Boris Johnson today warned that coronavirus is on the verge of ‘significant’ escalation in the UK – and the government could take more dramatic action to combat it.
The government is bracing Britons for the virus to spread further and faster after the number of cases in this country hit 40.
The PM finally waded in to take personal charge of the response by chairing a Cobra emergency committee meeting this morning.
The session agreed a new ‘battle plan’, being formally published tomorrow, which could include asking retired doctors and nurses to return to the NHS, urging people to work from home, closing schools, increasing class sizes and cancelling large public events.
Health Secretary Matt Hancock revealed this afternoon that the UK might also need to copy the measures taken by other European states ‘at more advanced stages of an outbreak’.
That could mean a French-style ban on crowds, cancelling sporting events, fines for entering restricted areas as in Italy, and advising against physical contact during greetings.
Writing in the Evening Standards, Mr Hancock also highlighted the government’s ability to detain people who refused to go into quarantine.
Legislation allowing the Government to use extra powers to help control the virus is expected to go through Parliament by the end of the month.
Mr Johnson said coronavirus was ‘likely to become more significant for this country in the course of the next days and weeks’.
But he also insisted that the public should try to go about ‘business as usual’, suggesting they wash their hands frequently while singing Happy Birthday twice.
‘We have been making every preparation for that. This country is very well prepared,’ he said.
Scotland has declared its first case, while 12 new patients were diagnosed in England on Sunday, when the Health Secretary admitted it was ‘inevitable’ coronavirus would continue to spread.
And England’s chief medical officer Professor Chris Whitty said today that four further patients had tested positive.
‘All four patients had recently travelled from Italy. The patients are from Hertfordshire, Devon and Kent. All are being investigated and contact tracing has begun.’
Speaking after the Cobra meeting today, Boris Johnson said coronavirus was ‘likely to become more significant over the next days and weeks’
Boris Johnson will take charge of the Government response to the coronavirus outbreak today after being stung by claims he was acting like a ‘part-time Prime Minister’ (pictured at Public Health England’s National Infection Service in Colindale on Sunday)
Cabinet Office minister Michael Gove was also in Downing Street today for the meeting
icola Sturgeon (left at a press conference in Edinburgh today) dialled into the Cobra meeting earlier. She said ‘we are in the containment phase’ but the Scottish government was preparing for a ‘significant outbreak of coronavirus’
Nicola Sturgeon, who dialled into the Cobra meeting today, said ‘we are in the containment phase’ but the Scottish government was preparing for a ‘significant outbreak of coronavirus’.
She repeated the ‘reasonable worst case’ figure that 80 per cent of the population could get coronavirus, although she stressed that most would not end up seriously ill.
‘Whatever figures we end up dealing with, whether it’s 80 per cent of something – which is entirely possible much lower than that – the vast majority of people who get this infection will have very mild symptoms, akin to the common cold,’ she said.
She added the Scotland v France Six Nations game is still scheduled to take place in Edinburgh this weekend and there has been no change to plans for the COP26 climate summit in Glasgow later in the year.
Mr Johnson has faced heavy criticism for dragging his heels before chairing a meeting on the deadly virus.
And speaking after Cobra today he said: ‘We have agreed a plan so that as and when if and when it starts to spread… we are in a position to take the steps that will be necessary… to contain the spread of the disease as far as we can and also protect the vulnerable.’
He added: ‘Don’t forget it is still the case that the single most useful thing we can all do is to wash our hands – two times Happy Birthday, hot water and soap.
‘Other than that though I wish to stress that people consider that they should, as far as possible, go about business as usual.’
Meanwhile, Trade Secretary Liz Truss suggested the government plans to appoint a single minister to coordinate the UK action. However, No10 refused to confirm whether that would happen.
It comes as the European Commission President Ursula von der Leyen said the EU had raised its coronavirus risk level from ‘moderate’ to ‘high’ for those in the European Union.
Professor Paul Cosford, emeritus medical director of Public Health England, said the situation in the UK was set to become more challenging.
Asked on BBC Breakfast if widespread infection was inevitable, Prof Cosford said: ‘I wouldn’t say anything is inevitable but it is now highly likely.’
Going on to speak on ITV’s Good Morning Britain, Prof Cosford explained that ‘the extent of infection we are seeing in other countries suggests it is likely that we will see more widespread infection in the UK’.
