The issue in tracking the spread of the SARS-CoV-2 virus throughout the population is that the two tests being suggested are, an untested antibody test, providing best results 21-28 days after showing symptoms of the COVID-19 disease, or a manpower, technology, reagent and skills intensive PCR test looking for active virus a period of time post infection.
A percentage of the population remains asymptomatic as they carry the virus but can transmit it.
The PCR tests are and will always be resource limited. Those infected with the SARS-CoV-2 virus may be infective for a period before the PCR tests will identify active infection. The test is only accurate at the moment of time the swab was taken and there is nothing to stop someone not infected at the time of test being subsequently infected at any time after the test. The reagents needed for the test are in a short supply across the globe and testing facilities are becoming overwhelmed.
Current “mass” screening capability used in several countries uses thermal cameras looking for people with elevated temperatures. However, it will not identify asymptomatic carriers and only detects one symptomatic indicator.
What is needed are a series of complimentary tests able to identify an infection and immune system activation as early as possible so that infected persons can isolate as early as possible to reduce cross infection risk, once isolated then individuals can be tested for specific viruses such as SAR-CoV-2 and then for antibodies.
Tests should be simple and cost effective enough to allow individuals to be tested as often as is deemed necessary. For example, healthcare staff on arrival at work and on leaving work each day. There is currently insufficient PCR capability to do this and it is unlikely there ever will be. PCR tests are relatively expensive.
Research post the original SARS epidemic believed to have emerged in 2002 identified the utility of a viral infection marker produced by the body as part of a stimulated immune response. The marker is called Neopterin. There are numerous scientific papers outlining the utility of this chemical marker including:
The immune system being activated and releasing Neopterin is not specific to SARS-CoV-2, however it is an early warning system that something is going on; currently there is no test that does this.
Professor Colin Self, an Emeritus professor with Newcastle University and recognised leading testing scientist as developed a simple revolutionary test that could be used for that early warning capability utilising the detection of Neopterin in saliva.
The base technology used for the test has been developed over many years of research under Framework 7 and Horizon 2020 funded research projects. It can be used to detect any small molecule where a specific antibody for that molecule can be found. It is simple positive read out test, that gives results in less than 2 minutes.
As an antibody is specific to a particular chemical structure, this methodology is extremely accurate. Professor Self has a very pure cell line producing antibodies to Neopterin. The use of saliva, the positive read out if neopterin is present and the speed of testing allows self-testing and self-reading of the result. Each test if produced in volume batches, only costs a few pounds.
Imagine everyone being able to test themselves several times a day and if positive the more expensive PCR tests can be used in a targeted way to track SARS-CoV-2, if negative you know you do not have an immune stimulating infection.
Professor Self has told me that whilst his test is in storage as his research grants have finished, he has identified a qualified team with availability, facilities to produce a production standard test in approximately 6 weeks and then the manufacturing process to produce 10’s of thousands of test strips per day or potentially significantly more would be easily achievable. His tests don’t need special reagents, he can grow volumes of the relevant antibodies quickly, large numbers of test strips can be manufactured easily.
A video of the test being used in real time is below:
The presence of small molecular weight analyte (Neopterin) gives rise to a positive line appearing out of a clear white background. Intuitively, the more line is seen the more Neopterin is present.
The cassette dipstick on the left receives neopterin-free buffer, whereas the cassette dipstick on the right receives buffer containing the small molecular weight analyte.
During the, real-time run, both cassette dipsticks display a positive control line towards the top of the window to show the devices have been used correctly. Only the cassette receiving a positive sample shows a positive test line, towards the bottom of the window.
This occurs very quickly. The fact that the positive sample is indeed positive can be seen by eye within a matter of seconds, allowing immediate action to be taken if necessary. Further development of the sticks over two minutes, allows the control line to stabilise and a quantitative determination of the concentration of the analyte.
All Professor Self needs is help taking this ground-breaking test to production. It could enable better control of pandemic conditions.
A war which is unrestricted in terms of the weapons used, the territory or combatants involved, or the objectives pursued, especially one in which the accepted rules of war are disregarded is the definition of ‘Total War’ in the Oxford Dictionary. The global fight against the invading army of microscopic virus particles is without doubt a total war. The fight against SARS-CoV-2 can be defined in no other way than World War 3.
