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Wuhan Novel Coronavirus Posted on 1 Feb 2020

Wuhan Novel Coronavirus Q&A

Key messages

• Enhanced monitoring is in place from all direct flights from Wuhan to the UK (subject to Chinese flight restrictions). The enhanced monitoring package includes a number of measures that will help to provide advice to travellers if they feel unwell. For those travelling back directly from Wuhan, this includes a Port Health team who will meet each direct flight aircraft to provide advice and support to those that feel unwell.

• This is fast moving and evolving situation but based on current evidence the risk to the UK population is low.

• People travelling to Wuhan should maintain good hand, respiratory and personal hygiene and should avoid visiting animal and bird markets or people who are ill with respiratory symptoms. Individuals should seek medical attention if they develop respiratory symptoms within 14 days of visiting Wuhan, either in China or on their return to the UK.

• Based on the current evidence, the risk to the UK population is low. However, we cannot be complacent and that is why we have issued clinical guidance. The pioneering work on developing diagnostic tests for SARS and MERS means that we are well positioned to be able to detect this virus in patients who may be infected, and manage them effectively.

Dr Nick Phin, Deputy Director, National Infection Service, Public Health England, said:

“This is a new and evolving situation where information on cases and the virus is being gathered and assessed daily. Based on the available evidence, the current risk to the UK is considered low. We are working with the World Health Organisation (WHO) and other international partners, have issued advice to the NHS and are keeping the situation under constant review.

"The risk to visitors to Wuhan is moderate reflecting an increase in the number of cases being identified in China and evidence that the virus has limited spread from person to person. People travelling to Wuhan should maintain good hand, respiratory and personal hygiene and should avoid visiting animal and bird markets or people who are ill with respiratory symptoms. Individuals should seek medical attention if they develop respiratory symptoms within 14 days of visiting Wuhan, either in China or on their return to the UK. They should phone ahead before attending any health services and mention their recent travel to the city.”

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Background

What has happened?

While the majority of cases are in Wuhan, there have been some detected in other Chinese cities, as well as abroad. Most cases, but not all, are linked to Wuhan, although the source is still under investigation. There have been a small number of fatalities. The World Health Organization has said there is evidence of limited transmission from person to person.

We are monitoring the situation in China closely, in liaison with international partners including the World Health Organization (WHO). The risk to the UK population is low.

What is a coronavirus?

A coronavirus is a type of virus. As a group, coronaviruses are common across the world.

Typical symptoms of coronavirus include fever and a cough that may progress to a severe pneumonia causing shortness of breath and breathing difficulties.

Coronavirus can cause more severe symptoms in people with weakened immune systems, older people, and those with chronic diseases such as diabetes, cancer and chronic lung disease.

Wuhan Novel Coronavirus is a new strain of coronavirus first identified in Wuhan City, China.

Is coronavirus fatal?

Certain strains of coronavirus can be fatal. There have been a small number of fatalities reported so far from Wuhan Novel Coronavirus, which makes the overall fatality rate approximately 2%. In epidemics this is often revised down as the most serious cases are usually detected early. The Chinese authorities have reported that all of the individuals who have died had underlying medical conditions.

What is the source of the Wuhan Novel Coronavirus?

The source of infection and how the virus is spread are still not completely understood, although the Chinese authorities believe the virus has spread from animals. There is evidence of limited transmission from person to person.

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Investigations into the source of the infection are ongoing by the Wuhan Municipal Health Commission.

What are the signs and symptoms of this new virus?

Symptoms include fever and respiratory symptoms including coughing, sneezing, chest tightness and shortness of breath. Anybody exhibiting these symptoms within 14 days of travel to Wuhan should contact their GP or NHS 111, informing them about their recent travel.

How is it treated?

If a person is diagnosed with the virus they will be transferred to an infectious disease treatment centre, infectious disease treatment centres have the facilities and specialist staff to implement robust infection control measures.

This is a new Coronavirus and there is currently not enough information to make specific treatment recommendations.

