Hospitals stopping covid testing for new asymptomatic patients admitted

[mrshoho]

www.independent.co.uk/news/health/covid-tests-hospital-nhs-trust-b2052283.html?gaa_at=la&gaa_n=AYc4ystdULRw3OF_g00gQzL_Oa0TVt82pJlYy6qC8p46gTkJQyLtNcTNVO3EHVH-r1M%3D&gaa_ts=62559b78&utm_source=newsshowcase&utm_medium=discover&utm_campaign=CCwqFggwKg4IACoGCAowzdp7ML-3CTDa0EYwx8RP&utm_content=bullets&gaa_sig=aUjn-abXUHglW5Y72CQVoZCqFNP5aU9Y7OllhVKn9GvbGWTTgwvsT5iaFXBA4n9cp4ydtrmXRZwGdl-8jDxMbg%3D%3D

At least 2 trusts have taken this decision as they can no longer cope with segregating covid/non covid wards. I get what they're saying that it's the lesser of two evils but the risks to patients is worrying.

@mrshoho

I feel for the medical professionals. They can see that people with life threatening illness need treating but they also see that they could be potentially putting them at risk of harms from contracting covid. Not a good position at all.

How can this be when all the NHS staff who wanted to be vaccinated have been?

Mrsa, cdiff & covid aren’t really comparable in terms of likelihood of catching an infection in hospital are they?

For a start, we’ve had maybe 1 case of hospital acquired mrsa in the last decade. Cdiff a bit higher but nothing like the number of hospital acquired covid infections. Secondly we screen all admissions for mrsa routinely, so treating it like mrsa would mean retaining the asymptomatic testing and segregating of patients. And if we are going to treat it like other infectious diseases such as flu, noro etc, then wards/bays with active outbreaks are going to need to be closed to new admissions. Which is going to seriously deplete the number of available beds given how infectious covid is and the extremely high levels of circulating covid in the community and will do nothing to get routine surgery up and running.

The trust where I work it's horrendous. We had a parent come in positive for Covid on a bone marrow transplant unit who met with 5 parents in the parent room and didn't tell anyone they were positive until 3 hours after they arrived on the ward.

WTF is wrong with people? Surely anyone with a brain would know how selfish and dangerous that was.

For a start, we’ve had maybe 1 case of hospital acquired mrsa in the last decade.

Really? A quick google suggests that there were 2280 odd cases in 2020, the year we spent mostly in lockdown. I don’t suppose all of those cased were acquired in hospitals, but it doesn’t seem unreasonable to assume that more than one was.

How can this be when all the NHS staff who wanted to be vaccinated have been?

I was referring to the potential harm to their vulnerable patients @mrziggycoco

@mrshoho

How can this be when all the NHS staff who wanted to be vaccinated have been?

I was referring to the potential harm to their vulnerable patients @mrziggycoco

And because despite being a fully vaccinated nhs worker, my vaccinated daughter caught it and gave it to me for the second time !

@mrshoho but all those patients who wanted to have also been vaccinated.

[quote mrziggycoco]@mrshoho but all those patients who wanted to have also been vaccinated.[/quote]
Which is why I referenced safe cancer care.

If your immune system is (or is about to be) severity depressed or temporarily wiped out as part of your treatment, would you really want to go to eg the MRI waiting room (because they need to see if your tumour has shrunk) knowing that the others in the waiting room might be covid +ve?

Thismove is really bad for safe cancer care

Like you say, many of those won’t have been hospital acquired. And I can’t speak for other trusts. But a huge amount of work has gone on in the last 2 decades to reduce hospital acquired MRSA infections.

But even if you assume that all 2200 odd cases were hospital acquired the numbers don’t really stack up. IIRC from last week about 22/23% of Covid cases in hospital are hospital acquired. With about 20,000 people in hospital with Covid at the moment then surely there’s twice as many people in hospital with Covid today as developed mrsa from any source in the whole of 2020.

[quote mrziggycoco]@mrshoho but all those patients who wanted to have also been vaccinated.[/quote]
Yes, but the vaccines don’t work for everyone.

Cancer (chemotherapy) patients, people on certain medication for arthritis etc.

If it was as simple as getting jabbed gave you 100% protection we’d have dropped measures completely nick earlier.

I can see what you’re saying but my point is that patients have always had some risk of infection from going into hospital. Usually, the risk of that is outweighed by the need for treatment for something else.

I think most people stuck on waiting lists now for treatment they should have received months ago are probably willing to accept the risk of covid considering it’s everywhere anyway.

Taken from part of the above article:

Dr Lawton, said that the decision to stop testing was “worrying” and that putting “blinkers” on was not a justified response to the problem.

He explained: “We don’t know exactly how dangerous hospital-acquired Covid is, but people have been dying with it, and we know from studies like CovidSurg that Covid adds risk to surgical patients in the form of clots and heart attacks.

“If we don’t have the resources to do infection control properly, we should at least do what we can, such as keeping Covid and non-Covid patients as far apart as possible. Stopping testing means we can’t do anything to reduce the risk.”

