All research cited by this document
4.3 System wide response plans for pandemic influenza, focused on the continuity of
public and critical services and the stability of the economy, have been adapted for
COVID-19, based on the best available scientific evidence and advice. For the
latest information on the current situation please refer to:
www.gov.uk/guidance/wuhan-novel-coronavirus-information-for-the-public. http://www.gov.uk/guidance/wuhan-novel-coronavirus-information-for-the-public...
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Link in text to http://www.gov.uk/guidance/wuhan-novel-coronavirus-information-for-the-public
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4.15 We have provided UK residents and travellers with the latest information to make
sure they know what to do if they experience symptoms and worked with NHS
111, NHS Direct Wales and NHS 24 in Scotland, to ensure people with symptoms
are given appropriate advice. Public health advice has been widely publicised and
is regularly updated at www.gov.uk/guidance/wuhan-novel-coronavirusinformation-for-the-public http://www.gov.uk/guidance/wuhan-novel-coronavirus-information-for-the-public...
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Link in text to http://www.gov.uk/guidance/wuhan-novel-coronavirus-information-for-the-public
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4.55 The UK Government is advising businesses to build their own resilience by
reviewing their business continuity plans and following the advice for employers
available on GOV.UK - www.gov.uk/government/publications/guidance-toemployers-and-businesses-about-covid-19 http://www.gov.uk/government/publications/guidance-to-employers-and-businesses-about-covid-19...
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Link in text to http://www.gov.uk/government/publications/guidance-to-employers-and-businesses-about-covid-19
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The Lancet (Elsevier BV)
2.5 As it is a new virus, the lack of immunity in the population (and the absence as yet
of an effective vaccine) means that COVID-19 has the potential to spread
extensively. The current data seem to show that we are all susceptible to catching
this disease, and thus it also more likely than not that the UK will be significantly
affected. Among those who become infected, some will exhibit no symptoms 1 .
Early data suggest that of those who develop an illness, the great majority 2 will
have a mild-to-moderate, but self-limiting illness – similar to seasonal flu 3 ....
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1 Chan JF-W, Yuan S, Kok K-H, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet 2020; 395: 514–23
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2.5 As it is a new virus, the lack of immunity in the population (and the absence as yet
of an effective vaccine) means that COVID-19 has the potential to spread
extensively. The current data seem to show that we are all susceptible to catching
this disease, and thus it also more likely than not that the UK will be significantly
affected. Among those who become infected, some will exhibit no symptoms 1 .
Early data suggest that of those who develop an illness, the great majority 2 will
have a mild-to-moderate, but self-limiting illness – similar to seasonal flu 3 ....
On page 5
3 Xu XW, Wu XX, Jiang XG, Xu KJ, Ying LJ, Ma CL, et al. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ. 2020 Feb 19;368
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The Lancet Digital Health (Elsevier BV)
2.6 It is, however, also clear that a minority of people who get COVID-19 will develop
complications severe enough to require hospital care 4 , most often pneumonia. In
a small proportion of these, the illness may be severe enough to lead to death 5 .
So far the data we have suggest that the risk of severe disease and death
increases amongst elderly people and in people with underlying health risk
conditions (in the same way as for seasonal flu) 6 7 . Illness is less common and
usually less severe in younger adults 8 . Children can be infected 9 and can have a
severe illness 10 , but based on current data overall illness seems rarer in people
under 20 years of age. So far, there has been no obvious sign that pregnant
women are more likely to be seriously affected 11 12 ....
On page 5
4 Sun K, Chen J, Viboud C. Early epidemiological analysis of the coronavirus disease 2019 outbreak based on crowdsourced data: a population-level observational study. Lancet Digital Health 2020; published online Feb 20. https://doi.org/10.1016/S2589-7500(20)30026-1
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Science China Life Sciences (Springer Science and Business Media LLC)
2.6 It is, however, also clear that a minority of people who get COVID-19 will develop
complications severe enough to require hospital care 4 , most often pneumonia. In
a small proportion of these, the illness may be severe enough to lead to death 5 .
So far the data we have suggest that the risk of severe disease and death
increases amongst elderly people and in people with underlying health risk
conditions (in the same way as for seasonal flu) 6 7 . Illness is less common and
usually less severe in younger adults 8 . Children can be infected 9 and can have a
severe illness 10 , but based on current data overall illness seems rarer in people
under 20 years of age. So far, there has been no obvious sign that pregnant
women are more likely to be seriously affected 11 12 ....
On page 5
5 Liu Y, Yang Y, Zhang C, Huang F, Wang F, Yuan J, et al. Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury. Science China Life Sciences. 2020 Feb 9:1-1
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The Lancet (Elsevier BV)
2.6 It is, however, also clear that a minority of people who get COVID-19 will develop
complications severe enough to require hospital care 4 , most often pneumonia. In
a small proportion of these, the illness may be severe enough to lead to death 5 .
So far the data we have suggest that the risk of severe disease and death
increases amongst elderly people and in people with underlying health risk
conditions (in the same way as for seasonal flu) 6 7 . Illness is less common and
usually less severe in younger adults 8 . Children can be infected 9 and can have a
severe illness 10 , but based on current data overall illness seems rarer in people
under 20 years of age. So far, there has been no obvious sign that pregnant
women are more likely to be seriously affected 11 12 ....