Can the Wuhan coronavirus be transmitted from person to person?

WHO has reported that there is evidence of limited transmission from person to person transmission.

Are there any cases of coronavirus in the UK?

No confirmed cases of Wuhan coronavirus have been detected in the UK. The risk to the UK population is low.

As has already been demonstrated in response to MERS, Ebola and Monkeypox, Public Health England and the NHS have robust protocols in place to the manage of imported infections and avoid any outbreak. These are strictly observed.

Have any UK nationals been diagnosed with the Wuhan Novel Coronavirus?

There are no confirmed cases of this new infection in UK residents – abroad or in this country.

On the risk

Why has the risk assessment changed from very low to low?

This is a new and evolving situation where information on cases and the virus is being gathered and assessed on a daily basis. The risk to the U.K. population is now considered low based on the overall situation including evidence that the virus has

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limited spread from person to person. All of this increases the likelihood that we may see a case in this country following travel to China - for which we are well prepared.

When would the risk to the UK change to moderate?

Factors that might affect any risk assessment could include evidence of further person to person spread and geographic spread within and outside of China.

Why is the risk to travellers now moderate?

We have upgraded our risk assessment for travellers following an increase in the number of cases being identified in China and evidence that the virus has limited spread from person to person. As the source of the infection is still not clear, on a precautionary basis, the risk to travellers is now considered moderate. Travellers can protect themselves by practising good hand and respiratory hygiene, avoiding animal and bird markets, and avoiding contact with those with respiratory symptoms.

Is it likely that the virus will reach the UK?

The risk to the UK population is low, as the current evidence suggests there is an increasing likelihood that cases will be imported into this country.

So far there have been no confirmed cases of Wuhan coronavirus in the UK.

However, we cannot be complacent and that is why we have issued clinical guidance. PHE’s pioneering work on developing diagnostic tests for SARS and MERS means that we are well positioned to be able to detect this virus in patients who may be infected and manage them effectively. People who exhibit symptoms within 14 days of travel to Wuhan should contact their GP or call NHS 111 and inform them about their recent travel.

Are Chinese tourists visiting the UK being monitored?

The risk to the UK population is low enhanced monitoring is in place for direct flights from Wuhan, China. Anyone who exhibits respiratory symptoms within 14 days of leaving Wuhan should seek medical attention, informing the healthcare staff of the fact that they have recently been in Wuhan.

What will happen if we get a case here?

Based on the current evidence, the risk to the UK population is low. However, we cannot be complacent and that is why we have issued clinical guidance to the NHS. The pioneering work on developing diagnostic tests for SARS and MERS means that we are well positioned to be able to detect this virus in patients who may be infected and manage them effectively.

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Is it safe to eat imported Chinese seafood?

There is no evidence that the outbreak has any impact on the safety of eating Chinese seafood.

People are starting to travel for lunar new year, which is the world’s biggest mass migration when approximately 3 billion trips are made, according to China’s transport ministry – does this increase risk of spread?

The risk to people travelling to the area is moderate. As a precaution, people should maintain good hand, respiratory and personal hygiene and should avoid visiting animal and bird markets or people who are ill with respiratory symptoms. Individuals should seek medical attention if they develop respiratory symptoms within 14 days of visiting Wuhan, either in China or on their return to the UK, informing their health service prior to their attendance about their recent travel to the city.

Public health actions

Will people returning from China be screened at airports and borders in the UK?

From 22 January 2020, enhanced monitoring will be in place from all direct flights from Wuhan to the UK (although currently all direct travel from Wuhan is suspended).

What is enhanced monitoring?

We have been carefully monitoring the situation in Wuhan for some time and are ready to put in place proportionate, precautionary measures.

The enhanced monitoring package includes a number of measures that will help to provide advice to travellers if they feel unwell. For those travelling back directly from Wuhan, this includes a Port Health team who will meet each direct flight aircraft to provide advice and support to those that feel unwell. The team will include the Principal Port Medical Inspector, Port Health Doctor, Administrative Support, and Team Leader.

