A St Petersburg court has ordered a Russian woman to be forcibly confined to hospital after she dramatically broke out of coronavirus quarantine and blogged about her escape.
Alla Ilyina, 32, was escorted by bailiffs and medical staff back to the Botkin infectious diseases hospital, where she had been held under quarantine, before short-circuiting the electronic lock to her hospital door and sneaking past doctors to an elevator.
What is Covid-19 - the illness that started in Wuhan?
It is caused by 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.
Have there been other coronaviruses?
Severe acute respiratory syndrome (Sars) and Middle Eastern respiratory syndrome (Mers) are both caused by coronaviruses that came from animals. In 2002, Sars spread virtually unchecked to 37 countries, causing global panic, infecting more than 8,000 people and killing more than 750. Mers appears to be less easily passed from human to human, but has greater lethality, killing 35% of about 2,500 people who have been infected.
What are the symptoms caused by the new coronavirus?
The virus can cause 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. Recovery depends on the strength of the immune system. Many of those who have died were already in poor health.
Should I go to the doctor if I have a cough?
UK Chief Medical Officers are advising anyone who has travelled to the UK from mainland China, Thailand, Japan, Republic of Korea, Hong Kong, Taiwan, Singapore, Malaysia or Macau in the last 14 days and who is experiencing a cough or fever or shortness of breath to stay indoors and call NHS 111, even if symptoms are mild.
Is the virus being transmitted from one person to another?
China’s national health commission has confirmed human-to-human transmission, and there have been such transmissions elsewhere.
How many people have been affected?
As of 20 Februrary, China has recorded 2,118 deaths from the Covid-19 outbreak. Health officials have confirmed 74,576 cases in mainland China in total. More than 12,000 have recovered.
The coronavirus has spread to at least 28 other countries. Japan has 607 cases, including 542 from a cruise ship docked in Yokohama, and has recorded one death. There have also been deaths in Hong Kong, Taiwan, France and the Philippines.
There have been nine recorded cases and no fatalities to date in the UK. As of 17 February, a total of 4,501 people have been tested in the UK, of which 4,492 were confirmed negative.
Why is this worse than normal influenza, and how worried are the experts?
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% in the epicentre of the outbreak, Hubei province, and less than that elsewhere. 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%.
Another key unknown is how contagious the coronavirus is. A crucial difference is that unlike flu, there is no vaccine for the new coronavirus, which means it is more difficult for vulnerable members of the population – elderly people or those with existing respiratory or immune problems – to protect themselves. Hand-washing and avoiding other people if you feel unwell are important. One sensible step is to get the flu vaccine, which will reduce the burden on health services if the outbreak turns into a wider epidemic.
Is the outbreak a pandemic?
A pandemic, in WHO terms, is “the worldwide spread of a disease”. Coronavirus cases have been confirmed outside China, but by no means in all 195 countries on the WHO’s list. It is also not spreading within those countries at the moment, except in a very few cases. By far the majority of cases are travellers who picked up the virus in China.
Should we panic?
No. 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. 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. Generally, the coronavirus appears to be hitting older people hardest, with few cases in children.
The escape, which took place on 7 February, went unreported for days until Ilyina herself told journalists she had broken out, posting a detailed video of her getaway on Instagram.
Ilyina fell ill after returning from the Chinese resort island of Hainan last month and was put under quarantine by doctors. But after she tested negative for the virus on 6 February, she was told she would be held under quarantine for two weeks regardless.
“When they told me I was totally healthy, I requested that the doctors let me go home,” she said in the video, which featured a schematic diagram detailing her escape plan. “I said that according to the constitution, I have a right to my freedom. Also under Russian law, I have a right to refuse hospitalisation. They refused. So, I worked out a plan.”
The story went viral and led to a police search for Ilyina, who had locked herself in her apartment. The court on Monday ordered her to be admitted to hospital until at least Wednesday, in order to receive new test results.
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.
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.
Russia has taken extraordinary measures to prevent the spread of the Covid-19 coronavirus, closing its borders with China and putting dozens more under quarantine. But patients have complained about delayed test results and draconian rules that have left them trapped in hospitals. At least three people have fled quarantine since the coronavirus outbreak began, including a 34-year-old mother who jumped out of a hospital window with her son in the city of Samara.
On Monday, the first Russian citizen was diagnosed with the new coronavirus – a woman onboard the Diamond Princess cruise ship docked in Yokohama, Japan. Two Chinese citizens in Russia were diagnosed with the disease and have since been released.
More than 140 Russians and others evacuees from Wuhan are also being quarantined at a sanatorium in western Siberia being patrolled by members of Russia’s national guard.
