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A pandemic is an epidemic (infectious disease outbreak) that spreads on a global scale. Pandemics usually occur when a new infectious disease emerges that can spread rapidly around the world.
The World Health Organization (WHO) declared the outbreak of COVID-19 a pandemic on 11 March 2020. This COVID-19 pandemic is the first caused by a coronavirus. (WHO)
A pandemic can occur when a new virus emerges and there is worldwide spread of the disease. Most people do not have immunity to a new virus. Viruses that have caused past pandemics usually come from animal viruses that have mutated to affect humans.
For a new virus to have pandemic potential it must meet three criteria:
Previous pandemics include Spanish Influenza in 1918 or H1N1 Swine Flu in 2009. Only Type A influenza viruses have been known to cause influenza pandemics. This COVID-19 pandemic is the first caused by a coronavirus.
On 11 March WHO declared COVID-19 a pandemic. The WHO used this declaration to call for urgent and aggressive action. They noted that this is a pandemic that can be controlled. Both China and the Republic of Korea have significantly declining outbreaks.
On 30 January, the WHO declared that COVID-19 was a Public Health Emergency of International Concern. In the last two weeks, the number of cases of COVID-19 has increased substantially and the number of affected countries has tripled (WHO).
The health impact of a pandemic on the community depends on how easily the virus can be spread between people (i.e. transmissibility) and the seriousness of the illness it causes (i.e. clinical severity). Healthcare systems can limit the impact on a community by slowing the spread of the infection between people and increasing the ability of the healthcare system to look after people who do get sick. NSW Health is putting a lot of effort into doing both of these things.
Coronaviruses are a large family of viruses. Some coronaviruses cause illness in humans and others cause illness in animals, such as bats, camels, and civets. Human coronaviruses generally cause mild illness, such as the common cold.
Rarely, animal coronaviruses can evolve to infect and spread among humans, causing severe diseases such as Severe Acute Respiratory Syndrome (SARS) which emerged in 2002, and Middle East Respiratory Syndrome (MERS) which emerged in 2012.
COVID-19 is a new strain of coronavirus that has not been previously identified in humans. It was first identified in Wuhan, Hubei Province, China, where it has caused a large and ongoing outbreak. It has since spread more widely in China. Cases have since been identified in several other countries. The COVID-19 virus is closely related to a bat coronavirus.
There is much more to learn about how COVID-19 is spread, its severity, and other features associated with the virus; epidemiological and clinical investigations are ongoing.
Outbreaks of new coronavirus infections among people are always a public health concern. The situation is evolving rapidly.
Human coronaviruses are spread from someone infected with COVID-19 virus to other close contacts with that person through contaminated droplets spread by coughing or sneezing, or by contact with contaminated hands, surfaces or objects.
The time between when a person is exposed to the virus and when symptoms first appear is typically 5 to 6 days, although may range from 2 to 14 days. For this reason, people who might have been in contact with a confirmed case are being asked to self-isolate for 14 days.
Most COVID-19 cases appear to be spread from people who have symptoms. A small number of people may have been infectious before their symptoms developed.
According to the World Health Organization, it is not certain how long the virus that causes COVID-19 survives on surfaces, but it seems to behave like other coronaviruses. Studies suggest that coronaviruses (including preliminary information on the COVID-19 virus) may persist on surfaces for a few hours or up to several days. This may vary under different conditions (e.g. type of surface, temperature or humidity of the environment).
If you think a surface may be infected, clean it with a common household disinfectant to kill the virus and protect yourself and others. Clean your hands with an alcohol-based hand rub or wash them with soap and water. Avoid touching your eyes, mouth, or nose.
Patients may have fever, cough, runny nose, shortness of breath and other symptoms. In more severe cases, infection can cause pneumonia with severe acute respiratory distress.
The first symptoms of COVID-19 and influenza (flu) infections are often very similar. They both cause fever and similar respiratory symptoms, which can then range from mild through to severe disease, and sometimes can be fatal.
Both viruses are also transmitted in the same way, by coughing or sneezing, or by contact with hands, surfaces or objects contaminated with the virus. As a result, the same public health measures, such as hand hygiene (hand washing), good respiratory etiquette (coughing into your elbow or into a tissue and immediately disposing of the tissue) and good household cleaning are important actions to prevent both infections.
The speed of transmission is an important difference between the two viruses. Influenza typically has a shorter incubation period (the time from infection to appearance of symptoms) than COVID-19. This means that influenza can spread faster than COVID-19.
