UK coronavirus patients are no longer all being admitted to hospital

Coronavirus patients are told to recover at HOME: People who have just mild symptoms will not be hospitalised as at least 45 people with the virus are already treating themselves in self-isolation with daily phone calls from health officials

  • The Department of Health confirmed not everyone will be sent to hospital
  • Younger, healthy patients who catch the virus will be told to recover at home
  • A total of 116 people in the UK have now been diagnosed with the virus
  • 18 of them have recovered, 45 are at home and one has died
  • The rest are believed to still be in hospitals around the country 

Coronavirus patients are no longer all being admitted to hospital, British health officials have confirmed.

Anyone confirmed to have the virus who is not seriously unwell or at risk of becoming more dangerously infected can recover at home.

At least 45 people out of the 116 confirmed in the UK have already been instructed to stay in their own houses and wait for their illness to blow over. 

Until the new rule was drafted – it is not clear when it began – all confirmed patients had to be taken to a specialist hospital unit in one of five locations around the country, some hundreds of miles from their hometowns.

An extra 29 cases of the coronavirus have been diagnosed in the UK today, bringing the total to 116 – 105 in England, six in Scotland, three in Northern Ireland and two in Wales.

Officials said it was ‘perfectly reasonable’ for people to recover at home because COVID-19 is a ‘mild illness’. 

NHS hospitals are no longer keeping all confirmed coronavirus cases as inpatients and dozens will be told to recover at home where they pose less of a risk to the public

Professor Chris Whitty, chief medical officer for the government, said that most people with minor cases of the virus will no longer be hospitalised

An extra 29 cases of the coronavirus have been diagnosed in the UK today, bringing the total to 116 – 105 in England, six in Scotland, three in Northern Ireland and two in Wales

Chief medical officer for the government, Professor Chris Whitty, said that most people with minor cases of the virus will no longer be hospitalised.

Instead they will be asked to stay at home, where they pose less of a risk to other people.

While recovering, they will receive daily phone calls from health officials and will be given a special number to call if they start to feel ill and need medical help.

Professor Whitty told reporters: ‘We have moved to a situation where if people have very minimal symptoms – so we think they are clinically safe and they are able to self isolate – we think it is actually safer for them as well as actually more pleasant if they can self isolate in their own homes, with support.

‘Anybody who needs hospitalisation will be hospitalised in a specialist centre as needed.’

What is the scale of the problem?

Cases of coronavirus in the UK more than doubled in 48 hours as the country moved towards the ‘delay phase’ of tackling the virus.

A patient with underlying health conditions became the first person in the UK to die after testing positive.

The older patient had been ‘in an out of hospital’ for other reasons but was admitted on Wednesday evening to the Royal Berkshire Hospital and tested positive.

Some 116 people have tested positive, including 105 in England, two in Wales, six in Scotland and three in Northern Ireland. Just two days ago there were 51 UK cases.

China has reported more than 80,000 cases and almost 3,000 deaths. Outside China, there have been more than 12,000 cases and over 200 deaths across more than 75 countries.

How bad could it get?

Half of all coronavirus cases in the UK are most likely to occur in just a three-week period, with 95 per cent of them over a nine-week period, according to England’s chief medical officer Professor Chris Whitty.

Professor Whitty said he had a ‘reasonably high degree of confidence’ that one per cent is at the ‘upper limit’ of the mortality rate for the virus, although Wuhan in China, which has a weaker health system, had seen an eight to nine per cent mortality rate for those aged 80 and over.

What is the Government doing now?

The UK has moved to the delay stage, which means measures can be ramped up to delay its spread, with possibilities including school closures, encouraging greater home working, and reducing the number of large-scale gatherings.

However, officials say closing schools would possibly only have a ‘marginal effect’, adding that children do not appear to be as badly affected by Covid-19 as other groups. 

The coronavirus causes a disease called COVID-19, which has symptoms similar to flu – a fever, cough and breathing difficulties.

Most people recover from it with no lasting problems, while a small proportion may develop more serious infections or pneumonia. 

Around three in 100 people will die from it, according to data from China, most of them elderly or sufferers of long-term health conditions like heart disease or asthma.

