Government Unveils 'Battle Plan' for COVID-19 

Peter Russell

March 03, 2020

Non-urgent hospital care could be delayed to focus on treating patients with COVID-19 in the event of a major outbreak, the Government said.

The 'battle plan' for dealing with a pandemic of the new coronavirus also included proposals to enlist newly retired doctors and nurses to bolster NHS services.

At a news conference earlier, Prime Minister Boris Johnson said the situation could be "challenging" and that his Government was committed to doing "everything possible" to "prepare for all eventualities" in order to keep the country safe.

Later, NHS England said that in January it had moved to a national incident response Level 4 "to ramp up preparation for a potential coronavirus outbreak".

A letter, sent on Monday, alerted hospital trusts and other health providers to the possibility of treating COVID-19 patients in general acute units rather than only specialist centres if the number of cases grows.

It called on them to identify how they could segregate emergency departments, wards, and diagnostic and intervention suites "to support the continued response in the event of a significant escalation in COVID-19 cases".

'A Significant Challenge'

The Government paper, Coronavirus: action plan – A guide to what you can expect across the UK , said that the lack of immunity in the population, coupled with the absence of a vaccine, meant that COVID-19 could spread extensively. The current data showed it was "more likely than not that the UK will be significantly affected".

The document warned that the new coronavirus presented a "significant challenge" and that in a worst case scenario, up to a fifth of workers could be absent from work during peak weeks.

"Let's not forget – we already have a fantastic NHS, fantastic testing systems and fantastic surveillance of the spread of disease," Mr Johnson said. "We will make sure the NHS gets all the support it needs to continue their brilliant response to the virus so far."

The Prime Minister was flanked by Prof Chris Whitty, the Government's chief medical adviser, and Sir Patrick Vallance, its chief scientific adviser.

Prof Whitty said that current modelling suggested that while up to 80% of people in the UK could be infected, that number "is likely to be lower than that, and probably a lot lower than that".

Based on data from China, where the outbreak began, the mortality rate from the virus could be put at a "current reasonable figure" of 1%, subject to fluctuations with age, he said.

Contain, Delay, Research, and Mitigate

The current Government strategy involved a phased response to COVID-19. Those phases were defined as:

  • Contain - Detect early cases, follow up close contacts, and try to prevent the disease taking hold

  • Delay - Slow the spread and push it away from the winter season

  • Research - Better understand the virus and innovate responses

  • Mitigate - Provide the best care possible for people who become ill and lessen the impact on society and the economy

At present, the UK was in the 'contain' phase. Any decision to move from one phase to another would be taken on the advice of the UK's chief medical officers.

Prof Whitty said that delaying the spread of the new coronavirus was critical. "One of the reasons we're so keen to delay is we're trying to push as far as we can the peak of the infection if it occurs out into the period of the year when the NHS is better able to do this because the other infectious diseases in winter are not there," he said.

In the event that the UK enters the 'mitigate' phase, measures affecting the health system could include delaying non-urgent hospital care, ensuring that health and social care services work together to support early discharge from hospital, and drawing down on the UK's stockpile of key medicines and protective clothing.

Using military personnel to support the health service has not been ruled out.

Speaking in the House of Commons later, Matt Hancock said it was "becoming more likely we will see widespread transmission" of the virus across the UK, and that tackling it was "a national effort".

Mr Hancock is understood to have spoken to social media firms, urging them to help focus on accurate information about COVID-19.

'Sensible Measures'

Prof Paul Cosford, emeritus medical director at Public Health England said: "We all need to take a common-sense approach to helping limit the spread of novel coronavirus. Wash your hands regularly and if you are not well with a cough or flu-like symptoms, stay at home.

"As we start to see more spread in the community, there may be other things we recommend the public does, such as limiting social activity, keeping families at home if anyone has symptoms, or restricting access to venues where large groups of people attend."

Professor Tom Solomon, director of the NIHR Health Protection Research Unit in Emerging and Zoonotic Infections at the University of Liverpool, told the Science Media Centre: "This Government's Action Plan look like a series of sensible measures, which will be implemented in a stepwise manner.

"We have seen from northern Italy how countries in Europe can be affected if control measures are not implemented promptly. It is almost certain that the number of cases in the UK will continue to grow. 

"The key priority is to slow this growth as much as possible. Even if large numbers of people will be affected overall, the NHS can cope much better if this number is spread out over many months, rather than over a few weeks."

Editor's Note, 3rd March 2020: This article was updated to include new information from Public Health England.

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