Coronavirus - COVID-19 Latest CMA Briefing

COVID-19 coronavirus

This page contains information that is highly relevant to complementary medical and integrated health practitioners and training schools who wish to return to work - providing they are allowed to do so.

 

 

 

What is the difference between legislation and guidance?

 

Information from https://www.legislation.gov.uk/coronavirus


To find out exactly what the rules are during the coronavirus pandemic, you need to look at both legislation and government guidance. Legislation sets out legal obligations and restrictions that are enforceable by law. If you do not abide by the legislation you are breaking the law. Guidance and advice is likely to be based on legislation (in which case it will be legally binding) and it might offer the best or most appropriate way to adhere to the law.

 


 

 

Quick links

 

Here are some helpful resources, but for more information on regulations in your area, more detailed COVID-19 information or more more details on the following links, please scroll down.

UK Country guidance:

Guidance on how to write a letter to your local authority - This document outlines what you should cover if you wish to write to your local authority to suggest that complementary medicine should be seen as essential healthcare, therefore allowing you to continue working. Information provided by Joe Baker, Redditch Borough Council Chair of Overview and Scrutiny and former Mayor of Redditch.

Basic disclaimer - This is a very handy general disclaimer form, but we suggest you also look at the more comprehensive Risk Assessment form below.

Risk assessment- this is a hugely comprehensive form generously created for The CMA by Laureen Finney, complementary Medical practitioner and former professional risk assessor. 

 


 

UPDATE 21st April 2021

We understand that many of you are now returning to work. Remember, we are here to provide guidance through the pandemic and beyond. You can find loads of helpful videos on The CMA’s YouTube channel - there are videos on PPE, Risk assessment, CMA Political Advisor Joe Baker’s interview on how to get in touch with your local Health Authority to get their support for your practice and much more.

 

UPDATE 17th March 2021

Yesterday, the Scottish Government published their timetable for easing restrictions. The full timetable can be viewed here. As it currently stands, based on these guidelines, complementary health practitioners should be able to return to work on 17th May. 

Practitioners are still able to work to support patients with pain, mental health issues and those conditions where patients would get worse if treatment was withheld. This is the same as we’ve been saying since November and which was confirmed by gov.uk. 

As always, the situation is ever-changing, and we will update you if any of the UK roadmaps change. 

 

UPDATE 24th February 2021

 

We have looked very carefully at the current legislation to see if there have been any changes to who can and cannot work at the moment, including at this page on the gov.uk website https://www.legislation.gov.uk/uksi/2021/8/made to check for any amendments.  We cannot see any at time of writing.  This means that practitioners may still provide services which address pain and injuries, mental/emotional health support and also treatments where it would be deleterious to the patient's or client's health if treatment was discontinued.

We will keep a very close eye on the situation - as always - and will notify you as soon as we learn of any changes to either legislation or government guidance.  The onus is upon you, as a professional, to ensure that you continue to operate within the current laws as set down by your government. We also advise you to check with your insurer to see if they have made any policy changes.  We have not been advised by either of our insurance brokers, Balen's and Westminster, of any policy amendments at this time.

Finally, if you are working at this time, please continue to keep your paper trails as consistently advised by The CMA (all details over in our CMA Tutorials on The CMA YouTube channel.  Ensure that your risk assessment procedures are up to date and your usage of PPE is correct - including donning, doffing and disposal.

 

With regards to lockdowns, at the time of writing, the following information is correct for the UK countries: 

 

Northern Ireland - The country remains in strict lockdown until April 1st, with measures being reviewed on March 28th.

Wales - Lockdown was extended for 3 more weeks on February 19th and is ongoing, although there is potential that some restrictions could ease before Easter.

Scotland - A phased reopening of businesses and economy will begin from March 15th. More detail will be given at this time, but it is hoped that the majority of businesses will be able to reopen by the last week of April. Find out more on the government website here.

England - A four stage plan has been revealed, with the goal of all measures being lifted by 21 June. If the roadmap is followed, complementary therapists should all be able to open again in step two on April 12th. A summary of the roadmap can be found on the government website here.

 

 

UPDATE 15th January 2021

 

Following the update to Gov.uk guidance issued yesterday (14th January 2021) we can report that there have been a few changes to the guidance itself, but no further updates to the actual legislation (https://www.legislation.gov.uk/uksi/2020/1374/schedule/3A/2021-01-06)  that relate to the complementary medical and natural healthcare sector. 

 

In this document we aim to assist with clarification for you – based upon our thorough investigation of the various guidance documents and the legislation - and our interpretation of these. 

 

As always, we remind you that this is a fluid situation and things are changing rapidly. 

 

Overall, it is essential that you are operating within the law and we strongly recommend that you maintain a robust paper trail which demonstrates that you are following the legislation and guidelines. 

 

Furthermore, please liaise with your insurer so ensure that your coverage is still in place – should you continue to teach or practice at this time.

 

We are presenting this to you in such a way that you can see how the guidance is shown on the Gov.uk site – so that you understand how to track it through for yourself – if you choose to do so.

 

Finally, our analysis indicates that all disciplines that can be delivered in a safe, socially distanced manner – within the law and guidelines, may continue to operate.  If you offer ‘hands-on’ treatments then please look at the final paragraph of this update (below), where it sets out who you may continue to treat – and the caveats to that.

 

The legislation, which is what is enforceable, clearly exempts from closure businesses in the following category:

“dental services, opticians, audiology services, chiropody, chiropractors, osteopaths and other medical or health services, including services which incorporate personal care services and treatments required by those with disabilities and services relating to mental health”

But not “beauty salons” or “massage parlours”.

 

This is in fact the same as was the case for tier 4 areas before the national “lockdown”.

 

The guidance is then intended to help clarify the intention of the legislation

 

The first guidance document to look at is here:

https://www.gov.uk/guidance/national-lockdown-stay-at-home

This tells us what we can and cannot do at this time.  

 

This links to ‘Businesses which can remain open’ – here:

https://www.gov.uk/guidance/national-lockdown-stay-at-home#businesses-and-venues-which-can-remain-open

This document says that medical and dental services may remain open.  Also, just a little further down the page under Healthcare and Public Services, you’ll see that they state the following:

 

The NHS and medical services remain open, including:

  • dental services,
  • opticians,
  • audiology services,
  • chiropody,
  • chiropractors,
  • osteopaths
  • other medical or health services, including services relating to mental health

 

From this page, there is a link to further guidance here:

https://www.gov.uk/government/publications/further-businesses-and-premises-to-close/closing-certain-businesses-and-venues-in-england

 

This page deals with 'Businesses allowed to remain open'

Under 'Retail', this includes

  • dental services, opticians, audiology services, chiropody, chiropractors, osteopaths and other medical or health services, including services relating to mental health

 

Further down the page under 'Personal care facilities and close contact services' you’ll see the following:

Personal care facilities and close contact services must close. This includes:

  • hair, beauty and nail salons
  • tattoo parlours
  • spas, saunas, steam rooms
  • massage centres
  • body and skin piercing services
  • tanning salons

These venues may continue to sell retail goods (such as shampoo or beauty products) online or via click-and-collect.

Those who provide personal care services from a mobile setting including their own home, in other people’s homes and in retail environments (such as a concession in a larger, separate business) must also stop operating.

