COVID-19 Bulletin: Wednesday 16 September

September 16, 2020

This is our weekly bulletin and will be issued every Wednesday. Please use this bulletin and cascade arrangements within care and corporate groups to guide your actions. We are determined to reduce avoidable harm and death in the people we are taking care of. Kindness remains the guiding principle of all the actions in our work to tackle the virus – kindness in how we look after patients, visitors, and one another.

Numbers not statistics: Today’s totals (last week’s data)

1. Rule of six now in effect nationally

New laws prohibiting social gatherings of more than six people came into effect on Monday 14 September as the Government calls on the public to remain vigilant in the fight against coronavirus.

The new “rule of six” simplifies and strengthens the rules on social gatherings, making them easier to understand and easier for the police to enforce.

It means that – apart from a set of limited exemptions including work and education – any social gatherings of more than six people will be against the law.

Police will be able to disperse any such gatherings and fine individuals involved £100, doubling up to a maximum of £3,200.

Visit the Government website for more information and watch the animation video.

New coronavirus restrictions in Sandwell, Birmingham and Solihull

In addition to the ‘rule of six’, there are further restrictions in Birmingham, Sandwell and Solihull.

Residents in these areas are no longer able to mix with people they don’t live with, in their homes or gardens. Your household is defined as the people you live with and any support bubble.

Households that have formed a support bubble with another single adult household behave as if everyone lives in the same house.

These new restrictions have come into effect for Birmingham, Sandwell, and Solihull to reduce the coronavirus rates of infection which is rising fast. Click here to access a full FAQ and for more information.

2. When and where should I be wearing my face mask?

Following the recent restrictions nationally and regionally as well as a sharp increase in COVID-19 infection rates, we want to remind colleagues when and where they should wear their face masks.

• Non-clinical office buildings – colleagues should maintain social distancing and handwashing. There is no requirement to wear masks, however you may wear your own face covering if you choose. However, where 2m social distancing cannot be maintained consistently, you must wear a face mask.
• Clinical areas including wards, clinic rooms and imaging  – wear PPE as currently advised (Fluid-resistant surgical mask (FRSM), disposable gloves and apron in all clinical areas with visor/FFP3 for close clinical care/AGP).
• If you are attending a meeting or huddle where social distancing cannot be maintained consistently, face masks should be worn.

See our overview here.

3. Support with childcare in the event of school closures

Following the increase in COVID-19 cases and the introduction local restrictions it is recognised that some colleagues will experience a breakdown in their normal childcare arrangements. Childcare arrangements could break down as a result of extended family or friends no longer being able to provide childcare for children, the temporary closure of schools or school bubbles being required to isolate following a suspected COVID -19 case.

Colleagues who cannot attend work (including on-call activity) because of the breakdown of their normal childcare arrangements may have the first day off to make alternative arrangements. This one day of absence will be classed as carer’s leave.

Managers are requested to be flexible to support staff and consider alternative shift patterns/allow colleagues to make up time to enable them to remain at work.

In the event that a colleague is unable to attend work and options to work alternative shift patterns have been exhausted, staff may take parental leave or annual leave/accrued time in lieu.  Consideration will also need to be made if work can be undertaken at home.

Test and Trace Guidance Reminder

1. If staff member’s child is symptomatic of COVID-19 or tests positive (they could be asymptomatic) then the staff member and other household contacts will need to self-isolate for 14 days.
2. If the child is a contact of a suspected or positive COVID-19 person, then the child will need to self-isolate for 14 days, but the parents or close contacts of the child do not need to self-isolate and can attend work.
3. The staff member must remember to adhere to social distancing and PPE whilst at work.

This advice should be followed regardless of the results of any SARS-CoV-2 antibody testing and previous COVID PCR positive result. A positive antibody result signifies previous exposure, but it is currently unknown whether this correlates with immunity, including protection against future infections.

4. Our colleague and family swabbing service is still available

Swabbing for symptomatic colleagues and their household member/s remains available through our drive through at City Hospital and Little Lane car park at Sandwell Hospital, with capacity for 75 swabs on each site per day.

If you have been experiencing symptoms you can book an appointment for a test by calling the community contact centre on 0121507 2664 option 5 Monday – Friday 8am – 6pm weekends call 07816992873. Please do not just turn up!

Note: Family member testing is only open to symptomatic household members. 

Test results will be available after 48 hours when the team will call you to give you individual results and those of your family member as appropriate.

5. Limited accommodation available, part of protecting you and others

Limited hotel rooms are available to support colleagues who may be exposed to COVID-19 from people in their households. The accommodation can be used to support you whilst your family access tests and enable you to be able to stay at work, as we now see an increase in COVID-19 cases.

