LetzInform

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.

Further information and instructions

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.

On 11 March, the global pandemic was declared by the World Health Organization (WHO).

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.

Is COVID-19 transmissible during sexual intercourse?

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.

Can pets transmit COVID-19?

At this time, there is no evidence that pets such as dogs or cats can be infected with the new coronavirus.

However, it is always a good idea to wash your hands with soap and water after contact with pets. This protects you against a variety of common bacteria such as E.coli  and Salmonella that can pass from pets to humans.

According to the World Health Organization, the subsequent predominant route of transmission is human-to-human.

Because animals and humans can sometimes share diseases, people with COVID-19 should avoid close contact with their pets. Whenever possible, leave them with family and friends for the duration of the illness.

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 formal preventive quarantine measures anymore, but instead focuses on isolation, auto-isolation and auto-quarantine. From now on, the accent lies on the protection of fragile populations at risk of severe complications.

Stay home. Limit your social contacts to the strict minimum. Leaving your house is restricted to the following activities:

• purchase of food, pharmaceuticals and basic necessities,
• purchase of agricultural, viticultural, horticultural and forestry products,
• going to health services,
• going to the place of work for the exercise of the professional activity,
• assistance and care for the elderly, minors, dependent people, disabled people or particularly vulnerable people,
• going to social security services in case of an emergency,
• going to financial and insurance institutes, as well as postal services, in the event of an emergency,
• going to commercial entities and service providers as listed here: Information and recommendations for Businesses
• in the case of force majeure or a situation of necessity,
• individual outdoor leisure activities or limited to people living together, excluding gatherings and under the condition that an interpersonal distance of two metres is respected.

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

1. Most importantly: wash your hands regularly and properly.
   
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 possible.
   
6. Avoid touching your face with your hands as much as possible.

Since Monday 20 April, covering your nose and mouth with a mask, scarf or bandana is mandatory in places where a distance of 2 metres cannot be respected, i.e. in shops, on public transport, at recycling centres or markets. Children under 6 years of age are not obliged to wear a mask.

To begin, every citizen was handed out five disposable masks. These cannot be washed and have to be disposed of in a waste bin after having worn them for a maximum of 8 hours.

Handmade cloth masks, scarves or bandanas may on the other hand be worn more often, as long as they are washed at 60 degrees every day after use.

In order to get more information about the correct use of masks, please read these recommendations. For wearing a mask is merely a complementary means to barrier gestures which, although reducing the dissemination of droplets carrying the virus, can also present an additional risk of infection when not handled properly. This is why the World Health Organization considers that the widespread use of masks in the whole population is only justified if other barrier measures are impossible or difficult to implement.

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
• Morbid obesity (body mass index > 40 kg/m2)

Stay home.

If you absolutely have to go out, observe the following recommendations:

• go shopping outside of peak hours, if possible;
• if possible, do your grocery shopping online, for example on the sales platform corona.letzshop.lu, which has been set up especially for vulnerable persons (Hotline 8002 9292);
  
• avoid places where it is not possible to keep a security distance of at least 2 metres;
• avoid public transport.

If you need to exert an economic activity, contact your physician by teleconsultation. In this way, you will be able to clarify whether you can continue your economic activity.

Protect yourself from coronavirus in the same way you'd do for the flu.

Observe the 6 protective measures and avoid poorly ventilated areas with many people.

Most of the time, the COVID-19 is not more severe for children. In China, the infection remained asymptomatic among half of the infected children, the disease showed signs of severity among only 5.6% of children, and no children under the age of 10 years died.

In Europe and the United States, deaths caused by COVID-19 among children remain the exception, and in these cases, the children were mostly suffering from a pre-existing condition, exposing them to an increased risk.

However, it cannot be ruled out that a child may have a severe form of COVID-19; in case of doubt, medical advice will help to establish the diagnosis and to determine the course of treatment.

