COVID-19 Nosocomial Review Group minutes: 31 July 2020

Items and actions

1. The group noted the report from PHS on HCW hospitalisation from COVID-19 and the national guidance and advice implemented since these data included in these analyses were done. The importance of the new IPC guidance, testing and IPC indicator work is noted in optimising HCW and patient safety going forward.

2. New UK IPC guidance for mobilisation of the NHS was reviewed. The updated guidance will supersede the current PHE guidance and tables adopted across the UK. IPC will be enabled via pathways for managing risk in remobilisation of the NHS. It was noted that standard infection control precautions (SICPs) will include physical distancing measures and during the COVID-19 pandemic masks will be a standard IPC measure also in healthcare. NSS ARHAI will consider the implications for the wider IPC guidance in Scotland in the national Manual for IPC (NIPCM) longer term.

3. The need for testing patients who were emergency admissions was an important part of the new IPC guidance. The group advised that to adopt the UK IPC cell guidance all emergency admissions would require to be tested in order to manage cohorting in the UK IPC guidance pathways.

4. The CNRG noted the importance of ventilation as a control measure for COVID-19 given the emerging evidence to date from COVID-19 outbreaks in closed settings and the uncertainty of the role of aerosols in transmission. An overview of current 4 country UK ventilation work underway was given. The group noted there is literature review looking at impact of ventilation needs for COVID-19 on dentistry and wider healthcare which would be used to inform future guidance and further research studies have been commissioned to look at UV light decontamination and use of HEPA filters.

5. All-cause mortality within 28 days of first positive nosocomial case reporting is being developed. A number of limitations and biases in the data were acknowledged – patients who are categorised as probable or definite HAI have longer hospital stays and therefore an increased risk of death from causes other than HAI. The importance capturing risk factor data to enable risk adjusted rates was noted. These considerations would be taken account of in future reporting being developed.