They will:

• check for symptoms of Coronavirus and provide information to all passengers about symptoms, and what to do if they become ill.

• Mandarin and Cantonese language support will be available to PHE and leaflets will be available to passengers

Leaflets and information will also be made available across all UK airports, advising travellers from China on what do to if they feel unwell.

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The measures to be introduced for flights arriving directly from Wuhan to the UK are:

• broadcasting of a vocal message to passengers whilst on the aircraft, to encourage reporting of illness

• provision of early warning of any passenger illness from the captain of the aircraft in transit. A response (nil or otherwise) will be requested no later than 60 mins before the actual arrival time

• use of an isolated area of London Heathrow Terminal 4 for the reception of the aircraft

• provision of a General Aircraft Declaration (GAD) by the captain of the aircraft, prior to passenger disembarkation

• support in accordance with current operating procedures by the PHE Port Health team and if required in liaison with the PHE North West London Health Protection Team (HPT) of any self-declaring passenger, and if required the NHS

What will people see when they land? Will doctors/nurses/paramedics be on the scene?

A team of public health experts, including a Principal Port Medical Inspector, Port Health Doctor, Administrative Support, team leader and translator, will meet every direct flight from Wuhan to Heathrow airport.

Before the flight lands, a message will be broadcast to passengers in several languages to encourage them to report illnesses to flight staff. The captain will be required to provide an early warning of any illnesses on the aircraft an hour before arrival time.

Are there plans to introduce full clinical screening at other UK airports/ travel ports?

The situation is constantly being kept under review and further action will be introduced if necessary.

We are introducing enhanced monitoring which includes a number of measures that will help to provide advice to travellers if they feel unwell.

For those travelling back directly from Wuhan, this includes a Port Health team and clinicians who will meet each direct flight aircraft to provide advice and support to those that feel unwell.

The team will:

• check for symptoms of Coronavirus and provide information to all passengers about symptoms, and what to do if they become ill

• have Mandarin and Cantonese language support and leaflets will be available to passengers

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Most people who develop symptoms will get them after leaving the airport and so our priority is providing UK residents and travellers with the latest information to make sure they know what to do if they experience symptoms, and the NHS and PHE have an established plan to respond to someone who becomes unwell. The latest advice from PHE is published on gov.uk: www.gov.uk/government/news/wuhan-novel-coronavirus-and-avian-flu-advice-for-travel-to-china

How does the testing process work? What is involved?

When a doctor, nurse or other medical professional suspects a case of the virus, they take samples from the nose, throat and deeper respiratory samples, package and send them safely to PHE Colindale. PHE can provide a laboratory result from this specific virus on the same working day.

PHE also has the capability to sequence the viral genome and compare this to published sequences from China, if a case occurs. This will provide valuable information on any mutations in the virus over time and allow an improved understanding of how it spreads.

If the situation gets worse in Wuhan, will you introduce full clinical screening?

As this is a new emerging infection, scientific understanding of this disease is evolving rapidly. The measures set out here will be regularly reviewed to assess their effectiveness in identifying cases and in light of the emerging global picture.

Why were enhanced monitoring procedures not implemented earlier?

UK public health measures are world leading and our excellent NHS is well prepared to manage and treat new diseases. We have been carefully monitoring the situation in Wuhan for some time and are ready to put in place proportionate, precautionary measures.

The risk to the UK public is low and no cases have been confirmed in the UK.

How are Scotland, Wales and Northern Ireland affected?

Scotland, Wales and Northern Ireland do not have direct flights from Wuhan so will not be introducing enhanced monitoring measures. They are working closely with Public Health England and DHSC to continually monitor the situation and will take action if necessary.

Have there been any confirmed cases in the UK or UK nationals abroad?

There are no confirmed cases of this new infection in the UK, or of UK citizens abroad.

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What measures do we have in place if a case arrives in the UK?

The UK is well prepared for new diseases and our approach is being kept under constant review. Doctors, nurses and other medical staff in primary and secondary care have already received advice, covering initial detection and investigation of possible cases, infection prevention and control, and clinical diagnostics.

