Public Health England has warned that widespread transmission of the coronavirus (covid-19) is now 'highly likely'. It comes as the number of UK cases reach 36 with two full recoveries and one death so far, a British man on the Diamond Liner cruise ship in Japan .
Appearing on BBC Breakfast this morning, medical director Professor Paul Cosford said the extent of infection globally suggests that the UK needs to prepare for more widespread infection.
'I wouldn't say anything is inevitable but it is now highly likely,' he confirmed.
Boris Johnson is expected to chair an emergency Cobra meeting today where senior ministers and health advisors will be told of the 'significant challenge' the virus presents and plans to finalise the government response will be finalised.
Economics experts are now warning the outbreak could impact the UK economy, with Bank of England governor Mark Carney telling Sky News this morning that it could lead to a downgrade of the UK's economic growth prospects. There also warnings of school closures and cancelling major sporting events and festivals in the UK. As of yet, nothing is confirmed.
Italy remains the worst affected country in Europe with 1128 cases and 29 deaths so far. In Tenerife, 168 Britons at the H10 Costa Adeje Palace hotel have been told to isolate themselves.
In the UK, Health Secretary Matt Hancock said there are no plans to stop flights to Italy. 'If you look at Italy, they stopped all flights from China and they're now the worst-affected country in Europe,' he said. Meanwhile, children returning from holidays in Northern Italy have been sent home from school on new travel advice from the Government.
New advice on the UK government website is as follows:
'If you have returned from these specific areas since 19 February, you should call NHS 111 and stay indoors and avoid contact with other people even if you do not have symptoms: Iran, specific lockdown areas in northern Italy as designated by the Government of Italy, "special care zones" in South Korea as designated by the Government of the Republic of South Korea and Hubei province (returned in the past 14 days).'
'If you have returned from these areas since 19 February and develop symptoms, however mild, you should stay indoors at home and avoid contact with other people immediately and call NHS 111. You do not need to follow this advice if you have no symptoms: northern Italy (anywhere north of Pisa, Florence and Rimini), Vietnam, Cambodia, Laos, Myanmar.'
What is the coronavirus?
Believed to originate in Wuhan, a city in central China, the flu-like virus belongs to the same family of coronaviruses that causes Severe Acute Respiratory Syndrome (Sars) – a disease that killed an estimated 800 people in 2002/03 around the world. The virus can be transmitted between humans, but details about how easily that can happen are not yet known.
What is the advice for Britons returning from Italy?
Britons returning from Northern Italy have been told they should self-isolate if they show symptoms of coronavirus. It comes after a spike in cases in Italy led to the government putting several towns in Lombardy and Veneto on lockdown.
Matt Hancock, the Health Secretary, made the warning this morning on BBC Breakfast, saying that anyone returning from north of Pisa with flu-like symptoms should stay at home for 14 days. For anyone who has returned from Italy's quarantined towns, they should self-isolate even if they show no symptoms.
What is a pandemic?
A spike in diagnosed coronavirus (COVID-19) cases around the world has led to fears the virus will soon be classed as a global pandemic. Most recently, there has been an increase of cases in South Korea, Italy and Iran.
According to the World Health Organisation, a pandemic is 'the worldwide spread of a new disease'. Tedros Adhanom Ghebreyesus, WHO chief, has warned that the window to contain the virus is 'narrowing' .
'The tipping point after which our ability to prevent a global pandemic seems a lot closer after the past 24 hours,' Paul Hunter, professor of health protection at the University of East Anglia said this morning. He told the BBC that the spike in cases outside China is 'extremely concerning'.
Worldwide, there are over 87,000 confirmed cases with a death toll of more than 2,900.
The UK Foreign & Commonwealth Office (FCO) has advised against all travel to Hubei Province, and against all but essential travel to the rest of mainland China. 'If you’re in China and able to leave, you should do so,' the website states.
The Department of Health and Social Care has also stated the following:
'UK Chief Medical Officers are advising anyone who has travelled to the UK from mainland China, Thailand, Japan, Republic of Korea, Hong Kong, Taiwan, Singapore, Malaysia or Macau in the last 14 days and is experiencing a cough or fever or shortness of breath, to stay indoors and call NHS 111, even if symptoms are mild.'
