Questions and answers regarding novel coronavirus (COVID-19)

Q.  What is known about this new virus and related outbreak at this stage?

A.  The epidemic is caused by a coronavirus not previously found in humans, closely related to SARS coronavirus, now called SARS-CoV-2, and the illness is now known as COVID-19. This virus is not as deadly as SARS or MERS, which had death rates of 10% and 35% respectively, but this new virus seems much more contagious and has already had a greater impact in China and the rest of the workd than the SARS epidemic.

The origin of COVID-19 seems to be in Wuhan city in China and most early cases had connections to certain markets specializing in animal products in that city. This new virus seems to have arisen in bats, possibly with another animal host bridging the transfer to humans before human-to-human transmission became dominant.

 

Q. What is coronavirus?

A. Coronaviruses are known to infect humans and a variety of animals (including birds and mammals). This family of viruses usually cause mild acute respiratory illness in humans (the common cold) but may cause more severe or even fatal diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS) which are associated with specific virus types believed to have spread to humans from animals. MERS and SARS have caused large but localized or primarily health-care related (nosocomial) outbreaks. Those viruses have a high mortality rate but seem to be less transmissible between people than seasonal influenza. So far COVID-19 seems to have significantly lower mortality associated with it than MERS or SARS.

 

Q.  Is there a vaccine?

A. There are currently no vaccines against coronaviruses.


Q. What are the symptoms?

A. Human infections with COVID-19 present with symptoms resembling those of influenza (cough, fever, muscle pain, fatigue, etc.). As with influenza, some of those affected develop more severe symptoms, with breathing difficulties, commonly between 4–8 days after illness starts.

 

Q. Can you confuse COVID-19 with influenza?

A. Symptoms of COVID-19 resemble influenza, with cough, fever, body aches and fatigue being the most common symptoms. Abdominal symptoms (abdominal pain, nausea/vomiting, diarrhoea) are not very prominent with COVID-19 but have been described, as with influenza. Similar to influenza, COVID-19 can be associated with severe illness with a lower respiratory infection or pneumonia, which often presents as breathing difficulties on day 4-8 of illness.

 

Q. Who is at risk for severe symptoms?

A. Risk groups for severe infection have not been well defined. Most people who died in the early phase of the epidemic were elderly and suffered from chronic conditions, such as heart disease or high blood pressure, lung disease, diabetes or liver disease. At this time it is unknown whether immune suppressive treatment (ex. steroids, methotrexate, biologicals) increase the risk of severe COVID-19 infection. Serious illness seems uncommon in children but information on the disease in children is sparse.

 

Q. Are pregnant women at risk of severe disease?

A. There is no information available at this time about the risk of severe disease or complications of pregnancy related to COVID-19. There are no specific recommendations for pregnant travellers, only general travel recommendations related to COVID-19.

 

Q. What are the treatment options?

A. There is not specific treatment for this disease although several anti-viral medicines have been tried in China and results of these studies are eagerly anticipated. Treatment is based on the patients‘ needs and symptoms.

 

Q. Is it possible to diagnose COVID-19 infection in Iceland?

A. Yes. The test is available here. Testing for the virus in people without symptoms is not recommended, as the test is expected to be negative until the presentation of symptoms and may cause a false sense of security in people incubating the illness.

 

Q. What about human-to-human transmission?

A. Person to person transmission is confirmed. It is thought that contact and droplet contamination spread the disease, similar to influenza. This means that there is risk of spreading the virus when a person with the disease sneezes, coughs or wipes their nose, and a non-infected person breathes in droplets from the sick person or their hands are contaminated with the virus and they then touch their eyes, nose or mouth. The risk of spread before the infected person develops symptoms is not confirmed, however some people have minimal symptoms but may be contagious. See also the answer to “What can I do to avoid infection with COVID-19?”

 

Q. What is the risk of this outbreak spreading further?

A. Most continents have reported imported cases and in some places the infection has started to spread.

In the past, hygiene measures such as handwashing and covering the mouth and nose when coughing/sneezing as well as hospital infection control measures have been effective in controlling both SARS and MERS. Similar interventions are thought to be likely to reduce the rate of spread within Europe.

 

 

Q. What are the response measures undertaken in Iceland?

A. The official response in Iceland will be decided by to the threat posed by COVID-19 according to the most recent reliable information available:

  • Preparations in Iceland are made according to the response plans generated by the chief epidemiologist and the civil protection authorities
  • Guidance documents for health care workers have been updated and distributed
  • Instructions for the Icelandic public and travellers on how to approach the health care system when COVID-19 infection is suspected have been published.
  • International airports in Iceland will make preparations and respond as appropriate according to specific response plans already in place, as will ports.
  • Health care facilities are urged to update their response plans
  • No travel restrictions are in force relating to travel to and from Iceland but travellers are advised to avoid non-essential travel to risk areas and hygiene measures are recommended for travel in general.
  • No entry screening is recommended at this time but the information on how to approach the health care system in Iceland for illness relating to the epidemic will be distributed in various ways.
  • Inhabitants of Iceland regardless of nationality are requested to observe quarantine for 14 days after leaving risk areas before rejoining Icelandic society.

 

Q. Why are residents of Iceland advised to observe quarantine after travel from risk areas but tourists arriving from China/risk areas recently are not?

A.

  • Inhabitants of Iceland who participate in Icelandic society are in contact with a lot more people in the community and therefore pose a higher risk for spreading disease here than visitors who are here only for a few days. This applies regardless of nationality for residents in Iceland.
  • Foreign nationals who are travelling here and contact health care services for illness or guidance due to contact with persons with COVID-19 will also be placed in quarantine or isolation by the civil protection authorities.
  • To begin with we did not have direct flight connections with risk areas and there is no system in place to track travel routes of people arriving in Iceland. This matter has been under review. Now that COVID-19 has started to affect areas in Europe with direct flight connections with Iceland the situation must be reassessed.

