British doctors call on government to INCREASE coronavirus testing

By | March 16, 2020

‘How can you manage the emergency without numbers?’ British doctors call on government to INCREASE testing to help get to grips with the scale of coronavirus as WHO piles on pressure saying it will help curb the pandemic

  • The government fears as many as 10,000 people are suffering the disease in UK
  • PHE is only testing a fraction of suspected cases, mainly the most vulnerable
  • Campaign group Doctors For The NHS said wider testing should be carried out 
  • Thousands of people have also called for frontline NHS workers to be tested
  • There is currently some confusion with suspected cases if they should be tested 
  • Do you have a coronavirus story? Email stephen.matthews@mailonline.co.uk 
  • Coronavirus symptoms: what are they and should you see a doctor?

Doctors have urged the government to ratchet up testing of suspected coronavirus victims so health chiefs are aware of the size of the outbreak confronting them. 

Although roughly 1,500 cases have been confirmed in the UK, it is feared as many as 10,000 are suffering the disease.    

Many of these undiagnosed infected will have symptoms so mild they are unaware they have the virus.

Yet others will have come down with the tell-tale signs but have gone untested as Public Health England is only advising them to self-isolate at home and is mainly just screening the most vulnerable patients.

The strategy to only test a fraction of all suspected cases was blasted by the World Health Organisation today, which bluntly warned: ‘You cannot fight a fire blindfolded.’

And British medics have also lined up to criticise Whitehall’s coronavirus task force and said more testing was urgently needed.

Campaign group Doctors For The NHS said much wider testing should be carried out for Covid-19.

Its chairman, retired eye consultant Dr Colin Hutchinson, said: ‘There is no mass testing for Covid-19. How can you manage an emergency like the Covid-19 pandemic without access to clear, up-to-date information on the number of new cases within the population?

‘If you are going to rely on counting the numbers dying, you will only have an indirect indication of the number of infections two to three weeks earlier.’

Thousands of people have also called for frontline NHS workers to be tested for coronavirus as a matter of priority.

The UN agency's director-general, Dr Tedros Adhanom, warned: 'You cannot fight a fire blindfolded'

The UN agency’s director-general, Dr Tedros Adhanom, warned: ‘You cannot fight a fire blindfolded’

Who is being tested for coronavirus? 

This is the official government guidance on coronavirus testing:

People who are in the community with a fever or cough do not usually need testing. 

Instead, tests will primarily be given to:

  • All patients in critical care for pneumonia, acute respiratory distress syndrome (ARDS) or flu like illness
  • All other patients requiring admission to hospital for pneumonia, ARDS or flu like illness
  • Where an outbreak has occurred in a residential or care setting, for example long-term care facility or prisons

All other individuals with a high temperature or new, continuous cough should stay at home for 7 days. 

People do not need to call NHS 111 to go into self-isolation. If your symptoms worsen during home isolation or are no better after 7 days contact NHS 111 online. 

If you have no internet access, you should call NHS 111. For a medical emergency dial 999.

Source: NHS  

Junior doctor Rebecca McCauley, who started the petition, said staff wanted to work with ‘a clear conscience’.

‘My cough is minor, and it’s March, so quite common to get a cough … but how do I know it’s not Covid? The truth is I don’t,’ she wrote.

‘So now I have to ask … do I stay off work for seven days, leaving a shortfall of staff and putting further strain on the already strained NHS, when the likelihood is that I don’t actually have Covid-19?

‘Or do I go to work with my minor cough (as I would normally) and risk potentially spreading Covid-19 to all of the sicker patients I see on a daily basis?’ 

Amid the confusion over testing, the NHS said it is planning to ‘ramp up’ testing facilities. 

At the moment, more than 25,000 tests have been conducted by PHE but it is hoped this will rise to 10,000 a day. 

It came after the stark warning from the WHO’s director-general, Dr Tedros Adhanom, who flatly pointed out the pandemic won’t be stopped if officials don’t know who is infected.

In a startling warning to the UK – which only tests patients in hospital, he added: ‘You cannot fight a fire blindfolded.’  

Almost 175,000 cases of the coronavirus have been recorded worldwide, with 6,500 deaths recorded on every continent except Antarctica. 

Britain’s true coronavirus crisis is now being masked because authorities are no longer testing everyone who may have the life-threatening disease.

The decision prompted the wrath of the World Health Organization, with Dr Tedros urging governments: ‘Do not let this fire burn.’

Instead, UK officials are restricting tests to patients who are seriously ill or already in hospital – even though the virus has been spreading in the UK since February 28. 

