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COVID-19 Bulletin: Saturday 14 March

March 14, 2020

The Trust is now publishing a daily bulletin. This will take all guidance and information and tell you which changes we are implementing when and how. Please use this bulletin and daily cascade arrangements within clinical groups to guide local action.  Remember KINDNESS is our watchword in implementing these changes.

1. Confirmation of people who have tested positive

Announced today are people who have tested positive in our area including, sadly, a death at City Hospital on Thursday evening. The patient, in his mid 80s, had a number of underlying health conditions. Thanks go to the colleagues who calmly and thoughtfully cared for the patient and supported his relative. Our thoughts and condolences are with the friends and family at this difficult time. To respect the interests of the patient’s family and to ensure we adhere to strict information governance we all have a responsibility as NHS staff to refrain from posting or commenting on social media or discussing details with friends and family. We are now monitoring social media accounts to actively look for breaches of confidentiality which let down the fantastic work teams across our Trust are doing

2. Visiting arrangements changed from 12noon today

At midday today our visiting arrangements (on all sites) change to protect patients, relatives and staff. There is no visiting apart from immediate next of kin who can remain with children, end of life patients and people who can’t make decisions for themselves (only for people covered in their notes as needing support because of mental capacity act regulations).

We have put digital phones and tablets in place in our ward areas so that patients can telephone or video call their family and friends. We hope this will help them stay in touch and reduce social isolation. PLEASE NOTE THAT THE EQUIPMENT SHOULD BE THOROUGHLY WIPED WITH CLINELL WIPES BETWEEN EACH USE

3. Who should self-isolate?

As you are aware, the guidelines for self-isolation have changed and this applies to staff as well as the public. People are advised to stay at home (self-isolate) without any testing for COVID-19, regardless of travel history or contact with confirmed cases, if they have:

  • A new continuous cough, OR
  • High temperature (of 37.8 degrees centigrade or higher)

Individuals should stay at home (self-isolate) for 7 days from the onset of symptoms following the current advice. If someone has serious symptoms they cannot manage at home they should use NHS 111 online (people should only call NHS111 if they cannot get online).

After 7 days of self-isolation, people who feel better and no longer have a high temperature can return to their normal routine. This includes back to work in a healthcare setting. If they have not had any signs of improvement after 7 days and have not already sought medical advice, they should use NHS111 online (people should only call NHS111 if they cannot get online) before they leave their home or let visitors in.  The cough may persist for several weeks in some people, despite the coronavirus infection having cleared. A persistent cough alone does not mean someone must continue to stay at home for more than 7 days.

Staff who have been in contact with a confirmed COVID-19 case are able to carry on working if they are asymptomatic. They should self-isolate for 7 days if they have symptoms.

4. Should my patient be tested for coronavirus?

In line with national guidelines there will be no further testing in the community. Testing is now only for inpatients regardless of travel history if they present with

  • Either clinical or radiological evidence of pneumonia
  • Acute respiratory distress syndrome
  • influenza like illness (fever ≥37.8°C and at least one of the following respiratory symptoms, which must be of acute onset: persistent cough (with or without sputum), hoarseness, nasal discharge or congestion, shortness of breath, sore throat, wheezing, sneezing)

Clinicians should be alert to the possibility of atypical presentations in patients who are immunocompromised.

5. I don’t know how to test my patient for coronavirus.

The Specimen Collection Advice gives you all the information you need for taking swabs including what Personal Protective Equipment (PPE) to put on and what to do with the specimen. Remember that it is only certain patients (see point above) that need testing.