- People in the UK told to stay at home in an effort to combat the spread of the COVID-19 virus.
- Schools and nurseries in the UK have been temporarily closed.
- Those who develop symptoms - a new continuous cough and/or high temperature – must self-isolate for seven days.
Coronaviruses are micro-organisms that cause serious infectious diseases. Previous outbreaks have included Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV).
COVID-19 is a new strain of coronavirus which first appeared in the Wuhan region of China at the end of 2019. The virus proved highly infectious and rapidly spread to other countries through infected travellers. In January 2020 the World Health Organisation declared a global emergency and early in March they defined the disease outbreak as a pandemic.
The virus spreads from person to person in droplets from the nose or mouth of an infected person. These are spread when the person coughs or exhales. Others become infected when they breathe in the droplets or touch contaminated surfaces and then touch their eyes, nose or mouth. Incubation is between 2 to 14 days.
It is known that some people may be infected but remain symptom free. However, it is not known if they can pass the virus on to others.
Symptoms and treatment
Symptoms of COVID-19 include fever, tiredness, and persistent dry cough. Other symptoms such as aches and pains, nasal congestion, runny nose, sore throat and diarrhoea are also reported.
Most infected people will have fairly mild symptoms with no significant infection in the lungs. Most people with mild symptoms will recover at home with no treatment needed. They should drink plenty of water and take paracetamol to lower fever.
However, some will have severe symptoms causing serious shortness of breath, low blood oxygen or other lung problems. A minority will suffer critical respiratory failure and pneumonia.
People who are critically ill require hospital treatment. Many will need to be placed on a ventilator.
The exact mortality rate of COVID-19 is as yet unknown. However, the virus has caused thousands of deaths around the world. It is particularly dangerous for older people over 70 and for people with weakened immune systems or long-term conditions, including diabetes, cancer and chronic lung disease.
There is no vaccine currently available and the virus does not respond to known anti-viral medication.
How can people protect themselves?
Public Health England (PHE) state that people can protect themselves from catching COVID-19 by regularly washing hands with soap and water for at least 20 seconds. They are advised to use 60% alcohol hand sanitiser gel if soap and water are not available. PHE also recommend that people cover their mouth and nose with a tissue or with their sleeve when coughing or sneezing. They should not use their hand. Used tissues should be disposed of straight away and frequently touched objects and surfaces cleaned and disinfected. Lastly, they should avoid close contact with people who are unwell and should not touch their eyes, nose or mouth if their hands are not clean.
As well as handwashing and respiratory hygiene, key government strategy is to prevent people from passing the virus on to each other. This is accomplished by ‘locking down’ the country and asking people to ‘self-isolate’ and observe ‘social distancing’ rules.
The following ‘self-isolation’ rules must be followed:
- those who live alone and have symptoms of new continuous cough and/or high temperature - however mild - should ‘self-isolate’ by staying at home for 7 days from the symptoms start
- those who live with others should self-isolate as a household for 14 days from the day the first person in the house became ill.
People self-isolating must stay-at-home. They must not have visitors and should arrange for friends or family to shop for them. They should use the internet and NHS111 online for information and call NHS111 if without internet access or if symptoms worsen. People are asked to avoid going directly to a GP, a pharmacy or a hospital. For a medical emergency they should dial 999.
People do not need to call NHS111 to go into self-isolation.
Social-distancing and lockdown
In addition to self-isolation many countries, including the UK, have introduced mandatory ‘social distancing’ as well as restrictions on people’s movements.
On the 23rd March the Prime Minister announced a ‘lockdown’ where the majority of the population are required to stay at home. They should only go outside if:
- shopping for necessities, such as food and medicine, as infrequently as possible
- to do one form of exercise a day, such as running, alone or with household members
- for medical or care needs, for example to help a vulnerable person
- travelling to and from work, but only if the work cannot be done from home.
Meeting friends, shopping for anything beyond essentials, and gathering in crowds or groups of more than two people are banned.
Every citizen must comply. The restrictions are designed to protect the NHS. They will be enforced by the police and may lead to fines for non-compliance.
To support the lockdown people are being asked to work at home, wherever possible, and to only travel for essential reasons. They should not have visitors, including friends and family.Sporting events have been cancelled and pubs, restaurants, bars, cafes, libraries, outdoor gyms and playgrounds, places of worship and leisure centres have been ordered to close. Shops that sell essentials such as food remain open.
A business operating in contravention of the Health Protection (Coronavirus, Business Closures) Regulations 2020 is committing an offence.
Social distancing means that when people do go out, or when they go to work, they should avoid any unnecessary social contact. They must stay at least 2 metres (about 3 steps) away from anybody outside their immediate household and should stay away from people who are unwell.
Because they are more at risk, vulnerable people such as those aged 70 and over are being strongly advised to stay at home. Even visits from family members must be avoided.
The intention of the lockdown and social distancing policy is to suppress the transmission of the disease and slow it down so that NHS critical care capacity can be protected for the sick. It is hoped that this will be enough to ensure that hospitals can avoid being over-whelmed with the strain of so many sick people all at once.
People are advised to keep in touch using the phone, internet, and social media.
The lockdown rules will be kept under review. In time the transmission rate of the virus will be suppressed far enough for the lockdown requirements to be gradually relaxed.
Guidance on social distancing for everyone in the UK can be found at www.gov.uk/government/publications/covid-19-guidance-on-social-distancing-and-for-vulnerable-people/guidance-on-social-distancing-for-everyone-in-the-uk-and-protecting-older-people-and-vulnerable-adults
‘Shielding’ high-risk individuals
Arrangements have been introduced to ‘shield’ people considered as especially high-risk.
