Update - Wuhan coronavirus

Eight 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 WHO's declaration that this is a public health emergency of international concern, the UK CMOs have raised the risk to the public from low to moderate, allowing the government to plan for all eventualities.

The risk to individuals in the UK remains low. 

The Secretary of State for Health and Social Care has announced strengthened legal powers to bolster public health protections against coronavirus. The regulations have been put in place to reduce the risk of further human-to-human transmission in this country by keeping individuals in isolation where public health professionals believe there is a reasonable risk an individual may have the virus.

As of 10 February, a total of 1,114 people have been tested, of which 1,106 were confirmed negative and 8 positive.

The Foreign and Commonwealth Office has advised UK nationals to leave China where possible. If the situation continues to escalate the pressure on the Chinese health system may intensify, and it may also become harder for people to travel.

A team of public health experts has been established in Heathrow to support anyone travelling in from China who feels unwell. These hubs will bring in rotational teams of 7 clinicians, working in shifts, who will be on hand to support patients on arrival. This is in addition to medical staff who are already permanently in place at all UK airports and the advice issued to all UK airports for people travelling to and from China. China has also introduced port-of-exit screening so people already exhibiting symptoms are not allowed to leave the country.

Advice to travellers from Wuhan or Hubei Province is to stay indoors for 14 days, avoid contact with other people, and call NHS 111 to inform them of recent travel to the area. Further advice has been offered for travellers from elsewhere in China, Thailand, Japan, Republic of Korea, Hong Kong, Taiwan, Singapore, Malaysia and Macau in the last 14 days who develop symptoms of cough, fever or shortness of breath, they should stay indoors, avoid contact with others, and call NHS 111. Patients with symptoms who have travelled from China and all patients who have travelled from Wuhan or Hubei should not use public transport. During time spent indoors, it is recommended to avoid public places entirely: where possible a friend, family member or delivery service should carry out errands on the individual's behalf.

A total of 94 individuals are in group isolation at Arrowe Park Hospital in the Wirral.

The Government has donated £20 million to the Coalition for Epidemic Preparedness Innovations to produce a vaccine to combat coronavirus. 

What is coronavirus?

Common human coronaviruses, including types 229E, NL63, OC43, and HKU1, usually cause mild to moderate upper-respiratory tract illnesses, like the common cold. Most people get infected with these viruses at some point in their lives. These illnesses usually only last for a short amount of time. Symptoms may include

  • runny nose
  • headache
  • cough
  • sore throat
  • fever
  • a general feeling of being unwell

Human coronaviruses can sometimes cause lower-respiratory tract illnesses, such as pneumonia or bronchitis. This is more common in people with cardiopulmonary disease, people with weakened immune systems, infants, and older adults.

Two other human coronaviruses, MERS-CoV (Middle East respiratory syndrome) and SARS-CoV (severe acute respiratory syndrome) have been known to frequently cause severe symptoms. MERS symptoms usually include fever, cough, and shortness of breath which often progress to pneumonia. About 3 or 4 out of every 10 patients reported with MERS have died. MERS cases continue to occur, primarily in the Arabian Peninsula. SARS symptoms often included fever, chills, and body aches which usually progressed to pneumonia. No human cases of SARS have been reported anywhere in the world since 2004.

Symptoms of the new coronavirus

According to the WHO, the new coronavirus causes a fever, fatigue, sore throat and dry cough in the early stages of the disease. As the illness progresses, patients may experience difficulty breathing. 

The virus was initially described by Chinese authorities as a new strain of pneumonia, but was later confirmed to be a novel coronavirus. 

These are a family of viruses that originate in animals before making the jump to humans. Seven, including the new virus, have been found in humans, with four causing only mild, common-cold like symptoms.

Like other coronaviruses – such as the common cold – the virus is spread via droplets when a person coughs or sneezes. It can also be spread when someone touches a contaminated surface such as a door handle. 

Hospitals are also key locations for "super spreading" events - when a single patient infects many people. When patients arrive in hospital with vague respiratory symptoms health workers may not know they need to take special precautions such as wearing masks or keeping them away from other patients. 

Treatment

There are no specific treatments for coronaviruses, so care is largely supportive: supporting the lungs and other organs until patients recover. 

Recommendations for prevention include basic hand hygiene, such as washing hands in soap and water, and respiratory hygiene, such as sneezing into your elbow. Additionally travellers to China should avoid unnecessary contact with live animals.

Nick Phin, deputy director of the National Infection Service at Public Health England, added: “Individuals should seek medical attention if they develop respiratory symptoms within 14 days of visiting Wuhan, either in China or on their return to the UK, informing their health service prior to their attendance about their recent travel to the city.”