Covid-19: Medical chief insists hospital infections 'tiny'

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Fewer patients are going to hospital but the deputy chief medical officer insists the proportion of infections is very small

Patients should be reassured that if they do go to hospital they will be treated "safely and effectively," says Wales' deputy chief medical officer.

It follows concerns about growing numbers of people catching Covid when in hospital.

The number has risen across Wales by 50% in the past week.

At least 57 deaths and 284 cases have been linked with outbreaks at hospitals in the Cwm Taf Morgannwg health board in recent weeks.

But Dr Chris Jones insists the number of infections is "absolutely tiny" compared to the number of patients being cared for the NHS.

"I want to reassure people that hospitals are safe places to come in for the care you need," he said.

"It's vitally important we maintain normal healthcare while tackling this pandemic - the number of cases we've seen of hospital transmission is absolutely tiny compared to the number of people coming through the door".

The statistics suggest less than 5% of patients are becoming infected in hospital with the vast majority of people catching in households or within the community.

Covid-19 infection in hospitals. Numbers of probable and definite hospital onset infections by week.  Up to 18 October.

What do the figures show?

Latest figures from Public Health Wales show 142 Covid-19 infections caught in hospital - the largest weekly number since the end of April.

Aneurin Bevan health board had 47 hospital-caught infections, overtaking Cwm Taf Morgannwg on 44.

But 95% of Covid-19 infections are still caught in the community.

Royal Glamorgan Hospital in Llantrisant has recorded at least 159 Covid cases and 43 deaths linked to it..

The hospital was closed to new admissions and emergency patients were diverted to other hospitals in an effort to contain the spread of infections for a period.

Infection control measures have been strengthened and the Cwm Taf Morgannwg board saw a fall in infections over the latest week, which Dr Jones said suggested they were on top of the outbreak.

Its medical director said he was "cautiously optimistic" that the situation had been brought under control and the extra vigilance was "beginning to make a significant impact on those numbers".

However he said that as the virus was circulating widely in the community it was inevitable there would be some hospital infections.

"The virus creeps in from the population outside but at the same time we are learning about how far apart to keep our beds, extra vigilance about how patients flow through the hospital, the use of washrooms, use of PPE - we have a 16-point plan across all our sites," said Dr Nick Lyons.

"I'd like to reassure patients if they are feeling unwell, if they have a medical problem... they shouldn't be nervous - we are doing everything we can possibly do."

Dr Lyons says the health board was eager to work with external experts to see what further lessons could be learnt.

"We are always looking for external advice. In relation to deaths at hospitals relating to this outbreak, we will be consulting with outside experts to make absolutely sure there are no further lessons that can be taken from this."

Fewer people are going to hospital

There are nearly 1,000 fewer outpatient referrals a day in Wales compared to the year before, according to latest NHS Wales figures out on Thursday.

There has been a 28.5% fall in referrals for first appointments in August, compared to the same month in 2019.

Nearly a quarter fewer patients were starting along the cancer treatment pathway than a year before.

Outpatient referrals in Wales. All treatment functions, by month.  .

Outpatients - There was an average of 2,470 outpatient referrals per day in August 2020. This is a fall of 8.9% (242 fewer referrals per day on average) compared to July 2020 and a decrease of 28.5% (985 fewer referrals per day on average) compared with August 2019.

Cancer - there were 3,129 (23%) fewer patients starting the single treatment pathway in August compared to the year before.

Under the old measures, in the year to August, 577 fewer cancer patients (6.9%) via the urgent route started treatment compared to 2019, while 761 fewer patients (8.3%) not diagnosed via the urgent route started treatment.

Accident and emergency - more patients are going compared to early in the pandemic but in September there were 561 fewer attendances per day on average and there were 561 fewer attendances a day (18.3% lower) than in the same month in 2019.

Dr Jones said he wanted to assure patients that action was being taken, even though the growing spread of Covid-19 within communities would inevitably lead outbreaks within healthcare settings.

"It's a characteristic of this infection - it's highly infectious when you have a higher prevalence in the community it gets into hospitals," he said.

"Hospitals are highly complex environments with many different wards, units and services - there's bound to be with such an infectious agent some episodes and clusters of infections. But the really important thing is that action is taken to close that cluster off - to test patients and staff and isolate it."