The coronavirus has now spread to almost 70 countries around the world and health officials are scrambling to stop people spreading the virus among themselves.
But with many patients not realising they’re ill, and others carrying on with normal life until they are diagnosed, the fast-spreading infection is proving difficult to contain.
Avoiding an infection with the virus, which causes a disease called COVID-19, may be as simple as sticking to usual good hygiene, according to scientists.
Here, MailOnline reveals some of the physical steps you can take to avoid catching the coronavirus – and they include not touching doorknobs, avoiding handshakes and wearing gloves.
The World Health Organization’s hand-washing method has six distinct steps (two to seven) which involve washing different parts of the hands to get rid of as much bacteria as possible
The coronavirus outbreak, which is teetering on the edge of becoming a global pandemic, has so far infected almost 90,000 people worldwide and killed more than 3,000
Rejected: German interior minister Horst Seehofer turns away Angela Merkel’s offer of a handshake this morning after revealing he had stopped shaking hands over virus fears
Regular and thorough hand-washing is thought to be the best protection against the virus, which can be transmitted from contaminated surfaces to the hands to the eyes, nose or mouth where it can enter the body. Surfaces which are regularly touched by a lot of people – such as doorknobs or handrails on public transport – may be particularly likely to harbour the virus
Coronavirus ‘more likely to spread on the hands than in the air’
Experts say the most common way the coronavirus is thought to spread is by people touching surfaces which have been contaminated by an infected patient.
This works by somebody who has got the disease coughing or sneezing onto their hand, then touching a surface while they have the viruses on their hands.
The viruses then survive on that surface – such as a doorknob or a handrail on a train – and are picked up by the next person who touches it, who then touches their face and transfers the virus into their mouth, nose or eyes.
Günter Kampf of the University of Greifswald in Germany said disinfectants can kill the viruses but many things we touch every day on transport or in public buildings are not frequently disinfected.
The World Health Organization’s advice is for people to wash their hands at least five times a day with soap and water or hand sanitiser. Friction, experts say, is the key to scrubbing off any signs of infection.
Prime Minister Boris Johnson last week said in a BBC interview: ‘The most valuable thing we can all do to prevent the spread of coronavirus is to wash our hands for 20 seconds or more with hot water and soap.’
The virus can live on hard surfaces which are touched by a lot of people for hours at a time, scientists say, with one study suggesting it could last for up to nine days.
For this reason, things like door knobs and lift buttons should be considered a danger zone, as well as handrails on buses or trains.
Professor Wang Lin Fa, an infectious disease expert at Duke-NUS Medical School in Singapore, told Straits Times: ‘You have to be very unlucky to get it from the droplets in the air; it means that the person coughed directly at your face, or very near you, or if an infected person coughed in the lift about 30 seconds before you went in.
Beware doorknobs, lift buttons and handrails
‘The lifts and the public toilets, these are the places where I would be very, very careful about touching any surfaces to not risk a coronavirus infection.’
He said that a lift was a particularly high risk place because everybody is trapped breathing the same air and having to press the same buttons.
One tip he saw on social media suggested pushing lift buttons with a pen rather than a finger.
According to Alistair Miles, an Oxford University researcher, everyone should stop touching their faces.
He said in a tweet: ‘Stop touching your face. Especially stop touching your eyes, nose or mouth. This is much much harder than it sounds, and takes practice.
‘But if you start practising now, you will quickly get a lot better at it.’
Professor Wang Lin Fa, from Duke-NUS Medical School in Singapore, said lift buttons and door handles were surfaces at a particularly high risk of contamination. People should avoid touching their face because the virus can spread into the body through the eyes, nose and mouth if it gets onto the hands
HOW HAS CHINA’S CORONAVIRUS SPREAD OVER TIME?
The vast majority of confirmed infections of the Wuhan coronavirus have been diagnosed in China.
