UK Keeps COVID-19 Response in Containment Phase

Peter Russell

March 09, 2020

The UK is to continue with current efforts to 'contain' COVID-19, a meeting today of the Government's emergency COBRA committee decided.

Ministers have decided against moving to a 'delay' phase at this stage, which could have led to a raft of 'social distancing' measures.

However, the Government's Chief Medical Adviser, Prof Chris Whitty, warned that the time could be imminent – possibly in the next 7 to 10 days – when people showing "even minor" signs of respiratory tract infections or fever could be asked to self-isolate to try to contain the virus.

His comments came just minutes before a fifth death from COVID-19 was announced.

The latest COBRA meeting followed details of further planning to help combat the spread of the coronavirus.

They formed part of a package of measures needed "ahead of an expected move from 'contain' to 'delay'," the Department of Health and Social Care (DHSC) said.

The Prime Minister, Boris Johnson, said there would be a further meeting of the emergency committee on Wednesday.

Rising Number of Cases and Deaths

It was confirmed that the fifth person to die in the UK from the virus was a patient at Epsom and St Helier University Hospitals NHS Trust. David Elkeles, the Trust's chief executive, said the patient was in their 70s and was "very unwell with a number of significant and long-term health conditions".

A fourth patient, also in their 70s, who died at the Royal Wolverhampton Hospital, also had underlying health conditions. It appeared that they contracted the virus in the UK. 

Yesterday it was announced that a surgical high dependency unit closed after a hospital worker tested positive for COVID-19. The healthcare professional worked one night shift last Friday at University Hospital Southampton and was now isolated at home.

A small number of patients and staff who had come into close contact with the individual were also being isolated, managers said.

Government Plans Emergency Legislation

The latest "enhanced" approach to pandemic preparations could be included in a forthcoming COVID-19 Emergency Bill.

Among the proposals directly affecting the health system were plans to maximise the number of health volunteers and the amount of time they could commit to supporting the health and social care system without fear of losing their regular jobs.

An estimated three million individuals volunteer in a health, community health, or social care setting. The proposal could see employment protection for up to 4 weeks for skilled, experienced, or qualified volunteers.

Business leaders would be consulted to explore the best way of implementing the initiative, the DHSC said.

Following last week's announcement that recently retired health professionals could be asked to return to work in the event of a pandemic, the Bill is also expected to look at ensuring that retired staff who help out in the NHS will not have their pensions negatively impacted.

The NHS announced that calls to NHS 111 had increased by more than a third compared with the same period last year.

An extra 120,000 calls to the service were placed in the first week of March. Between Thursday 27th February and Thursday 5th March, NHS 111 answered 389,779 calls, figures showed.

To help with demand, the NHS had trained an extra 500 initial call responders – an increase of 20%, the DHSC said.

Mr Hancock said: "We will do all we can to contain coronavirus, but as we know, COVID-19 is spreading across the world, so I want to ensure Government is doing everything in its power to be ready to delay and mitigate this threat.

"Public safety is my top priority. Responding to coronavirus is a massive national effort and I’m working with colleagues across Government to ensure we have a proportionate emergency bill, with the right measures to deal with the impacts of a widespread COVID-19 outbreak.

"We plan for the worst and work for the best, and the NHS is working 24/7 to fight this virus."

Protective Equipment

NHS England confirmed last week that it would provide GP surgeries with personal protective equipment (PPE) to help them deal with the coronavirus outbreak after doctors complained they were ill-equipped. The British Medical Association said it was "vital that these are provided in a timely fashion".

A letter from Dr Nikita Kanani, NHS England's medical director for primary care, sent last Thursday, said: "I recognise that Covid-19 is placing a new and increasing challenge on already busy practices, and this will be an area of concern for you, your teams and your patients."

She promised an initial stock of PPE for each practice, including 400 general use aprons, 300 pairs of examination gloves, and 300 fluid repellent face masks would be issued this week to all practices.

Emergency COBRA Committee

The outcome of today's COBRA meeting had been in doubt. Ministers had made it clear that they would be guided by the advice of health experts, including Prof Chris Whitty, the Government's Chief Medical Adviser, and Sir Patrick Vallance, the Government's Chief Scientific Adviser, before deciding whether to move from the current policy of containing the virus to one of delaying it.

Dr Jenny Harries, England's Deputy Chief Medical Officer, said on Saturday that although the UK was "teetering on the edge" of a sustained community transition of coronavirus, it had not reached that point yet.

Comments by one senior minister this morning suggested that the UK was not yet prepared to announce restrictions on large gatherings, including sporting events, as part of a package of 'social distancing'.

Oliver Dowden, Secretary of State for Digital, Culture, Media, and Sport, told BBC TV earlier: "The advice is clear from the Chief Medical Officer – there isn't a need to cancel such events.

"I was at Twickenham on Saturday with the Prime Minister, we had a huge crowd of people there – so there's no reason for people not to attend such events, or to cancel them at this stage, but we keep it under review."

Health Conference Cancellations

The likely impact of COVID-19 on the health service prompted the Royal College of Physicians (RCP) to postpone its annual conference until next year.

Medicine 2020 was due to take place in Birmingham in April with around 1000 delegates taking part but has been delayed until January 2021.

Prof Andrew Goddard, RCP president, said:  "Our aim is always to protect people's health and it simply wouldn't be sensible to bring together hundreds of doctors from all over the UK, and other countries too, when they are already stretched, dealing with COVID-19 on top of all the other pressures on the NHS.

"We shouldn't put doctors at unnecessary risk of contracting or spreading the virus so it is a wise precaution to postpone Medicine 2020. Now, as always, I want to protect the wellbeing of the NHS workforce."

The same concerns led to the cancellation last week of the Diabetes UK Professional Conference which had been due to take place in Glasgow later this month.

Editor's Note, 9th March 2020: This article was updated to include news of the fourth and fifth UK deaths. Find the latest COVID-19 news in Medscape's Coronavirus Resource Centre.    

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