Updated: Mar 13, 2020
The government has warned that up to a fifth of the workforce may be off sick during the peak of a coronavirus epidemic in the UK. Plans to contain Coronavirus if it spreads have been set out by the UK Government.
The UK is currently [9 March] in the first phase – “containment” – of the government’s four-part plan to tackle the spread of coronavirus. However, measures are expected to be ramped up to slow the spread of the virus and could involve “changes to society”.
Speaking to a committee of MPs on 5 March, Prof Whitty, the country’s Chief Medical Adviser ,said the country was now “mainly” in the delay phase of the government’s four-part plan to tackle the virus, but was still following aspects of the first phase. At time of writing, it is still being decided what measures will be taken in the delay phase – but the government has said they could include banning big events, closing schools and dissuading people from using public transport.
Prof Whitty said benefits of the delay phase included:
Pushing the peak of cases “further away from the winter pressures on the NHS” so that there was “more capacity to respond”;Buying time to allow the UK to improve its response or develop counter measures such as drugs, vaccines and diagnostics;There may be a seasonal element of the virus – so if the peak was delayed to spring or summer, the “natural rate”of transmission could be lower.
An emergency Cobra meeting is expected to consider whether the UK should officially move into the “delay” phase. However, the government’s clear message will be that everyone has a role to play in tackling the outbreak – as individuals, as employers and as communities.
According to the WHO’s latest Situation Report [8 March 2020], there have been:
105,586 confirmed cases globally;80,859 confirmed cases in China, with 3,100 deaths recorded;7,375 confirmed cases in Italy (the highest number of confirmed cases outside China), with 366 deaths recorded;273 confirmed cases in the UK. There have been three deaths recorded.
WHO is urging all countries to prepare for the potential arrival of COVID-19 by readying emergency response systems; increasing capacity to detect and care for patients; ensuring hospitals have the space, supplies and necessary personnel; and developing life-saving medical interventions.
WHO warns that supplies of PPE is “rapidly depleting”
In his daily briefing in Geneva on March 4 WHO Director-General Dr Tedros Adhanom Ghebreyesus warned that supplies of PPE, such as the gloves, medical masks, respirators, goggles, face shields, gowns, and aprons used by health workers fighting coronavirus are “rapidly depleting” and warned against “hoarding and misuse”.
“We are concerned that countries’ abilities to respond are being compromised by the severe and increasing disruption to the global supply of personal protective equipment … caused by rising demand, hoarding and misuse,” he said.
Healthcare workers rely on personal protective equipment to protect themselves and their patients from being infected and infecting others. But, says WHO, shortages are leaving doctors, nurses and other frontline workers dangerously ill-equipped. “Without secure supply chains, the risk to healthcare workers around the world is real. Industry and governments must act quickly to boost supply, ease export restrictions and put measures in place to stop speculation and hoarding. We can’t stop COVID-19 without protecting health workers first,” said Dr Tedros Adhanom Ghebreyesus.
Since the start of the COVID-19 outbreak, prices have surged. Surgical masks have seen a sixfold increase, N95 respirators have trebled and gowns have doubled.
Supplies can take months to deliver and market manipulation is widespread, with stocks frequently sold to the highest bidder.
WHO has so far shipped nearly half a million sets of personal protective equipment to 47 countries,* but supplies are rapidly depleting.
Based on WHO modelling, an estimated 89 million medical masks are required for the COVID-19 response each month. For examination gloves, that figure goes up to 76 million, while international demand for goggles stands at 1.6 million per month.
Recent WHO guidance calls for the rational and appropriate use of PPE in healthcare settings, and the effective management of supply chains.
WHO is working with governments, industry and the Pandemic Supply Chain Network to boost production and secure allocations for critically affected and at-risk countries.
To meet rising global demand, WHO estimates that industry must increase manufacturing by 40%.
Governments should develop incentives for industry to ramp up production, says WHO. This includes easing restrictions on the export and distribution of personal protective equipment and other medical supplies.
Every day, WHO is providing guidance, supporting secure supply chains, and delivering critical equipment to countries in need.
Getting your workplace ready for COVID-19
The WHO has set out guidance on how businesses and employers can help to stop the spread of the new coronavirus disease.
How does coronavirus spread?
When someone who has COVID-19 coughs or exhales they release droplets of infected fluid. Most of these droplets fall on nearby surfaces and objects – such as desks, tables or telephones.
