People returning to the UK from quarantine zones in northern Italy should immediately self-isolate to stop the spread of coronavirus, the health secretary, Matt Hancock, has said.
The British government updated its guidance on Tuesday morning and suggests anyone returning from the region north of Pisa should avoid contact with others if they start to show flu-like symptoms.
What is Covid-19 – the illness that started in Wuhan?
It is caused by 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.
Have there been other coronaviruses?
Severe acute respiratory syndrome (Sars) and Middle Eastern respiratory syndrome (Mers) are both caused by coronaviruses that came from animals. In 2002, Sars spread virtually unchecked to 37 countries, causing global panic, infecting more than 8,000 people and killing more than 750. Mers appears to be less easily passed from human to human, but has greater lethality, killing 35% of about 2,500 people who have been infected.
What are the symptoms caused by the new coronavirus?
The virus can cause 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. Recovery depends on the strength of the immune system. Many of those who have died were already in poor health.
Should I go to the doctor if I have a cough?
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 who is experiencing a cough or fever or shortness of breath to stay indoors and call NHS 111, even if symptoms are mild.
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.
How many people have been affected?
As of 20 Februrary, China has recorded 2,118 deaths from the Covid-19 outbreak. Health officials have confirmed 74,576 cases in mainland China in total. More than 12,000 have recovered.
The coronavirus has spread to at least 28 other countries. Japan has 607 cases, including 542 from a cruise ship docked in Yokohama, and has recorded one death. There have also been deaths in Hong Kong, Taiwan, France and the Philippines.
There have been nine recorded cases and no fatalities to date in the UK. As of 17 February, a total of 4,501 people have been tested in the UK, of which 4,492 were confirmed negative.
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% at the centre of the outbreak, Hubei province, and less than that elsewhere. 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%.
Another key unknown is how contagious the coronavirus is. A crucial difference is that unlike flu, there is no vaccine for the new coronavirus, which means it is more difficult for vulnerable members of the population – elderly people or those with existing respiratory or immune problems – to protect themselves. Hand-washing and avoiding other people if you feel unwell are important. One sensible step is to get the flu vaccine, which will reduce the burden on health services if the outbreak turns into a wider epidemic.
Is the outbreak a pandemic?
A pandemic, in WHO terms, is “the worldwide spread of a disease”. Coronavirus cases have been confirmed outside China, but by no means in all 195 countries on the WHO’s list. It is also not spreading within those countries at the moment, except in a very few cases. By far the majority of cases are travellers who picked up the virus in China.
Should we panic?
No. 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. 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. Generally, the coronavirus appears to be hitting older people hardest, with few cases in children.
Those entering the UK from areas quarantined by the Italian authorities – 10 small towns in Lombardy and one in Veneto – should follow the guidance, even if they do not have symptoms.
The health secretary said the government advice was in accordance with warnings from the World Health Organization that Covid-19 could become a pandemic.
“At present we don’t think there are any Brits in the area that’s been quarantined by the Italian government,” Hancock told Sky News. “But of course the government doesn’t track where people move around Europe, so if people are in that area they should get in contact and we will do what we can to help.”
The worsening situation in northern Italy was described as “very worrying” by Hancock, who said it was a significant outbreak with more than 200 people affected, including those who had died.
He said Britain was expecting cases of the illness and had been preparing. He will update the cabinet on Tuesday and hold a meeting with the Cobra emergency committee on Wednesday.
The Italian government has allowed regions to implement civil protection measures to stem the outbreak. In Lombardy, Veneto, Friuli Venezia Giulia, Piemonte and Emilia Romagna, it has ordered a seven-day suspension of public and private events, schools and higher education facilities, as well as museums and cultural institutions.
Hancock said: “There is a good chance that we contain this at [the virus] sort of level, where the number of cases … is relatively low. The numbers of cases in China are coming down and we think that direction of travel is credible.
“But the problem is there are outbreaks elsewhere, like in Italy, Iran and South Korea, and so we are preparing in case this becomes a pandemic. But we are confident there’s a good chance of avoiding that, but we are taking a belt and braces approach.”
A total of 6,536 people have been tested in the UK, of which 6,527 were confirmed negative and nine positive. There are also four confirmed cases from the Diamond Princess cruise ship who arrived in the UK from Japan.
About 80% of people with coronavirus experience only mild symptoms, and children do not seem to be affected, except in a small number of cases, according to the health secretary.
China has reported 77,658 cases and 2,663 deaths. Reports from Seoul in South Korea say 893 have been infected. Italy has 229 cases and seven deaths.
The shadow health secretary, Jonathan Ashworth, told Sky News: “We are all worried. We shouldn’t panic but this is extremely serious. It’s not yet a pandemic … but clearly it is hugely serious and we have to be alert, we have to act.
“I’m not going to criticise or throw stones at the government. Broadly they’ve taken the correct approach. We know the amount of pressure our NHS is under at the moment – intense strain after years of cuts. If this hits us very badly, there are questions about whether our NHS has the resources to cope.”