Medical expert explains why coronavirus is more dangerous than SARS

The coronavirus pandemic has had a bigger impact on British society than any disease in living memory.

Schools and businesses are closed, there’s a sense of panic in the streets and healthcare services are close to breaking point.

So why is the novel coronavirus, Covid-19, so different to other coronaviruses like Sars and Mers that have spread around the world in recent years?

Medical expert Dr Anna Hemming explains that because the disease kills fewer victims, and takes longer to show its symptoms, it’s actually much more dangerous.

Victims have much more time to spread the disease before they realise they have it.

Dr Hemming explains: "Transmission rates are higher for Covid-19, however, SARS has a higher fatality rate at about 10%.

"This is currently 2% for Covid-19. In some countries this will rise, for example, Italy's [fatality rate will be] eight to 10% due to the ageing population.”

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She says this once-in-a-generation event will change the way we live for a long time to come, continuing: “The effect on global society has already been demonstrated and is huge."

Dr Hemming explains that while many have compared the virus to flu, there are only superficial similarities.

"In some ways, Covid-19 is similar to flu in that it spreads, causes people to feel unwell and cannot be easily treated", she said.

"However it has some very different features. Typically, a virus takes five days to cause symptoms."

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"Covid-19 takes up to 14 days for an infected person to develop symptoms."

More importantly, Covid-19 causes many more people to require hospital treatment than seasonal flu does, which is why healthcare systems around the world are overstretched.

Dr Hemming says the hospitalisation rate for seasonal flu is "around 2%", whereas for COVID-19 it’s more like 19%.

Life can’t return to normal until there’s a vaccination available, and until a reliable test is produced which can determine who has already had the disease, many vital medical staff are being kept on the sidelines.

Dr Hemming says: "Scientists worldwide are working really hard to create a vaccination, as well as antibody testing kits which we understand are in their final stages before launching."

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‘Highly controversial’ mass graves could be used if UK Covid-19 death toll soars

Overwhelmed authorities may be forced to use mass graves if the coronavirus death toll soars, experts have warned.

The drastic measure will be brought in if councils are unable to handle the volume of people dying – which will happen if 1% of infected people die, researchers said.

A team from the University of Huddersfield said it is "highly likely" that local death services will be unable to keep up with demand.

If death certificates are not issued promptly, funeral services will not be able to cope, the Daily Mail reports.

And lack of space in cemeteries means mass graves may have to be considered.

But academics admitted this would be "highly controversial and would upset and anger many communities".

Last week work, began on creating a temporary mortuary at Birmingham Airport – which is next to the city's National Exhibition Centre.

The centre is said to poised to be turned into a field hospital to cope with the pandemic.

The mortuary will have space for up to 12,000 bodies, it has emerged.

Dr Julia Meaton, Dr Anna Williams and researcher Helen-Marie Kruger penned the paper examining how a northern English council could handle a crisis similar to the pandemic.

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Under normal circumstances, it would process 120 deaths a week, but coronavirus could see the number rise far higher.

They wrote: "The impact of such an increase from normal levels will mean that the authorities will struggle to maintain death registrations and disposals that will potentially have serious consequences.

"Practically, not being able to register a death or obtain a death certificate will mean that disposal cannot take place."

One worker told them that "certainly in some of the cemeteries we could end up going back to mass graves depending on the volume of excess deaths".

The team urged councils to get ready for a worst-case scenario, saying: "In a pandemic situation, there is likely to be a necessary change to the 'business as usual' death and bereavement management services."

Yesterday the death rate from coronavirus crossed 1,000, and experts warn that it would be viewed "as a success" if the overall deaths is kept to 20,000.

The research, Pandemic Continuity Planning; will coronavirus test local authority business plans?, has been published in the Emergency Management Review.

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Ventilators explained: Key device in fight against coronavirus

One in six COVID-19 patients can develop breathing difficulties, potentially needing access to a ventilator.

