Dr Jenny Harries, Deputy Chief Medical Officer for England, answers questions on coronavirus
27 March 2020
Dr Jenny Harries, Deputy Chief Medical Officer for England, joined us for a webchat on Wednesday 25 March to answer Mumsnet user questions about coronavirus. Read her answers here.
Is it safe for children to move between their parents’ households?
We know that most households have a similar 'risk exposure' – people in the household have the same risk of catching the virus. It is usually better not to mix across households. However there are safety and wellbeing issues as well as the virus to deal with and, for a few children, changes to their visiting arrangements could be emotionally very significant. So the advice is to try to keep in separate households, but focus on the most important wellbeing issues for your children.
Can vulnerable people go outside in their own gardens?
It depends on individual circumstances. If you have a private outside space at least two metres away from a neighbour in their garden, or another person’s house – and as long as you aren’t tempted to natter at the garden gate or head off to the shops – then being in the garden should be fine. The virus doesn't last so well outside – it is all to do with the risks of being near other people.
Is there enough PPE to go around health workers who need it?
This is right at the top of my work list at the moment. The masks we recommend in the UK are a higher specification than those the WHO recommends, and we have some different practices here about gowns and aprons because the NHS has a very strict approach to infection control on wards, including keeping arms bare to stop disease transmission. There is kit available to go around the country – I know there were a few distribution problems at the start but we have drafted in the army to help distribute and I know that all hospitals have had new stocks going into them this week, including through the night.
If you work out of the home, what should you do when you arrive home?
We think the virus lasts less time on soft materials such as clothing than it will on hard surfaces. It is fine to change your clothes at the end of the day and pop them in a washing machine. Best not to shake them out before you put them in. You can use a normal cycle. It’s much more important to ensure that the whole family, including your kids, wash your hands really thoroughly for at least 20 seconds far more frequently than you usually do. This will stop you putting dirty hands up to your eyes, mouth or nose and accidentally passing on the virus if it is on any surfaces. You should wash those down as well with your normal household cleaners
If you have symptoms, how long should you stay away from vulnerable people?
You should self-isolate for seven days. Most people will get over their symptoms in that time and after that they’re not likely to cause illness in someone else. If you are not fully recovered after seven days then you should wait until your symptoms have gone. You might have a little bit of a cough left, which is ok, but most people are fine at this point.
If you’ve been exposed to someone who has had the virus and 14 days have passed, can you behave normally (within the rules)?
If you’ve gone through the 14-day incubation period without any symptoms, then it is very unlikely you have the disease and you can help support more vulnerable people in your household. There have been reports of the virus being around a bit longer than this in rare cases, but it is unlikely that the disease can be transmitted.
Living with vulnerable people
If you have a very vulnerable, high-risk person in your family, you should really try to make sure they are as isolated as possible for their protection: absolutely scrupulous hand washing, using different bath towels etc, and supporting them where feasible to be in their own room. If you are really good at this, and you try whenever possible to keep a two-metre distance between your family members and are really careful about coughs and sneezes, you can avoid transmission in your own family and through that you will help reduce the disease numbers right across the population.
If a household member has symptoms, should household members self-isolate from each other?
The short answer is you should all be isolating. We think that people are at their most infectious in the early part of the illness, pretty soon when they get symptoms, so as soon as you have these you should stay right at home and off work and your whole household unit should stay with you for 14 days. There is some guidance on the government website.
Which everyday objects are likely to carry the virus and which aren't?
The virus can last in an active state a bit longer on hard surfaces than soft ones. This is why we suggest you clean down things like door handles and other frequently-touched objects more often than usual with your normal cleaning agents. Practically, however, it's difficult to keep cleaning everything all the time, so the important thing to do is to make sure you wash your own hands thoroughly and more frequently than usual for at least 20 seconds. The risk of transferring the virus is when you put dirty hands up to your face (your eyes, mouth and nose) where it is easier for it to enter the body. Washing your hands and changing your habits of touching your face will keep you much safer.
