Coronavirus protection measures
Situation with the disease caused by the new COVID-19 coronavirus (SARS — CoV-2)
- Measures taken by the Government
- Situation in Croatia
- Questions and answers about the disease caused by the new COVID-19 coronavirus
23 January 2020 At the initiative of the Ministry of Health, the Croatian Institute of Public Health has published a multilingual leaflet and a notification on coronavirus for travellers to China (in Croatian, English and Chinese).
24 January 2020 Coronavirus prevention and protection measures have been raised at international airports and seaports in Croatia, in cooperation with the border police, emergency medical services, sanitary border inspectors, county epidemiologists and air carriers.
28 January 2020 Due to the occurrence of isolated cases of coronavirus in some EU Member States, the Croatian Presidency of the Council of the European Union has decided to activate the EU integrated crisis response (IPCR) arrangements in an information exchange format. This mechanism is a crisis coordination mechanism and brings together all the information coming from different actors (EU Member States, EU institutions, World Health Organization, etc.) and is a very useful tool for monitoring the further development of the situation and for evaluating further activities.
1 February 2020 Although Croatia has a well-organized epidemiological service, the Crisis headquarters of the Ministry of Health has raised preparedness measures due to the COVID-19 coronavirus epidemic in order to be prepared for all scenarios.
2 February 2020 In cooperation with Croatian and French authorities, four Croatian nationals, among 250 passengers from fifteen European countries, arrived by a special French aircraft from China to the Istres military airport near Marseille, where they were kept in isolation due to precautionary measures to prevent the spread of the COVID-19 coronavirus epidemic. They were kept in isolation for 14 days i.e. during the incubation time of the disease.
On international flights arriving in Croatia, a systematic survey of passengers was introduced using special forms designed to identify passengers who could potentially have been exposed to infection.
3 February 2020 Health Minister Vili Beros, in the capacity of the country presiding the Council of the European Union, met in Brussels with the European Commissioner for Health Stella Kyriakides and the European Commissioner for Crisis
Management Janez Lenarcic. A decision was adopted to implement health surveillance measures for persons who have stayed in mainland China in the last 14 days.
7 February 2020 Assistant Minister for Health Vera Katalinic-Jankovic and Director of the Croatian Institute of Public Health Krunoslav Capak participated in a teleconference at the level of the Directors-General of all EU Member States and the European Commission on 7 February in Brussels.
11 February 2020 Minister Beros assessed the epidemiological situation regarding the coronavirus in Europe and Croatia as satisfactory for now.
13 February 2020 At the initiative of Croatia, which presides over the Council of the European Union, an extraordinary meeting of health ministers of the 27 member states was held, and they agreed on measures for better coordination in response to the emergence of the new COVID-19 coronavirus and measures to combat the risk of spreading.
The Croatian Government has established the Civil Protection Headquarters of the Republic of Croatia to coordinate all services in the event of the occurrence of COVID-19 coronavirus in Croatia. Deputy Prime Minister and Minister of the Interior Davor Bozinovic has been appointed Chief of the Headquarters.
20 February 2020 The first death of a COVID-19 coronavirus infection in Italy has been reported.
21 February 2020 Following the repatriation of people from a cruiser from Japan and in accordance with the authorities of the Law on the Protection of the Population from Infectious Diseases and at the proposal of the Croatian Institute of Public Health, the Decision on the Establishment of a Quarantine (at the Infectious Diseases Clinic “Dr Fran Mihaljevic”) relating to persons who are identified or suspected to have been in direct contact with patients with COVID-19 while on board ships has been adopted.
23 February 2020 In the Government, Prime Minister Andrej Plenkovic held a meeting with the expert group of the Crisis Headquarters of the Ministry of Health regarding the measures taken and planned to prevent the spread of coronavirus in order to protect the safety and health of Croatian citizens.
24 February 2020 The Crisis Headquarters of the Ministry of Health presented additional measures that Croatia will take against the spread of coronavirus including increased surveillance of border crossings to Italy. All travellers coming from the affected areas are foreseen to be placed in self-isolation with health surveillance and are obliged to report daily to the epidemiologist. The affected areas include China, the Republic of Korea (South Korea) and the provinces of Lombardy and Veneto in Italy. For all persons who have been in close contact with a patient, self-isolation is foreseen in their own home with daily contact with the epidemiologist or organized quarantine if there are no conditions for self-isolation. The Ministry of Health also issued a recommendation to schools recommending not to take school trips and excursions to Italy. Thus, the alert level due to the risk of coronavirus was raised.
