THE DAILY TELEGRAPH
This [UK oriented] guide on coronavirus symptoms, underpinned with advice from leading health experts, is designed to protect you and your family.
The new coronavirus (Covid-19) is spreading fast. More than 135,000 people are known to be infected, and more than 4,900 deaths have been recorded worldwide.
The bulk of new cases being recorded each day are now outside China, and the virus is spreading at some speed across Europe.
There have now been 590 confirmed cases in the UK, although 10,000 people are thought to be infected, and ten patients have died. More than 29,000 people have now been tested in England, Scotland, Wales and Northern Ireland.
Experts have been warning for years that the world is overdue a major disease outbreak, but there is much that individuals can do to protect themselves and others.
This practical guide is designed to keep you safe and will be updated daily. It is underpinned with advice from leading experts in the NHS and beyond.
What is a coronavirus?
Coronaviruses are a family of viruses that cause disease in animals. Seven, including the new virus, have made the jump to humans, but most just cause common cold-like symptoms.
Two coronaviruses – Middle East respiratory syndrome (Mers) and severe acute respiratory syndrome (Sars) – are much more severe, having killed more than 1,500 people between them since 2002.
The new virus, officially known as Covid-19, is also more dangerous than the common cold. So far, around 15 to 20 per cent of hospital cases have been classed as "severe" and the current death rate varies between 0.7 per cent and 3.4 per cent depending on the location and, crucially, access to good hospital care.
This is much lower than Mers (30%) or Sars (10%), but still a significant threat.
Scientists in China believe that Covid-19 has mutated into two strains, one more aggressive than the other, which could make developing a vaccine more complicated.
What are the symptoms of the new coronavirus?
According to the World Health Organization (WHO), the main symptoms of the coronavirus usually include:
- A dry cough
- A temperature
- Tiredness
- Shortness of breath (in more severe cases)
Some patients may have "aches and pains, nasal congestion, runny nose, sore throat or diarrhea", the WHO adds. "These symptoms are usually mild and begin gradually. Some people become infected but don’t develop any symptoms and don't feel unwell".
These symptoms are similar to other respiratory diseases including flu and the common cold. So if you have symptoms, consider the following:
- Have you travelled to a high risk area such as China, South Korea or Northern Italy in the last two weeks?
- Have you been in close contact with someone with coronavirus
- How quickly do symptoms emerge?
Symptoms are thought to appear between two and 10 days after contracting the virus, but it may be up to 24 days.
Most people (about 80%) recover from the disease without needing special treatment. However, around one out of every six people (16%) becomes seriously ill and develops difficulty breathing.
Older people, and those with underlying medical problems like high blood pressure, heart problems, lung complaints or diabetes, are more likely to develop serious illness.
When should I seek medical help?
People having difficulty breathing should seek medical attention quickly. But do not go out. Instead, you should call NHS 111.
If you just have a fever and a cough - the main early symptoms of coronavirus - the government now advises that you self-isolate for 7 days. This will help protect others.
If you live alone, ask your employer, friends and family to help you to get the things you need.
If you live with others, try and stay at least 2 metres away from other people. Also sleep alone if possible. And stay away from vulnerable individuals such as the elderly and those with underlying health conditions.
You do not need to call NHS 111 to go into self-isolation. But if your symptoms worsen during home isolation or are no better after seven days contact NHS 111 online. If you have no internet access, you should call NHS 111.
For a medical emergency dial 999.
What if I feel fine but have recently returned from a high risk area?
In some cases you may be asked to self-quarantine to protect others even if you do not have symptoms but have travelled to a high risk area.
Use this NHS advice tool to find out what to do to protect yourself and others - https://111.nhs.uk/covid-19
Do not go to a GP, pharmacy or hospital as if you have the virus you may infect others.
How to 'self isolate' if you think you might have coronavirus
If you think you may have the virus, you should try to isolate or quarantine yourself.
This means you should:
- Stay at home
- Avoid work, school and other public areas
- Avoid public transport and taxis
- Get friends and family to delivery food, medicines etc rather than going to the shops
- Discourage visitors
How is the new coronavirus spread and how can I protect myself?
Hand hygiene is the first and most important line of defence.
Like cold and flu bugs, the new virus is spread via droplets when a person coughs or sneezes. The droplets land on surfaces and are picked up on the hands of others and spread further. People catch the virus when they touch their infected hands to their mouth, nose or eyes.
It follows that the single most important thing you can do to protect yourself is to keep your hands clean by washing them frequently with soap and water or a hand sanitising gel.
Also try to avoid touching your mouth, nose or eyes with unwashed hands – something we all do unconsciously on average about 15 times an hour.
Other tips include:
- Carry a hand sanitiser with you to make frequent cleaning of your hands easy
- Always wash your hands before you eat or touch your face
- Be especially careful about touching things and then touching your face in busy airports and other public transport systems
- Carry disposable tissues with you, cover your nose and mouth when you cough or sneeze and dispose of the tissue carefully (catch it, bin it, kill it)
- Do not share snacks from packets or bowls that others are dipping their fingers into
- Avoid shaking hands or cheek kissing if you suspect viruses are circulating
- Regularly clean not only your hands but also commonly used surfaces and devices you touch or handle
Is it just droplets from the nose and mouth that spread the new virus?