He said: ‘We should expect at times that might be quite challenging for us, it is therefore very important that we do everything we can to reduce the spread of infection.
‘At the moment, the vast majority of cases we see in the UK are still linked to countries where there is more widespread infection, either in Italy or South East Asia.
‘It is true to say there is a small number now where it is much more difficult to find that link, and that is leading us to think we may well see more widespread infection in the UK fairly soon.
‘It could happen in the next few days or it could take a little longer.’
The Prime Minister’s official spokesman said: ‘The UK-wide action plan in response to Coronavirus was agreed and that will be published tomorrow.
‘That was agreed by all four parts of the UK and they will be working closely together, ensuring we have the best possibly response to the outbreak.’
The plan will ‘set out the steps we have already taken, things we could potentially consider in the event this outbreak were to progress further in the UK and also to set out the steps the public can take to contain the virus’.
The meeting was attended by senior ministers, as well as chief medical officer Professor Chris Whitty and chief scientific adviser Sir Patrick Vallance, as they ratify the Government’s proposed countermeasures.
Scottish First Minister Nicola Sturgeon dialed in, as well as Mark Drakesford from Wales and Arlene Foster and Michelle O’Neil from Northern Ireland.
However, London mayor Sadiq Khan was not involved because it was to discuss a ‘national response’.
It is understood the government wants emergency powers legislation in place by the end of the month, in case they are needed.
Three of the latest cases are family members of a man from Surrey who tested positive on Friday. He had no recent travel history and is the first person to contract Covid-19 within the UK.
All four are adults, including one more from Surrey and two from West Sussex.
Prof Whitty said another new patient, from Essex, had not recently travelled to an infected area.
He added investigations were ongoing as to whether the patient had contracted it ‘directly or indirectly’ from someone who had recently travelled abroad.
Another case is a person from Bury, Greater Manchester, who was infected in Italy and has now been taken to a specialist NHS infection centre.
Three cases were confirmed in West Yorkshire, including two Leeds residents – who became infected in Iran – while one is from Bradford who had been in Italy.
Two of the new patients are from Hertfordshire, including a clinician at the Mount Vernon Cancer Centre, which is part of East and North Hertfordshire NHS Trust.
A statement from the trust said: ‘All individuals who were in contact with the clinician have been identified and the appropriate measures taken.
‘The risk to patients and staff at Mount Vernon Cancer Centre is very low and we are working with individual patients to appropriately manage their care.’
Health Secretary Matt Hancock and No10 strategy chief Dominic Cummings were in Downing Street for the Cobra meeting this morning
Mr Hancock (centre) arrived today accompanied by Department of Health permanent secretary Chris Wormald (left) and Professor Chris Whitty (right)
Downing Street has insisted that Mr Johnson (pictured yesterday in Colindale) has remained in overall charge of the response since the virus first emerged in January. No 10 said there had been weekly Cobra meetings
Priti Patel arrives at the Home Office this morning. She could be at the Cobra meeting later
One other case is from London and the other is from Gloucestershire and linked to a member of staff at a Tetbury school in the Cotswolds, who was identified on Saturday.
Debra Lapthorne, centre director for Public Health England (PHE) South West, said: ‘The two cases are linked and both became infected whilst in Northern Italy.
‘Staff from PHE have continued to support St Mary’s Primary School, Tetbury, where one of the cases works.’
In a letter to parents, headteacher Mrs Jo Woolley said that while it was not necessary to close the school from a health perspective, it will close until at least Wednesday due to ‘operational difficulties’ with staff members.
A staff member at an infant school in Berkshire was confirmed to have tested positive on Saturday.
In an email, Willow Bank Infant School headteacher Michelle Masters urged parents to ‘remain calm and follow the recommended hygiene procedures’.
The Department of Health and Social Care announced yesterday that every department will have a ministerial lead on the virus, and a cross-Whitehall ‘war room’ is being set up to roll out an enhanced public information campaign.
Emergency powers designed to restrict Covid-19 if it becomes endemic, due to be announced this week, would only be ‘temporary’, said Mr Hancock.
He confirmed that ‘population distancing measures’, such as banning public gatherings and cancelling football matches, could be considered by the Government, while closing schools may be ‘necessary’.
