I make my living from gathering a bunch of germ-bag kids in a room and having a magical 40 minutes of story fun. By the end, we're super best friends, and they hug, kiss and lick me whether I want them to or not. I normally regard this as a perk of the job, but the Coronavirus has made me wonder if I might have been better off going into the movie business!
Equally, I have two children of my own. Some of their friends have asthma. My Dad falls into the high-risk bracket because of his age. The media coverage has been alarming, but does that mean that I too should be alarmed?
Can you imagine how bad it would be for business if the Story Storks workshops at Easter were the event that caused a pandemic! I'd never live it down! But joking aside, I have a duty of care to my patrons, and I want to make the right choices in terms of events that I put on. I am seeing major events being cancelled all around me. Should I be doing the same?
The media are in the business of selling papers, so their coverage is rarely comprehensive enough for me to make a fully informed decision. I also have a science degree and, in a previous life, worked with vaccine companies, once appearing on Newsnight as an expert (I was heavily edited so you couldn't tell I was hungover) so I have decided to apply this skillset and investigate it myself. What I found is going to inform my decisions about Story Storks. But it's also had the effect of calming me as a mum, friend and daughter. Given that, I thought that sharing it might pass on a bit of peace of mind to you too.
Before we dive into the nitty-gritty, I would remind you that the situation changes daily, so please do check the date on this if you are reading it. We may have already moved on! I've listed some useful sources of information in the references below so that you don't have to try to find your facts amongst the stories. I will start to put stuff on my Facebook page (www.facebook.com/storystorks) and Twitter (@storystorks), to help parents make informed decisions.
WHAT IS CORONAVIRUS?
Coronaviruses are a large group of viruses that affect mammals and birds. Mostly they cause mild coughs and colds, but some are more deadly. There are a number of coronaviruses that affect humans, COVID-19 being the most recent. SARS is another you may have heard of. MERS is another that you won't have heard of unless you're into this kind of thing! The first coronavirus was discovered in chickens in the 1960s. COVID-19 is a new variant, and so the human population has no immunity. We know about the Coronavirus family, but until it is studied fully the scientists can't say for sure if COVID-19 is a child that behaves just like his father, or the one that is going off the rails!
WHAT DOES INFECTION WITH COVID-19 LOOK LIKE IN ADULTS?
A typical adult infected with the COVID-19 virus first has an incubation period of around 2 to 3 days where they look and feel totally fine. They then develop symptoms including but not exclusively a cough and/or a fever which lasts for around 5 days. The vast majority of people then get better.
A small number go on to a second phase of the illness where they can experience complications such as pneumonia. This is because, instead of calming down, the immune response becomes overzealous and causes damage to the lungs (that's a simple version!). Those most likely to go on to this stage are those labelled as 'The Vulnerable'. This includes those in their 60s, 70s and 80s (I refuse to call them elderly - Grandpa Colin is fitter than some 40 years olds I know and he's in his 80s), and those with underlying health conditions including diseases of the lung, diabetes and heart disease.
The lucky stars amongst you might contract the virus, incubate it nicely and then develop no symptoms whatsoever. You feel fine. You hit the pub. You hug the kids. You hang out with grandma. Eeek!
And there lieth the problem. It's different in different people. It might kill you BUT you might not even notice you've had it! Viruses are sneaky like that.
WHAT DOES INFECTION WITH COVID-19 LOOK LIKE IN A PREGNANT WOMAN?
So far, it looks pretty much the same as in adults who are not pregnant, or pregnant ladies with flu (4). As all pregnant women are under 60 (!) the risk of age is negated. If you have underlying conditions such as asthma, diabetes or heart disease flag them with your midwife and make a plan for yourself. Share that plan with your loved ones. Talk to your other half about the time off work they may need, and get them to have that conversation with their boss now. Write it down, because as you get more pregnant you will forget the plan! Put yourself first - I know that's hard if you already have little ones to look after, but think about the support network that you'll need in place should the worst happen. Do it now whilst you feel OK because organising childcare and food when you feel ill is not where you want to be. If your parents are your first port of call for childcare then try to organise an alternative. If you come down with COVID-19 and give it to them, you would never forgive yourself.