On page 5
6 Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet. 2020 Jan 30
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The Lancet (Elsevier BV)
2.6 It is, however, also clear that a minority of people who get COVID-19 will develop
complications severe enough to require hospital care 4 , most often pneumonia. In
a small proportion of these, the illness may be severe enough to lead to death 5 .
So far the data we have suggest that the risk of severe disease and death
increases amongst elderly people and in people with underlying health risk
conditions (in the same way as for seasonal flu) 6 7 . Illness is less common and
usually less severe in younger adults 8 . Children can be infected 9 and can have a
severe illness 10 , but based on current data overall illness seems rarer in people
under 20 years of age. So far, there has been no obvious sign that pregnant
women are more likely to be seriously affected 11 12 ....
On page 5
7 Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020 Jan 24
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New England Journal of Medicine (Massachusetts Medical Society)
2.6 It is, however, also clear that a minority of people who get COVID-19 will develop
complications severe enough to require hospital care 4 , most often pneumonia. In
a small proportion of these, the illness may be severe enough to lead to death 5 .
So far the data we have suggest that the risk of severe disease and death
increases amongst elderly people and in people with underlying health risk
conditions (in the same way as for seasonal flu) 6 7 . Illness is less common and
usually less severe in younger adults 8 . Children can be infected 9 and can have a
severe illness 10 , but based on current data overall illness seems rarer in people
under 20 years of age. So far, there has been no obvious sign that pregnant
women are more likely to be seriously affected 11 12 ....
On page 5
9 Li, Q., et al Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus- Infected Pneumonia. NEJM. 2020 Jan 29 DOI: 10.1056/NEJMoa2001316
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The Lancet (Elsevier BV)
2.6 It is, however, also clear that a minority of people who get COVID-19 will develop
complications severe enough to require hospital care 4 , most often pneumonia. In
a small proportion of these, the illness may be severe enough to lead to death 5 .
So far the data we have suggest that the risk of severe disease and death
increases amongst elderly people and in people with underlying health risk
conditions (in the same way as for seasonal flu) 6 7 . Illness is less common and
usually less severe in younger adults 8 . Children can be infected 9 and can have a
severe illness 10 , but based on current data overall illness seems rarer in people
under 20 years of age. So far, there has been no obvious sign that pregnant
women are more likely to be seriously affected 11 12 ....
On page 5
11 Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, Li J, Zhao D, Xu D, Gong Q, Liao J. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. The Lancet. 2020 Feb 12
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2.6 It is, however, also clear that a minority of people who get COVID-19 will develop
complications severe enough to require hospital care 4 , most often pneumonia. In
a small proportion of these, the illness may be severe enough to lead to death 5 .
So far the data we have suggest that the risk of severe disease and death
increases amongst elderly people and in people with underlying health risk
conditions (in the same way as for seasonal flu) 6 7 . Illness is less common and
usually less severe in younger adults 8 . Children can be infected 9 and can have a
severe illness 10 , but based on current data overall illness seems rarer in people
under 20 years of age. So far, there has been no obvious sign that pregnant
women are more likely to be seriously affected 11 12 ....
On page 5
12 Qiao J. What are the risks of COVID-19 infection in pregnant women?. The Lancet. 2020 Feb 12
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World Health Organization
2.9 Work is in hand to contain the spread of the virus. This includes extensive
guidance provided to individuals returning from areas where there are cases being
reported, and encouraging self-isolation as the primary means to contain the
spread of the disease. Given that there is currently neither a vaccine against
COVID-19 nor any specific, proven, antiviral medication 14 15 , most treatment will
therefore be towards managing symptoms and providing support to patients with
complications. The majority of people with COVID-19 have recovered without the
need for any specific treatment, as is the case for the common cold or seasonal flu
- and we expect that the vast majority of cases will best be managed at home,
again as with seasonal colds and flu....
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14 World Health Organization [Internet]. R&D Blueprint: Coronavirus disease (COVID- 2019) R&D; accessed 23rd February 2020. Available from: https://www.who.int/blueprint/priority-diseases/key-action/novel-coronavirus/en/
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3.2 The UK is well prepared for disease outbreaks, having responded to a wide range
of infectious disease outbreaks in the recent past, and having undertaken
significant preparedness work for an influenza pandemic for well over one decade
(eg. our existing plan ‘flu plans 16 ). Our plans have been regularly tested and
updated locally and nationally to ensure they are fit for purpose. This experience...
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16 https://www.gov.uk/government/publications/Responding-to-a-uk-flu-pandemic
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4.1 There is similarity between COVID-19 and influenza (both are respiratory
infections), but also some important differences. Consequently, contingency plans
developed for pandemic influenza 17 , and lessons learned from previous outbreaks,
provide a useful starting point for the development of an effective response plan to
COVID-19. That plan has been adapted, however, to take account of differences
between the two diseases. Annex A sets out the structure for the UK’s response to
a disease outbreak....
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17 https://www.gov.uk/government/publications/Responding-to-a-uk-flu-pandemic
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