CORONAVIRUSES account for about 40 per cent of your annual coughs, colds and runny noses and sore throats. These are normally all limited to the nose and throat and of little consequence. They are common simple upper respiratory tract infections. However a variation of Coronavirus (COVID-19) for a small proportion of people can lead to lower respiratory tract complications – bronchitis and pneumonia and this is bad news. There is no vaccine at present available and viruses are biologically very clever and resourceful.

Protection for yourself and the greater population.

1. Thorough hand washing even with soap or hand sanitiser is an important contribution to flushing the virus down the drain. Please get into the habit of not touching your face or rubbing your eyes unless you have absolutely clean hands. Lots of people touch their faces without even thinking. Also regular washing of the face is an important factor in reducing risk. The virus can exist active on surfaces for a couple of weeks especially if cool and damp.

2. Do not seek out crowds. The virus thrives on people close together. If you start to have a sore throat, runny nose, cough or temperature– self isolate, stay at home in the warm. Do not mix with others. Do not allow other people with coughs or colds or feeling “under the weather” to visit your house, office or school. Be strict and disciplined in this matter.

3. Cough into a tissue covering your mouth or wipe your nose into a tissue which is put immediately down the toilet (not the office paper bin) and then wash your hands thoroughly.

4. If you are compromised (e.g. frail, elderly, being treated for cancer, immunosuppressed, or with a history of respiratory diseases from asthma to bronchitis or pneumonia etc.) then please keep warm and take precautions to make sure minimal contact is observed with others. Please do not go round the streets looking for the virus to find you….it will!

5. High quality masks can be helpful, they are not absolute but they do reduce risk (never forget, this is a numbers game which the virus is playing). If anybody in your house feels they are “going down” with something then give them a mask to wear. The other people in the house may not catch the condition if the general level of the virus in the air is low enough. The grades of mask which will give best protection and prevent you spreading your cough or cold or catching it are the grades FFP2 and higher grade FFP3 or N95. If you feel you have a cold or cough and that you must go to your GP please wear a mask or ask for a home visit, you have a responsibility to others (including your GP) and they have a responsibility to you, and waiting rooms and hospitals will have the most vulnerable people who could be infected. Never share a mask. Individual masks are usable for a very long time and can be cleaned even by placing on a hot radiator or in a low warmth oven (above 70C). Masks will have to be reused as there is already a shortage.

6. If you are ill, elderly or compromised in anyway, please have your groceries delivered to your front door. This will involve a minimum of contact. If you have other neighbours or relatives or friends in this bracket offer to bring them the supermarket shopping in a box and leave it at their front door.

7. Stay 6ft or more away from other people. Do not make a point of kissing relatives and friends or allowing them to kiss you, do not share cups or glasses.

It appears this Coronavirus is highly transmittable and on average leads to about a two per cent fatality amongst confirmed cases.

Will there be fatalities in Dorset? Without doubt. Rough estimates have been done for Dorset (population 750,000 of which the Bournemouth conurbation consists of 400,000). The Bournemouth region has an unusually high number of nursing homes, retirement homes, care homes, boarding schools, language schools and hotels. If only a minimum of one per cent of Dorset’s population had confirmed COVID-19 cases then that would generate around 1,500 cases of serious lower respiratory tract illnesses and 150 deaths. The county has just over 2,000 hospital beds, but of course only a tiny percentage are available. In the event of a major problem within eastern Dorset then the large heated Littledown sports hall (facing Royal Bournemouth Hospital) would provide an ideal area for an extra 500 emergency beds.

We who have worked in infectious diseases are always haunted by the events of 100 years ago, The Spanish Influenza (fall 1918 to 1919). That epidemic in the UK killed over 250,000 people, over 50 per cent between the ages 10 to 40 years in a 24 week assault. It however also had a two per cent fatality rate (WHO official estimate). To put this into perspective, the numbers killed in 24 weeks by the Spanish flu in Britain equalled the British war dead of the two largest battles of the First World War – the Somme and Passchendaele.

There is a cold and flu season in this country; the cooler damper months when there’s a lot more water vapour in the air. But we don’t know how the present COVID-19 virus will pan out and whether it will follow this hopeful path as we are currently entering spring. What we do know is that Bournemouth will be the likely first port of call in the county if the disease is confirmed in any numbers in London, as Bournemouth and London are joined at the hip.

There is an unsung hero organisation in all this which is never mentioned in the UK, Colindale, The Public Health Laboratory for the Nation and they will play a major part if COVID-19 enters the UK.

ROBERT WILSON

Former postgraduate in infectious diseases, London School of Hygiene and Tropical Medicine and Royal Postgraduate Medical School, Hammersmith Hospital

Ravine Road, Bournemouth