However, the next paragraph is as follows:

Personal care services provided for essential medical and health needs, which cannot be deferred, may continue. For example, treatments for a diagnosed health condition or injury that is currently causing severe pain or mobility issues, or severely impacting quality of life, or for cosmetic treatments associated with cancer treatment. This does not extend to services provided for general stress relief, relaxation or preventative healthcare purposes. The guidance on safer working in the Close Contact Services should be followed.  This is the section that we believe is the most relevant to CMA Members at this time. Our interpretation of this is that if you are able to demonstrate that your patient/client has a diagnosed health condition or injury that is currently causing severe pain or mobility issues, or severely impacting quality of life, or for cosmetic treatments associated with cancer treatment, you may continue to treat them.  Please see the link to Close Contact Services – working safely here:  https://www.gov.uk/guidance/working-safely-during-coronavirus-covid-19/close-contact-services

 - - - - - - -

In closing, we realise that this guidance and legislation are confusing, and we continue to seek clarifications as it develops.  We will update you as any further changes come through.

 

 


 

 

UPDATE 13TH JANUARY 2021

 

There have been various changes and some confusion regarding whether complementary therapists can work in England.

As it currently stands, all complementary therapy apart from massage are within the permitted businesses list:

 

Tier 4:

Personal care facilities and close contact services must close. This includes:

  • hair, beauty and nail salons
  • tattoo parlours
  • spas, saunas, steam rooms
  • massage centres
  • body and skin piercing services
  • tanning salons

 

Businesses and venues which can remain open:

Other businesses and venues are permitted to stay open, following COVID-19 secure guidelines. Businesses providing essential goods and services can stay open. The full list of these businesses can be found in the guidance on closing certain businesses and venues in England, but includes:

  • medical and dental services > dental services, opticians, audiology services, chiropody, chiropractors, osteopaths and other medical or health services, including services relating to mental health 

 

UPDATE 5th January 2021

 

We have now looked at the websites of all four countries of the UK.  All (except for Northern Ireland - theirs is coming later today) have made statements about lockdown - and of course they vary from country to country.  It is essential that you strictly observe the rules in your own area - to the letter.  Please carefully read the guidance below - we know that it can be confusing - and we have also observed that the governments make changes to the rules pretty often - so it is important to ensure that you are up to date on a daily basis.  We strongly suggest that you create a dated screenshot each day of your government's website each day that you work - this would provide proof that you were fully compliant at the beginning of that day - should the rules suddenly change.

As with the previous lockdowns, we strongly advise you to contact your local Health Authority, if you wish to continue to offer your services and you believe, based upon your government's statements below that you are allowed to do so.  You must get permission from them - in writing - to further protect yourself.

Do ensure that your insurance provider is happy to continue to cover you too - again, get this in writing - or screenshot and date any announcement they may make on their website.

Make sure you know exactly how to use PPE safely (you can see our advisory about this below), including correct donning, doffing and disposal procedures.

Conduct a thorough risk assessment and repeat as necessary.  The full details for how to do this are below.

Join CMA Tutorials - these are held via Zoom on Friday afternoons - you will receive an invitation to join in via The CMA e-Newsletter that we issue on Wednesdays at 11am (UK time).  These incredibly helpful sessions are totally free to join and open to everyone and many of our Members credit these with saving their practices throughout 2020!

Finally, please see the numerous, extremely helpful videos over on The Complementary Medical Association YouTube channel on all aspects of surving and even thriving personally and professionally at this challenging time.  We suggest you subscribe to the channel (it is free to do so) and that you click on the little bell icon that will ensure that you are notified when we release an important video update - this way, you'll never miss out.

Scotland

Stay at Home - Ruling

This, below, is the updated current guidance for Scotland  Please also see the full reference to complementary medical services at the end of this update:

To minimise the risk of spreading the virus, you must stay at home as much as possible.  By law, in a level 4 area, you can only leave your home (or garden) for an essential purpose.

There is a list of examples of reasonable excuses on the Scottish government's website here:  https://www.gov.scot/publications/coronavirus-covid-19-stay-at-home-guidance/

Although you can leave home for the purposes stated, you should stay as close to home as possible.  Shop on-line or use local shops and services wherever you can.   Travel no further than you need to reach to a safe, non-crowded place to exercise in a socially distanced way.  To minimise the risk of spread of Coronavirus it is crucial that we all avoid unnecessary travel.

The Scottish Government's statement specific to Close-contact Retail Services:

Close contact services and mobile close contact service providers must not operate.  Read more: Guidance for close contact services

Close contact services include:

  • hairdressing and barbers
  • beauty and nail services (including make-up)
  • hair removal
  • tattoo, piercing and body modification
  • fashion design, dress-fitting and tailoring
  • indoor portrait photography
  • massage therapies
  • complementary and alternative medicine services requiring physical contact or close physical proximity between persons, but not osteopathy and chiropractic services
  • spa and wellness services
  • other services or procedures which require physical contact or close physical proximity between a provider and a customer and are not ancillary to medical, health, or social care services.

Please also see the Scottish government's advice regarding "Support Services":

Support groups and one-to-one support should be delivered remotely where possible, but support may be delivered in-person if remote delivery is not possible and they are essential for people’s wellbeing. Examples of support services include peer support groups, vulnerable persons’ or families’ support groups, talking therapy groups, day centres, respite care, one to one talking therapy and counselling. Support services do not include close contact retail services, such as massage, which are covered by separate guidance on this page.

An essential support service is one where the participant’s health (including their mental health) and wellbeing would be significantly impacted by non-attendance. If services must take place in-person, relevant guidance must be followed.

WALES

Wales is currently at alert level 4

You can find all the updates for Wales here: https://gov.wales/business-closures-alert-level-4#section-58515

Of most relevance to Complementary Medical Association Members is this paragraph: 

MUST CLOSE

Close contact services – this includes beauty therapists, beauty advanced practices treatment practitioners, make-up artists, nail service technicians, reflexologists, aesthetics, holistic, wellbeing and other practitioners; acupuncture and  electrocautery practitioners and massage therapists including sports and clinical massage therapists.  It also includes establishments providing tanning services, body piercings, tattooing and similar services.

However, you are allowed to remain open in the following situation:

Treatments or services which are providing medical treatments for illness or injury. 

These would include therapists who are working alongside or in conjunction with a statutory regulated health professional - for example, a sports therapist based in a clinic owned by an osteopath, or working alongside doctors or nurses in a hospital or hospice to help support patients receiving medical treatment. Services that provide non-cosmetic laser / IPL medical treatment for illness or injury would also be permitted.

Interestingly, mental/emotional health services are not addressed - in this advisory.  However, we believe that it is permissible to continue to offer these - if you can do so safely, either online - or if you have a clinic situation that enables you to work at a safe distance.  Please be aware that this may change. you must keep an eye on the government website for updates.

 

NORTHERN IRELAND

Per the NI government's website announcement yesterday, the NI Government will be meeting today to update their rulings and we ensure you that we will issue a statement as soon as we see their announcement.


 

UPDATE 4th January 2021 - 8PM

 

ENGLAND
Please read carefully and share far and wide with your professional colleagues. This concerns lockdown ruling in England as of 8 pm this evening.
 
