Publicity

Publicity will be increased about the need for good hygiene measures (handwashing and “catch it, bin it, kill it”) and for workers to stay at home for the full duration of their illness.

Analysis: Simple measures have the ability to mitigate the risks of an individual contracting the virus. A public information campaign is key to reminding everyone of their responsibilities and the difference they can make.

Population distancing strategies

These include school closures, encouraging homeworking, and reducing the number of large-scale gatherings. It includes the caveat that the country should be able to continue “as normally as possible”.

Analysis: These are strategies that have already been implemented in countries with a higher number of cases. In Italy, many football matches in the top tier have been postponed, while France has banned all indoor gatherings of more than 5,000 people. Numerous other sporting and arts events around the world have been cancelled, postponed or relocated. The government has expressed its desire to limit the social impact but that may not be possible if its efforts at containment fail. The question will then become what constitutes a mass/large-scale gathering.

Q&A How can I protect myself and others from the coronavirus outbreak? Show Hide The World Health Organization is recommending that people take simple precautions to reduce exposure to and transmission of the coronavirus, for which there is no specific cure or vaccine. The UN agency advises people to: Frequently wash their hands with an alcohol-based hand rub or warm water and soap

Cover their mouth and nose with a flexed elbow or tissue when sneezing or coughing

Avoid close contact with anyone who has a fever or cough

Seek early medical help if they have a fever, cough and difficulty breathing, and share their travel history with healthcare providers

Advice about face masks varies. Wearing them while out and about may offer some protection against both spreading and catching the virus via coughs and sneezes, but it is not a cast-iron guarantee of protection Many countries are now enforcing or recommending curfews or lockdowns. Check with your local authorities for up-to-date information about the situation in your area. In the UK, NHS advice is that anyone with symptoms should stay at home for at least 7 days. If you live with other people, they should stay at home for at least 14 days, to avoid spreading the infection outside the home.

Reduced police capability

There is acknowledgement that the capability of the emergency services to operate may be impeded by increased spread of the virus. The document refers to a potential significant loss of officers and staff, which could force police to concentrate on serious crimes and maintaining public order.

Analysis: This raises the possibility of police forces in the UK being so overstretched that their capability is reduced to the extent that many crimes will not be investigated and officers will be reduced to making sure there is not a loss of confidence in forces’ ability to maintain public order. This is a scenario that the government, which has made cracking down on crime a priority, will want to avoid at all costs.

Medical detention of people with Covid-19

New powers introduced in England allow “medical professionals, public health professionals and the police to … detain and direct individuals in quarantined areas at risk or suspected of having the virus”. Scotland already has such powers, while in Wales and Northern Ireland a justice of the peace can let officials “isolate, detain or require individuals to undergo medical examination”.

Analysis: In China, whole populations have been put in quarantine, which medical experts say has slowed the spread of the virus. Italy has done the same on a smaller scale. It is unclear how the proposed draconian new power of detention would work in Britain if it was deemed necessary to use it. Questions arise over how people whose behaviour was causing concern would be identified, the availability of police officers to attend their detention and where they would be detained.

Coronavirus map: how Covid-19 is spreading across the world Read more

Specialist care for the seriously ill

Although “initial confirmed patients” who have serious breathing problems due to Covid-19 will be cared for in critical care units in hospital; “when necessary, the provision of care may move from specialist units into general facilities in hospitals”, the plan says. It refers to “well-rehearsed plans … [for] the provision of excellent care for all patients affected by this new disease”.

Analysis: The prospect of large numbers of people becoming seriously unwell raises two problems for the NHS: a shortage of beds in intensive care and high dependency units and the well-known lack of general and acute beds. The UK has about 4,250 critical care beds – one of the lowest rates of such beds per 100,000 of population in international terms. The faculty of intensive care medicine is worried that while demand for such beds has risen at 4% a year since 2009, the number of beds available has not increased, leaving a worrying lack of capacity to manage such patients.

Patients discharged early

Under the plan, “health and social care services will work together to support early discharge from hospital, and to look after people in their own homes”.

Analysis: That would lead to hospital doctors identifying patients who were the least sick, whose beds would then be used by people left seriously ill with coronavirus. However, the widespread shortage of social care services – which already leaves patients stuck in hospital despite them being medically fit to leave – could limit the potential for inpatients to be sent home, or to do that safely. The social care workforce is already very stretched due to the ageing population, so may struggle to take on this extra responsibility. In addition, the number of district nurses – who care for people at home – has fallen sharply in recent years.

Restricted hospital admissions

If the virus leaves more people ill enough to require hospital care and also NHS staff too sick to work, “clinicians may recommend a significantly different approach to admissions”, including delays to some non-urgent care, the plan says.

Analysis: This could see some or all non-urgent operations – for example hip and knee replacements, cataract removals and hernia repairs – postponed. That would increase the number of patients waiting for such care, which in England alone already stands at a record 4.5m. They could wait months until the virus has subsided and hospitals can get back to their usual way of prioritising patients.

Deaths/mortuary space

The action plan recognises that the coronavirus outbreak could lead to an increase in the number of deaths, particularly among vulnerable and elderly groups, and that dealing with these additional fatalities could put pressure on local authorities.

Analysis: The Human Tissue Authority has been warning about problems with mortuary capacity since 2014-15. Last week, Nickie Aiken, the Conservative MP for Cities of London and Westminster, said there were contingency plans relating to Covid-19 for a morgue in Hyde Park. She later rowed back from the claim, perhaps wary that it jarred with the government’s attempt to quell panic. However, she spoke to the truth, in that a large increase in deaths would stretch the ability of existing facilities to cope.

Bringing retired doctors and nurses back to work

The plan confirms that, if necessary, “leavers and retirees” may be called back to work to help relieve pressure on current NHS staff. No other details are provided but the General Medical Council has said it could grant doctors temporary registration for the duration of the emergency.