General prevention measures
• The only way to prevent infection is to avoid exposure to the virus and people should be advised to:
• Wash hands often with soap and water or an alcohol-based hand sanitiser and avoid touching
the eyes, nose, and mouth with unwashed hands
• Avoid close contact with people (i.e., maintain a distance of at least 1 metre [3 feet]), particularly
those who have a fever or are coughing or sneezing
• Practice respiratory hygiene (i.e., cover mouth and nose when coughing or sneezing, discard
tissue immediately in a closed bin, and wash hands)
• Seek medical care early if they have a fever, cough, and difficulty breathing, and share their
previous travel and contact history with their healthcare provider
• Avoid direct unprotected contact with live animals and surfaces in contact with live animals when
visiting live markets in affected areas
• Avoid the consumption of raw or undercooked animal products, and handle raw meat, milk, or
animal organs with care as per usual good food safety practices.
• [WHO: coronavirus disease (COVID-19) advice for the public]
• The World Health Organization (WHO) does not recommend that people wear a medical mask in
community settings if they do not have respiratory symptoms as there is no evidence available on
its usefulness to protect people who are not ill. However, masks may be worn in some countries
according to local cultural habits. Individuals with fever and/or respiratory symptoms are advised to
wear a mask, particularly in endemic areas.
• It is mandatory to wear a medical mask in public in certain areas of China, and local guidance should
be consulted for more information.
• [BMJ: facemasks for the prevention of infection in healthcare and community settings]
Screening and quarantine
• People travelling from areas with a high risk of infection may be screened using questionnaires about
their travel, contact with ill persons, symptoms of infection, and/or measurement of their temperature.
Combined screening of airline passengers on exit from an affected area and on arrival elsewhere has
been relatively ineffective when used for other infections such as Ebola virus infection, and has been
modelled to miss up to 50% of cases of COVID-19, particularly those with no symptoms during an
incubation period, which may exceed 10 days. Symptom-based screening processes have been
reported to be ineffective in detecting SARS-CoV-2 infection in a small number of patients who were
later found to have evidence of SARS-CoV-2 in a throat swab.
• Enforced quarantine has been used in some countries to isolate easily identifiable cohorts of people at
potential risk of recent exposure (e.g., groups evacuated by aeroplane from affected areas, or groups
on cruise ships with infected people on board). The psychosocial effects of enforced quarantine may
have long-lasting repercussions There is currently no vaccine available. Vaccines are in development, but it may take up to 12 months
before a vaccine is available. An mRNA vaccine (mRNA-1273) has been shipped to the National
Institute of Allergy and Infectious Diseases for phase I clinical trials in the US, with an estimated start
date of 6 March 2020.
General prevention measures