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Risk of catching Covid-19 in an NHS hospital is very low, study finds

Patients and their families are currently unlikely to catch Covid-19 from staff in hospitals, new research indicates.

The initial findings, published in The Lancet, show that current rates of asymptomatic COVID-19 infection among health workers is very low at around 1%.

Asymptomatic infection means the person has the infection and can potentially pass it on but shows no symptoms, like a cough or fever.

Professor James Moon, Chief Investigator of the COVIDsortium study, said patients and relatives should be reassured that the risk of catching the COVID-19 disease from NHS staff in hospitals is low at the current time.

These findings are significant because attendances to hospital of patients with other life-threatening conditions – such as cancer, heart attacks and strokes – have plummeted during the pandemic.

A&E attendances have fallen by more than half during ‘lock down’ amid concern that those with serious but treatable illnesses are staying away from fear over catching COVID-19.

This means patients only seek medical help late, resulting in delays to diagnosis and treatment, with worse outcomes and even deaths from treatable conditions.

With all NHS staff who show Covid-19 symptoms immediately self-isolating at home, this is the first research to show how much asymptomatic infection exists in staff working in hospitals, and how this relates to community infection rates.

The study recruited 400 healthcare workers who each provided weekly blood samples and nasal swabs from the start of ‘lock down’ on 23rd March. 

Results showed that rates of asymptomatic infection fell more than 6-fold from over 7.1% to just 1.1% last week.

Furthermore, these initial findings also suggest that the current risk to hospital staff of catching COVID-19 from patients is low.

Healthcare worker infection rates in London fell in parallel with community COVID numbers over the ensuing four weeks following lock down, despite persistently high numbers of patients in hospital with COVID-19.

Prof Moon said: “The research indicates that in the past two to three weeks despite high numbers of patients in our wards and intensive care units, rates of staff infection have fallen so much that it is very unlikely that staff are being infected by patients”.

The study also holds pointers for the emerging national Covid-19 testing strategy. Testing for prevalent infection is a key part of the exit strategy from lock down, but the role of testing for infection in healthcare workers who have no symptoms remains uncertain.

Prof Noursadeghi, Professor of Infectious Diseases at UCL, and one of the study’s lead investigators, said: “Tracking this epidemic will require ongoing monitoring of infection rates in both symptomatic and asymptomatic people in the general population.

“Our data suggest that routine screening of all health care workers without symptoms may not be necessary whilst infection rates in the general population are falling. If they begin to rise again, regular testing of health care workers irrespective of symptoms should be considered to protect these keyworkers and their patients.”

The COVIDsortium is a research collaboration between Barts Health, University College London and the Queen Mary University London, and is currently building a unique library of blood samples and data from NHS doctors and nurses working during the pandemic in East London.

It started on the day of lockdown, and will collect repeat samples over the next 4 months. The research focusses on NHS staff who have high exposure rates, comprise a diverse population representative group and who can be followed from before exposure throughout the pandemic. 

Unfortunately, studies of patients who attend hospital, do not provide any information on the overwhelming majority (likely over 95%) of people who develop only mild disease or show no symptoms. 

The library – or biorepository – will hold key information on people before, during and after exposure to Covid-19, and will record how the infection affects their health from start to finish.

The study is in the process of taking 200,000 samples from healthcare staff which are being divided up among 25 of the UK’s leading academic and pharmaceutical research institutions for collaborative, swift science on COVID-19.

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