Coronavirus (2019-nCoV)

Background

A coronavirus is a type of virus. As a group, coronaviruses are common across the world. Typical symptoms of coronavirus include fever and a cough that may progress to a severe pneumonia causing shortness of breath and breathing difficulties.

Generally, coronavirus can cause more severe symptoms in people with weakened immune systems, older people, and those with long-term conditions like diabetes, cancer and chronic lung disease.

Novel coronavirus (2019-nCov) is a new strain of coronavirus first identified in Wuhan City, China.

 

Situation in the UK

As of 31st January 2020, two patients in England have tested positive for coronavirus. If more cases are confirmed in the UK, it will be announced as soon as possible by the Chief Medical Officer of the affected country.

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. This permits the government to plan for all eventualities.

As of 31 January, a total of 177 UK tests have concluded, of which 175 were confirmed negative and 2 positive.

1,466 passengers and 95 staff arrived in the UK on direct flights from Wuhan between 10 and 24 January.

  • 162 of the passengers have already left the UK.
  • 53 of the crew have already left the UK.
  • 866 are now outside of the incubation period.

 

Diagnosis and analysis

Based on current evidence, novel coronavirus (2019-nCov) presents with flu-like symptoms including a fever, a cough, or difficulty breathing. The current evidence is that most cases appear to be mild. Those who have died in Wuhan appear to have had pre-existing health conditions.

The UK is now one of the first countries outside China to have a prototype specific laboratory test for this new disease. Healthcare professionals who are contacted by a patient with symptoms following travel to Wuhan have been advised to submit samples to Public Health England (PHE) for testing. Individuals should be treated in isolation

After the experience of severe acute respiratory syndrome (SARS) in 2003, PHE developed a series of diagnostic tests to detect any member of the family of coronaviruses. These have been used for several years, and were able to detect the first UK case of Middle East respiratory syndrome (MERS) in 2012.

With the first reported publication of the genome sequence of a 2019 novel coronavirus, PHE was able to rapidly develop further specific tests for this virus, working with WHO and global network of laboratories.

When a clinician suspects novel coronavirus (2019-nCov), they take samples from the nose, throat and deeper respiratory samples, package and send them safely to PHE Colindale. PHE can provide a laboratory result from this specific virus on the same working day.

PHE also has the capability to sequence the viral genome and compare this to published sequences from China, if a case occurs. This will provide valuable information on any mutations in the virus over time and allow an improved understanding of how it spreads.

 

Guidance

Advice for travellers from China

Travellers from Wuhan and Hubei Province

If you have travelled from Wuhan or Hubei Province to the UK in the last 14 days you should immediately:

  • stay indoors and avoid contact with other people as you would with the flu
  • call NHS 111 to inform them of your recent travel to the area
  • If you are in Northern Ireland, call your GP.

Please follow this advice even if you do not have symptoms of the virus.

 

Travellers from elsewhere in China

If you have travelled from elsewhere in China (but not Macao or Hong Kong) to the UK in the last 14 days and develop symptoms of cough, fever or shortness of breath, you should immediately:

  • stay indoors and avoid contact with other people as you would with the flu
  • call NHS 111 to inform them of your recent travel to the country
  • If you are in Northern Ireland, call your GP.

Follow this advice even if your symptoms are minor.

 

What this means in practice

The Government are asking people to take simple, common-sense steps to avoid close contact with other people as much as possible, like they would with other flu viruses.

This means remaining at home for 14 days after arriving from Wuhan or Hubei Province (or elsewhere in China if you have symptoms) and not going to work, school or public areas. Where possible, you should avoid having visitors to your home, but it’s ok for friends, family or delivery drivers to drop off food and other supplies.

 

How is coronavirus spread between people?

Because it’s a new illness, we do not know exactly how coronavirus spreads from person to person, but similar viruses spread by cough droplets.

 

Practical advice to prevent spread of flu like viruses

The Wuhan coronavirus outbreak is a new illness and scientists are still assessing how it spreads from person to person, but similar viruses tend to spread via cough and sneeze droplets.

When an infected person coughs or sneezes, they release droplets of saliva or mucus. These droplets can fall on people in the vicinity and can be either directly inhaled or picked up on the hands then transferred when someone touches their face, causing infection.

For flu, some hospital guidelines define exposure as being within six feet of an infected person who sneezes or coughs for 10 minutes or longer.

There is anecdotal evidence that the virus can be spread by people before they have symptoms. Some other illnesses such as flu can be passed from one person to another before symptoms occur – but the extent to which this is happening with the Wuhan coronavirus is not well understood yet.

Viruses can also be spread through droplets landing on surfaces such as seats on buses or trains or desks in workplaces.

However, whether this is a main transmission route depends on how long viruses survive on surfaces – this can vary from hours to months.

 

How to protect yourself and others

  • Adopt good hygiene procedures; wash your hands regularly.  Wet your hands with clean, running water and apply soap. Lather your hands, including the backs, between your fingers, and under your nails and scrub for at least 20 seconds. Rinse.
  • If you cannot wash your hands; use anti-bacterial/viral gels and wipes.
  • Cover your mouth and nose with a tissue when you cough or sneeze, then throw the tissue in the bin and wash your hands. If you do not have a tissue to hand, cough or sneeze into your elbow rather than your hands.
  • Face masks offer some protection as they block liquid droplets. However, they do not block smaller aerosol particles that can pass through the material of the mask. The masks also leave the eyes exposed and there is evidence that some viruses can infect a person through the eyes.
  • Seek early medical help if you have a fever, cough and difficulty breathing, and share your travel history with healthcare providers.
  • If you have returned from an infected area and develop a high temperature, cough, runny nose, sore throat or difficulty breathing do not leave your home until you have been given advice by a doctor.

 

For Further Information

See Government website which is updated daily:

https://www.gov.uk/guidance/wuhan-novel-coronavirus-information-for-the-public#information-about-the-virus

 

Also, the NHS Website;

https://www.nhs.uk/conditions/wuhan-novel-coronavirus/