United Kingdom

Should we wear them after all? Scientists urge UK to issue millions of face masks

Wearing surgical face masks in public may have helped slow the coronavirus crisis - despite Britons being repeatedly told they were pointless.

Experts say a full-scale outbreak in the UK could have been prevented if millions of masks had been issued - which has been the case in South Korea and Japan.

The British Government has long held the view that the cheap paper masks offer little protection against catching COVID-19.

This is because they are thin, loose-fitting and porous - which make it easy for the tiny viral particles to pass through.

But experts have always maintained that, while the masks may not shield someone from contracting the illness, they stop the wearer from infecting others.

As well as on surfaces, the virus can be transmitted via droplets that are released when a patient talks, breathes, coughs or sneezes. 

This may have been more important than initially thought now that researchers know infected people are contagious for several days before they have symptoms.

Professor Ian Jones, a virologist from the University of Reading, said the mass-issuing of masks 'should now be considered' in the UK.

Warning that the crisis is spiralling rapidly, he told MailOnline: 'Anything that reduces the rate of transmission will bring it under control sooner.' 

South Korea, Japan, Singapore and Hong Kong have issued millions of masks to their people and managed to prevent large outbreaks, despite being in such close proximity to China. 

Wearing surgical face masks in public may have helped slow the coronavirus crisis, it has been suggested. But the UK Government has long held the view that the cheap paper masks offer little protection against catching COVID-19

South Korea, Japan, Singapore and Hong Kong have issued millions of masks to their people and managed to prevent full-scale outbreaks, despite being in such close proximity to China. Critics say masks don't work because China still suffered more than 80,000 cases

The current official guidance from the CDC (above) urges people who are healthy to avoid using masks due to the ongoing shortage for doctors and nurses. The UK's Department of Health recommends the same thing

The World Health Organization has a list of recommendations for safely wearing and removing masks to avoid the risk of infection

Professor Jones told MailOnline: 'For me it's very simple, the epidemic is currently running [rampant] and anything that reduces the rate of transmission will bring it under control sooner. 

'On the basis that correct mask use would do no harm and potentially some good it should be considered.'

Dr Stephen Griffin, associate professor of infection and immunity at the University of Leeds, said masks prevent asymptomatic people spreading the disease by catching tiny droplets they exhale.

He added: 'They are also useful for people that are themselves symptomatic in stopping coughs and sneezes.

'They also reduce the propensity for people to touch their faces, which happens many more times a day than we all realise and is a major source of infection without proper hand hygiene.' 

George Gao, director-general of the Chinese Center for Disease Control and Prevention, this week said the 'big mistake' in the US and Europe was that 'people aren't wearing masks'.

He told Science magazine: 'This virus is transmitted by droplets and close contact. Droplets play a very important role – you've got to wear a mask, because when you speak, there are always droplets coming out of your mouth.

'Many people have asymptomatic or pre-symptomatic infections. If they are wearing face masks, it can prevent droplets that carry the virus from escaping and infecting others.'

People around the world have been using scarves as makeshift masks (like this woman in Lisbon) because they can't get access to them

Other have resorted to crafting masks out of household items. A man is seen using a nappy as a makeshift face mask in Brooklyn, New York City

THE TRUTH ABOUT FACE MASKS: WHAT STUDIES HAVE SHOWN

Research on how well various types of masks and face coverings varies but, recently, and in light of the pandemic of COVID-19, experts are increasingly leaning toward the notion that something is better than nothing. 

A University of Oxford study published on March 30 concluded that surgical masks are just as effective at preventing respiratory infections as N95 masks for doctors, nurses and other health care workers. 

It's too early for their to be reliable data on how well they prevent infection with COVID-19, but the study found the thinner, cheaper masks do work in flu outbreaks. 

The difference between surgical or face masks and N95 masks lies in the size of particles that can - and more importantly, can't - get though the materials. 

N95 respirators are made of thick, tightly woven and molded material that fits tightly over the face and can stop 95 percent of all airborne particles, while surgical masks are thinner, fit more loosely, and more porous. 

This makes surgical masks much more comfortable to breathe and work in, but less effective at stopping small particles from entering your mouth and nose. 

Droplets of saliva and mucous from coughs and sneezes are very small, and viral particles themselves are particularly tiny - in fact, they're about 20-times smaller than bacteria. 

