Laboratories told of an ‘evolving situation’ in January 2020

Submitted by Paul
Head Biomedical Scientist

My COVID-19 story began in January 2020 with Public Health England bulletins informing laboratories in the UK of an “evolving situation”.

Date 07/01/2020: Event: Cluster of pneumonia of unknown aetiology in Wuhan City, China

Background and Interpretation: On 31 December 2019, WHO was informed by the People’s Republic of China of cases of pneumonia of unknown microbial aetiology associated with Wuhan City, Hubei Province, China. Some but not all cases were associated with Wuhan South China Seafood City market, which sells meat, poultry and seafood. At the last report to WHO on 03 January 2020, there were 44 cases of which 11 were reported as severely ill. A Wuhan Municipal Health Commission update on 05 January reported 59 cases, including 7 critically ill patients, with no deaths. The first case became unwell on 12 December 2019 and the onset date of the last case was 29 December 2019. Current reports describe no evidence of significant human to human transmission, including no infections of healthcare workers. Cases of pneumonia possibly linked to Wuhan City have been assessed in Hong Kong. Limited clinical information available suggests some cases have bilateral pulmonary infiltrates. Wuhan Health Commission report that influenza, adenovirus, SARS-CoV and MERS-CoV have been ruled out. Investigations for other pathogens continue. It is possible that this cluster represents the emergence of a novel pathogen. Although the cluster in Wuhan City is not due to avian influenza, according to current reports, avian influenza has been reported in this region and it remains a possibility in returning travellers from Wuhan City. This is an evolving situation and further updates will be provided.

Implications and recommendations for clinical microbiology, virology and infectious diseases services NHS microbiology/virology/ID services should communicate the information in this briefing note appropriately within their Trust, including with Emergency Departments and acute medical services. Patients who present with pneumonia and have travelled to China in the 14 days prior to onset of symptoms should have a detailed travel and exposure history taken. 

Date 09/01/2020 Event: Wuhan novel coronavirus (WN-CoV) identified

On 9 January 2020, WHO reported that Chinese authorities had made a preliminary identification of a novel coronavirus from a patient hospitalised with pneumonia in Wuhan. Chinese investigators conducted sequencing of the viral genome. Reports to date describe no evidence of significant human to human transmission, including no infections of healthcare workers. Currently there are no known UK cases and no cases reported in countries other than China. Cases of respiratory infection in travellers from Wuhan City to Hong Kong have been assessed and the majority have been reported to have conventional respiratory pathogens; no cases of novel coronavirus have been reported from Hong Kong. Increased travel to and from China is expected around Chinese New Year on 25 January 2020. There are direct flights from Wuhan City to London. No travel restrictions are advised.

The story evolved over the news channels and ‘Downing Street’ briefings and my work life revolved around trying to implement all the competing demands.

Often on Friday we would hear what we were supposed to implement on Monday. Dilemmas regarding staff staying at home or running a microbiology laboratory and staff safety versus comfort played out throughout the year.

Furloughed friends spoke of catching up on games, books or Netflix, whilst the commute to work felt more like I would bump into Will Smith’s character from ‘I am Legend’. The death toll kept increasing.

My parents were locked down in nursing home and sheltered accommodation, whereas two of my three children were locked down in student accommodation.

The laboratory meanwhile worked on, as the statistics and news detailed.

The numbers of SARS-Cov-2 (as the virus was now known) tests increased with a level of 16,000 tests a month. There were colleagues in the laboratory, testing, between 7am to 3am the following morning. The normal work of a diagnostic Microbiology laboratory decreased and then started to rise again.

Colleagues stepped in to provide Point Of Care Tests as this technology developed. (Boris’s 90 minute tests).

I feel privileged to have so many amazing individuals making up such an extraordinary team, and to have worked with so many others in the Trust.

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