Nursery worker, 21, who was waiting for life-saving liver operation dies after being taken off transplant list when she tested positive for coronavirus in hospital

A nursery worker who was waiting for a life-saving liver operation has died after being taken off the transplant list when she tested positive for coronavirus in hospital.

Katie Horne, from Burgess Hill, was admitted around four weeks ago with a severe liver condition. 

The 21-year-old from West Sussex went to Princess Royal Hospital in Haywards Heath where it became apparent she needed a transplant.

Katie Horne (pictured) from Burgess Hill was taken off the transplant list when she tested positive for coronavirus 

She was then transferred to King's College Hospital in London, where she tested positive for coronavirus, her sister Emma told the BBC. 

Ms Horne then wasn't able to go on the transplant list and struggled with both the liver condition and coronavirus for 12 days. She was not using a ventilator during her stay. 

Her death comes as:

• Britain's death toll rose by 737 to surge past 10,000 with one expert warning it was set to be the highest in Europe; 

• It emerged the Cabinet is split over when to end the lockdown, with growing concerns about the impact of school closures; 

• Michael Gove revealed he had been granted special dispensation to have his daughter tested for the virus so he could get back to work; 

• The Archbishop of Canterbury urged that the dead be treated with dignity; 

• Ministers admitted that only 4,200 of 300,000 small firms had been given loans; 

• The Royal College of Nursing told its members to refuse to treat patients if they didn't have adequate protective clothing; 

• Some Britons flouted lockdown rules and were seen soaking up the sun in the nation's parks; 

• Health Secretary Hancock said he did not have any update on how many NHS staff had died following the 19 he confirmed on Saturday; 

• The Queen stressed the importance of maintaining the coronavirus lockdown, but insisted: 'Easter isn't cancelled; indeed, we need Easter as much as ever'. 

All organ donors are tested for coronavirus with transplants from infected patients being stopped to minimise risk.

Since the measures came in on March 31, the NHS have prevented some life-saving organs from being transplanted to recipients to stop the spread of the virus.

Donations are not known to transmit the killer bug, but transplant recipients are immuno-suppressed to prevent organ rejection.

Ms Horne's family say they are 'completely devastated' by her death after he life ended on Saturday. 

Emma wants her 'bubbly' sister's tragic death to be a 'wake-up call' for people to take the pandemic seriously. She said: 'People need to understand how serious this is.'

Speaking about her sister, she said: 'If anyone needed anything, you could always count on Kate to be there. She was so full of life and happy. We just can't believe it — we are absolutely devastated.'

Her heartbroken boyfriend, Jamie Carter, shared his sorrow on Facebook, writing: 'It's with great sadness that we have to inform all of Kate's friends that she sadly passed away this morning at 5.45am of a short illness and contributing to her death is this devastating coronavirus. She will always be loved and will forever be in our hearts.'

Tilly Carter, a friend of Katie's, also wrote on Facebook: 'Heaven gained another angel. She will always be loved and will forever be in our hearts.' 

Hundreds of gravely ill Britons waiting for organ transplants fear they could die in self-isolation because procedures have largely been stopped because of coronavirus.      

Hospitals have started suspending the life-saving surgery in a desperate attempt to free up beds with operations down from around 80-a-week to less than ten, it was reported on Thursday.

Health bosses have warned that the high-risk operations could be scrapped entirely within days as the NHS prepares for a larger surge coronavirus cases. 

A shortage of NHS workers and lack of critical care beds have already seen some hospitals suspend the procedures. Though partly-driven by a desire to protect patients' health, it will leave many facing an increased risk of death.

Ana-Rose Thorpe, 29, from Manchester, who is waiting for a liver transplant, says the issue is a 'matter of life and death' for her because her health is deteriorating at home.

She told the BBC: 'Having to go into hospital while there are coronavirus patients there is very worrying. This is a window of opportunity for a transplant without the coronavirus. Whilst my body could withstand the transplant, the longer I'm not being monitored, not being seen as often as I was, the longer I leave it, I could just get sicker and sicker.

'I feel like it's patients that are already on the transplant list, patients waiting for other operations, we have just been swept aside. It's not any fault of the NHS, no-one can help what is going on.

'They are trying to make it safe for us but we are still terrified of going into hospital. It's my life - it is a matter of life and death'. 

NHS Blood and Transplant said hospitals are having their capacity to carry out donations and transplants affected under the strain of coronavirus.

Professor John Forsythe, Medical Director for Organ Donation at NHS Blood and Transplant, said: 'As the situation with COVID-19 is ever changing across the country, so is the picture regarding donation and transplantation.

