A guide to what you can expect across the UK, The current novel coronavirus (COVID-19) outbreak, which began in December 2019, presents a significant challenge for the entire world.

The UK government and the devolved administrations, including the health and social care systems, have planned extensively over the years for an event like this, and the UK is therefore well prepared to respond in a way that offers substantial protection to the public.

Coronavirus action plan for 2021

Of course, this is a new virus, and new technology and the increasing connectivity of our world mean that our plans need to be kept up to date, to reflect that illnesses – and news and information about them – travel much more quickly today than even 10 years ago.

Recognising the respective roles and responsibilities of the UK government and devolved administrations, this document sets out what the UK as a whole has already done – and plans to do further – to tackle the current coronavirus outbreak, based on our wealth of experience dealing with other infectious diseases and our influenza pandemic preparedness work.

The exact response to COVID-19 will be tailored to the nature, scale, and location of the threat in the UK, as our understanding of this develops.

This document sets out:

  • what we know about the virus and the disease it causes
  • how we have planned for an infectious disease outbreak, such as the current coronavirus outbreak
  • the actions we have taken so far in response to the current coronavirus outbreak
  • what we are planning to do next, depending upon the course the current coronavirus outbreak takes
  • the role the public can play in supporting this response, now and in the future

2. What we know about the virus and the diseases it causes

Coronaviruses are a family of viruses common across the world in animals and humans. Certain types cause illnesses in people.

For example, some coronaviruses cause the common cold; others cause diseases that are much more severe such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS), both of which often lead to pneumonia.

COVID-19 is the illness seen in people infected with a new strain of coronavirus not previously seen in humans.

On 31 December 2019, Chinese authorities notified the World Health Organization (WHO) of an outbreak of pneumonia in Wuhan City, which was later classified as a new disease: COVID-19.

On 30 January 2020, WHO declared the outbreak of COVID-19 a “Public Health Emergency of International Concern” (PHEIC).

Based on current evidence, the main symptoms of COVID-19 are a cough, a high temperature and, in severe cases, shortness of breath.

As it is a new virus, the lack of immunity in the population (and the absence as yet of an effective vaccine) means that COVID-19 has the potential to spread extensively. The current data seem to show that we are all susceptible to catching this disease, and thus it is also more likely than not that the UK will be significantly affected.

Among those who become infected, some will exhibit no symptoms 1. Early data suggest that of those who develop an illness, the great majority will have a mild-to-moderate, but self-limiting illness – similar to seasonal flu.

It is, however, also clear that a minority of people who get COVID-19 will develop complications severe enough to require hospital care 4, most often pneumonia. In a small proportion of these, the illness may be severe enough to lead to death 5.

So far the data we have suggest that the risk of severe disease and death increases among elderly people and in people with underlying health risk conditions (in the same way as for seasonal flu)

Illness is less common and usually less severe in younger adults 8. Children can be infected 9and can have a severe illness, but based on current data overall illness seems rarer in people under 20 years of age.

So far, there has been no obvious sign that pregnant women are more likely to be seriously affected

Given that the data are still emerging, we are uncertain of the impact of an outbreak on business. In a stretching scenario, it is possible that up to one-fifth of employees may be absent from work during peak weeks. This may vary for individual businesses.

We do not yet have entirely complete data on this disease. But as we learn more about the virus, its effects, and its behavior (for example, the timing and extent of the peak of an outbreak, its precise impact on individuals), we will be able to revise estimates of its potential spread, severity and impact 13. We will then review, and (where necessary) adapt this plan accordingly.

Work is in hand to contain the spread of the virus. This includes extensive guidance provided to individuals returning from areas where there are cases being reported and encouraging self-isolation as the primary means to contain the spread of the disease. Given that there is currently neither a vaccine against COVID-19 nor any specific, proven, antiviral medication 14 15, most treatment will therefore be towards managing symptoms and providing support to patients with complications.

The majority of people with COVID-19 have recovered without the need for any specific treatment, as is the case for the common cold or seasonal flu. We expect that the vast majority of cases will best be managed at home, again as with seasonal colds and flu.

The UK is well prepared for disease outbreaks, having responded to a wide range of infectious disease outbreaks in the recent past, and has undertaken significant preparedness work for an influenza pandemic for well over one decade (for example, our existing flu plans).

