UK Downgrades COVID-19; No Longer Considered ‘High Consequence Infectious Disease’

Amid a social distancing campaign and stay-at-home orders around the world, the UK government has downgraded the status of coronavirus COVID-19 from a “high consequence infectious disease”.

As of 19 March 2020, COVID-19 is no longer considered to be a high consequence infectious diseases (HCID) in the UK.

The 4 nations public health HCID group made an interim recommendation in January 2020 to classify COVID-19 as an HCID. This was based on consideration of the UK HCID criteria about the virus and the disease with information available during the early stages of the outbreak. Now that more is known about COVID-19, the public health bodies in the UK have reviewed the most up to date information about COVID-19 against the UK HCID criteria. They have determined that several features have now changed; in particular, more information is available about mortality rates (low overall), and there is now greater clinical awareness and a specific and sensitive laboratory test, the availability of which continues to increase.

The Advisory Committee on Dangerous Pathogens (ACDP) is also of the opinion that COVID-19 should no longer be classified as an HCID.

The need to have a national, coordinated response remains, but this is being met by the government’s COVID-19 response.

Cases of COVID-19 are no longer managed by HCID treatment centres only. All healthcare workers managing possible and confirmed cases should follow the updated national infection and prevention (IPC) guidance for COVID-19, which supersedes all previous IPC guidance for COVID-19. This guidance includes instructions about different personal protective equipment (PPE) ensembles that are appropriate for different clinical scenarios.

The site defines HCID as:

  • acute infectious disease
  • typically has a high case-fatality rate
  • may not have effective prophylaxis or treatment
  • often difficult to recognise and detect rapidly
  • ability to spread in the community and within healthcare settings
  • requires an enhanced individual, population and system response to ensure it is managed effectively, efficiently and safely

It’s likely, though not specified, that the main reason for this downgrade is the recent data driving down the case-fatality rate.