'Some transplant units have made the difficult decision to close their transplant programmes for now.

'This to support the NHS in treating COVID-19 patients and other patients needing intensive care.

'Every potential organ donor on an Intensive Care Unit is being tested for the virus and if someone has COVID-19 they will not be able to donate.

'NHS capacity to deal with COVID-19 at this time and the safety of organ donation and patients in need of a transplant is paramount.

'Ensuring the safety of organ donation and transplantation during this pandemic is creating substantial challenges.'

Lifesaving organ transplants are still going ahead on a case-by-case basis at the discretion of local units' clinical staff.

Blood donations are being encouraged despite the lockdown as they are deemed vital to vulnerable people. 

Donors who have had coronavirus or have self-isolated are able to give blood just 14 days after their symptoms have settled.

Those who have had contact with a confirmed case of the virus can still donate as long as they are symptom-free.

However, donors above the age of 70 have been asked to stay at home, in line with government guidelines.  

More people with medical conditions - making them particularly vulnerable to coronavirus - are being added to the Government's shielding programme, the chief medical officer for England said this week.

Professor Chris Whitty said medical specialists and GPs had helped identify additional patients who were not initially included in the high-risk group, who need special protection amid the coronavirus pandemic.

A woman with type 1 diabetes who was awaiting a life-saving kidney transplant last month revealed her operation was been 'suspended' as a result of the coronavirus outbreak.

Lara Wahab, 32, of London, has lived with her condition for 25 years after being diagnosed when she was seven.

She told how she's nearly gone blind, suffered from a bone infection and been hospitalised for a month as a result of her debilitating condition.

Lara was informed in April last year that her kidneys are failing and was put forward for an SPK - simultaneous kidney pancreas - transplant, which involves waiting for a deceased donor who would need to be the perfect match for her.

But following the outbreak of the coronavirus, her operation is now on hold due to a lack of beds in intensive care units and her surgery being consider 'considered 'non-urgent elective'.

Lara, an account manager at advertising agency Wieden + Kennedy, is urging the government not to 'forget' about patients like her when putting measures in place to combat Covid-19.

She added that living with a chronic illness can make you feel 'invisible' and called on people to show kindness and check in with friends and relatives during this difficult time.

'I'm still looking for answers as to how they can define a life-saving operation such as my kidney transplant as 'non-urgent elective' surgery,' Lara wrote in Huff Post.

'Waiting for an operation of such magnitude is difficult. Waiting for the waiting to start again, with no idea on timeframe is unbearable. 

'Will I still have a chance to find love? Will I see my sister achieve her dreams? Will I be around to support my family in times of need? Will I see my friends get married and have children? Will I live, or will I die?' 

Lara acknowledged that the NHS needs to take drastic measures to handle the coronavirus crisis, and praised frontline workers for the work they're doing to contain it.

'Our wonderful NHS workers can only do so much without the support and resources that are required to deliver the care system necessary not to endanger lives,' she said.

'But, sometimes, living with a chronic illness can make you feel invisible. We carry on with daily lives hiding our internal struggles, constantly striving for normality, while our necessary care and treatment is cancelled left, right and centre. 

'I want people to know that this is the real fallout of a virus like this.'

Speaking about the day she was told her kidneys are failing, Lara recalled initially feeling 'angry and anxious' about missing work.

Having struggled to come to terms with her diabetes, which has 'denied her' of so much over the years, Lara said she felt 'numb, confused and without hope' that it was now taking away her vital organs and threatening her life. 

She was strongly advised to go for a pancreas transplant which would simultaneously address her kidney failure, meaning her diabetes would not threaten her new kidney.

'The thought of living out some of my life without type 1 diabetes seemed like nirvana – as if I was able to go back to my seven-year-old self, and tell her that everything was going to be okay,' she said. 

'I felt incredibly lucky – honoured – to be given this second chance.' 

After three months of rigorous testing and being accepted onto the double organ list, Lara likened the feeling of waiting for the phone call telling her an organ had come available to living on a knife's edge, 'surviving just long enough' to make it.

'There have been a few wobbles over the last six months on whether to accept a donation from my mum or stick out the wait, but time and time again, my amazing care team have convinced me that the long-term benefits of the operation will be worth the crippling anxiety,' she said. 

'Then, a plot twist: coronavirus.' 

Lara said she started to fear the worst in December, knowing that when the virus hit the UK, the fact she had type 1 diabetes and end-stage chronic kidney disease meant she would be in the vulnerable category.

