The Chinese city of Wuhan (size of London, 11 Million people) has been placed into effective quarantine by the local authorities. 6000 people are reported by local doctors to have been infected (571 confirmed by Chinese officials) with a new strain of Coronavirus. This respiratory virus is similar in structure and appearance to the common cold virus but is more lethal. It has already spread to the USA, Japan and it is expected to reach Europe. In China at least 25 people are confirmed dead. No trains or planes are allowed to leave Wuhan for an as yet undetermined period. Such drastic action was also taken during the Ebola outbreak of 2013-2016 when a segment of the population was prevented from leaving their town in Sierra Leone. This indicates just how serious the Chinese government sees the potential lethality of this virus. Asia has recent memory of the SARS (Severe Acute Respiratory Syndrome) outbreak in 2003 which spread rapidly killing nearly 10% of all people infected. SARS was also a Coronavirus.
Very few habitable places on Earth are more than a few hours air and road travel from each other. Natural and international borders that used to constrain the movement of people and our myriad of microbes no longer act as an effective barrier against disease spread. Pandemic infectious outbreaks that used to occur once a century or less frequently now surface almost annually. The evolution and spread of infectious agents is accelerating.
Rapid contagion is likely due to a combination of human activity including environmental degradation, intensive farming, global travel and over use of antibiotics.
There is a certain cry wolf element with episodes of global pandemic. Public risk perception is fed again and again by an abundance of caution by scientists and doctors who are understandably reluctant to downplay the health risks. The media has a voracious appetite for stories that keep us on the edge of our seats with the constant threat of apocalypse. It is very hard to maintain a balanced perspective. We risk pandemic fatigue. With each outbreak that (mercifully) turns out to be less catastrophic than originally forecast or that burns out before reaching escape velocity, we become desensitised. At a personal level this may be a protective factor as it does no good to stress over a situation you can do little about. On the other hand, it is helpful to be aware of some of the things you can do to avoid coming to harm during such episodes.
People with pre-existing medical conditions such as diabetes, cardiovascular or respiratory compromise including all smokers should look to optimise their health to avoid hospitalisation with pneumonia should they become infected. This is solid advice regardless of the presence of a new virus. Even the seasonal flu virus represents a real threat to the young, elderly and those with sub-optimal immunity. Address factors such as poor diet and stop smoking. Exercise regularly; aim for at least 30 minutes of fast walking 4 times a week or an equivalent. If you do catch a bug, any bug, you will be that much stronger to defend against it.
International travellers should be careful not to travel with unexplained fever. During a global outbreak such as the Whuan Coronavirus, governments will set up fever and symptom screening at points of entry such as airports and land crossings. While you may be suffering from an unrelated chest infection or tonsillitis, if you have a fever, you may be detained until it is very clear you do not represent a public health risk. This may take hours, days or weeks depending on the local procedures. Screening is often conducted by non-medical personnel with a limited understanding of the risk assessment. It may result in isolation or confinement to a local infectious diseases ward. Perversely, you may be more likely to contract a life-threatening illness if this happens! If possible, delay travel until you are well, without fever or carry a note from your doctor explaining your diagnosis.
Protect yourself to protect others. Wash your hands frequently with soap and water or carry a small personal hand sanitizer. Avoid touching your nose and mouth. Sneeze or cough into a handkerchief or your elbow, not into your hands. Don’t visit people who are unwell with respiratory symptoms and check to see guests are well before they visit your home especially if you are responsible for young children, elderly parents or ill family members.
What to do?
Presenteeism is as bad as absenteeism. If you are ill with cough or fever (not just dodging the boss on a Monday morning), don’t come to work. With so many communication devices and conference call services, many people are able to work from home without significant interruption. Turning up at the office and infecting half your team will not win you ‘Employee of The Month’. Companies should consider both how to support workers if they become unwell with fever while at work and more flexible work arrangements.
Symptoms to look out for
Many people who develop respiratory symptoms wonder if they should attend the doctor or not. That is a tricky one. If you develop shortness of breath on minimal exertion, then of course call a doctor. If you have upper respiratory symptoms with cough or runny nose and are not in any way weakened, then a phone call with the doctor and a regular catch up will likely be sufficient. Although most doctors should not routinely prescribe oral antibiotics for viral symptoms, they will at least offer you reassurance and practical advice on a more rapid recovery. Avoid attending the local emergency department unless you are sure you have no other suitable option. When the emergency services become congested with general practice cases and frontline staff contract the same viral illness, the knock-on effect can paralyse the rest of the healthcare system. If in doubt, don’t hesitate – call for advice.
As yet, with the Wuhan Coronavirus outbreak, there is no need to run for the hills. The World Health Organisation and other scientific bodies continue to monitor both the lethality and transmissibility of the virus. Pandemic episodes need both factors to wreak complete havoc. While this story develops (a tragic but still somewhat welcome diversion from the 24/7 Brexit and Megxit updates), take positive steps to improve your health - not because of another global infectious disease outbreak but because you deserve better health regardless.