Publicity
Publicity will be increased about the need for good hygiene measures (handwashing and “catch it, bin it, kill it”) and for workers to stay at home for the full duration of their illness.
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Analysis: Simple measures have the ability to mitigate the risks of an individual contracting the virus. A public information campaign is key to reminding everyone of their responsibilities and the difference they can make.
Population distancing strategies
These include school closures, encouraging home-working, reducing the number of large-scale gatherings. It includes the caveat that the country should be able to continue “as normally as possible”.
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Analysis: These are strategies that have already been implemented in countries with higher number of cases, most notably – but not only – in China. Last week, Chevron, became the first employer to send home employees in London. Several sporting events have been cancelled overseas, including the Ireland v Italy Six Nations match.
The World Health Organization is recommending that people take simple precautions to reduce exposure to and transmission of the Wuhan coronavirus, for which there is no specific cure or vaccine.
The UN agency advises people to:
- Frequently wash their hands with an alcohol-based hand rub or warm water and soap
- Cover their mouth and nose with a flexed elbow or tissue when sneezing or coughing
- Avoid close contact with anyone who has a fever or cough
- Seek early medical help if they have a fever, cough and difficulty breathing, and share their travel history with healthcare providers
- Avoid direct, unprotected contact with live animals and surfaces in contact with animals when visiting live markets in affected areas
- Avoid eating raw or undercooked animal products and exercise care when handling raw meat, milk or animal organs to avoid cross-contamination with uncooked foods.
Despite a surge in sales of face masks in the aftermath of the outbreak of the coronavirus outbreak, experts are divided over whether they can prevent transmission and infection. There is some evidence to suggest that masks can help prevent hand-to-mouth transmissions, given the large number of times people touch their faces. The consensus appears to be that wearing a mask can limit – but not eliminate – the risks, provided they are used correctly.
Reduced police capability
There is acknowledgement that the capability of the emergency services to operate may be impeded by increased spread of the virus. The document refers to a potential significant loss of officers and staff, which could force police to concentrate on serious crimes and maintaining public order.
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Analysis: This raises the possibility of police forces in the UK being so overstretched that their capability is reduced to the extent that many crimes will not be investigated and officers will be reduced to making sure there is not a loss of confidence in forces’ ability to maintain public order. This is a scenario that the government, which has made cracking down on crime a key part of its strategy during this parliament, will want to avoid at all costs.
Quarantine
Local authorities in England can apply to the courts to enforce quarantine and medical examination, restricting movement of individuals known to have or have been exposed to the disease. There are similar powers for authorities in Scotland, Wales and Northern Ireland.
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Analysis: Again, such an approach has already been used in countries such as China and Italy, where areas have been said to have been turned into ghost towns. In China, indications are that the approach is working as the daily toll of cases and deaths has fallen in recent days.
Isolation powers for police/courts
Powers have already been given to police, public health professionals and courts to enforce isolation on individuals, the report reveals.
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Analysis: While the publicity element enforces personal responsibility, this section acknowledges that individuals acting for the greater good cannot always be relied upon. In extreme times, this section allows for measures that may run counter to individual freedoms but are necessary to prevent, control a pandemic.
Specialist care for the seriously ill
Although “initial confirmed patients” who have serious breathing problems due to Covid-19 will be cared for in critical care units in hospital; “when necessary, the provision of care may move from specialist units into general facilities in hospitals”, the plan says. It refers to “well-rehearsed plans …[for] the provision of excellent care for all patients affected by this new disease”.
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Analysis: The prospect of large numbers of people becoming seriously unwell raises two problems for the NHS: a shortage of beds in intensive care and high dependency units and the well-known lack of general and acute beds. The UK has about 4,250 critical care beds – one of the lowest rates of such beds per 100,000 of population in international terms. The faculty of intensive care medicine is worried that while demand for such beds has risen at 4% a year since 2009, the number of beds available has not increased, leaving a worrying lack of capacity to manage such patients.
Patients discharged early
Under the plan. “health and social care services will work together to support early discharge from hospital, and to look after people in their own homes”.
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Analysis: That would lead to hospital doctors identifying patients who were the least sick, whose beds would then be used by people left seriously ill with coronavirus. However, the widespread shortage of social care services – which already leaves patients stuck in hospial despite them being medically fit to leave – could limit the potential for inpatients to be sent home, or to do that safely. The social care workforce is already very stretched due to the ageing population, so may struggle to take on this extra responsibility. In addition, the number of district nurses – who care for people at home – has fallen sharply in recent years.