THE coronavirus know as COVID-19 has spread around the world. The WHO may not have declared a pandemic yet but many countries - including the UK - are making preparations for one.

Coronaviruses are a large family of viruses that are known to cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS).

Scientists saythat SARS-CoV was transmitted from civet cats to humans in China in 2002 and MERS-CoV from dromedary camels to humans in Saudi Arabia in 2012. There are a number of other coronaviruses are circulating in animals that have not yet infected humans.

CORONAVIRUS:

The virus known as COVID-19 was detected in the final weeks of December and emerged in the city of Wuhan, in China.

Doctors initially thought it was just a particularly bad form of flu but when patients failed to respond to the normal medications they quickly realised it was something different.

What are the symptoms?

Common signs include respiratory symptoms, fever, cough, shortness of breath, and breathing difficulties. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death.

How deadly is the new virus?

Experts are still trying to get a clear picture of how dangerous the new strain is. Early indications are that it has a mortality rate of 2% - although this will change as more cases are diagnosed. By comparison most flu viruses have a mortality rate of less than 1%. Seasonal flu has a mortality rate of 0.1%. However, scientists don't know if there is a larger reservoir of people who have caught the new coronavirus but suffered mild - or no - symptoms. If that is the case, the mortality rate will fall.

The death rate in Wuhan is significantly higher. At the moment it is not clear why this is although the massive strain on hospitals at the epi-centre of the outbreak means some patients may not have been able to seek treatment to ameliorate their symptoms.

Can coronaviruses be transmitted human-to-human?

Yes - usually after close contact with an infected patient, for example, in a household workplace, or health care centre. Worryingly, patients infected with COVID-19 are infectious before they start to show symtoms. This has made it hard to limit the spread of the virus.

Is there a vaccine?

Not at this present time although scientific teams around the world are racing to find one. The most optimistic estimates are that a vaccine will not be ready for the general population until next winter, although it may be longer. Work done to find a vaccine for MERS could help speed things along. A team in the US was the first to say they had produced a vaccine earlier this week and they hope to start testing very soon. Even if the vaccine proves effective it may not be ready for the first wave of a pandemic.

Can anything be done for patients?

Although there is no cure many of the symptoms can be treated. Hospitals are concentrating on alleviating the worst effects to give the body time to fight off the infection. In China and Japan doctors have used drugs originally developed to treat HIV. Although the results are not yet in, early cases have shown promise.

What is the UK doing?

At the moment the UK is still in the containment stage - finding coronavirus cases and contact tracing people they have been in contact with. But as the number of new cases grows this will become unsustainable and the Department of Health will move to a mitigation strategy - urging people to self-quarantine and treating patients with serious complications. Measures may include closing schools, cancelling events and even placing whole communities in quarantine as we have seen in Italy. However, although the Government has all these measures at its disposal a decision when - or if - to implement them will only be taken as the outbreak spreads.

Hospitals - such as the BRI - have also installed testing 'pods' so people who feel unwell can be checked away from general patient areas. The UK has a very well developed testing protocol (the kits used all over the world were developed in Oxford) and patients can usually be diagnosed within 24 hours. 

So far there have only been 15 positives - although the NHS has widened the net to include people with general flu symptoms or respiratory illnesses to see if there has been wider transmission.

How will the NHS cope?

A review of the NHS action plan put into place during the H1N1 swine flu pandemic ten years ago concluded that the health service had performed very well. Since then the UK has been 'war gaming' for a possible pandemic ever since. Although the NHS is under-staffed and under-resourced we can be sure of doctors and nurses will meet the challenge.

In a recent review of pandemic resilience the UK was rated second only to the US.

Only a dozen or so countries were rated good enough to meet a viral pandemic.

How can I protect myself?

WHO’s standard recommendations to reduce exposure to and transmission of a range of illnesses include maintaining basic hand and respiratory hygiene, and safe food practices and avoiding close contact, when possible, with anyone showing symptoms of respiratory illness such as coughing and sneezing.

Should I be worried?

Despite the rising death toll it's important to remember that, for the vast majority, COVID-19 will be a relatively mild illness. Serious complications are more likely in the elderly and people with pre-existing underlying illnesses. For reasons scientists don't understand it seems to leave children relatively unscathed.

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