For this reason, a JAMA study published this month still contended that people without symptoms should not wear surgical masks, because there is not proof the gear will protect them from infection - although they may keep people who are coughing and sneezing from infecting others. 

But the Oxford analysis of past studies- which has not yet been peer reviewed - found that surgical masks were worth wearing and didn't provide statistically less protection than N95 for health care workers around flu patients. 

However, any face mask is only as good as other health and hygiene practices. Experts universally agree that there's simply no replacement for thorough, frequent hand-washing for preventing disease transmission. 

Some think the masks may also help to 'train' people not to touch their faces, while others argue that the unfamiliar garment will just make people do it more, actually raising infection risks.  

If the CDC does instruct Americans to wear masks, it could create a second issue: Hospitals already face shortages of masks and other PPE.

Dr Jake Dunning, Head of Emerging Infections and Zoonoses, Public Health England, told MailOnline: 'Face masks play a very important role in clinical settings, such as hospitals. 

'However, there is very little evidence of widespread benefit from their use outside of these clinical settings. 

'Facemasks must be worn correctly, changed frequently, removed properly, disposed of safely and used in combination with good universal hygiene behaviour in order for them to be effective. 

'Research also shows that compliance with these recommended behaviours reduces over time when wearing facemasks for prolonged periods.'

The US Centers for Disease Control (CDC) - which has taken the same stance as PHE on masks - is now reportedly considering switching its stance and recommending they should be worn.

The agency initially told Americans they didn't need to wear masks and that anything other than a high-grade N95 medical mask would do little to prevent infection any way. 

But experts are now increasingly leaning toward the notion that some form of protection is better than nothing as the crisis spirals out of control.

Whether or not the UK's Department of Health and Social Care will switch its stance remains to be seen. MailOnline has contacted DHSC for comment. 

It's thought British experts will need to see hard evidence that issuing face masks on a nationwide scale can slow the spread before going ahead.  

They may point to the fact China suffered a devastating outbreak despite mass-issuing masks. 

A University of Oxford study published on Monday concluded that surgical masks are just as effective at preventing respiratory infections as N95 masks for doctors, nurses and other health care workers.

It's too early for there to be reliable data on how well they prevent infection with COVID-19, but the study found the thinner, cheaper masks do work in flu outbreaks.

The difference between surgical or face masks and N95 masks lies in the size of particles that can - and more importantly, can't - get though the materials.

N95 respirators are made of thick, tightly woven and molded material that fits tightly over the face and can stop 95 percent of all airborne particles, while surgical masks are thinner, fit more loosely, and more porous.

This makes surgical masks much more comfortable to breathe and work in, but less effective at stopping small particles from entering your mouth and nose.

Droplets of saliva and mucous from coughs and sneezes are very small, and viral particles themselves are particularly tiny - in fact, they're about 20-times smaller than bacteria.

Not all masks are created equal: Single-use masks and surgical masks have larger pores which the coronavirus can easily slip through. A more expensive N95 mask is the gold standard for healthcare workers fighting infectious diseases

IF YOU CAN'T GET A MASK, SHOULD YOU MAKE ONE?

Experts in the US have suggested home-made masks could be a powerful defence against the coronavirus if there is a shortage of masks.  

'Homemade masks theoretically could offer some protection if the materials and fit were optimized, but this is uncertain,' Dr Jeffrey Duchin, a Seattle health official told the Washington Post. 

A 2013 study found that next to a surgical mask, a vacuum cleaner bag provided the best material for a homemade mask. 

After a vacuum bag, kitchen towels were fairly protective, but uncomfortable. Masks made of T-shirts were very tolerable, but only worked a third as well as surgical mask. The Cambridge University researchers concluded that homemade masks should only be used 'as a last resort.'  

Public Health England still does not recommend Britons wear face masks, unless they are infected themselves.

The health body also does not advise people use items of clothing as makeshifts masks, because they it claims they offer practically no protection.  

For this reason, a JAMA study published this month still contended that people without symptoms should not wear surgical masks, because there is not proof the gear will protect them from infection - although they may keep people who are coughing and sneezing from infecting others.

But the Oxford analysis of past studies - which has not yet been peer reviewed - found that surgical masks were worth wearing and didn't provide statistically less protection than N95 for health care workers around flu patients.

