Inside the NHS hospital where Britain’s first two coronavirus patients are quarantined and hazmat-clad nurses treat sufferers through a protective TENT to prevent the spread of highly contagious diseases
- Two family members are being treated at Royal Victoria Infirmary in Newcastle
- Team of trained medics have to wear protective gowns, gloves and eyewear
- Some patients treated through clear tent so they don’t touch nurses and docs
- Coronavirus patients had stayed at hotel in York and fell ill on Wednesday night
- Outbreak has killed 213 people and infected more than 9,900 around world
This is the NHS hospital where Britain’s first two coronavirus patients are being quarantined to stop the deadly disease sweeping the country.
The two family members, believed to be Chinese nationals, were rushed into isolation at a specialist unit at the Royal Victoria Infirmary in Newcastle this morning.
Access to the unit is restricted to the team of specially trained medical staff who are made to wear protective gowns, face masks, visors and gloves before entering.
In some cases, a specially-designed tent with a ventilator is set up around the patient’s bed which allows staff to treat and feed them without physically touching them.
It is unclear whether the two coronavirus patients will need this level of care because the Department of Health will not reveal the severity of their illness.
The coronavirus epidemic has killed 213 people in China and infected more than 9,900 around the world, including in the US, France, Australia and Germany.
Britain’s first two coronavirus patients are being treated at the Royal Victoria Infirmary in Newcastle (pictured)
Access to the unit is restricted to the team of specially trained medical staff who are made to wear protective gowns, face masks, visors and gloves before entering (some of its doctors nurses and physios, shown)
The RVI (pictured) is only one of two hospitals in England with the specialised ward, the other being the Royal Free Hospital in London
The coronavirus epidemic has killed 213 people and infected more than 9,900 since it started a month ago
The infected patients were taken to hospital on Wednesday night after complaining of feeling ill while staying at the StayCity hotel in York, MailOnline understands.
When tests results came back positive last night, the pair were driven two hours away to the Royal Victoria Infirmary in Newcastle.
They are being kept in the high consequence infectious disease (HCID) unit at the hospital.
The RVI is only one of two hospitals in England with the specialised ward, the other being the Royal Free Hospital in London.
There are various facilities in place at the RVI, including a laboratory for carrying out tests on infectious patients and dedicated waste units to avoid contamination with regular rubbish.
The air in the ward is funnelled through its own filter to remove the risk of infection spreading throughout the hospital.
Paul Hunter, a professor of medicine at the University of East Anglia, told MailOnline staff will need to wear protective gowns, gloves, face masks and visors for eye protection when entering the ward.
They will need to take their gear off immediately after leaving and dispose of them in extra thick bin bags. These are then put in autoclaves which decontaminate waste.
Actual treatment will depend on how ill the two patients are, according to Professor Hunter.
Asian tourists wearing face masks leave the Staycity Hotel in the centre of York where two family members from China fell ill with Coronavirus
The 220-room Staycity Hotel in the centre of York – a short walk from the Minster – is still open today with only the rooms in the area where the Chinese relatives fell ill cordoned off
British Nationals arrive at RAF Brize Norton in Oxfordshire on a rescue flight from Wuhan where people face two weeks in quarantine
The rate of deaths because of coronavirus is increasing as it reached 213 – and the rate of cases is also rising sharpl
WUHAN CORONAVIRUS: WHAT WE KNOW SO FAR
What is this virus?
The virus has been identified as a new type of coronavirus. Coronaviruses are a large family of pathogens, most of which cause mild lung infections such as the common cold.
But coronaviruses can also be deadly. SARS, or severe acute respiratory syndrome, is caused by a coronavirus and killed hundreds of people in China and Hong Kong in the early 2000s.
Can the Wuhan coronavirus kill?
Yes – 213 people have so far died after testing positive for the virus.
What are the symptoms?
Some people who catch the Wuhan coronavirus may not have any symptoms at all, or only very mild ones like a sore throat or a headache.
Others may suffer from a fever, cough or trouble breathing.
And a small proportion of patients will go on to develop severe infection which can damage the lungs or cause pneumonia, a life-threatening condition which causes swelling and fluid build-up in the lungs.
How is it detected?
The virus’s genetic sequencing was released by scientists in China and countries around the world have used this to create lab tests, which must be carried out to confirm an infection.
Delays to these tests, to test results and to people getting to hospitals in China, mean the number of confirmed cases is expected to be just a fraction of the true scale of the outbreak.
How did it start and spread?
The first cases identified were among people connected to the Huanan Seafood Wholesale Market in Wuhan.
