Dr Stephan Jost, WHO representative to Myanmar, is interviewed on a visit to India to discuss the efforts to rein in the spread of the coronavirus.
Please can you tell us about the coronavirus?
Coronavirus most probably came from an animal source and is causing illness in human beings, with particularly respiratory symptoms, shortness of breath, difficulty breathing and fever, can lead to a severe form of illness and even in some cases death.
It is new, we haven’t come across this coronavirus, this particular virus before, it originated from the Wuhan city (China), most likely source is around the sea food market, where also the trading of wild animals was happening, and it spread from there, most probably as mentioned through an animal source.
It is now important that we contain this virus and care for patients who have fallen sick, at the same time prevent further spread, and take good prevention measures, enhance our surveillance for possible cases and work together proactively across countries and continents to attack this challenge to humanity.
What is your recommendation? How can we contain this virus?
First of all it is important to keep up good surveillance at the point of entry into countries for the possible suspect cases that might be there. Those that experience difficult breathing, shortness of breath, fever, coughing, and have a travel history to China or indeed other countries where coronavirus has been detected. Not necessarily that those patients will have coronavirus but it is important to also exclude the possibility. So surveillance is key.
Another key thing is prevention to the extent that we can, take good prevention measures, wash your hands frequently with soap and water, avoid contact with wild animals, wash your hands carefully after contact with an animal. If you feel sick with fever, have difficulty breathing, shortness of breath, cold-like symptoms, please seek medical advice immediately and share your travel history with a healthcare provider. At the same time also, if you smoke, quit smoking, because smoking harms lung health and it is a respiratory disease, and also stay away from too close contact from people with respiratory disease, care for them but at the same time take care that you don’t fall sick also to yourself.
It is important that we keep up infection prevention and control to prevent the spread of this virus or indeed of other viruses both in health facilities but also in ordinary life, that we observe the normal ways of staying healthy like eating well, sleeping well and have mild exercise, and at the same time, as mentioned, wash hands frequently with soap and water, and seek medical advice when you do feel sick.
Everybody wants to buy a mask. What is your recommendation?
Masks are useful but really should be kept for people who really need it, that is specifically health workers and ancillary staff in hospitals and health facilities, they may need it the most from falling sick. In addition, there is a case for if you yourself are not feeling well, you may have fever or indeed anything else, where you also want to protect others from falling sick, then there is a case for also wearing the mask. There could be other instances say in very crowded conditions that might sometimes arise or even at present perhaps there is a case for a mask to be worn in aeroplanes to reduce the risk a bit, not particularly because of coronavirus but aircraft are of course a confined space and it is a circulating air system and obviously there is always a slight risk there that you might pick up something from that confined environment.
What is the situation in Myanmar?
The Myanmar health authorities have taken this very seriously. They have enhanced surveillance greatly, particularly at the point of entry into the country, the international airports of Yangon, Mandalay and Nay Pyi Taw but also the sea port and the border crossings. And from an early stage, and there are also health screening, there is a health declaration card introduced, and various other measures to follow up patients for possible suspect cases. A number of suspect cases have been identified and also have been placed under observation or even isolation if necessary and so far of the suspect cases that have been identified, 28 have been found negative of coronavirus. There is still a number in the pipeline and currently obviously there is a close interest in the subject and there is daily coordination ongoing from the Minister for Health and Sports and there is also intersectoral collaboration for this issue. There is an increasing emphasis on infection and control both in health facilities and also in prevention information for the public which is very important to have a good comprehensive approach also including case management, should a case occur and certainly from WHO we are confident that the country is prepared and is continuing to prepare keeping up the preparedness for the possibility of a case to be detected. This could happen at any time and at any place as has been shown in other countries and it therefore very important that surveillance is high.
You have been in India and India is a huge country and has a long border with China, so what is the current situation for WHO for this?
India, likewise, even though I am based in Myanmar and perhaps not that close to the day to day work in India but I know from my experience in the country that also India is taking events of this kind very seriously and in fact three cases have been detected in the state of Kerala in the very south of India and they have all been from what I know handled very professionally and by now have been discharged from hospital and are doing well, so it has been in fact a very good example of dealing with this and the state of Kerala of course is known for its good health system and its robust surveillance and response, which is very important, and it has been proven to be so in this novel coronavirus situation.
Interview conducted in India with the WHO representative for Myanmar on 19 February 2020.