However, any face mask is only as good as other health and hygiene practices. 

Experts universally agree that there's simply no replacement for thorough, frequent hand-washing for preventing disease transmission.

Some think the masks may also help to 'train' people not to touch their faces, while others argue that the unfamiliar garment will just make people do it more, actually raising infection risks.

If the CDC does instruct Americans to wear masks, it could create a second issue: Hospitals already face shortages of masks and other PPE.

The agency may recommend regular citizens use alternatives like cloth masks or bandanas.

'Homemade masks theoretically could offer some protection if the materials and fit were optimized, but this is uncertain,' Dr Jeffrey Duchin, a Seattle health official told the Washington Post.

A 2013 study found that next to a surgical mask, a vacuum cleaner bag provided the best material for a homemade mask.

After a vacuum bag, kitchen towels were fairly protective, but uncomfortable. Masks made of T-shirts were very tolerable, but only worked a third as well as surgical mask. 

NHS workers have been sharing shocking images of the damage caused by prolonged use of face masks. Anaesthetic registrar Natalie Silvey (left), from London, showed her face covered in red and purple marks after a gruelling shift. Emma Sterba, a critical care nurse from Kent also shared an image, with red marks across her face

Scientists design personalised masks to prevent NHS workers' faces becoming bruised after gruelling shifts

NHS staff have been sharing shocking images of their bruised faces after wearing masks for up to 18 hours on the trot.   

The stark images have highlighted the harrowing effects of prolonged mask use. 

Now scientists at King's College London and the University of Birmingham are designing person-specific reusable, medical grade silicone seals to fit with the generic facemasks currently used in the NHS.

The silicone padding would provide cushion for workers' faces and prevent injury. 

It would also help to improve the mask seal, thereby reducing the risk of catching the illness.

The scientists say they can scan staff members' faces using a smartphone camera to create a digital model. 

The silicone seal would then be made using a 3D printer to fit the individual's face.

Professor Owen Addison from King's College London said: 'We are exploring a number of novel approaches to improve facemask effectiveness.

'It is crucial we collaborate to push these vital projects forward, to better protect frontline healthcare workers during the pandemic.'

'Bringing together our collective expertise has enabled us to rapidly push forward these potential live saving innovations' added Dr Sophie Cox who leads the Centre for Custom Medical Devices at the Healthcare Technologies Institute in Birmingham.

'Our researchers brought together their 3D printing expertise and design knowledge to rapidly create a promising prototype customised mask seal.'

Over the coming week, the team plans to begin 3D printing their novel design in silicone and conducting feasibility testing.

The Cambridge University researchers concluded that homemade masks should only be used 'as a last resort.' 

It comes amid a row over a shortage of masks and other personal protective equipment (PPE) for frontline NHS staff.

More than 10,000 healthcare workers have written to the Prime Minister to demand PPE amid growing anger that a lack of supplies is putting lives at risk.  

It comes after the Royal College of Nursing (RCN) yesterday revealed there are medical staff working to save lives and turn the tide in Britain's war with coronavirus that have no access to basic protective clothing at all.

Dame Donna Kinnair, chief executive and general secretary of the RCN, has blasted the 'unacceptable' levels of masks, gloves and aprons in some hospitals and care homes.

Whistleblowers in the NHS say they have been 'hiding' safety equipment for their next shifts and others have gone off sick fearing they will fall ill if they don't get away from work.

Dame Donna's warning based on worried emails and phone calls from nurses came as horrifying pictures of unprotected staff on the frontline emerged today despite new Government guidance making it clear that anyone within 3ft of coronavirus victims must wear full PPE.

She said: 'I am hearing from nurses who are treating patients in Covid-19 wards without any protection at all. This cannot continue. They are putting themselves, their families and their patients at risk.

'Every minute we wait is a minute too long. All nursing staff, no matter where they work, must feel safe. We need action, we need equipment, we need it now'.

She added: 'The Government is finally prioritising Covid-19 testing for NHS staff, including social care, but it is completely unacceptable that weeks into this crisis there are colleagues in all settings - hospitals, community or care homes - who have not been provided with personal protective equipment.

