Coronavirus: medical chief says UK hopes to delay any outbreak until summer – The Guardian

Britain is hoping to delay any possible outbreak of coronavirus in order to prepare the NHS if it cannot be contained, the chief medical officer, Prof Chris Whitty, has said.

“If we are going to get an outbreak here in the UK, and it is an if, not a when, putting it back in time into the summer away from the winter pressures on the NHS … is a big advantage,” he told BBC Radio 4’s Today programme.

What is the virus causing illness in Wuhan?

It is a member of the coronavirus family that has never been encountered before. Like other coronaviruses, it has come from animals. Many of those initially infected either worked or frequently shopped in the Huanan seafood wholesale market in the centre of the Chinese city.

What other coronaviruses have there been?

New and troubling viruses usually originate in animal hosts. Ebola and flu are other examples – severe acute respiratory syndrome (Sars) and Middle Eastern respiratory syndrome (Mers) are both caused by coronaviruses that came from animals. 

What are the symptoms of the Wuhan coronavirus?

The virus causes pneumonia. Those who have fallen ill are reported to suffer coughs, fever and breathing difficulties. In severe cases there can be organ failure. As this is viral pneumonia, antibiotics are of no use. The antiviral drugs we have against flu will not work. If people are admitted to hospital, they may get support for their lungs and other organs as well as fluids. Recovery will depend on the strength of their immune system. Many of those who have died were already in poor health.

Is the virus being transmitted from one person to another?

China’s national health commission has confirmed human-to-human transmission, and there have been such transmissions elsewhere. As of 12 February there are now 45,182 confirmed cases and 1,115 deaths. There are cases in 28 other countries outside China, with deaths recorded in one case in Hong Kong, and one case in the Philippines. The number of people to have contracted the virus overall could be far higher, as people with mild symptoms may not have been detected.

The number of confirmed cases of coronavirus in the UK has doubled from four to eight after four more people in Brighton were diagnosed with the infection over the weekend.

One of the other four confirmed cases is being treated at the HCID unit at the Royal Free hospital in north London, and the two Chinese nationals who tested positive for Coronavirus in York are being treated at the HCID centre in Newcastle.

Why is this worse than normal influenza, and how worried are the experts?

We don’t yet know how dangerous the new coronavirus is, and we won’t know until more data comes in. The mortality rate is around 2%. However, this is likely to be an overestimate since many more people are likely to have been infected by the virus but not suffered severe enough symptoms to attend hospital, and so have not been counted. For comparison, seasonal flu typically has a mortality rate below 1% and is thought to cause about 400,000 deaths each year globally. Sars had a death rate of more than 10%.

Should I go to the doctor if I have a cough?

Unless you have recently travelled to China or been in contact with someone infected with the virus, then you should treat any cough or cold symptoms as normal. The NHS advises that people should call 111 instead of visiting the GP’s surgery as there is a risk they may infect others.

Is this a pandemic and should we panic?

Health experts are starting to say it could become a pandemic, but right now it falls short of what the WHO would consider to be one. A pandemic, in WHO terms, is “the worldwide spread of a disease”. Coronavirus cases have been confirmed in about 25 countries outside China, but by no means in all 195 on the WHO’s list.

There is no need to panic. The spread of the virus outside China is worrying but not an unexpected development. The WHO has declared the outbreak to be a public health emergency of international concern, and says there is a “window of opportunity” to halt the spread of the disease. The key issues are how transmissible this new coronavirus is between people and what proportion become severely ill and end up in hospital. Often viruses that spread easily tend to have a milder impact.

Sarah Boseley Health editor and Hannah Devlin 

But he added that the country should not rely on the change of the seasons coming to the rescue “in any way”, adding that a four-point tactical plan was in place for the UK.

“At this point in time … we have a strategy that relies on four tactical aims. The first is to contain, the second is to delay, the third is to do the science and the research, and the fourth is to mitigate so that we can actually brace the NHS,” he said.

He said that the future prevalence of coronavirus was heavily dependent on what happened in China and that currently the situation could go “one of two ways.”

“The first way is that China gets on top of the epidemic … and that there are spillover cases all over the world but those are contained and we will have cases in the UK – that is highly likely, we may even get a bit of onward transmission in the UK – and then the epidemic goes away,” he said.

“The alternative is this is not possible to contain in China and then this starts to spread, probably initially quite slowly around the world and at that point unless the seasons come to our rescue then it is going to come to a situation where we have it in the EU, and in the UK.”

Asked about the new case in London, Whitty said that officials were not in touch with everyone who had been on the same plane as the person who is now confirmed to have the virus, just those who had been in close proximity. Further infection of people who were outside that vicinity was unlikely, he added.

Whitty added that finding a vaccine in the short term was unlikely and impractical, suggesting that work on exploring the use of anti-viral drugs was a better focus. “People talk about vaccines, it will in my view be a long while until we have a vaccine that is ready to deploy but we need to get on with that,” he said. “We need to look at existing drugs, like existing HIV drugs – and the Chinese are starting to do this – and test if the existing drugs work against this virus. Some may, some may not.”

But he added that work had to be focused on containing the virus and delaying its spread as any drugs were only likely to be useful for a minority of people, as most who caught the virus would have few or no symptoms.

Whitty said that people in the UK should not be changing their behaviour but taking sensible precautions to avoid getting any virus, such as covering their mouths with a handkerchief or tissue when sneezing or coughing and throwing used tissues away safely.

On the Today programme on Wednesday, Prof Neil Ferguson, an infectious disease expert from Imperial College London, said he thought new cases of the virus could still arise and the world was in the “early phases of a global pandemic”. He estimated about 60% of the UK population in such a situation could be affected, which if the mortality rate was 1% could result in hundreds of thousands of deaths.

But Whitty said it was unhelpful to speculate on numbers without strong evidence. He said the fourth strand of the UK coronavirus plan was mitigation, and ensuring the NHS was able to cope.

“The best estimate for the number of people dying at the top end of the range is about 2%; in my view it could be considerably less than that, but we have to prepare for the worst,” he said. It was wrong to speculate on any potential death toll figures, he said. “It is a mistake to use numbers which are entirely speculative … At the moment the numbers we are seeing out of China are so variable that it is really difficult to put a fixed figure.”

While he said it was possible that “an epidemic is rolling our way”, Whitty said he would only talk about the potential number of people who could be affected when the facts were clear. Commenting on the figures that came out of China on Thursday, which rose sharply after authorities changed the way they calculate the figures, Whitty said any irregularity in the numbers coming out of the country were not “deliberately misleading” but instead the “reality is taking a long time to catch up with the facts”.

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