'Coronavirus epidemic cannot be stopped,' says Sheffield's top public health official

The top public health official in Sheffield has said the coronavirus epidemic cannot be stopped and the authorities are now trying to delay its spread through the population.

Monday, 16th March 2020, 4:03 pm

Greg Fell, the director of public health at Sheffield Council, spoke exclusively to The Star as cases of the killer disease continued to be confirmed across the country.

Mr Fell detailed the measures that were already being taken in response to the biggest public health crisis for a generation, and those we should expect in coming weeks.

But he said that it was equally important for the public to play their part in helping slow the spread of the virus and limit its impact on the most vulnerable in the city.

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What is the situation at the moment?

There are now three cases in Sheffield but we are expecting there will be more and are preparing for that. The Prime Minister yesterday was very clear we're moving from a contained phase to a delay phase and the first point of the delay phase is to protect the vulnerable. It's pretty clear that most people who have had this illness thus far have a pretty mild illness but some of them have more acute symptoms. But that is very dependent on age and underlying illness so protecting vulnerable clearly becomes quite important in that context.

The second aim is to implement social distancing measures. The point of those measures and interventions is to delay the peak of the epidemic curve. There's no way we can stop it so we delay the peak until late spring or early summer, the point of that is to keep it as far away from winter as is humanly possible. That lessens the impact on the NHS and social care and enables them to do what they do well which is looking after people with other illnesses.

And the third broad aim of the strategy is to keep Sheffield running to keep the economy going because life still continues.

How do you know if you have coronavirus?

Flu-like symptoms. As of yesterday, we broadly stopped testing in the community but the key message from the point of view of the public is if you have a new onset persistent cough, and temperature of 37.8 or more, then you should stay at home for seven days. So it is basically self-isolation on the basis of a self-diagnosis. The point of the seven days is that now we know a little bit more about the characteristics of the virus and most of the infectious period is from the point of onset of symptoms when you become poorly to about two to three days afterwards. By the time you get to seven days, you won’t be infectious anymore. So we won’t know that people derfinitely have it anymore, but we will be making an assumption that’s that is what it is, particularly outside of flu season.

What can we do to protect ourselves?

Sorry, you'll hear people like me say all the time, wash your hands. It's really dull 100-year-old advice but it really, really works. When it comes to how often, more often than we do now. I think the national guidelines say in the order of least five times a day for 20 seconds. When it comes to face masks no one's recommending them outside of the clinical context. We need all the face masks we can get for primary care and social care and those in hospitals so we're kind of trying to preserve the nation's stock for them.

Should people avoid public gatherings?

The national advice is that the world has to continue and we are too early on in the development of the epidemic for closing mass gatherings to really have much much benefit. There is also a displacement effect if we close the football everyone goes to the pub and the pubs are more enclosed environment and you're probably closer to people for longer. So there just aren't enough people with the illness, at the moment, to make the benefits in terms of interrupting the transmission of the virus worth the cost. We may get to a time where those kinds of measures become necessary but I genuinely think certainly the evidence doesn't support closing mass gatherings at this point in the epidemic. The same goes for schools. When we close school everyone goes home to look after our kids and that gives us a problem in terms of running health and social care services and every other kind of business in the city.

Is there any update on people in Sheffield who have coronavirus?

No, and if I did, I wouldn't be at liberty to comment because of patient confidentiality. I'm aware that the three people I know of are at home so they're clearly not fully enough to be in hospital. It is worth saying that the majority of people who have this illness will have a pretty mild illness and many might not even though they have it. That in itself is a problem because you know we've all been to work with a cough in the past and that becomes a problem with regards to people who are more likely to have a severe illness.

Should people avoid care homes?

That might be something that we do but for the time being I don't think we're quite there yet. We possibly will do it when the timing is right but there are other things that we can do to protect those with particular vulnerabilities that are more effective and less disruptive. When it comes to distancing ourselves from elderly relatives I’d be wary about it for now. It might be that for an 88-year-old lady with 15 things wrong with her we might not want her going to the supermarket to get groceries. I think it is really a bit early for those sorts of things but we’ll probably have to start thinking about then in the next few weeks.

What can we expect to happen over the next few weeks?

We know that there's more illness around than we have currently diagnosed but no one quite knows that proportion. However, I'm not overly worried about the numbers. They are going to continue to go up and I suspect this will be an epidemic that will last months not weeks. It's not something that we can magic and make go away.

What advice do you have for businesses?

The advice for businesses is that they do contingency planning. The epidemic is going to happen and there is no way to stop that. People will be poorly so I’m saying to businesses how will you cope if you've got 20 per cent of your staff off work. What if it's 30 per cent? What if it's 40 per cent? What will happen if your supply chain becomes disrupted? What was really helpful in the budget on Wednesday was the statutory sick pay kicks in on day one and that disincentivizes people from coming to work when they're poorly. The government is thinking pretty hard on that one and I and others in Sheffield need to do some work on how we get businesses as fit as they can be.