Coronavirus (COVID-19) Nosocomial Review Group: 17 September 2021

Items and actions

1. The risk of nosocomial SARS-CoV-2 cases remains lower than previous waves when community prevalence was similar and noted that the hospitalised cases are lower than previous waves and this is where the Nosocomial Infection (NI) risk arises. The impact of vaccination and high reliability of IPC processes may be impacting on the current lower NI risk. The median cluster size is lower in wave three compared to waves one and two, suggesting early identification and management to control being in place.
2. CNRG reviewed the latest all-cause mortality report. The report encompasses the period April 2021 to June 2021. It was noted that during this quarter there was lower all-cause mortality among in-patients with SARS-CoV-2.
3. The Winter Respiratory pathway Guidance has been drafted and will be issued for consultation by ARHAI Scotland. CNRG advice to date was taken account of in the new guidance. CNRG noted that the policy recommendation from the group on physical distancing has been issued to Health Boards, with a Directors Letter and guidance issued. CNRG noted the updated self-isolation guidance, which made it more explicit that healthcare workers who were vaccinated as part of a clinical trial are classed as being full vaccinated, and are therefore exempt from isolating if they are deemed a close contact, but do undergo daily testing. ​​​​​​​
4. CNRG were given an update of the first phase of the Edinburgh University IPC adherence study. Members noted the study was based on group psychology principles. An interesting initial finding indicates that healthcare workers see their colleagues as part of their group and therefore have a lower perceived risk of transmission from them than from patients. The initial findings align with the cluster/outbreak lessons learned to date and the next steps of the research are interviews which will be presented to CNRG when complete.
5. ​​​​​​​CNRG were then updated on the latest testing figures for healthcare workers. The uptake of eligible staff for twice weekly asymptomatic PCR testing remains high with 95 percent of eligible staff undergoing testing. Members were made aware that stock for LFDs is good, Health Boards are still working through stock of Innova branded test kits but moving to next stage of Orient Gene roll out NSS and are delivering packs to all Health Boards to start their preparations to switch over.
6. ​​​​​​​Finally, CNRG were made aware that the testing planning for the COP26 meeting in November is underway and that daily LFD testing for world leaders will be carried out by Department Health and Social Care (DHSC). All other tests to go through lighthouse labs some with prioritised. Work is underway to decipher who should be prioritised. Lighthouse labs will also be used for international arrival tests for delegates.