B•A•D Health Center information on SARS-CoV-2

The Hanover Health Center provides detailed information about the new coronavirus SARS-CoV-2.

With the kind permission of the B•A•D Health Center ( also found on Facebook ), we are publishing the information we have collected about SARS-CoV-2 here:

What is SARS-CoV-2?

The virus comes from the coronavirus family. There are hundreds of different coronaviruses. They can infect animals (birds, mammals) and humans. They cause harmless mild colds as well as serious respiratory illnesses that can be fatal.

How is SARS-CoV-2 transmitted?

How exactly and, above all, how quickly the virus spreads has not yet been conclusively clarified. Animal to human transmissions have been confirmed. Human-to-human transmission has been proven.

The following infection routes are therefore likely:

• Droplet infection (e.g. very fine cough droplets)
• Smear infection (e.g. viruses reach the mucous membranes of the eyes, nose and mouth via contaminated hands)

Coronaviruses do not survive particularly long on dry surfaces. Inactivation usually occurs within hours to a few days in a dry environment.

To date, no infection with SARS-CoV-2 via exclusively inanimate surfaces has been documented. Infection with SARS-CoV-2 after contact with imported objects, luggage or mail is unlikely. (BfR, February 24, 2020)

However, transmission via surfaces that were recently contaminated with viruses is conceivable through smear infections. However, due to the relatively low stability of coronaviruses in the environment, this is only likely within a short period of time after contamination.

Examples would be beds and bedside cabinets in the hospital, door handles contaminated with cough droplets, and traces of nasal mucus on hands.

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How long does the incubation period last?

According to the WHO, it is currently assumed that the incubation period lasts up to 12.5 days, but could also be up to 14 days, similar to MERS-CoV and SARS-CoV. Infected people can be contagious even before the disease begins. Even infected people with only mild or non-specific symptoms can transmit COVID-19. (RKI, as of February 24, 2020).

What symptoms do sick people have?

Some patients only have mild cold symptoms, others have a very serious and sometimes fatal respiratory illness. The symptoms are non-specific. Fever, cough, breathing problems, sore throat, body aches, runny nose and exhaustion are most likely to occur. Diarrhea has been reported in rare cases. Pneumonia can occur as a complication.

According to previous reports from China, four out of five cases of the disease are mild (RKI, February 28, 2020).

Who is particularly at risk?

It is currently assumed that older people and people with weakened immune systems (e.g. after organ transplants, cancer) or with underlying diseases (e.g. diabetes, chronic lung or kidney diseases) are particularly at risk of developing severe forms.

How can I protect myself from SARS-CoV-2?

• Stay home if you are sick.
  • This measure also makes sense given the current cold and flu wave.
• Avoid unnecessary physical contact with people:
  • No shaking hands
  • No hugs or greeting kisses
• Avoid crowds of people
• Avoid contact with (sick) people
  • Minimum distance of approx. 1 to 2 meters from people suspected of being sick
• In affected areas in Asia, avoid:
  • contact with (wild) animals and their excretions
  • Markets with animal products
  • raw, uncooked animal foods (meat, eggs, dairy products)
• Maintain regular hand hygiene (see below)
• Keep your hands away from your face (eyes, nose and mouth)
• Coughing and sneezing etiquette:
  • sneeze and cough into the crook of your arm or into a disposable tissue (then throw it away)
  • Stay at least one meter away from other people and turn away
  • Carry out thorough hand hygiene after blowing your nose, sneezing or coughing
• Ventilate your work rooms regularly (about four times a day for about ten minutes).
• A protective vaccination against SARS-CoV-2 coronaviruses is not yet available
• According to the RKI, a containment strategy is currently being pursued in Germany.

Protective measures – washing hands

Hands are our most important and most frequently used tool. They often come into contact with various pathogens.

Washing your hands actually reduces the incidence of infectious diseases. In order to achieve sufficient effectiveness when washing your hands, the correct method is crucial.

The Robert Koch Institute (RKI) recommends the following process when washing hands:

• Wet your hands under running water
• Soap your hands thoroughly (at least 30 seconds. Sing twice happy Birthday)
  • Rub the soap on the back of your hands, wrists and between your fingers
  • Rinse hands well under running water
  • Dry your hands carefully with a fresh disposable towel

The washing water should be lukewarm, as water that is too hot dries out the skin.