Professor Whitty added: ‘In the long run, to be clear, if we were to get a significant epidemic our advice would definitely be stay at home.

‘It would not make any sense for people with mild symptoms to come into the NHS. That would not benefit them and not benefit anyone else.’ 

Of the 116 cases so far, 18 people have already recovered from the infection, said Public Health England’s Dr Susan Hopkins.

One person has died, the NHS confirmed this afternoon – believed to be a woman in her 70s at the Royal Berkshire Hospital in Reading.

The patient had underlying health conditions and had only been diagnosed last night, the hospital said.

In a statement, the NHS trust which runs the hospital said: ‘Sadly, we can confirm that an older patient with underlying health conditions has died.

‘The patient has previously been in and out of hospital for non-coronavirus reasons, but on this occasion was admitted and last night tested positive for coronavirus.

‘The family has been informed and our thoughts are with them at this difficult time.’

Older people are most at risk of dying from the COVID-19 disease because they have weaker immune systems owing to natural decline as they age.

This may be partly behind the Government’s decision to tell younger people to recover at home.

A large number of hospital patients are elderly and coronavirus patients may be more likely to infect them if they are kept near them as inpatients.

And, if the coronavirus patients’ illnesses are mild and they are only in hospital to be kept away from the public, they will place extra strain on NHS resources.

This is especially likely as the number of people infected in Britain is expected to rise significantly in the coming weeks – Professor Whitty said it is ‘very likely’ the UK will see a full-blown outbreak.

Ministers have launched an advertising blitz featuring a dirty door handle, amid frantic efforts to halt the rise of coronavirus in the UK. The huge public information campaign will urge the public to wash their hands whenever they arrive somewhere

A coronavirus isolation pod is pictured outside St Thomas’ Hospital in south London – all hospitals in England have been ordered to set up the facilities so suspected coronavirus patients can speak to a specialist away from public areas

The chief medical officer and Jeremy Hunt, chair of Parliament’s health select committee, today admitted the Government has now moved into the second phase of its coronavirus action plan, the ‘delay’ phase.

Phase one of four – ‘contain’ – was intended to isolate small numbers of cases and stop the virus spreading inside the UK but appears to have failed.

Professor Whitty said there was now evidence of community transmission between people who had no connections to overseas cases or returning travellers.

He said: ‘We have moved from a situation where we are mainly in contain, with some delay built in, to we are now mainly delay.’

Trying to push a major epidemic back to the summer might be useful if it could slow the virus’s spread – it is thought to spread faster in the cold – and could mean it hits the NHS at a time when it’s less pressed.

WHAT DO WE KNOW ABOUT THE CORONAVIRUS?

Someone who is infected with the coronavirus can spread it with just a simple cough or a sneeze, scientists say.

More than 3,300 people with the virus are now confirmed to have died and over 96,000 have been infected. Here’s what we know so far:

What is the coronavirus? 

A coronavirus is a type of virus which can cause illness in animals and people. Viruses break into cells inside their host and use them to reproduce itself and disrupt the body’s normal functions. Coronaviruses are named after the Latin word ‘corona’, which means crown, because they are encased by a spiked shell which resembles a royal crown.

The coronavirus from Wuhan is one which has never been seen before this outbreak. It has been named SARS-CoV-2 by the International Committee on Taxonomy of Viruses. The name stands for Severe Acute Respiratory Syndrome coronavirus 2.

Experts say the bug, which has killed around one in 50 patients since the outbreak began in December, is a ‘sister’ of the SARS illness which hit China in 2002, so has been named after it.

The disease that the virus causes has been named COVID-19, which stands for coronavirus disease 2019.

Dr Helena Maier, from the Pirbright Institute, said: ‘Coronaviruses are a family of viruses that infect a wide range of different species including humans, cattle, pigs, chickens, dogs, cats and wild animals. 

‘Until this new coronavirus was identified, there were only six different coronaviruses known to infect humans. Four of these cause a mild common cold-type illness, but since 2002 there has been the emergence of two new coronaviruses that can infect humans and result in more severe disease (Severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronaviruses). 

‘Coronaviruses are known to be able to occasionally jump from one species to another and that is what happened in the case of SARS, MERS and the new coronavirus. The animal origin of the new coronavirus is not yet known.’ 