While the range of symptoms for the two viruses is similar, the fraction with severe disease appears to be higher for COVID-19. While most people have mild symptoms, approximately 15% of people have severe infections and 5% require intensive care in a hospital ICU. The proportions of severe and critical COVID-19 infections are higher than for influenza infections.
No, but it is more important than ever to get a flu vaccine this year. Flu vaccination reduces your chances of getting influenza, which means it also reduces the risk of you having two potentially serious infections, influenza and COVID-19, at the same time.
People are encouraged to discuss with their GP or other immunisation providers how to organise to get their influenza vaccination with the social distancing requirements and other measures in place to minimise potential exposure to coronavirus. People not eligible for free flu vaccine can consider also get vaccinated through many pharmacies. Children under 5 years can also access the free influenza vaccine through community health centres and local councils that immunise children.
See the Seasonal influenza immunisation FAQs for more information.
The infection period for the virus will vary from person to person. Mild symptoms in an otherwise healthy individual may resolve over just a few days. Similar to influenza, for an individual with other ongoing health issues, such as a respiratory condition, recovery may take weeks and in severe cases could be potentially fatal.
Infection with COVID-19 is diagnosed by finding evidence of the virus in respiratory samples such as swabs from the back of the nose and throat or fluid from the lungs. Samples for testing can be taken directly by GPs or at a range of private pathology sites across the state that are suitable for collection of COVID-19, or at public hospitals across NSW.
Refer to COVID-19 clinics for locations of NSW Health COVID-19/flu assessment clinics.
Some simple measures significantly reduce the risk of catching COVID-19 and of spreading it:
There are no vaccines that protect against COVID-19.
There is no specific treatment for COVID-19. Early diagnosis and general supportive care are important. Most of the time, symptoms will resolve on their own. People who have serious disease with complications can be cared for in hospital.
Infection with COVID-19 is a notifiable condition under the NSW Public Health Act 2010, so doctors and pathology laboratories are required to notify NSW Health of all people suspected or confirmed to have the infection.
Public health unit staff will investigate all cases to find out how the infection occurred, identify other people at risk of infection, implement control measures and provide other advice.
NSW Health has developed and exercised a range of procedures for case finding, diagnosis, and contact tracing for high consequence infectious diseases (such as pandemic influenza, SARS, MERS, and emerging infections) should they occur in NSW. These procedures are being used to identify contacts of any confirmed cases of COVID-19 in NSW.
In Australia, the people most at risk of getting COVID-19 coronavirus infections are those who have:
There is also evidence of limited spread of COVID-19 in the community in Australia.
Based on what we know so far about COVID-19 and what we know about other coronaviruses, those at greatest risk of serious infection are:
It is important to remember that even healthy young adults can have severe disease caused by COVID-19.
People living in group residential settings are at greater risk of being exposed to outbreaks of COVID-19 if a case is diagnosed in a resident or staff member. This includes:
People living in some group residential settings are also more likely to have conditions that make them at greater risk of serious COVID-19 infection.
Newborn babies and infants do not appear to be at increased risk of complications from the infection.
Most children and adolescents with COVID-19 have mild or no symptoms and recover within one to two weeks
Please see guidance for maternity and neonates and schools, universities and childcare for further information.
The best way to protect yourself is the same as you would against any respiratory infection. Practice good hygiene by:
Make sure you stay home if you are sick.
The Raising Children Network has information and an advice line about coronavirus and children including links to resources for parents on talking to children about disaster and distressing events which may assist parents of anxious children.
Find out more about how to protect yourself and others.
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) is the peak body for obstetrics and gynaecology and women’s health in Australia and New Zealand. RANZCOG has updated its advice and information for pregnant women and their families about COVID-19.Read the latest from Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) or listen to RANZCOG President Dr Vijay Roach.
The NSW Government website has information on how to protect yourself and others.
Everyone in the family should have the seasonal influenza (flu) vaccination when it becomes available. Babies can have the seasonal influenza vaccine from 6 months of age - the vaccine is free for all children aged 6 months to less than 5 years of age. For more information, including a list of all groups eligible for free seasonal influenza vaccine, visit Seasonal influenza vaccination 2020.
Make sure your baby’s vaccinations are up to date. This will protect them from other diseases that could make them sick.
Yes, you should continue to breastfeed or feed your baby expressed breastmilk.
The benefits of feeding your baby breastmilk outweighs any potential risk of transmission of coronavirus through breastmilk. You should however take all necessary precautions to avoid spreading the virus. This includes wearing a face mask when near your baby (including while feeding), washing your hands before and after contact with your baby (including feeding), and avoid coughing or sneezing on the baby while feeding. You should clean/disinfect contaminated surfaces.