Prime Minister Andrej Plenkovic held a meeting with members of the Crisis Headquarters of the Ministry of Health in the context of the developing coronavirus epidemic in neighbouring Italy and discussion on the raising the level of preparedness and new health protection measures for Croatian citizens.
25 February 2020 The first meeting of the Civil Protection Headquarters of the Republic of Croatia was held under the chairmanship of the Prime Minister, Andrej Plenkovic, to raise the level of preparedness of all competent authorities and protect the health of Croatian citizens.
After seven people died in Italy of COVID-19 coronavirus infection in three days, Health Minister Vili Beros attended a meeting of health ministers from neighbouring countries (Croatia, Slovenia, Austria, Germany, Switzerland and France) in Rome.
26 February 2020 The daily sessions of the Civil Protection Headquarters of the Republic of Croatia were introduced at 9 am and 4 pm, after which press releases were issued and published on the web site Civil Protection Directorate.
27 February 2020 - The Government of the Republic of Croatia approved at today’s session the Clinic for Infectious Diseases “Dr Fran Mihaljevic” the amount of HRK 2,250,000 to finance the procurement of nine artificial ventilation devices, to provide the necessary prerequisites for preventing further spread and treatment of coronavirus.
- A meeting with the diplomatic corps in the Republic of Croatia was held at the Ministry of Foreign and European Affairs. With regard to coronavirus events and health measures taken against persons entering the Republic of Croatia across all border crossings, representatives of all diplomatic missions and international organizations accredited in the Republic of Croatia received information on the actions of all involved stakeholders that they will be able to communicate to their citizens who travel to the Republic of Croatia. Special emphasis was put on holding events during the Croatian Presidency of the Council of the European Union HRPRES 2020, with a focus on the stability of holding all scheduled meetings at all levels.
28 February 2020 A course for health workers entitled “BIOSECURITY THREAT OF CORONAVIRUS - ORGANIZATION OF WORK AND PROTECTIVE MEASURES” was held at the Infectious Diseases Clinic “Dr Fran Mihaljevic”.
1 March 2020 It is recommended that health care institutions and health care professionals postpone the provision of health tourism services (providing health services to persons from outside Croatia, such as dental services, spa services, etc.) to persons coming from the affected areas in the next month to prevent the risk of possible spread of COVID-19 disease caused by the new coronavirus (SARS-CoV-2) from affected areas.
2 March 2020 Ministers of Health and Tourism of the Republic of Croatia jointly addressed the tourism market and business partners of the Croatian tourism industry. It was emphasized that despite the precautionary measures due to the emergence and spread of the corona virus, Croatia is still a safe tourist destination. All relevant services are ready to ensure the health security of all citizens and tourists in the Republic of Croatia. Arrival of passengers in the Republic of Croatia is not restricted and tourist traffic can continue to run smoothly.3 March 2020 The Croatian Institute of Public Health has issued additional recommendations for the preservation of health of persons over 60 years of age and those suffering from chronic diseases according to which visits and entry into crowded public areas (means of public transport during the times of biggest crowds, public gatherings, shops in daily peak periods) should be avoided and routine check-ups and visits to general practitioners and hospitals should be skipped unless there is a need for urgent health care services.
4 March 2020 The Croatian Institute for Public Health issued new recommendations regarding the disinfection of ambulance vehicles and sanitary vehicles: buses, trains, ships and aircraft, as well as recommendations for carrying out transport activities.
At the Infectious Diseases Clinic “Dr Fran Mihaljevic”, a meeting was held with heads of infectious services and head nurses regarding internal guidelines for dealing with the coronavirus situation.
5 March 2020 The Minister of Health has adopted the decision to declare the risk of an epidemic of the infectious disease Covid 19. It is an administrative measure that does not indicate the degree of threat but allows the Minister to mobilize all resources in the healthcare system, to relocate infectious diseases doctors and other healthcare professionals and equipment as needed, thus enabling better management of the healthcare system.
A video conference of all public health institutes on prevention of coronavirus spread was held.
6 March 2020
- Zagreb, In accordance with the recommendation of the Headquarters of Civil Protection, Ministry of Science and Education gave instructions primary and secondary schools and higher education institutions in connection with foreign travel.)
