Coronavirus fears gripped Brighton on Monday as the number of people in the city diagnosed with the disease rose to five.
Outside County Oak medical centre, which was closed after a member of staff contracted the virus, a number of local residents spoke of their concerns.
“It’s scary when you look in the windows and see the people in the hazmat suits,” said 23-year-old Ben Swan, a local dog walker. “You hear about it on the news and it sounds like it’s in China, like it’s really far away, but it gets quite scary when it’s round the corner on your doorstep.”
He said he and his partner luckily had not visited the practice in a few months, but that the risk of catching coronavirus ran through his mind when he was travelling around the area.
It is a member of the coronavirus family that has never been encountered before. Like other coronaviruses, it has come from animals. Many of those initially infected either worked or frequently shopped in the Huanan seafood wholesale market in the centre of the Chinese city.
New and troubling viruses usually originate in animal hosts. Ebola and flu are other examples – severe acute respiratory syndrome (Sars) and Middle Eastern respiratory syndrome (Mers) are both caused by coronaviruses that came from animals.
The virus causes pneumonia. Those who have fallen ill are reported to suffer coughs, fever and breathing difficulties. In severe cases there can be organ failure. As this is viral pneumonia, antibiotics are of no use. The antiviral drugs we have against flu will not work. If people are admitted to hospital, they may get support for their lungs and other organs as well as fluids. Recovery will depend on the strength of their immune system. Many of those who have died were already in poor health.
Human to human transmission has been confirmed by China’s national health commission, and there have been human-to-human transmissions in the US and in Germany. As of 8 February, the death toll stands at 722 inside China, one in Hong Kong and one in the Philippines. Infections inside China stand at 31,161 and global infections have passed 280 in 28 countries. The mortality rate is 2%.
The number of people to have contracted the virus could be far higher, as people with mild symptoms may not have been detected. Modelling by World Health Organization (WHO) experts at Imperial College London suggests there could be as many as 100,000 cases, with uncertainty putting the margins between 30,000 and 200,000.
The number of confirmed cases of coronavirus in the UK has doubled from four to eight after four more people in Brighton were diagnosed with the infection over the weekend. One of the men is a doctor who was part of a group that were skiing in the resort near Chamonix with the man who is at the centre of the Brighton outbreak.
One of the other four confirmed cases is being treated at the HCID unit at the Royal Free hospital in north London and the two Chinese nationals who tested positive for Coronavirus in York are being treated at the HCID centre in Newcastle.
We don’t yet know how dangerous the new coronavirus is, and we won’t know until more data comes in. The mortality rate is around 2%. However, this is likely to be an overestimate since many more people are likely to have been infected by the virus but not suffered severe enough symptoms to attend hospital, and so have not been counted. For comparison, seasonal flu typically has a mortality rate below 1% and is thought to cause about 400,000 deaths each year globally. Sars had a death rate of more than 10%.
Unless you have recently travelled to China or been in contact with someone infected with the virus, then you should treat any cough or cold symptoms as normal. The NHS advises that people should call 111 instead of visiting the GP’s surgery as there is a risk they may infect others.
Health experts are starting to say it could become a pandemic, but right now it falls short of what the WHO would consider to be one. A pandemic, in WHO terms, is “the worldwide spread of a disease”. Coronavirus cases have been confirmed in about 25 countries outside China, but by no means in all 195 on the WHO’s list.
There is no need to panic. The spread of the virus outside China is worrying but not an unexpected development. The WHO has declared the outbreak to be a public health emergency of international concern, and says there is a “window of opportunity” to halt the spread of the disease. The key issues are how transmissible this new coronavirus is between people and what proportion become severely ill and end up in hospital. Often viruses that spread easily tend to have a milder impact.
Melanie Roberts, 48, saw the centre was closed from her house just across the road.
“It’s worrying that it’s so close. My family are fairly young and healthy so hopefully we’ll be OK but it’s worrying for older people, especially if it’s been in a medical centre where people have been in and out who aren’t well – that’s a bit of a problem isn’t it?” said Roberts, a dressmaker with two young children.
“I think people will take more precautions now … I think it will have an effect on people now in social situations, in pubs and shops and things. Maybe not a week or two ago, but now I think it will affect people quite quickly.”
The third case of coronavirus in the UK was diagnosed in Brighton last Thursday, and the man has since been transferred to St Thomas’ hospital in London for treatment.
Over the weekend the number of UK cases doubled as four more people were diagnosed in Brighton – three men and one woman, all of whom had been in contact with the previously confirmed Brighton case.
However in many parts of Brighton, residents remained unconcerned by the latest developments.
In Hove, the Grenadier pub remains open after a man who was diagnosed with coronavirus was served there a few days ago.
There were about a dozen customers watching football and enjoying a pint on Monday afternoon. Although all staff who were on duty at the time the man was hosted had been told to isolate themselves, there were still plenty of workers behind the bar.
The pub’s spokesperson said: “We are following the advice and working closely with Public Health England who have advised us that there is minimal ongoing risk of infection to either guests or staff, and as such the pub remains open for business as usual.”
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:
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.
The Foreign and Commonwealth Office has advised UK nationals to leave China where possible. It is also warning that travellers from Hong Kong, Japan, Macau, Malaysia, Republic of Korea, Singapore, Taiwan and Thailand who develop symptoms of cough or fever or shortness of breath within 14 days of returning the UK should contact the NHS by phone.
At Brighton train station, travellers also seemed unperturbed, despite the giant billboard displaying headlines about the Brighton “super-spreader” – a term used to describe the man who contracted the disease in Singapore and had since passed it on to a number of other persons.
John Stephen, 68, a retired magazine journalist said he was not bothered by the situation, but knew many others were. “There’s a Chinese supermarket down there and I saw some girls walking past covering their faces – it seems to bother other people, but I think a lot of it is racism.”
There were a couple of people wearing protective face masks, but the vast majority around the station were not taking any visible extra precautions.
“I’m not perturbed but I am a little concerned about the racism surrounding it,” Stephen added.
Brighton and Hove city council said it was working closely with Public Health England (PHE) to respond to the situation.
A council statement said: “The latest patients from our city have been transferred to specialist NHS centres, and healthcare workers are using robust infection control measures to prevent any possible further spread of the virus.”
It said PHE was prioritising speaking to those with close and sustained contact with confirmed cases.