Police and fire services will only respond to the most serious call-outs if their staff fall ill through coronavirus, the government warned on Tuesday, in a key planning document setting out how ministers would deal with an escalating outbreak.
The action plan envisages that the army could be called in to help if requested by civilian authorities. And it says that up to a fifth of the national workforce could be absent from work, schools could close and elderly people would be advised not to attend social gatherings.
The measures would only be rolled out if the virus moved beyond the currently designated “contain” phase.
Speaking from Downing Street, Boris Johnson stressed: “The plan does not set out what the government will do; it sets out the things we could do at the right time and on the basis of scientific advice.”
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 3 March, the outbreak has affected more than 89,000 people globally, with a total death toll in excess of 3,000. In mainland China, of the 80,151 confirmed cases, over 44,000 people have recovered, and 2,943 (or 3.6%) have died. Over 125 deaths have occurred outside of China.
The coronavirus has spread to more than 60 other countries. The worst affected include South Korea with nearly 5,000 cases, and Iran, with over 1,500 cases.
There have been 40 recorded cases and no fatalities to date in the UK.
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.
The advice was released in the Coronavirus: Action Plan on Tuesday as the number of cases in the UK stood at 39.
It sets out plans for scenarios ranging from a milder pandemic to a “severe prolonged pandemic as experienced in 1918” when the Spanish Flu killed 50 million worldwide.
If the illness moves into the “delay” and “mitigate” phases in the UK, retired NHS staff could be brought back to help care for patients, the document says.
“With a significant loss of officers and staff, the police would concentrate on responding to serious crimes and maintaining public order,” it said.
The 28-page plan also says that:
• There could be an increase in deaths arising from the outbreak, particularly among vulnerable and elderly people. The government will “ensure dignified treatment of all affected, including those who die”, it says, and that local authorities will need help to deal with the rise in deaths.
• Businesses facing short-term cashflow because of low demand from customers could ask HMRC how to avoid falling behind with tax.
• If NHS staff numbers are affected, some non-urgent care may be delayed and retired healthcare professionals brought back on duty.
• Anyone who shows symptoms should consider options ranging from avoiding contact outside work and school to “social distancing”, household quarantine, and working from home.
• Widespread exposure in the UK may be inevitable – but “slowing it down would still nonetheless be beneficial”, partly because GP surgeries and hospitals will be less busy in the summer months outside of peak flu season.
At a press conference, the prime minister said it was “highly likely” the number of cases in the UK would rise but that “for the vast majority of people in this country we should be going about our business as usual”.
“I fully understand public concern, your concern, about the global spread of the virus … Keeping the country safe is the government’s overriding priority.”
Johnson said it was “too early to say” how many people would contract Covid-19. Chris Whitty, the chief medical officer for England, said he was reasonably confident “probably around 1% of people who contracted the virus might end up dying, based on the Chinese experience”. However, he said, it could be lower than that because there was no way to tell how many people had the illness but no symptoms.
He said the proportion of the total population who might contract coronavirus would not pass 80% but it would probably be a “lot lower than that”.
Asked about gig economy workers who might have to quarantine themselves with no statutory sick pay, Johnson did not announce an extension of sick pay to all, but said: “We’re going to keep all options under review but we’re well aware of the issue.”
He insisted the NHS was “well capable of handling the most tremendous pressures” but that if the situation worsened it would be important for everybody to think about how to reduce the burden on the health service, such as avoiding using GPs.
Asked which operations and treatments could be cancelled, Whitty said the aim was to push the peak of infections to the late spring or summer under the government’s “delay” strategy. He said the peak was likely to last a number of weeks, during which time the government would postpone treatment for the least urgent conditions.
He said it was important for older and vulnerable people to “isolate from the virus but not from society”. Whitty said the government was keen not to take stringent measures too early, such as banning visitors from care homes, as there would be a social cost when it was not yet necessary.
Asked about the possibility of a morgue being set up in Hyde Park, Johnson said there were long-established local resilience plans to deal with a pandemic.
Despite earlier suggestions that cities could be put on lockdown to try to contain the illness, experts are now suggesting that would have little effect.
Whitty said locking down cities was most useful when an outbreak started in one place rather than emerging all over a country, suggesting this scenario was unlikely in the UK.
He would not say what the specific rate of mortality would be for people aged over 80, but that it was clear there was a “ramp up” for older age groups. He said he would not necessarily expect the mortality rates in China to be replicated in the UK where the health service is stronger, and that even among the highest risk groups the “vast majority” of people would survive.
Whitty also dismissed the idea of further travel bans because the virus has already reached the UK and it would “make no difference”.
Hancock told the BBC Radio 4 Today programme earlier: “The message today is that, right now, we do not need to do many of the heavy things we are talking about in the plan. But we are also setting [them] out as transparently as we possibly can so people know the sort of things we might have to do in future.”