Our plans have been regularly tested and updated locally and nationally to ensure they are fit for purpose. This experience provides the basis for an effective response to COVID-19, which can be tailored as more specific information emerges about the virus.

These plans ensure the UK is equipped to deliver a coordinated multi-agency response to minimize the wider societal impact that could arise from a significant outbreak. An effective response also requires the active participation of a well-informed public and all service providers.

Planning draws on the idea of a ‘reasonable worst case’ (RWC) scenario. This is not a forecast of what is most likely to happen but will ensure we are ready to respond to a range of scenarios.

Planning principles

In preparing for, and responding to, a serious disease outbreak, the UK government, and the devolved administrations aim to:

  • undertake dynamic risk assessments of potential health and other impacts, using the best available scientific advice and evidence to inform decision-making
  • minimize the potential health impact by slowing spread in the UK and overseas, and reducing infection, illness and death
  • minimize the potential impact on society and the UK and global economy, including key public services
  • maintain trust and confidence among the organizations and people who provide key public services, and those who use them
  • ensure dignified treatment of all affected, including those who die
  • be active global players – working with WHO, the Global Health Security Initiative (GHSI), the European Centre for Disease Prevention and Control (ECDC), and neighboring countries, in supporting international efforts to detect the emergence of a pandemic and early assessment of the virus by sharing scientific information
  • ensure that the agencies responsible for tackling the outbreak are properly resourced to do so, that they have the people, equipment and medicines they need, and that any necessary changes to legislation are taken forward as quickly as possible
  • be guided by the evidence, and regularly review research and development needs, in collaboration with research partners, to enhance our pandemic preparedness and response

The UK government and the devolved administrations have been planning an initial response based on information available at the time, in a context of uncertainty, that can be scaled up and down in response to new information to ensure a flexible and proportionate response.

The fundamental objectives are to deploy phased actions to Contain, Delay, and Mitigate any outbreak, using Research to inform policy development.

The different phases, types, and scale of actions depend upon how the course of the outbreak unfolds over time. We monitor local, national and international data continuously to model what might happen next, over the immediate and longer terms.

The overall phases of our plan to respond to COVID-19 are:

  • Contain: detect early cases, follow up close contacts, and prevent the disease taking hold in this country for as long as is reasonably possible
  • Delay: slow the spread in this country, if it does take hold, lowering the peak impact and pushing it away from the winter season
  • Research: better understand the virus and the actions that will lessen its effect on the UK population; innovate responses including diagnostics, drugs and vaccines; use the evidence to inform the development of the most effective models of care
  • Mitigate: provide the best care possible for people who become ill, support hospitals to maintain essential services and ensure ongoing support for people ill in the community to minimize the overall impact of the disease on society, public services and on the economy

4. Our response to the current coronavirus outbreak

Current planning

There is similarity between COVID-19 and influenza (both are respiratory infections), but also some important differences. Consequently, contingency plans developed for pandemic influenza, and lessons learned from previous outbreaks, provide a useful starting point for the development of an effective response plan to COVID-19.

That plan has been adapted, however, to take account of differences between the 2 diseases. Annex A sets out the structure for the UK’s response to a disease outbreak.

Our response to COVID-19 is guided by the international situation, the advice of organizations such as WHO, surveillance, data modeling based on the best available evidence and the recommendations of our expert bodies (Annex B).

The Scientific Advisory Group for Emergencies (SAGE) provides expert medical scientific advice.

The 4 UK governments’ Chief Medical Officers (CMOs) continue to advise the health and social care systems across the UK, and government agencies in all parts of the UK involved in responding to this outbreak.

System-wide response plans for pandemic influenza, focused on the continuity of public and critical services and the stability of the economy, have been adapted for COVID-19, based on the best available scientific evidence and advice.

For the latest information on the current situation please refer to Coronavirus (COVID-19): latest information and advice.

The nature and scale of the response depends on the course of the disease, which cannot be predicted accurately at this point. As our understanding of the disease increases and its impact becomes clearer, we will issue further detailed advice about what to expect if/when further measures become necessary.

The phased response – what we have done so far

As there are already cases in the UK, the current emphasis is on the Contain and Research phases, but planning for Delay and Mitigation is already in train.

The Contain phase – actions to date

Across the whole of the UK, public health agencies and authorities, the NHS, and Health and Social Care NI (HSCNI) have established plans and procedures to detect and isolate the first cases of COVID-19 as they emerge in the UK.