 
??Important update: latest statement from Boris Johnson regarding lockdown in England: (The Scotland announcement is in the update below this and we will notify you as soon as we have analysed statements from Wales and Northern Ireland).
 
Following tonight‘s announcement of a more intensive lockdown for England, we want to let you know that we have looked at the government's statements very carefully, and when also looking at the accompanying document about who can remain open, nothing has changed since the last lockdown legislation, concerning medicine, healthcare and complementary medicine.
 
Please see here to read the statement about offering support to people with pain syndromes, injury, mental and emotional health issues: https://www.gov.uk/.../closing-certain-businesses-and...
This guidance was updated on the 24th of December and is the same wording as the guidance that was issued previously back in November - which the government confirmed in writing - that The Complementary Medical Association had interpreted correctly.
 
Remember, it is crucial that you are able to protect yourself and your patients/clients by using PPE correctly.
 
We have numerous articles here on the CMA website that explain exactly how to use PPE including donning and doffing it correctly.
 
We also have provided you with risk assessment forms below, and instructions on how to do walk-throughs so that you can insure that you are correctly sanitising your clinic.
 
We have also made numerous videos for you which you can find over at The Complementary Medical Association YouTube channel.
 
Because this situation is so fluid and subject to rapid change, we strongly suggest that you subscribe to the channel, and hit the little bell icon that allows you to be notified every time we upload a new video.
 
The onus is on you as a professional to ensure that you are fully up-to-date with all the guidance issued by us as your professional association, and that you are also compliant with government regulations at all times.
 
As with the previous legislation, absolutely no beauty or spa treatments are to be provided (the vast majority of Complementary Medical Association members don’t offer these treatments anyway so this generally isn’t an issue).
 
Please ensure that your insurance provider is still happy to cover you. If we get any updates from our recommended insurers we will of course advise you immediately.
 
You may find it useful to contact your local health authority again, showing them the accompanying wording in the link above.
 
 

UPDATE: 4th January 2021 - Midday

Important update regarding latest lockdowns:
Following the announcement just made, it looks as though Scotland has gone back into full lockdown again. The advisory is that no complementary medical approaches may be conducted if they are “hands-on“.
So we assume from this that if you can safely conduct a “hands-off” consultation in a properly distanced and shielded manner you may be able to continue to practice. Obviously, the governmental advice is not entirely clear, (as we have been finding all year!). We will endeavour to get clarification and will keep updating you as the situation develops.
Our assumption is also that of a countries of the UK may well follow suit. Please rest assured that we will keep you fully updated every step of the way.
 

 


 

UPDATE: 10th November 2020

 

Regarding the current lockdown situation in England. The Complementary Medical Association has been looking very carefully at the current lockdown legislation and we believe that our Members, who provide a range of complementary medical services, including those that constitute remedial work and support mental health and wellbeing, are eligible to work.  This position is based upon a careful analysis of the government's current legislation; Statutory Instrument Coronavirus Act 2020 nbr. 1200 (2020 No. 1200, PUBLIC HEALTH, ENGLAND, The Health Protection (Coronavirus, Restrictions) (England) (No. 4) Regulations 2020).

On page 8, clause 6, it clearly states the following:  (People are allowed to travel) to seek medical assistance, including to take any medical tests, be vaccinated or access any of the services referred to in paragraph 47 of the Schedule.

And then on the last page, these services are clarified as follows:

47: Dental services, opticians, audiology services, chiropody, chiropractors, osteopaths and other medical or health services, including services relating to mental health. (Underline our emphasis)

Based upon this document, we believe that our Members should be allowed to work in England under current legislation – and at time of writing.

However, we strongly advise you to get a 'paper trail' in place, so that the steps you are taking to protect them are very clear to your patients.  Create paper trails detailing your use of PPE and that you are observing correct 'donning' and 'doffing' procedures (see link below to Public Health England) and ensuring that you have all your risk assessment forms in place as detailed in our advice to you below and in our various ‘returning to work’ videos on The Complementary Medical Association’s YouTube channel.

We also advise that you print out the legislation and approach your local council for permission to return to practice.  We also advise you to liaise with the patient’s GP or other 'State Registered' professional and again – get everything in writing!

Your work must be REMEDIAL in nature – so you must be working with people who have named conditions – so our interpretation of this is that you can treat for pain, injuries and mental / emotional health issues. (No beauty or spa treatments are allowed).

We have been asked whether people can still work from home or whether work is only permitted in a clinic or similar setting.  Most of the guidance about this is incredibly unclear.  However, some CMA Members have reported that their Local Authority has given them permission to continue working in their own home clinic setting.  We have seen similar reports from other organisations too.  So, please do liaise with your Local Authority to get their permission – in writing.

We won’t cover issues such as social distancing in this update as we have covered this at huge length in other updates below – and we have made numerous videos about these issues – all available at The Complementary Medical Association’s YouTube channel.


We strongly advise that you look at the document and we do advise printing it out as your Local Authority may not be fully aware of its contents.  For Your convenience, we have highlighted the relevant paragraphs in yellow.  You will find the document over at our Complementary Medical Association group page here in the post about returning to work.

Remember, we will continue to hold our 3pm Thursday afternoon Practice (and school!) growth Q&A session over on Facebook at Jayney Goddard MasterClasses and that you will receive an invitation to our amazingly helpful and informative weekly live CMA tutorials that we hold each Friday via Zoom.  You will get the invitation to this in The CMA's weekly e-Newsletter.  If you don't already receive this do sign up for it at the top of this page. 

 

Finally, remember the lockdown situation is fluid - as a professional, the onus is upon you to ensure that you are in full compliance with government legislation in your area.  


August 2020 - documents and risk assessments

 

For all CMA Members in all categories, in England and Wales: Many of you have contacted us to ask about the QR code poster that all businesses now need to have in place. Many of you have not been able to locate this on the .gov website. Here is the page you need to download your own QR code poster
 

Below are some links to the important documents that we have created for Practitioners and where relevant for Training Schools / Colleges to use.

The first steps that you might like to take is to consider instigating a risk assessment. You can find out how to carry out a thorough risk assessment at the Health and Safety Executive website here.  Risk assessments are helpful as they can assist you in understanding elements of potential risk to yourself and others – furthermore, if you keep a written risk assessment (and we suggest you do), this is a document that could be very useful if a claim was brought against you – and you needed to call upon your insurers for support.

 

Basic disclaimer  This is a very handy general disclaimer form, but we suggest you also look at the more comprehensive Risk Assessment form below.

Risk assessment - this is a hugely comprehensive form generously created for The CMA by Laureen Finney, complementary Medical practitioner and former professional risk assessor. 

 

 

 


 

 

 

COVID-19 coronavirus

CMA Covid-19 Guidance

Published: 19th June 2020

This document accompanies the live tutorial delivered by Jayney Goddard MSc, FCMA, FRSPH on 19th June 2020 on the topic of ‘Emerging From Lockdown and Safely Returning to Work’. 

IMPORTANT: At this extremely challenging time, where information from the government seems to change from day to day, The CMA is providing our guidance based upon our experience and high-level understanding of what constituted best practice, in this field – across a wide variety of disciplines.  At no time do suggest going against UK Government guidelines – or if you are not UK based, that you should contravene the guidelines set out by the government in your own country. The CMA cannot be held liable for any errors or omissions. CMA members must satisfy themselves that they are following and adhering to the latest official guidance in your jurisdiction.