The enemy front line in this conflict are those directly affected by it, those wilding the weapon of mass destruction that is the virus, it is the people, all the people of planet earth as anyone could be carrying it, anyone could spread it, anyone could catch it, anyone can die from it.
The SARS-CoV-2 weapon is the COVID-19 disease it causes, and the effectiveness of that weapon is enhanced by the ability of the virus to move silently, undetected through the population, killing only a very few, but generating fear in many and disrupting if not destroying what was normality.
The deep battle fighting the viral enemy has two distinct elements, firstly the political battle, bringing in restrictions to ensure social distancing, allocating resources to ensure those fighting the close battle have what they need and the second element is scientific research, trying to find a better testing regime for the virus and a vaccine for the disease. The tacticians and planners are our chief scientists, chief medical staffs and financial planners. They are preparing the ground for those fighting the close battle.
The close battle is being fought by our doctors, nurses and paramedics; in military terms they are the F echelon, the fighting echelon. Of course, they need support and that support is provided by the laboratory staff, the other health care staff including porters, cleaners, volunteers, military personnel and more; they are the B echelon, the vital element keeping the f-echelon able to focus on the task in hand, fighting the disease, COVID-19 caused by the virus, the global enemy.
Corona viruses have caused conflict before this century, three coronaviruses have crossed the species barrier to cause deadly pneumonia in humans: severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV), and SARS-CoV-2. However, SARS-CoV and MERS-CoV only caused limited wars unlike the new deadly SARS-CoV-2 that has plunged the world into the new total war, that is our third World War.
The potential for a global conflict against a viral attacker is nothing new. Bill Gates said at the 2017 Munich Security Conference, “We ignore the link between health security and international security at our peril.” He concluded his talk by saying “When the next pandemic strikes, it could be another catastrophe in the annals of the human race. Or it could be something else altogether. An extraordinary triumph of human will. A moment when we prove yet again that, together, we are capable of taking on the world’s biggest challenges to create a safer, healthier, more stable world.”
We are seeing national and international industries change their focus and deliver vital war equipment; Dyson, JCB and Mercedes F1 delivering ventilators, airline staff delivering medical support, people from all walks of life helping supermarkets, delivery companies, charities and so many other initiatives. Our industry is on a total war footing.
We are seeing in a limited way at the moment but have no doubt it has the potential to increase, the use of deception, fake news and propaganda. This is where our responsible national media have moved to a total war footing, fact checking, broadcasting public information broadcasts and more.
What we have to realise is we can’t target the enemy directly this way like Sun Tsu espoused in the 6th century when he said, “All warfare is based on deception. Hence, when we are able to attack, we must seem unable; when using our forces, we must appear inactive; when we are near, we must make the enemy believe we are far away; when far away, we must make him believe we are near.” However, those comments could fit perfectly with the need for social distancing. But the lesson from this is we shouldn’t open a second front, exploitable by the virus by fighting amongst ourselves. This is a time for all to come together to fight a common enemy and put human differences to one side.
The US surgeon general, Jerome Adams told Chuck Todd on NBC’s “Meet the Press.”, “the next week is going to be our Pearl Harbor moment.”
Her Majesty the Queen continued the wartime analogy when she said in her rousing speech watched across the globe: “I am speaking to you at what I know is an increasingly challenging time.
“A time of disruption in the life of our country: a disruption that has brought grief to some, financial difficulties to many, and enormous changes to the daily lives of us all.”
“It reminds me of the very first broadcast I made, in 1940, helped by my sister. We, as children, spoke from here at Windsor to children who had been evacuated from their homes and sent away for their own safety.”
“Today, once again, many will feel a painful sense of separation from their loved ones.”
“But now, as then, we know, deep down, that it is the right thing to do.”
“While we have faced challenges before, this one is different.”
“This time we join with all nations across the globe in a common endeavour, using the great advances of science and our instinctive compassion to heal.”
“We will succeed – and that success will belong to every one of us.”
“We should take comfort that while we may have more still to endure, better days will return: we will be with our friends again; we will be with our families again; we will meet again.”
Invoking the emotion generated by our last global conflict. Her Majesty has clearly made the link to the current global conflict, World War 3, battling a virus, SARS-Cov-2. Ma’am, we will meet again.
