Background

Coronaviruses (CoV) are a family of microorganisms that can cause illnesses in people which ranges from colds to more severe diseases such as SARS - Severe Acute Respiratory Syndrome (caused by SARS-CoV) and MERS - Middle East Respiratory Syndrome caused by (MERS-CoV).

Strains of the disease not previously seen in humans are termed novel coronaviruses (NCoV) and the current outbreak is being caused by one of these novel viruses that has been named COVID-19.

Illness usually results from close contact with an already infected person – coronaviruses are typically transmitted through respiratory droplets/contact with infected secretions and other body fluids. Due to the fact the COVID-19 remains a new disease there is still only limited information currently available about its routes of transmission and contagiousness.

New, novel coronaviruses occur as a result of a virus “jumping” from one animal species to another and causing an infection that is then able to be passed on to other members of that new species.

Current outbreak

As of yesterday (12th February 2020) the World Health Organisation (WHO) were reporting global cases of COVID-19 to have reached 45,171, with 1,115 fatalities. China remains the largest country affected. There were 24 other countries reporting cases of COVID-19 of which 23 of them report cases with an exposure in China although additionally 11 of these countries were also reporting local transmission having now led to infection – these include, France, Germany, Spain, USA, Thailand, Japan, Singapore, Malaysia, Vietnam, Korea and UK.

While WHO had also reported yesterday that “no new countries reported cases of COVID-19 in the past 24 hours”, results today provided less positive news. New reports from China have seen the total cases rise to approximately 60,000 people, with the infection proving fatal in 1,355 of them. Numbers of cases have also increased in Singapore, Malaysia and the UK have all also reported increases in cases and Japan has reported its first fatality from the disease.

The United Nations (UN) has activated a Crisis Management Team (CMT) on the COVID-19 outbreak which is to be led by the WHO and the latter have also published key considerations for countries when considering the repatriation and quarantine of travellers in relation to COVID-19.

COVID-19 symptoms

The infection starts with a fever (high temperature) which develops over time into a dry cough, then shortness of breath after approximately a week. For some people the symptoms are mild and for others it is leading to hospitalisation.

Based on the available WHO data, the vast majority of people (82%) are only developing mild symptoms, it becomes more severe in approx. 15% of cases and critical in the remaining 3%. The fatality rate appears to be “low” (at between 1% to 2% of those diagnosed), although it is not known how accurate the current figures are.

As reported by GOV.UK, “the UK is one of the first countries outside China to have a prototype specific laboratory test for this new disease.” Where someone is suspected of having the disease, samples (from the nose, throat and/or deeper respiratory system) can now be collected and rapidly analysed (results the same working day).

There is no vaccine, antibiotic or specialist treatment for COVID-19 infections, although breathing support can be needed for the more acute cases. Whether anti-viral drugs will have any effect is being tested too.

NHS advice is to call 111 if you have been

  • to Wuhan or Hubei Province in China in the last 14 days (even if you do not have symptoms)
  • to other parts of China, including Macau and Hong Kong, in the last 14 days and have a cough, high temperature or shortness of breath (even if it’s mild)
  • to Thailand, Japan, Taiwan, Singapore, Republic of Korea or Malaysia in the last 14 days and have a cough, high temperature or shortness of breath (even if it’s mild)
  • 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.

Current outbreak planning

Because of the dynamic nature of the outbreak, information and advice on how best to manage it is also subject to change.

In the UK, the Chief Medical Officers have raised the risk to the public from low to moderate. But the risk to individuals remains low and anyone who has been in close contact with people already diagnosed with the virus are being contacted directly by the health services.

As the number of diagnosed cases in the UK grows, so will public awareness and concern. Maintaining good hygiene practises is one of the key essentials to help reduce the spread of not just COVID-19 but seasonal flu and other viruses too.

In light of the spread to secondary countries, some organisations are already reviewing their travel plans, although the Government advice is still focussed on travel back from Wuhan and Hubei Province over the last 14 days specifically and from a wider number of countries (China, Thailand, Japan, Republic of Korea, Hong Kong, Taiwan, Singapore, Malaysia and Macau) where people develop symptoms.

Additional information and updates can also be found at:

https://www.gov.uk/guidance/wuhan-novel-coronavirus-information-for-the-public?gclid=EAIaIQobChMIkoyy-t7O5wIVDETTCh3BuQk3EAAYASAAEgI4BfD_BwE

https://www.nhs.uk/conditions/coronavirus-covid-19/

https://www.who.int/emergencies/diseases/novel-coronavirus-2019

WHO recommendations and advice for the public

"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 for COVID-19 could 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 handwashing, 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 people travelling. 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.”

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