Friday, 31 January 2020

Novel Coronavirus (2019-nCoV)

The purpose of this (rather long sorry!) blog is to lead you to key resources as the developments of novel coronavirus (2019-nCoV) unfold.  Please note, as new resources become available I will post these updates right at the bottom of the page under the heading, Update on New Resources.  

On 31 December 2019, the World Health Organization (WHO) was informed of a cluster of cases of pneumonia of unknown cause detected in Wuhan City, Hubei Province, China. A novel coronovirus was identified as the cause and was named Coronovirus (2019-nCoV).  
Coronaviruses are a large family of viruses, some cause mild illness, such as the common cold but others can result in more severe disease such as Middle East respiratory syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS).  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.  The main symptoms reported for novel coronovirus (2019n-CoV) have been fever, cough or chest tightness, and dyspnoea. While most cases report a mild illness, severe cases are also being reported, some of whom require intensive care and some deaths have occurred. 

World Health Organization updates

The WHO publish a daily situation report and on 30th January 2020 recommended that the interim name of the disease causing the current outbreak should be “2019-nCoV acute respiratory disease” (where ‘n’ is for novel and ‘CoV’ is for coronavirus).  At this time there were 7818 cases confirmed globally of which 7736 were confirmed in China.  Of these, 1370 were severe and 170 deaths had occurred.  Outside of China there were 82 cases in 18 countries.  The report provides a global map of the countries, territories or areas with reported confirmed cases of 2019-nCoV and a surveillance table of the numbers within each location. 

However, this is a rapidly changing picture and on 30th January 2020 the WHO convened the second International Health Regulations (IHR) Emergency Committee on novel coronavirus in China.  The Committee stated they believed that ‘it is still possible to interrupt virus spread, provided that countries put in place strong measures to detect disease early, isolate and treat cases, trace contacts, and promote social distancing measures commensurate with the risk. It is important to note that as the situation continues to evolve, so will the strategic goals and measures to prevent and reduce spread of the infection’. As a result the Director-General declared that the outbreak of 2019-nCoV constitutes a Public Health Emergency of International Concern (PHEIC) and accepted the Committee’s advice and issued advice as Temporary Recommendations under the IHR to the People’s Republic of China, to all countries and then to the global community – full details can be viewed here 

A key page of very helpful resources from the WHO provides advice on protecting yourself, travel advice, myth-busters, situation reports and technical guidance.  It is suggested users visit it daily. The image below is one of the mythbusters, click on this image to view more.

News from the United Kingdom
In the UK our four Chief Medical Officers issued a press release on 30th January 2020 explaining in light of the current situation they considered it prudent for their governments to escalate planning and preparation in case of a more widespread outbreak.  For that reason, they advised an increase of the UK risk level from low to moderate clarifying that this didn’t mean they thought the risk to individuals in the UK had changed at this stage, but that government should plan for all eventualities.  To read in full see here

On the morning of 31st January 2020, the Department of Health and Social Care (DHSC) announced two patients in England who were members of the same family had tested positive for coronavirus and were receiving specialist NHS care, using tried and tested infection control procedures to prevent further spread of the virus. These are the first cases identified in the UK, but a very interesting blog prepared by Public Health England (PHE) explains the NHS is extremely well-prepared and used to managing infections.  PHE is a world leader in developing techniques to aid the public health investigation of infectious disease and the UK is one of the countries outside China to have an assured testing capability for this disease.  It is a complex test which can differentiate this type of coronavirus from any other coronavirus.  

UK Travel advice
Regarding travel advice, the Foreign and Commonwealth Office (FCO) advise against all travel to Hubei Province due to the ongoing novel coronavirus outbreak and against all but essential travel to the rest of mainland China (not including Hong Kong and Macao).  More details are found here, including a downloadable map. PHE were advising that anyone who had visited Wuhan in the last 14 days, should stay indoors and avoid contact with others where possible, and call NHS 111 informing them of your symptoms and recent travel to the city. Individuals in Northern Ireland, should call their GP

However in a CMO alert sent on 31st January 2020, (Alert Reference: CEM/CMO/2020/002) it was recommended that all travellers who develop relevant symptoms, however mild, within 14 days of returning from mainland China, should self-isolate at home immediately and call NHS 111.  This document is essential information of all clinical staff encountering patients with respiratory infections arrived from overseas and can be accessed within in the attachments at the bottom of the page here or directly on the image left below.   This page also provides a flowchart for use in the Management of a suspected case of 2019-nCoV acute respiratory disease or access directly on the image below right .  


As the situation unfolds, ongoing updates will be available by checking out the resources above but if an individual is planning travel abroad then excellent travel advice is available from fitfortravel  There is also a specific leaflet entitled Novel Coronavirus (Wuhan, China) Infection 

TravelHealthPro from NaTHNaC have advice for Coronavirus (2019-nCoV)  
This current information for travellers advises the following:

To reduce the risk of coronavirus infection all travellers should:
  •   Maintain good hand and personal hygiene. Wash hands regularly with soap and water or a disinfectant before handling or consuming food.
  • Avoid visiting live bird and animal markets, backyard or commercial poultry farms and do not touch wild or domestic birds (alive or dead).
  • Avoid any contact with animals, birds or surfaces that may be contaminated with animal or bird dropping.
  • Avoid eating or handling undercooked or raw meat including poultry, egg or duck dishes.
  • Avoid close contact with anyone with cold or flu-like symptoms, or who appears unwell.Avoid sharing personal items.

To reduce the risk of passing coronavirus to others, anyone with respiratory symptoms should:
  • Cover the nose and mouth when coughing and sneezing with a tissue or flexed elbow
  • Use paper tissues only once and dispose of them carefully
  • Should a mask be worn, all the recommended precautions in order to minimise the risk of transmission should still be used

There is currently no preventive vaccine or specific treatment for Coronavirus (2019-nCoV). 

Developments on novel coronavirus (2019-nCoV) is clearly an unfolding picture, but the speed with which the world seems to be responding so quickly is positive.