Overwhelmed hospitals halt routine Covid testing for new patients as “brutal” pressure mounts on doctors and nurses, The Independent understands.
On Monday there were 1,702 new Covid admissions to hospitals in England – with 16,442 positive patients occupying beds – NHS leaders warn their ability to manage the backlog of planned care is at risk.
Despite pleas from NHS bosses to reinstate measures like mask-wearing, ministers said there were no plans to change the guidance.
The Independent understands that at least two major hospitals in Newcastle and York have halted testing of all asymptomatic patients to ease the pressure on beds – raising fears Covid could be spreading through wards unchecked. Sources say other hospitals are likely to do the same if bed pressure worsens.
Sources have told The Independent some trusts have started dropping ‘red’ Covid wards while some are considering not segregating patients in A&E.
Emergency pressures on NHS hospitals have progressively worsened in recent weeks, with regions reporting critical incidents due to bed shortages and the ‘perfect storm’ of Covid admissions combined with staff absenteeism.
Healthcare leaders have called on the Government to introduce new measures such as mask-wearing and restrictions on indoor mixing to protect the NHS from “brutal” pressure.
One expert, critical care physician Tom Lawton, who analyzes hospital-acquired infection data, said stopping patient testing in hospitals was “concerning” and that the NHS would put on “blinkers” just as hospital infections were “as high as they are”. . I’ve been before.”
However, several hospital leaders have said not having beds to treat patients is the greater risk. Glen Burley, an NHS chief on hospital infection controls warned, is creating “more safety issues than benefits”.
Last week, The Independent revealed that patients who waited more than 12 hours after arriving at the emergency room reached an average of 1,721 a day, while it took ambulances four hours to reach patients with stroke and suspected heart attack.
The NHS Confederation, which represents hospitals in England, on Monday accused the government of abandoning all interest in Covid and “washing its hands of responsibility”.
Asked if there might be a return of Covid restrictions, a No10 spokesman said there was no change to the current guidance but he would monitor the behavior of the virus with the Office for National Statistics survey.
Covid cases have increased in the UK since restrictions were lifted
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dr Lawton said the decision to stop testing was “concerning” and that putting “turn signals” 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 died from it and we know from studies like CovidSurg that Covid poses an additional risk to surgical patients in the form of blood clots and heart attacks.
“If we don’t have the resources to do infection control properly, we should at least do what we can, e.g. B. Keeping Covid and non-Covid patients as far apart as possible. Stopping testing means there is nothing we can do to reduce risk.”
He pointed out that the risks of hospital-acquired Covid were “higher than ever”. In the 28 days to April 3 there were 11,936 probable or certain cases in England, totaling 23 per cent of hospitalized cases.
dr However, Chris Green, associate clinical professor and consultant infectious disease physician, warned that “it’s not going to be easy to get this right.”
He said a positive test does not define when someone is contagious and so it is safest to isolate all patients who test positive, but this places a “huge additional strain” on hospital resources when they are already limited.
“We really need patients at the right time under the right specialists and anything that disrupts the efficiency of the hospital can add to the indirect burden or impact of Covid,” he said.
“It’s always going to be a difficult balance: protecting patients from hospital-acquired infections while also devoting our resources as much as possible to the many people who desperately need it [treatment].”
Lateral flow tests are no longer freely available, raising concerns about the UK’s ability to contain the virus
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Internal infection control guidance at Newcastle hospitals, viewed by The Independent, shows the Trust is no longer testing patients who are asymptomatic on admission.
Patients who have to be discharged to a nursing home will be tested within 48 hours of discharge – previously, pre-discharge testing would have been required.
An NHS source in Newcastle explained: “We have had major problems with random cases in routine testing of inpatients. [which] started closing a large number of beds, so it was decided to test only symptomatic emergencies and electives.”
“Things are really a mess at the moment. It’s a real challenge with no good, evidence-based answers. That seems like the right thing to do, but we wouldn’t do it if we weren’t in beds, or staffing, or resilience.
“The accidental Covid patients are less contagious and so the logic follows that not knowing about them keeps the beds open and the overall risk is lower for everyone. You can’t treat anything if you don’t have beds,” they said.
Internal staff policy for Newcastle also states that staff caring for patients in a ‘standard’ way are not required to wear personal protective equipment for aerosol-generating procedures.
York hospitals have also moved to the same measures and both trusts have halted Covid testing for patients on days three, five and seven of their admissions.
A senior leader in the North East suggested Yorkshire’s move to end patient testing was “unsafe” with hundreds of Covid patients lying in beds.
According to an analysis by Dr. Lawton has one of the worst rates of hospital-acquired Covid infection, according to the York and Scarborough Teaching Hospitals Foundation Trust.
Official NHS guidance, published on April 5, says a PCR test should be offered to all symptomatic and asymptomatic patients who require emergency or unplanned admission. This could be a rapid PCR test.
It added that lateral flow devices could be used in emergency rooms as a means of early detection.
Saffron Cordery, deputy chief executive of NHS Providers, said in a statement to The Independent: “NHS trusts across England are still under tremendous strain as the number of people hospitalized with Covid continues to rise.
“The NHS still needs proper infection control measures to separate Covid and non-Covid patients [and] do everything possible to keep the number of hospital-acquired infections low.
“Reducing infection control procedures can significantly help foundations deal with the growing pressure as they manage existing supply backlogs on top of growing demands but need to amid the ongoing risk from Covid-19 and the need to protect patients, staff and visitors Foundations strike a careful balance.”
The Yorkshire Teaching Hospitals Trust said it had “advocated a risk-based approach for the Trust’s ‘Living with Covid’ guidance, in collaboration with NHS England’s regional infection prevention team and NHS Improvement. This reflects the current critical situation and will be reviewed regularly and de-escalated if necessary.”
A spokesman for the Newcastle upon Tyne Foundation Trust said: “The safety of our patients and staff is our top priority. Any changes to patient pathways and Covid testing take into account national guidance and our own comprehensive internal risk assessments.”