Coronavirus UK: What are 'underlying health conditions?

The Government is being urged to reveal exactly what health problems the UK’s 40 coronavirus fatalities had before they died.

‘Underlying health conditions’ has become a buzzword of the pandemic as officials have attempted to reassure the young and healthy they won’t die.

But a massive 43 per cent of adults in England – around 18million people – are living with long-term health conditions, according to an NHS survey.

Many are nervous that their illness might make them more likely to get seriously ill if they catch the coronavirus, and say there is not enough information to warn them or to allay their fears.

Statistics from China, where the outbreak began, showed the most common illnesses among the victims were diabetes, high blood pressure and heart disease.

But it’s not clear if this is because those conditions are the highest risk or simply because they are the most common and patients had other problems, too.

One Twitter user said: ‘What are these underlying health issues? Most adults I know have some sort of underlying health issue… very vague all this’.

It comes after a man in his 40s, with heart disease, survived coronavirus and revealed it turned his skin grey and he thought he would die.

Twitter users have said 'the public deserves to know what the "underlying conditions" are'

Twitter users have said 'the public deserves to know what the "underlying conditions" are'

Twitter users have said ‘the public deserves to know what the “underlying conditions” are’

Scientists have crunched coronavirus numbers to reveal the fatality rate for those with underlying health problems. Data from China shows 10.5 per cent of heart disease patients who became ill with COVID-19 did not survive, compared to 0.9 per cent of healthy people

Scientists have crunched coronavirus numbers to reveal the fatality rate for those with underlying health problems. Data from China shows 10.5 per cent of heart disease patients who became ill with COVID-19 did not survive, compared to 0.9 per cent of healthy people

Scientists have crunched coronavirus numbers to reveal the fatality rate for those with underlying health problems. Data from China shows 10.5 per cent of heart disease patients who became ill with COVID-19 did not survive, compared to 0.9 per cent of healthy people

An NHS England statement yesterday, which announced the deaths of 14 coronavirus patients, said: ‘Patients were aged between 59 and 94 years old and had underlying health conditions’.

The phrase ‘underlying health conditions’ was repeated in one form or another in 11 out of the 13 separate comments from the hospitals where the patients had died.

But no more details about what the conditions were, how severe they were or why the patients were in hospital in the first place, have been made available.

And the NHS website does not have any more clarification about which groups are most at risk.

Twitter users say people deserve to know what the conditions are, how severe they need to be to be a risk, and which ones are the most dangerous.

Ian Gallagher said: ‘All these poor people who have died from this virus, keeps getting reported they had underlying health conditions??

‘What are these underlying health issues? Most adults I know have some sort of underlying health issue’.

WHAT ARE THE CORONAVIRUS MORTALITY RATES AMONG DIFFERENT GROUPS?

Conditions 

  • Heart disease: 10.5%
  • Diabetes: 7.3%
  • Chronic respiratory disease: 6.3%
  • High blood pressure: 6%
  • Cancer: 5.6%
  • None: 0.9%

Ages

  • 0-9 years: N/A
  • 10-19 years: 0.2%
  • 20-29 years: 0.2%
  • 30-39 years: 0.2%
  • 40-49 years: 0.4%
  • 50-59 years: 1.3%
  • 60-69 years: 3.6%
  • 70-79 years: 8%
  • Over 80 years: 14.8%

Marion Fallon said: ‘What are the “underlying conditions”/chronic illness they keep talking about? Have looked all over & can’t find this’.

A woman called Emma added: ‘We need to know about people under 70 with underlying health conditions. What are they including and how serious do they need to be’.

And another user named Maria said: ‘The public deserves to know what the “underlying conditions” are’.

The NHS, Department of Health and Public Health England all declined to comment.

NHS England’s Health Survey for England, which is published every year, says almost half of over-16s have long-term health problems, either physical or mental.

Some 11 per cent of people have long-term heart problems, it said, while 17 per cent have muscle/bone disorders, and eight per cent have breathing difficulties.