The Complementary Medical Association has members across the world and in many countries the official lockdown is starting to ease somewhat. Governmental guidance is changing from day to day, and what we provide you with in this document is up to date at time of writing. We know that you are very keen to get back to work, if you practice any of the disciplines that have been subject to remaining closed.  This document provides you with guidance and best practice discussion points and we also provide support and discussion points for our Members who are not yet in a position to return to work – or who simply don’t feel it is right for them to do so in the near future (e.g. vulnerable or in designated ‘Shielding’ categories).

We have been inundated by CMA members asking us when they are allowed to go back to work. As you will appreciate, throughout the entire COVID-19 pandemic the Complementary Medical Association has been keeping you abreast of all the latest news – as it pertains to whether or not we can work with our clients.

Although lockdown is easing we will continue to keep you updated on this website – so do check back for updates - and of course will continue to support you in any way we can, through The CMA’s weekly newsletters, via our social media platforms, and of course by direct email messages as necessary. 

Action Points:

CMA Support for YOU!

It is important to stay connected to The CMA and we will continue to help you with growing your practice or training school with our exceptionally helpful weekly tutorials that we have provided free of charge to all our Members – and we are always here for you should you need to make contact at all.

Part of the absolute uniqueness of The CMA is that this incredible non-profit organisation is run by people who all have a complementary medical, natural therapy, science, caring and nursing background.  Therefore, when you make contact, you can be sure that we genuinely understand your issues – and we are in a position to help.

 

Steps to protect yourself – and your clients;

What follows below are CMA recommendations that are designed to help you in returning to work. Please remember though that we are not COVID-19 experts, neither are we lawyers, therefore please do not assume that what we are telling you is prescriptive, or in fact is legal advice. We are giving you the best advice that we feel is helpful at this time. As the situation develops, we may change this advice – in light of new findings.

Gather knowledge:

The first steps that you might like to take is to consider instigating a risk assessment. You can find out how to carry out a thorough risk assessment at the Health and Safety Executive website here https://www.hse.gov.uk  Risk assessments are helpful as they can assist you in understanding elements of potential risk to yourself and others – furthermore, if you keep a written risk assessment (and we suggest you do), this is a document that could be very useful if a claim was brought against you – and you needed to call upon your insurers for support.

You might also like to familiarise yourself with the most up-to-date ‘Best Practice’ information over at the British Medical Journal’s website https://bestpractice.bmj.com/patient-leaflets/en-gb/pdf/3000166/Coronavirus.pdf

Rethink your working practices:

Do you need to put any extra steps in place to protect yourself, colleagues and clients?

Consider the following:

  • Do you need to adapt your business premises and treatment areas?
  • Do you need to make any practical changes to the actual way that you deliver your therapy, treatment or consultations?
  • Are there any changes needed to your overall hygiene protocols?
  • Do you need to spend more time between clients to decontaminate areas?
  • Does your aftercare information need to be updated?
  • Do you need to make any special purchases in order to further maintain cleanliness?
  • How will your new way of practicing affect the more practical elements of the way that you run your business? (Fees, cash taking, card processing, payment up front?)
  • Do you need to update your website or leaflets to reflect any changes?
  • Have your insurance needs changed in any way?

We strongly suggest making an inventory of everything within your practice and workspace that could possibly be a source of cross-contamination or infection.  Think about where people place their hands – it is really quite surprising!  We suggest that a ‘walk-through’ of your practice would be helpful – so check everything right from the front doorbell, to the back door and all points between.

We have created this checklist for you, but we are sure that you will be able to add to this once you undertake a full assessment of your practice environment and identify potentially hazardous contamination points:

  • Main entry – doorbell, knocker, letterbox, intercom
  • Hallway, bannisters, rails, hall tables, literature boxes
  • Light switches, lift buttons
  • Chairs, tables, sofas your practice room / waiting area
  • Toilet, taps, sink, soap dispensers, towel / towel dispenser
  • Your treatment table / couch / seating
  • Payment methods: pen and pad or touch screen devices screens
  • Your computer / mouse / mouse mat. Your desktop, your seat, and more

Do add to this list as you see fit.  We have seen some really creative uses of this list – with CMA practitioners even making YouTube videos where they explain to their clients exactly how the premises will be sanitised between each client appointment.

Think about whether you will ask your clients to bring anything with them to their appointment – do you want them to bring a mask?  Bring their own refreshments? Will you expect them to provide any PPE of their own?

A note regarding PPE

It is crucial that you dispose of any PPE properly - guidance on how to do this can be found here https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/879105/PHE_COVID-19_Doffing_gown_version.pdf

Before your appointment

Conduct sensible pre-treatment assessments – is your client in good health – or are they (or anyone they have been in close contact with) displaying COVID-19 symptoms? Have they tested positive for COVID-19 or do they have a positive antibody test? Do they have a high temperature, sore throat, loss of smell or taste? Do check the current list for potential COVID-19 symptoms to make sure that you are fully up to date with these.

The consultation process and aftercare advice

We have complete faith in you as a professional and it is not up to The CMA to proscribe how you practice.  We know that you are aware of safety in practice – but if in doubt at all, please refer to the best source of information about managing potential contamination and reducing the risk of this happening at the NHS websites.

We know that for many of you, you are a vital support to your clients – they will be concerned about the risks of coming back to see you – so do demonstrate that you are taking steps for their (and your) safety – perhaps with videos as suggested above, and also point them in the direction of NHS and government websites that demonstrate how to reduce the spread of COVID-19 – to reassure your clients that you are absolutely up to date with all of this and are taking all the necessary measures to keep them safe.

What if I don’t want to return to work at this time?

If you do not yet feel that you want to return to face to face consultations, consider how you can begin – or continue to offer online support to your clients.  As an important lifeline at this time – it is crucial that you are there for them – so think about creative ways that you can branch out to offer your support.

What if you are in the shielding category yourself and don’t’ feel that you should return to work just yet?

You will need to make some decisions about when you will feel safe returning to work and set plans for that – bearing in mind of course that this is a very fluid situation which is changing day to day.  Nevertheless, at times of great uncertainty, it is helpful to set yourself targets and create plans, while building some flexibility into these.  Also consider whether you’ll still be eligible for any support that you might have been receiving from the government during lockdown and whether this is likely to continue after we emerge from lockdown.

Can you thrive, personally and professionally, in the face of adversity?

Th key to thriving at very challenging times is resilience and we have every faith in you! Consider ways of pivoting your business – so that you are able to not just survive but thrive in the face of adversity.  What else can you do, can you provide counsel, can you begin to teach? What other dormant talents do you have that you haven’t capitalised upon?

What else could you do?  For example, xould you set up an online course? (If you are curious about this option, see CMA President, Jayney Goddard’s brilliant free tutorial on ‘How to set up and teach an online course’).  There are lots of incredibly helpful professional resources over at the Private Facebook Group; Jayney Goddard MasterClasses – videos, worksheets, Facebook Lives and more. Do take advantage of these – they were created by Jayney and are supported by The CMA specially to help you in your work at this challenging time.

