COVID-19 Frequently Asked Questions

1. What is UNFPA doing to address the COVID-19 epidemic? 

UNFPA is working with governments and partners to respond to the essential needs of women and girls of reproductive age who are affected by the COVID-19 outbreak. UNFPA is focusing on countries that have weak public health and social support systems, including countries in fragile and humanitarian situations. 

UNFPA helps governments strengthen the capacity of their health systems, procuring and delivering essential supplies, ensuring access to sexual and reproductive health and gender-based violence services, promoting risk communication and community engagement, and contributing to the joint UN impact assessment of the pandemic.

In addition to advocating for gender-sensitive responses, UNFPA has been providing material support to affected health systems. For example:

  • In China, UNFPA has distributed sanitary napkins and adult diapers for vulnerable populations, including at-risk elderly persons, as well as personal protective equipment for health workers. 
  • In Iran, UNFPA has acquired supplies such as masks, disinfectants and gloves for more than 400 centres for elderly persons and those living with disabilities.
  • In the Philippines, UNFPA provided personal protective equipment – including coveralls, long-sleeve gowns, face shields, eye goggles, aprons, head covers, and shoe covers – to front-line health workers. These supplies supplement an earlier distribution of hand-held thermometers and surgical masks.
  • In Moldova, to assist health system responders, UNFPA has worked with partners to launch an online dashboard, updated in real time, showing caseloads disaggregated by location, sex, age and pregnancy status. 

During disease outbreaks, women face a variety of risks, yet they are too often absent in the design of epidemic/pandemic responses. This has been true in the COVID-19 experience thus far. UNFPA will therefore advocate with national and local authorities to ensure that women’s participation, including as health workers, is prioritized.

UNFPA is also mobilizing its extensive network of youth and women’s organizations, including faith groups, to engage communities on infection prevention, healthy behaviours, as well as preventing and ending disease-related stigma and discrimination.

2. Are pregnant women at increased risk of severe illness from COVID-19?

There is emerging evidence on the impact of COVID-19 on pregnancy and newborns.

Pregnant women’s overall risk of experiencing severe COVID-19 illness is low. However, recent studies report that pregnant women with COVID-19 are at increased risk of being admitted to intensive care and of requiring mechanical ventilation compared with women who aren’t pregnant. 

In the United Kingdom, among pregnant women with COVID-19, hospital admission was more likely among Black, Asian or other minority ethnic backgrounds. Pregnant women over the age of 35, those who have a BMI of 30 or more, and women with pre-existing medical problems, including high blood pressure and diabetes, also appear to be at higher risk of developing severe illness requiring hospitalization. 

The majority of women who have become severely ill were in their third trimester of pregnancy. Preterm birth rates are higher in pregnant women with COVID-19 than in pregnant women without the disease. 

Given that pregnant women undergo physical changes that can make them more vulnerable to experiencing serious respiratory infections, they must be treated with utmost priority. 

Evidence over vertical transmission (the spread of COVID-19 from mother to fetus) is not well established, and much remains unclear. However, we can still make concrete suggestions about caring for pregnant women, post-partum women and newborns during the pandemic. Women attending health facilities for care, must be cared for separately from identified COVID-19 cases to prevent virus transmission. 

All women, regardless of whether or not they have COVID-19 should be encouraged by their maternity care providers to access routine antenatal, delivery, safe abortion and postpartum, or postabortion care to the full extent of the law

UNFPA is also concerned about the risks pregnant women may experience as health systems grapple with the pandemic. During public health emergencies, human and financial resources are often diverted from various health programs to respond to the infectious disease outbreak. Quality maternal health services must remain available, even as health resources are increasingly diverted to deal with COVID-19.

3. What should pregnant women be doing to stay safe?

Pregnant women should take the same preventive actions recommended for all adults to avoid exposure to the virus, such as avoiding close contact with anyone who is coughing and sneezing, washing hands often with soap and water or alcohol-based hand rub, engaging in physical distancing, disinfecting surfaces, and covering their mouth and nose with a tissue or elbow when coughing and sneezing. Recommendations and guidelines for wearing a mask in public to prevent the spread of infection differ from country to country.

All recommended actions are available on the WHO website.

4. Should pregnant women be vaccinated against COVID-19?

At present there is insufficient evidence to recommend routine use of COVID-19 vaccines during pregnancy.

As of January 2021, the World Health Organization recommended not to use the Moderna or Pfizer-BioNTech vaccine during pregnancy unless the benefit of vaccinating outweigh the potential vaccine risks, such as for pregnant health workers at high risk of exposure and pregnant women with comorbidities increasing their risk of experiencing severe COVID-19 symptoms. At the same time, WHO notes that for the Moderna vaccine, “we don’t have any specific reason to believe there will be specific risks that would outweigh the benefits of vaccination for pregnant women.” WHO has no preferred vaccine product for pregnant women or the general population.

