1. What is the novel Coronavirus 2019-nCov?

The 2019 novel coronavirus, temporarily named 2019-nCoV, was identified in China at the end of 2019
and is a new strain of coronavirus that has not been previously identified in humans.

2. Where do Coronaviruses come from?

Coronaviruses are viruses that circulate among animals but some of them are also known to affect
humans. After they have infected animals, they can eventually be transmitted to humans.

A wide range of animals is known to be the source of coronaviruses. For instance, the Middle East
respiratory syndrome coronavirus (MERS-CoV) originated from camels and the Severe Acute Respiratory
Syndrome (SARS) originated from civet cats.

More information on coronaviruses can be found on the ECDC factsheet:

Factsheet for health professionals on Coronaviruses

3. Is this virus comparable to SARS or to the seasonal flu (influenza)?

The novel coronavirus detected in China is genetically closely related to the 2003 SARS virus and appears
to have similar characteristics, although there is still limited data available on this virus.

SARS emerged at the end of 2002 in China and more than 8 000 SARS-cases were reported by 33
countries over a period of eight months. At the time, one in ten people who contracted SARS died. The
current 2019-nCoV outbreak caused around 10 000 reported cases in China during the first month of the
outbreak, with additional cases subsequently being detected in Europe and other countries (see current
situation update). . At this point, there is too little data available to say for sure how deadly 2019-nCoV is
but preliminary findings indicate that it is less fatal than SARS coronavirus.

While both 2019-nCoV and influenza viruses are transmitted from person-to-person and may cause
similar symptoms, the two viruses are very different and consequently do not behave in the same way.
It is still very early to draw conclusions on how 2019-nCoV spreads, but preliminary information
indicates that 2019-nCoV is as transmissible in the same way as SARS and some other pandemic
influenza strains have been. ECDC estimates that each year up to 40 000 people in the EU, the UK,
Norway, Iceland and Liechtenstein die prematurely due to causes associated with influenza.

4. How severe is 2019-nCoV infection?

At this point, there is too little data available to say with certainty how severe 2019-nCoV is but
preliminary findings indicate that it is less fatal than SARS coronavirus.

5. What is the mode of transmission? How (easily) does it spread?

While animals are the source of the virus, this virus is now spreading from one person to another
(human-to-human transmission). There is currently not enough epidemiological information to
determine how easily and sustainably this virus spreads between people. The virus seems to be
transmitted mainly via respiratory droplets that people sneeze, cough, or exhale.

The incubation period for 2019-nCov (i.e. the time between exposure to the virus and onset of
symptoms) is currently estimated at between two and 14 days. At this stage, we know that the virus can
be transmitted as soon as those infected show (flu-like) symptoms. However, there are still uncertainties
as to whether mild or asymptomatic cases can transmit the virus.

If people with 2019-nCoV are tested and diagnosed in a timely manner and rigorous infection control
measures are applied, the likelihood of sustained human-to-human transmission in community settings
in the EU is low. Systematic implementation of infection prevention and control measures were effective
in controlling SARS and MERS coronaviruses.

6. Why has there been such a large increase in cases reported from China from 13th February? Is the
epidemic suddenly getting worse?

On February 13, official statistics reported from China included 15 141 new cases of COVID-19, which
represents the single largest number of cases reported on one day since the start of the epidemic.
Information from Chinese officials indicates that as of the 13th of February, there was a change in the
way that cases are being counted. This now includes all suspected cases with a clinical diagnosis of
pneumonia. These new cases have not necessarily been laboratory confirmed as having COVID-19.
Given this, we cannot compare the number of cases reported up to now with this new number and it
does not necessarily mean that the epidemic is increasing in China.

Medical information

1. What are the symptoms of 2019-nCoV

From what we know so far, the virus can cause mild, flu-like symptoms such as
fever

cough

difficulty breathing

pain in the muscles and

tiredness.

More serious cases develop severe pneumonia, acute respiratory distress syndrome, sepsis and septic
shock that can lead to the death of the patient. People with existing chronic conditions seem to be more
vulnerable to severe illness.

2. Are some people more at risk than others?

Generally, young children, elderly people and those with underlying conditions (e.g. hypertension, heart
disorders, diabetes, liver disorders, and respiratory disease) are expected to be more at risk of
developing severe symptoms. As this is an emerging disease and there is only limited data available, we
do not yet know which groups of people might be prone to a more severe outcome following infection
with 2019-nCoV.

3. Is there a treatment for the disease caused by 2019-nCoV?

There is no specific treatment for this disease so the approach used to treat patients with coronavirus-
related infections is to treat the clinical symptoms (e.g. fever). Supportive care (e.g. supportive therapy
and monitoring – oxygen therapy, fluid management and antivirals) can be highly effective for those
infected.