- Bruxelles, Minister of Health of the Republic of Croatia mr. Villi Beros chaired an meeting of the EPSCO Council in the format of ministers responsible for health. Ministers discussed the use of existing mechanisms at the EU level and further opportunities for improving communication and information exchange, in the context of dealing with the challenges posed by the spread of Covide-19 in the EU. One of the areas of discussion related to the assessment of the effectiveness of measures taken so far at national level and consider the need for a shift from measures of prevention and preparedness in treating and preventing the spread of so-called; local transmission of infection, in order to strengthen health systems response to this public health threat.
8 March 2020 National headquarters for coronavirus suggests again to avoid travelling to affected areas in North Italy, because of serious epidemiological situation.
9 March 2020 National headquarters for coronavirus introduced new measures to prevent spreading of virus:
- All foreign citizens that come from areas with high risk of infection, especially from some parts of China, Italy, South Corea etc, will be informed with obligatory measure of staying in the carantene for 14 days before entering Republic of Croatia.
- It is recommended to postpone all public events with more than 1000 people. If organizers however decide to organize such events, they must ensure high hygienic standards.
Pupils and students will not attend lectures in schools and universities from March 13 in Istrian county which is closest to Italian border. Lectures will be held online. The capacities of health system, beds and medical equipment are prepared and sufficient.
- Decision of declaration of epidemic diseases Covide-19 in the whole Republic of Croatia
15 March 2020 Ministry of Health has adopted the decision on measures of disposition of work and working time in health institutions and health workers
The Ministry of Health reminds of the following recommendations for persons returning from areas of increased risk of coronavirus.
During the 14 days after returning to Croatia during self-isolation at home:
- Contact an epidemiologist every day
- Measure your body temperature
- Watch out for symptoms of respiratory infection (cough, shortness of breath, etc.)
- Wash your hands regularly or use a hydroalcoholic solution
- Avoid contact with pregnant women, chronically ill, elderly and similar persons
- If you need to go to a healthcare facility, contact a competent epidemiologist
In case of signs of a respiratory infection within 14 days after returning to Croatia:
- Make a telephone call to a competent epidemiologist, describe your symptoms, and inform him of your recent stay in China, South Korea, or the Lombardy and Veneto regions in Italy
- Avoid contact with people around you and put on a mask
- Do not go to a doctor or emergency room without first consulting with a competent epidemiologist who will arrange for you to be taken to an examination
In the event of an urgent departure, it is recommended that you:
- Avoid contact with sick people, especially people who cough
- Avoid markets and places where live or dead animals are kept
- Follow the general rules on hands and food hygiene
- Wash hands with soap and water or use alcohol-based disinfectant before eating, after using the toilet or touching animals
- Avoid contact with animals, their excrement or faeces
- Follow the travel tips on the web pages of the Ministry of Foreign and European Affairs, the Ministry of Health and the Croatian Institute of Public Health
- Wherever you travel, follow the general rules on hands and food hygiene.
- Shaking hands is considered to be close contact for the spread of drip-borne diseases, and it is therefore recommended that people shake hands as little as possible, as this reduces the risk of potential transmission of the disease
In the case of respiratory infection symptoms while traveling, it is recommended that you:
- Wear a surgical mask if you are in contact with other people
- Use paper wipes for one-time use and wash your hands regularly
- Contact a local doctor as soon as possible when traveling to the affected area.
56 affected patients are confirmed in Croatia so far.
- 880 tested samples
- 9598 people have been placed under medical surveillance
12 March 2020 After two negative tests it is confirmed that the first patient is cured.
14 March 2020 After two negative tests it is confirmed that the second patient is cured.
15 March 2020 The first cases in the health system – 2 doctors in Zagreb Hospital Dubrava; pacienst will be evacuated to other hospitals
Rules of procedure of healthcare professionals. Croatian Institute for Public Health, in cooperation with the Clinic for Infectious Diseases “Dr Fran Mihaljevic”, drafted rules for procedure for healthcare professionals in case of suspicion of a new coronavirus. The rules of procedure describe in detail the criteria for suspicion of infection, how to treat the person suspected of infection, how to take and send samples for diagnosis, and measures to prevent and control the spread of infection in healthcare facilities in case of a suspected new coronavirus. The rules of procedure are updated regularly depending on new insights into the epidemic and the disease.
