The third person in Britain to test positive for coronavirus travelled to the UK from Singapore, it emerged on Thursday, prompting a significant widening of the government’s response to the epidemic.
The new case, a middle-aged man, was the first British national to contract the virus, government sources indicated. After it was confirmed that he had travelled to the UK from outside China, officials changed existing advice, putting doctors on alert for cases in people returning from a string of countries not previously considered to present a risk.
The UK’s four chief medical officers called on travellers from a list of countries popular with Britons or with higher numbers of cases to self-isolate when they return – guidance that had been confined to arrivals from China. They should stay at home, keep away from others, and phone for medical advice if they felt ill, the advice said.
By far the majority of coronavirus cases – more than 28,000 – are in China, where there have been 564 deaths, the World Health Organisation said on Thursday. There have been 225 confirmed cases and one death in 24 other countries.
But as the virus continued to spread, new guidance told those who had travelled to the UK in the last 14 days from mainland China, Thailand, Japan, Republic of Korea, Hong Kong, Taiwan, Singapore, Malaysia or Macau with a cough, fever or shortness of breath “to stay indoors and call NHS 111, even if symptoms are mild”.
Q&A How can I protect myself from the coronavirus outbreak?
The World Health Organization is recommending that people take simple precautions to reduce exposure to and transmission of the Wuhan coronavirus, for which there is no specific cure or vaccine.
The UN agency advises people to:
- Frequently wash their hands with an alcohol-based hand rub or warm water and soap
- Cover their mouth and nose with a flexed elbow or tissue when sneezing or coughing
- Avoid close contact with anyone who has a fever or cough
- Seek early medical help if they have a fever, cough and difficulty breathing, and share their travel history with healthcare providers
- Avoid direct, unprotected contact with live animals and surfaces in contact with animals when visiting live markets in affected areas
- Avoid eating raw or undercooked animal products and exercise care when handling raw meat, milk or animal organs to avoid cross-contamination with uncooked foods.
Despite a surge in sales of face masks in the aftermath of the outbreak of the coronavirus outbreak, experts are divided over whether they can prevent transmission and infection. There is some evidence to suggest that masks can help prevent hand-to-mouth transmissions, given the large number of times people touch their faces. The consensus appears to be that wearing a mask can limit – but not eliminate – the risks, provided they are used correctly.
Meanwhile, a doctor who had tried to warn about the outbreak was one of the latest victims. Li Wenliang, 34, died at a hospital in Wuhan after hours of confusion over his fate. Chinese police had targeted Li for “spreading rumours” in late December 2019 after he posted a warning on social media about a flu-like disease that had been treated at his hospital.
Professor Chris Whitty, England’s Chief Medical Officer, pointed up the significance of the new case, saying: “The person who caught this did not catch it in China – they caught it elsewhere in Asia. That’s an important point from an epidemiological point of view because, whilst it’s absolutely the case that by far the biggest risk remains in China … nevertheless there is now evidence of some limited transmission in a number of Asian countries.”
News of the new UK infection – which follows the diagnosis of a Chinese mother and son who travelled from mainland China and are currently being treated in Newcastle – will cause global concern as one of the first where the virus has moved out of China and into one country and then passed to a third.
For the UK, it presents clear evidence of the limited use of screening passengers at Heathrow airport who have flown in from mainland China. Many travellers from other affected Asian countries would fly in to Gatwick or other UK airports. Information and advice to everyone who has been in a coronavirus-affected country will now be vital.
Experts say, however, that the UK’s monitoring and surveillance efforts so far have been paying off. In the UK, there had been 466 negative tests for coronavirus as of Wednesday. Before direct flights were halted by the Chinese government, 1,466 passengers and 95 staff had arrived in the UK from Wuhan, the centre of the outbreak in China, between 10 and 24 January. All 1,304 who remained in the UK are now out of the incubation period for the virus.
On a fast-moving day of developments:
* Chinese President Xi Jinping declared a “people’s war” against the coronavirus as companies worldwide warned of the impact on business.
* Japan reported 10 more infections among passengers aboard the luxury cruise liner Diamond Princess, which is quarantined outside Yokohama.
* Hospitals in Wuhan said they were struggling to find enough beds for thousands of newly infected patients.
* There were warnings that Hong Kong’s economy risked being plunged deeper into recession as the coronavirus outbreak wrought havoc in the territory, with consumers panic-buying staple goods and airlines stopping flights.
* China’s ambassador to the UK, Liu Xiaoming, warned against “rumours and panic” and called on the UK government to support to support China in its handling of the coronavirus outbreak.
The third patient, who it is understood was diagnosed in Brighton, has been transferred to Guy’s and St Thomas’ hospital in London, which has a specialist infectious disease unit.
“A further patient has tested positive for coronavirus, bringing the total number of cases in the UK to three. The individual did not acquire this in the UK,” Whitty said in a statement.
“The patient is being transferred to a specialist NHS centre, and we are using robust infection control measures to prevent any possible further spread of the virus. The NHS is well prepared to manage these cases and we are working quickly to identify any contacts the patient has had.”
After a meeting of the scientific and advisory committee on Thursday morning, Whitty said, “We’ve decided … based on transmission potential and travel patterns … to extend geographically the countries where if a doctor in the NHS sees a patient who has travelled from Asia. Now they will start thinking about testing from a wider geographical area than would have been the case before.
“We knew this ratchet up might well happen and this is the moment where we feel it’s prudent, getting ahead of the epidemiology, to make this shift.”
Whitty did not initially specify the patient’s nationality, but government sources later revealed that he was British.
Experts said the news of transmission from another country was significant, although not a total surprise. Dr Bharat Pankhania from the University of Exeter said: “It’s a clear indication that this virus is now circulating in many countries,” he said. “That tells us that our control containment policies will need to be reviewed, as infected people may be entering the UK from countries other than China. The fact that we do not have any additional cases that were contacts of the initial two in the UK signals that our control policies appear to be working, although it’s still early days, so we must continue our vigilance.”
Meanwhile, China’s ambassador to the UK, Liu Xiaoming, condemned the British authorities’ handling of the crisis, accusing the government of sowing panic by becoming the first country in the world to advise its citizens to leave the country.
Ambassador Liu Xiaoming said the UK position was an overreaction that ignored World Heath Organization advice against sweeping travel restrictions, which he claimed UK officials had privately acknowledged was correct.
“We don’t think there should be such a panic,” Liu said. “We were given notice before they [the UK] made a formal announcement, we advised them we don’t think it’s a good idea. We believe the epidemic is controllable, preventable and curable.”