WHAT DOES INFECTION WITH COVID-19 LOOK LIKE IN CHILDREN?
The lovely Chief Medical Officer, Professor Chris Whitty (1), has stated in a press conference (2) that the early data suggests children do become infected, but experience a much milder form of the disease. This is the opposite of flu, where children under 10 are more likely to be hospitalised by flu than their parents - hence the vaccination.
Not only this, but children may be the answer to our prayers. Their immune systems can bat this virus off. If scientists can figure out how they're doing it, then they may be able to use that information to create a cure or vaccine.
On the basis of this evidence, there is no real case for closing schools as, of this very moment in time, it's not children we need to protect! Once the epidemic really hits, then there might be a case, but right now it's more about protecting their grandparents than them. More on that later.
WHAT DOES INFECTION WITH COVID-19 LOOK LIKE IN INFANTS?
This information hasn't been forthcoming, so I can only speculate. Breast-feeding infants will share their mother's immunity which is some reassurance. I will keep researching and asking to get a definitive answer on infants. Once I find it, I'll update this blog post and put it on Twitter and Facebook.
SO WHY ISN'T THERE A VACCINE OR CURE YET?
Vaccines are created by private companies - the pharmaceutical industry. They work in conjunction with our scientists and scientific institutions, but to create a new vaccine and bring it to market costs millions of pounds and takes several years. There are 4 stages of clinical trials, and a vaccine can fail at any one of those 4 stages meaning that it will never make it to market and the company has to absorb the costs with no hope of recuperation through sales.
This means that the market has to be big enough to bear the costs of the research and development of the drug or vaccine. The more people who have the disease, the more likely a vaccine will be developed.
Work started on a vaccine for SARS during the outbreak in 2002/3 but came to a stop when the virus stopped spreading. There have been no cases of SARS reported since 2004 - no market = no vaccine. Work has been going on to create a vaccine for the coronavirus MERS and a product is in the pipeline.
You may find this a bit appalling. Or you may accept it as the way of the world. Knowing I have friends in both camps I'm staying firmly on the fence!
However you feel, take heart, because the world has moved on since SARS. The scientific community is more united than ever (including China), and a massive international effort is going on to develop a vaccine to COVID-19, spearheaded by Dr Kate Broderick, a Scottish-born scientist who now lives in the US and works as Vice President in Research and Development for Inovio Pharmaceuticals (who have also been working on the MERS vaccine). Development is proceeding at a rapid rate thanks to outside investment from government bodies. The vaccine is already in the first stages of trials which aim to prove it is safe. The next stage is to trial it on healthy humans to make sure it raises the correct immune response - this could happen within the year.
THIS IS A HUGE ACHIEVEMENT - THANK-YOU SCIENTISTS
AND it gets better because clinical trials are underway for anti-viral drugs which are already on the market. This is super good news because they have already been proven safe, so the trial process will move along faster. Should one of the anti-virals prove effective, production can be scaled up pretty quickly. It is possible we will see one of these agents licensed for the treatment of COVID-19 within the year.
ANOTHER FANTASTIC ACHIEVEMENT FROM OUR SCIENTIST
I am of course saddened for those families who are mourning a lost one, but I am also incredibly proud of the human endeavour that is going into trying to fight this virus. China's efforts are just phenomenal. Our British born scientists are heading the field. I wish more of this was hitting the headlines.
HOW IS COVID-19 TRANSMITTED (POSH WORDS FOR 'HOW DO I CATCH IT - OR NOT!')
Again, it's early days, but it seems you can catch this virus in the same way as you would catch a cold. It is present in your secretions (delightful!) The main source of transmission is in the droplets that exit your body when you cough and sneeze, but should you find yourself looking after a COVID-19 patient in the future bear in mind it could be any of their bodily fluids and take precautions. It will certainly be in your toddler's snot. If your secretions end up on your hands, then touching another's hand will pass the virus on, unless they wash their hands before they touch their nose, mouth or face.
It has now been accepted into the public consciousness that being within a 2-metre radius of an infected person for a period of time puts you at risk. What the early data is revealing, however, is that transmission is occurring mostly in close groups i.e. your immediate contacts. One infected person is likely to infect 2 or 3 others (2).
