Weekly Covid tests for NHS staff in specialist cancer units
By Bill Heaney
The cheering had hardly died down after the SNP government caved in to public and political pressure and did a U-turn on the re-opening of schools on a full-time basis August 11.
Cabinet Secretary for Health and Sport, Jeane Freeman, found herself being quizzed on the re-opening of hospital wards to deal with the long list of patients whose surgery was cancelled to allow medics from all disciplines to concentrate on dealing with Covid-19.
Ms Freeman told MSPs: “As we re-mobilise our NHS, the chief nursing officer’s expert group on nosocomial transmission has made three important sets of recommendations. First, in addition to testing all staff connected to a suspected nosocomial outbreak, we will now test on a weekly basis staff working in specialist cancer units, in long-term care of the elderly and in long-stay mental health wards. Boards will be asked to start that additional testing from 8 July.
“Secondly, in hospitals and care homes for adults, face masks will now be worn by staff who have contact with patients or residents—that is, all staff who have contact with patients or residents—and out-patients, day-case attendances and visitors will be asked to wear a face covering.
“That new measure is designed to reduce the risk of transmission from the person who is wearing the mask or face covering. Guidance on that for health boards and employers will issue this week and will be effective from 29 June.
“Thirdly, enhanced cleaning and maintenance regimes will be implemented in areas of high patient volume and in areas in which surfaces are frequently touched. Again, that will be implemented from this week, and across our health boards from 29 June.
MEPs Monica Lennon, Miles Briggs, Alex Cole Hamilton, Alison Johnstone and Cabinet Secretary Jeane Freeman were involved in the debate.
Alison Johnstone, the Green party co-leader, asked: “Given that we know that those carrying Covid-19 can be asymptomatic while contagious, at what point does the Scottish Government intend to widen testing to all staff working in our NHS facilities such as hospitals?”
Ms Freeman replied: “The recommendation is to introduce it in the areas in which they[experts] believe that the risk of nosocomial infection is higher and in areas in which there are particularly vulnerable groups or cohorts of patients, such as specialist cancer units
“However, the group also recommends that we continuously review that; so it may be that, in time, its advice will change and it will recommend widening the testing to other cohorts of our NHS staff. At this point, however, the group’s expert and clinical advice is to focus it in the way that I have described.”
Labour’s Monica Lennon asked what measures will in future be used to screen patients for Covid-19 prior to and on admission?
Jeane Freeman said: “The polymerase chain reaction test will be used. Health boards are working out how far in advance of the admission date for, for example, elective surgery people will be asked to self-isolate, as well as the detail of how to get the test to the individual, and at what point, in advance of their planned elective procedure.”
She added: “Test and protect was successfully rolled out across health boards in Scotland on 28 May this year. Between 28 May and 14 June, that being the latest date for which data has been published, 992 cases were recorded, from which 1,239 contacts have been traced.
“We are on track to provide an initial public-facing digital tool by the end of June, as we intended. We will then take a decision on how quickly we will roll it out across the system, taking into account how our test and protect service has developed, international evidence that might be available and the volume of cases that are being experienced.
LibDem Alex Cole-Hamilton asked: “If the cabinet secretary is confident that the tracing process is rigorous, but it is still turning up just one contact for each new case, is she equally confident that the current definition of “contact” is catching everybody that it needs to catch?
“We know how important test and protect is to beating the virus, because we know how infectious the virus is. We also know the multitude of ways in which the virus can be passed on, including via hard surfaces. Has there been an update to the science that suggests that 15 minutes at 2m is the right threshold for contact tracing? If a patient identifies that they have visited a public space before testing positive, what deep cleaning protocols are then followed?”
However, Jeane Freeman said: “There has been no update to the science that would change the definition of ‘contact’. However, the chief medical officer’s expert advisory group and our advisers elsewhere, not least those in Health Protection Scotland, continually monitor whether there should be an update at any point.
“Based on their expert advice, I am confident at this stage that the process is proceeding and that test and protect is a system that is operating well across the whole of Scotland.
The concern that might exist about the difference between the number of contacts reported in England and the number reported in Scotland is explicable in the way that I have set out. As we see our data merge, we will get proper comparison of what is happening in Scotland and England.
Tory Miles Briggs told MSPs: “As of last night, over 452,000 tests that had been made available through the combined United Kingdom and Scottish Government facilities had not been utilised. The cabinet secretary made a pledge to test every member of staff in care homes across Scotland. Is it now the case that all staff working in care homes where there have been no Covid-19 cases are being routinely tested?
Health Secretary Jeane Freeman replied: “Yes, that is the case, and it should be clear when we publish the data tomorrow. As Mr Briggs will know, I issued what can only be described as an instruction to all health boards that the national policy is not open to local interpretation. We therefore now receive weekly their plans for that testing.
“The care home portal, through which the bulk of the testing is accessed, has increased the numbers available to us, which is a significant help. The last figure that I had, which might have increased since, is that 700 of our 1,083 care homes had registered for the portal and would be receiving test kits and returning them as appropriate. The testing of care home workers not only in care homes in which there are no active cases, but across the care home sector, is therefore well under way, and the figures in that regard will be published tomorrow.”