection, NIAID supports research to improve TB prevention, diagnosis, and treatment in the context of HIV infection.

“Tuberculosis remains the leading cause of death for people with HIV globally,” said NIAID Director Anthony S. Fauci, M.D. “This new analysis shows how devastating TB can be for people with HIV and underscores the need to do more to prevent and treat this co-infection.”

Investigators analyzed the clinical records of 15,999 people with HIV who received care in CCASAnet clinics in Brazil, Chile, Haiti, Honduras, Mexico and Peru. Each participant remained in care for at least 9 months after their first clinic visit; they had not received antiretroviral drugs to treat HIV infection before arriving at the clinic. 

Researchers found that 1,051 individuals—nearly 7 percent—were diagnosed with TB during their first visit and were prescribed anti-TB and HIV medications. After 5 years of observation, approximately 10 percent of patients with TB had died, compared with fewer than 6 percent of those without TB at their initial visit.  This pattern continued: after 10 years of observation, more than 19 percent of the group initially diagnosed with TB had died, compared with 10.5 percent of the group without an initial TB diagnosis. Investigators measured 5- and 10-year survival rates beginning at 9 months after each patient’s initial clinic visit, at which time most people recover from TB with standard treatment. 

“In recent years, the research community has observed that tuberculosis—even when treated and cured—is associated with an increase in an HIV-negative person’s long-term risk of mortality,” said Serena P. Koenig, M.D., M.P.H., assistant professor at Harvard Medical School and a lead study investigator. “Now we know this is also true for people living with HIV, but many questions remain as to why that is and how to lower that risk.”

In addition to an initial TB diagnosis, lower CD4 T-cell counts, older age and lower education levels also were associated with an increased risk of death in the 10-year follow-up period. The analysis did not take cause of death or personal health history—including previously cured TB infections—into account. Researchers also did not confirm how many individuals who received TB and HIV treatment continued treatment as directed, achieved HIV suppression to an undetectable viral load, cured their TB or experienced additional TB infections after successfully clearing TB disease identified at their initial clinic visit. The severity of TB infection was also not included in the analysis.

“Many factors may play a role in this increased risk of death among people with HIV,” said Catherine C. McGowan, M.D., associate professor at the Vanderbilt University Medical Center and co-principal investigator of the CCASAnet network. “Our study has revealed an important pattern in clinical outcomes, but further research is needed to improve our understanding of the relationship between HIV and tuberculosis coinfection and to guide evidence-based treatment recommendations for this significant population.”

Reference:  Morality after presumed TB treatment completion in persons with HIV in Latin America.  S Koenig et al. Conference on Retroviruses and Opportunistic Infections, Seattle. March 6, 2019. 

Harmful use of alcohol kills more than 3 million people each year, most of them men

More than 3 million people died as a result of harmful use of alcohol in 2016, according a report released by the World Health Organization (WHO).

This represents 1 in 20 deaths. More than three quarters of these deaths were among men. Overall, the harmful use of alcohol causes more than 5% of the global disease burden.

WHO’s Global status report on alcohol and health 2018 presents a comprehensive picture of alcohol consumption and the disease burden attributable to alcohol worldwide. It also describes what countries are doing to reduce this burden.

“Far too many people, their families and communities suffer the consequences of the harmful use of alcohol through violence, injuries, mental health problems and diseases like cancer and stroke,” said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “It’s time to step up action to prevent this serious threat to the development of healthy societies.”

Of all deaths attributable to alcohol, 28% were due to injuries, such as those from traffic crashes, self-harm and interpersonal violence; 21% due to digestive disorders; 19% due to cardiovascular diseases, and the remainder due to infectious diseases, cancers, mental disorders and other health conditions.

Despite some positive global trends in the prevalence of heavy episodic drinking and number of alcohol-related deaths since 2010, the overall burden of disease and injuries caused by the harmful use of alcohol is unacceptably high, particularly in the European Region and the Region of Americas.

Globally an estimated 237 million men and 46 million women suffer from alcohol-use disorders with the highest prevalence among men and women in the European region (14.8% and 3.5%) and the Region of Americas (11.5% and 5.1%). Alcohol-use disorders are more common in high-income countries.

Global consumption predicted to increase in the next 10 years

An estimated 2.3 billion people are current drinkers. Alcohol is consumed by more than half of the population in three WHO regions – the Americas, Europe and the Western Pacific. Europe has the highest per capita consumption in the world, even though its per capita consumption has decreased by more than 10% since 2010. Current trends and projections point to an expected increase in global alcohol per capita consumption in the next 10 years, particularly in the South-East Asia and Western Pacific Regions and the Region of the Americas.

How much alcohol are people drinking?

The average daily consumption of people who drink alcohol is 33 grams of pure alcohol a day, roughly equivalent to 2 glasses (each of 150 ml) of wine, a large (750 ml) bottle of beer or two shots (each of 40 ml) of spirits.

Worldwide, more than a quarter (27%) of all 15–19-year-olds are current drinkers. Rates of current drinking are highest among 15–19-year-olds in Europe (44%), followed by the Americas (38%) and the Western Pacific (38%). School surveys indicate that, in many countries, alcohol use starts before the age of 15 with very small differences between boys and girls.