The Foreign Office confirmed that non-essential staff, as well as dependants, are to be pulled out of the British Embassy in Tehran.
The Republic of Ireland reported its first case on Saturday, with a secondary school to be closed for 14 days after authorities identified its pupils and teachers as having been in contact with the male patient.
Globally, the number of people killed worldwide by the virus exceeds 3,000 and there have been almost 90,000 confirmed cases.
While most patients only have mild symptoms, Covid-19 appears to be much more deadly than seasonal flu.
In Italy, which has the most cases in Europe, the number of infections doubled in 48 hours over the weekend.
Italy now has 1,694 confirmed cases and has seen 34 deaths.
Coronavirus explained: What are the chances I will die? How do I avoid it? Is it all a big fuss over nothing? World experts answer your questions
Hundreds of flights have been cancelled. Tourists are stranded, quarantined in their hotels. World stock markets are in freefall, and there are reports of desperate shoppers stockpiling crates of supplies – from nappies to medicines to toilet roll.
Sales of surgical spirit have surged and Boots announced it has sold out of anti-bacterial hand gel. There’s even talk of cancelling – not just postponing – the Olympics.
It’s hard not to feel a sense of impending doom when reading about the coronavirus infection, known as Covid-19, sweeping the globe. At the time of writing, it has killed more than 2,900 and infected in excess of 85,000 people in 47 countries.
A woman pictured with a medical mask covering her face. The only reason to wear a mask in public is if you think you are infected – to protect others (file photo)
The majority of infections and deaths are in the Hubei province of China, where the virus emerged. But in Italy, nearly 5,000 miles from the source, cases have surged, forcing some northern towns – home to 55,000 people – into lockdown.
Twelve Italians have died so far, and on Friday the first British fatality, a passenger aboard the Diamond Princess cruise liner quarantined in Japan, was reported.
In the UK, of the nearly 8,000 who have been tested for the virus, 20 have been diagnosed, and there have been no deaths.
Plans are in place to close schools, disrupt our public transport system and postpone major sports events should the situation change. But for now, experts are urging the public to prepare and take measures to help prevent the spread of illness.
The world wants to know what to do about it and so – from risks to the elderly or ill and how to self-quarantine, to what ordinary people can do to protect themselves – we asked some of the world’s leading experts for answers to the big coronavirus questions.
How do you catch this virus?
Covid-19 seems to spread much like flu, through coughs and sneezes. Once contracted, it lives and replicates in the tissues that line the airways. Secretions from these tissues – mucus and saliva – therefore also contain the virus. When an infected person coughs, sneezes, or simply talks, tiny droplets of moisture are expelled into the air, carrying the virus out of the body. Unless you are directly in the firing line, you should be safe. Droplets travel only up to 7ft.
Struggling: Pope Francis wipes his nose as he takes part in the penitential procession on Ash Wednesday in Rome, Italy, on February 26. He said yesterday he was only suffering from a cold
But another risk comes when people cover their cough or sneeze with their hand and then touch something other people touch, such as a door knob or tap. Touch a contaminated surface, then touch your own mouth or nose, and the virus can be transmitted.
The World Health Organisation (WHO) says the coronavirus can live on surfaces for several days.
Günter Kampf of the University of Greifswald in Germany says such viruses can be killed by disinfectants such as alcohol or bleach – but many things we touch every day on transport or in public buildings are not frequently disinfected.
If 14 per cent of those infected develop a severe disease and five per cent of them are critically ill, it could be a ‘massive threat’ according to an interview Dr Peter Openshaw, professor of experimental medicine at Imperial College London, gave The Times.
‘It doesn’t present like a common cold and the symptoms can range from completely unapparent to serious disease to going into intensive care.
‘From what we have learnt so far, it seems that virus shedding – the transmission stage from infected persons – is going on relatively early during the course of infection.
‘Tests can quite often become negative but then sometimes go positive again,’ he said.
According to Alistair Miles, head of epidemiological informatics, Wellcome Centre for Human Genetics, we should stop touching our faces.
He told The Times: ‘Stop touching your face. Especially stop touching your eyes, nose or mouth.
‘Wash your hands often, especially before eating or touching food.