We have accommodation available at

• Mercure Hotel, West Bromwich and
• Holiday Inn Hotel, Snow Hill, Birmingham

You can access a hotel easily by emailing swbh.hotel-booking@nhs.net.

6. Routine swabbing: A ‘how to’ guide

It is vital that inpatients are not only placed in the right care environment (Red, Lilac, Blue ward) but also that swabbing is carried out appropriately and effectively in each environment.

Remember:

• Every patient MUST be swabbed on admission.
• Patients on Lilac wards MUST be swabbed every 3 days.
• Patients on Blue wards MUST be swabbed every 5 days.

Follow the Trust’s pathway here.

How a swab is collected is also extremely important. The team has produced a quick ‘how to’ video that shows you how to collect and package a PCR swab for Coronavirus.

Click below to watch the short film:

7. New fast test for respiratory viruses including COVID now available

To add to our existing swabbing processes, microbiology has now gone live with multiplex respiratory panel PCR. This is a rapid PCR with a turnaround time (TAT) of 2 hours (testing is done at the City lab therefore the TAT will be 2 hours at time of receipt).

The PCR can test 14 other respiratory viruses (see table below) and atypical pathogens. The current allocation is 20 tests per day:

• ITU – 6 tests per day
• Paediatrics – 6 tests per day
• Haematology – 4 tests per day
• There will be 3 tests per day for patients who develop new or worsening of symptoms in blue/lilac streams. Please use a rapid swab for these patients.
• One test is reserved for a staff member where clinically indicated.

The test should be only be used for clinical reasons and NOT for triage  or discharge purposes.

Routine black dry or red swab can be used for testing.

• The order name is Rapid Respiratory PCR
• The results line in Unity will be called Respiratory PCR including COVID
• We will continue to separately test COVID, Flu and RSV as routine.

Timing of the Rapid service  

• Week days 8am to 8pm (though the lab is open till 10pm, last swab will processed at 8pm)
• Weekends 9am to 3pm (though the lab is open till 5pm , last swab will processed at 3pm)

Approval/authorisation of test

During the week, email the list of patients requiring a test to swb-tr.SWBH-GM-micromedics@nhs.net. At the weekend you can contact the on-call consultant microbiologist for approval.

Note: 16 Cepheid Rapid PCR is still available (current allocation – 10 for red stream pathway, 1 for  patient who develops new or worsening of symptoms patient on blue/lilac streams and 5 for gynaeoncology).

8. Rediroom trial to start this week

We will be trialling our new Rediroom’s this week (from today Wednesday 16 September). The Redirooms are temporary, single-patient isolation rooms designed to assist in isolating infectious patients under contact or droplet precautions. The coverings for the Rediroom are disposable and can be used for up two weeks meaning they can be used in a variety of different settings.

We will be trialling the Redirooms on critical care at Sandwell this week and if successful, the trial will be extended to medicine.

If you wish to find out more about Redirooms, please click here.

9. Saying your prayers safely

New social distancing and infection control measures have been put into place which will ensure the safety of those colleagues who wish to use the chapel and prayer rooms. Jummah (Friday) Prayers (have resumed) will resume this week in the chapels at Sandwell and the Birmingham Treatment Centre, with three time slots 1.15pm, 1.30pm and 1.45pm. Prayer times are staggered so that there are only a maximum number of people using the room at any one time.

At Sandwell 11 people will be allowed in at each time slot, whilst at City, 10 worshippers will be able to use the prayer room during each time slot. Volunteers will hand out face masks, and distribute hand sanitiser and a paper prayer mat to each individual using the facilities. Once the slot has ended, worshippers will be able to dispose of their paper prayer mat. Please note, there may be a wait due to the number of people wishing to use the space.

Christian services will resume shortly and more details about this will follow later this month. The Chapels at both sites remain open for individual worship and both rooms are set out to reflect social distancing measures.

The chaplaincy has continued to provide a service throughout the pandemic and every Sunday they light candles for colleagues and patients. If you would like a candle lit for a loved one who has passed away or is sick, please contact Mary Causer, Lead Chaplain, via email at mary.causer@nhs.net or call her on ext. 3552.

10. Are you looking after you?

Looking after your mental health and wellbeing is paramount to a healthy lifestyle both inside and outside of work and is especially more important during the current pandemic. Be sure to take advantage of the wellbeing services on offer.

Pause and join in with mindful yoga:

A new addition to the wellbeing podcast library this week is a yoga video series “Mindful Yoga with Chris”.

Take time to pause and join in the free online sessions.

There are multiple benefits of yoga both mentally and physically as it may help reduce stress and improve relaxation levels.

For a full list of wellbeing services on offer visit Connect.