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Busy hospitals are becoming a Covid breeding ground once again

Health / Tue 8th Dec 2020 at 08:27am

THE proportion of patients being treated for Covid-19 who caught the virus in hospital has risen sharply amid reports of A&E overcrowding and shortcomings in testing reports The Times.

Nearly one in five Covid patients treated in English hospitals in November are believed to have caught the virus after being admitted, up from one in 10 in August. At one trust the rate was 67%.

An analysis of patients who tested positive more than seven days after they arrived — a measure statisticians use to estimate hospital-acquired infections — suggests 7,216 patients caught the virus in hospital wards last month.

NHS England said rates of hospital transmission were linked to the number of cases in the community.

The rate of these hospital-acquired infections was highest in the northwest at 21.1%. The region has been a Covid hotspot. But the east and southeast of England had some of the worst records on hospital-acquired infections, with 20.5% and 20.3% of inpatients infected after admission, despite lower Covid numbers overall.

Rates were lowest in London and the southwest of England, both at 16.3%. At a hospital trust level, the difference is stark.

At North Staffordshire, the worst affected NHS trust, 46 out of 69 Covid cases in November — 67% — were suspected hospital-acquired infections, more than triple the average in England of 18.4%. At United Lincolnshire Hospitals NHS Trust, 200 of the 613 patients in hospital with Covid-19 (33%) are believed to have caught it while being treated for something else.

Katherine Henderson, president of the Royal College of Emergency Medicine, said she was “extremely concerned” that A&E overcrowding “could be involved in making the situation worse”.

She said it would be “unrealistic” to expect to get hospital infections down to zero while the virus was in the community but added that Covid demand, social distancing and normal winter pressures had led to bed shortages, ambulance queues and busy departments.

On Thursday, the college wrote to trust bosses warning that some were being “complacent”. It wanted to get the message across that “crowding is acutely dangerous”. Henderson said that hospitals ran the risk “of infecting someone who’s vulnerable”. She added: “It’s one thing infecting somebody who’s fit and healthy, but our hospitals are where our sickest people are.

“We want to build confidence in the health service again and we’re not going to do that if they think when they come into hospital they’re going to catch Covid.”

Matt Godfrey, 35, believes his mother caught the virus at Maidstone Hospital in Kent.

The 62-year-old, who had rheumatoid vasculitis and was classed as vulnerable, was admitted on November 3 and did not test positive until November 18. The hospital is part of Maidstone and Tunbridge Wells NHS Trust, where the rate of hospital-acquired infections last month was about 24%.

Godfrey, an insurance auditor, said his mother was on a non-Covid ward where staff wore surgical masks, not full PPE. She was moved to a Covid ward and died on November 27.

Two other patients on the non-Covid ward also caught the virus.

He said his mother “had to have caught the virus from staff because she was bed bound” and they were the only people in close proximity: “I’m disappointed and angry. I feel it could have been avoided.”

The findings on hospital transmission come as a group of doctors prepares to launch legal action against the government for failing to protect staff with adequate PPE. The Doctors’ Association, which represents 29,000 medics and is backed in the action by the Good Law project and the Hourglass charity, wrote to the health secretary, Matt Hancock: “We have lost hundreds of our colleagues. Their families are owed explanations as to what happened and how as a nation we can learn from their sacrifice.”

More than 600 NHS staff and care workers have died with Covid-19. They include Dr Krishnan Subramanian, 46, an anaesthetist who died at Glenfield Hospital in Leicester last month.

Some staff report problems accessing regular Covid tests almost a month after the government pledged twice-weekly home tests for those coming into contact with patients. A paramedic in Yorkshire, who did not want to be named, said he had “never had a routine Covid test” and still had no kit.

An NHS doctor at a large hospital trust in London also said he had not been offered regular testing. “The reality on the ground is yet to catch up with the rhetoric,” he said.

NHS England said almost half a million staff had been tested. Maidstone and Tunbridge Wells trust said that it would investigate Maria Godfrey’s care on receipt of a formal complaint and that it had strict infection prevention processes to help keep everyone safe. Yorkshire Ambulance Service NHS Trust said that its all staff had been provided with tests.

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