Hospital transmission a ‘major driver of infection’ at start of second wave

In December, two-thirds of Scots with severe Covid-19 caught it in a healthcare setting, research reveals

ALMOST two-thirds of people who died or became severely ill from Covid in Scotland in December may have caught the disease in hospital, a study found.

Researchers from Public Health Scotland’s Covid-19 Health Protection Study Group looked at all Scottish coronavirus cases outside of care homes between March 2020 and Jan 28 2021.

Over the study period, 30 per cent of cases in which patients died, or spent time in critical care, were linked to a recent hospital visit, the study showed.

In the first wave it peaked at 46 per cent in May; by December, it had risen to 64 per cent of cases. Prof Helen Colhoun, the study’s lead author, said it was crucial to factor hospital acquired infections into modelling to get a true picture of the pandemic.

“There’s this relentless focus on schools but if the models for the future ignore an important setting for transmission, that seems exceedingly odd,” she said. “There’s been very little detailed discussion of hospital transmission by Sage. And this route of transmission doesn’t even seem to be put in as a component of those models.

“Unless we have a really full appreciation of how much infection has occurred within hospital settings we will not be prepared for the future.

“Although hospital transmission may account for a fairly small number of overall cases, it accounts for a substantial number of cases in the vulnerable that lead to serious consequences. ”

A recent report suggested that up to four in 10 patients with Covid in the first wave may have caught the virus in hospital, leading to a “substantial” impact on deaths. In October, the Healthcare Safety Investigation Branch launched an inquiry into hospital transmission, and made eight safety recommendations which included improving patient testing, ventilation and isolation.

The latest Scottish research warned that the layout, design and ventilation levels of some hospitals have reduced the effectiveness of shielding.

Recent exposure to hospitals was linked to 36 per cent of severe cases among people with underlying conditions who had been instructed to shield.

Commenting on the findings of the study, Prof Paul Hunter, of the University of East Anglia, said: “Going into hospital has carried with it a significant risk of catching Covid. Being an inpatient was the main risk factor for severe cases, rather than just attending as an outpatient. Even during the second wave we were still not adequately protecting non-Covid infection patients from getting hospital-acquired Covid.

“The other thing this study shows is that if you were on the shielding list, being told to shield if you live within a family wasn’t a great deal of help.”