Cases have since been identified around China and are known to have spread from person to person.
What are countries doing to prevent the spread?
Countries in Asia have stepped up airport surveillance. They include Japan, South Korea, Thailand, Hong Kong, Indonesia, Malaysia and Philippines.
Australia and the US are also screening patients for a high temperature, and the UK announced it will screen passengers returning from Wuhan.
Is it similar to anything we’ve ever seen before?
Experts have compared it to the 2003 outbreak of severe acute respiratory syndrome (SARS). The epidemic started in southern China and killed more than 700 people in mainland China, Hong Kong and elsewhere.
SCROLL DOWN TO SEE MAILONLINE’S FULL Q&A ON THE CORONAVIRUS
He said if they are suffering from mild symptoms they will be treated the way someone with the flu would be – with paracetamol.
There are no antiviral drugs that can treat the little-known disease so there is no ‘cure’.
Patients just have to wait it out and let the body mend itself, like it does with influenza or a cold.
Professor Hunter said: ‘If patients are more serious – then they’ll be held for a period of time [weeks] to see if they deteriorate.
‘If their oxygen levels drop they’ll be put on oxygen, then they might be given some drugs to help them breathe.
‘If people have got fluid on lungs antidiuretics [drugs that help control fluid balance in the body] , if they progressively get ill then could be put on breathing machies.
These more serious symptoms can happen because the coronavirus attacks the respiratory tract – the lungs and throat.
Most fit and able people will fight off the infection on their own, but for older people, newborns and those with pre-existing medical conditions, it can develop into pneumonia and be fatal.
The patients will likely be kept together, unless it turns out one is old or vulnerable – or if one is much sicker than the other.
They will be screened regularly via throat swabs to check whether they are still infectious. They could be kept in the special unit for a number of weeks.
The Newcastle hospital treating the two patients has urged other patients to attend their appointments as normal.
A spokesperson said: ‘We are currently treating patients with a respiratory illness known as coronavirus.
‘Our hospital is one of five highly specialised infectious disease units capable of dealing with this illness.
‘You should not be concerned – there is no risk to other patients and visitors.
‘All of our services are operating today as usual. If you have a hospital appointment, please this attend as planned.’
The World Health Organization (WHO) said last night that while coronavirus is usually transmitted through human-to-human contact such as a kiss – or a rogue sneeze or cough.
The virus also survives for a short period of time on surfaces and inanimate objects such as tables, handrails, handles, cutlery and glasses.
Health officials in the UK will need to carry out detective work in order to track down people who have been in contact with coronavirus cases, experts said.
The first cases of the new virus have been diagnosed in England, with two people from the same family being treated at a specialist centre at Newcastle-upon-Tyne Hospitals NHS Foundation Trust.
An outbreak investigation team has been formed to trace anyone who has been in contact with the pair to prevent onward transmission.
Professor Jimmy Whitworth, at the London School of Hygiene and Tropical Medicine, said that tracking people who have come into contact with an infected case will take a lot of detective work.
He added: ‘What you don’t want is this to spread any more in the community.
‘It would be a question of essentially a lot of detective work in identifying who are the people that the cases have been into contact with, tracking them down, and monitoring and testing them.
‘Now we believe that people can be infected before they actually show symptoms, that means cases and contacts will need to be tested to see if they are infected or not.’
What do we know about the Wuhan coronavirus?
Someone who is infected with the Wuhan coronavirus can spread it with just a simple cough or a sneeze, scientists say.
At least 213 people with the virus are now confirmed to have died and more than 9,800 have been infected in at least 21 countries and regions. But experts predict the true number of people with the disease could be 100,000, or even as high as 350,000 in Wuhan alone, as they warn it may kill as many as two in 100 cases. Here’s what we know so far:
What is the Wuhan 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 is currently named 2019-nCoV, and does not have a more detailed name because so little is known about it.
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.
WHERE HAS THE WUHAN CORONAVIRUS SPREAD TO?
The vast majority of confirmed infections of the Wuhan coronavirus have been diagnosed in China.
But 25 countries or territories outside of the mainland have also declared infections:
COUNTRIES
CHINA
THAILAND
JAPAN
SINGAPORE
HONG KONG
SOUTH KOREA
AUSTRALIA
TAIWAN
MALAYSIA
MACAU
US
FRANCE
GERMANY
VIETNAM
UAE
CANADA
UK
ITALY
RUSSIA
SWEDEN
PHILLIPINES
INDIA
FINLAND
NEPAL
SRI LANKA
CAMBODIA
TOTAL
CASES
9,755
19
17
16
12
11
9
9
8
7
6
6
6
4
4
3
2
2
2
1
1
1
1
1
1
1
9,905
DEATHS
213
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
213
‘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 seeing 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.