Probably not, but they are by far the most common risk.
The NHS and WHO is advising doctors that the virus is also likely to be contained in other bodily secretions including blood, faeces and urine.
Here again, hand and surface hygiene is the key.
How can I protect my family, especially children?
Children are a major vector for the spread of droplet-based viruses because they interact physically so much with each other and are not the best at keeping themselves clean.
The virus appears to impact older people more commonly but children can be infected and they can get severe illness, the government warns.
However, you can greatly lower the risk that children pose of spreading or catching viruses by:
Explaining to them how germs spread and the importance of good hand and face hygiene
Keeping household surfaces clean, especially kitchens, bathrooms, door handles and light switches
Using clean or disposable cloths to wipe surfaces so you don't transfer germs from one surface to another
Giving everyone their own towel and making sure they know not to share toothbrushes etc
Keep your home dry and airy (bugs thrive in musty environments)
What about face masks – do they work?
Paper face masks are not recommended by Public Health England, the NHS or other major health authorities for ordinary citizens, and with good reason.
They are ill-fitting and what protection they might initially provide soon expires. Worse, they quickly become moist inside, providing the perfect environment for germs to thrive in. They also become a hazard for others if carelessly discarded.
An exception to this would be if you were displaying symptoms such as coughing or sneezing – then a mask may help prevent you spreading the virus to others in busy locations.
Can the new coronavirus be treated?
There is no simple cure for the new coronavirus, just as there is no cure for the common cold.
In the vast majority of cases, the disease is only mild. Symptoms such as fever and general discomfort can be treated with aspirin and ibuprofen, or packaged cold and flu remedies containing the same.
It is in more severe cases, where pneumonia develops, that the danger lies. Viral pneumonia cannot be treated with antibiotics and, for the moment at least, there are no antivirals specific to this particular virus.
Instead doctors focus on supporting patients' lung function as best they can.They may be given oxygen or placed on a breathing machine (ventilator) in the most severe cases.
Other symptoms such as fever and discomfort will be treated using drugs such as aspirin and ibuprofen. Secondary infections may be treated with antibiotics.
Are some groups of people more at risk than others?
Data from China suggests that people of all ages are at risk of contracting the virus, although older people are more likely to develop serious illness.
People with a reduced chance of surviving pneumonia include:
- Those over age 65
- Children under the age of two
- People with underlying health conditions or a weakened immune system
Of the first 425 confirmed deaths across mainland China, 80% were in people over the age of 60, and 75% had some form of underlying disease.
Is there a vaccine for coronavirus?
There is currently no vaccine, but scientists around the world are racing to produce one thanks to China's prompt sharing of the virus's genetic code.
However, any potential vaccine will not be available for up to a year and would be most likely to be given to health workers most at risk of contracting the virus first. In addition, researchers in China believe that the virus may have mutated into two strains, one of which is highly aggressive, making a search for a vaccine more difficult.
For now, it is a case of containment and increasing hospital capacity to treat patients. The UK government's conornavirus action plan aims to delay and flatten the epidemic curve of the disease to avoid the NHS from becoming overwhelmed as happened in Wuhan.
Capacity to treat patients who require hospital care will be a major challenge for the NHS if the virus takes hold in the UK – do your bit to help slow down the outbreak by following the advice above.
What is happening at UK airports?
Public Health England has announced "enhanced monitoring of direct flights" from China and many other locations.
In other major hub airports around the world, authorities have gone further and are checking passengers' temperatures on arrival and distributing hand sanitisers to combat the spread of the virus.
Research suggests that hand cleansing at Heathrow and nine other global air hubs could slash the spread of the virus by up to 40 per cent.
Where is the best place to sit on a plane?
The best place to sit is in a window seat in the middle of the cabin, research suggests. This is is because it reduces your risk of being infected by droplets shed by people walking up and down the the aisles (as shown below):
What is the difference between a coronavirus and a flu virus?
Coronaviruses and flu viruses might cause similar symptoms but genetically they are very different.
"Flu viruses incubate very rapidly – you tend to get symptoms two to three days after being infected, but coronaviruses take much longer," says Professor Neil Ferguson, a disease outbreak scientist at Imperial College London. “[With the] flu virus you become immune, but there are lots of different viruses circulating. Coronaviruses don't evolve in the same way as flu, with lots of different strains, but equally our body doesn't generate very good immunity."
What risks are presented if the coronavirus mutates?
Chinese officials have warned that the virus is already starting to mutate, and that there are two strains in circulation.
"The worry is that if you have a new virus that is exploring a human host, it's possible that they might mutate and spread more easily in humans," Jonathan Ball, professor of molecular virology at the University of Nottingham, told The Telegraph.
The genetic sequence of the virus shows a slow mutation rate, Prof Ferguson adds. "Could it mutate to become more lethal and transmissible? That's speculation."
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