I don't know about you, but I'm surprised by that. I thought one infected person on the 85 bus would bring the whole route to a stop, but it doesn't seem to be panning out that way. That said, I'm not ready to take the Dettol spray out of my handbag just yet!
Transmission from person to person is much more likely to happen indoors, and in smaller rooms, than in large outdoor stadiums.
IS PANDEMIC SHORT FOR PANIC-DEMIC?
To term an infection a Pandemic means that it has spread to a whole country or the whole world. This one hasn't yet spread to the whole world; in smaller countries, it has spread far and wide, hence it can be declared a pandemic.
COVID-19 is certainly not the first infection to be declared a pandemic. Indeed, there is a lot of evidence as to how a pandemic will pan out, so scientists can predict with some accuracy how COVID-19 will go. In fact, Britain is a world leader in terms of modelling this kind of pandemic and helping countries to plan their response (5).
This is important for national institutions such as the NHS to plan and co-ordinate their response. IT DOES NOT MEAN THEY DON'T CARE ABOUT INDIVIDUALS. The whole point of this kind of planning is to save as many of 'The Vulnerable' as possible. Even saving one is a victory.
You'll see this chart a lot in the next few days, and it describes what the public health authorities are trying to achieve. The red line is the course of a pandemic should there be no intervention. Lots of people will be very ill at the same time, and the NHS won't be able to cope. The green line is why we're washing our hands. If we can delay the spread of the infection over a longer period of time the NHS will be able to cope, and more lives will be saved. The same number of people will get the infection; we just won't all get it at the same time.
It may also come to pass that COVID-19 is seasonal. By pushing the peak of the pandemic into the summer, we will help to flatten the curve further. The NHS is less busy in the summer months, so pushing the curve into the warmer weather would work in favour of the nation.
Currently, we are at the bottom of the curve. The estimate is that we are approximately 4 weeks behind Italy, and infection rates will peak 10 to 14 weeks from now, which puts the British peak somewhere around May and June. The peak is estimated to last for 4 weeks before subsiding.
To put into perspective the effectiveness of the British response, the US declared their first case on the 21st Jan, around 10 days before the UK. The US scientists believe they are now only 1 week behind Italy.
THE REST OF THE WORLD IS LOCKING DOWN. THE BRITISH RESPONSE IS TO SING HAPPY BIRTHDAY. ARE WE MISSING A TRICK?
We British have a reputation amongst the rest of the world for staying calm in the face of danger. Back in the day, if one found a body in the library, one would call the butler for tea before calling the police. In the rest of the world, the police are called in first!
Social distancing will be most effective in May and June - it is at this point that the government will likely lock us down. If they do it now, it will have no discernible effect on the virus but will close down businesses and cost people their jobs. We need to hold our nerve. Social distancing will be hard. Humans aren't good at it. You may be stuck with only a toddler to talk to for a whole month. The urge to break rank will be MASSIVE! This is why the current advice is business as usual.
For the lockdown to work, we need 100% compliance. Lockdown too soon, there will be no effect and, as such, no 'will' to try it again. It didn't work last time, so why would it work this time? It's all about timing.
Hold your nerve, people. We British are good at that.
I WANT TO HELP. WHAT CAN I DO?
Firstly, STOP PANIC BUYING! Prepare, yes, but panic - no.
The most useful thing you can do is teach your child how to wash their hands, and do it every time you change environments as well as the usual (before meals, then after meals because they made such a mess, after the toilet etc). As soon as you come in from outside, wash your hands. You need to wash for 20 seconds. Sing Happy Birthday twice. If you need to move on, there are other songs available. I'm currently using the chorus of 'Love on Top' by Beyonce. You don't need special soap. A bar of soap will have exactly the same effect as anti-bacterial soap. Coronaviruses are made up of fats, so you just need a detergent to break it down - normal soap is just that.
Secondly, think ahead to lockdown? I'm going to try to find out what a lockdown will look like, but I would imagine that the shops will either stay open or deliver. Start to stock up over the next 2 months, but do it gradually. If you empty the shelves, then those on a low income who can only shop on a weekly basis are left with very little.
Identify 'The Vulnerable' in your life and talk to them. Make a plan. It might be that you have to stop seeing your parents for a while, but there are other ways that you can stay in touch. Set them up with the tech now. Make sure they know the symptoms to look for and what to do should they get them. Talk to them regularly.