Fewer than 1,600 cases have been confirmed in Britain – but the British government has already admitted the outbreak could be 16 times bigger. 

A Number 10 adviser admitted the true number of cases could be as high as 10,000 last Thursday, when just 596 patients had been diagnosed. 

If that ratio has stayed the same, it would be there may now be more than 25,000 people already infected on British soil. 

America’s testing system has also been the centre of criticism because it is has significantly lagged behind other countries for a number of reasons.

The Centers for Disease Control and Prevention (CDC) sent out faulty test kits in February which significantly delayed testing. 

CORONAVIRUS CASES NOW HIGHER OUTSIDE CHINA THAN INSIDE, FIGURES SHOW 

Coronavirus cases and deaths are now higher outside China than inside the hardest-hit nation, with Europe now the epicentre of the worsening pandemic. 

More than 90,000 cases have been recorded across 152 countries – China has only confirmed 80,000 patients since the outbreak began. 

For a long time, China made up the majority of cases after the deadly bug emerged in the city of Wuhan in December 2019.

But as COVID-19 rapidly spread globally in a matter of weeks, Europe has now become the ‘new epicentre’, the World Health Organisation says.

Italy is nearing 25,000 confirmed cases, making it the worst affected by the disease outside of China, followed by South Korea and Iran.

This was followed by a hold-up in sending replacement kits for several weeks.

Then, regulatory red tape slowed down private labs who wanted to develop their own tests.

Now, it’s clear the US has failed to ensure mass testing seen in countries across Asia. 

The US government has been unable to confirm how many Americans have been tested because there is no central database. The true number of infected people, therefore, is also likely to be under reported. 

More than 4,000 confirmed cases have been reported. But experts warn the US is on course to be severely effected by the coronavirus outbreak due its dysfunctional testing. 

Vice President Mike Pence said on March 3 that any American, with a doctor’s order, can now be tested for coronavirus, after it was previously restricted to those who currently had symptoms or who require hospitalisation.  

But in a daily press conference in Geneva today, Dr Tedros again called on all countries to ramp up their testing programmes. 

Revealing the WHO has sent 1.5million tests to 120 countries, He said: ‘We have a simple message to all countries – test, test, test.

‘You can not fight a fire blindfolded, and we can not stop this pandemic if we don’t know who is infected.’

OFFICIAL STATISTICS SHOW THE TIP OF THE ICEBERG OF UK’S CORONAVIRUS CRISIS

The Government’s Department of Health releases updated statistics every day at around 2pm, showing the number of people confirmed to have coronavirus and the number of test results that have been received in the past 24 hours.

But thanks to a change in the way officials are tracking the outbreak, these numbers only represent a small proportion of the real epidemic spreading across the UK.

Only people who are seriously ill and need hospital care, or who are already in hospital when they show signs of the coronavirus, are now being tested, so these are the only people who will show up in new Government figures.

People who become ill after travelling, or think they have the coronavirus after being in contact with someone who does, will not be tested unless they need hospital care. Most patients will simply self-isolate at home until they are no longer ill.

An announcement by the Government last week sheds some light on the true scale of Britain’s epidemic.

On Thursday, March 12, when the official number of cases was just 596, chief scientific adviser Sir Patrick Vallance said the true figure was probably between 5,000 and 10,000.

Taking the upper estimate, that suggests each confirmed case is worth 16.8 undiagnosed patients.

The official number of patients is now 1,543 – multiply that by 16.8 and the potential real case toll is 25,889.

Without testing, cases could not be isolated and the chain of infection would not be broken – threatening the world’s ability to fight the virus. 

And Dr Tedros told the press conference: ‘Every day more tests are being produced to meet the global demand.’

UK and US officials have so far declined to use a 15 minute blood test for coronavirus that other countries, including China, have already used. 

The test, which takes a blood droplet from a finger prick, allegedly shows the severity of coronavirus infection in a patient even if they don’t show symptoms.

Results are displayed in a similar fashion to those of an at-home pregnancy test within minutes and could potentially save delays in diagnosis.

Currently, swab tests used by Public Health England take 24 to 48 hours to be read by a specialist in a lab. In that time, suspected patients could be spreading germs to other people.

PHE confirmed they were not using the advanced blood test because it was not accurate enough, and are hoping to develop their own. The US Food and Drug Administration (FDA) is also yet to approve it.

Dr Tedros’ warning comes as he revealed coronavirus cases and deaths are now higher outside China than inside the hardest-hit nation, with Europe now the epicentre of the worsening pandemic. 