Women are recommended to discuss the benefits and risks of taking the vaccine with their health-care professional and reach a decision based on individual circumstances.

5. Should new mothers exhibiting COVID-19 symptoms breastfeed their newborns? Should they be separated from their newborns?

There is currently no evidence that a woman with symptoms consistent with COVID-19 infection, who has recently given birth, needs to be separated from her infant. All mothers and infants, regardless of their COVID-19 status, need support to remain together to practice rooming-in, establish breastfeeding, and practice skin-to-skin contact or kangaroo mother care.

According to UNICEF, “considering the benefits of breastfeeding and the insignificant role of breastmilk in the transmission of other respiratory viruses, the mother can continue breastfeeding, while applying all the necessary precautions.”

Symptomatic mothers well enough to breastfeed should wear a mask when near her infant (including during feeding), wash hands before and after contact with the child (including feeding), and disinfect contaminated surfaces.

If a mother is too ill to breastfeed, she should be encouraged to express milk that can be given to the infant via a clean cup and/or spoon – while wearing a mask, washing hands before and after contact with the child, and disinfecting contaminated surfaces.

6. Is the COVID-19 epidemic affecting women disproportionately? How so? 

Accurate, reliable sex-disaggregated data on COVID-19 infection and mortality rates are still needed.

But it is known that disease outbreaks affect women and men differently. Evidence from prior epidemics shows that existing inequalities for women and girls, and discrimination of other marginalized groups such as persons with disabilities and those in extreme poverty, worsen in these times. Women and girls face higher risk of domestic violence, as well as other forms of gender-based violence including sexual exploitation and abuse

Women are less likely than men to have decision-making power during an outbreak, and as a consequence their general and sexual and reproductive health needs may go largely unmet. There is also an inadequate level of women’s representation in pandemic planning and response.

Globally, women are more likely than men to work in precarious, informal jobs while shouldering a greater burden of unpaid care, and can face interruptions to their work, loss of livelihoods, and increased care responsibilities as a result of COVID-19. Social protection systems that do not address gender inequalities during an outbreak can exacerbate the multiple and intersecting forms of discrimination women and girls face.

Women also represent approximately 70 per cent of the global health-care and social services workforce, which puts them on the front lines of the response and at increased risk of infection. As health systems undergo strain due to the virus, efforts must be made to account for the unique challenges faced by female health workers. For example, gender inequalities may leave women health workers less able to advocate for protective equipment. They may be less able to attend to their own sexual and reproductive health needs, such as hygiene supplies for menstruating staff or breaks for pregnant staff. 

7. What happens to pregnant women who contract COVID-19?

UNFPA is working to ensure that pregnant women with suspected, probable or confirmed COVID-19 infections, including those who may need to spend time in isolation, have access to woman-centred, respectful, skilled care, including routine testing and screening, appropriate referrals, safe delivery and newborn care, as well as mental health and psychosocial support. Health systems must also be ready to address maternal and neonatal complications in these cases. 

UNFPA is also working to ensure all women following birth, who have COVID-19, or who have recovered, are provided with information and counselling on safe infant feeding and appropriate measures to prevent COVID-19 virus transmission.

All women should be enabled and encouraged to access routine antenatal, delivery, and, safe abortion where legal and to the full extent of the law, and postpartum or postabortion care. 

8. Nurses and midwives are at increased risk of exposure. Do they have the necessary safety equipment? 

Around the world, women make up about 70 per cent of health and social service workers. Midwives, nurses and community health workers are on the front lines of efforts to combat and contain outbreaks of disease. They require personal protective equipment (PPE). Serious equipment shortages were seen at the start of the pandemic. Although the global supply chain for PPE has improved, shortages are still seen in many places. 

The protection of health workers, in particular midwives, nurses, obstetricians and anesthesiologists, must be prioritized. They must be provided with PPE if they are treating patients with suspected or confirmed COVID-19.

9. Have nurses and midwives on the front lines of humanitarian crises been trained on how to protect themselves from infection? 

UNFPA is working to ensure that health care personnel in infection prevention and control are trained or re-trained to reduce the risk of human to human transmission. Training will be based on World Health Organization guidance.

Health workers, particularly midwives, should also be trained in mitigating stigma and discrimination, watching for signs of gender-based violence, and educating people about COVID-19 infection symptoms and related hygiene messages.

10. Are rates of domestic violence rising as a result of the COVID-19 pandemic? 

Reliable data on gender-based violence are notoriously difficult to obtain, and conditions are rapidly changing as COVID-19 spreads around the world. We therefore do not have a clear view into how gender-based violence rates are changing. But we have plenty of reasons to be concerned.

Evidence from prior outbreaks indicates that women and girls face higher risks of intimate partner violence and other forms of domestic violence due to heightened tensions in the household. The financial impacts of epidemics also increase the risk of other forms of gender-based violence, such as sexual exploitation and abuse.