Worldwide, 45% of total recorded alcohol is consumed in the form of spirits. Beer is the second alcoholic beverage in terms of pure alcohol consumed (34%) followed by wine (12%). Worldwide there have been only minor changes in preferences of alcoholic beverages since 2010. The largest changes took place in Europe, where consumption of spirits decreased by 3% whereas that of wine and beer increased.

In contrast, more than half (57%, or 3.1 billion people) of the global population aged 15 years and over had abstained from drinking alcohol in the previous 12 months.

More countries need to take action

“All countries can do much more to reduce the health and social costs of the harmful use of alcohol,” said Dr Vladimir Poznyak, Coordinator of WHO’s Management of Substance Abuse unit. “Proven, cost-effective actions include increasing taxes on alcoholic drinks, bans or restrictions on alcohol advertising, and restricting the physical availability of alcohol.”

Higher-income countries are more likely to have introduced these policies, raising issues of global health equity and underscoring the need for greater support to low- and middle-income countries.

Almost all (95%) countries have alcohol excise taxes, but fewer than half of them use other price strategies such as banning below-cost selling or volume discounts. The majority of countries have some type of restriction on beer advertising, with total bans most common for television and radio but less common for the internet and social media.

“We would like to see Member States implement creative solutions that will save lives, such as taxing alcohol and restricting advertising. We must do more to cut demand and reach the target set by governments of a 10% relative reduction in consumption of alcohol globally between 2010 and 2025,” added Dr Tedros.

Reducing the harmful use of alcohol will help achieve a number of health-related targets of the Sustainable Development Goals (SDGs), including those for maternal and child health, infectious diseases, noncommunicable diseases and mental health, injuries and poisonings.

1 in 4 adults are inactive

Launch of new global estimates on levels of physical activity in adults

New data published in The Lancet Global Health on Wednesday show that more than one in four adults globally (28% or 1.4 billion people) are physically inactive. However this can be as high as one in three adults inactive in some counties.

The paper, authored by four World Health Organization experts, reports data that update 2008 estimates on levels of activity and, for the first time, reports trend analyses showing that overall, the global level of inactivity in adults remains largely unchanged since 2001.

Women were less active than men, with an over 8% difference at the global level (32% men vs 23%, women). High income countries are more inactive (37%) compared with middle income (26%) and low income countries (16%).

These data show the need for all countries to increase the priority given to national and sub-national actions to provide the environments that support physical activity and increase the opportunities for people of all ages and abilities, to be active every day.

The new Global Action Plan on Physical Activity sets the target to reduce physical inactivity by 10% by 2025 and 15% by 2030.

Regular physical inactivity increases peoples risk of poor health, including cardiovascular disease, several types of cancer and diabetes, falls, as well as mental health conditions. Publication of levels of participation in children and young people are forthcoming.

African Union commends the Congolese Government for its swift response in containing the Ebola outbreak

The African Union (AU) Commission, through the Africa CDC, will procure six laboratory diagnostic (Genexpert) machines and 2,000 cartridges (testing kits) for a total of US$ 147,000 to be donated to the Government to support diagnosis of Ebola virus diseases and other outbreak diseases.

Moussa Faki Mahamat, commends the Congolese Government for its swift and effective response

This comes following official announcement by the Government of the Democratic Republic of the Congo, on 24 July 2018, of the end of the Ebola virus outbreak in the country.

The Chairperson of the Commission of the African Union, Moussa Faki Mahamat, commended the Congolese Government for its swift and effective response since the outbreak was declared on 8 May 2018 in the province of Equateur.

The last case that tested negative was 42 days ago. This, as per the World Health Organization guidelines and International Health Regulations, marks the end of the outbreak.

The Chairperson of the Commission notes that the timely declaration of the outbreak, in accordance with the International Health Regulations, as well as the leadership and pro-activeness demonstrated by the Congolese Government, allowed a coordinated and efficient intervention of all concerned partners to swiftly contain the outbreak.

“The African Union Commission, through the Africa Centers for Disease Control and Prevention (Africa CDC), has made a significant contribution to the efforts aimed at containing the outbreak, in support of the Congolese-led response. The Africa CDC deployed health personnel in the affected areas, trained more than 300 local experts, procured diagnostic equipment, and supported the DRC Ministry of Health in central coordination of the response at national level,” he noted, adding that the African Union will continue to support the efforts of the Congolese Government during the 90-day period of enhanced surveillance following the official end of the Ebola outbreak.

The Ministry of Health of the Democratic Republic of Congo (DRC) declared the end of the Ebola Virus Disease (EVD) outbreak in Equateur province on 24 July 2018, after sustained national-led efforts to contain it within the affected areas.

The outbreak spread across three health zones, namely Bikoro, Iboko and Wangata in the Equateur Province, resulting in a total of 54 confirmed cases, with 33 EVD-related deaths.

On 8 May 2018, the Ministry of Health of the DRC declared a new outbreak of the EVD in the Bikoro health zone. This was the 9th outbreak of EVD over the past four decades in the country.

Following the declaration of the outbreak, the African Union (AU) Commission, through the Africa Centre for Disease Control and Prevention (Africa CDC), took a number of steps to contribute to the Government-led response, including the activation of its Emergency Operational Centre (EOC) to monitor and coordinate the AU response from the Headquarters; deployment of an advanced team of two epidemiologists within 48 hours following the outbreak, to support the Congolese Government efforts; and deployment of 37 staff both at Headquarters and to the field, including 21 surveillance experts in the affected health zones, as part of the Government-led response.