One of the biggest challenges faced by health workers around the world amid the coronavirus pandemic is trying to save lives when the number of patients needing critical care overtakes the available medical infrastructure.

Countries with a large number of cases are struggling to meet the demand for supplies and equipment needed to arm those on the front lines against COVID-19, the highly infectious respiratory disease caused by the virus.

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Ventilators – mechanical breathing devices – are crucial in the fight to save patients whose lungs are assailed by the virus.

According to the World Health Organization, one in six COVID-19 patients becomes seriously ill and can develop breathing difficulties.

In the United States, which has more confirmed cases than any other country in the world, the Society of Critical Care Medicine has projected that 960,000 coronavirus patients may need to be put on ventilators at one point or another during the pandemic. 

But the US has only about 200,000 machines, by the organisation’s estimate, approximately half of which are older models that may not be ideal for the most critically ill patients.

In addition, many ventilators are already in use, supporting other patients with severe, non-coronavirus ailments.

The United Kingdom’s National Health System is reported to have just 8,175 ventilators. The government believes up to 30,000 could be needed at the peak of the pandemic.

The situation is especially critical in countries with weak healthcare systems. For example, in the West African country of Mali, home to some 19 million people, there are 56 ventilators.

The Africa Centres for Disease Control and Prevention, meanwhile, said this week that countries in the continent were looking to engage with wealthier countries to secure key supplies, including ventilators, if the situation deteriorates.

How does a ventilator work?

In the most severe cases, the coronavirus damages healthy tissue in the lungs, making it hard for them to deliver oxygen to the blood.

Pneumonia can develop, along with a more severe and potentially deadly condition called acute respiratory distress syndrome, which can damage other organs.

To prevent this, mechanical ventilators feed oxygen into the lungs of patients with severe respiratory problems through a tube inserted down the throat.

The ventilator also has a humidifier, which adds heat and moisture to the air to match the patient’s body temperature.

Patients with milder symptoms may be put on non-invasive ventilation, using face masks, nasal masks or mouthpieces which allow pressurised air or mixtures of gases to be pushed into the lungs. 

Additionally, hoods with pressurised oxygen pumped in them via a valve are also commonly used.

What is being done to meet the demand?

Ventilator makers are under pressure to sharply increase production even as the pandemic has disrupted the transport and supply of crucial parts, such as hoses, valves, motors and electronics – some of which come from China, the original epicentre of the outbreak.

As companies struggle to meet the rising demand, governments have sought the help of the military, enlisted other manufacturers and even looked to 3D printing in the hopes of boosting production.

One of the world’s largest makers of ventilators, Swiss-based Hamilton Medical AG, aims to raise production numbers to about 21,000 ventilators this year, up from 15,000 last year, by deploying marketing staff on the production line, among other measures.

Italy’s Bologna-based company, Siare Engineering International Group srl, has 25 army technicians helping assemble machines as it aims to more than triple monthly production.

Meanwhile, a team of doctors in Italy has developed a way to provide oxygen to two people from one ventilator, therefore doubling capacity, according to the Italian region of Emilia Romagna’s commissioner for coronavirus.


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Boy, 14, dies of coronavirus in one of Europe’s youngest cases

The Portuguese youngster from Ovar half an hour’s drive south of Porto, lost his fight for life in the early hours of this morning after being rushed to Sao Sebastiao Hospital in nearby Santa Maria da Feira. Medics are said to have decided against transferring him to a hospital with a paediatric A&E unit in Porto, Portugal’s second largest city, because of the severity of his condition.

Local reports said he suffered from psoriasis, a skin disorder that can affect the immune system. 

He has been confirmed as Portugal’s youngest person with coronavirus to die so far.

The girl described earlier this week as Europe’s youngest coronavirus victim, named as Julie Alliot, was first rushed to her local doctor in Longjumeau, south of Paris, on Tuesday before being transferred to the Necker Hospital in the French capital. She died the following day.