Coronavirus public information. Information for the public about a new coronavirus is also published at the web site of the Croatian Institute of Public Health so that citizens may have access to available information at all times.
Multilingual leaflets on coronavirus. Leaflets in Croatian, English and Chinese language were made for travellers arriving to and returning from the affected area. The leaflets contain instructions on prevention measures during travel and what to do in case of signs of infection, as well as the contacts of competent epidemiologists on stand-by.
Instructions for procedures at border crossings. Detailed instructions for procedures at border crossing points have been drawn up for persons entering Croatia who, for the last 14 days, have been staying in the area affected by the COVID-19 virus epidemic.
At the moment, the Government and the relevant services are doing everything possible, with currently available and limited information about the virus itself as well as its transmission routes, so that Croatia is ready to tackle every possible suspected case of new coronavirus infection.
1. What is the new COVID-2019? What is SARS — CoV-2?
The new coronavirus, which appeared in 2019, called SARS — CoV-2, was discovered in China at the end of 2019. This is a new coronavirus strain that has not been previously detected in humans. The disease caused by this virus is called COVID-2019.
2. Where do the coronaviruses come from?
Coronaviruses are viruses that circulate among animals but some of them are able to pass to humans. Once passed from animal to human, they can be transmitted among humans.
A large number of animals are carriers of coronaviruses. For example, Middle Eastern Respiratory Syndrome coronavirus (MERS-CoV) originates from camels while SARS originates from civet, an animal from the Carnivora order related to cats.
3. Can this virus be compared to SARS or seasonal flu?
The new coronavirus detected in China is genetically closely related to the 2003 SARS virus and the two viruses have similar characteristics, although data on this virus are still incomplete.
SARS appeared in late 2002 in China. Over a period of eight months, 33 countries have reported more than 8,000 cases of SARS infection. At that time, one in ten infected people died from SARS.
The information currently available is not enough to say for sure how deadly 2019-nCoV is. Nevertheless, preliminary findings indicate that it is less lethal than SARS-CoV.
Although nCoV and influenza viruses are transmitted from person to person and may have similar symptoms, the two viruses are very different and therefore behave differently. It is still too early to make any conclusions about how the 2019-nCoV
spreads. Nevertheless, preliminary data indicate that 2019-nCoV is transmitted in the same way as SARS.
4. How is the virus transmitted? How easily does it spread?
Although the virus originates from animals, it is now spreading from person to person (human-to-human transmission). The epidemiological data currently available are not sufficient to determine the ease and success of the spreading of the virus among
humans. The virus seems to be mainly transmitted via dripping when sneezing and coughing.
Currently, the 2019-nCoV incubation time (time between virus exposure and symptoms occurrence) is estimated to be between two and 12 days. Although people are most contagious when they have flu-like symptoms, there are indications that some people can transmit the virus without having symptoms or before they appear. Should this information be confirmed, it will make early detection of 2019-nCoV infection more difficult. This is not uncommon in viral infections, as can be seen from the example of measles, but for this new virus there is no clear evidence that the disease can be transmitted before the occurrence of symptoms.
If people infected with 2019-nCoV are tested and diagnosed on time and rigorous infection control measures are implemented, the likelihood of successful human-to-human transmission among the European population is low. The systematic implementation of prevention and control measures has proven effective in controlling SARS-CoV and MERSCoV viruses.
1. What are the symptoms of 2019-nCoV infection?
As far as is known, the virus can cause mild flu-like symptoms such as
- shortness of breath
- muscle pain and
2. Are some people at greater risk than others?
In general, children, the elderly and those with chronic illnesses (such as high blood pressure, heart disease, diabetes, liver disorders and respiratory diseases) are at increased risk of developing more serious infectious disease symptoms. Given that this is a new disease and the data available are incomplete, it is not yet known which groups of people have a more severe outcome of COVID-19 infection.
3. Is there a treatment for SARS-CoV-2 disease?
There is no specific treatment for this disease. An approach to treating patients with coronavirus-related infections is to treat clinical symptoms (e.g. fever).
The provision of care (e.g. adjunctive therapy and monitoring - oxygen therapy, infusion and antiviral medication) can be very effective in infected persons.
4. Where can I get tested?
If your doctor thinks you need to be tested for SARS — CoV-2, he or she will refer you for further procedure. Currently, diagnostics are only performed at the Infectious Diseases Clinic “Dr Fran Mihaljevic” in Zagreb.