Protective measures – hand disinfection

Hand disinfection can definitely make sense if there is an increased risk of infection. Even if there is no running water available on the go, hand disinfection is a practical alternative.

If you want to carry out hand disinfection as an additional preventive measure, you can purchase hand disinfectants in small bottles cheaply. However, you should make sure that these remedies are sufficiently effective. It makes sense to pay attention to the manufacturer's instructions and, if necessary, seek professional advice, e.g. B. in a pharmacy.

Use hand sanitizer to disinfect your hands.

Further information can be found below under “ Protective measures – selection of disinfectants”.

How is hand disinfection carried out?

• a sufficient amount of disinfectant (at least 3 ml - depending on hand size) into the hollow of dry hand.
• Rub disinfectant over all areas of dry hands
  • Interior and exterior surfaces including the wrists, spaces between fingers, fingertips, nails, nail folds and thumbs
  • Keep moist for the duration of the exposure time, add disinfectant if necessary
• Massage the hand disinfectant into your hands until they are completely dry. This generally lasts about 30 seconds (sing Happy Birthday ).

Are hand sanitizers harmful to skin?

Hand sanitizers consist primarily of alcohol. There are also moisturizing substances and, if necessary, fragrances. As a result of hand disinfection, the skin only suffers a small loss of fat and no change in pH value. The acid mantle remains intact.

Contrary to its reputation, skin damage from hand sanitizers is extremely rare. Allergies to alcohol are not yet known. Intolerances are usually due to fragrances or other ingredients or due to incorrect application technique.

The hands moistened with disinfectant must be rubbed until the disinfectant has been completely massaged in (hands are “dry”). Only then can the moisturizing care substances have an optimal effect.

Frequent hand washing, on the other hand, can result in degreasing of the skin with warm water and soaps, a shift in the pH value and thus a loss of the protective acid mantle. In the worst case, dermatoses can form .

When and how often should hand hygiene be carried out?

• before the meal
• after using the toilet
• after sneezing, blowing your nose or coughing
• every time you arrive at home, in the office, in a hotel room or similar.
• after contact with dirty, contaminated materials (e.g. public transport, stair railings, handrails)
• after handling animals
• after visiting sick people or coming into contact with sick people's objects

When does hand disinfection make sense?

• after using public sanitary facilities
• after bus and train journeys
• after staying in train stations and airports

Protective measures – selection of disinfectants

Disinfectants that are listed by the Robert Koch Institute (RKI) or the Association for Applied Hygiene (VAH) and have a limited virucidal, limited virucidal PLUS or virucidal spectrum of action are useful:

• Limited virucidal disinfectants inactivate (make ineffective) all enveloped viruses in addition to bacteria. Enveloped viruses are e.g. B. Corona and influenza viruses.
• Limited virucidal PLUS disinfectants inactivate (make ineffective) in addition to bacteria and enveloped viruses, the non-enveloped adenoviruses, rotaviruses and noroviruses (gastrointestinal pathogens).
• Virucidal disinfectants inactivate (make ineffective) not only bacteria but also enveloped viruses and all non-enveloped viruses.
• Due to the high alcohol content of virucidal disinfectants, skin irritation can occur. Especially if it is not used correctly (note the exposure time; hand disinfectant must be rubbed in until the hands are completely dry). Surface disinfectants can also cause respiratory irritation.
• Disinfectants that are effective against viruses are available in pharmacies (NOT in drugstores and supermarkets).
• When using disinfectants, follow the manufacturer's information.

Protective measures – surface disinfection

Disinfecting surfaces can at best complement individual protective measures (e.g. intensive hand hygiene, keeping your hands away from your face), but cannot 100% prevent infection with SARS-CoV-2.

If necessary, it makes sense to disinfect objects and surfaces that are touched by many people. For example, when desk sharing, the disinfection of keyboard, mouse and telephone.

Only wipe sensitive surfaces (e.g. smartphone display, keyboard, screen) with a suitable disinfectant (“suitable for sensitive surfaces”).

When using disinfectants, pay attention to the manufacturer's information and occupational safety instructions.

Further information under “Protective measures – selection of disinfectants”.