Just a week after that, there had been more than 800 confirmed cases and those same scientists estimated that some 4,000 – possibly 9,700 – were infected in Wuhan alone. By that point, 26 people had died.
By January 27, more than 2,800 people were confirmed to have been infected, 81 had died, and estimates of the total number of cases ranged from 100,000 to 350,000 in Wuhan alone.
By January 29, the number of deaths had risen to 132 and cases were in excess of 6,000.
Where does the virus come from?
Nobody knows for sure. 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 the virus in Wuhan came from people visiting or working in a live animal market in the city, 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.
Bats are a prime suspect – researchers at the Chinese Academy of Sciences said in a recent statement: ‘The Wuhan coronavirus’ natural host could be bats… but between bats and humans there may be an unknown intermediate.’
And another scientific journal article has suggested the virus first infected snakes, which may then have transmitted it to people at the market in Wuhan.
Peking University researchers analysed the genes of the coronavirus and said they most closely matched viruses which are known to affect snakes. They said: ‘Results derived from our evolutionary analysis suggest for the first time that snake is the most probable wildlife animal reservoir for the 2019-nCoV,’ in the Journal of Medical Virology.
Experts say the difficulty of containing the coronavirus is that so many patients have mild, cold-like symptoms and don’t realise they have the infection – but it can quickly turn deadly
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.
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.
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.
There is now evidence that it can spread third hand – to someone from a person who caught it from another person.
What does the virus do to you? What are the symptoms?
Once someone has caught the virus it may take between two and 14 days 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 – at least 97 per cent, based on available data – will recover from these without any issues or medical help.
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.
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.
HOW WILL CORONAVIRUS PATIENTS BE TREATED AT THE NEWCASTLE HOSPITAL?
Staff at the Royal Victoria Infirmary in Newcastle who are specifically trained to deal with highly infectious patients will have to wear protective gowns, gloves, face masks and visors for eye protection.
They will follow a strict protocol that sees them bin all of the protective clothing as soon as they come out of the ward.
Special, extra thick bin bags will be used to dump the gear in and designated clinical waste bins are kept separate from normal rubbish to avoid contamination.
Actual treatment will depend on how ill the two patients are, according to Paul Hunter, a professor in medicine at the University of East Anglia.
He told MailOnline if they are suffering from mild symptoms will be treated the way someone with the flu would be – with paracetamol.
There are no antiviral drugs that can treat the little-known disease so there is no ‘cure’. Patients just have to wait it out and let the body mend itself, like it does with the flu or a cold.
Professor Hunter said: ‘If patients are more serious – then they’ll be held for a period of time [weeks] to see if they deteriorate.
‘If their oxygen levels drop they’ll be put on oxygen, then they might be given some drugs to help them breathe.
‘If people have got fluid on lungs antidiuretics [drugs that help control fluid balance in the body] , if they progressively get ill then could be put on breathing machies.
These more serious symptoms can happen because the coronavirus attacks the respiratory tract – the lungs and throat.
Most fit and able people will fight off the infection on their own, but for older people, newborns and those with pre-existing medical conditions, it can develop into pneumonia and be fatal.
The patients will likely be kept together, unless it turns out one is old or vulnerable – or if one is much sicker than the other.
They will be screened regularly via throat swabs to check whether they are still infectious. They could be kept in the special unit for a number of weeks.
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, yesterday 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 so far killed 213 people out of a total of at least 9,800 officially confirmed cases – 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.
However, experts say the true number of patients is likely considerably higher and therefore the death rate considerably lower. Imperial College London researchers estimate that there were 4,000 (up to 9,700) cases in Wuhan city alone up to January 18 – officially there were only 444 there to date. If cases are in fact 100 times more common than the official figures, the virus may be far less dangerous than currently believed.
Experts say it is likely only the most seriously ill patients are seeking help and are therefore recorded – the vast majority will have only mild, cold-like symptoms. For those whose conditions do become more severe, there is a risk of developing pneumonia which can destroy the lungs and kill you.
Can the virus be cured?
The Wuhan coronavirus cannot currently 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, 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 has not officially been confirmed as either an epidemic or a pandemic yet. This is likely because, despite the global concern, the number of people who have been confirmed to be infected is still relatively low.
A pandemic is defined by the World Health Organization as the ‘worldwide spread of a new disease’.
An epidemic is when a disease takes hold of a smaller community, such as a single country, region or continent.
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