Each nation’s public health agencies have worked with Border Force, port operators and carriers to enhance port health measures. Public Health England (PHE) teams are on site at appropriate international ports, and health advice and information has been widely cascaded, as part of our public communications plan, with appropriate arrangements also put in place in the devolved administrations (given that some aspects relating to the arrival of aircraft and shipping are devolved).

Border Force and the Foreign and Commonwealth Office (FCO) have assisted the repatriation of British nationals and their dependants from affected areas overseas. Where foreign nationals in the UK have been unable to return to affected areas, the Home Office has provided support enabling them to remain in the UK.

New regulations introduced in England under public health legislation provide new powers for medical professionals, public health professionals and the police to allow them to detain and direct individuals in quarantined areas at risk or suspected of having the virus.

In Scotland Health Boards have powers to place restrictions on the activities of individuals who are known to have the disease, or have been exposed to the disease, and to prohibit them from entering or remaining in any place. Boards may also apply for court orders for quarantine and medical examination.

In Wales, local authorities have powers to apply for an order to be made by the Justice of the Peace to isolate, detain or require individuals to undergo medical examination. Similar powers are available to the Public Health Agency in Northern Ireland. Welsh Ministers also have powers to make regulations equivalent to those now in place in England if the level of risk increases.

As part of the port health measures, direct flights arriving into the UK from countries within the UK’s CMOs’ case definition are required to provide a declaration (General Aircraft Declaration) to airport authorities stating that all their passengers are well, 60 minutes prior to landing. Similarly, The Maritime Health Declaration Form is required for all vessels arriving from any foreign port. For Scotland parallel measures are in place.

The health and social care systems and public health authorities in all parts of the UK have cascaded information widely to all health professionals on steps to take if they identify patients who may have COVID-19.

The NHS/HSCNI have well-rehearsed plans that have enabled the provision of excellent care for all patients affected by this disease. The initial confirmed patients are being cared for by specialist units with expertise in handling such cases, using tried and tested infection control procedures to prevent further spread of the virus. When necessary, the provision of care may move from specialist units into general facilities in hospitals.

The NHS/HSCNI have expert teams in every ambulance service and a number of specialist hospital units with highly trained staff and equipment ready to receive and care for patients – these provide coverage across the whole of the UK. If the current outbreak takes a greater hold, we will use those lessons about effective treatment methods and apply them throughout our health services, across all hospital sites and into community settings.

Once a case has been detected, our public health agencies use tried and tested procedures for rapid tracing, monitoring and isolation of close contacts, with the aim of preventing further spread.

The UK maintains strategic stockpiles of the most important medicines and protective equipment for healthcare staff who may come into contact with patients with the virus. These stocks are being monitored daily, with additional stock being ordered where necessary.

We have provided UK residents and travelers with the latest information to make sure they know what to do if they experience symptoms and worked with NHS 111, NHS Direct Wales and NHS 24 in Scotland, to ensure people with symptoms are given appropriate advice.

Public health advice has been widely publicized and is regularly updated. See Coronavirus (COVID-19): latest information and advice.

FCO Travel Advice gives British nationals advice on what they need to know before deciding whether to travel and what to do if they are affected by an outbreak of COVID-19 while traveling. Our travel advice and consular assistance also help to contain the spread of COVID-19 to the UK.

Advice has been provided to first responders, employers, the justice system (including prison and probation services), educational settings, and the adult social care sector.

The Department for Education provides advice about educational settings in England, which can be found on PHE’s website. A DfE helpline is being set up to manage the flow of increasing queries, from providers and from parents of pupils.

Equivalent guidance for educational settings in Scotland can be found on the Health Protection Scotland website. This guidance provides links to further advice via NHS Inform and contact details for local Health Protection Teams. Scottish local authorities can also provide advice and support to education settings in their areas, working closely with local Health Protection Teams and local and regional resilience partnerships.

In Wales, guidance for educational settings is provided on the Welsh Government website which also provides links to further public health advice.

Department for International Trade teams around the globe continue to support British companies facing disruption due to the coronavirus. The department’s officials across the globe are already working with UK businesses on the ground to relay public health advice and FCO travel advice, and provide practical and concrete support to firms, including engaging with local government and suppliers, and working with business associations to disseminate latest information on UK consular and visa services, and accessing existing UK Export Finance facilities.

All NHS and HSCNI emergency and urgent care facilities are working to establish coronavirus assessment services to