‘While a mask seems like a good idea, there isn’t a lot of good evidence that it can reliably prevent infection when worn by the public. But they are useful to put on a sick person to reduce their spreading of the virus.’
He said: ‘It looks unlikely this will be over quickly. It may be with us into next year and might eventually become a seasonal infection, returning each winter.’
Could I die if I get it?
It depends to some extent on how old you are. Covid-19 barely even causes symptoms in children, even babies, and in China is not known to have caused any deaths in under-tens. The main concern with children is that if they catch the virus they may pass it on to older at-risk individuals. This is why some headteachers have chosen to close schools, but this is not yet official policy.
According to the most recent data from the China Centre for Disease Control, death rates are 0.2 to 0.4 per cent between the ages of ten and 50, but then start climbing.
Deep cleaning: A worker in a protective suit disinfects a tram car in Pyongyang, North Korea, on February 26. Symptoms of Covid-19 are a fever, a cough or trouble breathing
You have a 1.3 per cent chance of dying from it in your 50s, a 3.6 per cent risk in your 60s, an eight per cent risk in your 70s, and a 14.8 per cent risk in your 80s.
Risk climbs with age because older people more often have other diseases, such as cancer or conditions such as high blood pressure, diabetes or pulmonary disease, which worsen Covid-19.
Professor Neil Ferguson, on the faculty of medicine at Imperial College London, told The Times: ‘China seems to be suppressing transmission at the moment. In Italy we think there are many thousands of cases distributed across the country. In Iran there are tens of thousands, if not more.
‘We calculated with an enormous amount of uncertainty that one per cent of those infected might die – with a fourfold margin of error in each direction. So a death rate of 0.25 per cent of cases would be similar to the 1957 and 1968 influenza pandemics while a four per cent rate would compare with the 1918 Spanish flu epidemic (with a death toll estimated at 40 million to 50 million).
I have a horrible cold – could it be coronavirus?
Symptoms of Covid-19 are not like those of a cold: it causes a fever, a cough and trouble breathing, not a runny nose or congestion. Most cases appear to be mild.
If it’s mild, could I have the virus and not know it?
The short answer is yes. Although at present only those who have been in contact with people known to be infected or who have been to a high-risk area (a full list of these locations comes later) should ask about being tested.
It takes from two to 14 days after being infected by the virus to show symptoms – the average is five days. Chinese scientists say 80 per cent of all cases are quite mild. Some victims have barely any symptoms at all, so if you get sick you might not realise it’s Covid-19.
Worryingly, it seems to be possible for people to spread it before they start showing symptoms – or even if they never do. Scientists at the Guangdong Centre for Disease Control and Prevention in China found one Covid-19 patient who showed no symptoms but had as much virus in his nose as people who had symptoms.
In Germany, a woman with very mild symptoms – not enough to make her or anyone else suspicious – passed the virus to two people who shared a meeting room with her, who then passed it to two more people before they got symptoms.
During the 2002 outbreak of severe acute respiratory syndrome, or SARS, it was discovered that people were infectious – with a high enough concentration of the virus in their fluids – only after they developed symptoms.
This meant that isolating patients, to stop it spreading, was more straightforward. This time, ‘if people are infectious and spreading the virus before symptoms, then containment becomes much more difficult,’ warns Caroline Buckee of Harvard Medical School in the US.
There have been these outbreaks before, like SARS, and we got through it. Do we really need to worry now?
Experts have urged the public not to panic – however, people are being advised to stay informed.
SARS infected more than 8,000 people and killed nearly 800 in 29 countries in less than a year.
It went away because it spread poorly among people, and only after symptoms started.
Safe: Airport staff check the temperature of a passenger travelling from Milan, Italy, as part of the coronavirus screening procedure at the Debrecen airport in Hungary
There was also a massive global campaign, led by the WHO, to isolate people who had been exposed.
‘It took a lot of hard work,’ says David Heymann of the London School of Hygiene and Tropical Medicine, who led that campaign at the WHO. ‘And we were lucky.’
SARS never invaded any developing countries which might have had trouble organising the surveillance and isolation required.
This coronavirus spreads more readily, and has already infected more than ten times as many people, on all continents.
But really, don’t more people die each year from falling down stairs than will be killed by coronavirus?