These concerns are particularly acute in the COVID-19 pandemic, which has resulted in movement restrictions on a scale never before seen. There are real dangers for women and girls forced into isolation with abusers, and concerns over whether and how they can receive assistance. Critical services provided by health systems, including clinical management of rape, psychosocial support and referrals to protection, may be cut off when health providers are overburdened with COVID-19 cases. 

Health workers must be equipped with the skills and resources to provide sensitive, respectful and confidential care to survivors of gender-based violence. 

11. How could the COVID-19 pandemic affect sexual and reproductive health and rights? Will women still be able to access sexual and reproductive health services during the outbreak?

Health systems may divert resources away from sexual and reproductive health services to deal with the outbreak. This could contribute to a rise in maternal and newborn morbidity and mortality, increased unmet need for contraception, and increased numbers of unsafe abortions and sexually transmitted infections.

In addition, the availability of family planning and other essential sexual and reproductive health commodities, including menstrual health items, may be impacted as supply chains are strained by the response to the pandemic.

Sexual and reproductive health services, including antenatal and maternal care, are life-saving and must remain accessible. Special attention must be paid to ensure vulnerable populations -- such as persons living with disabilities, persons living with HIV, indigenous people , and those living in poverty -- do not lose access to this care. Health staff providing these services must also strictly adhere to infection prevention and control measures. UNFPA is working to maintain the continuity of these services globally.

Women’s and girls’ sexual and reproductive health choices and rights must be respected regardless of whether they are infected, or have been infected, with COVID-19. This including access to contraception, emergency contraception, safe abortion where legal and to the full extent of the law, and post-abortion care.

12. How will the COVID-19 pandemic affect low-income countries? How will it affect humanitarian settings?

The short answer is that we do not know. 

Containing the rapidly spreading disease has been an enormous challenge even in well-resourced communities. There are reasons to believe low-income and humanitarian settings will face even greater risks. But it is important to note that all vulnerable populations will experience COVID-19 outbreaks differently

The COVID-19 pandemic is straining health systems, and is expected to severely impact the health systems of low- and middle-income countries - with worse impacts in countries experiencing fragility or humanitarian crises. For the nearly 48 million women and girls, including 4 million pregnant women, identified by UNFPA as being in need of humanitarian assistance and protection in 2020, the dangers posed by COVID-19 are magnified
Those facing long-running crises, conflict, natural disasters, displacement and other health emergencies face even greater dangers. Many displacement camps and informal settlements are densely populated and have poor access to running water, making infection prevention measures even more difficult. Shortages of health workers and poor access to critical care services exacerbate the challenges these communities will face.

Countries affected by conflict are particularly vulnerable. On 23rd March, the UN Secretary-General called for “an immediate global ceasefire in all corners of the world.” He said, “It is time to put armed conflict on lockdown and focus together on the true fight of our lives… to bring hope to places among the most vulnerable to COVID-19.” We hope that warring parties will heed his call.

13. Older people, and those with pre-existing conditions, are reportedly more vulnerable to COVID-19. Does that mean young people are safe from the pandemic?

No, young people are not safe from COVID-19. 

They are as likely as older people to become infected and contagious. They can also experience complications and death from the disease. They should strictly follow national guidelines to prevent exposure and infection. 

Some adolescents and youth face heightened risks, including those with pre-existing medical conditions. In addition, there are elevated risks for young people who lack reliable information, who have poor access to sanitary conditions, who are unable to engage in social distancing, or who have limited access to health services due to distance, resources or discrimination. This means risks are heightened for many adolescent girls, single adolescent parents, young migrants, young refugees, homeless young people, those in detention or living in crowded areas, and young people with HIV. 

Additionally, the pandemic has made young people’s lives more challenging due to strains on essential services. Formal education in many places has been severely impacted by the crisis. Young people's sexual and reproductive health may also be compromised as health services and supply chains are stressed. 

Yet at the same time, young people in many countries are well positioned to play a role helping their communities respond to the pandemic.

14. What can young people do to protect themselves and others?

The most important thing anybody can do to keep themselves and their community safe is to follow the prevention guidelines shared by the World Health Organization -- washing hands frequently, engaging in social distancing, and seeking medical care early if they experience a fever, cough and difficulty breathing. All recommended actions are available on the WHO website. 

With the right training on the disease and its transmission, young people can also take proactive measures to protect their broader communities. Many young people’s ease with technology means they are well positioned to maintain communication links with friends and networks even as their communities practice social distancing. Young people can therefore play a critical role in disseminating accurate information on COVID-19, including sharing information about risk reduction and national preparedness and response efforts.

 

The COVID-19 FAQs have last been updated on 12 August 2020

Photo credit: CDC.gov

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