When do you expect the peak to hit?
That's a really tricky question because our interventions – the social distancing measures and keeping washing our hands and coughing and sneezing into tissues etc – are all designed to move the peak. What we hope is that in about two to three weeks, if people have continued to do as we have asked and cut down their social interactions, we would start to see a change in the slope of the graph. That means the peak will be pushed forward, but the height of it will be lower and we can manage all those who need hospital and health care safely through our NHS.
What’s happening with testing?
At the moment the patients who need the most clinical care are prioritised. We test patients in ICU and being admitted to hospitals with pneumonia as a priority, as well as those who are in some special settings like care homes and prisons. We also are increasingly offering to support healthcare and care colleagues so they can stay safely in work. But we have some very advanced plans for new processes for testing to see if you have the disease at the time you have the test. One model for this is a drive-through version and gradually we should be able to extend it to more of the population.
What type of thermometer should we use? Should it be digital?
There are a few different types of thermometer, but digital ones are generally accurate and simple to use. You should take the temperature under the armpit for children under five. The NHS has some advice about the best way to take your temperature or a child’s. Make sure children aren’t hot from a bath or warm room, wrapped up in a blanket or wearing warm clothes. If they’ve just been running around that could also affect their temperature.
Will antibody tests be rolled out nationwide?
The antibody test will serve two different purposes. The first is to check whether people have had Covid-19 disease. Initially, this needs to be for frontline health and care staff, but we will roll it out to other people after that. The second is to understand who has been affected so we get a better picture of the transmission of the disease across the country. This will help us manage the end of the outbreak and get us all back to normal.
If you're pregnant, how likely is it that they will ban birth partners from the birth room?
The NHS is asking the public to help protect patients and staff from coronavirus as far as possible by advising strict limits on visitors in most cases. Having someone with you during childbirth is very important though so you'll need to check with your doctor or midwife nearer the time to make sure it is safe for the hospital and for your baby.
We can’t predict precisely where we will be on the epidemic curve at the time your baby is due – that depends, of course, on us all making sure we keep washing our hands and protecting each other by sticking to the social distancing rules until advised otherwise. However, we will be moving some antenatal and other clinical services to virtual clinics. That will mean that even if there are some staff shortages caused by self-isolation, there should still be enough midwives and doctors in our maternity units to support women through their pregnancy and to take care of you when you are due to give birth.
The Royal College of Obstetricians and Gynaecologists has published some advice for pregnant women and their families which you may find helpful.
If a relative has cancer, what will happen with their treatment plans?
People undergoing active chemotherapy are particularly vulnerable to this virus. They have been asked to follow our shielding advice and stay at home for a period of at least 12 weeks, and have been contacted by their GP or specialist and given expert advice. But arrangements for planned cancer treatments should go ahead – if they do develop symptoms of coronavirus, they should let their doctor know.
Cancer is a really difficult diagnosis to deal with and it affects both your physical and mental health so make sure your family member also takes a look at the useful links in the letter they should receive which will direct them to some online resources to help them cope more generally.
About Dr Jenny Harries
Jenny Harries was appointed Deputy Chief Medical Officer for England in July 2019, taking on a broad portfolio including the health service and commissioning support. Jenny’s previous roles include: PHE Deputy Medical Director, PHE Executive Lead for specialised commissioning and Welsh National Health and Healthcare Director.
Alongside these roles, Jenny has been a member of the Welsh Medicines Committee and the Clinical Priorities Advisory Group. Jenny has an extensive clinical and public health background (BSc (Hons) Pharmacology; MPH; FFPH) and her work has extended overseas as far afield as New Zealand, Pakistan and Kenya.
She was awarded an OBE in the 2016 New Year’s Honours List for services to Public Health. She advises the government on its response to coronavirus. Read the full webchat.