BMJ Best Practice monograph: COVID-19

News article 20 Feb 2020

With the ongoing international outbreak of Covid-19 (formerly novel coronavirus disease), the British Medical Journal has published a timely new Best Practice monograph to inform healthcare professionals about procedures and advice available to diagnose, isolate and manage cases in the UK and elsewhere.

Drs Nick Beeching and Tom Fletcher, both senior clinical lecturers at LSTM, co-authored the monograph with Professor Robert Fowler of the University of Toronto, Canada. The purpose of the review is to bring together guidance from many sources on the changing epidemiology, or spread of the virus, together with detailed advice on the clinical features of the illness, diagnosis, clinical management and public health measures to contain and prevent the spread of infection. 

Dr. Beeching, who also works as a consultant in the Tropical and Infectious Disease Unit at the Royal Liverpool University Hospital and is the Liverpool lead for the national Imported Fever Service, is keen to point out that, while the perceived risk level in the UK as a nation has been increased to moderate, the illness is currently rare in the UK and is mild in the majority of people.

He said: “Person to person transmission has taken place outside of China, so quarantine measures are being used to isolate people who may have been exposed to infection, such as those returning from Wuhan or from affected cruise ships, until they have remained clear of infection for 14 days (the longest possible incubation period for infection after exposure). The risks of any individual acquiring the infection in the UK are currently very low. Less than 1 in 500 people tested so far in the UK have been positive, and although they have been hospitalised, that was as much about isolation to prevent the spread of the virus, as for clinical reasons.”

Dr. Fletcher, who is currently seconded to WHO for the COVID-19 clinical response, has extensive clinical experience with other severe infections such as Ebola and Crimean Congo haemorrhagic fever, said: “We hope that this will provide a comprehensive “one-stop shop” with access to information about all aspects of this new disease. As information is changing on a daily basis, our challenge will be to keep it up to date at the same pace. It is aimed at an international as well as UK readership, as it draws together guidelines on both public health and clinical issues from other countries directly affected, such as China and Singapore, as well as the UK, Europe, the USA, and other countries.”

The BMJ has made these articles freely available to all. You can read the full monograph here and links to articles on the related infections SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome) are here