Leading experts advise so that you can make decisions
WITH seemingly endless advice and fast-moving changes regarding coronavirus it can be hard to know how to prepare.
It is not a matter of panic. It is about using expert advice to take reasoned and practical steps to keep yourself and your family safe. For many people, coronavirus presents about as much threat as flu. In fact, some people’s symptoms may have been so mild they wouldn’t even have sought medical attention.
However, the disease can be deadly. People with poor immune systems, respiratory problems or other underlying health problems are particularly at risk.
We have gone through the leading expert advice to help you make informed decisions.
■ How likely is it to spread?
Very likely. Nicholas Christakis is a doctor and professor of social and natural science at Yale University. Speaking on Sam Harris’ Making Sense podcast, he said: “Marc Lipsitch, an epidemiologist at Harvard, estimates as of last week that 20-60% of Americans will, over the course of a year, be infected with this pathogen.
“If we use the lower bound of his estimate it means 60 million Americans will be infected and if we use the lower bound of the case fatality ratio, which is 0.5%, that means 300,000 Americans are going to die of this condition. And that is one of the topthree killers.
“That is within the realm of the possible. I am not saying it is going to happen but we need to sit up and pay attention.”
In Germany, Angela Merkel estimates that 70% of the country’s population could be infected. In Italy, there are 12,000 confirmed cases and more than 800 deaths. However, in
the UK there are still only around 450 cases and eight deaths. ■ The danger posed by coronavirus
The evidence from analysis of cases so far is that Covid-19 infection causes mild disease (ie non-pneumonia or mild pneumonia) in about 80% of cases. And most cases recover, according to the European Centre for Disease Prevention and Control.
But 14 % have more severe disease and 6% experience critical illness.
The great majority of the most severe illnesses and deaths have occurred among the elderly and those with other chronic underlying conditions.
Covid-19 is more contagious than flu but not as deadly or as contagious as many infectious diseases. For example, measles can spread more quickly through an area not vaccinated against it. ■ The percentage of people who catch coronavirus who actually die
At the start of the outbreak the figure was around 2%, as reported at a World Health Organisation (WHO) press conference on January 29. By February 20, it was up to 3.8% as reported by the WHO-China Joint Mission.
Last week, the WHO director-general said: “Globally, about 3.4% of reported Covid-19 cases have died.”
But it could well be considerably lower. The figure is worked out by taking the number of known cases and comparing the amount of known deaths. Ultimately experts can not be certain until they have more data but scientists’ estimate of the death rate is lower because not all cases are reported. It is now estimated that the mortality rate is between 0.5-2%.
Professor Mark Woolhouse, Professor of infectious disease epidemiology at the University of Edinburgh, said: “If a significant number of mild cases have been missed or not reported then this estimate is too high. Though there is disagreement about this, some studies have suggested that it is approximately 10 times too high. This would bring the death rate in line with some strains of influenza.”
■ The death rate compared to flu
Flu kills people every winter. In the US the death rate from seasonal flu is typically around 0.1%, according to The New York Times. There are some similarities between flu and coronavirus.
Both cause respiratory disease and spread the same way, via small droplets of fluid from the nose and mouth of someone who is sick. However, experts warn that they are far from the same thing.
The WHO director-general said: “Covid-19 does not transmit as efficiently as influenza, from the data we have so far. The second major difference is that Covid-19 causes more severe disease than seasonal influenza. Third, we have vaccines and therapeutics for seasonal flu, but at the moment there is no vaccine and no specific treatment for Covid-19.
“While many people globally have built up immunity to seasonal flu strains, Covid-19 is a new virus to which no-one has immunity. That means more people are susceptible to infection, and some will suffer severe disease.
“Fourth, we don’t even talk about containment for seasonal flu – it’s just not possible. But it is possible for Covid-19.”
■ The death rate compared to swine flu, Sars and Ebola
The Sars death rate was nearly 10%, but could increase to over 50% in adults older than 60.
By comparison, Ebola killed over 11,000 people in West Africa and had a fatality rate of between 25% and 90% depending on the outbreak.
■ The symptoms of coronavirus
Symptoms may appear between two and 14 days after exposure and are fever, cough and shortness of breath. Reported illnesses have ranged from mild to severe and even death. Public Health England (PHE) describes the symptoms of Covid-19 as being “flu-like”.
NHS Direct Wales has launched a coronavirus symptom checker which asks you questions to determine if you need to take further action or self-isolate. Visit www.nhsdirect. wales.nhs.uk/
■ What to do if you think you have coronavirus
Wales’ chief medical officer, Dr Frank Atherton, said yesterday that anyone with new symptoms such as a cough, fever, or feel ill, should selfisolate for seven days.
Only call 111 (if available in your area) or 0845 46 47 if symptoms deteriorate to a point where you would normally seek medical care.
Routine testing will now only take place for certain groups such as healthcare workers.
■ The expert advice to avoid coronavirus
Current NHS advice is still that most people can continue to go to work, school and other public places. You only need to stay away from public places (self-isolate) if new symptoms emerge or if advised to by the NHS 111 online coronavirus service or a medical professional.
This is now a fast-moving situation, and advice could change quickly, but currently the only people who do need to stay away from public places are people who have new symptoms, have recently come from specified atrisk areas and people who have come into contact with someone with the virus.
You may have seen people walking around wearing face masks. Though face masks play a very important role in places like hospitals, there is little evidence of widespread benefit for members of the public.
One of the best ways to avoid the virus is by following basic hygiene advice like washing your hands regularly with soapy water.
■ The length of time coronarvirus can live on a surface
Coronavirus is known to spread mainly from person-to-person contact through sneezing and coughing, but a separate study published in The Journal of Hospital Infection found that the virus may be able to live on surfaces like metal, glass or plastic for up to nine days.
Increased temperatures of 30-40 degrees C were found to reduce the duration of how long the virus lasted.
According to the study, cleaning products such as bleach were found to be effective at killing the virus on surfaces within a minute.
■ The concerns over medical supplies
A massive mobilisation of resources is needed to combat the virus.
The WHO director-general said: “We are concerned that countries’ abilities to respond are being compromised by the severe and increasing disruption to the global supply of personal protective equipment – caused by hoarding and misuse.
“Shortages are leaving doctors, nurses and other frontline healthcare workers dangerously ill-equipped to care for Covid-19 patients, due to limited access to supplies such as gloves, medical masks, respirators, goggles, face shields, gowns, and aprons.”
In the UK, the four chief medical officers have said “we are confident in the ability of the NHS in England, Scotland and Wales and HSC in Northern Ireland to manage these in a way that protects the public and provides high–quality care.”
The UK is also behind many countries when it comes to hospital beds. According to The King’s Fund the UK currently has fewer acute beds relative to its population than almost any other comparable health system.
And a senior intensive care consultant has warned that Wales is “uniquely at risk” if there is a surge of very sick people with coronavirus as in Italy. Dr Jack Parry-Jones told the BBC he is concerned about the supply of beds and staffing, because critical care units normally work at more than 90% capacity.
■ The virus may not peak until next winter
It is not going anywhere any time soon. New modelling suggests the virus may peak next winter.
A paper by Richard Reher et al suggested there could be a small dip in the summer months. However, there will be larger peak in winter 2020-21.
Though there may be a reduction in infection into the summer it “does not necessarily mean the epidemic is contained”.
■ The spread of Covid-19 will not be the same as other outbreaks such as Sars
Nicholas Christakis, a doctor and professor of social and natural science at Yale University, has described the virus as a “perfect storm”.