'As the professional trade union representing potentially the largest group of affected workers, the RCN has said repeatedly that we will not accept anything less than aprons, gloves and masks for all staff, in all settings. But this is a minimum - and that is why we are so disappointed even that level of protection has yet to be provided'.

NHS medics must wear full protective equipment if they come within three feet of a coronavirus patient, the government warned today, as shortages of the gear saw a brave nurse forced to dress in just an apron and gloves.

Wear a SCARF: Donald Trump tells people to cover their faces 'if they want to do it' as he acknowledges there are NOT enough masks to recommend that everyone wear one when they go outside 

President Trump floated during Tuesday's briefing that Americans can wear scarves 'if they want to do it' if they're concerned about contracting coronavirus.

'And just about masks, you could get a mask, but you could also - but most people have scarves and scarves are very good and they can use a scarf and we're only talking about a limited period of time,' the president said.

Health officials who have previously urged Americans not to wear face masks unless they're ill are in the process of deciding if the public should wear them as a way to prevent the coronavirus from spreading.

At the White House Tuesday, Dr. Deborah Birx - known for wearing colorful scarves as she briefs the press - said a decision hasn't been made yet. So it's still under discussion.'   

The coronavirus outbreak has prompted Americans to don surgical, cotton or even makeshift masks when they leave the home to buy groceries or exercise with the majority of the US now in various stages of lockdown due to the pandemic. 

Presdident Trump floated the idea Tuesday that Americans could wear scarves if they're worried about contracting the coronavirus - as the administration wants the flow of masks to go to the medical community 

Dr. Deborah Birx, known for her colorful scarves, said the White House is still considering whether to advise all Americans to don masks when they go outside to stop the spread of the virus 

Despite the CDC and the World Health Organization recommending that healthy people don't need masks, some health experts are advocating for the need to wear some form of mask out in public to reduce the risk of asymptomatic spreading. 

They argue that people who have no idea they are infected are spreading the virus because they either have no symptoms or have not begun to experience symptoms. 

Healthcare workers, however, are currently facing shortages of personal protective equipment - including N95 respirator masks and surgical masks - as they treat the onslaught of highly contagious patients. 

Dr Anthony Fauci, the nation's top coronavirus expert, said on Tuesday that when the US gets into a situation where there are enough masks there would be very serious consideration about broadening the recommendations of face masks.   

The possible shift in guidance comes as the virus continues spread rapidly across the country with more than 189,000 cases and over 4,000 deaths as of Wednesday morning. 

It has prompted questions as to who should actually be wearing masks out in public and what to do if a person can't actually find one due to the current shortages.   

The coronavirus outbreak has prompted Americans to don surgical, cotton or even makeshift masks when they leave the home to buy groceries or exercise with the majority of the US now in various stages of lockdown due to the pandemic. Pictured above is the New York subway on Tuesday

Who should be wearing masks?  

The current official guidance from both the CDC and the World Health Organization urges people who are healthy to avoid using masks due to the ongoing shortage for doctors and nurses. 

Out the healthcare setting, people who are healthy are urged to wear masks if they are caring for a person who has or is suspected of having coronavirus. 

Others are asked to wear masks out in public if they are coughing or sneezing - given they are some of the symptoms of having the coronavirus.  

How to wear masks to protect against coronavirus? 

The WHO says that masks are only effective for the general public when used in combination with frequent hand-cleaning, including with alcohol-based sanitizer or soap and water. 

Health officials say that if people choose to wear a mask, it is important to know how to use it and dispose of it correctly.  

The US Surgeon General Jerome Adams has previously warned that healthy people who don't know how to wear a mask correctly can actually increase their risk of being infected. 

The risks increase because people wearing masks are likely to touch their face more often than others to make adjustments. 

The WHO has a list of recommendations for safely wearing masks, including putting it on with clean hands.

They advise to make sure the mask is covering both the mouth and nose and to make sure there are no gaps between the face and mask. 

People are urged not to touch the mask while wearing it and, if they do, to immediately wash their hands.  

To remove the mask, health officials warn that people should avoid touching the front of the mask and should instead take it off from the side closest to the mouth. People are advised to throw single-use masks away immediately and to then wash their hands.  

What to do if there are no masks available? 

The CDC currently has advice on its website for healthcare professionals to help them deal with situations where face masks are not available. The same advice can be implemented by the public.  