It was confirmed yesterday that Australia has implemented their emergency response plan, effectively 'operating on the basis that' there is a pandemic, the Prime Minister Scott Morrison said. The World Health Organisation is yet to declare the virus a pandemic, despite it meeting two of the three criteria: it spreads from human to human and kills.
The third criteria is for it to be worldwide and it is currently only in 38 countries - although exists on every continent. The New Scientist has reported that the WHO may be holding back because of the potential reaction from countries around the world.
Pandemic plans 'may not be appropriate for combating covid-19' with experts starting that where flu pandemics have been declared in the past there have been expensive countermeasures that some deemed unnecessary. You can read more about this here.
Do face masks work to prevent coronavirus?
Experts have warned that face masks aren't hugely effective in preventing the virus. 'The face masks that we see people wearing are surgical face masks,' Dr Mark Parrish, regional medical director of the medical and travel security firm International SOS told The Telegraph. 'As you breathe in and out you're breathing air from outside the face mask. So it will stop a little bit but not hugely.'
'There are reports in literature that face masks in a hospital setting can protect health care workers. But there, they are being used for short periods by trained professionals, changed frequently and properly disposed of,' Jonathan Ball, professor of molecular virology at the University of Nottingham has said. 'Those staff are also adopting good personal hygiene. But in the general population it may even be the case that they’re not helpful at all. If you don’t change them regularly enough, they could potentially start to trap viruses and eventually they can move through that mask into your respiratory tract.'
Wearing a mask would also have a different effect depending on how exposed you are to the virus. 'Wearing a mask walking around isn’t going to do any good, but if you’re in a situation where you’re highly exposed, a mask is helpful,' Colleen Kraft, associate chief medical officer for Emory University Hospital told The Washington Post. 'You may wear a mask when someone is going to cough directly on you or [in] a place with a lot of ill people. In a hospital, we wear a mask with patients who have influenza. '
What is the advice for the public?
The WHO states the following:
During previous outbreaks due to other coronavirus (Middle-East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS), human-to-human transmission occurred through droplets, contact and fomites, suggesting that the transmission mode of the COVID-19 can be similar. The basic principles to reduce the general risk of transmission of acute respiratory infections include the following:
• Avoiding close contact with people suffering from acute respiratory infections.
• Frequent hand-washing, especially after direct contact with ill people or their environment.
• Avoiding unprotected contact with farm or wild animals.
• People with symptoms of acute respiratory infection should practice cough etiquette (maintain distance, cover coughs and sneezes with disposable tissues or clothing, and wash hands).
• Within health care facilities, enhance standard infection prevention and control practices in hospitals, especially in emergency departments.
WHO does not recommend any specific health measures for travellers. In case of symptoms suggestive of respiratory illness either during or after travel, travellers are encouraged to seek medical attention and share their travel history with their health care provider.
Public Health England, however, does have advice for those returning from travels as mentioned earlier and listed under 'what is the travel advice because of coronavirus?'. You can find out more from the UK government website here.
How many people are infected with coronavirus?
According to the WHO's situation report on the 27 February, there are currently 87,137 confirmed cases of coronavirus and 2,977 deaths. The huge majority of these cases are in China, with 79,968 confirmed and 2,873 deaths. Outside of China, the virus has spread to 58 countries.
How do I self-isolate?
PHE has a clear guide on how to self-isolate which you can read by clicking here. They advise the following...
- Stay at home - do not go to work, public areas, use public transport or taxis until you've been told it's safe to do so. You will need help getting outside supplies, and if you decide to order by phone or online you must give clear delivery instructions that the items should be left outside, in the porch, or as appropriate for your home.
- Separate yourself from other people in your home. Stay in a well-ventilated room with a window to outside that can be opened, separate from other people in your home. If possible, use a separate bathroom, avoid using shared facilities unless necessary and regularly clean them - there is more information on this here.
- Call ahead before visiting the doctor - all medical appointments must be discussed in advance with a designated medical contact (a number will be provided to you).
- Wear a facemask if advised to do so.
