Coronavirus: COVID-19

Coronaviruses (CoV) are a large family of viruses that cause symptoms ranging from the common cold to more serious illnesses such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). A new coronavirus (nCoV) is a new strain of coronavirus that has not yet been identified in humans.

COVID-19 is the infectious disease caused by the latest discovered coronavirus (SARS-CoV-2). This new virus and disease were unknown before the outbreak in Wuhan, China, in December 2019.

COVID-19 infection remains mild in 80% of cases. In order to avoid spreading among the general population and to protect vulnerable and fragile populations, it is important to take a certain number of precautions.

SARS-CoV-2 is a new strain of coronavirus that had not be seen in humans before. The epidemic began in the Chinese city of Wuhan, capital of the Hubei province. At first, the epidemic seemed to be linked to the South China Seafood City market. This market welcomes traders in seafood, poultry, bats, marmots and other wild animals, which indicates a probable animal origin of this virus. Later, spread between humans has also been identified. Cases have since been discovered in other regions of China and in other countries, often linked to a history of travel to Wuhan. The health authorities of the various affected countries are currently investigating the coronavirus and the sources of the contamination.

There is no universally applicable definition. However, it can be said that a pandemic is the increased and sustained propagation of an extraordinary human disease that rapidly affects all parts of the world and a large part of the global population.

Symptoms vary from moderate to severe respiratory disease, accompanied by fever, cough and difficulty of breathing. Seniors and people with pre-existing chronic illnesses seem more vulnerable and susceptible to complications.

The incubation period, time between contamination and the appearance of the first symptoms of COVID-19 infection is maximum 14 days.

No. Only a test on respiratory secretions is currently available to detect the presence of the new coronavirus.

Currently, the test is only executed on persons suspected to be infected with COVID-19, in accordance with the recommendations issued by the Health Inspection and the National Service for Infectious Diseases.  In certain specific cases, a hospital doctor may ask for the test to be carried out on a pneumonia patient.  All these tests are realized by the LNS and paid for by a specific budget of the government.

The result of the test shall be transmitted, by means of a secure transmission, to the Health Inspection or the hospital service, which requested the test, and who communicates it to the patient without delay. At the patient’s request, the result can also be passed on to his/her physician.

The COVID-19 infection is transmitted by people carrying the virus. The disease can be spread from person to person through respiratory droplets expelled from the nose or mouth when a person coughs or sneezes.

These droplets can persist for some time on objects or surfaces around the person in question. An infection with COVID-19 can occur if you touch these objects or surfaces and then touch your eyes, nose or mouth. COVID-19 can also be contracted by inhaling droplets from a sick person who has just coughed or sneezed. This is why it is important to keep a distance of more than two meters from a sick person and to respect basic hygiene measures.

Coronaviruses spread through secretions from humans and animals. According to the WHO, a contamination by a package is not likely.

COVID-19 is not a sexually transmitted disease. However, the virus being present in the respiratory secretions and being able to be transmitted by direct contact of person to person, sexual intercourse is favorable to a transmission of the virus, if one of the partners is infected.

According to what is currently known, the SARS-CoV-2 does not seem to pose a particular threat to pregnant women. Pregnant women are therefore not subject to additional protective measures other than those normally recommended in the context of their pregnancy. 

To this day, the coronavirus has not been associated with fetal anomalies or a heightened risk of a premature birth. Studies that are currently being made should confirm this.

Source: ECDC: https://www.ecdc.europa.eu/en/novel-coronavirus-china/questions-answers

Source: CDC: https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/pregnant-women-and-children.html

At this stage, there is no vaccine yet. Research is ongoing.

There is no specific treatment at this time, although research is ongoing. The treatment is therefore mainly symptomatic, i.e. it is similar to the treatment for a cough, respiratory problems or high temperature.

Your physician is obliged to refer you towards the best possible care. If, after analysing your symptoms and risk factors, your doctor considers it appropriate to carry out a more in-depth assessment of your risk of COVID-19, it is his duty to refer you to the health services. If, at the end of this evaluation, the experts consider that your personal risk of COVID-19 does not justify any specific measures, your physician will be able to receive and care for you.

The same precautions should be taken as for any other respiratory infection.