Heath officials say that when masks are unavailable, homemade masks should be used as a last resort. 

Homemade masks include a bandana or scarf covering a person's mouth and nose.  

Officials do, however, warn that homemade masks are not considered personal protective equipment and caution should be used when using this option. 

There are also cases across the country where people have opted to sew their own DIY masks with a t-shirt or kitchen towel due to the shortage. 

Past studies have also shown that vacuum cleaner bags can be used to make homemade masks.   

When masks aren't available, the CDC also advises health professionals to use some form of face shield that covers the entire front and sides of the face. 

Is there any evidence that face masks actually work?

Research on how much protection face masks provides varies but, recently, experts are increasingly leaning toward the notion that something is better than nothing. 

Research published by the University of Oxford published on March 30 concluded that surgical masks were just as effective at preventing respiratory infections as N95 masks for doctors, nurses and other health care workers. 

While it is too early to tell if those masks can prevent infection in relation to coronavirus, the study found that thinner, cheaper masks worked in flu outbreaks. 

The difference between surgical or face masks and the N95 masks lies in the size of particles that are able to get through the material.  

N95 respirators are made of thick, tightly woven, molded material that fits over the face and can stop 95 percent of all airborne particles. Surgical masks are thinner, fit more loosely and have more holes - meaning they are less effective at stopping small particles from entering the nose and mouth. 

Research on how much protection face masks provides varies but, recently, experts are increasingly leaning toward the notion that something is better than nothing. A man wearing a face mask jogs in Venice Beach, California on Saturday

A crowd of people lined up wearing face masks outside a Whole Foods in Harlem, New York on Tuesday

A Pat's Farms grocery store worker wears a mask and plastic visor on Tuesday in Merrick, New York. When masks aren't available, the CDC has advised health professionals to use some form of face shield that covers the entire front and sides of the face

Will health officials change the guidance for face masks amid the coronavirus pandemic?

US health officials said on Tuesday they are discussing whether to recommend that the general public wear face masks as a way to prevent transmission of the new coronavirus but that it was too soon to take that step. 

Fauci, the nation's top infectious disease experts, said the use of masks outside the healthcare setting is under active consideration by the CDC and that the White House coronavirus task force would discuss it on Tuesday.

'The thing that has inhibited that bit is to make sure that we don't take away the supply of masks from the healthcare workers who need them,' Fauci, who is the director of the National Institute of Allergy and Infectious Diseases, said on CNN. 

When the country gets into a situation where there are enough masks, Fauci said, there will be very serious consideration of broadening the recommendation on face masks. 

'We're not there yet but I think we're coming close to some determination, because if in fact a person who may or may not be infected wants to prevent infecting someone else, one of the best ways to do that is with a mask,' Dr Fauci said.  

The consideration of wider use of masks stems from the likelihood that people who have no idea they are infected are spreading the virus because they either have no symptoms or have not begun to experience symptoms.

US Surgeon General Jerome Adams cautioned that wearing surgical-type cotton masks may not protect healthy Americans from contracting coronavirus and may even put them more at risk.

'Wearing a mask improperly can actually increase your risk of getting disease. It can also give you a false sense of security,' Adams told Fox News, adding that the CDC was looking at data involving the cotton masks. 

'The data doesn't show that it helps individuals,' he said. 'If you're sick, wear a mask. If you have a mask and it makes you feel better then by all means wear it. But know that the more you touch your face the more you put yourself at risk. 

'There may be a day when we change our recommendations - particularly for areas that have large spread going on - about wearing cotton masks... But again, the data's not there yet.' 

Who is pushing for the guidance to change? 

The idea is being pushed by some health experts, including Scott Gottlieb, a former commissioner of the US Food and Drug Administration.

In a pandemic roadmap for the conservative American Enterprise Institute think tank published on Sunday, Gottlieb advocated for people, even those without symptoms, to wear non-medical masks during this initial phase of rapid community transmission. 

He called for the public to 'initially be asked to wear fabric nonmedical face masks while in the community to reduce their risk of asymptomatic spread'.

Gottlieb told CBS on Sunday that the CDC should be issuing guidelines on how people can make adequate DIY masks so it would take away from the healthcare workers on the front line. 

