Britain is showing 'green shoots' of recovery from coronavirus

Britain is showing 'green shoots' of recovery from coronavirus

April 1, 2020

Britain is showing ‘green shoots’ of recovery from coronavirus but we are ‘not out of the woods yet’, NHS medical director says

  • Professor Stephen Powis said next few weeks of pandemic ‘critical’ for the UK 
  • But he pointed to signs of a plateau in the infection rate across the country 
  • 10,767 people in hospital in England, with most in London and the Midlands 
  • Coronavirus symptoms: what are they and should you see a doctor?

There are ‘green shoots’ signs that the rate at which people are becoming infected with Covid-19 is slowing, NHS England’s medical director has said.

Professor Stephen Powis said the next few weeks ‘will be critical’ to see how the UK epidemic would pan out but there were signs of a plateau in the infection rate.

It comes as critics said not enough was being done to test NHS frontline staff quickly.

Stephen Powis (pictured) has said that there are signs of green shoots in the fightback against the coronavirus but warned that the next few weeks are critical

Some 10,767 people are currently in hospital in England, with 3,915 of those in London and 1,918 in the Midlands, where hospital admissions are accelerating.

Prof Powis said the overall signs were that the ‘Great British public’ were heeding social distancing advice and reducing contact.

Turning specifically to the number of infections, Prof Powis told reporters at the daily Westminster press briefing: ‘We have had a rise in the number of new UK cases but recently there is a little bit of plateau.

‘It’s really important not to read too much into this. It’s early days, we’re not out of the woods, we’re very much in the woods.

‘The number of infections is not rising as rapidly as it once was. So green shoots, but only green shoots and we must not be complacent and we must not take our foot off the pedal.’

Prof Powis said the rate of hospital admissions was still increasing, as was expected at this stage of the epidemic.

However, he said if the number of infections started to drop, then in the next few weeks the ‘hope’ was that the number of admissions would also begin to fall.

A 13-year-old boy died in hospital, having tested positive for Covid-19, King’s College Hospital NHS Foundation Trust confirmed on Tuesday.

The UK is reportedly seeing ‘green shoots’ of progress amid the coronavirus crisis as soldiers set up a hospital in the East London (pictured) dubbed the NHS Nightingale 

The family of Ismail Mohamed Abdulwahab said they were not aware of any underlying health conditions and are ‘beyond devastated’ by his death.

NHS England earlier confirmed that a 19-year-old had died after testing positive for Covid-19 – at that stage believed to be England’s youngest victim who died in hospital with no existing medical issues.

A total of 1,789 patients have now died overall in UK hospitals as of 5pm on Monday, the Department of Health said, up by 381 from 1,408 the day before.

The jump is by far the biggest day-on-day rise in the number of deaths since the outbreak began.

Cabinet minister Michael Gove said the sharp rise in UK deaths from coronavirus was ‘deeply shocking’ but he could not say exactly when the peak of the epidemic would come.

‘There’s not a fixed date like Easter when you know that the peak will come, it depends on the actions of all of us,’ he told reporters.

He said despite signs that interventions were working, ‘now is absolutely not the time for people to imagine there can be any relaxation or slackening’ of lockdown measures.

Turning to testing, Mr Gove said a ‘critical constraint’ on the ability to rapidly increase testing capacity in the UK is the availability of chemical reagents.

He said Prime Minister Boris Johnson and Health Secretary Matt Hancock were working with companies worldwide to ensure the UK gets the material needed to increase tests ‘of all kind’.

The Government has faced serious criticism over testing, with fewer than 10,000 tests being carried out per day on average, despite claims this target had been hit.

Officials have said the target of 25,000 tests per day will most likely not be met for another month.

The Department of Health and Social Care said as of 9am on Tuesday, a total of 143,186 people have been tested, of which 25,150 tested positive.

The Royal College of Physicians (RCP), the Royal College of Nursing (RCN) and the British Medical Association (BMA) have all said testing of frontline staff is desperately needed.

BMA chairman Dr Chaand Nagpaul said: ‘It’s been well over two weeks since the Government said it was going to roll out priority testing for healthcare staff.

‘But many doctors still have no idea about where or how they can get tested.’

Mr Gove said the UK must go ‘further, faster’ to ramp up coronavirus testing capacity.

On the issue of ventilators, Mr Gove said the UK was buying them from EU nations and had also placed orders at home.

‘We have just over 8,000 ventilators deployed in NHS hospitals now,’ he said.

‘This number has increased since the epidemic began thanks to the hard work of NHS professionals, but we need more. That’s why we are buying more ventilators from abroad, including from EU nations. It’s also why we are developing new sources of supply at home.’

The first new ventilator devices will roll off the production line this weekend and be delivered to the NHS next week, Mr Gove said.

It comes as other figures revealed that the true death toll is higher than hospital statistics suggest.

Data from the Office for National Statistics (ONS) for England and Wales shows there were 24% more deaths relating to Covid-19 up to and including March 20, compared to hospital-only data for the same period.

The ONS looked at all deaths where Covid-19 was mentioned as a factor, including hospital deaths and those in the community and care homes.

A total of 210 deaths in England and Wales for the time period had Covid-19 mentioned on the death certificate, compared with 170 coronavirus-related deaths reported by NHS England and Public Health Wales.

Hospital figures are of people who have tested positive for Covid-19, whereas the ONS includes all deaths where Covid-19 is mentioned on the death certificate, even if only suspected.

However, the ONS data does provide a much wider picture of what may be happening in the community.

Earlier, Mr Johnson chaired a meeting of his Cabinet by videolink as he continues to self-isolate in Downing Street after testing positive for coronavirus.

The Prime Minister told the meeting: ‘The situation is going to get worse before it gets better – but it will get better.’

In Wales the rise in deaths is seven to 69, in Northern Ireland six to 28 and in Scotland a rise of 13 to 60.

WHAT DO WE KNOW ABOUT THE CORONAVIRUS?

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. 

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. It can also live on surfaces, such as plastic and steel, for up to 72 hours, meaning people can catch it by touching contaminated surfaces.

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. 

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 was declared a pandemic on March 11. A pandemic is defined by the World Health Organization as the ‘worldwide spread of a new disease’. 

Previously, the UN agency said 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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