Some see a perceived lack of testing as the latest stick to beat the government up with the current COVID-19 crisis. The perception that is being left with the general public and with healthcare workers is that testing will provide some magic solution to the crisis. The reality is, being blunt, it won’t; being more accurate, each test has its strengths and weaknesses and no one test is the complete answer, they will only help our understanding of the spread of the infection and help keep us safer.
The current test, which is the one being scaled up, is an ‘antigen’ test. Antigens are molecules capable of stimulating an immune response in the body and that immune response is the start of the production of antibodies.
The antigen test requires a swab to be taken, usually from the back of the throat. That swab then needs to be sent to a laboratory where the antigen is scientifically amplified and compared with a reference to see if it is what they are looking for. This test, called the Polymerase Chain Reaction (PCR), often referred to as real-time PCR (rt-PCR), or the quantitative PCR (qPCR) test, requires trained laboratory technicians, specialist equipment and time for each test, as well as an administrative burden matching tests to results and informing individuals of results.
The current PCR test is an excellent technology but leaves a window as it misses some early cases, at times not detecting infection until a period post symptoms, even though the person can be highly infectious during that time. The test is also manpower and equipment limited, needing people to take samples, technicians and scientists to process and interpret the tests and staff to deliver the results.
Of course, a negative test one day does not mean the individual could not become infected the next day, and this is why it is essential the complimentary Antibody test is further developed and rolled out to identify who has had the infection.
This is a much simpler test using a sample of blood taken from a finger pin prick and it is then put into a device like a pregnancy test kit, but the chemistry on the test stick is designed to look for antibody. Antibodies (sometimes called immunoglobins (IgM and IgG)) are proteins produced by the body over the course of a week or two in response to an infection and are there to fight the infection. Each antibody is designed to recognise a specific part of the cause of the infection (the antigen), lock onto it and stop it replicating thereby fighting the infection.
With the antibody test, a solution is added, and the blood sample moves up the test paper stick, interacting with the chemistry on the stick and giving an indicator that the antibody is present. This will tell someone that they have had the COVID-19 disease in some form and only takes a few minutes to carry out. It does not indicate early infection or necessarily that an individual currently has the infection.
There are other tests currently being offered to the fight against COVID-19 that will complement the PCR antigen and the antibody test. This test is similar in its physical form to the antibody test, but the chemistry is very different. It detects a key very early marker of the activation of the immune system in the body produced from the very early stages of the infection. This happens as the infection enters the body and is active as the body produces certain ‘help’ molecules. A marker that has been identified, following a great deal of research activity into HIV and earlier SARS infections is called neopterin.
The neopterin test does not specifically identify that an infection is COVID-19, but it does detect that someone is suffering from an activation of their immune system and, as such can detect infection at a much earlier stage in the disease than any of the other tests. It is a very simple to use and understand lateral flow test (as a pregnancy test) and can be used and interpreted by health workers and the general public, requiring no specialist support. It is projected to be non-invasive by using only a small sample of saliva, with the test results showing a positive result with a red line in a few minutes only if the individual is suffering a current viral infection.
This new test is not yet part of the governments offering but would complement the other two allowing the resource and time-consuming PCR test to be used only on those who have a positive indication of a viral infection and, critically, detecting those that are too early in the course of infection to be detected by the PCR or antibody test. It could also be used much more frequently as part of a wider screening programme as it can be self-administered, self-interpreted and produces rapid results and allow more informed self isolation, thereby reducing cross infection, potentially dramatically.
What is important is that the strengths and limitations of each type of test are known and understood and that a range of complimentary tests are available to maximise the collection of results that will rapidly let the health system and public understand the risks.
This article was written by Philip Ingram MBE with the some help from Professor Colin Self BSc, MB, BChir, PhD, DSc, FRSC, FRCPath who has developed the Neopterin test. Please use the contact us page if you want further details.
Travel is being restricted, people are being told to work from home, meeting cancelled, companies are desperately trying to take business online and remote, events are cancelled or postponed. The great British wartime spirit is being displayed by most as the few riot over toilet rolls, panic buy on a first come first served basis, forget our elderly, our sick, it’s me first; but one thing will be at the back of everyone’s mind; “what next?” This brings out the best in many if not most and the worst in some; a sad reflection on elements of our community. Businesses must be asking “how do I maintain my business proactivity?”
