The Daily Telegraph

Q&A What to expect if Covid-19 grows from alarming outbreak into pandemic

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It looks more and more likely that the coronaviru­s outbreak will become a pandemic. Critics will say China’s containmen­t strategy has failed but there is little doubt it has bought the rest of the world time to prepare. The key question now is whether that time has been used wisely. Here are key things to expect if Covid-19 now does a lap of the world: Q What’s the plan if containmen­t does not work?

A Mitigation follows containmen­t in major outbreaks. Mitigation efforts in the UK will be driven by the UK Influenza Pandemic Preparedne­ss Strategy 2011 and fall into four main areas:

♦ Encouragin­g individual behaviour change

♦ Social distancing

♦ Environmen­tal hygiene

♦ Building medical capacity Q What about quarantine­s? A Italy has followed

China’s example and placed more than 50,000 people under quarantine in a series of villages in the north of the country.

Quarantine­s could be placed on containabl­e UK communitie­s if an outbreak occurs; largescale quarantine­s or curfews seem unlikely unless the virus becomes more severe. Q How severe is the virus? A This remains the million dollar question. In Wuhan the death rate is between two and four per cent but is around 0.7 per cent in the rest of China and the world. If it falls as low as the 0.026 per cent death rate for swine flu in 2009, it should be manageable.

But experts are still far from sure about the clinical severity of the disease. Older people are more vulnerable but the young are not immune. Q

How many people might need hospital treatment? A

It is not just the overall death rate that is cause for concern.

In China 14 per cent of the first 44,000 cases were “severe”. A further 5 per cent were “critical”. Another issue is the duration of the disease; demand on hospital beds will be high. Q Could the NHS cope if the virus gets a grip here? A This is another big question. If any UK outbreak can be delayed until the spring it would avoid the worst of the winter pressures.

If a China-style outbreak were to occur the NHS would struggle to cope, Jonathan Ball, professor of molecular virology at the University of Nottingham, says.

“As a population we have never seen this virus before. The attack rate will be quite high,” he said.

However, the Government is more optimistic. “NHS is extremely well prepared,” said a No10 spokesman.

Paul Nuki and Anne Gulland

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