Lessons for managing high-consequence infections from first COVID-19 cases in the UK

These first UK cases of COVID-19 raise important points about the management of cases of HCID in England. The decision to test for SARS-CoV-2 is based on a clinical and epidemiological case definition, and testing is only approved if this is met. When tested, neither of these people clearly met the current case definition, and had criteria been strictly applied, testing might not have been done. A decision to test was made because of high clinical suspicion and in response to latest available information about the distribution of infection. It is important that testing is appropriately targeted, and this is best done by applying clear case definitions. However, with any newly emerging infection, case definitions must evolve rapidly as information accrues. There should also be room for flexibility on the basis of discussion with clinical and public health experts