Why are there so many large outbreaks among NHS staff?

[HomerRoberts]

...despite mask wearing?

In my local hospital it seems to be that high numbers of staff are simultaneously being infected despite mask wearing and distancing being in place.
Masks need to be worn at all times apart from lunch breaks, when staff still need to ensure social distancing.
I know that masks aren’t 100% effective at preventing spread but even accounting for that I’m still surprised at the high level of infection, so I wonder what’s going on here?
Shoddy masks?
Masks give even less protection than we thought?
Poor ventilation?
Or are the break times the weak point that create the opportunity for spread?

[quote IfOnlyOurEyesSawSouls]@ohfourfoxache I literally cant be arsed with armchair scientists who have not got the foggiest idea what is actually going on in the NHS .

I think people that ask questions like this literally rely on Twitter / social media /naff newspapers for their info . [/quote]
My mrs works in the NHS. Hence the routine test that showed she had it, hence my test though track and trace that showed I didn’t.

So the tests that show false negatives? Do they sometimes show false positives?

@ohfourfoxache i was actually agreeing & empathising with you

I too have been qualified 20 years and work in acute care. Thats why i cant be arsed with the armchair scientists on this thread.

But nevermind .

@Ihg27 I’ve not come across false positives, only false negatives (of the antigen test, so the swab kit)

There are an alarming number of “false negative” antibody tests too (if you can really call it a false negative that it - loads of people who have had the virus but showing no antibodies)

I would hope that the accuracy of the tests are improving, but the 4x false negatives were back in April (old boss is NHS worker, everyone in the workplace went down like dominoes and there were a number of positive tests from her colleagues)

Tests have a much higher false -ve than false +ve rate.

I've also had a patient with typical symptoms and X ray appearances test -ve twice but then +ve third time and go on to die of COVID.

After the initial -ve tests he was said to have a normal bacterial pneumonia (patchy and bilateral though and abx had no impact) and went to the 'green' ward to happily infect everyone else.

He was very confused and aggressive and having failed to get near the guy to examine him without dodging punches I suspect that no way were the first swabs accurately done.

Or else he didn't initially have COVID and then he got it in hospital from someone else. That was happening all the time in the first wave. We do have better access to tests, faster turnaround and better segregation now but hospital will still always be a good place to catch COVID whether you're a patient or staff.

@IfOnlyOurEyesSawSouls oh fuck I’m so, so sorry - I read that completely wrong

Sorry, I think my day has been coloured by a series of clusterfucks, the latest of which was my response to you - apologies

There can be false +ve but it's very rare. More likely because she had a mild asymptomatic infection she wasn't shedding much virus so you didn't catch it. And as a good hcp she was hot on handwashing etc.

Spent a few days in hospital recently. The staff are all touching the same things and quite close together at times, couldn't be helped, when it takes more than one of them to help a patient. Their masks are the flimsy paper ones and a number seem to wear them low on their noses with gaping gaps. They probably touch them occasionally as well. I know I did, as they get in your eyes or you have an itchy nose. I couldn't get the window open in the room so it stayed closed for the whole time. If a virus is present, it's bound to spread in these conditions.

@DougRossIsTheBoss

There can be false +ve but it's very rare. More likely because she had a mild asymptomatic infection she wasn't shedding much virus so you didn't catch it. And as a good hcp she was hot on handwashing etc.

Is hand washing relevant as to why I didn’t get it when she had her tongue in my mouth?

Sorry if that’s crude, but a serious question

What "large outbreaks"? Can you provide some evidence of this please

Well possibly not in that case
Maybe you have some immunity or maybe she had a mild case and was not very infectious or maybe it was a false +ve
She could get an antibody test to check.

@DougRossIsTheBoss

Well possibly not in that case Maybe you have some immunity or maybe she had a mild case and was not very infectious or maybe it was a false +ve She could get an antibody test to check.

Pointless now. It was months ago so antibodies would likely be gone anyway.

Ambulance driver here.

Patients who don't wear mask! That's how I caught my dose of corona. After being asked repeatedly they still refused! Now they was coughing like nothing else, I caught a mild dose I'm putting down to wearing a mask it could have been a lot worse for me.

Calls: if someone has a positive result they are calling as they want to be looked over...yes you have it and it will take some time to get over it. By calling I've now been exposed to an environment that I didn't need to be in if they hadn't been selfish and could have looked after themselves.
If I was getting furloughed I'd happily watch netflix everyday, wouldn't need to worry about bring it home to family members.

@ManInGreen I'm sorry you contracted it however speaking as someone who had more than a mild dose I can say how scary it was and despite being a respiratory ward sister in my previous life I too needed an ambulance call out. Not everyone is in a position to look after themselves and in fact a colleague who tried to do that ended up in ICU as their sats decreased day upon day and with earlier intervention they were told that this could have been avoided.

Because we all have to touch the same shit. The same equipment, toilets, tables, computers, chairs etc FOR 8+ HOURS A DAY... Every day. This is also why so many people are banned from bringing partners in to a hospital. It's impossible to clean every surface after each person has touched it. It's Impossible for only one person to deal with a patient from entering to leaving.