1. How to avoid infection?
If you are in China and other risk areas:
- Avoid contact with sick people, especially people who cough
- Avoid markets and places where live or dead animals are kept
- Follow the general rules on hands and food hygiene
- Wash hands with soap and water or use alcohol-based disinfectant before eating, after using the toilet or touching animals
- Avoid contact with animals, their excrement or faeces.
2. What if I was in close contact with a person with COVID-19?
Report to an epidemiologist or doctor. A person who has been in close contact with a COVID-19 patient in the last 14 days will be placed under active surveillance in self-isolation. This means that the person will be in self-isolation at home, measure their body temperature once a day and be in daily contact with a competent epidemiologist. If a person under health surveillance develops signs of a respiratory illness, the epidemiologist conducting the surveillance will act in accordance with the procedure for a suspected COVID-19 (transportation to the hospital for diagnosis and treatment will be organized) and his or her contacts shall be placed under medical supervision. If a person does not develop symptoms of a respiratory illness upon completion of health surveillance, the epidemiologist shall send a notification of completion of the health surveillance to the competent authorities.
3. What are the rules for disinfection / washing of hands?
Handwashing and disinfection are key to preventing infection. Hands should be washed frequently and thoroughly with soap and water for at least 20 seconds. When soap and water are not available you can use a disinfectant containing at least 60% alcohol. The virus enters the body through the eyes, nose and mouth. Therefore, do not touch them with unwashed hands.
4. Are surgical masks effective protection against SARS — CoV-2?
Surgical masks prevent the spread of infection from sick people to others. Surgical masks are less effective in protecting people who are not infected. For the usual social contact with the patient, a surgical mask and a distance of at least one meter from the patient are sufficient. Health care professionals who are in contact with patients who have suspected or confirmed SARS-CoV-2 are advised to use a surgical mask or a high-level filtering mask (FFP2), and for procedures where aerosol is generated, FFP3 mask are recommended.
5. Is there a vaccine for SARS — CoV-2?
There is currently no vaccine for coronavirus, and no SARS-CoV-2 vaccine. That is why it is important to prevent the infection or its further spreading.
6. Does this year’s SARS — CoV-2 flu vaccine protect me?
The flu virus and SARS-CoV-2 are very different and the seasonal flu vaccine does not protect against the disease caused by the SARS-CoV-2 virus.
However, the flu season in Europe is still ongoing, and the flu vaccine is the best available protection against seasonal flu.
What is the current situation in Croatia regarding COVID-19?
1. What is being done in Croatia?
The Croatian Institute of Public Health, in collaboration with the Clinic for Infectious Diseases, has developed rules of procedures for healthcare professionals in case of suspicion of a new coronavirus. The rules of procedure describe in detail the criteria for suspicion of infection, how to treat the person suspected of infection, how to take and send samples for diagnosis, and measures to prevent and control the spread of infection in healthcare facilities in case of a suspected new SARS—CoV-2 coronavirus. The rules of procedure are updated regularly depending on new insights into the epidemic and the disease.
Information for the public about a new coronavirus is also published at the web site of the Croatian Institute of Public Health so that citizens may have access to available information at all times and they may be accessed here.
Leaflets in Croatian, English and Croatian language were made for travellers arriving to and returning from the affected area. The leaflets contain instructions on prevention measures during travel and what to do in case of signs of infection, as well as the contacts of competent epidemiologists on stand-by.
Detailed instructions for procedures at border crossing points have been drawn up for persons entering Croatia who, for the last 14 days, have been staying in the area affected by the COVID-19 virus epidemic.
The web site of the Croatian Institute of Public Health regularly publishes up-to-date information on the number of patients and advice on the safety and protection of the population.
2. Is anyone infected in Europe?
Since the emergence of the virus, hundreds of cases of infections have been reported in Europe. Given the large flow of people and the fact that the virus is transmitted from person to person, more cases are expected in Europe.
3. Why is the number of cases growing so fast?
Two major reasons for the rapid increase in cases are the transmission of viruses from person to person and the improvement of capabilities for detection of cases. A sudden increase in the number of cases is common in the initial phase of a new disease.
