Concern is growing over the spread of Wuhan Coronavirus, which has killed at least 26 people in China. At least 800 cases have been confirmed, with 15 or more medical workers infected through human-to-human contact.
The outbreak began at a live animal market in Wuhan. Most cases are in the central China city itself, which has now effectively been placed in quarantine. Flights, trains and local public transport have been halted.
The Foreign Office has warned against all but essential travel to Wuhan. The warning against travel to Wuhan will affect very few British travellers, because it is not a tourist city.
Five cases of the disease have been reported in Thailand, three in each of Singapore and Taiwan, and two in each of Hong Kong, Macau, Japan, South Korea and Vietnam.
The only case outside east Asia has been confirmed in Seattle, Washington. The traveller had arrived in the US from China.
Fourteen people have also been tested for the virus in the UK, but they were all negative.
Imperial College’s MRC Centre for Global Infectious Disease Analysis believes the actual number of cases is far higher. By 18 January 2020, the centre estimates there were 4,000 cases in Wuhan alone.
With millions of people on the move for the Chinese New Year on 25 January and the Spring Festival, the World Health Organization (WHO) predicts many more cases will occur.
These are the key questions for travellers.
What is this virus?
It is a “novel coronavirus”. The term “novel” simply means that the strain is newly identified. A coronavirus (abbreviated to CoV) is so-called because, under a microscope, it appears to have a circular fringe.
Typically a coronavirus causes a runny nose, cough, sore throat, headache, fever and what the US Centers for Disease Control (CDC) calls “a general feeling of being unwell”. It adds: “Most people get infected with these viruses at some point in their lives. These illnesses usually only last for a short amount of time.”
The medical director at Public Health England (PHE), Professor Paul Cosford, said: “The vast majority of people who are infected do seem to be getting better.”
But coronaviruses can cause lower-respiratory tract illnesses, notably pneumonia, especially among very young or old people and those with weakened immune systems or existing cardiopulmonary disease.
This appears to have been the primary cause of death for the victims of the Wuhan Coronavirus, which is also known as WN-CoV and 2019-nCoV.
How is it transmitted?
Public Health England says: “As WN-CoV has only been recently identified, there is currently limited information about the precise routes of transmission.
“Coronaviruses are mainly transmitted by large respiratory droplets and direct or indirect contact with infected secretions.”
Until more evidence emerges, it is wise to assume that it can be contracted by airborne particles or contact with an ill person.
How soon does the infection become apparent?
The MRC Centre says that the delay between infection and detection is 10 days – made up of an incubation period of five to six days, and an estimated four- or five-day delay from the onset of symptoms to the detection and hospitalisation of a case.
China’s National Health Commission vice-minister Li Bin, said: ”Though the transmission route of the virus is yet to be fully understood, there is a possibility of virus mutation and a risk of further spread of the epidemic.”
Is this related to Sars?
To a degree. The “severe acute respiratory syndrome” was a coronavirus that spread, mainly in east Asia, in late 2002 and 2003. Nearly 800 people died during the outbreak, but no cases have been reported since 2004.
Another coronavirus, Mers (“Middle East respiratory syndrome”) has affected people in the Middle East, particularly the Arabian Peninsula, since 2012.
The World Health Organization currently says: “Based on currently available information, WHO does not recommend any restriction of travel or trade.”
Some countries, including the UK, have started screening passengers arriving on flights from China. This is of limited use, since people who contract the virus will not show any symptoms for the first five days. In addition it does not identify passengers who have travelled via other hubs in China, the rest of Asia and the Middle East.
The first affected arrival at London Heathrow was China Southern flight 673 on Wednesday 22 January. It was met by health officials who checked for symptoms of coronavirus and provided information to passengers about symptoms, and what to do if they become ill.
But all flights from Wuhan have now been halted by order of the Chinese authorities, so there will be no more arrivals until the all-clear is given.
Travellers from China to three airports in the US – Los Angeles, New York JFK and San Francisco – are having their temperatures taken and filling out a “symptom questionnaire” that asks if they are suffering with a fever, a cough or breathing difficulties.