Figure out your childcare. If you rely on a vulnerable person to help you with your childcare, come up with a way of working around that. Talk to your employer about your options.
If you or your child start coughing persistently (it's quite a dry cough apparently) you should now assume that you have COVID-19 and isolate immediately for 7 days. Pull your child straight out of school. Don't send them in because you have an important day at work and hope for the best. It's not as important as slowing down the spread of this virus. You don't need to recreate the set of E.T. to isolate your child, and you're going to have to look after them. Accept that you're going to get it too. If you are one of The Vulnerable, plan ahead what will happen if one of the members of your household gets the COVID-19. Don't put yourself in danger. Kids need their parents long term. They can do without you for a week.
Stop getting your information from the tabloids or word of mouth. Go to reputable scientific sources. Look on the NHS and Public Health England website and follow Prof Chris Whitty on Twitter. Don't believe everything you hear - fact-check it all. You will hear horror stories galore over the next few months. Just because it happened to somebody else does not mean it will happen to you and yours.
Hold your nerve people. Hold your nerve.
And finally, understand the national strategy, and the part that we as individuals will play. For the vast majority of us, infection with COVID-19 will be a week of illness, with a cough and a couple of days of feeling lousy. These strategies are not about protecting us. They are about protecting 'The Vulnerable' until our incredible scientists can find a cure or a vaccine. The Vulnerable include real people - my next-door neighbour, my Dad, and a friend. Today I'll be talking to them all. By working together, we can get them all through this and out the other side.
SO CAN I TAKE THE KIDS OUT?
In short, yes, but it depends on your circumstance. Make informed choices. Go out and play rather than playdates round at somebody's house. Keep playdates small, and look out for signs of infection in other people's kids. Also, look out for signs of anxiety in your friends. This is going to be tough on parents, especially those with very young kids. Getting together keeps you sane. Keep in contact with your support network, but do it safely.
Chin up. Hold your nerve. Make safe choices.
Sx
PS BEFORE YOU COMMENT, keep it civil. You may have a completely different opinion on the science being used by the government as detailed in this blog. That's allowed. If you want to argue an alternative case then I am all ears, but send evidence. Actual evidence from reputable medical sources. Tweets are an opinion, no matter how qualified the tweeter. Lambasting me with nothing to back it up makes you a troll, and troll comments will be deleted, and I shall immediately move on! And for the 99.9% of you who are sending me your happy thoughts, you have kept me going, so I shall keep going for you.
REFERENCES
1. Professor Chris Whitty is the Chief Medical Officer for England and is a key player in helping the UK Government to put measures in place that will save lives without totally destroying our economy. You can follow him on twitter (@CMO_England). His feed is a treasure trove of up to date facts, figures and science and I would highly recommend it.
2. This is a link to the full press conference. I would highly recommend making the time to watch it all. It's enlightening. https://youtu.be/NYgx9NJri4c
3. The New Scientist is a guilty pleasure of mine. Science + engaging writing = happy Sarah! The particular article that I've cited is below, and again worth a read.
4. The findings so far of COVID-19 infection in pregnant women from the Royal College of Obstetricians and Gynaecologists
5. The UK Governments plan for tackling COVID-19. Everyone should read this. It's well written, comprehensive and brings peace of mind knowing that highly trained scientists are running the show and not the politicians! https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/869827/Coronavirus_action_plan_-_a_guide_to_what_you_can_expect_across_the_UK.pdf
6. The NHS page for advice on the current plan for tackling COVID-19 https://www.nhs.uk/conditions/coronavirus-covid-19/
7. The very comprehensive resource that is Public Health England. https://www.gov.uk/government/topical-events/coronavirus-covid-19-uk-government-response
Sarah Cantrill BSc Hons FRSA, January 2020
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Sarah Cantrill is a woman on a mission to help and inspire every Early Years child in the UK and beyond to become a reader for pleasure. She does this through her day job as Artistic Director of Story Storks, an Early Years Theatre company who unlock the magic of fairytales through Interactive Story Workshops and Theatre to help kids build the language skills they need to read, and most importantly, to fall in love with stories.