Further overall support for your clients

It is important that your clients know that they can trust you to be a source of accurate and helpful information about COVID-19 and other aspects of general wellness.  Point them to The Complementary Medical Association’s website, Facebook page and YouTube channel for information about staying well at this time and overall selfcare.  Remember, any advice you give your clients constitutes a ‘consultation’ so this should be documented on your client notes as they could be required for insurance purposes in the event of a claim at some point in the future.

 Maintaining protection and coverage

Finally, ensure that your CMA Membership is up to date and that your insurance policy is current. These are confusing, fluid times so be sure that you, your practice or, if you teach, that your school is fully protected. 

IMPORTANT: At this extremely challenging time, where information from the government seems to change from day to day, The CMA is providing our guidance based upon our experience and high-level understanding of what constituted best practice, in this field – across a wide variety of disciplines.  At no time do suggest going against UK Government guidelines – or if you are not UK based, that you should contravene the guidelines set out by the government in your own country. The CMA cannot be held liable for any errors or omissions. CMA members must satisfy themselves that they are following and adhering to the latest official guidance in your jurisdiction.

Helpful contact details and information sources:

The Complementary Medical Association pages on COVID-19 and Coronavirus – Https://www.The-CMA.org.uk

We have incredibly helpful resources for you on The CMA site – everything including practice support, business development, mental healthcare, staying physically fit and well during this time, The development of COVID-19, symptomatology, natural antiviral suggestions and so much more.

Citizen’s Advice https://www.citizensadvice.org.uk

Health and Safety Executive website here https://www.hse.gov.uk

British Medical Journal Best Practice Overall Guidance https://bestpractice.bmj.com/topics/en-gb/3000168/patient-leaflets

British Medical Journal printable Best Practice leaflet https://bestpractice.bmj.com/patient-leaflets/en-gb/pdf/3000166/Coronavirus.pdf

United Kingdom Government site: “Closing Certain Businesses and Venues in England” page  https://www.gov.uk/government/publications/further-businesses-and-premises-to-close/further-businesses-and-premises-to-close-guidance

Wales: https://gov.wales/sites/default/files/publications/2020-03/coranivirus-closure-of-businesses-and-premises.pdf

Scotland: https://www.gov.scot/publications/coronavirus-covid-19-phase-2-business-and-physical-distancing-guidance/pages/businesses-and-premises-which-must-close/

Northern Ireland: https://www.nidirect.gov.uk/information-and-services/coronavirus-covid-19/advice-businesses-and-workers

World Health Organisation – Coronavirus Information Updates: https://www.who.int/health-topics/coronavirus#tab=tab_1

Royal Society of Medicine: RSM Live: free webinars which keep up to date with the latest developments on a range of topics and specialties. Https://www.rsm.ac.uk/resources/rsm-live/

 

 


 

  

Coronavirus 2019-nCoV / COVID-19

Jayney Goddard, President, The CMA

 

 

Video Resources

We have now prepared several videos on various aspects of this topic to help you to remain safe.  You can find these videos here. Please sign up for The CMA's newsletter so that we can keep you in the loop as things develop - and we discover more about this virus and steps we can take to protect ourselves.  You can find a link for this in the purple box at the top of this page.

How do you treat Coronavirus conventionally?

At the moment there aren’t any vaccines or other drugs that have shown any promise in treating Coronavirus at the moment the conventional advice is to rest and hydrate, much as one would if one had a mild cold and some centres are advising the use of ibuprofen, although, other centres disagree and state that ibuprofen is potentially harmful and may exacerbate symptoms. For those hospitalised and exhibiting respiratory distress, the use of ventilators and IV hydration drips are the most likely treatment pathways. Tests are under way in China to ascertain whether two antiviral drugs used to treat HIV - lopinavir and ritonavir - might offer effective treatment. These drugs were shown to help combat the SARS virus in 2003, after data emerged that HIV patients who were using the drugs and who also had SARS had better outcomes. Other drugs under consideration include Tocilizumab - the biological therapy that is used to suppress the immune systems of people with autoimmune illnesses including Rheumatoid Arthritis.  It is an IL-6 inhibitor - it supresses the activity of the pro-inflammatory IL-6 cytokine.

Coronavirus header

PART 1 - What are our options in Complementary Medicine?

As you will appreciate, this is my ‘best guess’ too as I have not treated anyone with Coronavirus, nor have I seen it first hand, but I am working from my knowledge of the well-described presenting symptoms in patients that have been provided by the doctors treating them, and using my own expertise based upon over three decades of working with patients presenting with a vast variety of conditions.  As we know, in Complementary Medicine, we do not ‘treat conditions’ as such – we aim to understand why a patient is expressing certain symptoms and we use these to ascertain how we can best support that person’s return to optimal wellness.

CAVEAT:

Under no circumstances deviate from the Governmental safety guidlines.  Handwashing is as important now as ever! Remember that 'personal distancing' is extremely important and observe any guidance (or laws that may come into place) that the government in your country have implemented.  We are keeping this information general as The CMA is a global organisation and each country has it's own set of guidelines that must be adhered to.

Lifestyle and Nutrition

Given that adults with compromised immune systems seem to be most at risk – particularly if they have respiratory or heart/circulatory conditions – it is essential for these people to take steps to develop healthy lifestyle habits and to stop smoking immediately – if that is an issue.

We will all need to eat healthily and the most robust data point to a whole food, plant-based diet as the optimal nutrition approach for general wellness and resilience.  Ideally, we should aim to eat a rainbow of different coloured fruits and veggies – with as much variety at every meal.  This nutritional advice applies to the generally well population – and those of us who struggle with other conditions.

Avoid sugar and all refined carbohydrates such as white bread, pastries, pasta, biscuits/cookies, sweets/candies etc.  Sugar compromises immune activity. It is best avoided in general – but more so if there is a potentially harmful virus in circulation.

Avoid alcohol.  The most up to date research really shows that there is no safe level for alcohol consumption.

Cut out processed, refined fats and all animal fats – these compromise circulatory function and promote inflammation – which weakens immune response.

Cut out caffeine as this too can compromise immune response in some people.

Hydration

Adequate hydration is crucial – hydration attenuates the viral load – should we succumb to any virus – which is why we are often told to rest and drink plenty of water when we are ill.  Remember to avoid tea, coffee and other caffeinated drinks – especially so if they contain sugar. You’ll know when you are adequately hydrated if your urine is a pale straw colour.

Exercise

Exercise is vital for us all – and it does a great deal to support a robust, healthy immune system.  We humans are designed to move, and it is impossible to be optimally healthy if we lead a sedentary life.  As we know, 'sitting is the new smoking' – and active gym sessions (even if the gyms were open!) and bouts of exercise don’t offset the damage done by long periods of sitting, e.g. watching TV, working on a computer etc. It’s vital to take at least 30 minutes exercise every day but aim for more than that – and spread your activity throughout the day too.  If you do watch TV, ensure that you get up and move about periodically.

Resistance training is hugely important for us all – this includes weight training, heavy manual work etc. see my video with one of the world's leading vegan bodybuilders and lastly, try more mindful forms of exercise, such as yoga, pilates, tai chi, qi gong etc. are helpful both physically and as a form of moving meditation.  

Try to get out into nature if at all possible - and remember to maintain a safe (2-3 meter) distance from others.  If you can't get out, remember that it is important to breathe fresh air - so throw those windows open for at least part of the day.

