GPs Given China Coronavirus Guidance

GPs in England have been issued with guidance on dealing with suspected cases of Wuhan novel coronavirus infection (WN-CoV).

Assessments are being made in a number of potential UK cases but none has yet been confirmed.

Downing Street called a meeting of COBRA, the Cabinet Office briefing room emergency committee, to discuss the outbreak. The meeting was chaired by the Health Secretary Matt Hancock. He said the risk to the UK from the virus remained low.

However, Professor Paul Cosford, emeritus medical director of Public Health England (PHE), told BBC News earlier: “I think it’s highly likely that we will have cases in the UK.”

He continued: “We do have a whole range of plans ready to go when that is the case and these are being implemented now.”

The World Health Organisation (WHO) has said the outbreak is an emergency for China, where at least 26 people have died from the virus. However, it hasn’t yet declared it an epidemic of international concern.

Commenting through the Science Media Centre, Peter Piot, professor of global health and director, London School of Hygiene & Tropical Medicine, said: “We are at a critical phase in this outbreak. Regardless of the decision not to declare this a Public Health Emergency of International Concern, intensified international collaboration and more resources will be crucial to stopping this outbreak in its tracks.  National authorities and the World Health Organisation will need to continue to monitor developments very closely.

“There are still many missing pieces in the jigsaw puzzle to fully understanding this new virus which is spreading rapidly across China, and most probably around the world. Over the coming days and weeks we will know much more, but there cannot be any complacency as to the need for global action.

“The good news is that the data to date suggest that this virus may have a lower mortality than SARS, we have a diagnostic test and there is greater transparency than decades gone by. And that is essential because you cannot deal with a potential pandemic in one country alone.”

NHS Guidance

PHE gave the current criteria for possible WN-CoV infection as:

  • Travel to Wuhan, Hubei Province, China in the 14 days before the onset of illness or contact with a confirmed case of WN-CoV

  • Severe acute respiratory infection requiring hospital admission with clinical or radiological evidence of pneumonia or acute respiratory distress syndrome OR acute respiratory infection of any degree of severity (including at least one of the following: shortness of breath, cough or sore throat)

However, it said atypical presentation is possible in immunocompromised patients.

It said the principles for primary care included:

  • Identifying potential cases as soon as possible, including through recent history of travel to China when booking patients in or by phone

  • Preventing transmission of infection to staff and patients

  • Telling potential cases to avoid using public transport or taxis to get to hospital

  • Avoiding direct physical contact during examination or exposures to respiratory secretions

  • Isolate suspected cases in a room away from other patients and inform local Health Protection Teams (HPT)

  • If a potential case is identified during a consultation, leave the room, wash hands, and prevent others entering the room. Continue the consultation by phone. Do not allow the patient to use shared toilets

  • If transfer to hospital is required, tell the ambulance control of potential WN-CoV infection. Do not allow further use of the isolation room until HPT advice is received

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