COVID-19 Nosocomial Review Group minutes: 28 May 2020

Items and Actions

1. A review of hospital current data was considered. It was noted that the numbers of cases of COVID-19 in hospital continue to decline and fewer clusters have been reported. The UK has agreed to HAI COVID-19 definitions and the data across the UK now required to be validated in each country before they can be considered for reporting in line with all surveillance systems.
2. It was noted that some data and wider literature point to HCW to HCW transmission in hospitals as a risk. It was noted that the transmission does not necessarily occur in the healthcare environment - many share flats, cars etc outside. So TTIS will help control this element to some extent when established. It was also discussed that transmission can happen in the non-clinical areas of hospital work place for certain HCWs e.g. in a shared office spaces in the hospital so physical distancing, HH and cleaning of shared high touch sites remains key and consideration of wider mask use in the IPC guidance is also worth considering.
3. Review of over 70s data and next steps for admission screening was considered by the group. The data available are very limited to inform an assessment. The group noted that evaluation was not considered when the policy was introduced. The data systems cannot differentiate those who do and do not have symptoms so evaluation is also limited by this currently and this needs addressed for future reporting. The group could see no additional value for this policy and it made no statistical difference to those patients being identified as COVID-19 positive and risk of nosocomial infection. The additional testing every 4 days of these patients had a number of challenges and the value was also questioned.
4. HCW testing was discussed and covered options to consider, evaluation of emerging evidence across Scotland, issues for getting HCWs safely back to work after isolation and recommendations going forward.
5. IPC guidance with respect to the built environment and remobilisation of the NHS was discussed and it was agreed that the next meeting would review this with colleagues from HFS.
6. The group considered the need for behavioural insights into IPC in hospitals to further inform how IPC practiced can be improved and sustained.