Strict hygiene is required if handling expressing equipment and expressed breastmilk. If expressing breast milk by hand or with a manual or electric breast pump, the mother should wash her hands before touching her breast, the pump or bottle parts.
Make sure you follow recommendations from the manufacturer for pump cleaning after each use. The Raising Children Network provides guidance on how to keep your expressing equipment clean.
If you are too ill to breastfeed, try to express milk and give it to your baby by a bottle, cup or spoon – following the same infection prevention methods. If possible, consider someone who is well feed the expressed breast milk to your baby following appropriate infection prevention methods. You should discuss feeding options with your health professional.
The Australian Breastfeeding Association (ABA) has advice about COVID-19 and breastfeeding.
The ABA runs the National Breastfeeding Helpline 1800 mum 2 mum (1800 686 268). The Breastfeeding Helpline is available 24 hours a day, 7 days a week.
The UNICEF Baby Friendly Initiative UK site has information about infant feeding during the COVID-19 outbreak.
Follow the advice provided by the Raising Children Network on Bottle feeding: cleaning and sterilising equipment.
If you have been identified as a contact of a person with confirmed COVID-19 infection in Australia, the local public health unit will contact you with advice. You need to isolate yourself at home for 14 days after contact with the infected person, and to monitor your health and report any symptoms.
Person to person spread of coronaviruses generally occurs between people who are close contacts with one another. A close contact is typically someone who has been face to face for at least 15 minutes, or been in the same closed space for at least 2 hours, with a person that was infectious. The public health unit will keep in touch with people who are close contacts of patients with COVID-19 infection. If any symptoms develop contacts must call the public health unit to report those symptoms.
If your contact with the person was less than this, there is a much smaller risk of you being infected. However, as a precaution you must still monitor your health until 14 days after you were last exposed to the infectious person. If you develop symptoms including a fever and/or respiratory signs, please call ahead to talk to a doctor or call healthdirect on 1800 022 222. Tell your doctor that you have been in contact with someone with COVID-19. The doctor may tell you to attend your nearest emergency department – if so when you arrive, immediately tell staff you have had contact with someone with COVID-19.
More information about home isolation is available for:
Practice simple hygiene by:
If you have been in contact with a person identified as a close contact of another person with confirmed COVID-19 infection, you do not need to self-isolate (although the close contact does) and don’t need take any other special precautions.
If a close contact develops symptoms and is confirmed as a COVID-19 case, public health authorities will determine who, if anyone, has been in close contact with them while they were infectious, and these people will be directed to self-isolate.
While some HIV drugs are being trialled as a potential treatment, there is currently no evidence that these medicines are effective against the virus.
For more information, refer to PrEP, HIV dru
The same goes for anti-viral medication for HIV (including PrEP), hepatitis B and hepatitis C – these drugs do not provide protection against COVID-19.
People with confirmed COVID-19 infection stay in isolation - either at home or at a health facility - under the supervision of health professionals. They are considered to no longer be infectious when at least 10 days has passed since they first became unwell and they have been free of symptoms for three days.
The key to handwashing is to wash often and wash well for at least 20 seconds. That's about the time it takes to sing two verses of "Happy Birthday", which is a handy tip for children too.
All you need is water and a detergent (surfactant) such as:
It doesn't have to be an expensive brand, and it doesn't have to be marked "antibacterial".
If you're using hand sanitiser, it should contain 60% alcohol or more. Keep your nails short and clean, wash your tea towels often and consider avoiding wearing rings.
Face masks are not recommended for the general population.
People who have symptoms and might be infected with COVID-19 are required to stay in isolation at home and should wear a surgical face mask when in the same room as another person and when seeking medical advice to reduce the risk of transmitting COVID-19 to anyone else.
Health care workers who are caring for patients with suspected COVID-19 should use appropriate personal protective equipment to protect themselves against COVID-19. For more information refer to Clinical Excellence Commission (CEC) - Coronavirus COVID-19.
Additional supplies of face masks have been distributed for specific health workers by NSW Health and the Australian Government to meet current demand. NSW Health will continue to monitor supplies of face masks in NSW.
Hand dryers are not effective in killing or preventing COVID-19 on their own, and they may increase the risk of spread of COVID-19 if used on hands that have not been cleaned properly.
To protect yourself against COVID-19, you should clean your hands with soap and water for 20 seconds or use an alcohol-based hand rub/sanitiser. If you have washed your hands, dry them thoroughly by using paper towels. If there are no paper towels available, use a hot air dryer or let your hands air dry. Your hands must be dried completely.
If you are using hand towels to dry your hands, such as in the bathroom at home, it’s important to wash them regularly. If someone in your home is unwell, they should use their own hand towel.