The most common specific conditions were arthritis (eight per cent); high blood pressure (six per cent); diabetes (five per cent); and asthma (five per cent).

Scientists who studied the statistics in China revealed a list of some of the most common ‘underlying’ illnesses they found in patients who had died of COVID-19.

They found that 10.5 per cent of heart disease patients who caught the virus ended up dying with it.

There are 1,543 confirmed coronavirus cases in the UK and at least 37 people have died, according to today's statistics

There are 1,543 confirmed coronavirus cases in the UK and at least 37 people have died, according to today's statistics

There are 1,543 confirmed coronavirus cases in the UK and at least 37 people have died, according to today’s statistics

OFFICIAL STATISTICS SHOW THE TIP OF THE ICEBERG OF UK’S COVID CRISIS

The Government’s Department of Health releases updated statistics every day at around 2pm, showing the number of people confirmed to have coronavirus and the number of test results that have been received in the past 24 hours.

But thanks to a change in the way officials are tracking the outbreak, these numbers only represent a small proportion of the real epidemic spreading across the UK.

Only people who are seriously ill and need hospital care, or who are already in hospital when they show signs of the coronavirus, are now being tested, so these are the only people who will show up in new Government figures.

People who become ill after travelling, or think they have the coronavirus after being in contact with someone who does, will not be tested unless they need hospital care. Most patients will simply self-isolate at home until they are no longer ill.

An announcement by the Government last week sheds some light on the true scale of Britain’s epidemic.

On Thursday, March 12, when the official number of cases was just 596, chief scientific adviser Sir Patrick Vallance said the true figure was probably between 5,000 and 10,000.

Taking the upper estimate, that suggests each confirmed case is worth 16.8 undiagnosed patients.

The official number of patients is now 1,543 – multiply that by 16.8 and the potential real case toll is 25,889.

The death rate for diabetics was 7.3 per cent, for people with lung disease it was 6.3 per cent and for cancer patients it was 5.6 per cent.

Age is one of the major contributors to likelihood of dying – this may be because older people are naturally weaker or because they’re more likely to have bad health.

Over 80s are the most at risk group and around 14.8 per cent of octagenarians who catch it don’t survive, according to the research.

Between 60 and 69 years old the death rate is around 3.6 per cent, while it is more like 1.3 per cent for those aged 50 to 59.

For people in their 40s this drops to 0.4 per cent, and it’s just 0.2 per cent for those in their 30s.

This is not to say younger people don’t die – a patient in their 50s yesterday became the youngest fatality in the UK.

One man in his 40s, who caught coronavirus and survived it, said he felt like he would die and it turned him grey.

A patient known only as Guy, a married father of two who has heart disease, told The Times that he stayed in isolation at home after being given an oxygen tank by paramedics in hazmat suits.

Guy said he woke up with grey skin one day and was gasping for air.

‘I was in a really bad way,’ he said. ‘They gave me oxygen for an hour and did lots of other tests, after which they said I was stable and gave me the option of going to hospital or not.’

He added: ‘My experience is hopefully worse than most might expect.’

And, playing down the horror of waking up unable to breathe, he said: ‘It is not at all pleasant, but aside from the breathing thing, it’s like a bad flu without the snot.’

WHAT DO WE KNOW ABOUT THE CORONAVIRUS?

What is the coronavirus?

A coronavirus is a type of virus which can cause illness in animals and people. Viruses break into cells inside their host and use them to reproduce itself and disrupt the body’s normal functions. Coronaviruses are named after the Latin word ‘corona’, which means crown, because they are encased by a spiked shell which resembles a royal crown.

The coronavirus from Wuhan is one which has never been seen before this outbreak. It has been named SARS-CoV-2 by the International Committee on Taxonomy of Viruses. The name stands for Severe Acute Respiratory Syndrome coronavirus 2.