More than 90,000 cases have been recorded across 152 countries – China has only confirmed 80,000 patients since the outbreak began. 

For a long time, China made up the majority of cases after the deadly bug emerged in the city of Wuhan in December 2019.

But as COVID-19 rapidly spread globally in a matter of weeks, Europe has now become the ‘new epicentre’, the World Health Organisation says.

Italy is nearing 25,000 confirmed cases, making it the worst affected by the disease outside of China, followed by South Korea and Iran.

WHAT DO WE KNOW ABOUT THE CORONAVIRUS?

What is the coronavirus? 

A coronavirus is a type of virus which can cause illness in animals and people. Viruses break into cells inside their host and use them to reproduce itself and disrupt the body’s normal functions. Coronaviruses are named after the Latin word ‘corona’, which means crown, because they are encased by a spiked shell which resembles a royal crown.

The coronavirus from Wuhan is one which has never been seen before this outbreak. It has been named SARS-CoV-2 by the International Committee on Taxonomy of Viruses. The name stands for Severe Acute Respiratory Syndrome coronavirus 2.

Experts say the bug, which has killed around one in 50 patients since the outbreak began in December, is a ‘sister’ of the SARS illness which hit China in 2002, so has been named after it.

The disease that the virus causes has been named COVID-19, which stands for coronavirus disease 2019.

Dr Helena Maier, from the Pirbright Institute, said: ‘Coronaviruses are a family of viruses that infect a wide range of different species including humans, cattle, pigs, chickens, dogs, cats and wild animals. 

‘Until this new coronavirus was identified, there were only six different coronaviruses known to infect humans. Four of these cause a mild common cold-type illness, but since 2002 there has been the emergence of two new coronaviruses that can infect humans and result in more severe disease (Severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronaviruses). 

‘Coronaviruses are known to be able to occasionally jump from one species to another and that is what happened in the case of SARS, MERS and the new coronavirus. The animal origin of the new coronavirus is not yet known.’ 

The first human cases were publicly reported from the Chinese city of Wuhan, where approximately 11million people live, after medics first started publicly reporting infections on December 31.

By January 8, 59 suspected cases had been reported and seven people were in critical condition. Tests were developed for the new virus and recorded cases started to surge.

The first person died that week and, by January 16, two were dead and 41 cases were confirmed. The next day, scientists predicted that 1,700 people had become infected, possibly up to 7,000. 

Where does the virus come from?

According to scientists, the virus almost certainly came from bats. Coronaviruses in general tend to originate in animals – the similar SARS and MERS viruses are believed to have originated in civet cats and camels, respectively.

The first cases of COVID-19 came from people visiting or working in a live animal market in Wuhan, which has since been closed down for investigation.

Although the market is officially a seafood market, other dead and living animals were being sold there, including wolf cubs, salamanders, snakes, peacocks, porcupines and camel meat. 

A study by the Wuhan Institute of Virology, published in February 2020 in the scientific journal Nature, found that the genetic make-up virus samples found in patients in China is 96 per cent identical to a coronavirus they found in bats.

However, there were not many bats at the market so scientists say it was likely there was an animal which acted as a middle-man, contracting it from a bat before then transmitting it to a human. It has not yet been confirmed what type of animal this was.

Dr Michael Skinner, a virologist at Imperial College London, was not involved with the research but said: ‘The discovery definitely places the origin of nCoV in bats in China.

‘We still do not know whether another species served as an intermediate host to amplify the virus, and possibly even to bring it to the market, nor what species that host might have been.’  

So far the fatalities are quite low. Why are health experts so worried about it? 

Experts say the international community is concerned about the virus because so little is known about it and it appears to be spreading quickly.

It is similar to SARS, which infected 8,000 people and killed nearly 800 in an outbreak in Asia in 2003, in that it is a type of coronavirus which infects humans’ lungs. It is less deadly than SARS, however, which killed around one in 10 people, compared to approximately one in 50 for COVID-19.

Another reason for concern is that nobody has any immunity to the virus because they’ve never encountered it before. This means it may be able to cause more damage than viruses we come across often, like the flu or common cold.

Speaking at a briefing in January, Oxford University professor, Dr Peter Horby, said: ‘Novel viruses can spread much faster through the population than viruses which circulate all the time because we have no immunity to them.

‘Most seasonal flu viruses have a case fatality rate of less than one in 1,000 people. Here we’re talking about a virus where we don’t understand fully the severity spectrum but it’s possible the case fatality rate could be as high as two per cent.’

