Hospital outbreak fuelled virus spread
THE Covid-19 outbreak at St Augustine’s Hospital in Durban fuelled the spread of the virus in the city, an investigation has found.
It also led to clusters of positive Covid-19 cases – four at a nursing home and 17 at an outpatient dialysis unit operated by National Renal Care on the hospital campus.
The findings of an investigation into the outbreak, which resulted in the hospital being shut down by the KwaZulu-Natal Department of Health on May 20, were released this week.
The investigation was led by infectious disease specialists and researchers from the Nelson R Mandela School of Medicine at the University of KwaZulu-Natal and the KZN Research Innovation and Sequencing Platform (Krisp) – Dr Richard Lessells and professors Yunus Moosa and Tulio de Oliveira.
Between March 9 and the end of April, 39 patients and 80 staff at the hospital tested positive for the virus.
The outbreak accounted for 14% of Covid-19 cases in the province reported until April 30.
The investigation found that the origin of the outbreak was most likely from an asymptomatic patient, who was assessed in the hospital’s emergency department, and infected another patient who was admitted at the same time with a suspected stroke.
“She did not have any of the typical risk factors Dr Richard Lessells Infectious disease specialist, Krisp
The report said the virus then spread widely through the hospital, infecting patients and health-care workers in at least five different wards. Fifteen of the infected patients died.
In the report, Lessells said the initial spread of the virus was not recognised because the first patient was not suspected of having Covid-19.
“She did not have any of the typical risk factors and initially only had a fever without cough or other respiratory symptoms. By the time she was diagnosed with the virus and the hospital began responding to the outbreak, several other patients and health-care workers had already been infected.”
Lessells said the investigation included analysing medical record reviews, ward visits and conducting interviews with health-care workers and management.
The investigation found that although the hospital had begun investigations into the outbreak on April 4, there had already been 13 confirmed cases of Covid-19 and three deaths.
The hospital performed systematic testing of all staff as part of their response to the outbreak, the report read.
Of the 80 staff infections, 14 required hospital admission. No staff were admitted to intensive care or died.
The majority of the infections were nurses or nursing students. There were a few cases of staff who were infected but had not been involved in direct patient care.
The investigation findings and recommendations have since been shared with the UKZN executive management team; the KZN Department of Health; the chairperson of the Ministerial Advisory Committee on Covid19, Professor Salim Abdool Karim; Netcare management; and National Renal Care management.