COVID-19 Nosocomial Review Group minutes: 13 August 2021

Items and actions

1. CNRG were presented with the latest COVID-19 sitrep. Data presented was to week ending 18th July 2021. CNRG were informed that nosocomial infections are continuing to track below community incidence and that the number of outbreaks and patient numbers remains low compared to that of previous waves and are more commonly reported as HIATT Green.
2. CNRG were then presented with the latest VOC/VUI data. CNRG were informed that variants of concern (VOC) and variants under investigation (VUI) are continued to be monitored and the Delta variant remains the dominant strain in both community and nosocomial cases.
3. CNRG were presented with NHS Lothian occupational health data. CNRG were informed that in April 2020, it was recognised that COVID-19 could be considered as an occupational disease in healthcare workers. NHS Lothian had adopted the WHO risk assessment to create a manager questionnaire set.
4. The data had been collected to ascertain potential exposure routes, healthcare worker activities both in and out of work and IPC procedures and practice. The data was then analysed by ARHAI. It was expressed to CNRG that the trend in healthcare worker infections broadly followed that in hospitals and the wider community.
5. CNRG were presented with the latest quarterly HAI surveillance reports on C. difficile infection (CDI), E. coli bacteraemia (ECB), S. aureus bacteraemia (SAB) and surgical site infection (SSI) in Scotland which was published on 6th July 2021.
6. Yearly trends (March 2020 vs March 2021) CDI show that there was an increase in NHS Ayrshire & Arran, NHS Lanarkshire and Scotland overall and from 823 in March 2020 to 826 in March 2021.
7. CNRG were also informed of the decrease in ECB infections in Scotland in the quarterly trends. Yearly trends for SAB healthcare associated infections (March 2020 vs. March 2021) show that there was an increase in NHS Borders and in Scotland overall. 
8. CNRG were then presented with hospitalised cases of COVID data. CNRG were informed that when adjusted for hazard ratios, the Delta variant (s gene positive) results in increased risk of hospitalisation when adjusting for age and sex. Additionally, CNRG were informed that vaccinated individuals, particularly those at least 28 days after the first dose, are less likely to be admitted even though they test positive.
9. CNRG were also presented with data of 3 plus days from admission. It was conveyed to the CNRG that the majority of patients within this cohort were over 75 years old with co-morbidities and are largely fully vaccinated.
10. CNRG members were presented with the final outputs of the Covid temporary facilities task group. The group chair asked for the CNRG endorsement of the outputs and the CNRG endorsed these.
11. CNRG were given an update on the formation of a ventilation short life working group. It was confirmed to CNRG that the group had finalised its terms of reference and membership lists and will initially run until October 2021.
12. It was highlighted to CNRG that the purpose of the group is to review and make recommendations for remobilisation, development of guidance and other activities with respect to ventilation within healthcare in relation to SARS-CoV-2 (COVID-19). The work is not limited to acute settings but also encompasses other settings including primary care; specifically general practice, dental, optometry and pharmacy settings; and social care residential settings including care homes.
13. CNRG were then made aware that a lessons learned report had been published, and it was confirmed to members that this report would form the basis for the Future Preparedness group considerations. CNRG were made aware that this report did not solely focus on Healthcare setting but the whole Health and Social Care system.
14. CNRG were updated on the outcomes of the summary of CNRG recommendations on physical distancing and wider use of FFP3 masks. Members were informed that the physical distancing advice had gone to the primary leads, the C-19 Advisory Group the SG Professional Advisory Group, the Clinical Cell and the Senior Workforce Leadership Group.
15. CNRG were informed of the latest testing figures. The uptake of PCR testing remains high among 95 percent of eligible HCWs. CNRG were reassured that Scottish Government performance colleagues are continuing to meet with Health Boards to scope solutions to encourage uptake.