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; and avoiding close contact with anyone that has a fever and cough.

WHO is working closely with global experts, governments and partners to rapidly expand scientific knowledge on this new virus and to provide timely advice on measures to protect people’s health and prevent the spread of this outbreak.

The detection and spread of an emerging respiratory pathogen are accompanied by uncertainty over the key epidemiological and serologic characteristics of the novel pathogen and particularly its ability to spread in the human population and its virulence (case-severity). This is the case for the COVID-19 virus, first detected in Wuhan city, China in December 2019 (1).

To date initial surveillance has focused primarily on patients with severe disease, and, as such, the full spectrum of the disease, including the extent and fraction of mild or asymptomatic infections that do not require medical attention are not clear. Estimates of the case fatality ratio, and other epidemiological parameters, will likely be lower than current crude mortality estimates once the full spectrum of disease is able to be included in the denominator. In addition, the role of asymptomatic or subclinical infections in human-to-human transmission of COVID-19 virus is not well understood and it is not yet clear whether those who are reported as asymptomatic may be able to transmit the virus to other individuals.

With a novel coronavirus, initial seroprevalence in the population is assumed to be negligible due to the virus being novel in origin. Therefore, surveillance of antibody seropositivity in a population can allow inferences to be made about the extent of infection and about the cumulative incidence of infection in the population.

This document is an update to the interim guidance document titled ‘Considerations in the investigation of cases and clusters of COVID-19.’ This version provides updated recommendations, including a revision to Figure 1.

This document offers operational guidance to Member States for the rapid investigation of suspected COVID-19 cases. It is to be used by local, regional, or national health authorities as considerations for investigating cases and contact tracing of COVID-19. This should not be considered a comprehensive guide to outbreak investigation. Detailed outbreak investigation guidance has been developed for other respiratory pathogens, including MERS-CoV and influenza. Further information on outbreak investigation for COVID-19 can be found on the OpenWHO website.

This guidance may be implemented in different countries with varying resources and epidemiological patterns and should be adapted accordingly. This document is intended to describe the specific components required to undertake an investigation.

This document is informed by current knowledge of the COVID-19 outbreak and similar considerations for other respiratory pathogens, including MERS-CoV and influenza viruses. WHO will continue to update these recommendations as new information becomes available.

Testiranje na COVID-19 / SARS-CoV-2 indicirano je kod osoba sa simptomima bolesti:

1. osobe sa postavljenom sumnjom na COVID-19 prema važećoj definiciji slučaja.

2. potvrđeni slučajevi COVID-19/SARS-CoV-2 infekcije u svrhu potvrde negativizacije.

Prioritetne skupine za testiranje su na COVID-19 / SARS-CoV-2 :

a) Osobe koje zbog svojih osobina, prvenstveno zanimanja, imaju visok potencijal širenja bolesti na osjetljive skupine

– zdravstveni djelatnici i hospitalizirani bolesnici, prvenstveno sa teškom akutnom respiratornom infekcijom (SARI) koja se ne može protumačiti drugom etiologijom: svi SARI pacijenti u jedinicama intenzivnog liječenja (JIL) te na ostalim bolničkim odjelima,bolesnici hospitalizirani zbog nekog drugog hitnog stanja, a imaju i simptome i/ili znakove akutne respiratorne infekcije.

– štićenici i djelatnici domova za starije i nemoćne te ostalih ustanova socijalne skrbi

b) Osobe koje zbog svojih osobina imaju visok potencijal zaražavanja velikog broj ljudi s rizikom brzog širenja infekcije i stvaranja klastera

– zatvorenici i djelatnici u zatvoru,

– izbjeglice i tražitelji azila,

– beskućnici,

– pripadnici etničkih/kulturoloških skupina čiji način života pogoduje prijenosu bolesti kapljičnim putem i direktnim kontaktom i sl.

Prebacivanje krivice za eventualne medicinske greške na zdravstvene radnike koji su trenutno na bolovanju je više slabost poslodavaca i odgovornih iskazana prema svojim jedinim i nenadoknadivim ljudskim resursima.

Prije obrazloženja: Poslodavac je odgovoran za sigurnost (Zaštitu na radu) i zdravlje zdravstvenih radnika (vidi Zakon o radu FBiH čak od 1997, godine.!!!) Iz ove definicije proizilazi da nesigurni radni uvjeti, loša organizacija posla, fizička i emocionalna preopterećenja na poslu, diskriminacija i omalovažavanje su najvažniji uzroci obolijevanju i onesposobljavanju zdravstvenih radnika, a posebno podsticaji na kršenja etičkog kodeksa i deontologije među zaposlenicima u zdravstvenim ustanovama!

Prebacivanje krivice za eventualne medicinske greške na zdravstvene radnike koji su trenutno na bolovanju je više slabost poslodavaca i odgovornih iskazana prema svojim jedinim i nenadoknadivim ljudskim resursima koji samo mogu podstaknuti njihovu želju da se nikad na posao više ne vrate!!! Još tužniji su komentari njihovih kolega koji su u nekom svojstvenom povlaštenom položaju ("nemoral"; " zaslužuju otkaz"...).

Moramo biti svjesni da je sad zaposleno najviše zdravstvenih radnika u dobi od 55- 65 godina i uglavnom su sa hroničnim morbiditetom. Nisu li to osjetljive skupine za najozbiljnije klinicke slike od korona virusa?

Na drugoj strani virus je ušao u kliničke centre, zdravstvene ustanove i ambulante i upravo zato je započelo širenje infekcije u zajednici. Značajan broj zdravstvenih radnika u našoj zemlji je zaraženo i oboljelo, neki su na hospitalnom tretmanu, a neki u samoizolaciji. Nažalost, imamo i jedan smrtni ishod, ugledni mr. med. sc. Šefik Pašagić, specijalista epidemiolog.