Novel Coronavirus Health Advice – updated 25th February 2020 (10:30)
- Public Health England (PHE) have placed at risk countries into two categories and issued specific guidance for each country
- Anyone who has visited Wuhan and Hubei in China, Iran, Daegu and Cheongdo (South Korea) or any Italian town under containment measures should immediately self-isolate, even if they do not have symptoms, and contact NHS 111 immediately
- Anyone who has visited China (other than Hubei and Wuhan), Cambodia, Hong Kong, Italy (North), Japan, Macau, Laos Malaysia, Myanmar, South Korea, Singapore, Thailand, Taiwan and Vietnam should immediately self-isolate and contact NHS 111 if they present with symptoms
- The rate of new cases presenting continues to drop markedly across China, which is a positive sign.
- Unverified indications are that some patients can harbour the virus for extended incubation periods, with one case occurring after a 27 day period.
- Reports indicate transmission can occur quickly, without obvious symptoms being present amongst carriers.
- It is possible the virus may become endemic and continue to be present amongst populations for many years to come.
- Remdesivir, a broad spectrum anti-viral drug, also shows promise in curbing the virus and further trials are underway.
- An additional anti-viral, Arbidol, is also showing promising results in early stage trials. However, although Arbidol has been used for decades in Russia and China, it is not licensed in Western countries.
The 2019-novel coronavirus (COVID-19) is likely to continue to attract high levels of attention in the media for many weeks. Some of the media reporting continues to be alarmist in nature, however, validated sources of information continue to build a better picture of the clinical situation and are enabling better advice to be formulated.
The World Health Organisation (WHO) and Public Health England (PHE) continue to be our main reference sources.
Cases in the UK
As of 24th February, PHE had tested 6,536 individuals in the UK with 9 positive results. Although confirmed cases continue to be found, PHE is very well prepared and robust protection measures are in place. Rapid contact tracing is underway to mitigate the risk of further transmission in the UK.
Currently (as of February 24th) there are 79,331 confirmed cases with 2,618 deaths reported, which continues to suggests a ~3% mortality rate. The evidence is that most cases appear to be mild.
Self-sustaining human-to-human transmission is occurring (amongst some individuals who may not display obvious symptoms) and the currently predicted rate of onward infection from each confirmed case is ~2.6 people. This in turn implies that control measures (travel restrictions, increased hygiene, face masks etc) need to block over 60% of transmissions to be effective in controlling the outbreak, which appears to be successful in China.
Although it is too early to confirm that the outbreak is being contained, the number of new cases has continued to increase at a relatively steady pace. However, the virus may still become endemic and present an ongoing risk for travellers.
As a comparison, Middle East respiratory syndrome coronavirus (MERS-CoV), which first presented in 2013, is still presenting with new cases in the Middle East today.
The steps taken to prevent the spread of the virus are mostly being seen amongst medical professionals as robust, however, the situation remains fluid and may change in the coming days. Although there is cause for concern, there is still no cause for alarm.
Advice for employers
It is unclear whether the outbreak will be contained, and it is likely to be some weeks before the full profile of risks and the likely progression of the disease is clear. It is not yet clear whether the disease has permanently taken hold in China, although it seems to have. The risk of continued progression across the world remains present.
Although there is a continuing risk, PHE are very well prepared and it is unlikely that UK businesses will need to take any special measures at this stage. It may be worth preparing for mitigating steps, such as providing alcohol-based gel cleansers for staff and facilitating preparations for home working if necessary.
Symptoms of Novel Coronavirus
Common signs of infection include respiratory symptoms, fever, cough, shortness of breath and breathing difficulties. A sore throat is no longer associated as a symptom of the disease.
It remains prudent to always:
- Maintain good hand and personal hygiene, using alcohol-based hand sanitisers frequently
- As the virus appears to be spreading via respiratory tracts, high quality face masks are likely to be an effective control method for those who may be working or travelling in the affected areas (however, the efficacy is reduced for those who have beards)
- Avoid animals (alive or dead), animal markets and products that come from animals (such as uncooked meat and eggs)
- Avoid close contact with anyone showing symptoms of respiratory illness such as coughing and sneezing
- Seek medical attention if any respiratory symptoms develop within 14 days of visiting the areas and inform your health service prior to attendance about your recent travel
- People with symptoms of acute respiratory infection should practice cough etiquette (maintain distance, cover coughs and sneezes with disposable tissues or clothing, and wash hands)
Please feel free to contact our health team of doctors at any time via our support team if there is any information, assistance or support we can provide at any time.
This article is based on currently available reports and reference sources: