AS CASES of Covid-19 approach six figures globally and close in on the century in the UK, our government has released its Action Plan. Before we look at it, let’s consider some other points.
We’ve been relatively lucky here and in the US. The virus reached us towards the end of the winter flu season and, thanks to a reasonably cleanly populace and alert medics ready to jump on new cases and take the more serious to specialist facilities, the situation has the appearance of being so well under control that wiseacres are telling us we’ve been over-reacting. Pass the port, old boy.
However, we could be in a Phoney War period. It seems that although Covid-19 is fatal to a small percentage, the potential scale of deaths relates more to the number of possible infections and nobody has an immunity. It’s not just a Chinese illness: early on, a Chinese study was released saying that East Asians might be more liable to contract the disease because of a genetic difference in their lung cells; yet as of 4 March 16:27 GMT, in Iran 92 out of 2,922 patients have died, in Italy 75/2,502 – a death-to-case ratio of 3 per cent in each case.
This coronavirus has now hit Africa, South America and the Middle East, where health screening and treatment systems are not universally well-developed. A simulation exercise conducted a few months before the real outbreak concluded that on average, the world’s nations were only 40 per cent prepared to deal with a pandemic, ‘WuFlu’ could go on to brew away among the billions in the southern hemisphere, where autumn is on its way. There is also the Islamic community, for whom pilgrimage to Mecca is one of the Five Pillars of religious duty, incurring a ‘super-spreader’ risk as noted by Shahul H Ebrahim and Ziad A Memish in the Lancet. There are many other holy sites visited by millions of pilgrims, including internally within Iran, so flight restrictions do not completely solve the problem.
A great global reservoir could be building up, and we shall know what we’re facing when Britain comes again to seasonal flu time. Paradoxically, the fact that for many the illness will be mild, even unnoticed, makes the situation worse because those people will likely go about as normal and stand to infect others. We should use our Phoney War period to plan and rearm.
So we shall. Johnson’s first big test has turned out to be not Brexit but disease. The challenge is to strike a balance between showing the government is prepared and scaring us. It’s not so much a death-puppet that waggles at us, but the prospect of overburdened hospitals and health services, and significant disruption to daily life.
At present, for every person who dies in hospital (thankfully, nobody in Britain, yet) there are several more in intensive care, plus further numbers within hospitals and even more at home. The action plan team estimate that at its peak the disease may cause up to a fifth of workers to be absent from duty. The Prime Minister has undertaken to allow Statutory Sick Pay to be paid from the first day of illness.
The general treatment strategy is fourfold: self isolation, managing symptoms, support for patients with complications, but most people to manage at home.
The wider strategy is to contain, delay (to allow time for more clement weather, for research and the development of a vaccine), mitigate the consequences, and continue with research. The plan also reminds us of the complexities of devolved government, so HMG is taking that into consideration.
The paper reminds us that the government can’t do it all for us,and the advice is worth quoting in full:
Everyone can help support the UK’s response by:
• following public health authorities’ advice, for example on hand washing
• reducing the impact and spread of misinformation by relying on information from trusted sources, such as the NHS. www.nhs.uk/
• checking and following the latest FCO advice when travelling and planning to travel
• ensuring you and your family’s vaccinations are up to date as this will help reduce the pressure on the NHS/HSCNI through reducing vaccine-preventable diseases
• checking on elderly or vulnerable family, friends and neighbours
• using NHS 111 (or NHS 24 in Scotland or NHS Direct Wales) (including online, where possible), pharmacies and GPs responsibly, and go to the hospital only when you really need to. This is further explained on the NHS website.
• being understanding of the pressures the health and social care systems may be under, and receptive to changes that may be needed to the provision of care to you and your family.
• accepting that the advice for managing Covid-19 for most people will be self-isolation at home and simple over-the-counter medicines
• checking for new advice as the situation changes.
So far, so good – it feels as though intelligent management is in charge.
3pm Update: The deaths in Italy have risen to 107 (3.46 per cent of cases), matching the World Health Organisation’s rate, which the US administration says is exaggerated; however, City Journal says the virus is spreading further in the US because over-regulation has led to failure to do enough tests. In the UK we are up to 90 cases, so the government has declared that we have failed to contain and have moved on to the delay phase. Saudi Arabia has put a moratorium on pilgrimage to Mecca, and Iran has cancelled Friday prayers in mosques.