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Saturday, March 14, 2020

Coronavirus 'Daily Telegraph' Guide - UK orientated

Should I be worried about coronavirus? Advice for living with Covid-19

Should you stockpile food, stop going to work and cancel your social arrangements? Or will it all have blown over by spring?

Coronavirus: it's everywhere and yet invisible. Look at the news and you'll learn that this microscopic pathogen is causing chaos around the world, from China to the City of London, where the FTSE suffered its worst one-week drop since the financial crisis.

But do you actually know anyone with coronavirus? Or someone who knows someone? Britain initially saw very few cases, which is partly why the official advice to begin with in the face of this deadly disease was to simply wash our hands, dispose of used tissues, and go about our daily business.

On the ground, we seem to be splitting into two camps: the Keep Calm and Carry On-ers, who are doing just as the government advises; and the Coronavirus Preppers, who are readying for the worst.

Speaking after an emergency Cobra meeting, Mr Johnson said: "Some people compare it to seasonal flu, alas that is not right. Owing to the lack of immunity, this disease is more dangerous.

"It is going to spread further and I must level with you, I must level with the British public, many more families are going to lose loved ones before their time."

What should you do? Are you at danger from the virus? What about your children, and your pets? Should you go to work, or is it time to avoid transport and cancel plans – including holidays? 

Read on to find out...

Coronavirus and your health

Why aren’t children getting it as much? Can they still be carriers?
Children certainly can get coronavirus: in fact, a newborn baby in Wuhan province tested positive for the virus at just 30 hours of age – and was given the all-clear 17 days later. “Cases in children have been rare”, according to a paper in the JAMA medical journal, which finds that the median age of sufferers is 49–56. But even if children have the virus without severe symptoms, anyone who is infected can still spread the disease. Several schools in the UK were closed down as a precaution after pupils returned from a school trip in the “red zone” in Italy.

How do you die from it?

Nobody yet knows exactly what happens in the small number of cases in which coronavirus kills. Some scientists think that the virus causes severe damage to lung cells and their alveoli, the air sacs that take in oxygen, causing lung tissue to stiffen – much like Sars. The heart must then work harder to get limited oxygen to the rest of the organs, says Vineet Menachery, a virologist at the University of Texas.

In some cases, death is caused by an overreaction of the body’s immune system, which fires too many cells into the lungs in order to battle virus – this is what scientists call a “cytokine storm”.
Is this likely?
Covid-19’s fatality rate is relatively low compared to other deadly virus outbreaks in recent history. In February, around 20 percent of confirmed cases were classed as severe or critical, and the current death rate stands at about two per cent. Ebola, which in 2014 killed over 11,000 people in West Africa, has had a fatality rate between 25 percent to 90 per cent, depending on the outbreak and area. Two other members of the coronavirus family, Sars and Mers, have fatality rates of around 10 percent and 35 per cent, respectively. You can see how it compares to other deadly diseases in the chart below:

The mortality rate for anybody below 40 is 0.2 per cent, before a steady increase. 50-59 year-olds was 1.3 per cent, 60-69 year-olds was 3.6 per cent, 70-79 year olds was 8 per cent, and 80+ was 14.8 per cent. So providing you aren’t elderly or suffering from an existing illness, you needn’t panic, but the illness still has a higher chance of leading to serious respiratory symptoms than seasonal flu and you are still contagious – so you mustn’t be complacent.
Can you get it more than once?
When you catch an infection your body produces antibodies, which fight it off. Sometimes these stay around in the body for a long time, but other times do not.

Previously it was reported that a Japanese tour guide has tested positive for the disease after she made a full recovery, so it seems possible that at least some people can get it more than once. Re-infection has been reported in China already, with 14 per cent of recovered sufferers in Guangdong province testing positive for the second time, according to authorities.
How is it tested, and how long will it take to get results back?
The most common test being used in the UK is a simple swab test: two samples are taken, one from the nose and one from the throat, before the swabs are placed in a sterile tube and sent away to be analysed.

Doctors or paramedics can do this, but the sheer number of tests needed has meant the NHS is now rolling out a “drive-thru” service in some areas, as well as pilots of home-testing kits.

Results from these can come back within a day or two, though the process is hastened, and medical advice different, under certain circumstances (if symptoms are showing, for example, or the patient has travelled to areas listed as unsafe).

This form of testing has some drawbacks, including the fact they only give a positive result when the virus is still present. They cannot identify people who went through an infection, recovered, and cleared the virus. It’s for this reason that other, more advanced ways of detecting the virus – including blood tests and antibody tests – are currently in development..
Will Covid-19 subside when spring arrives?
Many find they are more likely to get a cold in the winter when people spend more time indoors, making the virus more likely to spread between people in close proximity. There is no evidence that the change in season will alter Covid-19’s potency.
Do saunas help?
Saunas have been recommended for arthritis, asthma and chronic fatigue, among other maladies, and some research has indicated that they may reduce the occurrence of colds.

In reality the idea of “sweating out” a virus isn’t proven, and while a sauna may alleviate symptoms of a cold for a short time, it won’t abbreviate the illness itself. Saunas are hot, but not hot enough to kill bacteria, and they’re also moist: conditions germs generally thrive in.

Coronavirus and your home

Should I be stockpiling, and what?
Probably not. The parts of east Asia worst hit by coronavirus have witnessed severe panic buying. But Mark Woolhouse, professor of medicine at Edinburgh University, says there is no need – yet – for Britons to stockpile food, whilst Michael Osterholm, a professor of public health at the University of Minnesota, warns against stockpiling prescription medicines in case it causes a shortage for others.
Can pets get coronavirus?
A Pomeranian in Hong Kong belonging to a coronavirus patient tested positive for a “low level” of the strain. The dog is not believed to have had any symptoms, and the result came from a nasal and mouth swab, rather than a blood test.