The first human cases were publicly reported from the Chinese city of Wuhan, where approximately 11million people live, after medics first started publicly reporting infections on December 31.

By January 8, 59 suspected cases had been reported and seven people were in critical condition. Tests were developed for the new virus and recorded cases started to surge.

The first person died that week and, by January 16, two were dead and 41 cases were confirmed. The next day, scientists predicted that 1,700 people had become infected, possibly up to 7,000.

Just a week after that, there had been more than 800 confirmed cases and those same scientists estimated that some 4,000 – possibly 9,700 – were infected in Wuhan alone. By that point, 26 people had died. 

By January 27, more than 2,800 people were confirmed to have been infected, 81 had died, and estimates of the total number of cases ranged from 100,000 to 350,000 in Wuhan alone.

By January 29, the number of deaths had risen to 132 and cases were in excess of 6,000.  

By February 5, there were more than 24,000 cases and 492 deaths.

By February 11, this had risen to more than 43,000 cases and 1,000 deaths. 

A change in the way cases are confirmed on February 13 – doctors decided to start using lung scans as a formal diagnosis, as well as laboratory tests – caused a spike in the number of cases, to more than 60,000 and to 1,369 deaths.

By February 25, around 80,000 people had been infected and some 2,700 had died. February 25 was the first day in the outbreak when fewer cases were diagnosed within China than in the rest of the world. 

Where does the virus come from?

According to scientists, the virus almost certainly came from bats. Coronaviruses in general tend to originate in animals – the similar SARS and MERS viruses are believed to have originated in civet cats and camels, respectively.

The first cases of COVID-19 came from people visiting or working in a live animal market in Wuhan, which has since been closed down for investigation.

Although the market is officially a seafood market, other dead and living animals were being sold there, including wolf cubs, salamanders, snakes, peacocks, porcupines and camel meat. 

A study by the Wuhan Institute of Virology, published in February 2020 in the scientific journal Nature, found that the genetic make-up virus samples found in patients in China is 96 per cent identical to a coronavirus they found in bats.

However, there were not many bats at the market so scientists say it was likely there was an animal which acted as a middle-man, contracting it from a bat before then transmitting it to a human. It has not yet been confirmed what type of animal this was.

Dr Michael Skinner, a virologist at Imperial College London, was not involved with the research but said: ‘The discovery definitely places the origin of nCoV in bats in China.

‘We still do not know whether another species served as an intermediate host to amplify the virus, and possibly even to bring it to the market, nor what species that host might have been.’  

So far the fatalities are quite low. Why are health experts so worried about it? 

Experts say the international community is concerned about the virus because so little is known about it and it appears to be spreading quickly.

It is similar to SARS, which infected 8,000 people and killed nearly 800 in an outbreak in Asia in 2003, in that it is a type of coronavirus which infects humans’ lungs. It is less deadly than SARS, however, which killed around one in 10 people, compared to approximately one in 50 for COVID-19.

Another reason for concern is that nobody has any immunity to the virus because they’ve never encountered it before. This means it may be able to cause more damage than viruses we come across often, like the flu or common cold.

Speaking at a briefing in January, Oxford University professor, Dr Peter Horby, said: ‘Novel viruses can spread much faster through the population than viruses which circulate all the time because we have no immunity to them.

‘Most seasonal flu viruses have a case fatality rate of less than one in 1,000 people. Here we’re talking about a virus where we don’t understand fully the severity spectrum but it’s possible the case fatality rate could be as high as two per cent.’

If the death rate is truly two per cent, that means two out of every 100 patients who get it will die. 

‘My feeling is it’s lower,’ Dr Horby added. ‘We’re probably missing this iceberg of milder cases. But that’s the current circumstance we’re in.

‘Two per cent case fatality rate is comparable to the Spanish Flu pandemic in 1918 so it is a significant concern globally.’

How does the virus spread?

The illness can spread between people just through coughs and sneezes, making it an extremely contagious infection. And it may also spread even before someone has symptoms.

It is believed to travel in the saliva and even through water in the eyes, therefore close contact, kissing, and sharing cutlery or utensils are all risky. 