For businesses, many that can afford to are looking for ways to provide support to front line services. Only yesterday I was contacted by the investigation’s software company Altia-ABM asking for introductions to front line services who may benefit from their capabilities for free. We are seeing reports of major manufacturers like JCB and Dyson changing their production lines to make medical ventilators, we are hearing of distilleries switching to the production of alcohol-based hand gel (and not for internal use).
One thing is clear, the current COVID-19 pandemic is changing and will change the business landscape for some time to come if not make a permanent change. However, the first thing to recognise is that capabilities will still be needed, help provided, services delivered. The world is not stopping completely, so businesses that take a proactive approach are more likely to come out the other side of this crisis better than those that don’t. That is just simple logic.
So, what do I mean by a proactive approach in an environment with no meetings, increasingly restricted travel and no events? It is all about communicating, about informing, about contributing. It’s all about keeping a sense of perspective and as much of a sense of normality as possible. The crisis will pass, and a newer version of ‘normality’ will return so it is important that businesses don’t just disengage completely.
So how do you engage, what should you be doing?
First and foremost, inform, inform, inform. Keep your staff and customers up to date with what is happening. Ensure you have clear statements and contact details on the front of your websites if appropriate and in your telephone answering system. You know who your main customers are, make sure you or your team are talking to them throughout this crisis.
Secondly, secure, secure, secure. Threats to your data, your IP are not going to go away and will likely increase over the crisis period. GDPR fines will not be waived for careless data breaches so ensure your working practices for remote working are as secure as your practices in the office. Those that were a threat before COVID-19 hit are still a threat and will see this as an opportunity. Be on the lookout for phishing, malware, ransomware and people exploiting online social engineering opportunities.
Thirdly, engage, engage, engage. Don’t fall into the trap of isolating yourself, your business, your services. There are lots of ways to remain engaged. Talk to your suppliers and customers, keep them reassured. Publish articles, blogs, thought pieces, updates on your website and use email and social media to distribute them widely. Engage on social media, a perfect way to keep your followers confident that all is as normal as it can be. Finally look for different opportunities to communicate. I am doing PODCASTS and will likely start restart VLOGS as well. Webinars have long been an excellent way of delivering informed content and good debate. The key to getting and maintaining your audience is to provide good informative content.
With all of the social media enabled communications means almost enabling the building of a virtual world, this is a perfect opportunity to stand out from the rest and show how progressive you can be making the transition back to proper normality that much easier. So, don’t sit and wat for something to happen, take the initiative and be proactive that is the key to standing out in this crisis.
Note:: Grey Hare Media provides focused content – drop us a line or gave a call for a chat to see if we can help. It costs nothing to chat and could save or better your market position.
One of the worst things a Prime Minister has to admit to his country is that, “many more families are going to lose loved ones before their time,” as Boris Johnson was forced to say in his press conference about what the UK was going to do about the COVID-19 pandemic. He, with the country’s chief scientist and the Chief Medical Officer for England and Wales, who had consulted got agreement with the Chief Medical Officers of Scotland and Northern Ireland, explained the current position with the COVID-19 pandemic and what the government’s response would be.
The general feeling after the briefing was it was considered, informative, measured and frightening all at the same time. However, this hasn’t stopped the armchair scientific and medical experts such as Nigel Farage and Piers Morgan from berating the response because it doesn’t match or go further than the responses of some other countries. Comments from influencers like Morgan, such as “The government seems to be avoiding draconian ‘shutdown’ action now because we will all get too bored with it,” display a shocking naivety that, from a journalist, is at the least unhelpful and is certainly unprofessional. Maybe now is the time to do a proper intelligence assessment of what we know.
The thing to realise about intelligence assessments, as intelligence is very often blamed after the fact for not seeing things that were not there at the time of writing. It is an assessment at a snapshot of time and as the situation develops and more information, or ‘unknowns’ be come known, then it is likely to change. No enemy on the battlefield follows your plan because it is in your intelligence assessment, no terrorist gets caught because you have assessed how small the threat is, no virus will do exactly what you predict.
What is a virus?
