A St Petersburg court has ordered a Russian woman to be forcibly confined to hospital after she dramatically broke out of coronavirus quarantine and blogged about her escape.
Alla Ilyina, 32, was escorted by bailiffs and medical staff back to the Botkin infectious diseases hospital, where she had been held under quarantine, before short-circuiting the electronic lock to her hospital door and sneaking past doctors to an elevator.
What is the virus causing the illness that started Wuhan?
The virus is officially called Sars-CoV-2 and this causes the disease Covid-19. It is a member of the coronavirus family that has never been encountered before. Like other coronaviruses, it has come from animals. Many of those initially infected either worked or frequently shopped in the Huanan seafood wholesale market in the centre of the Chinese city.
What other coronaviruses have there been?
New and troubling viruses usually originate in animal hosts. Ebola and flu are other examples – severe acute respiratory syndrome (Sars) and Middle Eastern respiratory syndrome (Mers) are both caused by coronaviruses that came from animals.
What are the symptoms of the coronavirus?
The virus can cause pneumonia. Those who have fallen ill are reported to suffer coughs, fever and breathing difficulties. In severe cases there can be organ failure. As this is viral pneumonia, antibiotics are of no use. The antiviral drugs we have against flu will not work. If people are admitted to hospital, they may get support for their lungs and other organs as well as fluids. Recovery will depend on the strength of their immune system. Many of those who have died were already in poor health.
Is the virus being transmitted from one person to another?
China’s national health commission has confirmed human-to-human transmission, and there have been such transmissions elsewhere. As of 12 February there are now 45,182 confirmed cases and 1,115 deaths. There are cases in 28 other countries outside China, with deaths recorded in one case in Hong Kong, and one case in the Philippines. The number of people to have contracted the virus overall could be far higher, as people with mild symptoms may not have been detected.
The number of confirmed cases of coronavirus in the UK has doubled from four to eight after four more people in Brighton were diagnosed with the infection over the weekend.
There are nine cases of the virus in the UK. Four were located in Brighton, one in London. At Arrowe Park Hospital in Merseyside 83 people in quarantine were told they would be allowed to leave on Thursday after they all tested negative. Of the 1,750 tests carried out so far in the UK, more than 99% had been negative.
Why is this worse than normal influenza, and how worried are the experts?
We don’t yet know how dangerous the new coronavirus is, and we won’t know until more data comes in. The mortality rate is around 2%. However, this is likely to be an overestimate since many more people are likely to have been infected by the virus but not suffered severe enough symptoms to attend hospital, and so have not been counted. For comparison, seasonal flu typically has a mortality rate below 1% and is thought to cause about 400,000 deaths each year globally. Sars had a death rate of more than 10%.
Should I go to the doctor if I have a cough?
Unless you have recently travelled to China or been in contact with someone infected with the virus, then you should treat any cough or cold symptoms as normal. The NHS advises that people should call 111 instead of visiting the GP’s surgery as there is a risk they may infect others.
Is this a pandemic and should we panic?
Health experts are starting to say it could become a pandemic, but right now it falls short of what the WHO would consider to be one. A pandemic, in WHO terms, is “the worldwide spread of a disease”. Coronavirus cases have been confirmed in about 25 countries outside China, but by no means in all 195 on the WHO’s list.
There is no need to panic. The spread of the virus outside China is worrying but not an unexpected development. The WHO has declared the outbreak to be a public health emergency of international concern, and says there is a “window of opportunity” to halt the spread of the disease. The key issues are how transmissible this new coronavirus is between people and what proportion become severely ill and end up in hospital. Often viruses that spread easily tend to have a milder impact.
The escape, which took place on 7 February, went unreported for days until Ilyina herself told journalists she had broken out, posting a detailed video of her getaway on Instagram.
Ilyina fell ill after returning from the Chinese resort island of Hainan last month and was put under quarantine by doctors. But after she tested negative for the virus on 6 February, she was told she would be held under quarantine for two weeks regardless.
“When they told me I was totally healthy, I requested that the doctors let me go home,” she said in the video, which featured a schematic diagram detailing her escape plan. “I said that according to the constitution, I have a right to my freedom. Also under Russian law, I have a right to refuse hospitalisation. They refused. So, I worked out a plan.”
The story went viral and led to a police search for Ilyina, who had locked herself in her apartment. The court on Monday ordered her to be admitted to hospital until at least Wednesday, in order to receive new test results.
The World Health Organization is recommending that people take simple precautions to reduce exposure to and transmission of the Wuhan 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
- Avoid direct, unprotected contact with live animals and surfaces in contact with animals when visiting live markets in affected areas
- Avoid eating raw or undercooked animal products and exercise care when handling raw meat, milk or animal organs to avoid cross-contamination with uncooked foods.
Despite a surge in sales of face masks in the aftermath of the outbreak of the coronavirus outbreak, experts are divided over whether they can prevent transmission and infection. There is some evidence to suggest that masks can help prevent hand-to-mouth transmissions, given the large number of times people touch their faces. The consensus appears to be that wearing a mask can limit – but not eliminate – the risks, provided they are used correctly.
The Foreign and Commonwealth Office has advised UK nationals to leave China where possible. It is also warning that travellers from Hong Kong, Japan, Macau, Malaysia, Republic of Korea, Singapore, Taiwan and Thailand who develop symptoms of cough or fever or shortness of breath within 14 days of returning the UK should contact the NHS by phone.
Russia has taken extraordinary measures to prevent the spread of the Covid-19 coronavirus, closing its borders with China and putting dozens more under quarantine. But patients have complained about delayed test results and draconian rules that have left them trapped in hospitals. At least three people have fled quarantine since the coronavirus outbreak began, including a 34-year-old mother who jumped out of a hospital window with her son in the city of Samara.
On Monday, the first Russian citizen was diagnosed with the new coronavirus – a woman onboard the Diamond Princess cruise ship docked in Yokohama, Japan. Two Chinese citizens in Russia were diagnosed with the disease and have since been released.
More than 140 Russians and others evacuees from Wuhan are also being quarantined at a sanatorium in western Siberia being patrolled by members of Russia’s national guard.