Experts say the bug, which has killed around one in 50 patients since the outbreak began in December, is a ‘sister’ of the SARS illness which hit China in 2002, so has been named after it.

The disease that the virus causes has been named COVID-19, which stands for coronavirus disease 2019.

Dr Helena Maier, from the Pirbright Institute, said: ‘Coronaviruses are a family of viruses that infect a wide range of different species including humans, cattle, pigs, chickens, dogs, cats and wild animals.

‘Until this new coronavirus was identified, there were only six different coronaviruses known to infect humans. Four of these cause a mild common cold-type illness, but since 2002 there has been the emergence of two new coronaviruses that can infect humans and result in more severe disease (Severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronaviruses).

‘Coronaviruses are known to be able to occasionally jump from one species to another and that is what happened in the case of SARS, MERS and the new coronavirus. The animal origin of the new coronavirus is not yet known.’

The first human cases were publicly reported from the Chinese city of Wuhan, where approximately 11million people live, after medics first started publicly reporting infections on December 31.

By January 8, 59 suspected cases had been reported and seven people were in critical condition. Tests were developed for the new virus and recorded cases started to surge.

The first person died that week and, by January 16, two were dead and 41 cases were confirmed. The next day, scientists predicted that 1,700 people had become infected, possibly up to 7,000. 

Where does the virus come from?

According to scientists, the virus almost certainly came from bats. Coronaviruses in general tend to originate in animals – the similar SARS and MERS viruses are believed to have originated in civet cats and camels, respectively.

The first cases of COVID-19 came from people visiting or working in a live animal market in Wuhan, which has since been closed down for investigation.

Although the market is officially a seafood market, other dead and living animals were being sold there, including wolf cubs, salamanders, snakes, peacocks, porcupines and camel meat.

A study by the Wuhan Institute of Virology, published in February 2020 in the scientific journal Nature, found that the genetic make-up virus samples found in patients in China is 96 per cent identical to a coronavirus they found in bats.

However, there were not many bats at the market so scientists say it was likely there was an animal which acted as a middle-man, contracting it from a bat before then transmitting it to a human. It has not yet been confirmed what type of animal this was.

Dr Michael Skinner, a virologist at Imperial College London, was not involved with the research but said: ‘The discovery definitely places the origin of nCoV in bats in China.

‘We still do not know whether another species served as an intermediate host to amplify the virus, and possibly even to bring it to the market, nor what species that host might have been.’

So far the fatalities are quite low. Why are health experts so worried about it? 

Experts say the international community is concerned about the virus because so little is known about it and it appears to be spreading quickly.

It is similar to SARS, which infected 8,000 people and killed nearly 800 in an outbreak in Asia in 2003, in that it is a type of coronavirus which infects humans’ lungs. It is less deadly than SARS, however, which killed around one in 10 people, compared to approximately one in 50 for COVID-19.

Another reason for concern is that nobody has any immunity to the virus because they’ve never encountered it before. This means it may be able to cause more damage than viruses we come across often, like the flu or common cold.

Speaking at a briefing in January, Oxford University professor, Dr Peter Horby, said: ‘Novel viruses can spread much faster through the population than viruses which circulate all the time because we have no immunity to them.

‘Most seasonal flu viruses have a case fatality rate of less than one in 1,000 people. Here we’re talking about a virus where we don’t understand fully the severity spectrum but it’s possible the case fatality rate could be as high as two per cent.’

If the death rate is truly two per cent, that means two out of every 100 patients who get it will die.

‘My feeling is it’s lower,’ Dr Horby added. ‘We’re probably missing this iceberg of milder cases. But that’s the current circumstance we’re in.

‘Two per cent case fatality rate is comparable to the Spanish Flu pandemic in 1918 so it is a significant concern globally.’

How does the virus spread?

The illness can spread between people just through coughs and sneezes, making it an extremely contagious infection. And it may also spread even before someone has symptoms.

