Coronavirus advice from Public Health England after Essex man tests positive.

Yesterday we saw the first case of Coronavirus in Essex. Authorities are trying to trace back how the man has contracted COVID 19 as he has not travelled to any infected countries.

Here is some important advice and information from Public Health England.

At PHE we respond to around 10,000 disease outbreaks and health emergencies every year both at home and abroad, ranging from e-coli, legionnaires and TB through to emerging threats such as the outbreak of coronavirus in Wuhan, China.

This is a rapidly evolving situation which we are monitoring carefully but based on the available evidence, the current risk to the UK population is low to moderate.

In this blog we’ll answer some of the questions many people have. We’ll update this blog as new information becomes available.

Please note we cannot answer any questions that relate to individual health concerns.

What is coronavirus and should I be concerned?

A coronavirus is a type of virus. As a group, coronaviruses are common across the world.

Typical symptoms of coronavirus include fever and a cough that may progress to a severe pneumonia causing shortness of breath and breathing difficulties.

Generally, coronavirus can cause more severe symptoms in people with weakened immune systems, older people, and those with long term conditions like diabetes, cancer and chronic lung disease.

What are the signs and symptoms of this new virus?

The symptoms of this new coronavirus (now known as COVID-19) include fever and respiratory symptoms including coughing, sneezing, and shortness of breath. The current evidence is that most cases appear to be mild.

If you have returned from these specific areas since February 19, you should call NHS 111 and stay indoors and avoid contact with other people even if you do not have symptoms:

• Iran
• Specific lockdown areas in the Lombardy and Veneto regions of Northern Italy as designated by the Government of Italy
• Daegu or Cheongdo in South Korea
• Hubei province (returned in the past 14 days)

If you have returned from these areas since February 19th and develop symptoms, however mild, you should stay indoors at home and avoid contact with other people immediately and call NHS 111:

• Northern Italy (defined as North of Pisa but not including Pisa, Florence and Rimini)
• Vietnam
• Cambodia
• Laos
• Myanmar

If you have a cough, or fever or shortness of breath and have visited any of the following areas in the last 14 days

• China
• Thailand
• Japan
• Republic of Korea
• Hong Kong
• Taiwan
• Singapore
• Malaysia
• Macau

Stay indoors and call NHS 111 informing them of your recent travel to the city.

What is the current risk level to the UK?

We have been working in close collaboration with international colleagues and the World Health Organisation to monitor the situation in China and around the world.

Based on the World Health Organization’s declaration that this is a public health emergency of international concern, the UK Chief Medical Officers have raised the risk to the public from low to moderate. This does not mean we think the risk to individuals in the UK has changed at this stage, but that government should plan for all eventualities.

How do we decide the risk level?

Several factors are taken into account to determine the risk level including the number of cases, the speed at which new cases are being identified and other information about the virus such as how easily it spreads from person to person.

How many cases do we have in the UK?

As of 01 March at 9am, a total of 11,750 people have been tested in the UK, of which 11,715 were confirmed negative and 35 positive.

The patients are receiving specialist NHS care, and we are using tried and tested infection control procedures to prevent further spread of the virus. Experts at PHE continue to work hard tracing patient contacts from the UK cases.

We will update these figures at 2pm every day.

What measures are being taken to protect the UK?

PHE has introduced advanced monitoring at airports with direct flights from China. A team of public health experts has been established in Heathrow airport to support anyone arriving on flights 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.

What’s the current travel advice?

The Foreign and Commonwealth Office (FCO) advise against all travel to Hubei Province and now advise against all but essential travel to the rest of mainland China (not including Hong Kong and Macao). If you’re in China and able to leave, you should do so. The elderly and those with pre-existing medical conditions may be at heightened risk.

The FCO is working to make available an option for British nationals to leave Hubei province. If you’re a British national in Hubei Province and need assistance, contact our 24/7 number +86 (0) 10 8529 6600 or the FCO in London on (+44) (0)207 008 1500.

How does this new coronavirus spread – I’m concerned I could catch it?

Because it’s a new illness, we do not know exactly how it spreads from person to person, but similar viruses spread by cough droplets or sneeze droplets. These droplets fall on people in the vicinity and can be directly inhaled or picked up on the hands and transferred when someone touches their face.

How long any respiratory virus survives will depend on a number of factors; for example:

• what surface the virus is on
• whether it is exposed to sunlight
• differences in temperature and humidity
• exposure to cleaning products

Under most circumstances, the amount of infectious virus on any contaminated surfaces is likely to have decreased significantly by 24 hours, and even more so by 48 hours.