Stress Response Management

You’ll notice that I don’t talk about ‘stress management’ as it is impossible to manage sources of stress – life happens – and it’s how we deal with things that distress us that actually matters.  Building resilience to stressors is vital to maintaining optimal physical health – as well as giving us psychological poise – and one of the best ways to do this is to learn a technique called “The Relaxation Response”.  This 20-minute meditation technique was pioneered by Dr Herbert Benson of Harvard Medical School and it is incredibly simple to do.  I have recorded an instructional download for you that you can access completely free at my personal website JayneyGoddard.org

Sleep

Adequate sleep is vital to health as we all know – and so much has been written about this already so I won’t go into it in depth here. However, it is a fact that poor, disrupted sleep and insomnia really do dramatically compromise immune function. So, with this in mind, I wanted to point you towards a Yoga Nidra Meditation for Deep, Restorative Sleep recording download that is also available free of charge at my website JayneyGoddard.org

Hygiene

Hand-washing

It is always a sensible precaution to observe general hand sanitation procedures all year round - and even more so when there is a potentially serious virus doing the rounds, whether it is seasonal flu (which kills many thousands of people every year) or Coronavirus. I always carry hand sanitiser with me when out - especially if I'm travelling on public transport.  There are plenty of videos on YouTube that demonstrate how to wash one's hands the correct way - It's surprising how many people don't know how to do this!

 

Essential Oils

Essential oils can be dispersed with an atomizer (one to five drops essential oil for every 3 tablespoons of distilled water). For a very basic anti-microbial spray, mix a few drops of the essential oils of Lavender and Tea-tree with distilled water in a plant sprayer and spray liberally around your rooms.

Spritz the air regularly. Do feel free to add other oils as desired, as various oils do have differing anti-microbial effects – so there is a good rationale for using a mixture of any of the following essential oils: Clove, Cinnamon, Thyme, Oregano, Lavender, Sweet Marjoram, Peppermint, Tea-tree. Get Jayney Goddard's e-book on the use of anti-viral essential oils during this pandemic here (totally free of charge)

 

Of particular relevance to Coronavirus is that research study has found that the essential oils mentioned above have specific properties which protect our respiratory tract from pathogens, although it is important to realise that none of the oils above have been tested against this novel form of coronavirus - yet. If such research is undertaken, we will be sure to let you know.  We can only provide data about the performance of oils against previously-seen coronaviruses and other pandmic flu viruses.

Treating symptoms of Coronavirus using Complementary Medical Approaches

I have analysed the symptom picture of those presenting with symptoms and so well described by the doctors in China, that I believe that the best homeopathic remedy that is the closest match, over all, to the symptoms described is Gelsemium.  You can read about this remedy here on The CMA site.  Personally speaking, if I were to feel unwell following exposure to Coronavirus, this would be my go-to remedy.  I would then prescribe according to how my symptoms developed and possibly consider other remedies.  Obviously that’s easy enough for a trained homeopath, but if you aren’t then I suggest looking for trained, qualified homeopaths here on The CMA site as they will be in a position to guide you – according to any symptoms you might display, should you start to feel unwell. Homeopathy has a history of performing well in other pandemics and major epidemics - and has been especially useful when there were no other viable conventional treatment options around. In the 1918 Spanish Flu (H1N1) pandemic we have reliable data which show that: 

•Spanish flu deaths in infected and symptomatic people using homeopathy were <1%
 
•Deaths in those using allopathic medicine were in excess of 30%
 
•Cohort sizes were 26000 in one record and 24500 in another.  These data are reliable and were collated by the army doctors who were responsible for the welfare of the soldiers at two major bases. Similar cohorts showed the same statistics.
 
You can view my presentation on just how well homeopathic medicine performed in the 1918 "Spanish Flu" pandemic here.  At the moment, it is simply a set of Powerpoint slides, but now that we have a pandemic upon us I shall, in the next couple of days, record a voiceover that will better explain the data for you.
 

Other Complementary Medical Options

All of the 'holistic lifestyle' disciplines or complete 'systems' of medicine such as Traditional Chinese Medicine (TCM), Ayurveda and more have much to offer and many of the herbs used in both Eastern and Western medicine show strong anti-viral activity. Of particular interest is elderberry as it does seem to perform well as an antiviral, however, I am not advising people to take commercial elderberry syrup preparations which contain a lot of sugar as this is, as we know, counter-productive and weakens the immune response. Essentially, any approach that we offer in the field of Complementary Medicine that takes into account the patient's individual totality of symptoms and prescribes upon this, is useful.
 

The following herbs are proven to have strong anti-pathogen activity - and are oustanding additions to a healthy diet:

Turmeric

  • Anti-Pathogenic (including anti-viral)
  • Anti-Hypertensive
  • Anti-Inflammatory
  • < Tumour Formation
  • Anti-Cancer(Anti-Proliferative)
  • Cholesterol Lowering
  • Mucin Increasing
  • Antibiotic

Ginger

  • Anti-viral
  • Anti-Inflammatory
  • Analgesic
  • Suppresses Inappropriate production of PG and LT
  • Prevents Platelet Aggregation
  • Anti-Oxidant
  • Cardio-tonic
 

Garlic

  • Anti-viral
  • Anti-Inflammatory
  • Analgesic
  • Suppresses Inappropriate Production of PG and LT
  • Prevents Platelet Aggregation
  • Anti-Oxidant
  • Cardio-tonic
 

Resveratrol (usually found as a supplement but derived from plant sources including red grapes)

  • Anti-viral
  • Anti-Inflammatory
  • Anti-Oxidant
  • Anti-Cancer and Anti-Proliferative
  • Anti-Angiogenic
  • Anti-Cardio-Fibrotic
  • Anti-Ageing
 

Rosemary

  • Anti-viral
  • Supports Anti-inflammatory Action of D3
  • Potent Cox2 Inhibitor
  • Anti-Oxidant
  • Anti-Cancer
  • Fights Against Lipid Peroxidation (LDL)

Can pets at home spread the new coronavirus (2019-nCoV)?

This information comes from the World Health Organisation:

At present, there is no evidence that companion animals/pets such as dogs or cats can be infected with the new coronavirus. However, it is always a good idea to wash your hands with soap and water after contact with pets. This protects you against various common bacteria such as E.coli and Salmonella that can pass between pets and humans.

In Closing

We hope that you will find this article useful and we'd love to hear from you with your thoughts, observations and suggestions for ways that we in Complementary Medicine can support people, should the virus mutate and become more transmissible between humans. Email us here with your comments

  


 

 

 

Part 2

Fighting the new Coronavirus (2019-nCoV) has been a battle against the unknown for doctors and virology/immunology researchers and of course they are looking for ways to fight the virus in those already infected – and to find vaccines that will be able to prevent infection.  The trouble with this approach is that it takes AT LEAST 6 months to grow a vaccine in sufficient quantities that will enable global coverage.

This DOES NOT include the lead time that it takes to ascertain which version of the virus will be the one that is in circulation in over six months’ time.  Remember, viruses constantly mutate – so we really don’t know exactly how the virus will be behaving in six months+ time - it really is a ‘best guess’ situation and one where a crystal ball really would come in handy.  BBC reports state that the experts they have interviewed do not believe that a vaccine will be available for at least a year - and they point to the fact that there's still no vaccine available against the 2009 Swine flu virus - over ten years later.

