The novel coronavirus 2012 infectious disease or the Middle East Respiratory Syndrome (MERS-CoV) is a strain of coronavirus (MERS Corona Virus: MERS CoV), which so far has majorly spread in the Middle East, as well as recent reported outbreak in South Korea with reported human-to-human transmission among different groups of patients, including care takers, family members and healthcare professionals. However, widespread virus transmission in the public hasn’t been identified yet. Regarding human-to-human transmission, the disease can be spread through patients’ sputum while coughing, as well as through intimate exposing to the patients without prevention, particularly in hospitals. MERS-CoV patients are usually identified with fever and coughing symptoms. In some cases, patients concurrently develop symptoms in gastrointestinal tract such as diarrhea. For other severe cases, patients could suffer some respiratory related symptoms, including panting, dyspnea respiration and pneumonia. For Thailand, currently there is no report of the disease. However; in prevention and mitigation of risks on spreading of virus, both indoor and outdoor, the gathering of large people, especially those from the MERS CoV-affected countries within grounded space, large-scale meeting or any other activities participated by individuals from countries affected by the outbreak, following preventive measures should be taken:
Pre-event preparations
• Publicizing related information via documents, handbooks, email notice or other media channels to communicate on potential risks relating to the infection of novel coronavirus 2012, as well as related preventive measures and disease controls;
• Providing instructions for those with fever, cough, rhinorrhea, sore throat on the board at the entrance of the event;
• Setting points to give away hygienic masks and alcohol-based gels gel for hand washing in the venue of event;
• Allocating staff to regularly clean equipment and highly exposed areas, such as handrails, doorknobs, toilet doors, by using detergent liquid or general cleaning liquid. This should be done more often that normally. (Door that users can use other parts of body such as the back to push can reduce the exposing to the disease.);
• Provide sufficient basins with soap, as well as tissue paper in the toilets;
• Organizing meeting layout to reduce overcrowding of area used, and increase the frequency of event participants transport service so as to reduce the risk of disease spreading;
• Coordinating between event organizer as well as healthcare professionals or hospital to take up necessary measures in case of emergency. This includes training, practicing of personal skills and preparations in terms of equipment and disease control;
• Setting up two medical service points, including one primary medical care point and the other for condition monitoring on the suspected patients. Ambulance should also be in place to enable timely patient transportation;
• Providing communication channel or do the system test to enable communication between meeting organizer and healthcare professionals for maximum convenience;
• Formulating team network to follow up on meeting participants travelling from the disease affected countries. The team will act as center to facilitate meeting participants by proving information and receiving information from them. Providing that the participants have related symptoms, the team shall coordinate for instant treatment, as well as inform related officials in timely manner;
• Team of healthcare/ public health professionals based at the service points/ screening area must have been trained and practice personal skills in terms of infectious control, as well as on using personal protective equipment (PPE). They should be responsive to emergency case. Training can be provided by local hospital;
• Setting up free medical hotline for the meeting participants to provide practical advice or provide medical service for those developing illness symptoms during the meeting or at the venue. The patients should be advised to stay at dedicated area before hospitalizing;
• Preparation of personal protective equipment (PPE) for immediate availability;
• Providing of appropriate infectious waste disposal system; and
• Offering participants with other alternatives, in addition to joining the meeting, such as communicating via website or telecasting via mass media.
During the event
1. Asking for name and address of participants coming from epidemic affected countries, as well as providing the list of accommodation, including checking in or checking out dates for local hospitals for monitoring purposes;
2. Arranging form of the meeting to minimize risk of disease spreading. This includes appropriate seat layout, controlling of crowding, catering, socializing, transportation, accommodation management etc;
3. Providing preliminary medical services in support of primary screening, in case of developing illness in the participant, as well as transporting them to healthcare professional for appropriate treatment;
4. Publicizing and giving advice to the participants and related staff, enabling them to stay abreast of preventive guidelines, for instance wearing protection masks, washing hands with soap or alcohol gels; and
5. Team network to follow up on health of the team members, and reporting necessary information for the meeting participants.
Post the event
In case of having the suspected patient of novel coronavirus 2012 infectious disease, following measures to be taken:
1. Meeting organizer should coordinate with the team network and healthcare professionals to transport and facilitate in providing information to those with illness, including transport information, booking of accommodation and etc.
2. Participants who develop illness should refrain from close associating with others, and seeking help from doctor, keeping network team or healthcare professionals informed for preliminary treatment, providing traveling details as well as disease exposing details, both in the country of meeting and when returning to own country.