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39,000 hospital-acquired COVID-19 infections in England in 5 months

Figures published by NHS England suggest that 39,088 people were likely to have been infected with COVID-19 in hospitals between 1 August last year and 21 February 2021, reports The Guardian.

More than 31,000 people were infected with COVID-19 hospitals in English hospitals during the first wave, estimates the UK's Scientific Advisory Group for Emergencies (Sage). It cites research estimating the R rate, the effective reproduction number for the virus,  of such hospital-acquired (nosocomial) infections was up to 14 .

Infection prevention and control (IPC) in hospitals kept cases much lower than they otherwise would have been, the Sage paper says, but it notes that hospital outbreaks are potentially catastrophic for vulnerable patients.

According to The Guardian report, pinpointing with certainty when someone contracted COVID-19 is not easy, and bereaved families say they understand that hospitals and their staff have been facing an unprecedented pandemic. But many feel strongly that there have to be answers, and some accountability, over why so many people appear to have been infected with coronavirus in hospitals.

The extent of hospital-acquired (nosocomial), COVID-19 infections and deaths in the pandemic’s first wave led to an investigation by the Healthcare Safety Investigation Branch (HSIB), a body that investigates patient safety in NHS-funded operations in England.

David Oliver, a consultant in geriatrics and acute general medicine who has worked on COVID-19 wards throughout the pandemic, is now campaigning against alleged failings contributing to infections in hospitals, particularly inadequate protective personal equipment (PPE) and poor ventilation.

He points to under-resourcing of the NHS, citing figures showing the UK second lowest of European OECD countries for hospital beds per 1,000 people. “The pandemic has exposed structural problems many of us have known for years,” he said.

Adrian Boyle, a vice-president of the Royal College of Emergency Medicine, also cited building inadequacies. “Many of our emergency departments are not big enough or well enough designed to offer adequate social distancing or allow infection prevention and control,” he said.

The report says a principal finding of the HSIB investigation, which examined six unnamed NHS trusts, was that the age, quality and design of hospital buildings could hamper infection control.

The report also said national guidance on controlling and preventing infections was not comprehensive, and there was “a lack of clarity” about which national health organisation was responsible for it. It found “a national lack of IPC staff and shared understanding of their role and national IPC requirements”.

Responding to questions, a Department of Health and Social Care spokesperson told The Guardian it accepted the HSIB recommendations that related to it.

 

[link url="https://www.theguardian.com/world/2021/feb/26/nhs-faces-questions-over-covid-infections-contracted-in-hospital"]Full report in The Guardian (Open access)[/link]

 

[link url="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/961210/S1056_Contribution_of_nosocomial_infections_to_the_first_wave.pdf"]Sage report on nosocomial infections in the first wave[/link]

 

[link url="https://www.hsib.org.uk/documents/257/hsib-report-covid-19-transmission-hospitals.pdf"]HSIB report[/link]

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