Organisations representing people vulnerable to coronavirus are stepping up preparations for a UK outbreak, in a bid to allay growing fears among those with underlying health conditions.
According to the World Health Organization, older people and those with pre-existing medical conditions such as asthma, diabetes and heart disease are more vulnerable to the virus.
What is Covid-19 – the illness that started in Wuhan?
It is caused by 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.
Have there been other coronaviruses?
Severe acute respiratory syndrome (Sars) and Middle Eastern respiratory syndrome (Mers) are both caused by coronaviruses that came from animals. In 2002, Sars spread virtually unchecked to 37 countries, causing global panic, infecting more than 8,000 people and killing more than 750. Mers appears to be less easily passed from human to human, but has greater lethality, killing 35% of about 2,500 people who have been infected.
What are the symptoms caused by the new coronavirus?
The virus can cause 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. Recovery depends on the strength of the immune system. Many of those who have died were already in poor health.
Should I go to the doctor if I have a cough?
UK Chief Medical Officers are advising anyone who has travelled to the UK from mainland China, Thailand, Japan, Republic of Korea, Hong Kong, Taiwan, Singapore, Malaysia or Macau in the last 14 days and who is experiencing a cough or fever or shortness of breath to stay indoors and call NHS 111, even if symptoms are mild.
Is the virus being transmitted from one person to another?
China’s national health commission has confirmed human-to-human transmission, and there have been such transmissions elsewhere.
How many people have been affected?
As of 20 Februrary, China has recorded 2,118 deaths from the Covid-19 outbreak. Health officials have confirmed 74,576 cases in mainland China in total. More than 12,000 have recovered.
The coronavirus has spread to at least 28 other countries. Japan has 607 cases, including 542 from a cruise ship docked in Yokohama, and has recorded one death. There have also been deaths in Hong Kong, Taiwan, France and the Philippines.
There have been nine recorded cases and no fatalities to date in the UK. As of 17 February, a total of 4,501 people have been tested in the UK, of which 4,492 were confirmed negative.
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% at the centre of the outbreak, Hubei province, and less than that elsewhere. 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%.
Another key unknown is how contagious the coronavirus is. A crucial difference is that unlike flu, there is no vaccine for the new coronavirus, which means it is more difficult for vulnerable members of the population – elderly people or those with existing respiratory or immune problems – to protect themselves. Hand-washing and avoiding other people if you feel unwell are important. One sensible step is to get the flu vaccine, which will reduce the burden on health services if the outbreak turns into a wider epidemic.
Is the outbreak a pandemic?
A pandemic, in WHO terms, is “the worldwide spread of a disease”. Coronavirus cases have been confirmed outside China, but by no means in all 195 countries on the WHO’s list. It is also not spreading within those countries at the moment, except in a very few cases. By far the majority of cases are travellers who picked up the virus in China.
Should we panic?
No. 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. 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. Generally, the coronavirus appears to be hitting older people hardest, with few cases in children.
Diabetes UK has recently updated the information pages on its website after calls for advice; while Asthma UK posted a comprehensive blog and the British Heart Foundation has issued guidance. The Cystic Fibrosis Trust, the Primary Immunodeficiency UK (PID UK), Macmillan UK and the Mental Health Foundation have also sought to allay fears and provide support.
But people with respiratory conditions and compromised immune systems have described facing crippling anxiety about what could happen to them should an outbreak of coronavirus hit the UK.
Georgie Wishart, a 30-year-old charity worker with ankylosing spondylitis, a condition which requires her to take immunosuppressants, described the daily battle to deal with her anxiety.
“When it first came into the news, I was on the verge of having anxiety attacks because I didn’t know how I was going to cope,” she said. “There was genuinely a part of me thinking this is how I might die.
“I keep reminding myself of the facts: there aren’t that many confirmed cases, precautions are being taken, and that if it becomes a problem I will deal with it. Because if I didn’t say that to myself every day, it would be really difficult to leave the house.”
A 37-year-old business owner from Brighton, which has seen the highest concentration of UK cases, explained that his family decided to self-isolate to protect his asthmatic daughter.
“We are just checking news websites all the time,” he said. “We have spoken over the phone with our GP, but he was a young guy that just read out the general Public Health England guidelines.”
He home-schooled his daughters for two weeks before sending them back to school after finding more statistics regarding children. Current evidence suggests that children do not appear to be vulnerable, with few cases of children testing positive for the virus.
Several organisations representing people with underlying health conditions said they have seen an increase in calls for advice.
Asthma UK has set up a crisis management group to track the progress of the virus. Calls to the charity are increasing daily, said Emma Rubach, head of health advice at Asthma UK.
“We know that the risk to people with asthma from viruses like coronavirus is higher than the general population, so we are encouraging people to make sure their asthma is well-managed,” she said.
Anxiety is high among other patient groups, such as people with cystic fibrosis, which can result in respiratory complications. Kevin Southern, a consultant paediatrician and cystic fibrosis specialist said: “It is very difficult to be reassuring at the moment, as it is unknown territory, but we are telling our families to follow the official advice, to be prepared, have extra antibiotics in the house and contact their teams with any concerns.” Advice from the Cystic Fibrosis Trust states that there is currently no need for people with cystic fibrosis to limit their activities.
Susan Walsh from the PID UK said they were advising people to follow PHE guidelines. “We are also telling people that if they do feel ill they should contact a doctor promptly with details of their diagnosis, medication and immunology centre,” she said. “It’s a balance between raising awareness, but not creating great fear. It needs to be handled very carefully.”
Derek Nott, director of support line services at Macmillan Cancer Support, said it was understandable that people with cancer “may be feeling more anxious” and said anyone concerned that they may have been in contact with someone with coronavirus, should follow advice from Public Health England, and call 111. He added that people needing clinical, practical and financial information should call the Macmillan support line on 0800 808 0000.
Several people the Guardian spoke to said they were struggling to cope with the psychological weight of worrying about coronavirus. One 28-year-old PR consultant whose mother has late-stage ovarian cancer, said she had never “felt so totally out of control”.
“Cancer robs people of a lot of choices and it feels like coronavirus is limiting me and my family even more,” she said. “I am desperate for someone to say something comforting. I yearn for an expert on coronavirus or cancer to tell us it’ll all be ok.”
The Mental Health Foundation, which has advice for people with coronavirus-related anxiety and stress, said the uncertainty around coronavirus could breed fear. “The huge volume of news, fake news and comment about the virus can also leave people stressed out and afraid of what’s ahead,” said a spokesperson. The foundation suggests getting information from reliable sources, following hygiene advice, using stress management techniques and limiting news consumption.
All the charities and individuals the Guardian spoke to called for members of the public to be aware that their hygiene habits were not only key to their own health and that of their families, but to vulnerable people throughout the country.
“I am much more aware of the risk of catching infection and I am very diligent with my own hygiene but you really notice how other people just aren’t,” said Wishart, who travels into central London daily.
“Yesterday I heard some people joking about it and it did make me quite angry. This is not a joke for people like me. If I catch [coronavirus] there is a very high risk of hospitalisation, and I could die.”