The microbiological society describes a virus as the smallest of all microbes. With some, they are so small that 500 million could fit on to the head of a pin. They are unique because they are only alive and able to multiply inside the cells of other living things. The cell they multiply in is called the host cell.
A virus is made up of a core of genetic material, either DNA or RNA, surrounded by a protective coat called a capsid which is made up of protein. Sometimes the capsid is surrounded by an additional spikey coat called the envelope.
Under a process called Lysis, virus particles burst out of the host cell into the extracellular space resulting in the death of the host cell. It is this that causes the damage to the host organism, and the symptoms experienced, when many cells are killed. Once the virus has escaped from the host cell it is ready to enter a new cell and multiply.
An organism, if exposed to the virus or a similar version may have a degree of immunity as it has the genetic pattern to develop antibodies to fight the viruses and restrict their spread. The danger is when a novel virus is discovered, as organisms will have no pre prepared defences to these.
The next question has to be, what is CoronaVirus and what is COVID-19?
According to the Centre for Disease Control and Prevention in the US (CDC), coronavirus is the name for a family of viruses that were first identified in the 1960’s. They are named for the crown-like spikes on their surface (envelope) and there are four main sub-groupings known as alpha, beta, gamma, and delta.
People around the world commonly get infected with some human coronaviruses and in recent years it has been identified that coronaviruses that infect animals can evolve and jump the species gap to humans. Three recent examples of this are; severe acute respiratory syndrome, or SARS (SARS-CoV-1), Middle East Respiratory Syndrome, or MERS which were both identified as beta viruses and now we have coronavirus disease 19 or COVID-19 which has been designated as a novel corona virus, i.e. it doesn’t fit into any already known category and therefore any immunity to other types of coronavirus that is present in a species can be bypassed by this strain. The name of the virus that causes COVID-19, the disease, is Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2).
Comment: Much is already known about coronaviruses, about their protein makeup, their genetic coding, their transmission, their strengths and their weaknesses, there has been over 50 years research into them already and SARS and MERS have given recent impetus to the scientific community. SARS-COV-2 is closely related to SARS-COV-1 which emerged in 2002. Therefore, the scientific fight against COVID-19 disease is not from a standing start, it is from a position of many years research. Comment Ends.
Where did COVID-19 come from?
Here conspiracy theories abound, as the reality is the origin of SARS-CoV-2 is only a scientific assessment. However, based on over 50 years research into coronaviruses and that the international scientific community is quick at checking and commenting on all of the relevant works and studies in the scientific community, their current assessment is probably accurate; it is certainly extensively peer reviewed.
The World Health Organisation (WHO) situation report of 21st January 2020 said that on 31st December 2019, the World Health Organisation’s (WHO) China office heard the first reports of a previously unknown virus behind a number of pneumonia cases in Wuhan, a city in Eastern China.
On 11 and 12 January 2020, WHO received further detailed information from the National Health Commission China that the outbreak is associated with exposures in one seafood market in Wuhan City.
In February nature magazine reported that, “Chinese scientists suggested, on the basis of genetic analyses the prime suspect was the scaly ant eating pangolin. However, it then went on to say that scientists have now examined that data and say that although the animal is still a contender, the mystery is far from solved.
Other animals that are known as host of various coronavirus strains are Bats and they, like the Pangolin, were sold live in the Wuhan market. MERS and SARS were originally corona viruses hosted on bats, so it is now thought that they are the most likely contender.
Apportionment of its source is made slightly more conspiratorial by the fact that Wuhan is the site of China’s only facility designated at Biosafety Level 4 (BSL-4) and is known as the Wuhan Centre for Disease Control (WHCDC). It was constructed in 2004 following the SARS emergency to conduct research into countering such viruses. Level 4 facilities are designed to stop the escape of even the smallest particles, so accidental escape is highly unlikely. Despite sensational speculation in some press circles, there is no evidence in the scientific community that the COVID-19 disease is a result of WHCDC activity.
Comment: Coronavirus species jumps have been identified in the past, bats were identified as the source of the SARS corona virus and given the initial reporting in the city of Wuhan, the focus around the seafood market, it is highly likely that the ground zero for the COVID-19 disease is Wuhan and the seafood market. However, it is possible that the exact source will never be identified and therefore likely that sensationalised speculation will continue. Comment Ends.
