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COVID-19: How safe are our hospitals – for staff and patients?

Solicitor Sarah Moore discusses the issue of the spread of coronavirus within hospitals, both to patients and staff.

Hospital corridor
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Sarah Moore specialises in product liability and claims for groups of people who have suffered an injury because of unsafe products. She has written a number of articles on topics such as drug regulation, cigarette packaging and food safety.
A recent study published by Public Health England (PHE) has identified that up to 20% of patients with COVID-19 may have caught the virus whilst in hospital for other non-related health problems; and 89% of infected health care workers may have contracted the virus whilst at work within our NHS hospitals.
The study, released by a PHE research team is based on computer models of transmission within UK hospitals and has yet to be peer-reviewed.

However the findings are likely to be unsurprising for many hospital workers who have continually raised concerns about how rife, even ‘endemic’, the virus is within the hospitals at which they work, – such that many frontline NHS staff have come to accept the grim reality that the question is not if they contract COVID-19, but rather when – and how severe the infection will be.

The PHE study also identifies strategies that would help to relieve the ‘in-hospital’ infection rate, including seemingly simple measures, such as: placing COVID-19 patients in single bays or rooms; and, periodic (ideally daily) testing of all onsite health care workers – to pick up those who are asymptomatic but infected.

What the study does not do is seek to identify the factors which might be responsible for driving up the risk of on-site infection for patients and medical staff. However, with reference to other reporting throughout the crisis highlighting: lack of access to any/appropriate PPE; lack of access to any/accurate COVID-19 testing for health care workers; and lack of systematic access to that testing; it is not difficult to speculate why NHS hospitals, in-patients, and our frontline workers have been hit so hard by the virus.

Combine these ‘in-crisis’ factors, with the years of chronic under-funding for our NHS hospitals, and in that context it is not difficult to understand why, despite the best efforts of our frontline workers, the ‘in hospital’ transmission rates appear to be so high. Trusts across the country have had to drastically reduce spending including cutting all off-site office space for staff, such that all medical staff, from consultants to health care assistants, are routinely required to ‘hot desk’ in order to  access patient details, records and test results. 

This newly published PHE study may also provide further context for understanding the high number of hospital workers who have tragically lost their lives whilst working within NHS Hospitals as a result of COVID-19 infection.

As the study highlights, the transmission of any virus within a hospital is a primary concern in managing the spread of the disease. The data is not yet available to analyse the contribution that ‘in hospital’ transmission has had on the overall infection burden in the UK, however, the study highlights the role that ‘nosocomial’ or in-hospital transmission played in the spread of other corona virus outbreaks including SARs and MERS.

A PHE spokesperson told the Guardian newspaper that “There remains a large degree of uncertainty around the estimates for many reasons and findings should be treated as preliminary”.

However, whether the estimates are confirmed or not, what we can be certain of is that our NHS workers are daily exposed to a risk of contracting COVID-19; and that through simple steps – including adequate access to PPE, routine on-site testing and the ability to ‘social-distance’ between colleagues on-site wherever possible - that risk could have been better controlled. 

When the current modelling exercise is completed, if we do find that NHS hospitals have been a key factor in driving up UK infection rates so that we now have the highest rates in Europe, the Department of Health will have some difficult questions to answer.

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