Her sister Manon paid tribute to her after news of her death became public, saying she was “bright and much loved” and “loved to dance, sing and make people laugh.”

The number of coronavirus deaths in Portugal stood at 119 at lunchtime today. Nearly 6,000 are infected with the virus and another 5,500 were awaiting the results of tests according to Ministry of Health figures.

Earlier today it emerged a British man has died on the Algarve after falling ill with coronavirus.

The OAP, who was in his seventies, lost his two-week fight for life yesterday/on Saturday at Faro Hospital.

He lived in Benagil, a beach area near Lagoa which is known for its spectacular cave.

Lagoa’s mayor Luis Encarnacao confirmed the death, the town’s second since the start of the coronavirus crisis.

The first was a 60-year-old teacher who lived in Carvoeiro and has been named as Manuel Magalhaes.

Mr Encarnacao said he had spoken to the families of both men to offer them his condolences. The Brit expat has not been named. 

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European airlines resist mounting coronavirus refund claims

PARIS (REUTERS) – European airlines waiting in line for coronavirus bailouts want to tap another source of interest-free loans: their customers.

Cash-strapped carriers are seeking to suspend European Union rules requiring refunds for cancellations and instead issue vouchers to clients left out of pocket as hundreds of thousands of flights are grounded by the pandemic.

Refund claims, if honoured, would be a big additional cash drain on many airlines already in need of government aid to survive a sustained travel slump.

Consumer organisations say some major airlines are already flouting the refund rules and condemn what they describe as an attempt to force consumers to lend them cash.

“We’ve been absolutely inundated with passengers complaining they can’t get a refund from their airlines,” Mr Rory Boland of British consumer group Which? said on Friday (March 27).

The European Commission has rejected industry calls to relax the requirement in EU regulations to refund cancellations within a week, but the airlines say they are unable to comply.

“Faced with a cashflow catastrophe, many airlines can only offer vouchers in lieu of immediate cash refunds for cancelled flights,” their lobby group Airlines for Europe (A4E) said.

A prolonged shutdown would make about 3.5 billion euros (S$5.6 billion) of Lufthansa revenue eligible for refund in the second quarter, Citi estimates – ahead of the 3 billion euros at British Airways parent IAG or Air France-KLM, 770 million euros at easyJet and 760 million at Ryanair.

“Basically, we are trying to push as many vouchers as possible, and not allow for cancellations just to be refunded immediately,” Lufthansa’s finance chief Ulrik Svensson told investors last week.

A Lufthansa spokesman said on Friday that refunds remain”possible in principle,” but not “within the usual time limits.”

EasyJet and British Airways are among airlines that have made it harder to obtain refunds, by disabling them online and offering only vouchers.

Twitter on Friday was aflame with customers who had been referred to swamped call centres.

BA and easyJet said cash reimbursements remained available through their contact centres.

Air France-KLM, which like Lufthansa has grounded the vast majority of its flights, is telling clients it no longer offers the immediate refunds required under European law. Instead it is issuing a customer credit valid for one year that can be refunded only at the end of that period.

“Air France recognises clients would normally receive immediate reimbursement,” its website says, blaming exceptional circumstances and “a very high number of refund requests.”

Airlines are now asking European authorities to waive refund requirements on condition that vouchers are reimbursable after a minimum of 12 months, an A4E spokeswoman said.

The EU has already relaxed airport slot rules and passenger compensation and will offer airlines more help, Transport Commissioner Adina Valean told Reuters. “But people have to receive their money back if that is what they want.”

Consumer groups remain unmoved by the industry’s pleas. “It isn’t fair to people who have been left out-of-pocket and may be in financial difficulties themselves,” said Boland at Which? – who cited the example of a family denied a refund on their annual holiday booking to Florida.

“The airlines should not be asking to keep that family’s 2,000 pounds (S$3,556),” he said.

