In a epidemic, nothing spreads as fast as fear.
There are only so many pictures of Italy’s deserted cafes and empty streets that the average Briton can look at without beginning to wonder why we’re not on lockdown too. Social media only feeds the hysteria, spawning endless scary-looking graphs plotting Italy’s soaring death toll against the rest of Europe’s and suggesting that everyone else is simply a few days behind on the same awful trajectory. Why doesn’t our government act now, before we get there? The political consensus around how far and how fast to go is already breaking down, with the London mayoral hopeful Rory Stewart calling for school closures even though the resulting childcare crisis would make it impossible for many NHS staff to get to work. Meanwhile, Nigel Farage is inexplicably given airtime on the BBC’s Newsnight to demand screening at airports, because apparently even the guy who once suggested doctors had got it wrong about smoking is an amateur epidemiologist now.
Yet it’s experts we crave now, not opportunists, which is why Boris Johnson barely emerges in public lately without the chief medical officer and the chief scientific adviser flanking him. It was left to Prof Chris Whitty, the chief medical officer, on Monday to explain why some things that make intuitive sense to the public – like screening anyone getting off a plane from Italy, or banning crowds at football matches – make a lot less sense to doctors.
Screening is only useful if you know exactly what you’re looking for, and coronavirus sufferers may be infectious but without obvious symptoms for several days. Going to watch the football in an open-air stadium, within coughing range of only a handful of people, may be less risky than watching it indoors in a crowded pub with a load of mates. (If anything it’s smaller gatherings full of people who know each other, like parties where everyone is mingling and chatting, that I’d worry about; World Health Organization experts studying the early stages of the Chinese outbreak found most clusters of cases were within family circles, not linked to specific public places where strangers gather).
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.
What are the symptoms this coronavirus causes?
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?
In the UK, the medical advice is that if you have recently travelled from areas affected by coronavirus, you should:
- stay indoors and avoid contact with other people as you would with the flu
- call NHS 111 to inform them of your recent travel to the area
More NHS advice on what to do if you think you have been exposed to the virus can be found here, and the full travel advice to UK nationals is available here.
Is the virus being transmitted from one person to another?
China’s national health commission confirmed human-to-human transmission in January, and there have been such transmissions elsewhere.
How many people have been affected?
As of 9 March, more than 110,000 people have been infected in more than 80 countries, according to the Johns Hopkins University Center for Systems Science and Engineering.
There have over 3,800 deaths globally. Just over 3,000 of those deaths have occurred in mainland China. 62,000 people have recovered from the coronavirus.
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. 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.
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.
But as the crisis in Italy grows, so does the niggling fear here. And nothing fuels it like any sliver of difference between the experts and the politicians – as when Whitty signalled to MPs last week that we were moving towards the “delay” stage of trying to flatten out the curve of a likely pandemic so it doesn’t overwhelm the NHS, while Johnson seems keen to insist we’re still at the earlier “contain” stage. There are good clinical reasons for not leaping to the nuclear options yet, including the risk that people will get bored and break out of self-isolation if it lasts too long, but any whiff of political interference from a government desperate to keep the economy ticking over sets alarm bells ringing. How can we be sure the balance they’re currently striking between containing infection and bringing national life, including the emergency services we would need in a pandemic, to a grinding halt is the right one?
The honest truth is that I don’t know for sure, and with apologies to any internationally renowned epidemiologists who may be reading this, you almost certainly don’t either. The circle of people actually qualified to judge the clinical merits of this strategy is both tiny, and mostly too busy tackling an epidemic to be writing long alarmist Twitter threads about it, which means the public are largely asked to close our eyes and trust.
Yet, regardless of what Boris Johnson wants to call it, the truth is that we entered a different phase the minute the chief medical officer declared on live television that in about a fortnight’s time things will change. Worrying about coronavirus isn’t something you can do by appointment or by setting an alarm clock, reminding the nation to wake up and panic obediently on the correct date. The natural response to being told we’ll soon be asked to self-isolate for minor illnesses is, for those who can, to get ahead of the curve now – and that means a staggered introduction of more serious restrictions is effectively already under way. People who can easily work from home will now do so at the first sign of a cough, if they’re not already, although people who can’t easily stay away (including many emergency workers) are more likely to wait until the formal advice kicks in. (One reason for waiting a fortnight is that by then the normal cold and flu season should be slowing down; suspicious coughs and fevers should become easier to distinguish from general winter sniffles).
Many people will voluntarily stop throwing parties, buying festival tickets or taking the kids to see the grandparents long before they’re formally advised to start social distancing. Change may be coming more slowly than in Italy, which seemingly failed to get a grip on the very early stages of the outbreak and is now racing to catch up, but it will be upon us very soon. Until then, it’s worth remembering how much easier it is to be the bloke in the pub roaring that something must be done, than the one responsible for doing what actually works.
• Gaby Hinsliff is a Guardian columnist