- Cover coughs and sneezes. Dispose of tissues into a plastic waste bag and immediately wash your hands with soap and water for at least 20 seconds rinse and dry thoroughly.
- Wash your hands.
- Avoid sharing household items.
- Monitor your symptoms - seek medical attention if your illness is worsening i.e. if you have difficulty breathing.
- Don't have visitors in your home. Anyone deemed essential to visit must be discussed with your medical contact first.
- All waste that comes into your contact should be put in a plastic rubbish bag, tied when full and placed in a second bin bag and tied. You should not dispose of it or put it out for collection until it is confirmed you do not have coronavirus. If you do you will be instructed on how to dispose of the waste.
The countries with coronavirus and how the virus spread
After the virus was found in Wahun, China, it quickly spread to other cities including Beijing and Shenzhen.
Then, the virus spread to Japan, Taiwan, Thailand, South Korea, Macau and the US. Soon after, cases were reported in Hong Kong, Singapore, Vietnam and France before reaching Malaysia, Nepal, Australia and Canada. Then Cambodia, Germany, Sri Lanka, Finland, UAE, India and the Philippines recorded cases. Since 31 January, coronavirus has reached Italy, Russia, Sweden, the UK, Spain and Belgium.
As of 23 February, there are cases reported in Israel, Iran, Egypt and Lebanon. The spike in cases in Italy has been of particular concern - the death toll now stands at seven - with the country putting lockdown efforts in place that mirrors China's. This is across several small towns in Lombardy and Veneto, where 50,000 residents will not be able to leave for the next two weeks without special permission.
As of the 26 February, the virus has spread from Italy to Austria, Croatia, Switzerland, Algeria, Africa and Latin America.
Austria, Croatia and Switzerland all reported their first coronavirus cases yesterday, all seemingly linked to the growing spread in Italy.
Confirming that the cases involved people who had been to Italy, there are also new cases in Algeria and across Africa linked to the outbreak. Latin America too, confirmed their first case after a Brazillian resident returned from Italy.
As of the 27 February, the virus has spread to Brazil, Denmark, Estonia, Georgia, Greece, Norway, Pakistan, Romania, and North Macedonia.
Despite the spread, health ministers in France, Italy, Germany and the EU commission have decided not to close any borders saying it would be a 'disproportionate' reaction.
'We're talking about a virus that doesn't respect borders,' Italian Health Minister Roberto Speranza said at a meeting on Tuesday. His German counterpart, Jens Spahn, added that the situation was being taken 'very, very seriously' but 'it could get worse before it gets better.'
South Korea is the worst affected country outside China with 760 cases and seven deaths. After 11 military members were infected, nearly 8,000 troops were quarantined. North Korea has quarantined 380 foreigners despite having no confirmed cases as health experts warn that the country does not have the health infrastructure to test and treat cases effectively.
How many people in the UK have coronavirus?
Currently, there have been 36 cases of coronavirus in the UK and two recoveries. The virus has spread to all parts of the UK, with Scotland reporting it's first case this morning.
As of 01 March at 9am, a total of 11,750 people have been tested in the UK, of which 11,715 were confirmed negative and 35 positive. This does not include the case in Scotland reported this morning.
13 people were diagnosed on Sunday, three of which were linked to a man from Surrey who caught the infection in the UK - as oppose to abroad. The cases were confirmed in Gloucestershire, Hertfordshire, Berkshire, London, West Yorkshire, Essex and Greater Manchester.
One of the cases had 'no relevant travel' history and so it was unclear how they contracted the virus, while others had visited Iran and Italy recently. One college in south-west London has closed after a staff member tested positive, with two other school staff members among the 13 new cases - they were from St Mary's School in Tetbury and Willow Bank Infact School in Berkshire.
A British man on the Diamond Liner cruise ship that is currently being quarantined in Japan has died from coronavirus (covid-19). He is the first British fatality and one of six that have died on the ship.
Japan's Health Ministry reported the death this morning with no further information about the patient, however the UK Foreign Office have confirmed they are investigating the case. The man was one of hundreds infected on the cruise ship with 30 British nationals and two Irish citizens flown back to the UK last week to be quarantined in specialist NHS facilities across the UK.