4. When should I be tested for 2019-nCoV?

If you have

an acute respiratory infection (sudden onset of either a cough, and/or a sore throat, and/or shortness of
breath),

AND

in the 14 days before the start of your symptoms, you were either:

in close contact [1] with a confirmed or probable case of 2019-nCoV infection, or travelled to an area
where there is ongoing community transmission of 2019-nCoV,
or worked in or attended a healthcare facility where patients with 2019-nCoV infections were being
treated, you should contact your doctor by phone for advice.

ECDC has developed guidance on how to identify suspected cases and when to initiate testing:

Publication

Public health management of persons having had contact with novel coronavirus cases in the European
Union

Technical report - 29 Jan 2020

[1] A close contact would be someone living in the same household as a person who has been diagnosed
with 2019-nCoV, a person who had face-to-face contact or stayed in a closed environment with a 2019-
nCoV case, or a healthcare worker or other person providing direct care for a 2019-nCoV case, or
laboratory workers handling 2019-nCoV specimens.

5. Where can I get tested?

If your doctor believes there is a need for a laboratory test for 2019-nCoV, he/she will inform you of the
procedure to follow and advise which laboratory can perform the test. Several laboratories in Europe
can process 2019-nCoV samples.

Prevention

1. How can I avoid getting infected?

When visiting areas with presumed ongoing community transmission of coronavirus you should:

avoid contact with sick people, in particular those with a cough;

avoid visiting markets and places where live or dead animals are handled;

follow general rules governing hand hygiene and food hygiene;

wash your hands with soap and water OR use an alcohol-based disinfectant solution before eating, after
using the toilet and after any contact with animals;
avoid contact with animals, their excretions or droppings.

Wherever you travel, apply general rules governing hand and food hygiene.

2. What should I do if I have had close contact with someone who has 2019-nCoV?

Notify public health authorities in your area who will provide guidance on further steps to take. If you
develop any symptoms, it is important that you call your healthcare provider for advice, mentioning that
you have been visiting an area of presumed ongoing community transmission of 2019-nCoV.

More information is available in the guidance:

Publication

Public health management of persons having had contact with novel coronavirus cases in the European
Union

Technical report - 29 Jan 2020

3. What are the rules for disinfection/hand washing?

Hand washing and disinfection is the key to preventing infection. You should wash your hands often and
thoroughly with soap and water for at least 20 seconds. If soap and water are not available, you can also
use alcohol-based hand sanitiser with at least 60% alcohol. The virus enters your body via your eyes,
nose and mouth, so avoid touching them with unwashed hands.

4. Are face masks effective in protecting against 2019-nCoV?

Face masks help prevent further spread of infection from those who are sick to others around them.
However, face masks do not seem to be as effective in protecting those who are not infected.

5. Is there a vaccine against 2019-nCov?

There are currently no vaccines against coronaviruses, including 2019-nCoV. This is why it is very
important to prevent infection or contain further spread of an infection.
The development of vaccines takes time. Several pharmaceutical companies are working on vaccine
candidates. It will, however, take months before any vaccine can be widely used as it needs to undergo
extensive testing to determine its safety and efficacy.

6. Am I protected against 2019-nCoV if I had the influenza vaccine this year?

Influenza and 2019-nCoV are two very different viruses and the seasonal influenza vaccine would not
protect against disease caused by 2019-nCoV.

However, as the European influenza season is still underway, the influenza vaccine is the best available
protection against seasonal influenza and it is not too late to get vaccinated.

What is the current situation in the EU regarding 2019-nCov?

1. How prepared is Europe for 2019-nCoV and what is the EU doing?

The European Centre for Disease Prevention and Control (ECDC) is in continuous contact with the
European Commission, the public health authorities in China and the World Health Organization
regarding the assessment of this outbreak. To inform the European Commission and the public health
authorities in Member States of the ongoing situation, ECDC publishes daily summaries and continuously
assesses the risk for EU citizens (re-assessed on a daily basis). ECDC and WHO have developed technical
guidance to support the EU Member States in their response. The European Commission is ensuring the
coordination of risk management activities at EU level.

Current risk assessment on the novel coronavirus situation, 15 February 2020

2. Am I at risk of contracting 2019-nCoV infection in the EU?

This outbreak is evolving rapidly and the risk assessment is changing accordingly. ECDC is continuously
assessing the risk for EU citizens and you can find the latest information in the above link.

3. Has anyone in the EU become infected?

Several cases have been reported in the EU and the UK since the beginning of the outbreak. Given the
extensive movement of people and the fact that the virus is transmitted from one person to another, it
is expected that further cases will be reported in Europe.

4. Why is the number of cases increasing so rapidly?

Two of the main reasons for the rapid increase in the number of cases are that the virus is spreading
from one person to another and that the capacity to detect cases is improving. This is why a sudden
increase in the number of cases is often observed during the initial phase of an outbreak of an emerging
disease.

5. How long this outbreak will last?

Unfortunately, it is not possible to predict how long the outbreak will last and how the epidemic will
evolve overall. We are dealing with a new virus and therefore a lot of uncertainty remains. For instance,
it is unknown whether transmission will decrease during the summer, as is observed for seasonal
influenza.

