COVID-19 Nosocomial Review Group minutes: 6 November 2020

Items and actions

1. The IPC evidence rapid review update was presented. CNRG were informed of the updated evidence regarding periods of infectivity of COVID-19 and the evidence of prolonged viral RNA detected, and viral shedding after 28 days even when symptoms have subsided. However, it was noted that this prolonged shedding does not necessarily equate to infectivity. In mild cases the peak infectivity is around onset of symptoms and in more severe cases there is a prolonged peak infectivity. 

2. It was also noted in the transmission route update that there is no evidence of airborne transmission of COVID-19 as there are matched studies that have found positive and negative air samples. Additionally, in cases where there have been suspected airborne transmission i.e. in densely populated rooms, it is difficult to differentiate droplet/ airborne transmission. 

3. Confirmed to CNRG that current IPC Guidance does not require updating currently in the light of this evidence review. 

4. ARHAI Scotland presented a rapid review on studies on ultraviolet light type C (UV-C) decontamination of the air. Studies that looked at bacterial efficiency and animal studies were excluded. Six experimental SARS-COV2 (Covid-19) that studied surface decontamination were included. Concluded that there is little evidence that supports UV-C decontamination, it does not replace the need for cleaning and should not replace adequate ventilation mitigations.

5. CNRG were updated on the latest position regarding visitation guidance and Scottish Government policy leads sought input from CNRG regarding end of life care and maternity care. It was highlighted that there is emerging evidence that the restriction/pausing of visitation is beginning to be detrimental to patient and staff wellbeing. CNRG were made aware that there is little evidence of visitors being the source of COVID-19 outbreaks within hospitals.

6. CNRG were updated on the current Winter Planning monitoring dashboard. CNRG were informed that the slide pack used the Winter Planning Group has weekly data but could be stepped up to daily if the situation warranted. Furthermore CNRG were made aware that currently elective surgery is still continuing. A daily sitrep is currently being drafted and CNRG agreed that ARHAI Scotland cluster data could be fed into this sitrep.

7. CNRG were also informed that the developed dashboards and Eviz reporting from ARHAI Scotland are to be rolled out across the service now. This enables real time reporting and sharing of lessons learned real time. It was emphasised that key common themes point to the importance of PPE adherence and staff physical distancing (inclusive of outside work) remains a risk for COVID-19 entry into hospitals. ARHAI confirmed that further context of outbreaks is to be added to the electronic reporting to give a wider picture of clusters.