The Pomeranian testing positive marks the first case of a pet catching the virus, amid a global outbreak that’s now infected more than 110,000 people and claimed over 3,800 lives.

Images of dogs and cats wearing tiny masks may be striking, and slightly adorable, but the Hong Kong government said that there is no evidence that pets can transmit Covid-19 to their owners or that they can become sick. 

“Pet owners are reminded to adopt good hygiene practices (including hand washing before and after being around or handling animals, their food, or supplies, as well as avoiding kissing them) and to maintain a clean and hygienic household environment,” the department spokesman said.

“People who are sick should restrict contacting animals. If there are any changes in the health condition of the pets, advice from a veterinarian should be sought as soon as possible.”

It means the existing advice has not changed: people self-isolating should not be in close contact with their cats and dogs. Sensible precaution should be taken, not least because this is a swiftly evolving situation that could see advice change at any moment – just as it has in Hong Kong over the past week.

The safest thing is to restrict contact with pets and other animals while you are unwell and isolated with Covid-19, exactly as you would with other humans, by sticking to one room and not sharing a bathroom or food. So no sharing a bed with the dog, no licking, no stroking, and certainly no feeding your leftovers to an animal. 
Should I be worried about deliveries from China?
We may be in the era of ‘Made in China’ global shopping, but there is no reason to worry, according to the US Centers for Disease Control and Prevention, which says it carries a “very low risk” thanks to the “poor survivability” of coronaviruses on surfaces.

Coronavirus and work/education

If I have cold symptoms, should I stay off work?
The most recent advice from the government is now to stay at home and self-isolate for seven days if you are showing symptoms of a mild cough or cold. People with symptoms are no longer required to call NHS 111, as the system is under strain, but are instead urged to look for information on the NHS website and 111 online.
Should I avoid public transport?
Using public transport during a flu outbreak makes you six times more likely to pick up a respiratory infection, according to research published in the British Medical Journal, and those most at risk are commuters who use busy interchange stations, so it might be tempting to avoid trains and buses altogether.

Experts recommend going about your commute as usual – but making sure you wash your hands with soap when you reach your destination and, if you can, use alcohol-based hand rub a few times during your journey. If you do travel on the London Underground, though read this piece for more advice and watch out for the areas of the carriages and stations which carry most bacteria, as usefully laid out here:
What if my children’s private school closes – can I claim fees back?
Maybe. If you inspect the small print of many major private schools you’ll find a ‘refund scheme,’ detailing the circumstances under which parents might be able to claim money back. Lengthy absences due to illness may be covered, but so might “the necessary closure of the whole of or a separate house of the school owing to an outbreak of an infectious disease amongst the pupils and/or staff which renders continuance of school work impossible.”

Those words are taken from Abingdon School’s Refund Scheme, but you’ll find similar in the literature from Eton College, Exeter Cathedral School and dozens of others. It’s important to note, however, that almost all of these schools will only offer cover after seven days of any such closure, meaning if coronavirus shut the school for 10 days, you would only be refunded three days’ fees.

There could easily be exceptions – double check with the school’s bursar or head teacher.  

Coronavirus and your holiday

Should I cancel my holiday?
You will have to make a judgment based on where and when you are going, your aversion to risk, your age and your general health. Don’t however cancel anything until you have to, and if your departure is more than a couple of weeks away, hold tight and see how the situation pans out.
Can I get my money back if I do cancel?
If you have booked with a tour operator, you will only be automatically entitled to a refund only if the Foreign Office advises against travel or against “all but essential travel” to the destination. If you are not due to travel for a few weeks, you will probably have to wait before any cancellations are confirmed. Some operators are allowing customers to postpone travel or change destinations, so talk to them if you are worried. If you cancel unilaterally, you will normally face a hefty charge. If you have booked your flight and hotel separately and independently you have no automatic right to a refund even to an “all but essential travel” zone.

However, some airlines may allow you to postpone your flight, and some of the better travel insurance policies will cover any losses you incur. Travel insurance will definitely not cover cancellation costs if you are simply nervous about travelling and there is no Foreign Office advice against visiting the destination you have booked. We've put together a simple table below outlining the position of the major insurance companies, airlines and tour operators which was correct at the time of writing:
What happens if I’m quarantined or asked to self-quarantine while on holiday?
The bad news: even though your trip has been spoiled you are not legally entitled to compensation or a refund. The good news: if you are on a package holiday, the tour operator is obliged to look after you and arrange to repatriate you at the end of your quarantine, and if you are travelling independently and have insurance, most travel policies will also cover you in this situation.
If I get coronavirus when travelling in Europe would my EHIC card cover me for treatment now we are leaving the EU?
Yes, it will cover you until December 31 this year. But you would be wise to buy a good quality travel insurance policy as well – it will give you much more comprehensive cover. See our guide at telegraph.co.uk/tt-travelinsurance.
Should I hold off booking my overseas holiday this year?
Depending when are where you are going, the answer is probably “yes”. Wait at least a week or two. However, there are lots of bargains out there at the moment, so if you feel confident of travelling and you are looking for a cheap deal, then you will certainly find one.
What should I do if my tickets to a sports match are cancelled?
For games abroad – i.e next weekend’s postponed Six Nations match in Dublin, you’ll need to check with your ticket agent, as some only offer refunds in cases where the event has been cancelled. If flights or other travel has been booked separately, you will need to contact the companies themselves; Ryanair, for instance, only refund flights that are delayed by more than three hours, or due to the death or serious illness of a customer booked to travel, or a death of their immediate family member. Unless the flight itself is cancelled, no refund is given.

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