Coronaviruses are a group of viruses belonging to the family of Coronaviridae, which infect both animals and humans. Human coronaviruses can cause mild disease similar to a common cold, while others cause more severe disease (such as MERS – Middle East Respiratory Syndrome and SARS – Severe Acute Respiratory Syndrome). A new coronavirus that previously has not been identified in humans emerged in Wuhan, China in December 2019.
Signs and symptoms include respiratory symptoms and include fever, cough and shortness of breath. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome and sometimes death. Standard recommendations to prevent the spread of COVID-19 include frequent cleaning of hands using alcohol-based hand rub or soap and water; covering the nose and mouth with a flexed elbow or disposable tissue when coughing and sneezing (use of mask is being widely recommended); and avoiding close contact with anyone that has a fever and cough.
There is a growing body of literature on aerosol transmission of COVID 19 virus. Some medical procedures can produce very small droplets (called aerosolized droplet nuclei or aerosols) that are able to stay suspended in the air for longer periods of time. When such medical procedures are conducted on people infected with COVID-19 in health facilities, these aerosols can contain the COVID-19 virus. These aerosols may potentially be inhaled by others if they are not wearing appropriate personal protective equipment. Therefore, it is essential that all health workers performing these medical procedures take specific airborne protection measures, including using appropriate personal protective equipment. Visitors should not be permitted in areas where such medical procedures are being performed.
Current evidence indicates that COVID-19 does not appear to directly impact newborns. Few novel coronavirus infections have been reported in newborns, and these were almost uniformly asymptomatic. The few that had symptoms were reported to have mild illness. There is no evidence of vertical mother-to-newborn transmission during pregnancy or via breastfeeding. The pandemic response requires redoubled efforts by health providers and facilities to ensure hygiene practices such as handwashing with soap before and after handling the newborn; frequent, routine cleaning surfaces with disinfectant; and use of masks for mothers who either have tested positive for COVID-19 or who have fever and/or respiratory symptoms typical of COVID-19.
Whereas the direct effects of COVID-19 on pregnancy and newborns are minimal, indirect adverse effects are becoming increasingly apparent and important areas of concern. These include potential disruptions of routine maternal and newborn health (MNH) care that is essential for the health and survival of mothers and newborns. Countries’ responses to the pandemic – such as social distancing measures – can pose threats to continuing best practices by health care providers, as well as to home caregiver practices that are essential to newborn health and survival. Leading examples of these threats to best MNH practices include separation of mothers and newborns instead of promoting immediate skin-to-skin contact and rooming in in facilities, immediate and exclusive breastfeeding, and Kangaroo Mother Care (KMC) for preterm and small babies. Thus, pandemic mitigation by social distancing should not result in unintended harm to mothers and their newborns.
There is also a risk to mothers and babies that pandemic responses limit needed psychosocial support to mothers during pregnancy, delivery, and in the postpartum period. Additionally, the economic toll of the pandemic response poses serious risks to many families – especially mothers and newborns – living in poverty or near-poverty. Policies and programs must recognize and take steps to prevent or ameliorate these important risks which may otherwise be overlooked.
The World Health Organization (WHO) and partners continue to monitor the evidence and provide guidance accordingly.