We have staff who used to work in completely different careers who have no scientific background and address less than useful at following guidelines for cleanliness. We have staff who think they know better and cut corners. We have staff who simply forget covid hygiene because they are to mentally overworked.

Viruses are at different levels of potency for infection. Say a virus is a bag of sand. Some viruses need to sprinkle a handful sand on you to infect you and take hold of your immune system, maybe 100,000 grains (vital loads). Covid literally needs to get three grains of sand (viral loads) on you, in the right mucosal entrance (eyes, nose, cracked skin, ears, mouth) and as long as it finds a route in to your body within three days, you can be infected.

Because even when they're dropping on the ward floor, there are ward managers who are adamant that a clearly sick person is not going off - took and nurse and doctor getting involved when a relative was obviously unwell and getting worse to send him home.

The attitude of some seems to be if you're in with covid patients, you're going to get sick and have the same illness so you may as well be in work.

Said relative is now safe at home and very poorly but just about staying out of hospital as a patient themselves at the moment.

My experience working in hospitals is that they can be very crowded. Does anyone remember that "come into my office" sketch? It's not far off. In addition many offices are converted storage cupboards with poor ventilation or no windows.

Thats before you even factor in infected patients

I thought that it could get through the eyes, and it's not like people wear goggles everywhere?

One of my children recently spent a few months in hospital.

The nurses said it’s impossible for them to socially distance from each other but I didn’t see them even try.

The ward only had 3-5 patients in it the whole time we were there. Typically this meant a full staff of nurses sitting cheek by jowl behind their reception desk cackling all day. Often maskless, unless a parent walked past in which case they would quickly put it back on.

And the only hand washing I witnessed on the ward was from other parents or doctors doing their rounds. I don’t think I saw a nurse wash their hands once.

And yet they were absolutely brutal in enforcing the ‘one parent only’ rule on the ward. Even when the trust changed this policy they didn’t inform parents.

I hope this isn’t typical of other hospitals, but my respect for nurses went totally downhill during this day. They were also pretty foul towards me and my child, which didn’t help.

Because nurses are being told to phone their friends and find out if anyone has the virus because they have an alert to isolate. If not, they are told to come back to work as they probably left their phone in their bag too close to someone else's in the locker room. 🤔

It was reported yesterday that University Hospitals of North Midlands Trust had to send six members of staff home as they did not wear masks whilst sharing car journeys to and from work and developed Covid-19 symptoms.

Maybe this sort of irresponsible behaviour is being replicated and staff somehow think they only have to use safety measures when actually in the hospital?

Because even when they're dropping on the ward floor, there are ward managers who are adamant that a clearly sick person is not going off
Nurses have personal responsibility to comply with the Govt guidelines and get tested and self-isolate too. They should go off sick, especially if they have Covid symptoms, and report the Ward Manager for that behaviour.

I wouldn't want to be treated by a nurse who was too stupid to stay at home when ill in these covid times.

@orangesamphire those nurses were probably already cheek to jowl providing personal care to patients, pressed up against each other in the treatment room doing medications, together in small staff rooms where masks needed to be removed to eat. So they may be forgiven for not socially distancing while sitting at the nurses station when they have already been in close proximity in the above situations. You might not have respect for nurses but you will I guarantee need them one day.

@AwaAnBileYerHeid I have two children with complex needs and a huge amount of experience in hospitals as a result.

I can say that 90% of our negative experiences in hospitals have been because of nurses, not doctors.

We need to stop idolising them and congratulating them while blindly ignoring their faults.

I'm sorry if anyone finds this difficult, or insulting.

I understand the challenges of socially distancing as a nurse but, really, the ones on our ward could have done a great deal more to manage their risk.

It is no surprise to me that this particular hospital last week announced a covid outbreak.

@ohfourfoxache

NHS supplied PPE is basically just a load of plastic that may or may not fit correctly. It’s not a magic wand.

Sorry, I know that sounds snappy but so much of what has been supplied isn’t adequate, and it really upsets me to think that the public can’t understand why NHS staff are being infected. There are literally hundreds of us who have died, with more infected than we will ever know.

Yes, the viral load of a sick Covid-19 patient is massive and on non-ICU Covid wards, the PPE is totally inadequate - a mask and a rubber pinny.

And many nurses are still having to wear their own uniforms that they have to wash at home in their household machines. Everyone in hospitals needs scrubs that are boil washed industrially. That should have been sorted since March.

Even in ICUs the quality of the PPE can vary between hospitals. Some ICUs have high standard PPE, some have the bare minimum.

The staff are catching Covid-19 in hospitals and infecting their families, then it gets into the wider community.

The fault lies with the government's underbuying and buying of inadequate levels of full PPE. There was money for EOTHO but not proper PPE.

And no, it is not true that hospital staff are being routinely tested. The government mentioned it months ago, but it never happened. My close relative has not been tested once for Covid-19.

My sister is a nurse. She says infection control training was all about blood - basically if it wasn't red and they couldn't see, they weren't interested.