But almost 70 countries or territories outside of the mainland have also declared infections:
December 31: HUBEI PROVINCE (China)
January 13: THAILAND
January 16: JAPAN
January 20: USA, SOUTH KOREA
January 21: TAIWAN
January 22: MACAU, HONG KONG,
January 23: SINGAPORE
January 24: FRANCE, NEPAL, VIETNAM
January 25: CANADA, AUSTRALIA, MALAYSIA,
January 27: GERMANY, CAMBODIA, SRI LANKA
January 29: FINLAND, UNITED ARAB EMIRATES
January 30: ITALY, PHILIPPINES, INDIA
January 31: UK, RUSSIA, SWEDEN, SPAIN
February 1: DIAMOND PRINCESS CRUISE SHIP
February 4: BELGIUM
February 14: EGYPT
February 19: IRAN
February 21: ISRAEL, LEBANON
February 24: KUWAIT, BAHRAIN, AFGHANISTAN, IRAQ, OMAN
February 25: AUSTRIA, CROATIA, SWITZERLAND
February 26: NORTH MACEDONIA, BRAZIL, GREECE, PAKISTAN, GEORGIA, NORWAY, ROMANIA
February 27: ESTONIA, DENMARK, NETHERLANDS, SAN MARINO
February 28: NIGERIA, LITHUANIA, BELARUS, NEW ZEALAND, MEXICO, ICELAND
February 29: MONACO, ECUADOR, QATAR, AZERBAIJAN
March 1: IRELAND, ARMENIA, DOMINICAN REPUBLIC, CZECHIA, LUXEMBOURG
March 2: INDONESIA
Wear gloves in public and wash hand-held objects
Science writer Laurie Garrett, who travelled around China during the SARS outbreak in 2002/03, said her top piece of advice is to wear gloves in public.
Keep them on when using public transport or spending time in public spaces, she wrote in Foreign Policy, and when opening or closing doors.
She said: ‘If it’s possible to open and close doors using your elbows or shoulders, do so. Wear gloves to turn a doorknob — or wash your hands after touching it.
‘If anybody in your home takes sick, wash your doorknobs regularly.
‘Similarly, be cautious with stairway banisters, desktops, cell phones, toys, laptops — any objects that are hand-held.’
Ms Garrett also recommends not sharing towels and opening windows at home, where possible, to ventilate the house.
This can also be done in cars, where people are in ‘close contact’, as defined by Public Health England – within two metres of someone for 15 minutes or more.
World Health Organization (WHO) advice centres around good hand-washing.
People should clean their hands after coughing or sneezing; when looking after ill people; before, during and after preparing food or eating; after going to the toilet; after handling animals and whenever they look dirty.
‘Hands touch many surfaces and can pick up viruses,’ the WHO said in its official advice.
‘Once contaminated, hands can transfer the virus to your eyes, nose or mouth. From there, the virus can enter your body and can make you sick.’
Catch coughs and sneezes and stay away from sick people
People should also cough or sneeze into a tissue, which they should bin immediately afterwards, and avoid spitting in public.
If they don’t have a tissue at hand, sneezing or coughing into the crease of the elbow is better than doing it onto hands.
And stand at least a metre away from anyone who coughs or sneezes, the WHO says.
‘When someone coughs or sneezes they spray small liquid droplets from their nose or mouth which may contain virus,’ it says.
‘If you are too close, you can breathe in the droplets, including the COVID-19 virus if the person coughing has the disease.’
People should cough into their elbow rather than their hand, but in an ideal world should use a tissue and then bin it and wash their hands, the World Health Organization say. Hugs, kisses and hand-shakes should be reduced to try and limit the risk of people passing the viruses among themselves, experts say
GLOBAL DEATH TOLL HITS 3,000
The global coronavirus death toll has hit 3,000 following a sudden spike in Italian cases.
Five fatalities were announced in Italy today, taking its death toll to 34 as infection continues to cripple the country’s northern regions.
Total patient numbers rose to 1,694 after the Civil Protection Agency revealed roughly 500 fresh positive tests this evening – an alarming 50 per cent climb in just 24 hours.
The outbreak is the second largest outside of mainland China and is steadily seeping across the continent, despite the infection hotbeds of Lombardy and Veneto on lock-down.
