Coronavirus: COVID-19

Coronaviruses (CoV) are a large family of viruses that cause symptoms ranging from the common cold to more serious illnesses, i.e. the Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). The new coronavirus (nCoV) is a new strain of coronavirus that had 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 delay spreading among the general population and to protect vulnerable and fragile groups in the population, it is important to take a certain number of precautions.

SARS-CoV-2 is a new strain of coronavirus that had not been 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 hosts merchants for seafood, poultry, bats, marmots and other wild animals, which indicates a probable animal origin of this virus. The virus was later confirmed to also transmit between humans. Cases have since been discovered in other regions of China and in other countries, often linked to a previous visit of Wuhan. The health authorities of the various affected countries are currently investigating this new 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 infectious 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 infection, accompanied by fever, coughing and breathing difficulties. Seniors and people with pre-existing chronic illnesses seem more vulnerable and at risk of complications.

The incubation period, the 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.

A laboratory test carried out on medical prescription can identify the SARS-CoV-2 infection.  However, this test is of no use in the absence of symptoms. Your personal physician is in the best position to assess the value of the test in your case.

The test result is sent to the physician who requested the test, through a secure channel, who communicates it to the patient without delay. The result is also sent to the Health Inspectorate, in application of the law of 1 August 2018 on the compulsory declaration of certain diseases. 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.

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 implemented to help affected persons.Your physician is obliged to refer you towards the best possible care.  If, at the end of this evaluation, the experts consider that your personal risk of COVID-19 does not justify any specific provisions, 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.

Immuno-compromised people protect themselves like vulnerable people. Only people 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.

Isolation applies to people who have a confirmed infection with SARS-COV-2.  This measure is designed to prevent the infected person, who is contagious, from spreading the infection to his surroundings.

Isolation is prescribed by the physician for a minimum of 14 days after the onset of symptoms. During this period of confinement at home, contact with other people must be avoided and a surgical mask must be worn whenever the infected person is in the presence of others.

What you and your family should do when you need to be isolated at home (french)

The auto-quarantine applies to people who have had intimate contact or who live in the same household as a person who is confirmed to be infected. They must stay at home during seven days counting from the day of the confirmed diagnosis. During this period, contact with other people should be avoided.  During the seven days following a self-quarantine, self-monitoring should be carried out.

What to do while in auto-quarantine (french)

Auto-isolation applies to people who have symptoms of illness compatible with COVID-19 but whose infection is not confirmed.  They should stay home for 7 days from the onset of symptoms and avoid contact with other people if possible. Once the symptoms have disappeared, they must stay at home for 24 more hours.

What to do if you have a fever or are coughing and you are staying at home (french)

Auto-monitoring lasts 14 days and applies to people who are likely to have been infected with the virus through contact with a sick person.  The purpose of auto-monitoring is to detect symptoms of infection as soon as they appear.  The person under auto-monitoring measures his or her temperature twice a day and makes sure there are no breathing problems or coughing. During auto-monitoring, normal activities can be continued.

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.

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

Directors of structures may allow, in exceptional cases, exceptions from the prohibition of access and exit for relatives and family members, provided that they do not show symptoms. All persons entering the premises must disinfect their hands and respect the general rules of hygiene.

Given that many hospitalised people are vulnerable, 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 order to minimise the impact of the COVID-19-epidemic on the population and our society.

During the initial phase of containment, 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 (Laboratoire national de santé, LNS) is approved by the World Health Organisation (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.

Since 12 March, the government has moved to a strategy of reinforcing the protection of vulnerable populations. This strategy implies that efforts are focused on preventing the transmission of the infection to these people rather than on identifying any cases of COVID in the general population.

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. Furthermore, Luxembourg is participating in a joint acquisition with other EU member states aiming to bolster the existing stock.

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 (Inspection sanitaire) is a division of the Health Directorate. It is responsible, among other things, for ensuring the protection of public health, both in terms of environmental health and the surveillance and control of communicable diseases.

Yes, our hospitals are prepared. A referral service, namely the National Service of Infectious Diseases at the CHL, is in charge of the reception of patients infected with the coronavirus. If the epidemic spreads, other hospitals are prepared to receive patients infected with SARS-COV-2.

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 and it no longer relies on confinement and quarantine measures.  From now on, it will have to focus more on dealing with serious cases and protecting vulnerable people. Luxembourg is following the measures taken by many other countries, in particular 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.

In general, it is recommended to avoid unnecessary travel. In case of travel, the respect of barrier gestures is indicated:

• 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.

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.