People could catch COVID-19 by touching contaminated surfaces or objects – and then touching their eyes, nose or mouth. If they are standing within one meter of a person with COVID-19 they can catch it by breathing in droplets coughed out or exhaled bythem. In other words, COVID-19 spreads in a similar way to flu.
Preventing coronavirus in the workplace
The guidance stresses that employers should start taking these the following measures now, even if COVID-19 has not arrived in the communities where they operate:
Make sure your workplaces are clean and hygienic.
Surfaces (eg desks and tables) and objects (eg telephones, keyboards) need to be wiped with disinfectant regularly.Promote regular and thorough hand-washing by employees, contractors and customers.
Put sanitizing hand rub dispensers in prominent places around the workplace. Make sure these dispensers are regularly refilled;Display posters promoting hand-washing;Offer guidance from occupational health and safety officers;Make sure that staff, contractors and customers have access to places where they can wash their hands with soap and water.Promote good respiratory hygiene in the workplace.
Display posters promoting respiratory hygiene. Combine this with other communication measures;Ensure tissues are available at your workplaces, for those who develop a runny nose or cough at work, along with closed bins for hygienically disposing of them;Advise employees and contractors to consult national travel advice before going on business trips.Brief your employees, contractors and customers that if COVID-19 starts spreading in your community anyone with even a mild cough or low-grade fever (37.3 C or more) needs to stay at home.
Make clear to employees that they will be able to count this time off as sick leave.
The guidance goes on to advise on procedures for employees who travel (before travelling, during and after), and sets out advice for getting a business ready should COVID-19 arrive in the workplace. It is stressed that simple precautions and planning can make a big difference. Action now will help protect your employees and your business.
Coronavirus action plan. A guide to what you can expect across the UK
Last month, the government declared coronavirus a “serious and imminent threat” to public health, as it announced new powers to fight its spread. Under the measures, people can now be forcibly quarantined and will not be free to leave.On 3 March, the government revealed its coronavirus action plan. It believes that in a “stretching scenario”, up to a fifth of the workforce may be off sick during the peak of an epidemic.Some points from the government’s briefing include the following:A possible delay strategy could be used to move the peak of the outbreak to warmer months so that it does not overlap with normal flu and allows more time for research;There are plans ready for a range of outcomes, from mild pandemic with low impact on services (like Swine Flu in 2009) through to severe and prolonged pandemic;There are plans for the Ministry of Defence to provide support to Civilian Authorities if requested;If the disease becomes established in the UK, further measures to be considered include school closures, home working and reducing large-scale gatherings;Police would concentrate on serious crimes and maintaining public order if a lot of officers are on sick leave, in the case of the disease being fully established;There could well be an increase in deaths, particularly amongst the vulnerable and elderly;Concessions may be made by tax officials if businesses struggle to pay tax bills;Some non-urgent care in the NHS may be delayed to focus on treating coronavirus patients;Recently retired doctors and nurses may be called back to work.While the vast majority of patients will have a mild to moderate illness, similar to seasonal flu, a minority will require hospital care and a small proportion could die, the plans warn.
The policy paper, issued by the Department of Health and Social Care, details what the health and social care system across the UK has done to tackle the coronavirus (COVID-19) outbreak, and what it plans to do next.
It is based on the government’s experience dealing with other infectious diseases and its influenza pandemic preparedness work. It is stressed that the exact response to coronavirus (COVID-19) will be tailored to the nature, scale and location of the threat in the UK, as understanding of this develops.
This document sets out:
What is known about the virus and the disease it causes;How government have planned for an infectious disease outbreak such as the coronavirus (COVID-19) outbreak;The actions taken so far in response to the coronavirus (COVID-19) outbreak;What government are planning to do next, depending on the course the coronavirus (COVID-19) outbreak takes;The role the public can play in supporting this response, now and in the future.
The current novel coronavirus (COVID-19) outbreak, which began in December 2019, presents a significant challenge for the entire world, says the Department. The UK government and devolved administrations, including the health and social care system, have planned extensively over the years for an event like this, it says. Therefore, it is stressed that the UK is well prepared to respond in a way that offers substantial protection to the public.
