Tracking hospital patients with Covid-19 remains 'very difficult', health secretary admits

Establishing whether patients being admitted to hospitals across Scotland are free from Covid-19 remains “very difficult,” Scotland’s health secretary has admitted.

Jeane Freeman said that even if new hospital patients tested negative for Covid-19, it did not mean that they were not incubating the virus.

Jeane Freeman said that even if new admissions tested negative for the virus, they could still be incubating it.

She said that the Scottish Government could not yet tell how many people have contracted the virus in hospital settings, but stressed it was working with its partners to secure the data.

Speaking at topical questions in Holyrood, Ms Freeman said that the prolonged incubation period of Covid-19, which can last for up to 14 days, meant that “it is not possible to be certain exactly how many people have contracted the disease after admission to hospital.”

She said: “The Scottish Government is working with UK counterparts and the European Centre for Disease Prevention and Control to establish international definitions for hospital acquired Covid-19 infections.

“We will reach those definitions and publish information about the data collected in NHS boards against those definitions in the coming weeks.”

Monica Lennon, Scottish Labour’s health spokeswoman, said it was vital that “robust and reliable” data was in the public domain, and pointed to an outbreak of Covid-19 in Gartnavel Hospital in Glasgow, highlighting the death of David Holgate, a 91-year-od who tested negative for the virus on admission, only to die of it last month.

Ms Freeman expressed her condolences to those families who had lost loved ones, but stressed that it was “very difficult to know” if new patients risked spreading the virus to others.

“They test negative at the point when they are tested, that does not mean that they are not incubating Covid-19,” she explained. “The 14 day incubation period does make it difficult to be absolutely certain in these matters.

“[Health] boards and hospitals should have very clear infection prevention and control procedures, and Ms Lennon is absolutely right, this is a very serious matter, and we need to understand as best we can what more it is we need to do in hospital settings to minimise the transmission of Covid-19.”

Ms Lennon pointed out that given hundreds of patients, including those who were untested, were discharged into care homes, and asked what steps were being taken to trace those who were in hospitals where outbreaks occurred.

Ms Freeman said Public Health Scotland was working to bring together testing and discharge datasets, and said that once the comparable data was deemed to be robust, it would be published on an ongoing basis.

Alison Johnstone, the Scottish Green MSP, said that determining who was contagious in hospital settings would help minimise transmission of the virus, and asked when the Scottish Government would introduce routine testing for NHS staff.

Ms Freeman replied: “That is currently being considered by the chief medical officer’s advisory body on what they would see as the risk versus benefit in undertaking that.

“That’s because there is a continuing debate around the value of testing individuals who do not have symptoms. At the early part of this pandemic, the advice was that there was no value to testing in those circumstances.

“That has changed. There is now a lively debate that argues that there is some value, albeit that the test is not as reliable in its results as it is in terms of symptomatic people. It is reliable to a degree.

She added: “What it tells you, though, is whether the individual has the virus on the day of the test, so in order to ensure that you use it for the purposes of prevention and precaution, then it is a test you have to keep repeating every seven days.

“So we await that advice and view, at which point we will take a decision as to whether we intend to do that for particular groups or not”

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