Why know the WHO advice on COVID-19?

As healthcare professionals, we need to be aware of the advice given by WHO to the public so that we can re-iterate this in consultations and interactions with patients, and incorporate it into our institutional policies and programmes.

The WHO has extensive pages and infographics for the public. Healthcare professionals dealing with the pandemic may not have time to roam these pages, so the below is a distillation of the key messages by topic.  This advice was summarised on 11th June 2020, much of it seems broad enough to be unlikely to change, but the WHO website provides the latest recommendations.

Exercise during Coronavirus

• Encourage by emphasising the benefits to mental health, prevention of non-communicable disease and improvements to sleep (1)

• Recommended 30 mins/day for adults and 60 mins/day for children (1)

• Suggested forms of exercise for the home: strength and balance training, dancing, if available technology:  active video games, online exercise classes (1)

• Break up periods of sitting by standing, stretching, dancing, if applicable: climbing stairs (1)

Food and COVID-19

• Healthy diet supports a healthy immune system and can reduce likelihood of certain non-communicable diseases (2)

• Reduce salt where possible, eat unprocessed wholegrains, choose options without added sugar, reduce fats and oils, limit consumption of processed meats and transfats, choose white meats over red meats, drink recommended amounts of water, limit alcohol intake (2)

• There have been no confirmed cases transmitted on food packaging (3)

• Wash hands after grocery shopping, then wash fruit and vegetables in clean water (3)

Smoking cessation during Coronavirus pandemic

• Encourage due to higher severity of COVID-19 in smokers (4)

• Smokeless tobacco poses a risk of COVID-19 transmission due to hand to mouth contact, and spitting of saliva (4)

• There is currently insufficient data to confirm any link between nicotine and prevention/treatment of COVID-19 (5)

• WHO recommends smokers access local support to quit smoking (4)

This quote could be very powerful for patients:

“Quitting will help your lungs and heart to work better from the moment you stop.  Within 20 minutes of quitting, elevated heart rate and blood pressure drop. After 12 hours, the carbon monoxide level in the bloodstream drops to normal. Within 2-12 weeks, circulation improves and lung function increases. After 1-9 months, coughing and shortness of breath decrease. Quitting will help to protect your loved ones, especially children, from exposure to second-hand smoke.” (5)

Mental wellbeing in COVID-19

• Keep a structure to the day: maintain regular waking and bed time, regular personal hygiene, meals and exercise. Allot time to be working and separate rest time, as well as time for things for enjoyment (6)

• Keep up social interactions through safe and allowed means – through phone or online if this is accessible (6)

• Limit or stop alcohol intake.  There is no evidence of a protective effect of alcohol against coronavirus and excessive alcohol consumption is damaging (6)

• Do not consume recreational drugs (6)

• Monitor screen time and take breaks from screens (6)

• Limit constant or distressing news if it makes you anxious. Get advice and information from trusted sources such as local and national TV and radio, and WHO once or twice a day (6)

• Provide help to others in the community if able to (6)

Pregnancy and breastfeeding and Coronavirus

• Women with COVID-19 should breast feed if they wish to, have skin-to-skin contact with their baby and share a room with their baby (3)

• Women with COVID-19 should wear a mask or practice respiratory hygiene, wash their hands before and after touching the baby, and surfaces should be disinfected regularly (3)

• If a woman is too unwell to breastfeed she can be supported to express or offered donor breast milk for her baby (3)

Hygiene and COVID-19

• Wash hands regularly or use hand sanitiser (3)

• Regularly washing hands is more protective than wearing plastic gloves (3)

• Wash hands before eating, caring for the sick, before and during food prep or if hands are visibly dirty (with soap and water) (3)

• Wash hands after coughing or sneezing, caring for the sick, toilet use, food prep, handling animals or animal waste (3)

• Keep hand sanitiser out of the reach of children except during supervised use, as these products are toxic if ingested (3)

• Keep hand sanitisers away from flames (3)

• Only a coin-sized amount of hand sanitiser is required (3)

• Avoid irritation of eyes/mouth/nose by touching them after using hand sanitiser (3)

• Wash clothes and linen as normal if no one in the household has COVID-19 (3)

• If someone in the household has COVID-19 or is suspected to, there is specific advice shown below (3):

Isolation and general advice

• Maintain at least 1 metre distance from others (3)

• Avoid crowds (3)

• Avoid touching eyes, mouth and nose (3)

• Cover mouth and nose with a bent elbow during a cough or sneeze, or with a tissue which should be immediately disposed of into a closed bin (3)

• Those with symptoms should stay home and avoid leaving the house or contact with others (3)

• Do not shake hands as a greeting or make physical contact (3)

• There is no evidence of transmission through use of money (3)

References

1. World Health Organisation. #HealthyAtHome: Physical Activity. [Online]. Available from: https://www.who.int/news-room/campaigns/connecting-the-world-to-combat-coronavirus/healthyathome/healthyathome---physical-activity [Accessed 11.6.20].

2. World Health Organisation. #HealthyAtHome: Healthy Diet. [Online]. Available from: https://www.who.int/campaigns/connecting-the-world-to-combat-coronavirus/healthyathome/healthyathome---healthy-diet [Accessed 11.6.20].

3. World Health Organisation. Coronavirus (COVID-19) advice for the public. [Online]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public [Accessed 11.6.20].

4. World Health Organisation. #HealthyAtHome: Quitting Tobacco. [Online]. Available from: https://www.who.int/campaigns/connecting-the-world-to-combat-coronavirus/healthyathome/healthyathome---quitting-tobacco [Accessed 11.6.20].

5. World Health Organisation. Q&A: Tobacco and COVID-19. [Online]. Available from: https://www.who.int/news-room/q-a-detail/q-a-on-tobacco-and-covid-19 [Accessed 11.6.20].

6. World Health Organisation. #HealthyAtHome: Mental Health. [Online] Available from: https://www.who.int/campaigns/connecting-the-world-to-combat-coronavirus/healthyathome/healthyathome---mental-health [Accessed 11.6.20].