How dangerous is COVID-19?
COVID-19 is a new illness and as such no one will have any inherent immunity to the virus that causes it and an understanding of how the disease develops in humans is just being observed. This lack of inherent immunity means that the herd immunity principals that restrict the spread of known viruses and the peak of their impact in numbers, does not exist.
The main symptoms of COVID-19 are a cough, a high temperature and, in severe cases, shortness of breath.
According to NHS England, because COVID-19 is a new illness, exactly how it is spread from person to person is not fully understood. However, the WHO says, “The disease can spread from person to person through small droplets from the nose or mouth which are spread when a person with COVID-19 coughs or exhales. These droplets land on objects and surfaces around the person. Other people then catch COVID-19 by touching these objects or surfaces, then touching their eyes, nose or mouth. People can also catch COVID-19 if they breathe in droplets from a person with COVID-19 who coughs out or exhales droplets.”
It goes on to say, “Illness due to COVID-19 infection is generally mild, especially for children and young adults. However, it can cause serious illness: about 1 in every 5 people who catch it need hospital care. While we are still learning about how COVID-19 affects people, older persons and persons with pre-existing medical conditions (such as high blood pressure, heart disease, lung disease, cancer or diabetes) appear to develop serious illness more often than others.”
The UK Government says, “a minority of people who get COVID-19 will develop complications severe enough to require hospital care, most often pneumonia. In a small proportion of these, the illness may be severe enough to lead to death. The Prime Minister, Boris Johnson, confirmed this in his statement of 12th March 2020.
On 30 January 2020, the WHO declared the outbreak of COVID-19 a “Public Health Emergency of International Concern” (PHEIC). On 11 March 2020 the WHO formally declared COVID-19 as a pandemic and a pandemic is simply a new disease for which people do not have immunity that spreads around the world beyond expectations.
Exact death rates expressed as a percentage of infections is impossible to accurately state at this time as many who contract the disease will have very mild symptoms, are unlikely to be tested so formally diagnosed and recorded as having it but could still transmit it to others.
Comment: COVID-19 is extremely dangerous to certain parts of the community but will have little impact on most sufferers. However, as there is no herd immunity there is very real potential for the most vulnerable to require hospitalisation all at the same time, overwhelming medical facilities. Anyone with the disease, even with very mild symptoms, can transmit it.
Much has yet to be learned about this disease and its impact but the “So What?” is that it is critical that measures to reduce the number of severe cases and spread them over as long a time period as possible, to ensure medical facilities and staff are not overwhelmed, are taken. Those measure must be taken by all potential sufferers to have the best outcome.
People should take statistics in the press with an understanding of the reality that they are likely wrong and an over exaggeration of the risk if taken in isolation. Comment Ends.
What can and is being done about it?
Every county seems to be taking a slightly different approach to dealing with the COVID-19 pandemic, which is fuelling political opportunism, sensational headlines playing on the very real fears of the population, and in turn causing anxiety in the financial markets wiping billions of their value. One thing is clear, it will pass.
The UK has very robust, tried and tested processes and procedures for dealing with pandemics. This is nothing new and the WHO has been talking about the threat form a disease X scenario for some years. Understanding of the spread, measures to deal with it for theoretical diseases have been modelled and exercised frequently and the government has a series of plans to deal with these incidents ready to go.
On 03 March 2020 the Government published its Coronavirus (COVID-19) action plan based on its experience in dealing with other infectious diseases and its influenza pandemic preparedness work. The UK government and devolved administrations, including the health and social care system, have planned extensively over the years for an event like this. The UK is therefore well prepared to respond in a way that offers substantial protection to the public.
The plan confirms that, “The majority of people with COVID-19 have recovered without the need for any specific treatment, and it is expected that the vast majority of cases will best be managed at home.
The planning principles for the UK and Devolved administrations used are:
Undertake dynamic risk assessments of potential health and other impacts, using the best available scientific advice and evidence to inform decision making.
Minimise the potential health impact by slowing spread in the UK and overseas, and reducing infection, illness and death.
Minimise the potential impact on society and the UK and global economy, including key public services.
Maintain trust and confidence amongst the organisations and people who provide key public services, and those who use them.
Ensure dignified treatment of all affected, including those who die.
