Overcrowded hospitals are suspending routine Covid tests for new patients as “brutal” pressure on doctors and nurses increases, according to The Independent.
On Monday, there were 1,702 new admissions of Covid to hospitals in England as of April 9 – with 16,442 positive patients taking beds – NHS leaders warn that their ability to cope with delays in planned care is at stake.
Despite requests from NHS leaders to reinstate measures such as wearing masks, ministers said there were no plans to change the guidelines.
The Independent understands that at least two major hospitals, in Newcastle and York, have stopped testing all asymptomatic patients to relieve pressure on their beds, raising concerns that Covid could spread to untested wards. Other hospitals are also likely to do the same as bed pressure worsens.
Sources told The Independent that some trusts have started throwing only “red” wards for Covid, while some are considering not splitting patients at A&E.
Emergency pressure on NHS hospitals has worsened in recent weeks, with regions announcing critical incidents due to lack of beds and the “perfect storm” caused by Covid’s admission, combined with staff absences.
Health leaders have called on the government to introduce new measures, such as wearing masks and restrictions on indoor mixing, to help the NHS protect itself from “brutal” pressure.
One expert, critical care physician Tom Lawton, who analyzes data on hospital-acquired infections, said that stopping testing of patients in hospitals was “alarming” and that the NHS would set “flashers” just as nosocomial infections are so as tall as they once were. ”
However, several hospital managers said the lack of beds to treat patients was a greater risk. Glen Burley, head of the NHS, warned that controlling nosocomial infections “creates more safety issues than benefits.”
Last week, The Independent found that patients waiting more than 12 hours to arrive at A&E reached an average of 1,721 a day, while ambulances took four hours to reach patients with stroke and suspected heart attack.
On Monday, the NHS Confederation, which represents hospitals in England, accused the government of abandoning all interest in Covid and “washing its hands of responsibility”.
Asked if there could be a return to Covid’s restrictions, a spokesman for No. 10 said there was no change in the current guidelines, but that he would monitor the behavior of the virus with a survey by the National Statistics Office.
Covid’s case is on the rise in the UK after restrictions were lifted
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Dr Lawton said the decision to stop testing was “alarming” and that placing “turn signals” was not a justified answer.
He explained: “We don’t know exactly how dangerous Covid is, but people are dying with it, and we know from studies like CovidSurg that Covid adds a risk to surgical patients in the form of clots and heart attacks.
“If we don’t have the resources to control infections properly, we should at least do what we can, such as keeping Covid and non-Covid patients as far away from each other as possible. Stopping the tests means there is nothing we can do to reduce the risk. “
He said the risks of acquiring Covid Hospital were “as high as they once were”. In the 28 days to 3 April, there were 11,936 probable or definite cases in England, representing a total of 23 per cent of hospital cases.
However, Dr. Chris Green, an associate professor of clinical disease and infectious disease consultant, warned that “it will not be easy to fix this.”
He said that a positive test does not determine when someone is infected, so the safest course of action is to isolate all patients who test positive, but this puts a “huge additional burden” on hospital resources when they are already limited.
“We really need patients under the right specialists at the right time, and anything that disrupts the hospital’s effectiveness risks increasing the indirect burden or impact of Covid,” he said.
“There will always be a difficult balance: protecting patients from hospital-acquired infections, while at the same time making our resources as far away as possible for the many people in desperate need [treatment]”
Side-flow tests are no longer freely available, raising concerns about the UK’s ability to maintain the virus.
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Internal guidelines for controlling infections in Newcastle hospitals, seen by The Independent, show that trust no longer tests patients who have no symptoms on admission.
Patients who need to be discharged to a nursing home will be tested within 48 hours before leaving.
An NHS source in Newcastle explained: “We have encountered huge problems with random cases in routine testing of patients, [which] began to close a large number of beds, so it was decided to simply test symptomatic emergencies and eligible.
“It simply came to our notice then. This is a real challenge to which there are no good answers based on evidence. This seems like the right thing to do, but we wouldn’t do it if we had residual resilience in either the beds or the staff.
“Casual patients with Covid are less contagious, so the logic is that the lack of information about them keeps the beds open and the overall risk for everyone is lower. “You can’t cure anything if you don’t have beds,” they said.
Newcastle staff’s internal guidelines also say that staff who care for patients in the “standard” way do not need to wear personal protective equipment for aerosol-generating procedures.
Hospitals in York also went to the same measures, and both trusts refused Covid tests for patients on the third, fifth and seventh days of admission.
A senior leader in the Northeast has suggested that Yorkshire’s move to drop patient testing is “unsafe” as hundreds of Covid patients are in bed.
According to an analysis by Dr. Lawton, the York and Scarborough Teaching Hospitals Foundation Trust has one of the worst levels of nosocomial infections with Covid.
The official NHS guidelines, published on April 5, say that all symptomatic and asymptomatic patients requiring urgent or unplanned admission should be offered a PCR test. This can be a quick PCR test.
He added that side-flow devices could be used in emergency departments as a means of early detection.
Saffron Cordery, deputy chief executive of NHS Providers, told The Independent: “NHS trusts across England are still under tremendous pressure as the number of people with Covid in hospital continues to rise.
“The National Health Service still needs appropriate infection control measures to separate patients with Covid and non-Covid [and] to do everything possible to reduce the levels of nosocomial infections.
“Reducing infection control procedures can significantly help trusts cope with growing pressures, as they address existing care delays amid growing demands, but given the continuing risk of Covid-19 and the need to protect patients, staff and visitors, trusts must strike a careful balance. “
The Yorkshire and Scarborough Teaching Hospitals Trust said it had approved a risk-based approach to the Covid Trust’s guidelines, along with the NHS England and NHS Improvement Regional Infection Prevention Team. This is in response to the current critical situation and will be reviewed regularly and de-escalated if necessary. “
A spokesman for the Newcastle upon Tyne Foundation said: “Keeping our patients and staff safe is our first priority. All changes in patient pathways and Covid tests take into account national guidelines and our own extensive internal risk assessments. ”
“Our IPC guidelines are reviewed regularly and changes are made when necessary. We have a low level of nosocomial infection throughout the pandemic, “they added.
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