If the death rate is truly two per cent, that means two out of every 100 patients who get it will die. 

‘My feeling is it’s lower,’ Dr Horby added. ‘We’re probably missing this iceberg of milder cases. But that’s the current circumstance we’re in.

‘Two per cent case fatality rate is comparable to the Spanish Flu pandemic in 1918 so it is a significant concern globally.’

How does the virus spread?

The illness can spread between people just through coughs and sneezes, making it an extremely contagious infection. And it may also spread even before someone has symptoms.

It is believed to travel in the saliva and even through water in the eyes, therefore close contact, kissing, and sharing cutlery or utensils are all risky. It can also live on surfaces, such as plastic and steel, for up to 72 hours, meaning people can catch it by touching contaminated surfaces.

Originally, people were thought to be catching it from a live animal market in Wuhan city. But cases soon began to emerge in people who had never been there, which forced medics to realise it was spreading from person to person. 

What does the virus do to you? What are the symptoms?

Once someone has caught the COVID-19 virus it may take between two and 14 days, or even longer, for them to show any symptoms – but they may still be contagious during this time.

If and when they do become ill, typical signs include a runny nose, a cough, sore throat and a fever (high temperature). The vast majority of patients will recover from these without any issues, and many will need no medical help at all.

In a small group of patients, who seem mainly to be the elderly or those with long-term illnesses, it can lead to pneumonia. Pneumonia is an infection in which the insides of the lungs swell up and fill with fluid. It makes it increasingly difficult to breathe and, if left untreated, can be fatal and suffocate people.

Figures are showing that young children do not seem to be particularly badly affected by the virus, which they say is peculiar considering their susceptibility to flu, but it is not clear why. 

What have genetic tests revealed about the virus? 

Scientists in China have recorded the genetic sequences of around 19 strains of the virus and released them to experts working around the world. 

This allows others to study them, develop tests and potentially look into treating the illness they cause.   

Examinations have revealed the coronavirus did not change much – changing is known as mutating – much during the early stages of its spread.

However, the director-general of China’s Center for Disease Control and Prevention, Gao Fu, said the virus was mutating and adapting as it spread through people.

This means efforts to study the virus and to potentially control it may be made extra difficult because the virus might look different every time scientists analyse it.   

More study may be able to reveal whether the virus first infected a small number of people then change and spread from them, or whether there were various versions of the virus coming from animals which have developed separately.

How dangerous is the virus?  

The virus has a death rate of around two per cent. This is a similar death rate to the Spanish Flu outbreak which, in 1918, went on to kill around 50million people.

Experts have been conflicted since the beginning of the outbreak about whether the true number of people who are infected is significantly higher than the official numbers of recorded cases. Some people are expected to have such mild symptoms that they never even realise they are ill unless they’re tested, so only the more serious cases get discovered, making the death toll seem higher than it really is.

However, an investigation into government surveillance in China said it had found no reason to believe this was true.

Dr Bruce Aylward, a World Health Organization official who went on a mission to China, said there was no evidence that figures were only showing the tip of the iceberg, and said recording appeared to be accurate, Stat News reported.

Can the virus be cured? 

The COVID-19 virus cannot be cured and it is proving difficult to contain.

Antibiotics do not work against viruses, so they are out of the question. Antiviral drugs can work, but the process of understanding a virus then developing and producing drugs to treat it would take years and huge amounts of money.

No vaccine exists for the coronavirus yet and it’s not likely one will be developed in time to be of any use in this outbreak, for similar reasons to the above.

The National Institutes of Health in the US, and Baylor University in Waco, Texas, say they are working on a vaccine based on what they know about coronaviruses in general, using information from the SARS outbreak. But this may take a year or more to develop, according to Pharmaceutical Technology.

Currently, governments and health authorities are working to contain the virus and to care for patients who are sick and stop them infecting other people.

People who catch the illness are being quarantined in hospitals, where their symptoms can be treated and they will be away from the uninfected public.

And airports around the world are putting in place screening measures such as having doctors on-site, taking people’s temperatures to check for fevers and using thermal screening to spot those who might be ill (infection causes a raised temperature).

However, it can take weeks for symptoms to appear, so there is only a small likelihood that patients will be spotted up in an airport.

Is this outbreak an epidemic or a pandemic?   

The outbreak was declared a pandemic on March 11. A pandemic is defined by the World Health Organization as the ‘worldwide spread of a new disease’. 

Previously, the UN agency said most cases outside of Hubei had been ‘spillover’ from the epicentre, so the disease wasn’t actually spreading actively around the world.

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