Information for travellers

1. Should I reconsider travelling to Asia at present, privately or for business?

At present, most cases are being reported in China, with a smaller number of cases reported in certain
other Asian countries. The likelihood of becoming infected in other countries across Asia is currently
considered low and the World Health Organization has not advised against travel to these areas.
However, the outbreak is evolving very rapidly and the risk of infection is therefore changing. (See the
list of areas with presumed community transmission). Follow the travel advice provided by public health
authorities in your country of residence.

2. What should I be most cautious of when travelling abroad, including trips to China?

When visiting China you should:

avoid contact with sick people, in particular those with a cough;

avoid visiting markets and places where live or dead animals are handled;

follow general rules concerning hand hygiene and food hygiene;

wash your hands with soap and water OR use an alcohol-based disinfectant solution before eating, after
using the toilet and after any contact with animals;

avoid contact with animals, their excretions or droppings.

Wherever you travel, you should apply general hand hygiene and food hygiene rules.

Data

Advice for travellers: outbreak of a novel coronavirus 2019-nCoV

Brochure - 30 Jan 2020

3. What if I have recently been to China and have become ill?

If you have been to China and within 14 days of your return you feel sick or have a fever, cough, or
experience shortness of breath, you should:

Seek immediate medical attention. Before you go to a doctor’s office or emergency room, call them and
tell them about your recent travel and your symptoms.

Avoid contact with others.

Ensure you do not travel while sick.

Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing. If
you have easy access to surgical face masks, use one, and dispose of it safely after use. Remember to
wash your hands after disposing of a mask.

Follow appropriate disinfection/hand washing rules to avoid spreading the virus to others.

4. What about on a plane or in an airport?

If it is established that a case of 2019-nCoV has been on an airplane, the people who were at risk will be
contacted by public health authorities. Should you have questions about a flight you have taken, please
contact your local health authority for advice. The risk of being infected on an airplane cannot be
excluded, but is currently considered to be low for an individual traveller.

The risk of being infected in an airport is similar to that for any other place where many people gather.
5. Why are people arriving from China not being checked for 2019-nCoV at the airport?

There is evidence that checking people at the airport (known as entry screening) is not very effective in
preventing the spread of the virus, especially when people may not be presenting symptoms or the
symptoms of the disease are very similar to those for other illnesses and the timeline coincides with
increased activity in seasonal influenza across the EU and in China. It is generally considered more useful
to provide those arriving at airports with clear information explaining what to do if they develop
symptoms after arrival.

What is the current situation in China regarding 2019-nCov?

1. What is China doing to stop this outbreak? Are those measures efficient?

To limit the spread of the virus, the Chinese authorities have implemented a number of extraordinary
control measures across the country, including in Hubei province, where the outbreak started. Among
other measures, they cancelled the Lunar New Year celebrations and closed cinemas and theme parks to
ensure social distancing between people. In addition, to reduce the movement of people they
suspended public transportation and closed the international airport of Wuhan Tianhe. To monitor the
outbreak, they have enhanced their surveillance system.

The scale of these measures is unprecedented and the economic costs of such measures to the Chinese
economy are considerable. Although the effectiveness and collateral effects of these measures are
difficult to predict, they are expected to limit the immediate likelihood of further spread of the virus via
travellers returning from Hubei province and China in general.

2. How many cases have been reported by China and in which regions?

The number of cases reported by China is rapidly evolving. ECDC is publishing updates on the number of
cases and deaths reported in and outside of China on a daily basis:

Situation update – worldwide

2019-nCoV and animals and food products

1. What about animals or animal products imported from China?

Due to the animal health situation in China, notably the presence of contagious animal diseases, only a
few live animals and unprocessed animal products from China are authorised for import into the
European Union. There is no evidence that any of the animals or animal products authorised for entry
into the European Union pose a risk to the health of EU citizens as a result of the presence of 2019-nCoV
in China.
2. What about food products imported from China?

As with the imports of animals and animal products, due to the animal health situation in China, only a
few products of animal origin are authorised for import into the EU from China, on the condition that
they meet strict health requirements and have been subjected to controls. For the same reasons,
travellers entering the EU customs territory are not allowed to carry any meat, meat products, milk or
dairy products in their luggage.

There has been no report of transmission of the 2019-nCoV via food and therefore there is no evidence
that food items imported into the European Union in accordance with the applicable animal and public
health regulations governing imports from China pose a risk for the health of EU citizens in relation to
2019-nCoV. The main mode of transmission is from one person to another.

3. What about contact with pets and other animals in the EU?

Current research links 2019-nCoV to certain types of bat, but does not exclude the involvement of other
animals. Several types of coronaviruses can infect animals and be transmitted to other animals and
people. There is no evidence that companion animals (e.g. dogs or cats) pose a greater risk of infection
than humans. As a general precaution, observe basic principles of hygiene when in contact with animals.