It is hugely challenging for Big Pharma to realistically come up with anything viable and of course, you’ll realise that I haven’t even touched on the potential harms from added vaccine ingredients – preservatives and adjuvants – that have the potential to seriously compromise health.  There are plenty on online resources that provide reliable, up to date, evidenced-based data about these issues, should you wish to read further.

 

Coronavirus is a pandemic

A pandemic like the current corona virus outbreak is a bonanza for the drug companies – and as I wrote in my books on pandemic flu1, governments globally are sitting ducks for the pharmaceutical companies, who would love nothing better than for mass coronavirus panic to break out so that their coffers can be lined. 

Governments have their arms twisted behind their backs as they are under huge public pressure to “DO SOMETHING” to protect the populace – so they really have to be seen to be spending billions purchasing drugs and vaccines that have little, to no proof, of efficacy.

Back in 2005 and again in 2009, during the Bird flu (H5N1) and Swine flu (H1N1) pandemics, respectively, governments spent literally billions stockpiling supplies of Tamiflu (oseltamivir) – a neuraminidase inhibitor drug that was supposed to prevent flu from developing, and it was eventually discovered that not only did it not adequately prevent, or even reasonably shorten, the duration of these influenzas, it came with an array of horrendous side-effects (which particularly affected children, with some appalling neuropsychiatric outcomes)2. In fact, Tamiflu was deemed so dangerous that some governments actually banned the drug. 

Let us not also forget that the manufacturers of Tamiflu, Gilead Sciences and F Hoffmann-La Roche, falsified or (if we are being charitable), made grave errors when reporting their trial results, and it is believed by many that they perpetrated a huge crime against governments and thus, taxpayers, worldwide - scamming them out of all those billions. Oddly enough, no one was ever prosecuted!

Back to Coronavirus:

Due to the difficulties in producing any viable treatment via the usual conventional pharmaceutical routes as described above, we need to look at what we can contribute from our health and wellness perspective in complementary medicine.  And, of course this article is not the place to explore the dastardly doings of Big Pharma and their lies about Tamiflu, you can read all about these issues in my books – where I cover all this in great depth. Instead, in this article, I wanted to provide you with information about how the current version of the virus operates, and the types of symptoms that it produces – and which population cohorts are most likely to be affected – so that we, complementary medicine and lifestyle medicine practitioners have a heads up on what is actually going on.  I have collated this information from various sources including The Lancet, the World Health Organisation, BMJ and more.  Sources and references are at the end of this article.

Hopefully the information here will help clarify what is happening at the moment, and the types of symptoms infected patients will display – and we will look at what we might be able to do to help people, should the virus mutate to become more highly transmissible between humans – and demonstrate a higher mortality rate.

 

 

What are the main symptoms displayed by patients?

Primary complaint - Lung involvement

Patients have been admitted to the hospital with pneumonia - their lungs were inflamed and the alveoli, which transfer oxygen from air to the blood, were filling with fluid. There is evidence of a cytokine storm in some patients - an overwhelming immune response that is highly dangerous.

Other symptoms exhibited by patients included:

  •  fever
  • cough
  • shortness of breath
  • muscle ache
  • confusion
  • headache
  • sore throat
  • Gastrointestinal symptoms

Where it all began - China

This next section will give you some helpful background that will illustrate what happened right at the point that COVID-19 became serious:

First deaths

The first two patients to die were generally healthy, aside from the fact that they were long-term smokers and that would have weakened their lungs. 

The first man was 61 years old, and already exhibited symptoms of severe pneumonia upon arrival at hospital. He was in acute respiratory distress thus his lungs couldn’t provide enough oxygen to his organs to keep his body alive. 

He was put on a ventilator, but his lungs failed, and his heart stopped beating, and he died 11 days after he was admitted.

The second patient was a 69-year-old man who also exhibited symptoms of acute respiratory distress syndrome.

He was put onto an ECMO (extra-corporeal membrane oxygenation) machine – sometimes called an ‘artificial lung’ but this wasn't sufficient to save his life. He succumbed to severe pneumonia and septic shock after his blood pressure plummeted.

 

Initial Mortality Rate

At least 10% of those known to be infected and showing symptoms died – but view these figures with extreme caution

As of 25 January, of the 99 patients:

  • 57 were still in hospital
  • 31 had been discharged
  • 11 had died

Current Mortality rate for comparison:

 

Infection Fatality Rate (23k / 1.7M = 1.4% IFR)

Actual Cases with an outcome as of May 1 = estimated actual recovered (1,671,351) + estimated actual deaths (23,430) = 1,694,781.

Infection Fatality Rate (IFR) = Deaths / Cases = 23,430 / 1,694,781 = 1.4% (1.4% of people infected with SARS-CoV-2 have a fatal outcome, while 98.6% recover).

Mortality Rate (23k / 8.4M = 0.28% CMR to date) and Probability of Dying

As of May 1, 23,430 people are estimated to have died out of a total population of 8,398,748 in New York City. This corresponds to a 0.28% crude mortality rate to date, or 279 deaths per 100,000 population, or 1 death every 358 people. Note that the Crude Mortality Rate will continue to increase as more infections and deaths occur

 

Incubation Period (how long it takes for symptoms to appear)

See full details: COVID-19 Coronavirus Incubation Period

Symptoms of COVID-19 may appear in as few as 2 days or as long as 14 (estimated ranges vary from 2-10 days, 2-14 days, and 10-14 days, see details), during which the virus is contagious but the patient does not display any symptom (asymptomatic transmission).

Age and conditions of Coronavirus cases

See latest findings: Age, Sex, Demographics of COVID-19 Cases and Deaths

According to early estimates by China's National Health Commission (NHC), about 80% of those who died were over the age of 60 and 75% of them had pre-existing health conditions such as cardiovascular diseases and diabetes.[24]

According to the WHO Situation Report no. 7 issued on Jan. 27:

  • The median age of cases detected outside of China is 45 years, ranging from 2 to 74 years.
  • 71% of cases were male.

A study of 138 hospitalized patients with NCIP found that the median age was 56 years (interquartile range, 42-68; range, 22-92 years) and 75 (54.3%) were men.[25]

The WHO, in its Myth busters FAQs, addresses the question: "Does the new coronavirus affect older people, or are younger people also susceptible?" by answering that:

  • People of all ages can be infected by the novel coronavirus COVID-19.
  • Older people, and people with pre-existing medical conditions (such as asthma, diabetes, heart disease) appear to be more vulnerable to becoming severely ill with the virus.

Patient who died in the Philippines was a 44-year old male

The patient who died in the Philippines on February 2, in what was the first death occurring outside of China, was a 44-year-old Chinese man from Wuhan who was admitted on Jan. 25 after experiencing fever, cough, and sore throat, before developing severe pneumonia. In the last few days, “the patient was stable and showed signs of improvement, however, the condition of the patient deteriorated within his last 24 hours resulting in his demise." according to the Philippine Department of Health.

 

Serious Cases of 30 year old patients in France

As of Jan. 29, according to French authorities, the conditions of the two earliest Paris cases had worsened and the patients were being treated in intensive care, according to French authorities. The patients have been described as a young couple aged 30 and 31 years old, both Chinese citizens from Wuhan who were asymptomatic when they arrived in Paris on January 18 [19].

