Posted: Thu 23rd Jul 2020

Updated: Thu 23rd Jul

Health Board “actively encouraging patients, public & staff to wear face coverings or masks in public areas of all sites” as Chairman says ‘there has been an increase’ at the Maelor for people living in or visiting the wrexham area
This article is old - Published: Thursday, Jul 23rd, 2020

There has been an ‘increase’ in coronavirus in Wrexham Maelor Hospital, and has been told further local testing in as yet unknown areas will start next week.

The latest 2pm update from Public Health Wales states there are 9 new cases in Wrexham, the highest in Wales again, out of a total of 43. There have been 34 confirmed cases in the last seven day period in Wrexham, and 100 new cases in the last twenty one day period.

This afternoon has also seen the regular Outbreak Control Team update after a meeting yesterday morning, that gives a full Wrexham update as below, noting a +4 increase in confirmed cases linked to the outbreak:

“An Outbreak Control Team was convened to look at the outbreak associated with the workforce at Rowan Foods, and part of its work is to constantly review its data on cases of Novel Coronavirus (COVID-19) infection.

“As part of this process we are investigating cases within the Wrexham area through the Test Trace Protect process. This work naturally includes identifying where we believe transmission may be occurring, and identifying local clusters of cases.

“The outbreak associated with the workforce at the Rowan Foods plant in Wrexham remains active, although the number of reported cases has slowed down considerably.”

“As of 22 July, the total number of positive cases associated with this outbreak is 313, which is a small increase of four since Wednesday 15 July. There is no evidence that these infections were acquired either onsite or that the infection is factory-based.”

“We will continue to analyse the data to ensure we are taking appropriate and timely decisions to bring the outbreak to a close.”

The Chair of Betsi Cadwaladr University Health Board, Mark Polin headed up a meeting today (stream here) where coronavirus issues in the east area of the health board was lightly touched upon.

Mr Polin said he has asked for a review to be carried out on ‘in hospital transmission’, with it later noted that ‘transmission can be staff to staff as well as patient to patient’. He asked about the east area of the health board, and specifically Wrexham Hospital where he explained “there has been an increase” in cases, and referred to possible ‘in hospital transmission’.

The meeting was told there is ongoing work with the Outbreak Control Team, believed to be working in connection to the Rowan Foods ‘outbreak’, and there are ‘agreed control measures’ being put in place due to a ‘small increase in cases’ at the hospital, with it noted ‘where we are seeing outbreaks on wards we are testing all patients on wards’ along with staff in those areas.

The meeting was told there is a ‘change in focus’ in Wrexham and a change in testing approach in the area. Where and what that will entail is not public, however has been told that Public Health Wales is due to start testing in the area with a focus not on the hospital, nor at the Rowan Foods site.

Mr Polin said he believed staff would support use of masks or face coverings, with others explaining staff have requested use of them in public areas and corridors, and the health board is ‘actively encouraging’ the use of them now for staff and public where they feel able to.

Yesterday we asked the health board if there had been an increase in cases at the hospital, naming a specific ward we had been told had been affected. The health board did not comment at the time.

This morning we asked Betsi Cadwaladr University Health Board if there had been any policy change this week over mask use in the hospital, and if so why. We also asked if that advice had changed since it was issued, and if so, why.

Simon Dean, Interim Chief Executive at Betsi Cadwaladr University Health Board said today,

“We take our infection prevention and control responsibilities very seriously and are doing all we can to reduce the risk of COVID-19 infection in our hospitals amongst both our staff and patients.

“We have taken a range of actions to prevent the spread of the virus including testing all patients who are due to come in for planned surgery before they are admitted to hospital.

“As of this week, all admissions – including emergencies – across the Health Board will be tested.

“We are also providing widespread staff training on infection prevention and hygiene supported by a high visibility communications campaign; following official guidance from the Chief Medical Officer on the use of PPE and checking compliance through PPE ‘champions’; undertaking extra cleaning of hospitals; imposing visiting restrictions and increasing the number of hand sanitiser stations for staff and patients.

