WHO had previously slammed Mr Johnson for being slow to react to the escalating crisis after other European countries went into full lockdown to halt its spread.
But in a dramatic u-turn, the Prime Minister yesterday announced people should stop socialising, work from home, avoid travelling and that entire households should quarantine if one family members falls ill.
WHO’s Dr David Nabarro said Mr Johnson’s sudden shift in strategy was ‘absolutely right’, even if the social distancing measures were distressing.
So far the coronavirus outbreak has claimed the lives of 55 people in the UK and infected more than 1,500.
Prime Minister Boris Johnson yesterday announced that the UK was going to war with the coronavirus – people were urged to work from home, not to socialise and to self-isolate if anyone in their house becomes ill
WHO’s Dr David Nabarro said Mr Johnson’s dramatic shift in strategy was ‘absolutely right’, even if was distressing
The draconian measures will be in force for a ‘prolonged period’ which could stretch into months, according to ministers.
Dr Nabarro, part of the WHO’s special envoy for coronavirus, told BBC Radio 4’s Today programme this morning: ’As it became clear how quickly the virus has been advancing in other European countries a shift in position was absolutely right.
‘I’m really pleased this has happened. And I would like to stress that in every other country positions are having to be shifted as we know more about the outbreak.
‘We are just dealing with something that’s so new with so many things we don’t know that we have to be prepared for a change in tack from time to time even though it’s distressing.’
But Dr Nabarro stressed the need for further testing so plans on tackling the coronavirus can be formed.
He added: ‘I think it’s right that there is more testing made available that’s because it helps all of us to understand much more precisely how the outbreak is advancing.
‘This virus is an unseen enemy and the only way it presents itself is when a person is ill and if we’ve got more understanding of where the virus is going and how is affected it makes it easier for us to plan our lives and to organise ourselves.’
A report today by leading scientists who are advising the Government said the Prime Minister’s social distancing measures may stay in place for 18 months or more.
Healthy people below the age of 70 have been urged to work from home if they can, to avoid socialising or going out and to stop all non-essential travel
Data from the Imperial College team shows that nothing can stop the coronavirus overwhelming NHS intensive care units. Even the most strict quarantine measures would not prevent there being far more cases than there are beds to handle
The Imperial College response team predicted that the peak of deaths is likely to come three months from now, in mid-June – the figure quoted in the graph is based on a worst-case scenario if the Government did not act
The Imperial College COVID-19 Response Team predicted that 260,000 people could have died if the Government hadn’t changed tack yesterday and tightened its rules.
It said British officials had only realised the danger ‘in the last few days’ after watching the situation in Italy spiral out of control and overwhelm hospitals – around 2,200 people have now died there and there are 28,000 confirmed infections.
This inspired a dramatic ramp-up of UK policy and Mr Johnson announced a move to war-footing to try and stop the outbreak.
The switch-up was an admission that officials’ original plans to control and slow an outbreak – to ‘flatten the curve’ – had been too ambitious.
The new measures could need to stay in place for around 18 months until a vaccine becomes available, the Imperial College London researchers said.
If no action at all had been taken against the coronavirus, it would have claimed 510,000 lives.
The Imperial model predicted that closing schools and universities would not necessarily relieve pressure on the NHS, but simply delay it – the spike in critical care bed occupancy is the same size as it would be if nothing was done, but it happens six months later
London Waterloo was bereft of commuters this morning after official advice told people to work from home if they could
Bristol Temple Meads train station was eerily quiet this morning at a time when it would usually be heaving in rush hour
Rush hour traffic was missing from the M60 near Oldham, Greater Manchester, this morning
WHAT IS THE NEW GOVERNMENT ADVICE?
- Avoid social contact
- Work from home if possible
- Avoid pubs, clubs, theatres and other social venues
- If someone in your household has symptoms of coronavirus (cough, shortness of breath or fever), everyone in the home self-isolate for 14 days
- If isolating, only go outside for exercise, and do it away from other people
- Ask for help with daily necessities like food and medical supplies
- If that is not possible – for example if you live in a remote area – you should limit social contact as much as possible
- Vulnerable groups should self-isolate for 12 weeks from this weekend even if they have no symptoms – This includes people aged 70 and over and other adults who would normally be advised to have the flu vaccination, including people with chronic diseases such as chronic heart disease or chronic kidney disease, and pregnant women
- All unnecessary visits to friends and relatives in care homes should cease
- Continue to take your children to school unless they, or someone else in your home, has symptoms of the coronavirus
- Londoners need to socially distance and work from home even more than the rest of the UK because the disease is more widespread there
- Mass gatherings should not happen – they will no longer receive emergency services’ protection if they do go ahead
Had the Government stuck with their strategy of controlling the spread with limited measures such as home isolation for those with symptoms this number would be roughly halved to 260,000.
If the strictest possible measures are introduced – including school closures and mandatory home quarantine – the number of deaths over a two-year period will fall below 20,000, the scientists said.
Professor Neil Ferguson, lead author of the study, said: ‘Instead of talking about hundreds of thousands of deaths, there still will be a significant health impact that we’ll be talking about. Hopefully, tens of thousands… maybe, depending on how early we are, just a few thousands.’
The scientists emphasised there will be no end in sight to the measures until a vaccine is created.
Professor Azra Ghani, a professor of infectious disease epidemiology from the virus modelling team, warned: ‘We have explored a scenario where these measures stayed in place for five months, which is what is taking us through to the summer.
‘We haven’t found any way, at least in our understanding of this so far, that we can ever release these methods until some other intervention can be put in place.
‘So really, we are essentially waiting for a vaccine. A vaccine is not five months away. We know it’s at least 12 to 18 months away. So we will have difficult choices to make.’
Professor Chris Whitty, England’s Chief Medical Officer, said that social lockdown in Britain over coronavirus could last for a prolonged period.
He said: ‘This is going to be a marathon, not a sprint… People should be thinking of minimum of weeks to months and depending how it goes it could be longer. It is really important people realise they are in for the long haul on this.’
The Government brought forward the much stricter restrictions after it was stung by criticism that it was not moving as fast as other countries.
Ministers have been shocked by figures that suggest the UK will suffer more deaths than the current modelling had predicted.
Initially, Mr Johnson resisted pressure to bring in ‘social distancing’ for fear that people would grow fatigued and abandon the practice just as the virus began to peak.
Yesterday’s measures went far further than previous advice, though they remain voluntary, so pubs are not required to shut, and people are not being ordered to stay at home.
The Prime Minister said it was unlikely that curfews and criminal sanctions could be introduced in the near future to enforce this – but added that all measures are under review. He said the UK already has extensive powers to deal with potential breaches of orders. He told the press conference: ‘Most people would accept we are already a mature and liberal democracy where people understand very clearly the advice that is being given to them.’
The Imperial College London study revealed that had Ministers continued to follow their relatively limited ‘mitigation’ strategy, around 11,000 patients would have needed intensive care at any one time, more than double NHS capacity.
The stricter measures could keep the number of patients in intensive care below 5,000, they said.
The report said vaccination was the ‘only exit strategy’ from the draconian measures announced yesterday. Modelling by the scientists says that school and university closures will be necessary to keep deaths to a minimum.
‘A minimum policy for effective suppression is therefore population-wide social distancing, combined with home isolation of cases and school and university closure,’ it says. ‘To avoid a rebound in transmission, these policies will need to be maintained until large stocks of vaccine are available – which could be 18 months or more.’
The research also revealed that around a quarter of over-70s who contract the virus end up in hospital. Four in ten of these need critical care.
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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