Citi analyst Mark Manduca said airlines must do everything they can to ensure that “fees and taxes and anything that involves complaint money can be held to an absolute minimum during this tough time.”

But he added: “As a voucher holder, you end up effectively becoming an unsecured creditor of an airline.”

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Malaysia arrests hundreds for flouting curbs on movement as virus deaths rise

KUALA LUMPUR (Reuters) – Malaysia this week arrested hundreds of people for violating restrictions aimed at stemming the spread of coronavirus, a senior minister said on Sunday, amid a spike in the number of deaths linked to the outbreak.

The death toll rose from 27 to 34 within a 24-hour period, the biggest daily rise so far, while the number of reported cases was up to 2,470, the highest in Southeast Asia.

Malaysia has closed schools and non-essential businesses and imposed restrictions on travel and movement until April 14 to try to contain the spread.

Defence minister Ismail Sabri Yaakob told reporters 649 people were detained on Saturday, while 73 people have plead guilty to offences such as gathering in groups, obstructing public officials, and breaking through police blockades.

This was in addition to 614 people arrested since the movement curbs were imposed on March 18.

“Some people gave the excuse that they were just going out to buy food,” Ismail said.

“But they were caught outside up to four times a day, to the point at which police recognized their faces… clearly, they were not being genuine.”

Those who flout the restriction of movement order can be fined or face up to six months’ jail.

The shutdown has caused widespread business disruptions. The world’s biggest glovemaker and condom producer, both based in Malaysia, this week warned of global shortages as demand for their products surged amid the virus outbreak.

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Fetish site joins coronavirus fight with donation of vital medical kit to NHS

With the UK coronavirus outbreak building to its peak and a huge new emergency hospital being lashed together in east London to cope with the expected torrent of cases, the focus is turning to scavenging medical supplies from any source.

Letters have been sent to more than 65,000 retired doctors and nurses in England and Wales asking them to return to the NHS to help tackle the coronavirus outbreak.

Thousands have already answered the call, but they need uniforms and personal protective equipment (PPE).

Protective goggles have been donated from schools’ science departments, tattoo studios and nail bars have offered gloves and masks, and authentic surgical scrubs has come in from a most unlikely source.

Hardcore medical fetishists demand a more authentic experience than an Ann Summers "sexy nurse" outfit. Their attention to detail makes an episode of Holby City look like a childhood game of doctors and nurses.

So MedFet, an online store that describes itself as being “100% dedicated to medical fetish, kink and roleplay”, keeps a stock of authentic medical kit just for them.

Except now it’s not just for them any more. The store has handed its stock of surgical-grade scrubs to the fight against Covid-19.

The company tweeted: “Today we donated our entire stock of disposable scrubs to an NHS hospital. It was just a few sets, because we don't carry large stocks, but they were desperate, so we sent them free of charge.”

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MedFet added that they were responding to enquiries from NHS medics who had been trying to source their own PPE because health service cuts had left them woefully under-equipped to face the pandemic.

MedFet said: “When you see someone from the government saying the NHS is getting what it needs, that is a lie.

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“We have been contacted this week by representatives of NHS procurement all over the country, trying to source basic protective equipment and clothing.”

They added that they laid the blame for this shortfall squarely at the feet of the current government: “So when it's all over…" they said, "and the doctors, nurses and other staff have done an amazing job (as they undoubtedly will despite the circumstances)…let's not forget, or forgive, the ones who sent the NHS into this battle with inadequate armour and one hand tied behind its back.”

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UK's Johnson warns on coronavirus: Things to get worse before they get better

LONDON (Reuters) – Prime Minister Boris Johnson is warning Britons in a letter to 30 million households that things will get worse before they get better, as he himself self-isolates in Downing Street to recover from the coronavirus.

Britain has reported 17,089 confirmed cases of the disease and 1,019 deaths and the peak of the epidemic in the country is expected to come in a few weeks.

In the letter to be delivered to homes, Johnson urges people to stick with the lockdown measures that his government has imposed to try to prevent the state National Health Service from being overwhelmed by a surge of cases.