More people do die in a year falling on stairs in the UK – 787 last year – than die of HIV, the virus that causes AIDS, which killed 428. Few would argue that HIV is trivial, or not something to avoid.
At present, it is believed that one per cent of Covid-19 cases die. But this makes it as deadly as the 1918 ‘Spanish’ flu – one of the worst pandemics known, thought to have killed up to 50million worldwide.
Should I wear a mask in public?
No. Studies show they do not really protect you from being infected. Some think it makes you touch your face less, but others report it makes you do it more.
The only reason to wear a mask in public is if you think you are infected – to protect others.
No risks: Commuters on a train in Milan, Italy, cover up completely. But studies show that wearing a face mask does not really protect you from being infected
And, regardless, those who suspect they are infected are advised to stay at home and self-isolate (more on this later).
Current advice from Public Health England is to wear one at home if you are caring for a sick person – and if you get sick, to stop you infecting others. The NHS may give you some if they tell you to self-quarantine.
But don’t buy large quantities of masks. There is a global shortage and the close-fitting ‘respirator’ style ones, like N95 or FP2, which are similar to those worn by builders to protect them from toxic fumes, should be saved for the healthcare workers who will really need them.
I think I’ve been exposed, but I feel fine. What should I do?
Do not go to a clinic or the doctor’s without calling first. If you have the virus, you could infect more vulnerable people.
The current official advice is this: if you have visited Hubei province in China in the past 14 days, or Iran, northern Italy and the Daegu and Cheongdo areas of South Korea since February 19, call NHS 111 – even if you do not have symptoms.
You may well be asked to self-isolate for 14 days.
If there is a risk that you may be infected, other family members or close contacts may also need to be contacted and questioned.
Stuck indoors: A guest wears a protective face mask as he stands by an open window at H10 Costa Adeje Palace, which is on lockdown over cases of cornoavirus, in Tenerife, Spain
You should also contact the NHS on 111 if you have a cough, high temperature or are suffering shortness of breath and have been to other parts of mainland China or South Korea, Hong Kong, Japan, Macau, Malaysia, Singapore, Taiwan or Thailand in the past 14 days, or other parts of northern Italy (anywhere north of Pisa, Florence and Rimini), Cambodia, Laos, Myanmar or Vietnam since February 19.
You should call the helpline if you think you may have been in close contact with someone who is infected. Even if you’ve been to a high-risk area, from what we know so far, if you don’t develop symptoms in 14 days, you don’t have the virus.
This list may change, and the latest advice for England and Wales is on gov.uk.
How do I isolate myself?
Public Health England says stay home for 14 days.
It means not going to work or school – employers and school heads should be informed.
Do not go to public areas such as parks or shops and public transport or use taxis. Avoid having visitors, and ask friends, family or delivery services to get the shopping – and put it down outside, where you can pick it up.
Sweaty: Iran’s Deputy Health Minister Iraj Harirchi wipes the swear off his face during a press conference in Tehran, before he confirmed being tested positive for coronavirus
If you share a home with others, and they have not been advised to self-isolate, then stay in a separate, well-ventilated room.
If you share a bathroom, use it after other people, use separate towels – and then clean it.
If you share a kitchen, try not to use it when others do, eat in your room and wear a mask if others are there. Stopping you from infecting others is the one thing a surgical mask is good for. Public Health England advise that if a family returns from somewhere that requires quarantine when they get back, they can stay together and don’t have to be in separate rooms.
Isn’t staying home for two weeks a bit extreme?
Self-isolation for two weeks may be an unpleasant prospect. But it is absolutely vital, aimed at stopping the virus from getting loose and circulating generally, whereupon there will be far more cases, and it will be harder to protect the vulnerable, such as the elderly.
Dirty money: A bank clerk disinfects banknotes in the quarters of Suining Bank. China’s central bank has ordered to disinfect cash and destroy cash received from hospitals
Officials may also try to slow the spread of the virus by cancelling large gatherings and perhaps shutting down schools or transport.
Apparently people with flu symptoms in some areas of the UK are being tested now. Why?
Covid-19 is diagnosed by looking for the virus in samples taken from the nose or mouth. The UK has mostly tested people with risky travel or contact history.
But Public Health England is now working with some hospitals and GP surgeries to test other patients, to see if the virus has already spread more widely.