Be active global players – working with the World Health Organization (WHO), the Global Health Security Initiative (GHSI), the European Centre for Disease Prevention and Control (ECDC), and neighbouring countries, in supporting international efforts to detect the emergence of a pandemic and early assessment of the virus by sharing scientific information.
Ensure that the agencies responsible for tackling the outbreak are properly resourced to do so, that they have the people, equipment and medicines they need, and that any necessary changes to legislation are taken forward as quickly as possible.
Be guided by the evidence, and regularly review research and development needs, in collaboration with research partners, to enhance our pandemic preparedness and response.
The key is that they are evidence based, balanced, well planned and frequently modelled and lead to four phases:
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.
The aim across the board is to delay the onset of rapid cross infection throughout the population and spread the peak and most severe cases out over a longer time period enabling current and surge medical capabilities to deal with the effects of the COVID-19 disease on those most affected.
However, a plan is only as good as those who adhere to it and the government advice to the general public needs the general public to follow that advice if there is a hope of the plan succeeding. Social distancing, seeking advice from the 111 website, handwashing are all examples of what the general public need to do to keep the government plan on track and to save as many of the most vulnerable and severe cases as possible.
Comment: The measures being outlined to deal with the COVID-19 epidemic are considered, modelled, progressive, well planned and thought through by every expert in the field. They are not made up ‘on the hoof’ and are designed to minimise the impact on sufferers, society, business and life in general. The measures do require a greater public understanding and cooperation, and this is one time when sensationalism and speculation is unhelpful at best, but more likely deadly. Comment Ends.
Why are other governments taking different actions?
Other governments may take different actions as they have different cultural norms, different scientists with differing opinions, they are likely to be at a different stage of the pandemic and all healthcare systems and social care system likely differ so strain and breaking points won’t be the same between countries. A final consideration is there is a possibility of different political considerations in decision making for example, France’s closing of schools and universities puts additional strain on adults, some of whom are key to the yellow vest processes, the banning of groups of 100 or more again could (and I emphasise could as I don’t believe this question has been asked), make it easier for President Macron to control anti Government sentiment such as the yellow vest protests which with greater pandemic spread could flare up more. In Ireland, the pressure from the closure will force the political parties to agree a new government more quickly. Unfortunately in this world one has to consider political actions as part of disaster consequence management.
The key is when you make drastic decisions such as closing schools, as you want to leave them as late as possible to reduce the social impact but take them as early as possible to reduce the spread – the Government is doing that and the scientists are watching for that point on a daily basis. Thank goodness it is an evidence based decision and not a politically expedient one or and emotionally based one. Things could be very different if we had a minority government in power and politics, not evidence based science, drove decision making.
Assessment: The current COVID-19 pandemic is a serious situation that will likely result in a number of deaths, that number will be a very small percentage of those who catch the disease as most people will recover, many without ever being formally diagnosed.
Critical to keeping the death toll to the lowest numbers possible is flattening out the peak number of severe cases at any one time in order to reduce the burden on medical facilities and personnel.
Current understanding of how pandemics spread is good, current planning for dealing with pandemics has been scrutinised by some of the best brains in the country and are generally well thought through. They rely on evidence-based assessments and have been modelled extensively.
COVID-19 will disrupt normal activities for a period of time and then society will recover. However, as ever, the success of any plan requires the support and cooperation of all involved, and in a pandemic scenario that means the general population. Recovery time for society will depend on cooperation and sticking to a well tested plan.
MERS, SARS, COVID-19 are just the latest in a series of viral infections, there will likely be more in the future and many will have a smaller impact but the potential remains for some with an even greater impact on society. Assessment Ends.
The best advice remains that on the front cover of Douglas Adam famous book, “The Hitch Hikers Guide to the Galaxy,” it says: “Don’t Panic.” The current continuously updated statistics for the pandemic can be followed here: https://www.worldometers.info/coronavirus/
This blog was written by Philip Ingram MBE a former senior Military Intelligence officer and specialist in CBRNE. He grew up in a family immersed in disease identification and control as his late father, Brian, ran a laboratory at the local hospital and his biomedical science journals were Philip’s youthful reading. He is always available for comment through the contact us page. You can always listen to this blog through our PODCAST site by clicking here:
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