She logged onto her patient portal and made the agonising discovery that her transplant status had changed to suspended.

Lara contacted her care team and was told all SPK transplants and kidney transplants are being suspended for the time being, which 'rippled through her like a shockwave'. 

She received a letter the following day citing the limited number of ICU beds and the potential risk to other patients should it go ahead. 

Lara said in this period of self-isolation, people like her now need the love, kindness and support of others around her, adding that a call or text goes a long way.

'Don't underestimate the power of the smallest gesture to give people like me the will to survive,' she said. 'Please don’t let us disappear.' 

WHAT DO WE KNOW ABOUT THE CORONAVIRUS?

What is the coronavirus? 

A coronavirus is a type of virus which can cause illness in animals and people. Viruses break into cells inside their host and use them to reproduce itself and disrupt the body's normal functions. Coronaviruses are named after the Latin word 'corona', which means crown, because they are encased by a spiked shell which resembles a royal crown.

The coronavirus from Wuhan is one which has never been seen before this outbreak. It has been named SARS-CoV-2 by the International Committee on Taxonomy of Viruses. The name stands for Severe Acute Respiratory Syndrome coronavirus 2.

Experts say the bug, which has killed around one in 50 patients since the outbreak began in December, is a 'sister' of the SARS illness which hit China in 2002, so has been named after it.

The disease that the virus causes has been named COVID-19, which stands for coronavirus disease 2019.

Dr Helena Maier, from the Pirbright Institute, said: 'Coronaviruses are a family of viruses that infect a wide range of different species including humans, cattle, pigs, chickens, dogs, cats and wild animals. 

'Until this new coronavirus was identified, there were only six different coronaviruses known to infect humans. Four of these cause a mild common cold-type illness, but since 2002 there has been the emergence of two new coronaviruses that can infect humans and result in more severe disease (Severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronaviruses). 

'Coronaviruses are known to be able to occasionally jump from one species to another and that is what happened in the case of SARS, MERS and the new coronavirus. The animal origin of the new coronavirus is not yet known.' 

The first human cases were publicly reported from the Chinese city of Wuhan, where approximately 11million people live, after medics first started publicly reporting infections on December 31.

By January 8, 59 suspected cases had been reported and seven people were in critical condition. Tests were developed for the new virus and recorded cases started to surge.

The first person died that week and, by January 16, two were dead and 41 cases were confirmed. The next day, scientists predicted that 1,700 people had become infected, possibly up to 7,000. 

Where does the virus come from?

According to scientists, the virus almost certainly came from bats. Coronaviruses in general tend to originate in animals – the similar SARS and MERS viruses are believed to have originated in civet cats and camels, respectively.

The first cases of COVID-19 came from people visiting or working in a live animal market in Wuhan, which has since been closed down for investigation.

Although the market is officially a seafood market, other dead and living animals were being sold there, including wolf cubs, salamanders, snakes, peacocks, porcupines and camel meat. 

A study by the Wuhan Institute of Virology, published in February 2020 in the scientific journal Nature, found that the genetic make-up virus samples found in patients in China is 96 per cent identical to a coronavirus they found in bats.

However, there were not many bats at the market so scientists say it was likely there was an animal which acted as a middle-man, contracting it from a bat before then transmitting it to a human. It has not yet been confirmed what type of animal this was.

Dr Michael Skinner, a virologist at Imperial College London, was not involved with the research but said: 'The discovery definitely places the origin of nCoV in bats in China.

'We still do not know whether another species served as an intermediate host to amplify the virus, and possibly even to bring it to the market, nor what species that host might have been.'  

So far the fatalities are quite low. Why are health experts so worried about it? 

Experts say the international community is concerned about the virus because so little is known about it and it appears to be spreading quickly.

It is similar to SARS, which infected 8,000 people and killed nearly 800 in an outbreak in Asia in 2003, in that it is a type of coronavirus which infects humans' lungs. It is less deadly than SARS, however, which killed around one in 10 people, compared to approximately one in 50 for COVID-19.

Another reason for concern is that nobody has any immunity to the virus because they've never encountered it before. This means it may be able to cause more damage than viruses we come across often, like the flu or common cold.

Speaking at a briefing in January, Oxford University professor, Dr Peter Horby, said: 'Novel viruses can spread much faster through the population than viruses which circulate all the time because we have no immunity to them.

'Most seasonal flu viruses have a case fatality rate of less than one in 1,000 people. Here we're talking about a virus where we don't understand fully the severity spectrum but it's possible the case fatality rate could be as high as two per cent.'

