Conference 2021 Pre-Recorded Video

 

Project title

Outbreak of SARS-COVID-19 in Surgical Wards at the Tertiary Hospital

 

Authors and Affiliations

B. Karki1, M. Sahloul1,Chung WY1,AlSaoudi T1, A. ElTweri1, Garcea G1

1. HPB Unit , University Hospitals of Leicester NHS trusts

 

Abstract

Background

The SARS-COVID-19 has had a huge impact on the NHS infecting well over 789K population(1). Since the second surge of SARS-COVID-19 on 18th of September, there has been a recorded 2,191 deaths in the UK(1,2). When the outbreak began, several measures were introduced, and pathways created in order to execute safe surgical practices and protect both patients and staff from SARS-COVID-19(3,4). Despite these measures, there have been reported cases of outbreaks in various parts of UK amongst patients and clinical staff(5).

Methods

We report the experience from the University Hospitals of Leicester NHS Trust, Leicester General Hospital surgical wards where there have been three outbreaks in the past 6 weeks (10, September 2020 to 21, October 2020) and we compiled the timing, initial source, number of affected individuals and immediate management steps taken (Fig1). There were no instances of patient mortality or harm. All affected individuals were asymptomatic and remained so during the period of isolation.

Results

Following the first outbreak onwards, several measures were taken among which 28-day surveillance helped us understand several factors responsible for the recent outbreaks. Several staff members were found walking out of hospital, in groups once they had removed their PPEs. Communal lunching with inadequate social distancing, attending work with symptoms (albeit atypical for COVID), sharing cars to/from work or not wearing PPE correctly were highlighted in the subsequent investigations. The reduction in number of affected individuals during the last two incidents reflected a degree of efficacy of the implemented preventative measures, which were reviewed again following the subsequent incidents.

Conclusions

In the present climate, a robust and prompt response to outbreaks is required. Continual iteration with regards to the need for PPE, adequate social distancing and avoiding over-crowding in communal areas is paramount to reduce the probability of ward outbreaks and inter-professional transmission. Asymptomatic staff testing, particularly in high-risk areas could also be considered but would require adequate laboratory capacity and rapid turnaround of test results.