Covid Scotland: One in ten first wave patients caught infection in hospital

More than one in ten Covid patients during the first wave caught the infection in hospital, a new study has revealed.

The ground-breaking research, led by Lancaster University in collaboration with scientists from Edinburgh University, examined the records of more than 70,000 patients at 314 hospitals across the UK.

It found that at least 11.3 per cent of cases among hospital patients during the first wave caught the infection in hospital, possibly rising to as high as 19.6 per cent by the middle of May.

The figures were likely to be an underestimate, researchers said, as they do not include patients who may have been discharged before they could be diagnosed.

Picture: Getty Images.

"There will be tragedies behind this story,” said Professor Calum Semple of Liverpool University, co-lead of the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) team behind the research.

"We do know of people that came into hospital for one problem, caught Covid and sadly died. One cannot minimise the tragedies that occurred.”

Prof Semple said the “good news story” of the findings, published as a research letter in the Lancet medical journal, is that scientists and healthcare staff were working to gather information and help hospitals reduce infections in future.

Information about hospital acquired infections was made available to governments “right from the start”, he said.

"I don't think there was a huge blind spot from policy or government here,” he said.

"It's just very difficult when you're dealing with the new virus and you don't have all the knowledge about the mode of transmission – we now accept there is an airborne component.

"And we don't know enough about the incubation period. We also never understood that this virus, unusually, is very infectious in the pre-symptomatic phase … that hadn’t been appreciated.

"So there are people who would have gone into hospital potentially with a broken leg and minimal symptoms [of Covid] could have brought it in, staff could have brought it in. There were a lot of opportunities for nosocomial [hospital-acquired] infection to occur.”

The proportion of infections caught in hospital has significantly reduced, researchers said.

While formal studies have yet to be done, the current rate of hospital acquired infections is estimated at around three to 5 per cent.

Dr Annemarie Docherty, Wellcome Clinical Research career development fellow and an honorary consultant in critical care at Edinburgh University, said the findings should not put people off going to hospital when needed.

“We're talking about the first wave, when nosocomial infection was really high,” she said.

"I think that does need to be investigated and it will be investigated.

"But one of the key messages is not say that that is the situation now.

"Actually … hospital-acquired rates are really low at the moment.

"We've got really good procedures for how to screen people when they come in, how to put them in the right places, so that they are not exposed to Covid, how to minimise transmission.

"So if people are sick for a different reason, and they need to come to hospital, then they absolutely should.”

People must learn to live with Covid, Dr Docherty said, alongside treating other diseases.

One of the reasons that “important lessons” must be learned from the findings, the researchers said, is that Covid is likely to remain as a seasonal virus for some time to come.

The team recorded levels of hospital-acquired infection for 314 different hospitals in the UK.

Information broken down by individuals has been shared with the NHS for learning and improvement purposes.

But this information will not be shared publicly, to avoid placing blame on any individual sites.

Figures were also not broken down across nations.

The team did record significant variation between hospitals, which they said required “urgent investigation".

There was also variation across the type of hospital, which was less surprising, researchers said, as patients may live permanently in some settings or spend significantly more time there.

Those providing general and acute care had a 9.7 per cent rate of hospital acquired infection, while this rose to 62 per cent in residential community care hospitals and 68 per cent in mental health hospitals.

There was “no clear relationship” between nosocomial infections and how busy the hospital was, the team added.

Prof Semple said: “The reasons for the variation between settings that provide the same type of care requires urgent investigation to identify and promote best infection control practice.

"Research has now been commissioned to find out what was done well and what lessons need to be learned to improve patient safety.”

The Scottish Government was contacted for comment.

Figures surrounding the spread of Covid infection in hospitals during the first wave were released as the UK is set to face its sternest test since lockdown restrictions were eased this weekend as up to 1.7 million people travel to attend football matches, festivals, music gigs and the theatre.

With the return of England’s Premier League, there will be almost 400,000 football fans attending games, and many more cheering on their team in pubs and clubs up and down the county.

Along with cup and league matches in Scotland and Wales, England’s test match against India at Lords, and tens of thousands attending music festivals and the Edinburgh Fringe, experts are warning the strategy of the governments across the four UK nations will result in an increase in Covid infections, hospitalisations and deaths.

The UK Government said a further 94 people had died within 28 days of testing positive for Covid-19 as of Thursday, bringing the UK total to 130,701.

Separate figures published by the Office for National Statistics show there have been 155,000 deaths registered in the UK where Covid-19 was mentioned on the death certificate.

As of 9am on Thursday, there had been a further 33,074 lab-confirmed Covid-19 cases in the UK.

There have been 8,782 cases detected over the past seven days in Scotland, with 1,525 cases confirmed on Thursday.

A message from the Editor:

Thank you for reading this article. We're more reliant on your support than ever as the shift in consumer habits brought about by coronavirus impacts our advertisers.

If you haven't already, please consider supporting our trusted, fact-checked journalism by taking out a digital subscription.