According to what is currently known, the COVID-19 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

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

Directors of structures may allow, depending on the circumstances, exceptions from the prohibition of access and exit for relatives and family members. All persons entering the premises must disinfect their hands and respect the general rules of hygiene.

The current crisis can be particularly worrying for people. Fear and anxiety can sometimes be overwhelming, especially in cases of social isolation.

• Choose reliable sources of information such as the government website gouvernement.lu and limit the amount of time you consume online media (check these media 1-2 times a day).
• Be aware of your anxiety. Observe when you feel anxious and try to understand why. Focus on the here and now, don't brood over uncertainties.
• Stay close to your usual routine.
• Talk to calm people.
• If you feel that your anxiety is becoming more and more pervasive, you can call the Hotline 8002 8080.  
  

www.covid19-psy.lu

Since the beginning of the crisis, the coronavirus has been accompanied by another curse with sometimes fatal effects: fake news on social networks. Thus, in March, several hundred people died in Iran after ingesting methanol, believing that they could protect themselves against COVID-19. The consumption of volcanic ash, cocaine or bleach are other examples of false recommendations that endanger those who believe in them.

To make the distinction, trust only established sources of information and do not take medication without consulting your doctor.

For more information, please visit these sites:

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters

https://www.consilium.europa.eu/en/policies/covid-19-coronavirus-outbreak/fighting-disinformation/

https://ec.europa.eu/info/live-work-travel-eu/health/coronavirus-response/fighting-disinformation_en

Symptoms vary from moderate to severe respiratory infection, accompanied by fever, coughing, breathing difficulties and fatigue. 

Loss of sense of smell (anosmia) and/or taste, as well as skin rashes, are other symptoms of the disease. 

 Seniors and people with pre-existing chronic illnesses are 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..

How to act.

The pollen season has begun causing allergies that affect between fifteen and twenty percent of the population. Symptoms can be similar to those caused by a COVID-19 infection, especially for people with allergies who experience asthma and respiratory disorders.

A person with chronic asthma is usually very familiar with the symptoms of his disease and can easily differentiate these symptoms from those of a COVID-19 infection. Asthma attacks are usually not accompanied by fever, although it occurs in 80 per cent of cases of COVID-19. Respiratory disorders from asthma occur in time-limited asthmatic attacks and are marked by fairly typical wheezing. Respiratory troubles caused by COVID-19 are progressive and permanent over the day and are accompanied by dry coughing.

www.pollen.lu

• In case of an emergency, always call 112!
• If you have a dental problem, call the Hotline 8002 8080, which will put you in touch with the medical on-call service in your area.
• Consult your family doctor by phone or through teleconsultation (eConsult). If you are a vulnerable person, teleconsultation is the best option!
• Alternatively, you can visit:

o   the advanced care centres (Centre de soins avancés - CSA) for a medical examination. You do not need a prescription. You can go there if you have symptoms related to COVID-19 or for health problems not related to COVID-19.

o   the hospital emergency departments when you have a serious health problem.

Teleconsultation is a form of medical practice like any other. It allows a physician, dentist or midwife to give a remote consultation using information and communication technologies.

To better understand how teleconsultation works, do not hesitate to view these explanatory videos:

• The first provides general information and information on how to register on the teleconsultation platform (Tutorial eConsult).
  
• The second explains how to make a medical appointment (Tutorial eConsult).
• The third is about the teleconsultation process (Tutorial eConsult).
• The fourth explains what happens after teleconsultation (and in particular the electronic sending of documents) (Tutorial eConsult).  

General physicians' practices will limit themselves to treating the most severe and/or urgent medical conditions.

Medical teleconsultation has been put in place. This does not necessarily mean that clinics are closed as of now. So as to protect the patients' health, they continue to operate, but only at a distance.  

Your physician is obliged to refer you towards the best possible care for you. If your physician is unavailable, he has to redirect you to another physician who provides continuity of care for his patients.

Dental practices are closed, only urgent needs are provided by an on-call service of at least two dentists in the north, centre and south of the country.

