Police and fire services will only respond to the most serious call-outs if their staff fall ill through coronavirus, the government warned on Tuesday, in a key planning document setting out how ministers would deal with an escalating outbreak.
The action plan envisages that the army could be called in to help if requested by civilian authorities. And it says that up to a fifth of the national workforce could be absent from work, schools could close and elderly people would be advised not to attend social gatherings.
The measures would only be rolled out if the virus moved beyond the currently designated “contain phase”.
The advice was released in the Coronavirus: Action Plan on Tuesday as the number of cases in the UK stood at 39.
It sets out plans for scenarios ranging from a milder pandemic to a “severe prolonged pandemic as experienced in 1918” when the Spanish Flu killed 50 million worldwide.
If the illness moves into the “delay” and “mitigate” phases in the UK, retired NHS staff could be brought back to help care for patients, the document says.
“With a significant loss of officers and staff, the police would concentrate on responding to serious crimes and maintaining public order,” it said.
At a press conference on Tuesday, Boris Johnson said that it was “highly likely” the UK would see a growing number of cases but stressed that “for the vast majority of people in this country we should be going about our business as usual”.
And he said: “Our country remains extremely well prepared as it has been since the outbreak in Wuhan several months ago”.
The 28-page plan also says that:
• There could be an increase in deaths arising from the outbreak, particularly among vulnerable and elderly people. The government will “ensure dignified treatment of all affected, including those who die”, it says, and that local authorities will need help to deal with the rise in deaths.
• Businesses facing short-term cashflow because of low demand from customers could ask HMRC how to avoid falling behind with tax.
• If NHS staff numbers are affected, some non-urgent care may be delayed and retired healthcare professionals brought back on duty.
• Anyone who shows symptoms should consider options ranging from avoiding contact outside work and school to “social distancing”, household quarantine, and working from home.
• Widespread exposure in the UK may be inevitable – but “slowing it down would still nonetheless be beneficial”, partly because GP surgeries and hospitals will be less busy in the summer months outside of peak flu season.
The health secretary, Matt Hancock, has been in talks with social media companies about trying to ensure public health messages are spread widely.
Despite earlier suggestions that cities could be put on lockdown to try to contain the illness, experts are now suggesting that would have little effect.
Government advice remains that the action everyone should be taking is to regularly wash their hands for 20 seconds and cover the mouth with a disposable tissue when sneezing or coughing.
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 3 March, the outbreak has affected more than 89,000 people globally, with a total death toll in excess of 3,000. In mainland China, of the 80,151 confirmed cases, over 44,000 people have recovered, and 2,943 (or 3.6%) have died. Over 125 deaths have occurred outside of China.
The coronavirus has spread to more than 60 other countries. The worst affected include South Korea with nearly 5,000 cases, and Iran, with over 1,500 cases.
There have been 40 recorded cases and no fatalities to date in the UK.
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.
The document was published after Hancock urged members of the public to carry on as normal “for now”.
He told the BBC Radio 4 Today programme earlier: “The message today is that, right now, we do not need to do many of the heavy things we are talking about in the plan. But we are also setting [them] out as transparently as we possibly can so people know the sort of things we might have to do in future.”
Warning that school closures would currently be clinically ineffective as well as disruptive, he added: “We are saying to schools: do not close if you do not have a positive case and if you don’t have the advice from Public Health England.”
He said the government’s goal was “to have the minimum social and economic disruption, subject to keeping people safe. So … as long as you follow the advice from Public Health England – wash your hands more often than you would, for 20 seconds and use soap and hot water – then you should carry on your ordinary business as normal.”
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.
Hancock said it would take weeks for the number of cases to rise to epidemic level even under the “reasonable worst-case scenario” and that the situation would then last “a matter of months”.
The outgoing Bank of England governor, Mark Carney, told MPs on Tuesday that the bank would “take all necessary steps to support the UK economy and financial system, consistent with its statutory responsibilities” as the country dealt with the virus.
He said the bank’s role was to “help UK businesses and households manage through an economic shock that could prove large but will ultimately be temporary”.