Ministers in Rome have taken drastic measures to firefight the epidemic, including scrapping public events and erecting police checkpoints around the 11 contaminated towns.
But despite the travel freeze from the virus-hit areas, where 50,000 citizens are in quarantine, cases scattered across Europe have been traced back to Italy.
Of the 13 new patients announced in the UK, seven had recently returned from Italy.
Avoid hugs and hand-shakes
Keeping people apart is one of the main ways governments can attempt to stop the spread of the virus – what officials call ‘social distancing measures’.
In Italy, France and Switzerland, for example, public gatherings of large groups of people have been cancelled or banned.
And the French government has urged people to avoid ‘la bise’ – the traditional greeting of kissing someone on either cheek – and not to shake hands.
Health minister Olivier Veran said: ‘The reduction in social contacts of a physical nature is advised. That includes the practice of the bise,’ Bloomberg reported.
Face masks are not virus-proof
Face masks, although people have been pictured wearing them all over the world since the outbreak began, are probably not any good at protecting people from catching COVID-19.
University of Reading scientist, Dr Simon Clarke, said individual viruses are so small they could pass through the filters on most masks people would buy from shops.
Researchers tend to agree with this, but do say anyone who is already infected could reduce their risk of passing the virus on by wearing a mask.
They may be able to block droplets carrying the virus from being coughed out into the air around them.
The virus infects someone by taking hold in flesh inside their airways and lungs after it is breathed in. Because of this, mucous and saliva contain the viruses and are infectious.
When an infected person coughs, sneezes, or simply talks, tiny droplets of moisture are expelled into the air, carrying the virus out of the body up to approximately seven feet (2.1m).
Prime Minister Boris Johnson has hailed NHS staff as the UK’s ‘greatest asset’ in the face of the coronavirus outbreak. Pictured: Mr Johnson visiting a Public Health England laboratory on Sunday
Britain’s Health Secretary Matt Hancock (left) arrives at Downing Street in central London this morning with Chris Whitty, Chief Medical Officer for England, for an emergency Cobra meeting
WHAT DO WE KNOW ABOUT THE CORONAVIRUS?
Someone who is infected with the coronavirus can spread it with just a simple cough or a sneeze, scientists say.
More than 3,000 people with the virus are now confirmed to have died and almost 90,000 have been infected. Here’s what we know so far:
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.
Just a week after that, there had been more than 800 confirmed cases and those same scientists estimated that some 4,000 – possibly 9,700 – were infected in Wuhan alone. By that point, 26 people had died.
By January 27, more than 2,800 people were confirmed to have been infected, 81 had died, and estimates of the total number of cases ranged from 100,000 to 350,000 in Wuhan alone.
By January 29, the number of deaths had risen to 132 and cases were in excess of 6,000.
By February 5, there were more than 24,000 cases and 492 deaths.
By February 11, this had risen to more than 43,000 cases and 1,000 deaths.
A change in the way cases are confirmed on February 13 – doctors decided to start using lung scans as a formal diagnosis, as well as laboratory tests – caused a spike in the number of cases, to more than 60,000 and to 1,369 deaths.
By February 25, around 80,000 people had been infected and some 2,700 had died. February 25 was the first day in the outbreak when fewer cases were diagnosed within China than in the rest of the world.
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.
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.
There is now evidence that it can spread third hand – to someone from a person who caught it from another 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 is an epidemic, which is when a disease takes hold of one community such as a country or region.
Although it has spread to dozens of countries, the outbreak is not yet classed as a pandemic, which is defined by the World Health Organization as the ‘worldwide spread of a new disease’.
The head of WHO’s global infectious hazard preparedness, Dr Sylvie Briand, said: ‘Currently we are not in a pandemic. We are at the phase where it is an epidemic with multiple foci, and we try to extinguish the transmission in each of these foci,’ the Guardian reported.
She said that most cases outside of Hubei had been ‘spillover’ from the epicentre, so the disease wasn’t actually spreading actively around the world.