For urgent dental needs, you can call 8002 8080, which will direct you to the on-call dental practice in your area.

If you have symptoms of a respiratory infection or if you have any doubts about possible COVID-19 contamination(fever with cough, etc.), you can go to one of the Advanced care centres (Centre de soins avancés - CSA).

You do not need a prescription from your physician to visit the CSA. Currently, four CSAs are open:

• At the Kirchberg in the halls of Luxexpo (8:00 - 20:00 hours);
• In Esch/Belval in the Rockhal (8:00 - 20:00 hours);
• In Ettelbruck in the Däichhal (8:00 - 20:00 hours);
  
• Grevenmacher (cultural centre) (10:00 - 18:00 hours).

Finally, consultation in a CSA is free of charge: you will only be asked to present your  social security card and an identity document.

From Monday, 30 March, Luxembourg sets up four containers equipped with thoracic scanners to carry out a diagnosis at the emergency services. This is a device for patients with severe respiratory disorders, as COVID-19 can rapidly cause fatal bilateral pneumonia if not promptly managed in intensive care.

A thoracic CT scan can show signs indicating a COVID-19 infection and, if necessary, confirm a suspicion of lung damage, without having to wait for the PCR test result.

Recommendation of the "Conseil scientifique"

A laboratory test carried out on medical prescription can identify the SARS-CoV-2 nfection.  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.

If needed, contact your physician via telephone or by teleconsultation eConsult. Do not go to a physician's office.

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.

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

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

If you have contracted the virus and your state of health allows it, you must stay at home in isolation for two weeks.

You will receive two mailings from the Health Directorate (Direction de la santé) within days of the start of your isolation:

• a set of masks you have to wear in case of contact with other people;
• an explanation on how you should behave to avoid contaminating others (e.g. what you should do) and an isolation order that will serve as your certificate of incapacity for work.

You will also be invited to be monitored at a distance, by registering voluntarily to the online application "Maela". This is a national remote monitoring system that allows medical teams to know if you are well or if you may need assistance.

Every day for two weeks, you are invited to answer a medical questionnaire sent to a team of professionals from the Health Directorate.

In this context, the website www.suivicovid.lu has been set up.

Isolation applies to people who have a confirmed infection with COVID-19.  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 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

Self-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

The self-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 self-quarantine

Self-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 self-monitoring is to detect symptoms of infection as soon as they appear.  The person under self-monitoring measures his or her temperature twice a day and makes sure there are no breathing problems or coughing. During self-monitoring, normal activities can be continued.

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.

The World Health Organization (WHO) recommends that no medications, including antibiotics, should be self-medicated to prevent or cure COVID-19.

Some specific treatments are being studied and will be tested in clinical trials. Thus, Luxembourg is taking part in the European trial called "Discovery", launched in six countries to test four treatments. The WHO is also due to launch a large international clinical trial.

There is currently no scientific evidence linking ibuprofen to the aggravation of COVID-19 infection.

Formal proof of their efficacy has not yet been demonstrated, neither in the treatment nor in the prevention of COVID-19 disease. Numerous clinical trials are underway to generate robust data to determine the efficacy and safety of chloroquine and hydroxychloroquine in the treatment of COVID-19.

Their use for COVID-19, outside of existing authorisations, carries significant risks and requires close monitoring.

• Do not take these medicines on your own.
• Talk to your physician or pharmacist if you have any questions about the use of chloroquine or hydroxychloroquine or any other medicines.
• Use chloroquine or hydroxychloroquine only on prescription and under the supervision of a physician.

The Ministry of Health also draws attention to the fact that many falsified medicines against COVID-19 are circulating through the illegal internet shopping channel. Obtaining medicines through this channel carries major risks and is prohibited.

Expected drug interactions with drugs used to treat COVID-19 :

www.covid19-druginteractions.org.

