COVID-19 Nosocomial Review Group minutes: 7 May 2020

Items and actions

1. The Group were invited to comment on the group Terms of Reference (ToR) and the remit and membership agreed.
2. Current and past COVID-19 hospital data were reviewed from a variety of sources inclusive of virology, epidemiology, activity data and intelligence on clusters and outbreaks. It was noted that ECDC were agreeing case definitions for HAI COVID-19 which would be helpful to consider adopting in the UK to enable consistency of data collection and cross country comparison.
3. The group considered the importance of whole genome sequencing data being available to support differentiating those cases which were hospital onset from those which may be considered hospital acquired. The group noted that whole genome sequencing data was in its infancy in Scotland with respect to its use in COVID-19, however was an important aspect to supplement available data to date and asked that these be brought to future meetings for discussion when available.
4. Group members considered the testing strategies for healthcare being discussed across the UK and wider internationally. Given where we are in the current epidemic curve, the group discussed the importance of testing all symptomatic patients and HCWs and also those hospital contacts with a high degree of exposure to confirmed COVID-19 cases, particularly individuals in the same ward as a case is detected. The group agreed that both patient and HCW testing was important strategically for recommendations and should be a priority for the group.
5. The role of asymptomatic PCR positive COVID-19 was debated in the light of emerging evidence internationally and the uncertainties about transmission risk in these cases. Consideration was given to the current definition of COVID-19 and the fact that there was a wide clinical spectrum of symptoms being reported in published literature. In many early studies those considered asymptomatic were in fact mildly symptomatic or became symptomatic (pre- symptomatic)
6. The importance of IPC measures, inclusive of social distancing in hospitals was discussed. It was agreed that further communications and messaging should be done to emphasise the importance of social distancing throughout hospital building environment, beyond the direct patient care environment.
7. There is a need to better establish consistent and national monitoring of IPC measures in hospitals and ensure they are optimised, the group agreed there was a case for considering developing national IPC indicators further and bring these back for further discussion.