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One in five UK hospital patients caught COVID-19 while on wards — SAGE paper

Papers by UK government scientists have revealed that one in five hospital patients with coronavirus caught it while on wards, reports The Daily Telegraph. The findings come alongside orders to all hospitals to enforce social distancing between staff in order to stop doctors and nurses from "congregating" and fuelling the spread of the virus. It comes amid growing concern that National Health Service (NHS) trusts have become a major source of coronavirus "re-seeding" into communities. Government scientific advisers are worried that, while medics are keeping their distance from patients, their "backstage" behaviour is allowing the virus to circulate.

The report says recent papers published by the government's Scientific Advisory Group for Emergencies (SAGE) show that, at the peak of the epidemic, transmission within hospitals was believed to account for up to 22% of hospitalised patients and up to 11% of deaths. The research, prepared for the Cabinet Office, says these figures do not include staff or those attending outpatient appointments, meaning they are "very likely to be an underestimate".

The report says the failure to stem the crisis has prompted a letter from the NHS England medical director, Professor Stephen Powis, instructing hospitals to "minimise" close contacts between staff, with workers told to "avoid congregating at central work stations" and take staggered staff breaks.

One senior NHS manager said: "The situation is ridiculous. It seems hard to believe, given that the whole country has been talking about social distancing for months, but it is only now that some NHS trusts are really thinking about basic measures like ensuring nurses aren't all hanging out together."

The letter from Powis instructs health service hospitals to take "further action to tackle infections acquired in the NHS itself". The letter, also signed by the NHS chief nurse and operating officer, spells out the importance of "all staff adhering to social distancing (two metres) wherever possible in non-clinical areas".

The Daily Telegraph reports that it follows growing concern that coronavirus is spreading within hospitals because Britain failed to introduce basic measures, such as masks, routine staff testing and strict social distancing, which have helped to contain the virus in other parts of Europe. The 18 May updating of the Public Health Service (PHE) guidance on infection control included advice about how NHS trusts should ensure that staff follow social distancing protocols. This was a full week after the government had issued advice to other employers considering reopening their workplaces. The PHE guidance said all staff should adhere to social distancing wherever possible, and ward practice should be reviewed to minimise close contact between groups of staff for prolonged periods and congregation at nurses' stations. Previous advice had said "social distancing of two metres should be facilitated wherever this is possible", without making any reference to staff.

The report says there are growing fears that the behaviour of health and care workers – who are often working in crowded and stressful situations – is driving up the rate. Members of the New and Emerging Threats Advisory Group (Nervtag), which advises the government, are concerned that workers who observe social distancing rules in public behave differently "backstage".

Dr Chris Moran, the deputy national strategic incident director for COVID-19 said: "We know when directly managing patients social distancing is impossible, that's what PPE is for, to protect both sides of the equation. But I think in the staff-only areas we could do quite a lot better in some of the places that I've visited."

Research led by University College London Hospitals (UCLH), which was co-authored by Sage member Professor Susan Michie and has yet to be peer-reviewed, has shone a light on how far the infection has spread among staff. The study found that, of 200 frontline health workers at University College London Hospitals, 43.5% had been infected with COVID-19 by early May. This was considerably higher than researchers had expected after larger studies of healthcare workers at hospitals in Barcelona and Birmingham found that just 11% and 24% respectively had been infected.

An NHS spokesperson said: "Hospitals across the country have long-standing, effective mechanisms for infection prevention and control, and the NHS has regularly communicated the guidance which is set by PHE, as well as supporting trusts with data and a checklist to share learning and help limit the spread of infection. The government has always been clear that social distancing is recommended for everyone."

PHE said the four UK chief medical officers, alongside PHE and the NHS, jointly issued infection prevention control guidance for health and social care workers on 24 April, which reinforced existing guidance for the UK that "social distancing of two metres should be facilitated wherever this is possible".

[link url="https://www.telegraph.co.uk/news/2020/06/12/exclusive-one-five-hospital-coronavirus-patients-caught-illness/?WT.mc_id=e_DM1255808&WT.tsrc=email&etype=Edi_FAM_New_ES_Sat&utmsource=email&utm_medium=Edi_FAM_New_ES_Sat20200613&utm_campaign=DM1255808"]Full report in The Daily Telegraph[/link]

 

 

[link url="https://www.gov.uk/government/groups/scientific-advisory-group-for-emergencies-sage-coronavirus-covid-19-response"]SAGE paper[/link]

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