First Minister: outbreak at Maelor “making progress” – Rowan Foods outbreak “is in any practical sense over” – community response “effectively stood down”

The First Minister has said the coronavirus issue at the Maelor Hospital is ‘making progress’ with ‘numbers heading in the right direction’, along with positive updates on two other areas of local concern.

As well as being in the midst of a global pandemic response, Wrexham has been in the unwelcome position of having three areas of coronavirus concern.

An issue connected to a local food factory was formally declared an outbreak on the 23rd of June (with staff walking out in protest at the start of April). Wrexham Maelor Hospital also has an ‘Outbreak Control Team’ at work, with additional concerns of wider community transmission meaning pop up mobile testing facilities appearing at the end of July in parts of the town testing over 1,400 people in a few days.

With an outbreak in Llangefni officially downgraded and declared ‘over’, we asked First Minister Mark Drakeford about the local trio of issues and if they are expected to be downgraded in a similar manner.

The First Minister said it is his understand that of the three areas “the Rowan Foods outbreak is in any practical sense over”

He noted a single linked case since the 25th of July and that ‘the outbreak was effectively dealt with’.

He added: “With the community level, we had those 1400 people come forward for testing in Caia Park and Hightown, the numbers there demonstrated that fortunately the virus hadn’t got into community circulation.

“So that part of it is as I understand it, effectively stood down.

“It’s is the Maelor Hospital that continues to be the focus of the Outbreak Control Team and it continues to meet very regularly.

“There hasn’t been a new healthcare acquired infection at the Maelor for the last five days.

“The number of patients in the hospital with coronavirus is down, and most of those patients who are at the Maelor Hospital who have coronavirus have been there now for more than 15 days.

“Last week I said I thought the position was stable, I think we can say this week that it is stable and making progress. It is not just stable, as actually the numbers are heading in the right direction.”

Latest update from Health Board: “As of this morning there are 30 confirmed COVID-19 cases at Wrexham Maelor Hospital, most of these patients have now been cared for more than 15 days at the hospital and are recovering.” No new confirmed cases in last 7 days there.

— Wrexham.com (@wrexham) August 15, 2020

On Tuesday we asked Minister Julie James about local issues as part of an ongoing quest to get more local data, and in her reply she referred to a “lessons learned exercise” that has taken place at the hospital. We asked the First Minister if he had sight of any such documents, and if so, what was the contents.

The First Minister replied: No, I haven’t myself had sight of that document.

“I am very keen, as is the hospital itself, that there is a lessons learned exercise.

“Obviously in every case of a death in the hospital there is its own investigative process to make sure that an accurate story can be provided particularly to relatives and family.

“The way that things happen is that if coronavirus is there when somebody dies then it is recorded as being there, as I think Mark Polin the Chair of the Health Board has said. What people often do then is to assume that the death was caused by coronavirus, whereas that isn’t necessarily the conclusion that can be drawn.

“I am very keen that in those incredibly distressing circumstances there is an account of the care that the person had provided, the reason why they died, that it is accurately and properly conveyed to families so that people don’t end up thinking that something was a case where it wasn’t, but if something is the case then they need to know that too.”

Before the 27th of July the health board had said they would be unable to release confirmed case figures for the local hospital, before u-turning and then giving daily updates.

Until yesterday death data was a similar secret, however after multiple query routes we finally had partial data released.

We have long questioned Ministers about such localised data, and asked the First Minister if that kind of battle for information was what he had in mind when he pledged to give the people transparency by making data available.

The First Minister said: “I’m glad that you’ve had the information now. I know that the Health Board have felt that they have to make sure that when they put information in the public domain that the information has been thoroughly checked and validated so that we don’t end up, as we have occasionally Wales and as you’ve seen across our border in England this week with the wholesale revision of their death data, we ended up having to go back and repeat an exercise and put corrected data into the public domain.

“So they’ve been keen to make sure that the data they provide to you and to public in Wrexham is reliable, that’s why it’s taken a while, but I am glad it has been released to you now.”

The data released yesterday also included information we had asked around ‘all staff’ testing in the hospital. We asked if the aim was still to test all staff, and pointed out at the current rate that could mean it would be done by November or December, and if so will it be speeded up.

The First Minister replied: “20% of staff have been tested, but anyone who is symptomatic is being tested immediately. But as from the start of next week, the 17th of August they will be an accelerated program of testing all staff at the Maelor symptomatic or non symptomatic and that the arrangements are now in place for that to happen.”

With the question of symptoms and tested mentioned, we pointed to the policy that the local health board have quoted; ‘Routine screening is not in place for staff as Public Health Wales guidance states staff are to be tested when they show symptoms of COVID-19’ and asked if that would be reviewed.

The First Minister replied: “I think it depends upon the level at which the virus is circulating. If the virus is in low circulation, then the case for testing a lot of people who aren’t symptomatic just doesn’t result in a product that is telling you anything that you can use for policy or clinical purposes.

“Obviously, there is more of a virus around then that calculation changes. At the moment the advice as you’ve said, is that surveillance testing in care homes remains worthwhile, but a wider program of asymptomatic testing isn’t justified by the level of virus circulation.

“Like all of these things it is always reviewed because the virus is changing all the time, although the figures we have this week suggests that the virus has gone down again.”

One question that has been on our to-ask list however has not been able to be asked due to time constraints was about indemnity clauses in the The Coronavirus Act 2020. The emergency laws contains a wide ranging indemnity for health service activity in Wales and was brought in on the 25th of March.

We asked the First Minister if that had been an item for discussion on revoking, and what his view was on how long it should persist as part of the law in Wales.

He said: “I think it was an important part of the initial arrangements because we were obviously asking our clinicians to operate in circumstances of high uncertainty.”

“It is funny how how fast things move on and how fast we forget, I spent weekends in the beginning of April in really difficult conversations about choices clinicians might have had to have made between treatment between patients if they weren’t sufficient ventilators or critical care beds and so on, making sure that when clinicians were making – had they had to which mercifully they didn’t have to – they had to make those really difficult decisions that they didn’t make them also fearing indemnity issues associated with them.”

“All the coronavirus regulations are time limited. They all run out. I think the bar should be high for reviewing them but given all we are hearing about second waves of the virus in other parts of Europe and the fact that the autumn and the winter may be difficult times for the virus in Wales as well, I think that decision will have to be made in the context of the time.”

(The First Minister was speaking with us yesterday afternoon)