The Guardian (USA)

What is the basis of the UK government's coronaviru­s measures?

- Ian Sample and Rajeev Syal

With Britain dramatical­ly stepping up its action plan to fight the coronaviru­s, we explore the measures outlined by Boris Johnson on Monday and the thinking and science behind them.

Avoid all nonessenti­al social contact and ‘unnecessar­y’ visits to care homes

The idea behind avoiding all unnecessar­y contact is simple: the fewer people you come into contact with, the fewer people can infect you, and the fewer you can infect if you are harbouring the virus. This is what social distancing is all about.

At the moment, the vast majority of the population are susceptibl­e to coronaviru­s infection. Interact less, and the rate of infections will slow down. This is especially important in care homes, where people are likely to be highly dependent on others and extremely vulnerable because of their age. Fewer cases means less demand on the NHS and with that, fewer fatalities.

Avoid pubs, clubs, cinemas and theatres, and work from home

The prime minister said everyone should avoid gatherings and social meeting places, but stopped short of asking them not to open. Those who can work from home, should. Any place where people sit close together – within two metres of each other – for a period of time is a place where the virus can spread.

Coronaviru­s spreads primarily through airborne droplets, mostly those coughed or sneezed into the air. But the virus can also spread via tabletops, cutlery and toilet doors: it can survive on hard surfaces for several days if they are not cleaned properly.

The over-70s, pregnant women and those with health issues

Those who are aged over 70, people with underlying health conditions and pregnant women should be particular­ly careful, according to Prof Chris Whitty, the chief medical officer.

Coronaviru­s tends to be far more dangerous to older people. In China, only 0.4% of 40-somethings known to have contracted the virus died. But in those aged 80 or over, the death rate was 15%.

The reason is that with old age comes other diseases, a weaker immune system and worse overall health. The respirator­y system itself is also weaker in the elderly. Underlying health conditions such as high blood pressure and diabetes are known to raise mortality risk, but the evidence is not in on pregnant women.

Last week, the Royal College of Obstetrici­ans and Gynaecolog­ists and others said there was no evidence the virus could pass from mother to baby. This was not the case with previous lethal coronaviru­ses, Sars and Mers.

12 weeks’ isolation for the most vulnerable

Johnson said that by this weekend, it will be necessary to go further to ensure that those with the most serious health conditions are shielded from social contact for about 12 weeks. He did not define the most serious health conditions on Monday. “This is going to be very disruptive for people who have such conditions, and difficult for them, but, I believe, it’s now necessary,” Johnson said.

The most vulnerable face the toughest restrictio­ns: to reduce as far as possible all contact with others. The intention is to protect those most likely to fall seriously ill and die if they contract the infection. The 12-week period is aimed to cover the weeks when the outbreak is at its peak, whenthe highest number of people are infected.

Entire households should selfisolat­e for 14 days if anyone suspects they have the virus

Johnson said all members of any household which includes a single person who suffers from a dry cough or a fever should, if possible, avoid leaving the house “even to buy food or essentials”.

This is an admission by the government that if one person in a household gets infected, any others in the house are likely to contract the infection too. The entire household must self-isolate for 14 days, giving enough time not only for the first person’s infection to run its course, but any other infections that result to appear. The advice remains to self-isolate for seven days if you have coronaviru­s symptoms and live alone.

Testing will be ramped up

On Monday, the head of the World Health Organizati­on said not enough tests were being carried out. Prof Whitty defended the UK’s testing regime but said: “We do intend to continue to scale up testing.”

Scaling up testing will give scientists a clearer idea of how many infections are in the community, but Whitty was keen to promote a new test being developed by Public Health England that will detect whether people have had the infection without knowing.

That test will give a truer figure of the spread of the infection in the community and reveal how dangerous the disease is not only to those who fall ill, but to all who become infected.

The UK is “three weeks” behind Italy

Sir Patrick Vallance, the UK’s chief

 ??  ?? Avoiding unnecessar­y social contact is especially important in care homes. Photograph: Simon Rawles/Alamy
Avoiding unnecessar­y social contact is especially important in care homes. Photograph: Simon Rawles/Alamy

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