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Coronavirus (COVID-19) Nosocomial Review Group minutes: 11 February 2022

Minutes from the thirty-sixth meeting of the group, held on 11 February 2022.

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Items and actions

     Items and actions

1. Coronavirus Nosocomial Review Group (CNRG) were updated on the latest COVID-19 situation report. Data presented was to week ending 23 January 2022 and compared with the previous week 16 January 2022. CNRG were informed that nosocomial cases account for 0.3 percent of all COVID-19 and 38.1 percent of all hospital onset cases. The vaccination status of the nosocomial cases was noted. The majority of patient cases were vaccinated and aged over 65 years old.

2. CNRG noted the decline in clusters in the non-respiratory pathways. The key lessons learned from outbreak clusters, these include; difficulty in linking staff cases with clusters given the increased community prevalence; issues with mask use by in patients; staffing and bed pressures; and challenges with capacity for patient isolation.

3. The Public Health Scotland (PHS) and NSS ARHAI process for analysing COVID-19 reinfection data was considered using the 90 day rolling definition that was adopted by Public Health England and Public Health Northern Ireland. The aim is to fully implement this definition in all reporting by the end of February. The intention is to include reinfection data in the total hospital onset case figures, with accompanying summary text. A retrospective analysis of cases will also be undertaken for all pre November 2021 cases.

4. CNRG were then given an update on the Genomic Clustering Pipeline work. The aim of this work was to for the comparison of genetic relatedness of samples collected from a given area/space and time. A pilot board presented feedback comparing Alpha and Omicron variant cases across its three main hospital sites.

5. CNRG were presented with comparisons of both variants across the three sites, noting that outbreaks/ clusters among its main sites remain small and that confirmed contacts of COVID-19 cases within wards in the main did not develop COVID-19 themselves. CNRG noted that both events are evidence for the positive impact of the vaccination programme and that the HoC IPC measures, including testing, are working to prevent NI transmission.

6. CNRG noted that there is lots of variability in board level use of rapid testing which is key to IPC. It was also noted that WGS can help disentangle some direction of transmission, however it is very limited with SARS-CoV-2 and only indicative. Further clusters are very often multiple community importations in a time and place.

7. After the pilot, the weekly genomic cluster reporting will start at the end of the month, offering reports to boards if they want to receive them, and supporting them in their interpretation of them.

8. CNRG were then given a presentation on a single boards RIDDOR data which had been record linked for local analysis. Data from the start of the pandemic indicated that 75 percent of staff had not reported COVID-19 infection, and 23.4 percent had reported one COVID-19 infection (only 1.2% had more than one). It was noted it was a typical NHS workforce demographically with good vaccine uptake. Further analysis was planned as the numbers are small and any risk inference is challenging. The summary results to date concluded there was no evidence of significant occupational acquisition (beyond very early cases).

9. The final draft of the sub group work on future IPC research priorities including feedback from CNRG members was presented and endorsed as advice.

10. An update on the work of the UK IPC Cell was given. It was highlighted that NHSE/I undertook a review of the AGP evidence, assessing evidence from studies from 2019- November 2021, which resulted in 37 studies being considered for review. A number of procedures are being considered for removal from the list by the UK IPC cell based on this.

11. Changes to date of the Scottish Winter respiratory addendum were noted and endorsed. It was noted that the UK IPC cell are also considering next steps for guidance.

12. The CNRG Testing Sub group updated on their commission from CNOD policy for views on moving away from daily LFT testing for HCWs in response to Omicron and revert back to the twice weekly testing. CNRG endorsed this advice.

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