07-09 May, 2020 Timelines: Decisions of the Moroccan governement concerning COVID-19 since the beginning of the crisis

Publication of a circular on the organization of care for pregnant women and newborns: On the 4th May, the Ministry of Health published a circular on  “care management for pregnant women and newborns in the context of the COVID-19 pandemic”. This note is addressed to regional health directors and directors of university hospital centres.

At present, the limited information available on the virus does not show a higher risk for pregnant women to become infected with COVID-19 compared to the general population. The World Health Organization (WHO) points out that, to date, there are few data on the perinatal impact of coronavirus infection during pregnancy or postpartum. Moreover, there is no evidence of mother-to-child transmission when the infection occurs during pregnancy. However, the impact of this health crisis on maternal and neonatal health protection services needs to be considered.

Prevention of infection

The Ministry of Health recommends that health care facilities implement a list of measures to prevent Covid-19 infection and continue prenatal care, including educating women in labour on what to do (washing hands regularly, avoiding crowds, avoiding touching eyes, nose and mouth, and following respiratory hygiene rules). Hygiene measures must also be respected in the examination and reception rooms by the caregivers (ventilation of the premises, continuous availability and use of soap and/or hydroalcoholic solutions, wearing of surgical masks, etc.).

To avoid congestion in the waiting rooms, it is recommended to organise prenatal consultation appointments for all pregnant women, and to develop communication channels with them if necessary. During consultations, access must be forbidden to any non-essential person (accompanying person, child, visitor…).

Care of pregnant women infected with COVID-19

Pregnant women with coronavirus are cared for in the same facilities designated for the care of possible or confirmed cases. These facilities must, however, have a maternity ward, an operating theatre and postpartum isolation facilities. Also, a special circuit within maternity hospitals and delivery homes must be dedicated to confirmed pregnant women, to anticipate an imminent delivery and ensure their orientation in postpartum care in the designated structures according to the standards of the Ministry of Health.

Obstetric care for these women is carried out according to the usual protocols, without specific recommendations for the mode of delivery or postpartum.

If there is a threat of premature delivery, tocolysis is not contraindicated in case of Covid-19 infection, unless the patient’s condition requires termination of pregnancy. Corticosteroid therapy for fetal lung maturation should be used according to the usual indications and treatment regimens.

In addition, the treatment regimen depends on the gestational age, maternal health, and symptomatic forms of Covid-19 disease. Prior to initiation of treatment, an initial clinical and biological assessment, followed by regular monitoring and evaluation of maternal and fetal well-being, is necessary.

Administration of chloroquine?

In view of the genotoxic potential, reproductive toxicity and limited clinical data available, chloroquine and hydroxychloroquine should not be used during pregnancy.

Nevertheless, taking into account the clinical situation and within the framework of a multidisciplinary team (gynaecologist-obstetrician, neonatologist-paediatrician, resuscitator and pneumologist) the use of hydroxychloroquine can be discussed, with the informed consent of the couple and rigorous follow-up.

Postpartum women can be treated as adults in accordance with the protocol for the management of patients with Covid-19 in force by the Ministry of Health.

And in all newborns of confirmed mothers, a PCR screening test must be performed. To date, there is no specific management for Covid-19 infection in newborns, but it must be adapted according to the state of health of the newborn. Suspect or positive newborns should be transferred to a closed incubator after conditioning.

The criteria for recovery are the same as those in the management protocol for confirmed patients.

Moreover, according to the Ministry’s circular, separation is not recommended between the confirmed mother and her newborn, and breastfeeding and skin-to-skin contact are preferred, depending on the state of health of the mother and the newborn, and in accordance with the rules of hygiene.

For more information, please consult (in french) the following link.

FRMF (Royal Moroccan Football Federation) cuts salaries and contracts to cope with COVID-19 crisis: Reductions in coaches’ salaries, contracts and player transfer periods were at the centre of a videoconference meeting held on Thursday 7 May by the Royal Moroccan Football Federation. The aim was to examine the situation of the sport following the spread of COVID-19.

For more information, please consult (in french) the following link.

Comité de veille économique – new provisions concerning consumer credit, real estate credit and Damane Oxygène: The Comité de veille économique (CVE) has taken new measures to deal with the effects of COVID-19. These provisions concern individuals and businesses and affect consumer credit and real estate credit, as well as the Damane Oxygène scheme.

For individuals whose income has fallen as a result of the state of health emergency decreed, the CVE has decided that the State and the banks will pay all the interim interest generated by the extension of the maturities of housing and consumer loans for the period between March and June 2020. This measure is valid for people with monthly credit maturities of up to 3,000 DH for housing loans and 1,500 DH for consumer loans, including those contracted with finance companies.  In total, 400,000 people should benefit from the extension of credit maturities.

For more information, please consult (in french) the following link.