Originally, people were thought to be catching it from a live animal market in Wuhan city. But cases soon began to emerge in people who had never been there, which forced medics to realise it was spreading from person to person.

There is now evidence that it can spread third hand – to someone from a person who caught it from another person.

What does the virus do to you? What are the symptoms?

Once someone has caught the COVID-19 virus it may take between two and 14 days, or even longer, for them to show any symptoms – but they may still be contagious during this time.

If and when they do become ill, typical signs include a runny nose, a cough, sore throat and a fever (high temperature). The vast majority of patients will recover from these without any issues, and many will need no medical help at all.

In a small group of patients, who seem mainly to be the elderly or those with long-term illnesses, it can lead to pneumonia. Pneumonia is an infection in which the insides of the lungs swell up and fill with fluid. It makes it increasingly difficult to breathe and, if left untreated, can be fatal and suffocate people.

Figures are showing that young children do not seem to be particularly badly affected by the virus, which they say is peculiar considering their susceptibility to flu, but it is not clear why. 

What have genetic tests revealed about the virus? 

Scientists in China have recorded the genetic sequences of around 19 strains of the virus and released them to experts working around the world. 

This allows others to study them, develop tests and potentially look into treating the illness they cause.   

Examinations have revealed the coronavirus did not change much – changing is known as mutating – much during the early stages of its spread.

However, the director-general of China’s Center for Disease Control and Prevention, Gao Fu, said the virus was mutating and adapting as it spread through people.

This means efforts to study the virus and to potentially control it may be made extra difficult because the virus might look different every time scientists analyse it.   

More study may be able to reveal whether the virus first infected a small number of people then change and spread from them, or whether there were various versions of the virus coming from animals which have developed separately.

How dangerous is the virus?  

The virus has a death rate of around two per cent. This is a similar death rate to the Spanish Flu outbreak which, in 1918, went on to kill around 50million people.

Experts have been conflicted since the beginning of the outbreak about whether the true number of people who are infected is significantly higher than the official numbers of recorded cases. Some people are expected to have such mild symptoms that they never even realise they are ill unless they’re tested, so only the more serious cases get discovered, making the death toll seem higher than it really is.

However, an investigation into government surveillance in China said it had found no reason to believe this was true.

Dr Bruce Aylward, a World Health Organization official who went on a mission to China, said there was no evidence that figures were only showing the tip of the iceberg, and said recording appeared to be accurate, Stat News reported.

Can the virus be cured? 

The COVID-19 virus cannot be cured and it is proving difficult to contain.

Antibiotics do not work against viruses, so they are out of the question. Antiviral drugs can work, but the process of understanding a virus then developing and producing drugs to treat it would take years and huge amounts of money.

No vaccine exists for the coronavirus yet and it’s not likely one will be developed in time to be of any use in this outbreak, for similar reasons to the above.

The National Institutes of Health in the US, and Baylor University in Waco, Texas, say they are working on a vaccine based on what they know about coronaviruses in general, using information from the SARS outbreak. But this may take a year or more to develop, according to Pharmaceutical Technology.

Currently, governments and health authorities are working to contain the virus and to care for patients who are sick and stop them infecting other people.

People who catch the illness are being quarantined in hospitals, where their symptoms can be treated and they will be away from the uninfected public.

And airports around the world are putting in place screening measures such as having doctors on-site, taking people’s temperatures to check for fevers and using thermal screening to spot those who might be ill (infection causes a raised temperature).

However, it can take weeks for symptoms to appear, so there is only a small likelihood that patients will be spotted up in an airport.

Is this outbreak an epidemic or a pandemic?   

The outbreak is an epidemic, which is when a disease takes hold of one community such as a country or region. 

Although it has spread to dozens of countries, the outbreak is not yet classed as a pandemic, which is defined by the World Health Organization as the ‘worldwide spread of a new disease’.

The head of WHO’s global infectious hazard preparedness, Dr Sylvie Briand, said: ‘Currently we are not in a pandemic. We are at the phase where it is an epidemic with multiple foci, and we try to extinguish the transmission in each of these foci,’ the Guardian reported.

She said that most cases outside of Hubei had been ‘spillover’ from the epicentre, so the disease wasn’t actually spreading actively around the world.

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