Coronavirus: three more cases in UK amid fears over strain on NHS

Calls for doctors to be brought out of retirement if possible epidemic hits NHS workforce

A music teacher is among the latest coronavirus cases confirmed in the UK, with a school pupil also being a suspected victim, as concern grows about the impact of the outbreak on an already stretched NHS.

London’s prestigious Guildhall School of Music and Drama said it would close for up to a fortnight after one of its teachers was diagnosed with the virus. He is being treated at a specialist isolation unit at the Royal Free hospital in north London, and the school is contacting his pupils.

Three patients in England tested positive for Covid-19 on Monday, bringing the total number of UK cases to 39. A clinician at Mount Vernon Cancer Centre was confirmed positive but then tested negative, East and North Hertfordshire NHS trust said.It had earlier warned the public not to panic, saying any risk to patients was low.

Meanwhile, a survey showed that an overwhelming majority of doctors fear the NHS is ill-prepared to deal with a major outbreak. More than 99% of 1,618 medics questioned by the Doctors’ Association did not agree that the service is well prepared to cope if it is hit by an epidemic.

Boris Johnson accepted that a large-scale outbreak was now “very likely”, while Scotland’s first minister, Nicola Sturgeon, said that up to four out of five Scots could become infected.

“We’re expecting perhaps 50% or as much as 80% of the population would be infected during that epidemic,” she said. The Scottish government is preparing for up to 250,000 severely affected patients to require hospital treatment in a worst-case scenario.

Johnson urged the public to help stop the spread of the disease after signing off schemes that are expected to involve asking doctors and nurses to come out of retirement if the virus hits the NHS workforce. The “battle plans” also propose an expansion in the use of volunteers from the Red Cross and St John’s Ambulance in order to relieve pressure on medics.

Paul Hunter, a professor of medicine at the University of East Anglia, said the government should be planning for a situation where half the NHS workforce becomes ill.

“In an ideal world it would not be safe for doctors to come out of retirement, but if half your medical workforce is off sick then that’s probably the least bad option,” he said. “It probably won’t get that bad but I wouldn’t bet against it. So it is a sensible contingency plan for doctors to come back into practice if they want to.”

A family doctor in Brighton and a member of staff at Worthing hospital, West Sussex, were among the first coronavirus cases to be identified in Britain last month.

There were concerns last week that a Surrey GP may also have been infected. The regional director for Public Health England said on Monday that none of the four patients in a cluster in the county were GPs or health workers.

A Guardian straw poll of 30 retired doctors and nurses found most were sceptical about the idea of returning to work to tackle the likely crisis. Eighteen opposed the idea, saying it would not be safe for them or their patients, and of the 12 who said they would be prepared to return to work, seven expressed safety concerns and reservations.

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.

John Coakley, a 64-year-old retired intensive care doctor from Liverpool, said: “I last dealt with an ICU patient over five years ago, and things have moved on a lot. I don’t think I’d be much help. I wouldn’t be confident I could insert a cannula [a tube placed in a vein] now, let alone set up a patient on mechanical ventilation.”

Pamela Melding, 74, a former psychogeriatrician, said: “Retired doctors are in a demographic most likely to succumb to the virus, so putting them on the frontline is not safe for them or the public.”

But Hunter, 63, who retired as a consultant virologist at Norfolk and Norwich hospital three years ago, said he would be willing to sign up. “I guarantee there would be a lot of retired medics out there who would feel it was something they had to do, and I would be one of them,” he said.

He warned that the plan would require a series of practical measures, including renewing licences to practice and indemnity against insurance claims.

Sarah Wollaston, who was a GP before a nine-year stint as an MP, tweeted: “Retired clinicians would have a huge amount to offer and many would want to help.” But she raised a number practical considerations including the greater risk to older medics if they contract the virus.

The General Medical Council said it had been working with the government on a plan. Prof Colin Melville, its medical director, said: “We could, if necessary, grant temporary registration for the duration of the emergency to certain groups of appropriate people to supplement doctor numbers and provide cover in a range of roles. The first group we would grant temporary registration to is doctors who have recently relinquished their licence to practice, for example because they have recently retired.”

He added: “We understand that there could be health or personal reasons why some of those doctors would not feel they could return to work, and they would be able to opt out.”

Two of the latest UK patients to test positive are from south Devon, and there were unconfirmed reports that one is a pupil at Churston Ferrers grammar school. The school was one of five in Devon to close over coronavirus fears on Monday. Its website said it would also be shut on Tuesday.

The global coronavirus death toll surpassed 3,000 on Monday and South Korea reported another 500 cases.

Some of the British guests at a quarantined hotel in Tenerife are due fly back to the UK after testing negative for coronavirus.


Matthew Weaver, Denis Campbell and Severin Carrell

The GuardianTramp

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