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Protective measures – mouth and nose protection (MNS) and particle filtering half mask (FFP)

In some regions of China, authorities have ordered the wearing of a face mask in public places.

Wearing a face mask can also supplement individual protective measures (e.g. intensive hand hygiene).

The protective effect of self-sewn masks, single-layer paper masks and masks without standards marking is uncertain. Avoid these materials.

Mouth and nose protection ( MNS ) (synonymous surgical masks, surgical masks) in accordance with EN 14683 protect the wearer from small droplets of saliva/mucus and from e.g. B. larger droplets in other people's sputum. The MNS also prevents touching the mouth, nose and possibly eye mucous membranes with contaminated hands. MNS according to EN 14683 are available in pharmacies. An MNS does not protect against inhaling tiny aerosols (contaminated with viruses).

The Robert Koch Institute, for example, recommends wearing MNS when providing initial medical care for suspected coronavirus cases.

Particle-filtering half masks ( FFP ), when used correctly, have an even greater protective effect than MNS. They protect against inhaling aerosols (smallest droplets). Depending on the retention capacity of the particle filter, a distinction is made between device classes FFP1, FFP2 and FFP3. FFP3 masks have the highest protective effect.

The FFP masks should be tested according to the European standard DIN EN 149.

The Robert Koch Institute, for example, recommends wearing FFP2 masks when providing medical care for probable coronavirus cases or for already confirmed cases of infection. However, the medical staff then also stays in closed rooms with a correspondingly high number of virus particles in the room air, so the higher protective effect of FFP2 masks is necessary.

Wearing an FFP mask for long periods of time is physically demanding. Breathing is very difficult even for healthy people. Heat builds up under the mask and the pressure on the facial skin is uncomfortable. Wearing FFP3 masks is more strenuous than wearing FFP2 masks.

Please seek advice on travel medicine from your B·A·D health center.

• RKI information sheet: Resource-saving use of mouth and nose protection and FFP masks in healthcare facilities

https://www.rki.de/DE/Content/InfAZ/N/Neuhaftes_Coronavirus/Quelle_schonen_Masken.html

Application – MNS and FFP mask

• Store and transport MNS and FFP masks in a dry place, protected from contamination.
• MNS and FFP masks are disposable items. Discard after use.
• If possible, wash or disinfect your hands before dressing.
• Do not touch the inside of MNS and FFP masks with your hands.
• Before putting on the MNS and FFP mask, carefully bend the nose clip.
• MNS and FFP masks must fit tightly to the face. Carefully adjust the nose piece. Adjust the fit of the elastic straps or loops.
• If MNS and FFP masses are moist, they must be disposed of.
• When removing MNS and FFP masks, do not touch the outer surface of the masks with your mouth, nose, mucous membranes or unprotected hands.

Courtesy of B·A·D GmbH
Article image: Shutterstock / By Panachevs

Sources:
Robert Koch Institute: COVID-19 (Coronavirus SARS-CoV-2) https://www.rki.de/DE/Content/InfAZ/N/Neuhaftes_Coronavirus/nCoV.html (downloaded on March 2nd, 2020)
Robert Koch -Institute: Infection Epidemiological Yearbook of Notifiable Diseases for 2003
Foreign Office, China: Travel and safety advice, current information. https://www.auswaertiges-amt.de/de/ReiseUndsicherheit/chinasicherheit/200466#content_1 (downloaded on February 28, 2020)
Federal Foreign Office - Health Service (information sheet): Information sheet COVID-19.
As of February 28, 2020 (downloaded on March 2, 2020) Bavarian State Office for Health and Food Safety: Mouth and nose protection (MNS) or particle-filtering respiratory protection (FFP).
As of January 5, 2016 (downloaded on January 27, 2020) Federal Institute for Risk Assessment (BfR): Can the novel coronavirus be transmitted via food and toys?
As of February 24th, 2020 (downloaded on February 26th, 2020) Kampf G, Todt D, Pfaender S, Steinmann E.: Persistence of coronaviruses on inanimate surfaces and its inactivation with biocidal agents. [ On the persistence of the coronavirus on inanimate surfaces and its effective inactivation ], January 31, 2020, Journal of Hospital Infection, Elsevier Inc, https://www.journalofhospitalinfection.com/article/S0195-6701(20)30046-3/fulltext ( downloaded on February 21, 2020)

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