Q. Will Iceland be closed for tourism?

A. The Chief epidemiologist in consultation with other authorities has the power to use harsh measures to limit the spread of epidemics according to the Act on Health Security and Communicable Diseases. The response should at all times be appropriate to the threat and repercussions of the response must be weighed against the effects of the epidemic. Existing response plans provide the framework for the consideration of response measures, where limitations on travel and transportation are considered in alert and emergency phases. The current response is according to uncertainty phase and the chief epidemiologist, civil protection authority and minister for health have determined that closing the borders is not appropriate at this time. The illness may be imported to Iceland by tourists but the experience in other European countries has shown that the greatest risk of infection is from those with close personal connections to the inhabitants, usually other inhabitants who have somehow been exposed to COVID-19. If the borders are closed residents now abroad would not be able to return home and all importation of provisions and exportation would be halted. Closing the borders now would additionally be of indefinite duration. The possibility for closing borders is continually reviewed in relation to the risk assessment at each time.

 

Q. Why is there no screening for COVID-19 at the airport here?

A. Testing for the virus in people without symptoms is useless for screening as the virus is not reliably identified in secretions before symptoms arise. Temperature measurements and questionnaires for passengers arriving from infected areas have been used in airports in various countries in previous epidemics, with little or no success. Quarantine of travellers from risk areas is much more likely to successfully limit spread. Sick individuals and contacts of sick individuals are also encouraged to step forward to access medical care and information on how to limit spread to others.

 

Q. What can I do to avoid infection with COVID-19?

A. Hand washing/sanitizer is the most important aid to avoiding infection. Washing with soap and water is preferred if hands are dirty, but if they seem clean but have touched common surfaces, such as doorknobs, or received items such as money or credit cards from the general public alcohol-based hand-sanitizer is useful. As much as is feasible, you should avoid contact with sick persons, in particular those with respiratory symptoms (sneezing, coughing, runny nose). Masks are most useful for those already infected to reduce droplet production when they cough or sneeze. Masks can also be of use for health care workers and first responders who must tend to sick people. When cleaning up after other people, for example in restaurants or public toilets, gloves may be useful, but it is of vital importance to remove gloves promptly and clean hands after the task is completed.

 

Q.  What is exposure to COVID-19?

A.  An individual who has been in close contact with a person ill due to COVID-19 has been exposed. Close contact means being within 1 meter distance from someone who is coughing or sneezing, or touching a sick person, sleeping in the same bed as a sick person, or staying in the same room or vehicle where someone is coughing or sneezing. Health care workers who have taken care of patients with COVID-19 may also be exposed, but as they habitually use protective equipment when taking care of patients with cough/sneeze this can mitigate their exposure and risk of illness. Because of the apparent wide spread of this virus in Wuhan city, all those who have been there are considered exposed to the virus. Coronaviruses cause symptoms within 14 days of infection, so only those who are within 14 days of their last exposure are considered at risk of illness.

 

Q. Is there a difference between quarantine and isolation?

A. Quarantine involves isolating a person who is well but may be a carrier of contagious disease from others.

Persons who are ill with suspected or confirmed COVID-19 would be placed in isolation, in or out of hospital.

For both quarantine and isolation, the key for successful interruption of disease spread is to limit interactions with other people, as detailed in instructions for people in isolation and quarantine. All material needs must be taken care of during the quarantine. The authority of the chief epidemiologist to implement quarantine procedures is layed out in article 12 of the Act on Health Security and Communicable Diseases

The Red Cross will assist those who require help with acquiring necessities during quarantine and isolation. Any person in quarantine or isolation in Iceland can contact the Red Cross Helpline at 1717 (+354 580 1710 from foreign numbers) or by webchat at www.1717.is. You can request assistance or information, seek support, or enjoy a confidential conversation. The Helpline is open 24/7 and free of charge.

 

Q.  I have been exposed to COVID-19, what should I do?

A. At this time there is no risk of exposure to the virus here in Iceland. If you have been traveling in risk areas in the past 14 days or otherwise in contact with COVID-19 infected persons, but have no symptoms of illness, please contact svl@landlaeknir.is. You will be asked for contact information and given information on recommended precautions and what to do if illness occurs while in Iceland. Testing for the virus in people without symptoms is not recommended, as the test is expected to be negative until the presentation of symptoms and therefore a negative result in a person without symtoms is unreliable.

 

Q. I think I am ill due to COVID-19, what should I do?

A. At this time there is no risk of exposure to the virus here in Iceland. If you have been traveling in risk areas or otherwise in contact with COVID-19 infected persons in the past 14 days, and now have symptoms of illness, please call 1700 (or +354 544 4113 if you are calling from a foreign phone number). You will be advised on precautions to prevent spreading the illness to others and how to access health care services appropriate to your degree of illness. In case of emergency call 112. Please remember to report your travel history and connection to COVID-19 when contacting the health care services. Please do not visit any clinic or hospital where others may also be exposed without calling ahead. While you wait for the results of the medical examination and possible testing for COVID-19, please review instructions for people in quarantine. If you cannot avoid contact with other people please consider using a facemask, or at least cover the nose and mouth with tissue when coughing or sneezing.

 

Q. Can I contract COVID-19 from opening packages sent from China?

A. No.

 

 

The chief epidemiologist is monitoring the situation closely and will update and add new information to this site as indicated.


Fyrst birt 24.01.2020
Síðast uppfært 25.02.2020

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