1. Most importantly: wash your hands regularly and properly. The best way to wash your hands is illustrated online at www.sante.lu
2. Do you cough or sneeze? Do it in a tissue or in the crease of the elbow. Throw the tissue in a bin with a lid.
3. Avoid shaking hands or kissing.
4. Avoid close contact with sick people (keep a distance of at least 2 meters).
5. Stay home if you are sick. Don't go to work!
6. Avoid touching your face with your hands as much as possible.

Individuals are considered vulnerable if they are over 65 years of age or if they are already suffering from one of the conditions mentioned hereafter. Those conditions are:

• Diabetes
• Cardiovascular diseases
• Chronic diseases of the respiratory tract
• Cancer
• An immune deficiency due to a condition or therapy

Protect yourself from coronavirus in the same way you'd do for the flu. Follow the 6 instructions listed above and avoid poorly ventilated areas with many people.

In addition, follow these recommendations:

• Go shopping outside of peak hours, if possible;
• Delay non-necessary travels;
• Avoid large events and gathering spaces, confined spaces, large crowds (at cinemas, concert halls, sports venues) and places where you are not able to keep a security distance of at least 1 to 2 metres;
• Avoid public transportation as much as possible.

No. These people are not subject to special precautions under COVID-19. Only people who have an immunodeficiency or who are taking treatment that weakens their immune defenses, and for whom the attending physician has already prescribed specific protective measures (such as wearing a mask in a hospital) should continue to follow these prescriptions.

Wearing a mask in a preventive manner is not recommended by the World Health Organization (WHO) as a means to avoid contamination with the COVID-19 virus.

The use of special masks (FFP2) to prevent infection with coronavirus only makes sense in hospitals where patients infected with coronavirus are treated and in laboratories for the analysis of the body material of these patients.

In order to stop the virus from spreading unhindered, you should act responsibly, i.e. through auto-isolation and auto-quarantine.

The virus must no longer be allowed to spread without control. Auto-isolation and auto-quarantine are means to slow the virus down.

Auto-quarantine:

If you have been in contact with a person who has been confirmed to bear the new coronavirus, stay at home during seven days counting from the day of the confirmed diagnosis. During this period, avoid any contact with other people. During the 7 days following these first 7 days, monitor yourself: take your temperature twice a day.

Auto-isolation:

If you are showing signs of the sickness, i.e. Fever and cough, stay at home during seven days and avoid any contact with other people, if possible. Once the symptoms have disappeared, stay at home for 24 more hours.

As more and more cases have appeared in Europe and Luxembourg and as it has become clear that it is impossible to keep the virus from spreading throughout the general population, the control strategy has been adapted. The strategy does not rely on quarantine measures anymore, but instead focuses on the protection of the fragile population and individuals who risk developing severe complications, also through auto-quarantine and auto-isolation.

No. As these facilities care for very vulnerable people, visits and leaves are prohibited until further notice.

The facility managements may allow exceptions to the ban on visits, in exceptional cases, for loved ones and family members, provided that they do not show any symptoms. Every person who enters a facility will have to disinfect his/her hands and respect general rules of hygiene.

Visits of hospital patients are prohibited. If a visit has to take place, all of the necessary protective measures must be taken in order to protect the patients.

Scheduled activities should be cancelled, if possible.

If possible, the leaves of hospital staff should be cancelled.

An inter-ministerial coordination group continuously plans and prepares the measures to be taken in the event of a COVID-19 infection in order to prevent or contain the spread.

Health authorities have developed procedures to take in charge suspected cases of infection and to follow up with their contacts. These procedures have been communicated to all physicians on several occasions.

The National Health Laboratory (LNS) is approved by the World Health Organization (WHO) for the diagnosis of the virus. The national service for infectious diseases at the Centre Hospitalier de Luxembourg (CHL) is prepared to receive possible cases of suspected or confirmed illness.

The procedures for quarantine and self-monitoring of contacts have been defined by the Health Directorate and can be implemented quickly by the Health Inspectorate (Inspection sanitaire).

Luxembourg has a stock of special masks (FFP2) and surgical masks. These masks are intended for caregivers in close contact with a sick person or a person in quarantine. Further, Luxembourg is participating in a joint acquisition with other EU member states aiming to strengthen the existing stock.

