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Healthcare-acquired clusters of COVID-19 across multiple wards in a Scottish health board

Dancer, S.J.; Cormack, K.; Loh, M.; Coulombe, C.; Thomas, L.; Pravinkumar, S.J.; Kasengele, K.; King, M.-F.; Keaney, J.

Authors

K. Cormack

M. Loh

C. Coulombe

L. Thomas

S.J. Pravinkumar

K. Kasengele

M.-F. King

J. Keaney



Abstract

Background
Healthcare-acquired COVID-19 has been an additional burden on hospitals managing increasing numbers of patients with SARS-CoV-2. One acute hospital (W) among three in a Scottish healthboard experienced an unexpected surge of COVID-19 clusters.

Aim
To investigate possible causes of COVID-19 clusters at Hospital W.

Methods
Daily surveillance provided total numbers of patients and staff involved in clusters in three acute hospitals (H, M and W) and care homes across the healthboard. All clusters were investigated and documented, along with patient boarding, community infection rates and outdoor temperatures from October 2020 to March 2021. Selected SARS-CoV-2 strains were genotyped.

Findings
There were 19 COVID-19 clusters on 14 wards at Hospital W during the six-month study period, lasting from two to 42 days (average, five days; median, 14 days) and involving an average of nine patients (range 1–24) and seven staff (range 0–17). COVID-19 clusters in Hospitals H and M reflected community infection rates. An outbreak management team implemented a control package including daily surveillance; ward closures; universal masking; screening; restricting staff and patient movement; enhanced cleaning; and improved ventilation. Forty clusters occurred across all three hospitals before a January window-opening policy, after which there were three during the remainder of the study.

Conclusion
The winter surge of COVID-19 clusters was multi-factorial, but clearly exacerbated by moving trauma patients around the hospital. An extended infection prevention and control package including enhanced natural ventilation helped reduce COVID-19 clusters in acute hospitals.

Journal Article Type Article
Acceptance Date Nov 22, 2021
Online Publication Date Dec 1, 2021
Publication Date 2022-02
Deposit Date Mar 7, 2022
Journal Journal of Hospital Infection
Print ISSN 0195-6701
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 120
Pages 23-30
DOI https://doi.org/10.1016/j.jhin.2021.11.019
Keywords COVID-19, SARS-CoV-2, Outbreak, Healthcare, Patient boarding, Genotyping
Public URL http://researchrepository.napier.ac.uk/Output/2851477