This morning Jeremy Hunt chaired the first hearing of the new Health and Social Care Select Committee to discuss the government’s plans for handling of the coronavirus (COVID-19) outbreak. What should we believe? Are some of the figures being banded around factual, incorrect, or simply scaremongering?
Below are the takeaway points from the session, in which Chief Medical Officer for England, Professor Chris Whitty, and Deputy Chief Medical Officer, Dr Jenny Harries, spoke clearly and openly about the current state of play.
As of 5th March, there are 96, 739 reported cases of coronavirus worldwide (including 90 in the UK). From these there have been 3, 308 deaths, over 3,000 of which have been in China. Cases in China are now declining in number.
Taken as a percentage of those reported cases, the number who have died is a little over 3.4% which is what reporters have quoted the World Health Organisation as having said the mortality rate of the virus is. However, Professor Whitty suggests this has been misreported, explaining that dividing one by the other doesn’t equate to a mortality rate, and there are other factors involved, such as number the of cases going unreported.
A far more realistic mortality rate has been modelled at 1%, and this, according to Whitty, is the upper limit.
The mortality rate was higher in the over 80 age category, with figures coming out of Hubei Province suggesting it was more like 8-9%. However, Prof Whitty is keen to emphasise that this was in an overwhelmed and overstretched health service, and even in such conditions, over 90% of people over 80 who were infected, survived.
The first symptom is a fever, followed by a dry cough, and then shortness of breath. These can be very mild, and it is thought many people will have it without ever knowing. For some, however, these symptoms may require hospital treatment.
In severe cases, it can lead to pneumonia, severe acute respiratory syndrome, multiple organ failure, and even death. Older people and people with pre-existing medical conditions such as heart disease and diabetes, are more likely to become severely ill.
The virus is a respiratory droplet infection, meaning the primary transmission route is airborne, under conditions of prolonged exposure. So, at the risk of sounding stupid, try to avoid people coughing or sneezing on you. And if in rooms with large amounts of people, try and keep it ventilated, letting “Nature do its job.”
The secondary route of transmission is via hands: handshaking, touching surfaces, etc. However, “it doesn’t get in through the skin,” explains Prof Whitty. That is an intermediate step, and it will only infect you if your hand then touches your eyes, nose or mouth. So, wash your hands – a lot! The virus can live on hard surfaces for hours or even days (less on soft surfaces). For example, if you touch the same handrail as somebody who has the virus a few hours after them, that’s fine, as long you don’t the touch your face. Be aware of what you’re doing with your hands then, when you can, wash your hands for 20 seconds, as recommended.
What’s Being Done
The Government have proposed a four-phase management programme for controlling the coronavirus: Contain, Delay, Research, Mitigation.
These aren’t divided by sharp boundaries, but overlapping. We are currently still partly in Phase 1, Contain. However, Prof Whitty says that we have to assume that there’s some level of community transmission now, and for that reason, we now mainly in Phase 2, Delay.
This comes with three aims:
- Help the NHS by pushing the peak infection period back until after the winter period, as this is already the busiest time of year for them. This would therefore limit the chance of the system being overwhelmed.
- Provide scientists and health officials with time for research into drugs and diagnostics as well as vaccinations.
- Push the peak back until summer as there may be a seasonal effect of the virus whereby transmission rates go down, as respiratory viruses are far easier to transmit in winter months.
Phase 3 is also underway research being conducted, but factoring in the required rounds of clinical trials and time for manufacturing, it’s likely to be at least a year before a vaccine is available.
Assuming there will be a widespread transmission, it could take two three months to peak. It is theorised that the peak would last about two to three weeks, within which time 50% of the total infections would happen. There would then be a period of two to three months of cases declining in number.
Prof Whitty was keen to emphasise that the action taken is a marathon not a sprint, and that there is no need for people to start stockpiling food and supplies.
What to do if you think you might have coronavirus?
Don’t go to your GP or hospital. Instead, call NHS 111 phone service, and they will advise. You may be told to self-isolate, at which point your details will be passed onto local health practitioners. You may then be tested for the virus, whereupon you will be given further advice from a doctor or nurse.
If you have to self-isolate:
- Stay at home for 14 days
- Keep your home well-ventilated to help “Nature do it’s job”
- Ask friends and family to deliver groceries and medication
- It’s okay to have people drop off deliveries, but not to have visitors within the two weeks
More information about the government’s action plan can be found here.