The initial response to the outbreak has the fundamental objectives to deploy phased actions to Contain, Delay, and Mitigate any outbreak, using Research to inform policy development. The different phases, types and scale of actions depends upon how the course of the outbreak unfolds over time, says the plan. The overall phases of the plan to respond to COVID-19 are as follows:
Contain: detect early cases, follow up close contacts, and prevent the disease taking hold in this country for as long as is reasonably possible;Delay: slow the spread in this country, if it does take hold, lowering the peak impact and pushing it away from the winter season;Research: better understand the virus and the actions that will lessen its effect on the UK population; innovate responses including diagnostics, drugs and vaccines; use the evidence to inform the development of the most effective models of care;Mitigate: provide the best care possible for people who become ill, support hospitals to maintain essential services and ensure ongoing support for people ill in the community to minimise the overall impact of the disease on society, public services and on the economy.
Ultimately, the response to COVID-19 is guided by the international situation, the advice of organisations such as the WHO, surveillance, data modelling based on the best available evidence and the recommendations of expert bodies.
System wide response plans for pandemic influenza, focused on the continuity of public and critical services and the stability of the economy, have been adapted for COVID-19, based on the best available scientific evidence and advice. Click here for the latest information on the current situation.
It is stressed that the nature and scale of the response depends on the course of the disease, which cannot be predicted accurately at this point. As understanding of the disease increases and its impact becomes clearer, the government will issue further detailed advice about what to expect if/when further measures become necessary.
In addition to actions taken as part of the Contain phase, the plan emphasises the actions that people can be taking themselves to help delay the peak of the infection; especially washing hands more; and the catch it, bin it, kill it strategy for those with coughs and sneezes.
Delaying the spread of the disease requires everyone to follow the advice set out in this document. The benefits of doing so are that if the peak of the outbreak can be delayed until the warmer months, the risk of overlapping with seasonal flu and other challenges (societal or medical) that the colder months bring can be significantly reduced.
The role the public can play
The plan stresses that everyone can help support the UK’s response by:
Following public health authorities’ advice, for example on hand washing;Reducing the impact and spread of misinformation by relying on information from trusted sources;Checking and following the latest FCO travel advice when travelling and planning to travel;Ensuring you and your family’s vaccinations are up to date as this will help reduce the pressure on the NHS/HSCNI through reducing vaccine-preventable diseases;Checking on elderly or vulnerable family, friends and neighbours using NHS 111 (or NHS 24 in Scotland or NHS Direct Wales) (including online, where possible), pharmacies and GPs responsibly, and go to the hospital only when you really need to;Being understanding of the pressures the health and social care systems may be under, and receptive to changes that may be needed to the provision of care to you and your family;Accepting that the advice for managing COVID-19 for most people will be selfisolation at home and simple over the counter medicines;Checking for new advice as the situation changes.
What happens next?
In the event of the outbreak worsening, or a severe prolonged pandemic, the response will escalate, and the focus will move from Contain to Delay, through to Mitigate. During this phase the pressures on services and wider society may start to become significant and clearly noticeable, says the plan.
It is noted that if the disease becomes established in the UK, we will need to consider further measures to reduce the rate and extent of its spread. Based on experience with previous outbreaks, it may be that widespread exposure in the UK is inevitable; but slowing it down would still nonetheless be beneficial.
The plan notes that:
Government will increase publicity about the need for good hygiene measures (hand washing, and catch it, bin it, kill it) and further promote the need for people with symptoms to stay at home for the full duration of their illnessOther actions taken to achieve a Delay in the spread of the disease will be taken. This could include population distancing strategies such as school closures, encouraging greater home working, reducing the number of large scale gatheringsConsideration will be given to measures to protect vulnerable individuals with underlying illnesses and thus at greater risk of becoming seriously affected by the disease.
As and when more is discovered about the disease and what, if any, impact its course has on the UK, the government will provide further updates on how our plans are being adapted to respond to specific, changing circumstances.
Coronavirus: Advice for businesses
The Budget Chancellor Rishi Sunak has ordered Treasury officials to work up plans to support the public health response, businesses and the economy in his Budget on 11 March.Bank of England governor Mark Carney said policymakers stand ready to help businesses and households through an economic shock caused by the virus that could “prove large but will ultimately be temporary.”A public information campaign will be launched later this week outlining how the public can help to limit the spread of the virus, including by washing hands regularly with soap and water.
The TUC is calling on the government to respond to the COVID-19 outbreak by providing emergency support for the millions of UK workers who are currently missing out on Statutory Sick Pay (SSP).