As of 23 February, there had been two full recoveries. Patients are being treated in specialist NHS facilities.
'These specialist centres are well prepared to deal with cases and earlier this year the Newcastle unit successfully treated and discharged two patients who had contracted the virus,' Keith Willett, NHS strategic incident director for coronavirus, said in a statement.
After the ninth case of coronavirus was confirmed in the UK, it was revealed the woman in question flew from China into London and developed symptoms after landing at Heathrow airport. She tested positive and was transferred to a specialist centre at Guy's and St Thomas' in central London.
The patient had contracted the virus in China. She joined eight others at the time who contracted the virus, although one man - Steve Walsh - fully recovered and left hospital. Professor Paul Cosford from Public Health England has warned that more cases are 'highly likely' in the UK.
Walsh's case has been particularly high profile as the 53-year-old businessman from East Sussex unknowingly passed it on to 11 other people after contracting it in Singapore on business. Five of those people returned to the UK, two of whom are GPs. PHE has confirmed all close contacts of the GPs have been traced and advised including 12 patients.
'Based on the World Health Organization’s declaration that this is a public health emergency of international concern, the UK Chief Medical Officers have raised the risk to the public from low to moderate,' reads Public Health England's website. 'This does not mean we think the risk to individuals in the UK has changed at this stage, but that government should plan for all eventualities.'
Cases are updated on the website here at 2pm every day.
What are the coronavirus symptoms?
The NHS website states that main symptoms are a cough, high temperature and shortness of breath. They are advising people to call 111 if they have symptoms or have been to Wuhan or Hubei Province in China in the last 14 days (even if you do not have symptoms) or have been in close contact with someone with confirmed coronavirus.
'Do not go to a GP surgery or hospital. Call 111, stay indoors and avoid close contact with other people,' they state. 'Tell 111 about any recent travel and any symptoms you have.'
Read its advice on symptoms, self-isolating and treatment here.
How does coronavirus spread?
Since the virus is new, it's not known exactly how it spreads from person to person. However, the PHE website states 'similar viruses [are] spread by cough droplets or sneeze droplets'.
'These droplets fall on people in the vicinity and can be directly inhaled or picked up on the hands and transferred when someone touches their face,' the statement continues.
'Under most circumstances, the amount of infectious virus on any contaminated surfaces is likely to have decreased significantly by 24 hours, and even more so by 48 hours,' it adds.
What is being done about it?
As well as the WHO studying the disease, officials in China have said that they are doing the ‘utmost to tackle the situation’. Public Health England has ‘recommend practising good hand and respiratory hygiene and avoiding animal and bird markets’. You can read their guidelines here.
'PHE has introduced advanced monitoring at airports with direct flights from China,' the PHE website reads. 'A team of public health experts has been established in Heathrow airport to support anyone arriving on flights from China who feels unwell. These hubs will bring in rotational teams of seven clinicians, working in shifts, who will be on hand to support patients on arrival. This is in addition to medical staff who are already permanently in place at all UK airports and the advice issued to all UK airports for people travelling to and from China.'
What is the travel advice because of coronavirus?
'The Foreign and Commonwealth Office (FCO) advise against all travel to Hubei Province and now advise against all but essential travel to the rest of mainland China (not including Hong Kong and Macao),' the PHE website states. 'If you’re in China and able to leave, you should do so. The elderly and those with pre-existing medical conditions may be at heightened risk.'
If you're returning from travelling, this is the current government advice:
'If you have returned from these specific areas since 19 February, you should call NHS 111 and stay indoors and avoid contact with other people even if you do not have symptoms: Iran, specific lockdown areas in northern Italy as designated by the Government of Italy, "special care zones" in South Korea as designated by the Government of the Republic of South Korea and Hubei province (returned in the past 14 days).'
'If you have returned from these areas since 19 February and develop symptoms, however mild, you should stay indoors at home and avoid contact with other people immediately and call NHS 111. You do not need to follow this advice if you have no symptoms: northern Italy (anywhere north of Pisa, Florence and Rimini), Vietnam, Cambodia, Laos, Myanmar.'
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