‘High-risk’ individuals are identified as those who:
- have had an organ transplant
- are having certain types of cancer treatment
- have blood or bone marrow cancer, such as leukaemia
- have a severe lung condition, such as cystic fibrosis or severe asthma
- have a condition that makes them much more likely to get infections
- are taking medicine that weakens their immune system
- are pregnant and have a serious heart condition.
People in these categories have been written to by the NHS advising them not to leave their home for a period of at least 12 weeks from receipt of the letter. They are urged to avoid close contact with other people in their home, not to go out for shopping, not to visit friends or family, and not to attend any gatherings. Other people living with high-risk individuals are not required to adopt these protective shielding measures for themselves. However, they should be stringent in following guidance on social distancing.
Details of the scheme are set out in Guidance on shielding and protecting people defined on medical grounds as extremely vulnerable from COVID-19 , published by PHE.
A test is available for determining whether somebody has the virus. However, due to a shortage of test kits in the UK these have largely been employed on symptomatic people in hospital. They are not routinely done on people who self-isolate themselves at home. Plans are in place to roll out the testing for NHS workers.
It is hoped that additional antibody tests will become increasingly available. These will be able to show whether someone recently had coronavirus, even if they had no symptoms.
More widespread testing is seen as key to tackling coronavirus.
Schools and nurseries in the UK were closed by the government on the 20th March. Exceptions are a network of schools that have remained open in order to provide places for the children of critical ‘key’ workers and for vulnerable children where safe alternative arrangements for their care at home cannot be made. All other children must stay at home with their parents or guardians.
The government position is that schools remain safe for those pupils who absolutely need to attend. However, the fewer children and staff attending school at the moment the better.
With only a small number of pupils attending schools that remain open can greatly reduce the number of staff who are required to go to work.
Local authorities are being asked to coordinate provision.
A range of government guidance applies. This includes:
- Closure of educational settings: information for parents and carers provides information for parents on school closures https://www.gov.uk/government/publications/closure-of-educational-settings-information-for-parents-and-carers
- Guidance for schools about temporarily closing sets out the vital role of schools during the crisis in looking after key worker children and vulnerable children https://www.gov.uk/government/publications/covid-19-school-closures
- Guidance for schools, colleges and local authorities on maintaining educational provision explains what is meant by ‘key workers’ and who should be identified as ‘vulnerable’ children https://www.gov.uk/government/publications/coronavirus-covid-19-maintaining-educational-provision/guidance-for-schools-colleges-and-local-authorities-on-maintaining-educational-provision
- Coronavirus (COVID-19): cancellation of GCSEs, AS and A levels in 2020 explains what will be done to provide qualifications for pupils who have been forced to miss their exams https://www.gov.uk/government/publications/coronavirus-covid-19-cancellation-of-gcses-as-and-a-levels-in-2020/coronavirus-covid-19-cancellation-of-gcses-as-and-a-levels-in-2020
- Coronavirus (COVID-19): safeguarding in schools, colleges and other providers: Guidance for schools and colleges to support them keeping children safe, including online, during the coronavirus (COVID-19) pandemic https://www.gov.uk/government/publications/covid-19-safeguarding-in-schools-colleges-and-other-providers
- Further guidance on the protection of vulnerable children is contained in Coronavirus (COVID-19): guidance on vulnerable children and young people https://www.gov.uk/government/publications/coronavirus-covid-19-guidance-on-vulnerable-children-and-young-people
Schools that remain open must ensure the safety of staff and pupils. Further guidance applies:
- COVID-19: guidance for education settings includes cleaning advice and explains what to do if someone is confirmed or suspected to have COVID-19 at school https://www.gov.uk/government/publications/guidance-to-educational-settings-about-covid-19
- Coronavirus (COVID-19): implementing social distancing in education and childcare settings explains how schools can help to ensure that pupils attending are able to maintain a safe distance from others https://www.gov.uk/government/publications/coronavirus-covid-19-implementing-social-distancing-in-education-and-childcare-settings
Additional school COVID-19 guidance can be found on the GOV.UK website relating to safeguarding, travel advice, isolation for residential schools and free school meals.
Teachers working from home are engaged in supporting the majority of school pupils who are at home with their parents. These efforts to support home schooling are predominantly carried out via online educational platforms.
Parents are being asked to do everything they can to ensure that their children cooperate with home schooling efforts and are not mixing socially in a way which can continue to spread the virus. They are also being urged to avoid relying for childcare on people who may be vulnerable to infection, such as grandparents or friends or family members with underlying conditions.
It is important that school governors, heads, leadership teams and staff keep as up-to-date as possible with the latest official guidance. The outbreak has escalated rapidly so check often for updates.
The following sources may be useful:
- The NHS111 online service https://111.nhs.uk/service/COVID-19/
- Daily data on the outbreak from the Department of Health and Social Care www.gov.uk/guidance/wuhan-novel-coronavirus-information-for-the-public#information-about-the-virus
- NHS ‘advice for everyone’ on symptoms and treatment www.nhs.uk/conditions/coronavirus-covid-19/
- Public health ‘stay-at-home’ guidance on self-isolation www.gov.uk/government/publications/covid-19-stay-at-home-guidance/stay-at-home-guidance-for-people-with-confirmed-or-possible-coronavirus-covid-19-infection
- Travel advice www.gov.uk/guidance/travel-advice-novel-coronavirus
Information should be passed on to pupils and parents as required.
The information in this article was correct at the time of publishing. Schools should always consult the latest guidance from the government.
Use the following item in the Toolkit to put the ideas in the article into practice:
About the author
Martin Hodgson MSc, PGCEA is a community psychiatric nurse by background, and has had a long career working as a senior manager in various health agencies, including mental health, primary and community care.