In eight hospitals, patients in intensive care with severe respiratory infections will be tested.
In 100 GP surgeries, those coming in with milder flu-like symptoms – dry coughs, fever, shortness of breath – will be tested. As of Saturday, two cases had been found.
What can I do to protect myself, and my family, if the virus starts spreading in the UK?
‘Think through how you will look after infected family members while avoiding infection yourself,’ says risk expert Peter Sandman.
‘Maybe get some plastic gloves in the case of caring for someone who is sick – perhaps a few disposable surgical masks to wear, for the same reason. Plan what to do for childcare if you or they are sick,’ he advises.
Possibilities include making arrangements with neighbours or family to care for each other’s children if one or the other is sick – or see whether there are any emergency arrangements being organised in your community.
When you are in public places, wash your hands often with soap, or at least alcohol-based hand cleaner, in case you’ve picked up the virus from some surface.
If you must touch a public surface, don’t touch your face afterwards until you’ve washed.
You can wear gloves, but don’t touch your face with those without taking them off first.
Use a knuckle to push elevator buttons and a tissue to open doors and hold railings. Substitute an elbow bump for a handshake.
Practise not touching your face when you are out in public, says Sandman. It’s hard, he admits, but not a bad skill to acquire.
Sneeze or cough into a tissue (then bin it), or your elbow – as the old saying goes, it’s coughs and sneezes that spread diseases.
I’ve read that there’s no vaccine for this virus. Will a flu jab protect me?
Scientists are racing to come up with a vaccine or an antiviral drug for Covid-19, and some are now being tested, in record time.
But there is currently no specific treatment, as it is an entirely new virus. Realistically, it’s not going to be available until next year.
A sunbather wears a face mask in the pool of H10 Costa Adeje Palace, which is on lockdown after cases of coronavirus were detected there, in Tenerife
Coronaviruses are different from flu viruses, so the flu jab won’t offer protection.
However, if you’re in a high-risk group for flu, and are eligible for a jab, it is advisable to have one. You don’t want complications of flu at a time when hospitals may be stretched by Covid-19 patients.
I know people who have recently come back from holiday, and are now ill. Should they be self-quarantining? And if they aren’t, should I call the police or someone else?
It is still flu season – other illnesses can be in circulation. The UK is advising self-quarantine only for people exposed to a known case, or who went to places where they might have encountered the virus. Check online for the current list of such places, and call the NHS, not the police, if you have doubts.
My child’s school has been closed due to children there having come back from a high-risk area. Should we be self-isolating now?
The school closed so you wouldn’t be exposed, and you will not have to self-quarantine.
People wearing protective face masks, following an outbreak of coronavirus, are seen in front of the giant Olympic rings at the waterfront area of Odaiba Marine Park in Tokyo, Japan
Is it safe to travel at all right now?
If you’re going somewhere with the same or lower levels of the virus than the UK, there seems little reason not to. In airports, rail terminals or other places where people with the virus may have been, take the precautions mentioned above. Don’t go close to places that have large or suspected outbreaks – this virus can spread fast. Check gov.uk for the latest travel advice.
Dr Carmen Dolea, head of International Health Regulations Secretariat, World Health Organisation, told The Times: ‘Aircraft cabins are absolutely not dangerous and travellers do not need to cancel their plans unless visiting restricted.
‘The International Air Traffic Association (Iata) maintains an up-to-date list on its Travel Centre website.
‘The best thing to do in aircraft cabins is to practise proper hand hygiene with alcohol-based rub or gels, and to use coughing etiquette.
‘Make sure you cough and sneeze into your elbow, use a tissue and throw it in a bin.’
I’ve read that the virus jumps from animal to humans. Could my dog be at risk?
No. The WHO says there is no evidence of any involvement of cats or dogs with this virus.
Last week’s reports about a dog in Hong Kong testing ‘weak positive’ for coronavirus were ‘incredibly irresponsible’, according to Jonathan Ball, Professor of Molecular Virology at the University of Nottingham.
Experts say that the test probably picked up a bit of virus from contamination in the environment, not because the dog was infected.
The coronavirus is thought to have come originally from East Asian fruit bats – so unless you have one of those for a pet, you’re OK.
Even if you do have a bat, it will be fine – the virus doesn’t hurt them.