On the issue of face masks, President Donald Trump said at the White House coronavirus briefing on Monday that 'it's certainly something we could discuss'.

'After we get back into gear, people could - I could see something like that happening for a period of time, but I would hope it would be a very limited period of time,' Trump said.

DO FACE MASKS MAKE A DIFFERENCE AND WHAT SHOULD YOU WEAR IF YOU CAN'T GET ONE?

Americans are increasingly being spotted wearing face masks in public amid the coronavirus pandemic, as are people are around the globe.

Soon, the Centers for Disease Control and Prevention (CDC) may advise all Americans to cover their faces when they leave the house, the Washington Post reported.  

The agency is weighing that recommendation after initially telling Americans that they didn't need to wear masks and that anything other than a high-grade N95 medical mask would do little to prevent infection any way. 

FACE MASKS DO HELP PREVENT INFECTION - BUT THEY'RE NOT ALL CREATED EQUAL 

Research on how well various types of masks and face coverings varies but, recently, and in light of the pandemic of COVID-19, experts are increasingly leaning toward the notion that something is better than nothing. 

A University of Oxford study published on March 30 concluded that surgical masks are just as effective at preventing respiratory infections as N95 masks for doctors, nurses and other health care workers. 

It's too early for their to be reliable data on how well they prevent infection with COVID-19, but the study found the thinner, cheaper masks do work in flu outbreaks. 

The difference between surgical or face masks and N95 masks lies in the size of particles that can - and more importantly, can't - get though the materials. 

N95 respirators are made of thick, tightly woven and molded material that fits tightly over the face and can stop 95 percent of all airborne particles, while surgical masks are thinner, fit more loosely, and more porous. 

This makes surgical masks much more comfortable to breathe and work in, but less effective at stopping small particles from entering your mouth and nose. 

Droplets of saliva and mucous from coughs and sneezes are very small, and viral particles themselves are particularly tiny - in fact, they're about 20-times smaller than bacteria. 

For this reason, a JAMA study published this month still contended that people without symptoms should not wear surgical masks, because there is not proof the gear will protect them from infection - although they may keep people who are coughing and sneezing from infecting others. 

But the Oxford analysis of past studies - which has not yet been peer reviewed - found that surgical masks were worth wearing and didn't provide statistically less protection than N95 for health care workers around flu patients. 

However, any face mask is only as good as other health and hygiene practices. Experts universally agree that there's simply no replacement for thorough, frequent hand-washing for preventing disease transmission. 

Some think the masks may also help to 'train' people not to touch their faces, while others argue that the unfamiliar garment will just make people do it more, actually raising infection risks.  

If the CDC does instruct Americans to wear masks, it could create a second issue: Hospitals already face shortages of masks and other PPE.

WHAT TO USE TO COVER YOUR FACE IF YOU DON'T HAVE A MASK 

So the agency may recommend regular citizens use alternatives like cloth masks or bandanas. 

'Homemade masks theoretically could offer some protection if the materials and fit were optimized, but this is uncertain,' Dr Jeffrey Duchin, a Seattle health official told the Washington Post. 

A 2013 study found that next to a surgical mask, a vacuum cleaner bag provided the best material for a homemade mask. 

After a vacuum bag, kitchen towels were fairly protective, but uncomfortable. Masks made of T-shirts were very tolerable, but only worked a third as well as surgical mask. The Cambridge University researchers concluded that homemade masks should only be used 'as a last resort.' 

But as the pandemic has spread to more than 164,000 people worldwide, it might be time to consider last resort options.  

But numerous medical staff including doctors and nurses have expressed serious concerns about a lack of PPE in NHS hospitals.

One described how staff are 'hiding' equipment out of sheer desperation.

Some workers are saying they are sick as they fear the provisions are inadequate, another said.

Another doctor compared the situation to sending a soldier to war without the necessary equipment while a junior doctor said it feels like it is 'inevitable' that they will contract the virus due to a lack of PPE

Public Health England has issued stricter guidance on personal protective equipment (PPE), making it a requirement to wear a face mask, gloves, an apron and eye-protection as a shield against infectious airborne droplets.

A global shortage of the equipment medics and carers need to protect themselves against Covid-19 have led to shortfalls in the UK, with warnings the lives of thousands of NHS staff are being put at risk.

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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