Can the virus survive on cargo that has arrived from an affected area?

There is currently no evidence to suggest that the virus can be transmitted from post, packages or parcels from China.

What can I do to reduce my risk of catching coronavirus? 

There are things you can do to help stop germs like coronavirus spreading:

• Always carry tissues with you and use them to catch your cough or sneeze. Then bin the tissue, and wash your hands, or use a sanitiser gel.
• Wash your hands often with soap and water, especially after using public transport. Use a sanitiser gel if soap and water are not available.
• Avoid touching your eyes, nose and mouth with unwashed hands.
• Avoid close contact with people who are unwell.

Should people wear face masks to protect themselves from infection?

Face masks play a very important role in clinical settings, such as hospitals but there’s very little evidence of widespread benefit from their use outside of these clinical settings. Facemasks must be worn correctly, changed frequently, removed properly and disposed of safely in order to be effective.

The best way to protect ourselves from infections like coronavirus is to wash our hands frequently with soap and water or use a sanitiser gel, as well as always carrying tissues and using them to catch coughs and sneezes, then putting the tissue in a bin.

If I live in the area where coronavirus patients are reported as coming from – am I at extra risk?

We ensure that someone with coronavirus doesn’t put others at risk by treating them in isolation and carefully investigating who they had close contact with through contact tracing.

Contact tracing is a fundamental part of outbreak control that’s used by public health professionals around the world.

If a person tests positive for coronavirus, we speak to the patient to identify anyone who has who has had close contact with them during the time they are considered to be infectious and go all out to find these people as soon as possible.

Once we have contacted them we can then give them the advice they need. If they are in groups considered to be a higher risk, we make sure that we follow up with them daily to see how they are.  If they become unwell we are then able to assess them quickly and take appropriate action.

What does self-isolation mean for people who don’t have symptoms?

Just like when you have the flu, individuals should remain at home and should not go to work, school or public areas. Where possible, individuals should avoid having visitors to their home but it is ok for friends, family or delivery drivers to drop off food. Individuals should not use public transport or taxis until 14 days after their return from a specified area.

Individuals should monitor their symptoms and call NHS 111 (or your national alternative) if they develop any of the following symptoms – fever, cough, and difficulty breathing.

Am I allowed to go out to the shops to get food?  I need to collect medicine from the pharmacists, what should I do?

Individuals are advised to stay at home for 14 days after arriving from Wuhan or Hubei Province (or elsewhere in China or specified areas if you have symptoms), and avoid public places. Where possible, contact a friend, family member or delivery services to carry out errands on your behalf.

Who will take my kids to school?

We recommend that you stay at home for 14 days after arriving from Wuhan or Hubei Province (or elsewhere in China or specified areas if you have symptoms), and avoid public places. Where possible, contact a friend or family member to take your children to school.

Can we test people for coronavirus and how does this work?

PHE is a world-leader in developing techniques to aid the public health investigation of infectious diseases. The UK is one of the countries outside China to have an assured testing capability test for this disease.

When a clinician suspects novel coronavirus, they take samples from the nose, throat and deeper respiratory tract and send them for laboratory testing.

Using the diagnostic test, scientists can look for evidence of the presence of any type of coronavirus and then hone in on specific genetic clues that identify the novel coronavirus associated with this outbreak.

PHE’s diagnostic test for coronavirus is being rolled out to 12 laboratories across the UK to accelerate the country’s testing capabilities. This increases testing capacity to more than 1,000 people a day for England.

What happens if I’m tested for novel coronavirus?

A doctor or nurse will swab your nose and throat if you need testing for the novel coronavirus.  These samples are then safely transported to one of our labs.  Testing starts when your sample reaches the lab; it takes 24-48 hours for testing to be done.  Once the result is available, it is sent back to your doctor or nurse who will let you know the result and give you advice on what to do next.

How do we know if the virus is evolving? 

PHE has used whole genome sequencing to sequence the viral genome from the first two positive cases in this country and has made the sequence available to the scientific community. Our findings are consistent with viral genomes sequenced in China, and we are not seeing changes that suggest the virus has evolved in the last month.

What advice are healthcare professionals being given?

Clinicians in primary and secondary care have already received advice from PHE, covering initial detection and investigation of possible cases, infection prevention and control, and clinical diagnostics.

A Central Alerting System (CAS) Alert will be issued by CMO, Medical Director PHE and Medical Director NHSE/I to frontline staff to increase awareness of the situation and actions to take if potential cases present. NHS England has developed an algorithm to support NHS 111 in identifying suspected potential cases.