Australia has said that it will screen arrivals from Wuhan. Dubai airport in the UAE, where many passengers transfer, says it will carry out thermal screening on all incoming passengers from China, rather than just from Wuhan itself.
Where are the key airports where infected travellers might be?
According to analysis of airline schedules by John Grant of OAG, Bangkok is the most popular international destination from Wuhan, followed by Hong Kong (classed as international even though it is part of the People’s Republic), Tokyo, Seoul and Taipei.
For domestic connections, Guangzhou is the leading airport for travellers from Wuhan.
What precautions can I take?
The same basic hygiene regime that every traveller should observe: washing hands frequently with soap, avoiding close contact with anyone showing symptoms of respiratory illness such as coughing and sneezing, and avoiding meat and egg dishes that have not been thoroughly cooked.
Airline passengers are particularly susceptible. Wearing a medically approved face mask, which is certified as offering FFP3 protection, may protect the wearer against contracting the virus. But the main benefit of wearing a mask is for symptomatic passengers, because it reduces the possible spread of the virus.
For anyone who thinks they may have contracted the virus, Dr Nick Phin, deputy director of PHE’s National Infection Service, says: “Individuals should seek medical attention if they develop respiratory symptoms within 14 days of visiting Wuhan, either in China or on their return to the UK, informing their health service prior to their attendance about their recent travel to the city.”
I am booked to travel to Asia. What are my options?
Travel to specifically to Wuhan is unlikely to be possible until the outbreak is deemed to be under control, and any British traveller who goes there against Foreign Office advice will not be covered by standard travel insurance policies.
Airlines serving Wuhan itself are offering refunds, with most of them allowing even holders of non-refundable fares to get their money back for journeys up to 29 March 2020.
For trips elsewhere in China and the region, there is no general entitlement for a refund from your travel organiser or from travel insurance.
A spokesperson for British Airways said: “We are monitoring the situation closely, and our flights continue to operate as normal. Like other airlines, we are liaising closely with both government and health organisations and following their advice.”
Some companies are offering flexibility. IHG, the global hotel chain which includes Holiday Inn, InterContinental and Kimpton, is allowing penalty-free cancellations for bookings at properties in mainland China, Hong Kong, Macau and Taiwan, up to and including 3 February 2020.
The company said the policy was “in response to the recent new coronavirus outbreak and in order to prioritise the health and wellbeing of our employees”.
Accor, Hilton, Mandarin Oriental, Peninsula and Shangri-La are also reported to be offering flexibility to guests booked at hotels in China.
What if the Foreign Office were to warn against travel elsewhere in the region?
In that highly unlikely event, travellers who are on a package holiday organised by a British firm should be able to cancel without penalty for a full refund.
Airlines are not obliged to refund tickets whatever the Foreign Office advice, but in the past they have offered some flexibility.
A spokesperson for the Association of British Insurers said: “Travel insurance may cover some out-of-pocket losses, and also help you to leave the area if a warning to return back to the UK comes into effect while you are there, if you are unable to get assistance from any other source.”
Conversely, travelling to an area against the advice of the Foreign Office will invalidate most insurance policies.
What if I feel ill when I return?
If you have recently been in Wuhan and believe you may have been infected, seek medical help. But before you turn up at your GP’s surgery or A&E, call NHS Direct ahead on 111 to tell them about your symptoms and recent travels so they can put precautions in place.
Will it spread far and wide?
I don’t know how the new coronavirus will evolve over the next few months. Cases are likely to be reported worldwide, but mainly among travellers who have travelled from China.
Wuhan Coronavirus may spread across the globe and cause widespread harm as well as massive disruption.
More optimistically, new cases might peak soon but then subside; if previous “killer virus” scares are typical, concern will soon dwindle.
The European Centre for Disease Prevention and Control says it is likely that cases will be identified in the EU. But it adds: “Assuming that timely and rigorous infection prevention and control measures are applied around imported cases detected in the EU/EEA, the likelihood of further sustained spread in community settings is considered low.”
Tom Jenkins, chief executive of the European Tourism Association said: “[The virus] remains a very remote threat – effectively no threat – for any traveller in Europe.“