UK public services must prepare to do things “very differently” if the spread of novel coronavirus continues, with an epidemic now likely, the government’s most senior doctor has said.
The chief medical officer, Chris Whitty, said this morning it was probable Covid-19 was now being transferred between people within the UK and that an epidemic was “likely”. So far there are 53 confirmed cases of the virus in the country, but Whitty said it was impossible to know how much further it had already been spread.
He was speaking on Radio 4’s Today programme after the government published its action plan to tackle the virus. The four-strand plan set out actions the government might take to contain, delay, research and mitigate the effects of Covid-19.
At the moment, measures to contain the virus – including quarantining for people who have contracted it and self-isolation for those at risk of having caught it – are in place. But Whitty said the government was now “on the borderline between containing and delaying”.
“Many of the things you do to contain this also delay it, so the difference is relatively small,” he said.
The delay phase of the plan could see schools close and people being instructed to work from home to reduce the opportunities for the virus to spread between people.
The CMO acknowledged there will be a “social cost” of some measures to contain and delay the spread of the virus. “The social disruption from school closures is very significant, not just to the children themselves, whose education is interrupted, but also to their parents and to potentially their workplaces,” he said.
“So we would only want to go for something like school closures if it was clearly going to be beneficial, and we would want to do it at the last possible point where it is still effective, so we minimise the amount of disruption over time.”
He said at the moment, the public was being encouraged to take action with lower social cost - like washing their hands more frequently and carefully. The government has launched a public awareness campaign stressing the importance of personal hygiene to “protect yourself and others”.
The campaign encourages people to wash their hands when they get to work or arrive home; after coughing or sneezing or blowing their noses; and before eating or handling food.
But Whitty said more extreme measures may be necessary if the situation worsens, to “pull down the peak” of the epidemic rather than just trying to delay it.
"If this higher end of this epidemic happens, we're going to have to do things pretty differently, or very differently, for a relatively discrete period of time," he added.
“We would have to reconfigure the NHS quite profoundly,” he said. Some elective procedures would need to be delayed, and medical institutions could be encouraged to use video consultations to contact patients. Some hospitals have already been instructed to see patients via video link.
Yesterday’s plan also said people who have left the health service could be brought out of retirement temporarily if large numbers of NHS staff fall in, and that health and social care services would work together at that stage to discharge people early from hospital and support at-home care.
Whitty said the peak of the epidemic would probably last a “few weeks”.
In a reasonable worst-case scenario, as much as 80% of the UK population could become infected with the novel coronavirus strand, Whitty said. However, he stressed this was the “absolute top end of the range that will be infected” and that he expected the numbers to be much lower.
Based on existing data from other countries that have seen outbreaks, including China, the infection could be fatal for around 1% of those who contract it, he said.
“It is important that we plan for the worst that is currently plausible, given the information that we have at this point in time.”