Hospital acquired COVID-19 remains a major problem as it STILL accounts for 15% of COVID hospital patients: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/973495/S1147_CO-CIN_dynamic_report.pdf It remains the biggest undiscussed problem in the pandemic to date: a thread.

It was even worse: a paper by PHE and LSHTM for SAGE in January stated that 20-25% of infections in hospital patients in the first wave were hospital acquired: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/961210/S1056_Contribution_of_nosocomial_infections_to_the_first_wave.pdf

Upper estimates of this data suggest that around 36,000 cases in the first wave were caught this way which could mean 8,000 deaths related to hospital acquired COVID occurred in that wave: https://www.dailymail.co.uk/news/article-9254495/Stopping-Covid-spreading-hospitals-substantial-reduction-wave-deaths.html

This is not just an England issue. In Scotland at the end of January there were 4055 hospital acquired cases which made up around 21% of COVID hospital patients: https://www.heraldscotland.com/news/19097947.covid-scotland-almost-1-000-hospital-infections-three-weeks/

Why does this matter? Apart from the human tragedy of so many avoidable deaths, the SAGE paper noted “without any nosocomial transmission the duration of the first wave in hospitals may have been shortened.”

So what should the lesson be? Given the CQC has looked at some hospitals who have had multiple hospital acquired outbreaks and found infection controls were good it makes you think that these weren’t the right controls.

We should definitely have earlier advice to adhere to social distancing in the non-Covid areas of hospitals. This select committee exchange with Prof Steve Powis demonstrates why crucial time was lost in the early stages: https://parliamentlive.tv/event/index/a6a5a4c2-3109-446b-be70-341117ba18d3?in=11:23:46&out=11:27:04

Speed of testing in hospitals is also a vital tool we should have used earlier: why did it take until November to introduce weekly testing of NHS staff?
https://parliamentlive.tv/event/index/a6a5a4c2-3109-446b-be70-341117ba18d3?in=11:34:46&out=11:37:57

But the biggest unknown was the extent of airborne rather than surface infections. Future guidelines need more focus on ventilation than hands & surfaces. Upgrading ventilation systems - esp in old hospitals - is expensive, but clearly worth doing to prepare for future pandemics.