COVID-19: Blog Coronavirus: What do I need to be aware of?

The new coronavirus* disease, COVID-19, has the attention of the whole world. This virus has spread rapidly since the outbreak began in the east of China in December 2019. But what exactly is it? How can you avoid catching it? Can you still travel? As a doctor at KLM Health Services, these are the questions I have been asked most often by travellers, crew and ground personnel. Below I offer some answers and explanations.

The new coronavirus

Coronaviruses are a group of viruses that look a bit like crowns (corona being the Latin word for crown). There are different kinds of coronaviruses, most of which only cause mild symptoms and illness, such as a cold.

We do not know (yet) what caused this novel coronavirus (COVID-19), but research is being carried out to find its source. What was striking about the start of this outbreak was that all the people who first went down with the virus had visited the same market where lots of live animals were being traded. It is probably here that the virus was first transmitted to humans. Infectious diseases occur especially where animals and humans live in close proximity to one another. This gives viruses an opportunity to jump from animals to humans and then to spread among the human population. This is why we often see that new viruses emerge in densely populated regions, such as parts of China.

Many viruses are known to originate in bats, which then transmit them via other animals to humans. SARS and Ebola also originated in bats.


The new coronavirus initially produces the same symptoms as the common cold, but these can develop into feverbreathing difficulties and pneumonia. How ill you become depends on a number of factors. So far we have seen that people with weakened immune systems (the elderly and people with other underlying medical conditions) are becoming more seriously ill than young, healthy people.

Symptoms of COVID-19 are:

The problem with a new disease is that at the beginning of the outbreak you often only see the most extreme cases. These people end up in hospital and some of them die. What we do not know at the beginning of an outbreak is how many people have been infected, but have only mild symptoms, perhaps similar to the common cold, and therefore do not go to a doctor. It’s only once more research has been carried out that these cases are also brought into the picture and the disease comes to appear less serious than was originally thought. Current estimations suggest that serious symptoms occur in around 17% of COVID-19 patients and that the disease becomes fatal for around 2% of these people. But, this statistic might turn out to be lower, once more information becomes available.

What can you do to avoid becoming infected?

The coronavirus is transmitted in the tiny droplets that are produced when people cough and sneeze. These droplets do not stay suspended in the air, but descend quickly. It is therefore very important that you stay at a distance of at least 1 metre from infected people.

The droplets can also end up on objects in the vicinity of the patient. The virus cannot survive very long there, but if ‘fresh’ droplets get onto your hands and you then touch your face (mouth, nose, eyes), you can become infected. It is therefore important that you wash your hands thoroughly and often. To prevent the spread of coronavirus we also advise avoiding physical contact with others and to stop shaking hands.

If you do become infected, you are advised to sneeze or cough into the inside of your elbow and to use paper handkerchiefs (tissues). This will reduce the chance of infecting other people.

Is there any point in wearing facemasks?

There isn’t much point in wearing a facemask, unless you are a care provider working with patients. Not all facemasks protect against viruses and they can also be a hindrance. A mask quickly gives a false sense of security and can generate additional risks; people tend to adjust facemasks frequently, which means constantly putting their hands near their faces. This increases the risk of infection.

However, if you are an infected patient, then wearing a facemask does make sense. A mask prevents droplets infected with the virus from getting into the air, because they get caught in the mask. If you are ill, but do not have a facemask available, then sneeze and cough into your elbow, or use disposable paper handkerchiefs (tissues).

In an aircraft

It is a commonly held belief that diseases are more easily transmitted on board aircraft, because everyone spends hours breathing the same air. This is a myth. The air in aircraft is continually renewed with fresh air drawn in from outside. This air is first warmed by the aircraft’s engines before being pumped into the cabin. Some of the air is circulated, but this is cleaned using very efficient filters that remove pathogens.

In an aircraft you do sit very close to one another. It is therefore hard to keep a distance of at least 1 metre if someone is in the seat next to you. Should you worry about every person who coughs or sneezes near you? No, that isn’t necessary. Only when there is a combination of symptoms (fever, respiratory complaints) AND a link to a region where there is a coronavirus outbreak, there should be cause for alarm. Besides, people who have been to an infected region and who are displaying coronavirus symptoms are not allowed to fly.

Passengers are being tested at some airports before they board flights. This is not (yet) being done in the Netherlands. If we were to test passengers at Schiphol now, we would primarily find common cold and flu viruses.

Is it still safe for me to travel?

There is no need to worry about travelling to most countries at the moment. However, it is wise to keep yourself up-to-date with the latest information surrounding travel risks. Due to coronavirus some countries now have a negative travel advice, including China and Italy. Check the website of the Ministry for Foreign Affairs for travel advice. This will provide you with the most current information on the risks and recommendations.

The most important steps you can take against the new coronavirus when travelling are very simple. Follow the general hygiene rules that apply to all common cold and flu viruses. It is important that these steps are always taken:

  • Wash your hands regularly with soap and water and/or use sanitising hand gel or spray;
  • Cough and sneeze into the inside of your elbow and use paper handkerchiefs (tissues);
  • Stay away from ill people and animals;
  • Only consume animal products that have been thoroughly heated.

Look out for the most recent travel advice and flight information, and follow any recommendations issued by local authorities.

Can you become infected by touching packages from China?

Coronaviruses are transmitted between people and animals. They cannot survive for long outside a body and certainly not on cardboard, packaging, or other materials. Other coronaviruses are not transmitted in this way and we have no reason to believe that the COVID-19 coronavirus will behave any differently.

*What is a virus?A virus is a microscopic organism that consists of a piece of genetic material (usually DNA) encased in protein. Viruses are not actually living organisms; they don’t move, they don’t eat, and they can’t reproduce by themselves. Viruses need a cell in a host organism in order to reproduce. When a virus enters a human body, it penetrates a living cell. The virus then sets mechanisms in motion within the human cell, which ensure that the virus’s genetic material is copied as many times as possible. Once the cell has been filled with virus particles, it collapses. This releases the virus particles, which go on to infect new cells. Sometimes ‘mistakes’ occur when the DNA is copied. This is called a mutation (change). A mutation sometimes works against the virus and sometimes in its favour.