Public drinking water supplies are safe to drink, however the surfaces around the fountain including the spout and button/lever could pose a transmission risk for COVID-19 and other germs. At this stage, it is not certain how long viruses that cause COVID-19 survives on surfaces.
NSW Health recommends that you not place your mouth on the spout of a water fountain. Test the water flow and let the water run for a few seconds before drinking the water without putting your mouth or lips on the spout.
If the fountain requires you to push a button or lever, clean the surface first or use your elbow. Clean your hands afterwards with an alcohol-based hand rub or wash them with soap and water. NSW Health recommends that organisations carry out more frequent cleaning of water bubblers and fountains.
Hospitals ensure surfaces are cleaned and disinfected after each suspected case, as are ambulances. There is an Infection Prevention and Control Practice Handbook that outlines the appropriate steps for cleaning a room to ensure there are no viruses remaining. Staff also wear protective gear when cleaning to protect themselves and limit any spread of infection.
NSW Health works with its hospitals to maintain high infection control standards. NSW hospitals and clinicians are well trained in caring for people with infectious diseases, and in preventing their transmission to other patients.
Australian supplies of medicines are strong, however recent increases in demand have meant some community pharmacies have experienced a temporary strain on supply.
New limits have been set on dispensing and purchase of some prescription and over-the-counter medicines, so that everyone can access what they need, when they need it.
Pharmacists will be required to limit dispensing of certain prescription products to one month's supply at the prescribed dose, and sales of certain over-the-counter medicines will be limited to a maximum of one unit per purchase.
While COVID-19 seems to have emerged from an animal source, it is now mainly spreading from person-to-person. There is no reason to think that any animals including pets in Australia might be a source of infection with this new virus. There have been no reports of pets or other animals becoming sick with COVID-19 in Australia.
There is also no evidence that companion animals including pets can spread COVID-19. However, since animals can spread other diseases to people, it’s always a good idea to wash your hands after being around animals.
At this stage, there is no evidence that bats (or any other animals) carry the COVID-19 virus in Australia. However, Australian bats can carry other serious infections, such as Australian bat lyssavirus and Hendra virus so they are best avoided. You should also avoid bats overseas.
NSW Health now recommends that anyone with respiratory symptoms or unexplained fever should be tested for COVID-19.
This is especially important for:
Samples for testing can be arranged by GPs or at one of the many COVID-19 clinics across NSW. GP’s may also refer patients to a specimen collection centre run by a private pathology service.
COVID-19 clinics have been established within all local health districts across NSW to assess and diagnose patients with possible COVID-19 infections and other respiratory illness such as influenza as we approach the winter season.
The locations of COVID-19/Flu clinics are available.
Testing of asymptomatic people (that is, people with no symptoms) is not recommended routinely.
In certain high-risk outbreak settings, public health officials may recommend testing of asymptomatic close contacts of COVID-19 cases to help with the management of the outbreak.
Testing of people who have recovered from a COVID-19 infection is also required if they work in a high-risk clinical setting, such as health care workers and aged care workers, to ensure that they test negative prior to them returning to work.
The nose/throat swab for COVID-19 looks for signs of the virus in someone's nose and throat. A negative result means that COVID-19 is unlikely to be the cause of someone's current symptoms.
However, a negative test result in someone who is well does not guarantee that they have not been infected as it may still be early in their illness.
If you are in home isolation because you have had close contact with a confirmed COVID-19 case, a negative test result does not mean you can end your home isolation. You need to remain in home isolation for a total of 14 days after your last close contact with a COVID-19 case.
If you are seeking medical advice and your general practitioner is not able to speak with you, you can call healthdirect on 1800 022 222. They will be able to discuss your symptoms with you to help decide if COVID-19 testing is recommended.
From 11.59pm on Saturday 28 March 2020, all travellers arriving in Australia from overseas have been required to undertake their mandatory 14 day self-isolation at designated facilities (for example, a hotel). Travellers are being transported directly to designated facilities after appropriate immigration, customs and enhanced health checks at the airport.
There is no need for these people to be tested unless they develop symptoms. People who have completed their 14-day quarantine and have not developed symptoms do not need to be tested or obtain a clearance medical certificate.
There is no particular value in requiring a medical certificates or pre-work testing for most people in the community.
People who have recovered from a COVID-19 infection, and people identified as close contacts who have completed their 14-day quarantine may be provided letters to confirms their isolation or quarantine period has finished.
If you do not have any symptoms there is no testing that can be done to predict whether or not you will become unwell.
