COVID-19 Nosocomial Review Group minutes: 25 September 2020

Items and actions

1. CNRG were informed of the current focus within testing on rapid point of care (POC) testing. A 12 minute antigen test is currently being validated and if successful will be the preferred POC testing method.  CNRG noted their previous testing advice given for hospital patients and staff and that POC testing may help with testing in hospital pathways and should be considered for this.

2. The hospital testing strategy for asymptomatic testing was approved by the group. It was highlighted that the ECDC testing strategy was also published this week and also confirmed that the CNRG testing paper is aligned to the hospital testing recommendations content of that paper. 

3. The group noted the importance of ensuring the prevention of all HAI continued to be focussed on. SSI infections where very low compared to 2019, however this may be due the reduction and pausing of elective surgery during the pandemic response. Additionally, there was a reduction in reported respiratory infection related outbreaks, however this may be due to the COVID - 19 management and reporting mechanisms. CNRG were informed that the next quarterly report on HAI is due to be published in October.

4. The CNRG noted there was a decrease in antibiotic prescribing during the peak of the pandemic and there has been an increasing trend in antibiotic prescribing as the service remobilised back to pre-pandemic activities, which are currently close to seasonal norms. 

5. Evidence shows that COVID - 19 patients typically do not have a co-bacterial infection so antibiotics are not needed to treat COVID-19. CNRG noted this was an important message for the hospital prescribers and SAPG were leading this communication. It was noted that wider literature indicates secondary bacterial infection is a risk and so needs a focus and monitoring going forward.

6. CNRG noted that PHS data for 11th and 24th September indicated there was an increase in COVID – 19 patients being admitted to hospital and increase in ICU patients with COVID-19. This is expected given the rise in community cases in Scotland and CNRG noted that hospitals need to ensure they are prepared for a further surge in cases. CNRG also noted that ECDC has risk assessed the UK position as concerning, with a trend towards moderate risk. The R value is estimated to be between 1.1 and 1.4.

7. CNRG noted that these data are helpful to show context of the public and their role in reducing COVID-19 transmission with FACTS; higher transmission in the community results in hospital admissions and transmissions and therein morbidity and mortality impacts.