The Government's objective is to implement a gradual exit from confinement in phases while remaining cautious to avoid the onset of a second wave of the epidemic. Thus, construction sites and recycling centres, e.g., resumed their activities from 20 April  2020. Schools will open their doors in stages from May onwards.: Ministry of Education, Children and Youth.

To enable this gradual opening, it is essential to

• guarantee, at all times, the necessary hospital capacities,
• maintain the possibility of reintroducing stricter measures in the event of a strong resurgence of the virus among the population,
• provide close monitoring of the evolution of the pandemic throughout the transition period out of confinement,
• ensure testing capacities and to support research in particular with regard to tests measuring the acquired immunity of the population.

In general, this means that all members of society must absolutely continue to

• apply the basic barrier gestures and support them with other specific measures to  reduce as far as possible the risk of uncontrolled spread of the virus - including in the workplace,
• protect vulnerable people in particular.

The exit strategy

The exit - Phase 1

Temporary health recommendations (fr)

Taking into account the evolution of the coronavirus COVID-19 in our neighbouring
countries and on the national territory, it is necessary to take additional
measures to limit the spread of the virus in the population and to protect
those at risk. It has also become necessary to adapt the organisation of the health care system in order to cope with an increase in the number of people infected with the virus. The proposed measures take into account the pathogenic and contagious nature of the COVID-19 virus. In this context, the respect of appropriate distance rules in interpersonal relations is one of the most effective measures to limit the spread of the virus.

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.

On 17 March, the Governement has declared the state of crises on the national territory.

Given that many hospitalised people are vulnerable, visits of hospital patients are prohibited until further notice. If a visit has to take place, all of the necessary protective measures must be taken in order to protect the patients.

The hospital business continuity plan is to be activated.

Health staff leave can be cancelled, if necessary.

Hospitals will deploy their staff mainly to urgent and acute activities.  In order to reduce the risk of the virus circulating in hospitals, medical, surgical and care activities which are not short-term indispensable are cancelled. Patients with COVID-19 who do not show severe complications (cases with light symptoms) will be cared for at home, while respecting the recommended isolation measures.

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 also ready to receive patients infected with COVID-19.

Establishments receiving the public, activities of a cultural, social, festive, sporting and recreational nature are suspended. Playgrounds are closed.

As a general rule, the gathering of people on public roads is not permitted. Individuals may pursue outdoor leisure activities as long as they remain alone. Otherwise, they must respect the requirement of a distance of two metres between people.

A group of people living under the same roof can also pursue outdoor leisure activities. These people in the same household do not need to distance themselves from each other. Thus, parents and children can e.g. walk around holding hands, parents can carry their child across the street. On the other hand, they must all respect the two-metre distance from people who do not live with them.

When parents are separated and have visitation and accommodation rights and alternate custody of their children, they are not bound by the travel restrictions for the public. This applies to the duration of trips from one household to another.

Owners of pets, e.g. cats, dogs, horses, can travel to ensure their well-being. Thus, when these animals are not at home, they can go to the premises to take care of them. However, here again, no gathering of people is allowed, the distance of at least 2 metres must be respected.

Establishments in the cultural, recreational and sports sectors, as well as restaurants and cafés, are closed. The same applies to company canteens, except where an interpersonal distance of two metres is respected.

The prohibition does not apply to take-away, drive-in and home delivery services.

The prohibition does not apply to hotels. However, hotel restaurants and bars, with the exception of room service and take-out, are closed

Volunteers are recruited via the platform www.govjobs.lu. This way, the national sanitary reserve is optimised. For regulated health professionals, registration is mandatory. The call also goes out to doctors in the process of specialising, students, retirees and people on leave without pay.

This platform also seeks to coordinate the call for volunteers who wish to support health-related efforts (e.g. administrative officers, educators, carers, cleaning agents) and lists the specific needs. On govjos.lu, you can match your skills and experience to the offers of reinforcement, and communicate your contact details and availability using the online form. The offers posted on these pages are regularly updated, don't hesitate to browse through them.