Up to 20% of patients and 90% of UK nurses and doctors who caught coronavirus, picked it up in hospitals, The Daily Telegraph reports research suggests. Modelling by Public Health England (PHE) also suggests one in five patients who got the virus became infected on wards.
Scientists have called for a war to be waged on COVID-19 transmission within hospitals, in the same way the National Health Service (NHS) has previously successfully battled superbugs such as MRSA. They warned that a lack of physical distancing between staff – not just on wards, but also in canteens, offices, and corridors – could be fuelling the spread of the virus.
A report by the Royal Society‘s Data Evaluation and Learning for Viral Epidemics (Delve) group, which provides advice to the UK governmentʼs Scientific Advisory Group for Emergencies (Sage), examined a number of studies. Among them is modelling by PHE, dated 20 May, which suggests that “approximately 20% of infections in inpatients, and 89% of infections in healthcare workers, were due to nosocomial (hospital-acquired) transmission”.
Despite widespread advice to the public to practice social distancing, it was not until 18 May that PHE updated its own infection control guidance advising trusts on how to keep workers apart, and it was not until June that all hospital staff were advised to wear masks.
Researchers from Delve said their own estimates, which covered a period after the peak, suggested that in the six weeks from 26 April to 7 June around 10% of all COVID-19 infections in England were among frontline health and care workers.
The study also suggests that, during that period, at least 1% of patients with the virus acquired it in hospital. Dr Guy Harling, from University College London, said: “We can see things like inconsistent use of masks and PPE. We can see a lack of physical distancing … between staff, between patients and between staff and patients. So not just on wards or in theatres but also in canteens, and offices in corridors.”
Dr Nigel Field, the chair of the Delve working group, said: “We’d like to see a really ambitious and comprehensive approach to the prevention of COVID transmission in hospitals and care settings of the kind that was really successfully implemented for MRSA.”
Researchers said shortages of PPE, lack of testing of staff and the failure to advise general mask-wearing may have fuelled the spread, but added that there was a lack of data to show the impact of any particular interventions. They said staff would also have been at greater risk of COVID-19 than the general public because they were more mobile and likely to be using public transport to get to work during lockdown.
Professor Dame Anne Johnson, professor of infectious disease epidemiology at University College London, said: “In the beginning, we really didn’t understand the extent of the asymptomatic issue and the difficulties of staff social distancing. “They were aware they were using PPE – once it got going – in these very acute settings, but because there was less recognition of infection that was in other parts of the hospital then of course there was transmission going on in those environments.”
Cleaners, porters and office staff working for the UK’s National Health Service (NHS) were “super-spreaders” of coronavirus within hospitals, according to initial results from a national screening drive, The Daily Telegraph reports.
Sir John Bell, who oversees the UK government’s antibody testing programme, said domiciliary workers in some hospitals were found to have “sky-high” levels of antibodies compared to doctors and nurses who treated patients in intensive care.
The report says the discovery has prompted health bosses to examine how lower-paid workers can be better protected from the virus in the event of a second coronavirus wave, he said. It comes amid growing suspicion that a large proportion of virus cases were spread by medical workers rather than in the community.
Meanwhile, the report says, data released last month showed that doctors and nurses did not have higher rates of death involving COVID-19 compared to the rate among the wider population of the same age and sex.
People working in elementary jobs faced the greatest risk. Of those, there were more security guard deaths than in any other profession at 74.0 per 100,000, or 104 deaths. The data showed that, compared with the wider rate among people of the same sex, those working in the lowest-skilled occupations had the highest rate of death.
“These data are already prompting hospitals to think differently about who might be most at risk from coronavirus,” Sir John said. “We mustn’t forget about valued NHS staff just because they’re not on the front line.”
Report in The Daily Telegraph
Royal Society DELVE Initiative report
Full report in The Daily Telegraph
See alsoOne in five UK hospital patients caught COVID-19 while on wards — SAGE paper