COVID-19 Nosocomial Review Group minutes: 14 May 2020

Items and actions

1. The group reviewed the current data on HAI COVID-19 inclusive of hospital onset and hospital acquired using unvalidated provisional data from the RAPID dataset and testing the ECDC definitions proposed.
2. The group considered local intelligence of reported clusters and outbreaks in hospitals and noted that these were not all hospital acquired. Discussions were had around the type of care settings where clusters and incidents were most frequent. These tended to be mainly Long Term Care Facilities (LTCF), rather than Acute Care settings, reflecting what is seen in other countries, given the highest risk of COVID-19 is in older people.
3. Consideration was given to the IPC compliance in LTCFs, and the role of estate and the built environment aspects in terms of design and system in LTCFs has on IPC. It was noted that local assessment of the environment was key for IPCTs to promote IPC measures in all hospitals- acute and community (LTCF).
4. The group noted the on- going work on reviewing the evidence to inform the need for asymptomatic healthcare worker testing and agreed that decisions on policy advice would be made at the next meeting.
5. A review of the evidence to consider patient admission testing in hospitals was considered and the importance of prevalence in making these decisions considered, given that lower prevalence resulted in a risk of false negative and positive results.
6. The group noted the progress on IPC and AMS process indicators that could account for variation in COVID-19 HAI data at the hospital-level and the measurement of which may provide intelligence that could be used to inform IPC and stewardship programmes to support improvement. Some of these indicators are available now through national data sources while others would need to be collected and submitted by the NHS boards so the protocol for this should be developed.
7. The importance of continuing to reinforce the physical distancing messaging in all hospitals was considered and the group supported the development of further work by NSS ARHAI Service, HAIPU and SG Health workforce who have created aid memoires for staff. Five key messages have also been created and a poster for NHS workplaces has been created.