It is believed to travel in the saliva and even through water in the eyes, therefore close contact, kissing, and sharing cutlery or utensils are all risky. It can also live on surfaces, such as plastic and steel, for up to 72 hours, meaning people can catch it by touching contaminated surfaces.

Originally, people were thought to be catching it from a live animal market in Wuhan city. But cases soon began to emerge in people who had never been there, which forced medics to realise it was spreading from person to person.

What does the virus do to you? What are the symptoms?

Once someone has caught the COVID-19 virus it may take between two and 14 days, or even longer, for them to show any symptoms – but they may still be contagious during this time.

If and when they do become ill, typical signs include a runny nose, a cough, sore throat and a fever (high temperature). The vast majority of patients will recover from these without any issues, and many will need no medical help at all.

In a small group of patients, who seem mainly to be the elderly or those with long-term illnesses, it can lead to pneumonia. Pneumonia is an infection in which the insides of the lungs swell up and fill with fluid. It makes it increasingly difficult to breathe and, if left untreated, can be fatal and suffocate people.

Figures are showing that young children do not seem to be particularly badly affected by the virus, which they say is peculiar considering their susceptibility to flu, but it is not clear why.

What have genetic tests revealed about the virus? 

Scientists in China have recorded the genetic sequences of around 19 strains of the virus and released them to experts working around the world.

This allows others to study them, develop tests and potentially look into treating the illness they cause.

Examinations have revealed the coronavirus did not change much – changing is known as mutating – much during the early stages of its spread.

However, the director-general of China’s Center for Disease Control and Prevention, Gao Fu, said the virus was mutating and adapting as it spread through people.

This means efforts to study the virus and to potentially control it may be made extra difficult because the virus might look different every time scientists analyse it.

More study may be able to reveal whether the virus first infected a small number of people then change and spread from them, or whether there were various versions of the virus coming from animals which have developed separately.

How dangerous is the virus?  

The virus has a death rate of around two per cent. This is a similar death rate to the Spanish Flu outbreak which, in 1918, went on to kill around 50million people.

Experts have been conflicted since the beginning of the outbreak about whether the true number of people who are infected is significantly higher than the official numbers of recorded cases. Some people are expected to have such mild symptoms that they never even realise they are ill unless they’re tested, so only the more serious cases get discovered, making the death toll seem higher than it really is.

However, an investigation into government surveillance in China said it had found no reason to believe this was true.

Dr Bruce Aylward, a World Health Organization official who went on a mission to China, said there was no evidence that figures were only showing the tip of the iceberg, and said recording appeared to be accurate, Stat News reported.

Can the virus be cured?

The COVID-19 virus cannot be cured and it is proving difficult to contain.

Antibiotics do not work against viruses, so they are out of the question. Antiviral drugs can work, but the process of understanding a virus then developing and producing drugs to treat it would take years and huge amounts of money.

No vaccine exists for the coronavirus yet and it’s not likely one will be developed in time to be of any use in this outbreak, for similar reasons to the above.

The National Institutes of Health in the US, and Baylor University in Waco, Texas, say they are working on a vaccine based on what they know about coronaviruses in general, using information from the SARS outbreak. But this may take a year or more to develop, according to Pharmaceutical Technology.

Currently, governments and health authorities are working to contain the virus and to care for patients who are sick and stop them infecting other people.

People who catch the illness are being quarantined in hospitals, where their symptoms can be treated and they will be away from the uninfected public.

And airports around the world are putting in place screening measures such as having doctors on-site, taking people’s temperatures to check for fevers and using thermal screening to spot those who might be ill (infection causes a raised temperature).

However, it can take weeks for symptoms to appear, so there is only a small likelihood that patients will be spotted up in an airport.

Is this outbreak an epidemic or a pandemic?

The outbreak was declared a pandemic on March 11. A pandemic is defined by the World Health Organization as the ‘worldwide spread of a new disease’.

Previously, the UN agency said most cases outside of Hubei had been ‘spillover’ from the epicentre, so the disease wasn’t actually spreading actively around the world.

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