“We know things will get worse before they get better,” Johnson writes. “At this moment of national emergency, I urge you, please, to stay at home, protect the NHS and save lives.”

Senior minister Michael Gove said on Sunday the government is “very concerned” about the death toll.

He also said the country has boosted the amount of testing for the virus.

“The number of tests being carried out has hit 10,000 a day. We want to increase that to 25,000 a day.”

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N Korea fires more missiles than ever amid coronavirus pandemic

Sunday’s ballistic missile tests mark the fourth such launch this month as the world battles the coronavirus pandemic.

North Korea has fired two suspected ballistic missiles into the ocean off its east coast – according to South Korea and Japan – the latest in a flurry of weapon launches that Seoul decried as “inappropriate” amid the global coronavirus pandemic.

Two “short-range projectiles” were launched from the coastal Wonsan area on Sunday, and flew 230 kilometres (143 miles) at a maximum altitude of 30 kilometres (19 miles), South Korea’s Joint Chiefs of Staff reported.

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“In a situation where the entire world is experiencing difficulties due to COVID-19, this kind of military act by North Korea is very inappropriate and we call for an immediate halt,” the JCS said in a statement, according to Yonhap news agency.

Japan’s Ministry of Defense said the projectiles appeared to be ballistic missiles, and they did not land in Japanese territory or its exclusive economic zone.

“Recent repeated firings of ballistic missiles by North Korea is a serious problem to the entire international community including Japan,” a ministry statement said.

Pyongyang is yet to issue a statement on Sunday’s weapons launches.

They would be the eighth and ninth missiles launched in four rounds of tests this month, and the most missiles ever fired in a single month by North Korea, according to a tally by Shea Cotton, senior researcher at the James Martin Center for Nonproliferation Studies.

“Coming this early in the year, the only time we’ve seen tests this frequently were in 2016 and 2017, both of which were huge years for North Korea’s missile program,” he said in a post on Twitter.

All the missiles fired so far this year have been small, short-range weapons, such as the KN-24 fired during the last launch on March 21.

Some experts say the latest launches were likely designed to shore up unity and show that leader Kim Jong Un is in control in the face of US-led sanctions and the global pandemic.

Kim “wants to show he rules in a normal way amid the coronavirus (pandemic) and his latest weapons tests were aimed at rallying unity internally, not launching a threat externally,” Kim Dong-yub, an analyst at Seoul’s Institute for Far Eastern Studies, told The Associated Press. “North Korea doesn’t have time now to spare for staging (external threats).”

North Korea has been engaged in an intense campaign to prevent the spread of the virus that has infected more than 660,000 worldwide.

It has called its campaign a matter of “national existence” but has steadfastly denied there has been a single confirmed case on its soil. Many foreign experts question that claim, warning that an outbreak in North Korea could be dire because of its chronic lack of medical supplies and poor healthcare infrastructure.

A week ago, North Korea said US President Donald Trump sent a personal letter to Kim, seeking to maintain good relations and offering cooperation in fighting the pandemic. A North Korean state media dispatch did not say whether Trump mentioned any of the latest weapon tests by the North.

UN Security Council resolutions bar North Korea from testing ballistic missiles, and the country has been heavily sanctioned over its missile and nuclear weapons programmes.

In the past, North Korea has typically conducted military drills, including tests of its ballistic missiles, in March as the winter weather turns warmer. For the previous two years, however, it had avoided such springtime launches amid denuclearisation talks with the US.

Those talks have since stalled after Trump turned down Kim’s calls for broad sanctions relief in exchange for a limited denuclearisation step during their second summit in Vietnam in early 2019.

Pyongyang set a unilateral deadline for Washington to offer fresh concessions by the end of 2019, and in late December last year, Kim declared his country no longer considered itself bound by moratoriums on nuclear and intercontinental ballistic missile tests.

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