Information for travellers
1. Should I delay my trip to Asia?
Currently, most cases are reported in China while only sporadic cases are reported outside China. The likelihood of infection in other Asian countries is currently low. However, the infection spreads very quickly, which is why the risk of infection changes over time.
2. What if I had recently been to China, the Republic of Korea, or Italy (Veneto or Lombardy regions) and became ill?
A person who has stayed in China or other affected areas in the last 14 days and rapidly develops signs of respiratory illness (fever, cough, sore throat or breathing problems) should contact a competent epidemiologist by phone, describe the signs of the illness, and disclose when he or she has been in China. Persons who have been in the area affected by the epidemic of the disease caused by SARS-CoV-2 in the last 14 days before entering Croatia, will be placed under health surveillance in self-isolation upon entering Croatia.
This means that if they do not have symptoms of illness upon entering the country, the border sanitary inspector will issue a decision to undergo health surveillance in self-isolation at home and will be in contact with a competent epidemiologist for the duration of the surveillance. If a person under health surveillance develops signs of a respiratory illness, the epidemiologist will act in accordance with the procedure for a suspected illness caused by COVID-19 (transportation to the hospital for diagnosis and treatment will be organized) and his or her contacts shall be placed under medical supervision in self-isolation at home or in organized quarantine if there are no conditions for self-isolation.
3. What happens during a flight or at the airport?
If signs of illness are detected in one of the passengers during a flight, the aircraft staff will distribute survey forms to all passengers (Passenger locator cards ) that they have to fill out. The aircraft staff will then pick up the forms before landing the aircraft and, upon landing, hand them over to the state sanitary inspector at the border crossing.
Based on the form and a survey, the border sanitary inspector will issue a decision on health surveillance and refer passengers to a territorially competent epidemiologist. The epidemiologist will be in contact with the referred passengers and will collect additional information on the likelihood of infection, depending on the manner of contact with the infected passenger and apply appropriate health surveillance. If a person does not develop symptoms of a respiratory illness upon completion of health surveillance, the epidemiologist shall send a notification of completion of the health surveillance to the competent authorities. The diseased person from the aircraft will be transported to the hospital for further treatment. If it becomes apparent before the expiry of the health surveillance that the sick passenger does not suffer from SARS — CoV-2, the health surveillance of his contacts shall be terminated.
The risk of infection at an airport is similar to that of any other place where large numbers of people gather.
SARS — CoV-2 virus and animals and food products
1. What about animals or products of animal origin imported from China?
Due to the animal health situation in China, and the presence of infectious diseases in animals, only a limited import of animals and unprocessed products of animal origin from China is allowed into the European Union. There is no evidence that animals or products of animal origin authorized for import into the European Union pose a risk to the health of European Union citizens due to the presence of COVID-19 in China.
2. What about food imported from China?
As regards imports of animals and products of animal origin, due to the animal health situation in China, only a few products of animal origin from China are allowed for import to the European Union, provided that they comply with strict health standards and are subject to controls. For the same reasons, passengers entering the customs territory of the European Union are not allowed to carry meat, meat products, milk or dairy products in their luggage.
Transmission of SARS-CoV-2 via food has not been reported and therefore there is no evidence that food products imported from China to the European Union in accordance with human and animal health safety regulations pose a health risk related to COVID-19 to European Union citizens. It is primarily transmitted from one person to another.
3. What about contact with pets and other animals in the European Union?
Existing research has linked SARS — CoV-2 to some bat species in China, but the presence in other animals has not been ruled out. Several types of coronaviruses occur in animals and can be transmitted to other animals and humans. It has not been shown that pets (e.g. dogs and cats) are at a higher risk of infection than humans. As a general precautionary measure, observe the basic principles of hygiene in contact with animals.
4. Security of postal items from China
Based on the information available on the new coronavirus and on previously known coronaviruses, we believe that the risk of transmission of the new coronavirus to humans via postal items is negligible. Namely, the transmission of the new coronavirus via postal items has not yet been recorded. Although the transmission pathways of this new virus have not been fully understood, all available information indicates that close contact such as family contact (caring for the ill person) or manipulation of a patient in a healthcare facility are required for human-to-human transmission.
All known coronaviruses to date, including the virus that caused SARS 18 years ago and the virus that causes MERS seven years ago, are transmitted by direct close contact (drip-borne) and are very sensitive to atmospheric conditions (they very briefly retain infectivity outside the human body) and transmission through postal items has not been identified for any of them.