Most people that are not eligible for Medicare will have health or travel insurance. For those that do not have adequate insurance coverage, NSW Health will waive these costs. This includes the waiving of payment and debt recovery procedures for ambulance transfers of people suspected to have COVID-19 infection, who are taken to NSW Health facilities for assessment.
These arrangements have been put in place to ensure payment issues are not a barrier for people from overseas with respiratory symptoms seeking early medical advice.
From 11.59pm on Saturday 28 March 2020, all travellers arriving in Australia from overseas will be required to undertake their mandatory 14 day self-isolation at designated quarantine facilities (for example, a hotel). Travellers will be transported directly to designated facilities after appropriate immigration, customs and enhanced health checks at the airport.
If you develop a fever, a cough, sore throat or shortness of breath within 14 days of travel, you should immediately tell health staff at the quarantine facility.
Yes. If you are sharing your home with others, you should stay in a different room from other people or be separated as much as possible. Wear a surgical mask when you are in the same room as another person, and when seeking medical care. Use a separate bathroom, if available.
Make sure that you do not share a room with people who are at risk of severe disease, such as elderly people and those who have heart, lung or kidney conditions, and diabetes.
Visitors who do not have an essential need to be in the home should not visit while you are isolating.
Other members of the household are not required to be isolated unless they have also:
Make sure you maintain a safe distance from that person at all times but support them as much as possible to maintain their self-isolation.
If you need groceries or medicines (including prescription medicines), ask a family member or friend (who is not in isolation) to deliver them to your home or shop for groceries online. To prevent infecting other people, make sure you wear a mask when receiving a delivery or have the groceries left at your door.
You can also receive essential Medicare funded health services in your home, and for most prescription medicines, your doctor can send your prescription directly to your preferred pharmacy. Your relative or friend can collect the medicine from the pharmacy on your behalf, or you may be eligible for free home delivery under the Home Medicines Service.
If you remain well after 14 days, you do not require any tests before leaving isolation.
If you develop any respiratory symptoms or fever during isolation, contact your doctor or the local public health unit on 1300 066 055 to get assessed and tested for COVID-19.
Even if you test negative, you will still need to remain in isolation for the original 14 day isolation period.
The criteria for being released from self-isolation vary depending on your circumstances. Read more about release from isolation.
Contact one of the services below for support or talk to your general practitioner.
Social distancing means reducing the number of close physical and social contacts we have with one another.
Combining social distancing with good personal hygiene slows the spread of a pandemic. This helps protect the most vulnerable members of the community and reduces the impact of the pandemic on essential, life-saving health services.
While practising social distancing, people can leave to seek medical care, buy food and supplies, exercise or go to work or education (if you can’t do so from home).
For those activities outside the workplace or attendance at schools, universities and childcare - social distancing includes:
For more information about social distancing, refer to NSW Government - Social distancing.
Everyone should practice social distancing, as it reduces the potential for transmission.
No. On 23 March 2020 the Minister made Public Health Order that directs the closure of certain places of social gathering (Places Order), including gyms and other indoor recreation facilities.
Keeping fit remains important, visit Make Healthy Normal for workouts you can try at home.
Ocean pools and baths are filled with untreated sea water, which is changed periodically.
The risk of contracting COVID-19 through swimming in ocean pools/baths is considered low. The COVID-19 virus is unlikely to survive for long periods in salt water.
People using ocean baths should:
Operators should clean facilities and surrounds regularly.
As children can spread a range of respiratory infections, and are generally unable to comply with hygiene measures, children aged 16 years and younger should not visit aged care facilities. Exemptions to this can be assessed by the facility on a case-by-case basis, for example where the resident is in palliative care.
Anyone who is sick, even with minimal symptoms, should also defer their visit until they are well.
For each cruise ship arriving into NSW from overseas, a NSW Health expert panel conducts a risk assessment based on the ports visited, whether passengers and crew have a risk of exposure to COVID-19, whether the ship’s doctor has identified a respiratory outbreak on board, and the results of test results done on board the ship.
Following this risk assessment, further assessment may be done when the ship docks, including checking people with fever and respiratory symptoms or who have risk of exposure to COVID-19, and testing them for respiratory infections, including COVID-19. As there is an incubation period (before symptoms develop and tests are positive) for all infections including COVID-19, screening people for disease is not a failsafe, and is only one piece of the assessment.
Cruise ships have large number of passengers (often thousands), many of whom are older and have chronic medical conditions. Respiratory infections (unrelated to COVID-19) among passengers and crew are common on cruise ships. Cruise ships are responsible for, and have policies to prevent and manage outbreaks of disease on board.
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