Advice for Brits to quit China on coronavirus fears criticised by WHO

The UK has been criticised by the World Health Organization’s director general for urging all its 30,000 citizens in China to leave the country because of the coronavirus outbreak.

It was wrong to imply that the whole of China had an outbreak on the same scale as that in Wuhan in Hubei province, where it began and where most of the cases and deaths are still occurring, said Dr Tedros Adhanom Ghebreyesus.

“Considering China as if the problem was the same in all provinces could be wrong – and it is wrong,” said Tedros. “For instance, 80% of cases in China are in Hubei province, so that blanket approach may not help.

“We are concerned that all countries make their decisions based on evidence. Even in China there are provinces with very few cases, like other countries in the neighbourhood and beyond.”

What is the virus causing illness in Wuhan?

It is 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.

What other coronaviruses have there been?

New and troubling viruses usually originate in animal hosts. Ebola and flu are other examples – severe acute respiratory syndrome (Sars) and Middle Eastern respiratory syndrome (Mers) are both caused by coronaviruses that came from animals. 

What are the symptoms of the Wuhan coronavirus?

The virus causes 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. If people are admitted to hospital, they may get support for their lungs and other organs as well as fluids. Recovery will depend on the strength of their immune system. Many of those who have died were already in poor health.

Is the virus being transmitted from one person to another?

Human to human transmission has been confirmed by China’s national health commission, and there have been human-to-human transmissions in the US and in Germany. As of 5 February, the death toll has climbed to 490 in mainland China. There remains one additional fatality in Hong Kong and one in the Philippines. There are 24,505 confirmed cases around the world, with 24,292 being in mainland China. The mortality rate stands at 2.1%.

Two members of one family have been confirmed to have the virus in the UK, after more than 400 were tested and found negative. The Foreign Office has urged UK citizens to leave China if they can.

The number of people to have contracted the virus could be far higher, as people with mild symptoms may not have been detected. Modelling by World Health Organization (WHO) experts at Imperial College London suggests there could be as many as 100,000 cases, with uncertainty putting the margins between 30,000 and 200,000.

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%. However, this is likely to be an overestimate since many more people are likely to have been infected by the virus but not suffered severe enough symptoms to attend hospital, and so have not been counted. 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%.

Should I go to the doctor if I have a cough?

Unless you have recently travelled to China or been in contact with someone infected with the virus, then you should treat any cough or cold symptoms as normal. The NHS advises that people should call 111 instead of visiting the GP’s surgery as there is a risk they may infect others.

Is this a pandemic and should we panic?

Health experts are starting to say it could become a pandemic, but right now it falls short of what the WHO would consider to be one. A pandemic, in WHO terms, is “the worldwide spread of a disease”. Coronavirus cases have been confirmed in about 25 countries outside China, but by no means in all 195 on the WHO’s list.

There is no need to panic. 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, and says there is a “window of opportunity” to halt the spread of the disease. 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.

Sarah Boseley Health editor and Hannah Devlin 

There have been 24,363 cases of the new coronavirus confirmed in China and 490 deaths, he said at a briefing in Geneva. In the previous 24 hours the largest number of cases were reported in a day since the outbreak began. Outside China, there were 191 cases in 24 countries and one death, in the Philippines.

Dr Michael Ryan, head of the WHO’s emergencies programme, said they were asking governments to adopt calm, well-considered public health measures. “Certainly in a situation where many individuals are potentially living in the country, we don’t believe those individuals are necessarily at the highest risk.”

He pointed out that recalling such a large number of people to the UK would require a great deal of screening and public health support on their return. The WHO was monitoring all the measures that countries outside China were taking and would be sharing its findings with other member states “to try to bring some cohesion and order” to countries’ responses to the crisis.

The new advice to British nationals in China came out of the blue on Tuesday in a statement from foreign secretary Dominic Raab: “We now advise British nationals in China to leave the country if they can, to minimise their risk of exposure to the virus.”

The advice came just a few days after the WHO declared a public health emergency of international concern, but urged countries not to impose travel or trade restrictions on China. Many airlines have, however, stopped flying to the country.

While the UK is among a number of countries to have evacuated thei citizens from Wuhan, the centre of the outbreak, which is under lockdown, it is alone in advising all citizens anywhere in China to leave. But the Foreign Office briefed that early return was advisable in case the outbreak spread within China and travel restrictions made it difficult to leave.

The shadow foreign secretary, Emily Thornberry, accused the government of asking Britons in China to fend for themselves. “How on earth has the Foreign Office not got plans and protocols in place for how these crises are managed? The first duty of any government is to protect its citizens, at home and abroad, and Boris Johnson is manifestly failing to do that,” she said.

Matt Hancock said on Wednesday morning that the government’s stance was based on scientific advice. “There are still commercial flights available,” the health secretary said on BBC Breakfast. “The principle that we are taking is that we want to take no chances with this virus. We want to take a science-led approach. The approach we have been taking is very much driven by the advice of the chief medical officer.

“This is a very serious virus and having a very serious impact in China. There are two cases only here in the UK, but we do expect more, so we are taking no chances.”

Meanwhile, Canada’s foreign minister said on Wednesday that Canadians who do not need to be in China should leave while they still can. François-Philippe Champagne told reporters: “We are advising Canadians whose presence in China is not essential to depart via commercial means while they remain available.”

Canada intended to fly 200 citizens out on Wednesday, but was waiting another 24 hours because of bad weather, prime minister Justin Trudeau said earlier.


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