Tameside hospital fights fatal outbreak of hospital-acquired Covid


A small district hospital where more than a third of all coronavirus deaths among inpatients in England occurred last week is battling a fatal outbreak of hospital-acquired Covid-19, the Guardian can reveal.

The NHS has launched an inquiry after an unknown number of patients died of Covid-19 after becoming infected when they were in hospital being treated for another illness.

The deaths occurred in the week up to 10 September at Tameside general hospital in Greater Manchester, which experienced a sudden and unexplained rise in Covid fatalities that increased its death toll to 18, up from six a week earlier.

The 18 patients who died equated to more than a third of the total 52 coronavirus deaths in all of England’s hospitals, the most recent NHS data released on Tuesday shows. A further two people died of Covid at Tameside hospital over the weekend.

The incident is thought to be one of the first times the NHS has confirmed that an outbreak of hospital-acquired Covid has cost lives. Last week Weston general hospital in Somerset issued an apology after an investigation found that Covid-19 may have contributed to the deaths of 18 people who contracted the infection during their treatment there.

An outbreak is defined by Public Health England (pdf) as two or more linked cases or deaths, or a situation where there is a greater than expected rate of infection.

It will raise serious concerns about infection control procedures and testing as hospitals brace themselves for an increase in admissions.

The number of confirmed coronavirus cases in England rose again on Tuesday to 3,105, up from 2,621 on Monday.

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It is unclear how many of the 18 Tameside patients died after catching Covid-19 following their admission for treatment for a different medical condition.

However, well-placed NHS sources confirmed that some of them were the result of what is known as nosocomial infection – transmission within a hospital. All 18 are thought to have been elderly and to have had one or more underlying illnesses.

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Public Health England and Tameside hospital are now examining the medical history of each of the 18 fatalities to identify how many had Covid when they arrived and how many got it after being admitted.

An official with knowledge of the inquiry said: “The deaths fall into three categories: community transmission, probable hospital-acquired infection and actual hospital-acquired infection. There are a few of each so far. We know that some were related to the outbreak of hospital-acquired Covid.”

“I’m really concerned to hear about so many deaths happening in Tameside hospital,” said Dr Kailash Chand, the chair of Tameside Healthwatch, a local patient watchdog, who was a GP in the area for 20 years.

“I’m also concerned to hear of this outbreak at Tameside of hospital-acquired Covid, which is well-known to pose a significant risk to hospitals and their patients. There needs to be an investigation and we need to learn the lessons if something has gone wrong here.”

Hospital sources said that “the majority” of the 18 people had Covid before they came in and that the number of deaths linked to the nosocomial outbreak was “low”. They stressed that the patients involved were already in poor health before they became infected.

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Cases

Some of the 18 fatalities were found upon arrival to have Covid but not have any symptoms, a hospital source said. “We test all patients who are being admitted. Some of them came back as positive [after they were tested] even though they were asymptomatic.”

The spread of Covid poses a recognised risk to patients who are on wards or receiving critical care, including a risk of death. It can involve someone becoming infected because of transmission from a healthcare worker or fellow patient and it can be linked to inadequate infection control procedures in hospitals.

As many as a fifth of inpatients with Covid-19 may have become infected that way, according to recent research undertaken by Public Health England (PHE).

In May Boris Johnson told Conservative MP Laurence Robertson, whose father Jim had just died of hospital-acquired Covid, that the problem was one of “twin epidemics”, alongside deaths in care homes, that needed urgent action

Tameside has had an unusually high number of deaths recently. Analysis by the Guardian shows that it has accounted for nearly one in four of England’s hospital coronavirus deaths in the three weeks to 10 September: 32 out of a total of 134. The hospital’s worst day came last Monday, 7 September, when it recorded five Covid-related deaths, out of a total of nine across all hospitals in England.

In a statement Tameside and Glossop Integrated Care NHS trust, which runs the hospital, said: “We are working with Public Health England and other partners to fully understand the recent number of deaths. But we know that our local population is older, with many pre-existing health conditions, and that Covid-19 prevalence is higher in our local area.

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“We continue to prioritise infection prevention in our hospital and patients should continue to attend their appointments wearing a face covering, maintain social distancing and regularly wash their hands.”

Following the deaths officials from NHS England visited the hospital last week to assess its infection control procedures, which include testing of all admitted patients and staff wearing the right personal protective equipment for the risk posed by the area they work in. They were satisfied that hygiene practices were robust enough, a hospital source said, adding: “There were no issues.”

Tameside is one of the 10 boroughs that make up Greater Manchester, which is one of the areas in the UK still under local Covid-related restrictions, which vary between the boroughs. Tameside has the fourth highest rate of infections in England. It currently has 98 cases per 100,000 people, almost four times higher than the England-wide average of 26.



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