He pointed out that the risks of hospital-acquired Covid are “as high as they’ve ever been”. In the 28 days to 3 April there were 11,936 probable or definite cases in England, which amount to 23 per cent of hospital cases.

There is no way hospitals can carry on long term dealing with covid the way they have. People are exposed everywhere they go, not just in hospital, just like colds and flu.

Yes, but they don't receive chemotherapy everywhere they go, or radiotherapy, or have extensive operations to remove tumours, or have their immune systems deliberately wiped for a bone marrow transplant.

Pray you don't get cancer if you don't think even an attempt should be made to keep hospitals safe. Because for many cancers there is now a good chance of a cure, but you could die of covid along the way without clean wards, ICUs HDUs, scanning departrnents, theatres etc. And that's witout considering precautions for staff treating the highly vulnerable, and also protocols for visitors.

@nether

Yes, but they don't receive chemotherapy everywhere they go, or radiotherapy, or have extensive operations to remove tumours, or have their immune systems deliberately wiped for a bone marrow transplant.

Pray you don't get cancer if you don't think even an attempt should be made to keep hospitals safe. Because for many cancers there is now a good chance of a cure, but you could die of covid along the way without clean wards, ICUs HDUs, scanning departrnents, theatres etc. And that's witout considering precautions for staff treating the highly vulnerable, and also protocols for visitors.

That's basically irrelevant if it isn't possible to avoid the possibility that people may have covid. There are all kinds of illnesses and viruses that circulate through the population and there is no way to avoid them all coming into the hospital or screen for them all.

A much better option would be to have different covid protocols where people with compromised immunity have to be such as chemo clinics, but even there you are going to have people who need treatment that may be infected. You could make an argument for testing everyone in those places for covid, flu, etc. Even so being killed by an illness rather than the cancer has always been a possibility and it's pretty naive to think otherwise.

People who are having their immune system totally wiped should really not be in any general part of the hospital, which is by it's very nature full of sick people. But testing everyone who comes into hospital for covid is going to be like testing them all for cold, yes it's potentially more serious but the logistical problem is at the same scale and has real harms attached to it.

And as for this "pray" business - do you really imagine everyone thinks they will never get cancer, or has not had loved ones who have had cancer? We all understand that if we get ill and go to hospital we could be infected, but that is one possibility for our deaths among thousands, and they all need consideration.

Figure of speech.

I know only too well that between a third and a half of us will.

I just wanted to get people to think, really imaginatively think what it would be like to be a cancer patient in a hospital with no covid control.

Because it's not irrelevant - not least as cancer patients need to use the services other than oncology and haematology units. You can box and cox and reschedule around the peak weeks in the winter virus season, but not the ongoing weeks/months with high levels (even with the massive reduction in testing, it's still nearly 450 per 100k).

Covid has spread like mad through hospitals anyway.

@HollysBush

I can’t see the whole article but I’m assuming they mean they are starting to treat Covid like flu. For example, If someone comes into A&E with symptoms of Covid, they will isolate, test, then go to red ward if confirmed positive. If someone comes in with symptoms of bowel obstruction they won’t test and send them to a surgical ward. At the moment we have so many bed shortages because we’re testing everyone, if someone pops up as positive (no matter how asymptomatic) we send them to red isolation and the whole rest of the bay need to be isolated. Any empty beds in that bay then can’t be filled until all those patients have been discharged, or get the all clear after at least a week. We were tying ourselves up in knots yesterday trying to find beds for people stuck in A&E.

This is exactly how it is in the hospital in which I work. We do have 2 green wards for elective surgery where patients are screened and isolate pre admission but every other ward takes covid patients into side rooms. If cases are picked up on routine 5 day swabs we have to chase our tails trying to isolate and close beds. There's always a ward closed with lost beds due to an outbreak and all sorts of jiggery pokery goes on trying to use them for contacts or covid recovered patients. Almost but not quite all the patients are asymptomatic or mildly symptomatic with very few even requiring oxygen.

@FairyCakeWings

I can see what you’re saying but my point is that patients have always had some risk of infection from going into hospital. Usually, the risk of that is outweighed by the need for treatment for something else.

I think most people stuck on waiting lists now for treatment they should have received months ago are probably willing to accept the risk of covid considering it’s everywhere anyway.

Speak for yourself. Covid while in hospital having surgery is much more dangerous than covid outside of hospital caught in normal life.

Some people are certainly going to be desperate enough to accept that their planned treatment is likely to be much more dangerous than it would have been before, and still want it, but that doesn't mean it's all OK, nothing to see here.

@nether

Figure of speech.

I know only too well that between a third and a half of us will.

I just wanted to get people to think, really imaginatively think what it would be like to be a cancer patient in a hospital with no covid control.

Because it's not irrelevant - not least as cancer patients need to use the services other than oncology and haematology units. You can box and cox and reschedule around the peak weeks in the winter virus season, but not the ongoing weeks/months with high levels (even with the massive reduction in testing, it's still nearly 450 per 100k).

I don't really see the alternative. Covid controls in hospitals aren't really working. And they are causing other problems. People need treatment for all kinds of things, and covid is at large in the population and is not especially amenable to controls.

What might be effective is to put really significant controls in small areas where it is especially important.