If the death rate is truly two per cent, that means two out of every 100 patients who get it will die. 

'My feeling is it's lower,' Dr Horby added. 'We're probably missing this iceberg of milder cases. But that's the current circumstance we're in.

'Two per cent case fatality rate is comparable to the Spanish Flu pandemic in 1918 so it is a significant concern globally.'

How does the virus spread?

The illness can spread between people just through coughs and sneezes, making it an extremely contagious infection. And it may also spread even before someone has symptoms.

It is believed to travel in the saliva and even through water in the eyes, therefore close contact, kissing, and sharing cutlery or utensils are all risky. It can also live on surfaces, such as plastic and steel, for up to 72 hours, meaning people can catch it by touching contaminated surfaces.

Originally, people were thought to be catching it from a live animal market in Wuhan city. But cases soon began to emerge in people who had never been there, which forced medics to realise it was spreading from person to person. 

What does the virus do to you? What are the symptoms?

Once someone has caught the COVID-19 virus it may take between two and 14 days, or even longer, for them to show any symptoms – but they may still be contagious during this time.

If and when they do become ill, typical signs include a runny nose, a cough, sore throat and a fever (high temperature). The vast majority of patients will recover from these without any issues, and many will need no medical help at all.

In a small group of patients, who seem mainly to be the elderly or those with long-term illnesses, it can lead to pneumonia. Pneumonia is an infection in which the insides of the lungs swell up and fill with fluid. It makes it increasingly difficult to breathe and, if left untreated, can be fatal and suffocate people.

Figures are showing that young children do not seem to be particularly badly affected by the virus, which they say is peculiar considering their susceptibility to flu, but it is not clear why. 

What have genetic tests revealed about the virus? 

Scientists in China have recorded the genetic sequences of around 19 strains of the virus and released them to experts working around the world. 

This allows others to study them, develop tests and potentially look into treating the illness they cause.   

Examinations have revealed the coronavirus did not change much – changing is known as mutating – much during the early stages of its spread.

However, the director-general of China's Center for Disease Control and Prevention, Gao Fu, said the virus was mutating and adapting as it spread through people.

This means efforts to study the virus and to potentially control it may be made extra difficult because the virus might look different every time scientists analyse it.   

More study may be able to reveal whether the virus first infected a small number of people then change and spread from them, or whether there were various versions of the virus coming from animals which have developed separately.

How dangerous is the virus?  

The virus has a death rate of around two per cent. This is a similar death rate to the Spanish Flu outbreak which, in 1918, went on to kill around 50million people.

Experts have been conflicted since the beginning of the outbreak about whether the true number of people who are infected is significantly higher than the official numbers of recorded cases. Some people are expected to have such mild symptoms that they never even realise they are ill unless they're tested, so only the more serious cases get discovered, making the death toll seem higher than it really is.

However, an investigation into government surveillance in China said it had found no reason to believe this was true.

Dr Bruce Aylward, a World Health Organization official who went on a mission to China, said there was no evidence that figures were only showing the tip of the iceberg, and said recording appeared to be accurate, Stat News reported.

Can the virus be cured? 

The COVID-19 virus cannot be cured and it is proving difficult to contain.

Antibiotics do not work against viruses, so they are out of the question. Antiviral drugs can work, but the process of understanding a virus then developing and producing drugs to treat it would take years and huge amounts of money.

No vaccine exists for the coronavirus yet and it's not likely one will be developed in time to be of any use in this outbreak, for similar reasons to the above.

The National Institutes of Health in the US, and Baylor University in Waco, Texas, say they are working on a vaccine based on what they know about coronaviruses in general, using information from the SARS outbreak. But this may take a year or more to develop, according to Pharmaceutical Technology.

Currently, governments and health authorities are working to contain the virus and to care for patients who are sick and stop them infecting other people.

People who catch the illness are being quarantined in hospitals, where their symptoms can be treated and they will be away from the uninfected public.

And airports around the world are putting in place screening measures such as having doctors on-site, taking people's temperatures to check for fevers and using thermal screening to spot those who might be ill (infection causes a raised temperature).

However, it can take weeks for symptoms to appear, so there is only a small likelihood that patients will be spotted up in an airport.

Is this outbreak an epidemic or a pandemic?   

The outbreak was declared a pandemic on March 11. A pandemic is defined by the World Health Organization as the 'worldwide spread of a new disease'. 

Previously, the UN agency said most cases outside of Hubei had been 'spillover' from the epicentre, so the disease wasn't actually spreading actively around the world.