Last updated: 28 May 2020

The current COVID-19 global pandemic is constantly evolving. The Center for Systems Science and Engineering (CSSE) data dashboard at John Hopkins University has the latest COVID-19 statistics from around the world. There is currently no vaccine available for COVID-19.  

During the COVID-19 pandemic it is vitally important that patients and the public recognise that they must continue to seek medical assistance if they have symptoms which cause concern, or they already are being treated for a serious health condition. The risk of developing other serious or life-threatening conditions remains unchanged and people must be fully confident that they can and should, seek medical assistance if they are worried about themselves or a relative.

The NHS not only remains open to see people with urgent and serious problems, it is actively asking that such people seek help. Urgent and acute illnesses or conditions will continue to be treated and the public must not hold back from seeking NHS help regarding serious illness in themselves or their family. This applies to new symptoms or recurrences of existing conditions.

UK four nation responses to COVID – 19

Scotland

The Scottish Government has an online hub for the latest news and guidance. The NHS in Scotland has been placed on an emergency footing until June 2020 at the earliest.

A number of screening programmes (Breast Screening (mammograms); Cervical Screening (smear tests); Bowel Screening (home test kits); Abdominal Aortic Aneurysm (AAA) Screening (ultrasound of abdomen) and Diabetic Retinopathy (Eye) Screening (images taken of the eye)) have been paused to enable healthcare staff to be re-allocated to support other essential services, including COVID-19 laboratory testing and covering for colleagues who are unwell or self-isolating.

 

England

All the guidance and information on the UK Government online hub is applicable in England unless otherwise stated. 

Wales

Welsh Government guidance on COVID-19 has been published and announcements are regularly updated. 

Northern Ireland

Guidance from the Northern Ireland Executive is available. Health Minister Robin Swann previously outlined actions that will be taken in Northern Ireland.

Action Plans to tackle COVID -19 in the UK

The UK Government has published an action plan, and the Scottish Government has published its response to date. The 4 phases of the UK's approach are:

  • Containment - caring for any infected people and identifying their close contacts
  • Delay - deciding what actions to take to slow down the spread
  • Mitigate - damage limitation if the virus spreads widely
  • Research - constant and ongoing work to inform the three other phases

Discussions with CMOs

Over recent weeks, the College has participated in teleconferences with the Chief Medical Officers (CMO) for England and Scotland regarding coronavirus. Through this process, the College has been advised that Public Health England (PHE) have published a flow chart for management of a suspected case of COVID-19 acute respiratory disease. The UK CMOs have co-signed a letter in support of UK doctors.  The GMC has published information for healthcare professionals.

The CMOs for England and Scotland (Professor Chris Whitty and Dr Gregor Smith), have regularly updated representatives from the Royal Colleges, including the Royal College of Physicians of Edinburgh. Below are highlights from recent updates:

  • It is positive news is that most of public are adhering very well to the restrictions in the UK and modellers think this will assist in taking the pressure off the NHS in due course
  • Incubation period is up to 14 days and illness appears to last longer than seasonal flu. 
  • COVID-19 appears to result in peak virus shedding after symptoms begin, and then decreases at approximately 10-11 days.
  • Coronavirus differs from SARS in that SARS viraemia was mainly deep in the lung tissue, where Coronovirus is mainly upper airways.
  • The virus remains on hard surfaces for up to 72hrs – and, for practical reasons, the virus will be gone by then. The virus fades faster on soft furnishings or clothes. 
  • The CMO in Scotland has been advised that the R0 (the number of cases one case generates on average over the course of its infectious period) is 2-3, meaning that one person with coronavirus could infect another two or three people on average.  
  • There are a number of vaccine trials underway around the world. The CMOs in England and Scotland don't think that a mass vaccine will be available within the year. Vaccine trials running on the premise that “this might work".
  • The mortality rate for coronavirus is estimated at 2-3% versus the Chinese Sars outbreak in 2002, which was 10%.

International update: WHO

The WHO has published online a range of public health advice and information on COVID-19, including situation reports, technical guidance, travel advice, and advice for the public about how to protect themselves.

International perspectives

To help us understand the differing responses to COVID-19 across the world, our Overseas Regional Advisers shared their local experience. You can read these international perspectives here.

MRCP(UK) Exam updates

The Federation of the Royal Colleges of Physicians of the UK is pleased to confirm that MRCP(UK) clinical and written examinations will recommence from this autumn, both in the UK and internationally, dependent on the impact of COVID-19 in each country and in accordance with their latest policies on travel, social distancing and infection control. All examination dates will be confirmed as soon as possible and we will provide candidates with further details and guidance on how things will run on the day ahead of their exam date.

To read the latest updates, guidance and advice, please visit the MRCP(UK) website.

Coronavirus Act 2020

On 17 March it was announced that new laws would be introduced in the UK through the Coronavirus Bill to protect public health, increase NHS capacity, strengthen social care and support the public. The Coronavirus Bill is now an Act of Parliament (law).

The Act sets out a wide variety of measures including some relating to NHS staff and healthcare regulation:

"The (Act) will allow recently retired NHS staff and social workers to return to work without any negative repercussions to their pensions..... It will enable regulators to emergency register suitable people as regulated healthcare professionals, such as nurses, midwives or paramedics. This might include (but will not be limited to) recently retired professionals and students who are near the end of their training. Registered staff can then be used appropriately, with decisions made on a local basis, to increase the available health and social care workforce and enable essential health and care services to function during the height of the epidemic”

What next?

The College continues to receive regular updates from relevant public health bodies and departments, including the CMOs for England and Scotland. At this stage, it is important that public health and health protection departments continue to keep the public and clinicians updated as much as possible during what is a fast-moving situation. 

I hope that you have found this update helpful. We will continue to monitor coronavirus closely, and if you have any enquiries, please do get in touch.

Dr Conor Maguire, International Vice President