An inter-ministerial coordination group continuously plans and prepares the measures to be taken in the event of a COVID-19 infection.

The amended law of 23 July 2016 on the organisation of the High Commission for National Protection (HCPN) appoints the HCPN to plan and implement a national protection concept. The national protection plan includes, among other things, the prevention and management of large-scale crises which is are events that,

• affect the vital interests or essential needs of the whole or part of the population ;
• require urgent decisions;
• and require coordination at a national level of the actions of the government administrations, departments and agencies.

If necessary, the crisis unit is activated by the Prime Minister and summoned by the High Commission for National Protection. It is chaired by a member of the Government. In the scenario of a health crisis, the crisis unit is chaired by the Minister of Health. It brings together representatives of all departments, administrations and State services concerned by the nature of the crisis.

If necessary, the crisis unit may be supported in its work by other units, such as the "administration and logistics unit" placed under the responsibility of the Chief of Staff of the Army, the "means of communication" unit placed under the responsibility of the Director of the government IT centre or the "legal support" unit placed under the responsibility of a representative of the Minister of Justice.

The crisis unit ensures the political and strategic lead of major crises. It is in charge of

• analysing the situation in the country;
• setting the general strategy of the State's response;
• initiating, coordinating and ensuring the implementation of all measures to deal with the crisis

The Health Inspectorate is a division of the Health Directorate. The mission is:

• to ensure the protection of public health, both in terms of environmental health and the surveillance and control of communicable diseases,
• to organize medical checkups for third-country nationals,
• to process documents from foreigners seeking treatment in Luxembourg and whose care is not provided by social security organizations,
• to decide on the medical fitness for deportation measures.

The World Health Organization (WHO) does not advocate additional measures for airports. In aviation, very strict procedures still apply. If the crew notices a passenger on board who is showing symptoms, this is reported to the airport before the plane even lands, and a medical team is ready at the airport to take care of the passenger in question. Other passengers will be taken care of according to the degree of exposure upon arrival of the Health Inspectorate.

Yes, our hospitals are prepared. A referral service, namely the National Service of Infectious Diseases at CHL, is in charge of the reception of patients infected with the coronavirus.

As of Friday 13 March 2020, any event in a confined space bringing together more than 100 people and any event in an non-confined space bringing together more than 500 people is prohibited.

The goal of the decisions taken by the government on 12 March is to control or slow the spread of the coronavirus down, in order to allow the healthcare services to continue to care for infected individuals to the best of their abilities. Commercial activities can still be continued. Essential services are provided.

The situation also changed at the international level. As of 11 March, the World Health Organisation (WHO) has qualified the COVID-19 as a global pandemic. Moreover, the European Centre for Disease Prevention and Control (ECDC) published an updated risk assessment on March 12, underlining the ‘necessity of an immediate targeted action’ in order to dampen the impact of the pandemic. According to this appreciation, the risk of severe complications for elderly people and people with a chronic condition is high.

For these reasons, the strategy for the national strategy to combat the epidemic must be adapted. The strategy does not rely on confinement and quarantine measures anymore. From now on, it focuses on the protection of fragile individuals. In doing so, Luxembourg aligns itself on the measures taken by a number of other countries, i.e. Switzerland and Belgium.

Almost all the regions of the world are risk zones and present a risk of infection by the new coronavirus. This is why no particular regions are mentioned.

• Monitor symptoms daily (cough, breathing problems);
• Measure your temperature twice a day;
• Wash your hands frequently and properly;
• Avoid contact with vulnerable and fragile people;
• Continue your usual activity.

• Stay at home and avoid contact with other people
• Call the Hotline 8002 8080
• Stay within reach for the Health Inspectorate

You are considered to have been in close contact:

• If you shared the same living area as the sick patient when the latter presented symptoms
• If you have had direct, face-to-face contact, within two meters of the patient while coughing, sneezing, or talking
• With your flirts and intimate people
• With your class or office neighbors
• If you are a neighbor of the sick patient on an airplane or train, or if you have stayed in a confined space with him (e.g. private car)

If these people have not been proven to be in close contact with a sick and contagious person and do not have typical symptoms (cough, fever, breathing problems), they can resume their professional activity.