COVID-19 Nosocomial Review Group minutes: 16 July 2021

Items and actions

1. CNRG were presented with nosocomial infection modelling for NHS England from Public Health England (PHE) from 01 March 2020 to 31 August 2020.

CNRG were told of policy interventions put into practice including: reducing bed capacity, testing symptomatic patient admissions and cohorting positive cases into red pathways, increased use of PPE/hand hygiene, restriction of visitors, and HCW isolation when tested positive. Additionally, CNRG were told that in the modelling scenarios, the majority of infections had been patient to patient, and not between staff and patient.

2. CNRG were presented the latest COVID-19 sitrep for week ending 27th June 2021. Members were informed of a slight increase in the number of reported outbreaks since the 15th June. However, the number of clusters and outbreaks were low compared to previous waves and the number of infections in each outbreak remains low.
3. CNRG were informed that nosocomial infections trends are not tracking with community transmission and hospital admissions, unlike the previous peaks.
4. CNRG were presented with the latest antimicrobial stewardship update. CNRG were informed that total antibiotic use in March – May 2021 is trending below 2019 figures, however, dental prescribing is continuing to trend above 2020 figures. CNRG members were also made aware that the SAPG guidance was updated for community and acute prescribing guidelines
5. CNRG were made aware that the UK IPC Cell has no immediate plans to update the current IPC guidance, but will instead focus on updating the winter respiratory guidance. Furthermore, a dental appendix was highlighted to members. This states that if AGPs are being carried out on members of a household, there will be no requirement for fallow times between these patients.
6. Discussion then moved on to scoping the views and assessing the practicality of reducing physical distancing measures to aid the remobilisation of NHS services. CNRG members were made aware of several requests by Health Boards.
7. CNRG made aware that WHO have recently updated their guidance on IPC (July 2021) and reinforced that >1m is required in healthcare settings and more as required based on risk assessment.
8. CNRG then presented a review of FFP3 mask use in clinical settings. It was highlighted that the continuing evidence base comes from observational studies with a lot of confounding variables, therefore making it more difficult to confirm the efficacy of FFP3 masks in clinician practice beyond that of AGPs.
9. CNRG were updated on discussions with the Health and Safety Executive (HSE) and Scottish Government. The HSE confirmed that their position is that they support the UK IPC Cell guidance. They also confirmed that they are in regular contact with the UK IPC Cell. HSE confirmed that there will be no change to the current requirements to FFP3/2 mask fit testing.
10. CNRG were updated on the Future Preparedness Sub Group and were informed that the finalised questionnaire had been agreed.
11. CNRG were then given an update on HCW testing. CNRG were informed that the positivity rate for the LFD testing is in line with the community positivity rate. HCW testing marketing materials have been finalised and the comms package would be sent to Health Boards.