Age and Sex of the first deaths as reported by the China National Health Commission (NHC)

The NHC reported the details of the first 17 deaths up to 24 pm on January 22, 2020. The deaths included 13 males and 4 females. The median age of the deaths was 75 (range 48-89) years.[21]

WHO Risk Assessment: Global Emergency

See full details: WHO coronavirus updates

On January 30, the World Health Organization declared the coronavirus outbreak a Global Public Health Emergency.

For more information from the WHO regarding novel coronavirus: WHO page on Novel Coronavirus (2019-nCoV)

 

NOTE: it is extremely difficult to analyse actual mortality rates.  The current estimates do not accurately indicate that the mortality rate of the Coronavirus is circa 11%, though, as some of those still in hospital may yet die and many others have very mild symptoms, so they do not end up in hospital. Furthermore, some leaked data from China indicate that greater numbers of people are succumbing to the disease and dying – but as these reports are not officially substantiated, it is impossible to tell. At time of writing – we don’t yet know how dangerous coronavirus really is.  For comparison, seasonal flu typically has a mortality rate below 1% and is thought to cause about 400,000 deaths each year globally4. SARS had a death rate of more than 10%. And the 2005 pandemic of Bird Flu (H5N1) had a mortality rate of circa 85% according to the WHO.

Now, let's look at the Coronavirus Incubation Period:

2 - 14 days
Possible outliers: 0 - 27 days
 
  • 2-14 days represents the current official estimated range for the novel coronavirus COVID-19.
  • However, a case with an incubation period of 27 days has been reported by Hubei Province local government on Feb. 22 [12]
  • In addition, a case with an incubation period of 19 days was observed in a JAMA study of 5 cases published on Feb. 21. [13]
  • An outlier of a 24 days incubation period had been for the first time observed in a Feb. 9 study.[11]WHO said at the time that this could actually reflect a second exposure rather than a long incubation period, and that it wasn't going to change its recommendations.
  • Period can vary greatly among patients.
  • Mean incubation period observed:
    3.0 days
    (0 - 24 days range, study based on 1,324 cases)
    5.2 days (4.1 - 7.0 days range, based on 425 cases).
  • Mean incubation period observed in travelers from Wuhan:
    6.4 days
    (range from 2.1 to 11.1 days).

Demographics:

Who was affected initially?

Market workers were originally infected

It is believed that, similarly to the 2005 Bird Flu (H5N1) and the 2009 Swine Flu (H1N1) live animals sold at the Huanan seafood market are the source of the infection, called 2019-nCoV or COVID-19 – which has become transmissible to humans. 

It is believed that market workers have been affected primarily, as 49 out of the 99 patients had a direct link to the market:

  • 47 worked there, as managers or working on the market stalls
  • 2 were customers who had briefly visited the market

Middle-aged men worst affected

The majority of the 99 patients were middle-aged men, (average age 56 - and 67).   

However, more recent figures suggest a more even gender split. The China Centres for Disease Control and Prevention has stated a gender ratio of 1.2 infected men to 1.0 infected women. 

Why might men be more vulnerable?

It isn’t known why men might be more susceptible to Coronavirus – there are so many confounding factors that could be responsible for the difference – lifestyle, socio-cultural reasons, immune system variance and more.

Dr Li Zhang, who works at the hospital, suggested: "The reduced susceptibility of females to viral infections could be attributed to the protection from X chromosome and sex hormones, which play an important role in immunity."

Which health conditions/illnesses did those people who were already infected have?

It should be noted that the 99 patients had other diseases that may have made them more susceptible to the virus as a "result of the weaker immune functions of these patients":

  • 40 had a weak heart or damaged blood vessels due to disorders including heart disease, heart failure and stroke
  • A further 12 patients had diabetes

Age, Sex, Existing Conditions of COVID-19 Cases and Deaths

Most recent data available. Last updated: February 29, 4:40 GMT

There are two sources that provide age, sex, and comorbidity statistics:


  • The Report of the WHO-China Joint Mission published on Feb. 28 by WHO, [2] which is based on 55,924 laboratory confirmed cases. The report notes that "The Joint Mission acknowledges the known challenges and biases of reporting crude CFR early in an epidemic" (see also our discussion on: How to calculate the mortality rate during an outbreak)
  • A paper by the Chinese CCDC released on Feb. 17, which is based on 72,314 confirmed, suspected, and asymptomatic cases of COVID-19 in China as of Feb. 11, and was published in the Chinese Journal of Epidemiology [1]

We will list data from both, labeling them as "confirmed cases" and "all cases" respectively in the tables.

 

 

COVID-19 Fatality Rate by AGE:

*Death Rate = (number of deaths / number of cases) = probability of dying if infected by the virus (%). This probability differs depending on the age group. The percentages shown below do not have to add up to 100%, as they do NOT represent share of deaths by age group. Rather, it represents, for a person in a given age group, the risk of dying if infected with COVID-19.

 

AGE

 

DEATH RATE
confirmed cases 

DEATH RATE
all cases

80+ years old 

21.9%

14.8%

70-79 years old 

 

8.0%

60-69 years old 

 

3.6%

50-59 years old 

 

1.3%

40-49 years old 

 

0.4%

30-39 years old 

 

0.2%

20-29 years old 

 

0.2%

10-19 years old 

 

0.2%

0-9 years old 

 

no fatalities 

 

Pre-existing medical conditions (comorbidities)

As we now know - patients who reported no pre-existing ("comorbid") medical conditions had a case fatality rate of 0.9%. So, pre-existing illnesses that put patients at higher risk of dying from a COVID-19 infection are:

COVID-19 Fatality Rate by COMORBIDITY:

*Death Rate = (number of deaths / number of cases) = probability of dying if infected by the virus (%). This probability differs depending on pre-existing condition. The percentage shown below does NOT represent in any way the share of deaths by pre-existing condition. Rather, it represents, for a patient with a given pre-existing condition, the risk of dying if infected by COVID-19.

PRE-EXISTING CONDITION

DEATH RATE
confirmed cases 

DEATH RATE
all cases

Cardiovascular disease

13.2%

10.5%

Diabetes

9.2%

7.3%

Chronic respiratory disease

8.0%

6.3%

Hypertension

8.4%

6.0%

Cancer

7.6%

5.6%

no pre-existing conditions 

 

0.9%

*Death Rate = (number of deaths / number of cases) = probability of dying if infected by the virus (%). The percentages do not have to add up to 100%, as they do NOT represent share of deaths by condition.

 

 

 

 

References:

1 See The Survivor’s Guide to Swine Flu: The Complementary Medical Approach Over 577 pages in the Kindle edition with in excess of 600 references to robust research supporting all the recommendations and data in this book.

2 Neuraminidase inhibitors for preventing and treating influenza in healthy adults: systematic review and meta-analysis BMJ 2009;339:b5106 https://doi.org/10.1136/bmj.b5106 (Published 08 December 2009) Last accessed 06 February 2020

3 Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study The Lancet (Online First) https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2820%2930211-7/fulltext Last accessed 06 February 2020

4 Global mortality associated with seasonal influenza epidemics: New burden estimates and predictors from the GLaMOR Project J Glob Health. 2019 Dec; 9(2): 020421. Published online 2019 Oct 22. doi: 10.7189/jogh.09.020421 Last accessed 06 February 2020

News

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