The Chief Medical Officer, Medical Director PHE and Medical Director NHSE/I have issued advice to frontline staff to increase awareness of the situation and actions to take if necessary.

There are a number of infectious disease units around the country able to take suspected patients.

Thanks to PHE, the UK is now one of the first countries outside China to have a prototype specific laboratory test for this novel disease.

What precautions should people take / what should people experiencing symptoms do?

If you are traveling to Wuhan, you should maintain good hand, respiratory and personal hygiene and should avoid visiting animal and bird markets or people who are ill with respiratory symptoms. Individuals should seek medical attention if they develop respiratory symptoms within 14 days of visiting Wuhan, either in China or on their return to the UK. They should phone ahead before attending any health services and mention their recent travel to the city.

The latest advice from PHE is published on gov.uk: www.gov.uk/government/news/wuhan-novel-coronavirus-and-avian-flu-advice-for-travel-to-china

What is the travel advice for people planning to visit China or affected areas?

Currently, the risk for those travelling to Wuhan is moderate. UK travellers are recommended to consider avoiding all but essential travel to Wuhan, Hubei province, China.

The latest advice from PHE is published on gov.uk: www.gov.uk/government/news/wuhan-novel-coronavirus-and-avian-flu-advice-for-travel-to-china

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What is the current risk level to the UK / why has this been raised

The risk to the UK population has been assessed as low. This has been raised from very low due to current evidence on the likelihood of cases being imported into this country.

What advice are doctors, nurses and other medical staff being given?

The UK is well-prepared for emerging infectious diseases and has being putting in place plans for this novel disease.

Clinicians in primary and secondary care have already received advice from PHE, covering initial detection and investigation of possible cases, infection prevention and control, and clinical diagnostics.

Further advice will be issued by Chief Medical Officer, PHE’s Medical Director and NHS England and Improvement’s Medical Director to frontline to increase awareness of the situation and actions to take if potential cases present.

What has PHE advised to healthcare professionals?

Healthcare professionals who are treating individuals with unexplained pneumonia following travel to Wuhan have been advised to submit samples to Public Health England for testing. Individuals should be treated in isolation.

This is a new emergent infection with a significant number of unknowns. It is therefore prudent and sensible to ensure that information on any new, emergent infection is disseminated as quickly as possible to clinicians to aid recognition, enable action to be taken to ensure patients get the best possible treatment and so that appropriate steps can be taken to safeguard staff and others.

This is standard preparedness, and the advice mirrors to that issued for other coronaviruses.

Are you prepared for cases appearing in this country?

Based on the current evidence, the risk to the UK population is low. However, we cannot be complacent and that is why we have issued clinical guidance. PHE’s work on developing diagnostic tests for SARS and MERS means that we are well positioned to be able to detect this virus in patients who may be infected, and manage them effectively.

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How serious is the current risk to the UK public?

This is a new emergent infection with a significant number of unknowns. It is therefore prudent and sensible to ensure that information on any new, emergent infection is disseminated as quickly as possible to clinicians to aid recognition, enable action to be taken to ensure patients get the best possible treatment and so that appropriate steps can be taken to safeguard staff and others.

These are standard preparations, and the advice is similar to what we would advise for other coronaviruses.

What prompted the decision to classify the novel coronavirus as a High Consequence Infectious Disease?

This precautionary approach is standard practice when dealing with new emergent infections. The categorisation may be changed in the light of new data and information. The new coronavirus has some genetic similarities to other coronaviruses and therefore on a precautionary basis while data on this new coronavirus is being collected and assessed it was deemed prudent to handle any potential cases and samples in line with the processes and procedures used for airborne high consequence infectious diseases.

On a UK case

Have there been any cases of Wuhan Novel Coronavirus in the UK?

There are no confirmed cases of this new infection in the UK.

A small number of people with respiratory symptoms following travel to Wuhan, China, have been assessed and tested for Wuhan Novel Coronavirus. These tests have been negative.

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