“We are also increasing staffing levels in areas where the management of patients can be more challenging – for example, care of the elderly wards.

“A Post Infection Review is undertaken for each case of hospital acquired COVID-19 to help us learn from incidents.

“We are the largest Health Board in Wales, covering 22 per cent of the Welsh population and have had more cases of COVID-19 than other Health Boards. COVID-19 is highly infectious and it can be challenging to prevent the spread of the virus.”

“We are not complacent and we are building on what we have learned to date.

“We are actively encouraging patients, the public and staff to wear face coverings or masks in public areas of all Health Board sites and are actively exploring repeat testing of patients seven days after a negative test to improve surveillance of the virus on our sites.

“Everyone has a role to play in preventing the spread of infection and we are grateful for the support of the public in observing good hand hygiene, maintaining social distancing and not visiting healthcare premises if displaying any symptoms of COVID-19.”

We asked Public Health Wales about the understanding of the situation inside Wrexham Maelor Hospital, and specifically how many confirmed cases are there as of this morning, and how many where there this time last week and it was possible to clarify if these are new covid admissions or confirmed/suspected internal transmissions.

We also asked them regarding face mask use, and also about areas of concern outside of the hospital.

Public Health Wales pointed us to the statement issued late last night to us, where they said “As part of this process we are investigating cases within the Wrexham area through the Test Trace Protect process. This work naturally includes identifying where we believe transmission may be occurring, and identifying local clusters of cases” , as well as pointing us to pre-prepared lines based off the addition of hospital data to the Public Health Wales dashboard, noting “…the material on nosocomial data (hospital acquired infection) for COVID-19 is released on a Wales level and also by Health Board. There is no published breakdown by hospital.”

We also asked questions to Wrexham Council, however as is usual in the pandemic, they are sent ‘upwards’ to Public Health Wales with no local response.

This morning we asked Welsh Government what their understanding of the situation inside Wrexham Maelor Hospital is, along with queries over face mask use and PPE stock levels.

We also asked Welsh Government about areas of concern outside of the hospital, and if there was an update possible on any future testing believed to be starting next week. We asked if that was due to concerns over wider community spread.

We also asked if it was acceptable that the local authority, health board and public health wales all pass queries between them, rather than being proactive and accountable in informing the public of Wrexham about the situation on their doorstep.

We have had no reply from Welsh Government.

This week, the data science team at ZOE and King’s College London have created the “COVID Symptom Study Watch List” for the first time. The top 10 is the Upper Tier Local Authority (UTLA) regions which have the highest estimates of symptomatic COVID in the past week. The data team say the “new analysis found that nine in 10 regions on the watch list are in the North of England, suggesting that it is now these areas of the North that the country needs to pay special attention to”.

The ZOE app is one Welsh Government and others have pointed to for the public to join in and crowdsource symptom information.

Tim Spector, Professor of Genetic Epidemiology at King’s College London, said:

“We are now starting to see the figures in the North creep up week on week. The numbers are still very small so we can’t say with 100% certainty that COVID is increasing significantly but it does make us focus on those areas.

To understand if these increases are significant or not, we need as many people as possible in these areas to be logging in the app. So we are calling for people living in the North, to download the app and get logging, as without them, it will make spotting any real hotspots accurately much harder.

This week, the app also revealed that COVID symptoms and outcomes get worse in colder, less humid weather, which makes it even more important that we get this virus under control as we only have a month or two of warm weather left. Our data suggests that levels have bottomed out at around 2000 cases per day which is too many, so we all need to be conscious of the dangers and to continue to practice high levels of personal hygiene, wear a face mask, social distance and know all the signs of early disease.”

Prevalence is the number of symptomatic cases in the population based on the daily new cases and symptoms being logged in the app, whereas incidence rates are simply the number of daily new cases based on the results from swab tests. More detail , and how to take part in the ZOE project, can be found here.

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