Politics

Mass isolation, crisis plans and months of disease – what’s next for coronavirus

Boris Johnson has said Covid-19 "is the worst public health crisis for a generation" – as he introduced a range of measures to tackle the spread of the virus.

The Prime Minister introduced new measures to try and protect the elderly and vulnerable, saying anyone with coronavirus symptoms, however mild, such as a continuous cough or high temperature, must now stay at home for seven days.

The advice also applies to children, meaning parents could need to take time off to look after their youngsters at home.

The PM said school trips abroad should be stopped, while people over 70 with serious medical conditions should not go on cruises.

Mr Johnson told reporters at a press conference in Downing Street that there was no need to close schools now as the scientific advice "is that this could do more harm than good".

He said this may change at some point while in the future, if somebody is taken ill, their entire household could be told to self-isolate.

Mr Johnson said families would continue to "lose loved ones before their time" as the coronavirus outbreak worsens.

"We've all got to be clear, this is the worst public health crisis for a generation," said the PM.

"Some people compare it to seasonal flu, alas that is not right.

"Due to the lack of immunity this disease is more dangerous.

"It is going to spread further and I must level with you, I must level with the British public: many more families are going to lose loved ones before their time."


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What are the symptoms?

Experts say the symptoms of coronavirus are a high temperature and a new, continuous cough.

A high temperature is deemed to one above 37.5C.

Chief Scientific Adviser Sir Patrick Vallance said modelling predicted a 20-25% reduction in the peak of the epidemic by getting people to stay at home for a week if they have mild symptoms.

Moving to whole household isolation adds an extra 25% reduction – so together those measures roughly half the size of the peak.

Preventing the elderly from getting infected could reduce death rates by 20-30%, Sir Patrick added.

Will there be more announcements?

Chief Medical Officer Professor Chris Whitty spoke of the need of isolating older and more vulnerable people – but that would not happen yet because it could have other negative consequences like increasing loneliness.

But the tactic may change in the future.

The Government could also advise anybody living with somebody who is taken ill to self-isolate for seven days, taking the total to 14 days, though that measure has not yet been introduced.

The likelihood is measured will continue to be ramped up as scientists continue to decide how to best to defend citizens from Covid-19, by studying how the disease acts, and by watching and learning from other countries’ experiences.

What actions are the NHS taking?

The NHS is examining how it can prepare to deal with the peak of the virus when it hits.

Ultimately this means health service chiefs are looking at cancelling non-essential procedures and some primary care to free up capacity.

The ultimate aim is to add to the 5000 ventilated beds nationally – as the most serious cases of coronavirus will require oxygen to treat.


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How long until the government thinks we will hit the peak?

The government currently believes that the peak of the virus is about 12 to 15 weeks away.

At the peak, the NHS could be stretched to capacity.

Measures like self-isolation are expected to push down the peak of the infection and delay peak.

If they can delay the peak, experts believe the pressure on the NHS will be lessened and we may see some benefit of the warm weather in slowing the spread.

Why does the government think up to 10,000 people may now be infected?

Modelling is understood to suggest that between 5000 to 10000 people could be infected.

This is based on the number of people who have developed Covid-19 through community transmission – ie without a direct link to someone who is known to have the virus.

At his press conference, Mr Johnson said: “The true number of cases is higher, perhaps much higher, than the number of cases we’ve confirmed with tests.

"Families are going to lose a loved one before there time."

Chief Scientific Advisor Sir Patrick Vallance said: “Currently we’re on a trajectory that looks as though it’s four weeks or so behind Italy, and some other countries in Europe.”

He added: “There are currently 590 cases that have been identified in the UK and there are more than 20 patients on intensive care units.

“If you calculate what that really means, in terms of the total number, it’s much more likely that we’ve got somewhere between 5,000 and 10,000 people infected at the moment.

“The same sorts of ratios will be true in other countries depending how much testing they’ve done.”


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What do I do if I feel ill?

Today's announcement marks a shift in the official advice.

While previously people were told only to self-isolate if they have been in contact with an infected person or hotspot area or are told to by NHS 111.

But now anyone who has a new and a persistent cough or a temperature – categorised by 37.5C – is asked to stay at home.

The Chief Medical Officer advised those with mild symptoms to treat it as they would do a sprain i.e. to stay at home and look after themselves. 

People are asked to avoid calling 111 unless their symptoms get worse to keep it free.

“It helps to protect older or more vulnerable people who they might come directly or indirectly into contact with,” he said.

“It is important that people with very minor symptoms do not call 111.”

But if people’s symptoms deteriorate then they should use the helpline.

Prof Whitty said the virus was its most contagious when symptoms first appear so that by seven days the great majority of people are not infectious.

“The evidence would appear to be that some people with even quite mild symptoms can spread this virus to a lot of people,” he said.

“It is no longer necessary for us to identify every case and we will move from having testing mainly done in homes and outpatients and walk-in centres, to a situation where people who are remaining at home do not need testing.”


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Are schools being closed?


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No. Unlike in Ireland and a number of other European countries the UK has no plan to close schools.

The CMO advised that school closures were useful when a virus particularly hits children but that this form of coronavirus actually seems to affect children less.

Meanwhile, closing schools would have a knock-on effect as it would keep parents at home – including some who are needed to staff the NHS and other vital services.

But individual schools may be told to close if they have cases of the virus.

Mr Johnson said: "We are not – repeat not – closing schools now. The scientific advice is that this could do more harm than good at this time. But we are of course keeping this under review and this again may change as the disease spreads. Schools should only close if they are specifically advised to do so. And that remains our advice."

All schools have been told to cancel any planned international trips.

Education is devolved to the Northern Ireland and Welsh Assembly and Scottish Parliament who could decide to close schools if they want to.

Chief Scientific Adviser Patrick Valance said: "It's true that there's some effect in closing schools but that effect is minimal and you'd have to do it for 13-16 weeks or longer and you don't need to be a very advanced mathematician to work out that the chances of keeping children not speaking to each other or playing with each for 13-16 weeks is zero and therefore you have to be very careful to make sure you take the right measures that will stop this rather than things which might end up with children for example going to stay with grandparents at the time they might be most vulnerable."


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Are large-scale events like football matches going to be cancelled?

Not as a matter of course in the UK apart from in Scotland where the First Minister Nicola Sturgeon has taken a separate decision to axe any events where more than 500 people are gathering.

But that is not because of the spread – large-scale events actually don't make the spread more likely.

Instead Ms Sturgeon says she was putting a stop to them to free up the NHS and other emergency workers.

Mr Johnson said that he wasn't taking a similar decision yet but that could change in the coming weeks and months.

He said: "We are considering the question of banning major public events such as sporting fixtures. The scientific advice as we’ve said over the last couple of weeks is that banning such events will have little effect on the spread.

"But there is also the issue of the burden that such events can place on public services. So we’re discussing these issues with colleagues in all parts of the United Kingdom and will have more to say shortly about the timing of further action in that respect."

Why do other countries appear to be doing more?

 

Schools in Italy and Ireland are closed and America banned incoming flights. But according to the British experts drastic measures require the support of the public – and so when they are introduced is important.

Prof Whitty said: “The important part of the science of this is the behavioural science.

“People start off with the best of intentions [of following the rules] but if you start too early then people’s enthusiasm starts to run out just about the peak.

“Which is the time we want people to be doing these interventions, that is not a productive way to do it.

“So we do need to it at the last point it is reasonable so that people retain their enthusiasm through what will actually be things which are quite difficult to do.”

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