People who were in contact with a family who contracted COVID-19 while in Italy have tested negative for the virus, health authorities said on Monday.

The three Italian patients - a 12-year-old girl and her parents - are in a stable condition at Mater Dei's Infectious Diseases Unit. Doctors do not believe their condition will deteriorate but no discharge date has yet been set.

A special 111 helpline set up by the authorities for anyone concerned about the outbreak has so far received 13,000 calls.

The media was briefed about their condition by a team of health professionals with rolled-up sleeves and ties tucked into their shirts - the protocol adopted at hospitals to minimise any transmission from patient to patient.

Pathology professor Chris Barbara said that so far, 231 swab tests of suspected cases and another 309 random tests have been administered. All, except for three, tested negative. Another two carried out on Monday morning also tested negative.

There have also been requests for swab tests from hotels, and all resulted negative.

Medical training

Charles Mallia Azzopardi, from the IDU meanwhile noted that front-line medical staff - those at the IDU and the Intensive Treatment Unit - have all been trained on how to handle COVID-19 cases. Training, he added, is being extended to other staff. Some 200 doctors and hundreds of nurses have been trained so far.

Michael Borg, a professor who heads infection control services, explained that COVID-19 is transmitted in a similar way that the common flu is, that is, through respiratory excretion.

This meant that those in contact with COVID-19 patients needed to cover their mouth, nose, eyes and palms of their hands, as they might touch their face. The virus was ineffective when it came to skin contact. 

Protective gear

Protective gear used by staff at Mater Dei Hospital was therefore different to that used during the Ebola outbreak, where the risk of contagion was higher and the virus was spread through blood as well, he added.

Health professionals also addressed concerns raised by nurses about the protective gear being used.

Local medical workers have been given personal protective equipment in line with World Health Organization and European Centre for Disease Control recommendations, Borg said. The PPE provided is the same that used in Hong Kong, where, despite a high number of coronavirus patients, no healthcare professional had yet been infected, he noted.

On the other hand, countries which had introduced other PPE which was more awkward to remove had seen cases of health workers being infected, Borg said.

Borg dismissed claims made by the nurses’ union that PPE being used in Malta was only adequate in IDU and ITU settings, which have negative pressure environments.

Clinical circumstances determined PPE type, he said, irrespective of where it is worn.

Mater Dei Hospital has also brought over 14 additional units that can be installed in rooms outside of the infectious diseases unit to filter and purify the air.

Borg said that he was not aware of any nurses or health professionals who required PPE and were not given the gear.

Fielding questions from the media he also noted that the ECDC did not recommend the use of masks outside of hospitals. This is because, even if worn properly, people still risked touching their mouth, nose or eyes with contaminated hands.

The best way to prevent the spread of the virus was by practising good hand hygiene, he insisted.