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Stay safe from COVID-19
Stay safe from COVID-19

12 March 2020

Due to the increasing concern related recent upgrade of COVID-19 to pandemic status, it is important that all Two Oceans Marathon runners, their families, close contacts, staff, and all stakeholders involved stay informed and understand how to best protect themselves from illness. Together with relevant health authorities, the TOM medical team is monitoring the situation and undertake to update you on the latest developments and plans to limit any risks.

The following information is based on the World Health Organisation (WHO) and the National Institute for Communicable Diseases (NICD) guidelines. This is not meant to cause unnecessary alarm, but the  health of  the TOM participants, all affiliates, and the global community as a whole is of paramount importance.

What  is  COVID-19  (Coronavirus)?

Human coronaviruses are common throughout the world. The  name  corona refers to a crown because these viruses have crown-like spikes on its surface. There are numerous different coronaviruses identified in animals, but only  a small number  of these can cause disease in humans. They are a common causes of illness in humans throughout the world. Occasionally coronaviruses infecting animals can evolve to cause disease in humans and become a new (novel)  coronavirus  for humans (eg. Middle East  Respiratory Syndrome Coronavirus MERS-CoV and Severe Acute Respiratory Syndrome Coronavirus SARS-CoV).

On 7 January 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was confirmed as the causative agent  of coronavirus disease 2019 (COVID-19).

How is COVID-19 spread?

The first cases likely involved exposure to an animal source/s. However, the virus now seems to be spreading from person to person. It is thought to occur primarily via respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza and other respiratory pathogens are spread. It is also spread via direct contact, and self-inoculation, such as when touching your mouth/nose/eyes with infected hands. Thus far the majority of cases have occurred in people with close physical contact to cases and healthcare workers caring for patients with COVID-19.

Common COVID-19 symptoms:

Current symptoms reported for patients with COVID-19 have included  mild through to severe respiratory illness with associated cough, sore throat, shortness of breath, or fever [≥  38°C] (objectively  measured)  or history of fever (subjective). Headache, a runny nose and general feeling of malaise (fatigue, abnormal muscle and joint aches) may  also  occur. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, organ failure and death. The complete clinical picture with regard to COVID-19  is  still  not  fully  understood. Reported illnesses have  ranged  from  infected  people  with  little to no symptoms to people being  severely ill and succumbing to the illness.

Who is most at risk of infection?

As it stands, travellers to/from areas where there is ongoing sustained transmission of the virus, including Mainland China (all provinces), Hong Kong, Japan, Republic of Korea, Singapore, Vietnam, Taiwan, Italy and the Islamic Republic of Iran are at greatest risk of infection with COVID-19.

The geriatric population, individuals with co-morbidities (e.g. existing cardiac, pulmonary, kidney, auto-immune, renal and metabolic disease), and healthcare workers have been found to be at a higher risk  of  morbidity  and  mortality  associated  with  the  SARS-CoV-2.

Current  treatment  for  conformed COVID-19 infection:

Currently  there  is no vaccine  available, and  no specific anti-viral medication proven to be of benefit.

Treatment is supportive (e.g. oxygen for patients with shortness of breath, and medication for fever reduction). Antibiotics are ineffective in  treating  viral  infections. However, antibiotics may be required  if a bacterial secondary infection develops. In severe cases, admission  to  hospital  (high care and ICU) may be necessary.

Prevention measures against COVID-19:

At this stage, there are no specific measures recommended to prevent  COVID-19, but the following points may reduce the risk of infection:

  • Wash your hands often with  soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitiser (at least 60 percent alcohol based).
  • •Avoid touching your eyes, nose, and mouth with unwashed hands.
  • •Avoid close contact with people who are sick.
  • •Stay at home when you are sick and try and keep distance from others  at home.
  • •Cover your cough or sneeze with a flexed elbow or a tissue, then throw the tissue into a closed bin.
  • •Clean and disinfect frequently touched objects and surfaces.
  • •Avoid contact with farm or wild animals (alive or dead), animal markets, and products that come from animals (such as uncooked meat).

•Masks: people with no respiratory symptoms, such as a cough, do not need to wear a mask. The use of masks should be reserved for people who have symptoms of the virus, and for those caring for individuals who have symptoms or confirmed COVID-19 infection. A mask does however prevent you from touching your own face, and hence reducing the risk of self-inoculation.

•Important, if you do not require a mask, please don’t stock up on them. These are invaluable resources necessary for healthcare workers who are treating patients with confirmed/suspected COVID-19 cases, and are thus at much higher risk of contracting the virus.

Travel considerations for COVID-19:

As of 12 March 2020, there are currently no travel restrictions in place. These decisions are solely the responsibility of government cabinet in consultation with the relevant health authorities. If traveling from other countries where restrictions and quarantine periods are in place, individuals may encounter travel disruption. The situation in SA may change in the coming days. If traveling from countries with ongoing sustained transmission of the virus, and/or you are symptomatic, it’s advised to get tested for COVID-19 before departure.

What to do in the case of a suspected infection:

If you have been exposed to someone who is confirmed to be infected (laboratory result confirmation):

  • Notify your doctor immediately, share any relevant travel history, and follow local health authority protocols.
  • •Patients with confirmed COVID-19 should remain under home isolation precautions until the risk of secondary transmission to others is thought to be low. The decision to discontinue home isolation precautions should be made on a case-by-case basis, in consultation with healthcare providers and state and local health departments.
  • •On average persons who are infected become ill on day 5 or 6, but this ranges from 2 to 14 days.

If you develop symptoms (fever, general malaise, upper respiratory symptoms such as congestion or cough):

  • •Notify your doctor immediately, share any relevant travel history, and follow local health authority  protocols.
  • •If you have no history of contact with any known infected person,  stay  at  home  and  if  your symptoms  worsen, seek immediate medical attention.
  • •If you have had a history of contact with a person who is known to be  infected with COVID-19, seek immediate medical attention.

Important  COVID-19  information resources:

Please see links to information resources below.

SA COVID-19 HOTLINE: 0800 029 999 (Mon-Fri 8am-4pm)

Informative COVID-19 information links:

https://www.who.int/emergencies/diseases/novel-coronavirus-2019

http://www.nicd.ac.za/diseases-a-z-index/covid-19/

https://www.afro.who.int/health-topics/coronavirus-covid-19

https://portal.who.int/eios-coronavirus-newsmap/

Important link to the standard operating procedures for preparedness,  detection, and response to a COVID-19 outbreak in South Africa:

https://sasom.org/wp-content/uploads/2020/02/SOP-Coronavirus-29-Jan-2020.pdf

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