The British government’s surprise announcement telling Britons to leave China “if they can” comes amid mounting international concern about the spread of coronavirus.
But the advice came with no detailed guidance about why the UK’s position had changed – making it unclear whether this was a political stance, or a position based on new medical guidance that British authorities have not shared publicly.
Other governments have cautioned against travel to China, or barred travellers who have made a recent visit. But the UK is the first country to advise its citizens to leave China, suggesting even greater concerns about the virus.
It is almost certain to anger Chinese authorities, who have already strongly criticised American and Australian bans on travellers from China entering the respective countries. It also puts tens of thousands of Britons living in China in an extremely difficult position.
What is the virus causing illness in Wuhan?
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.
What other coronaviruses have there been?
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.
What are the symptoms of the Wuhan coronavirus?
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.
Is the virus being transmitted from one person to another?
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 7 February, the death toll stands at 636 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%.
Two members of one family have been confirmed to have the virus in the UK, and a third person was diagnosed with it in Brighton, after more than 400 were tested and found negative. The Foreign Office has urged UK citizens to leave China if they can.
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.
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%. 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%.
Should I go to the doctor if I have a cough?
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.
Is this a pandemic and should we panic?
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.
Sarah Boseley Health editor and Hannah Devlin
For many, a decision to leave could have significant personal, financial and professional ramifications, as it seems increasingly likely that the outbreak may last weeks or even months, so any absence would be long-term.
Those who have set up or run businesses may worry about how they will operate without key staff. Students may be penalised for leaving a course if they need credits towards a degree, while employees with contracts may be penalised for breaking them.
Families with children in school may not be able to find them a place to study in the UK – or elsewhere – at short notice.
Those whose relatives do not hold UK passports are likely to be particularly anxious after watching the confusion over who would be allowed to leave Wuhan, the centre of the virus outbreak, on evacuation flights.
The British government has not said if it will offer any financial support to help them leave, any guidance on whether insurers might cover some costs, or advice on whether dependents could get fast-track help with paperwork to come to the UK.
Nor is it clear what support – if any – the government will be willing or able to offer those who decide to stay on despite the latest advice. It has already reduced the number of diplomatic staff and warned that its support for citizens in China could be affected.
Tuesday’s decision effectively leaves tens of thousands of people forced to weigh up a decision with huge consequences – without any real understanding of why they are being urged to leave now.
Those who were in the quarantined centre of the outbreak, Wuhan, have already been evacuated. Those who are left are likely to be asking if the UK authorities know or suspect the coronavirus is spreading widely elsewhere.
