How is Covid-19 transmission being prevented at Queen’s and King George and how likely is it you’ll catch it?
- Credit: Barking, Havering and Redbridge
The short answer is unlikely to very unlikely, depending on how you’re admitted. A reporter spoke to Magda Smith, chief medical officer of Barking, Havering and Redbridge University Trust, to find out what happens on admission to Queen’s or King George Hospital.
How does the second wave feel compare to March?
“The pandemic came hard and fast at the end of March, there was very rapid rise of patients being admitted with Covid and at that point, certainly from a healthcare perspective, we knew very little about how to manage it as there was little known in the way of treatment at the time.
“Sadly, some patients who didn’t have Covid were scared and didn’t come to hospital when they needed to for other things. And I think we’re seeing the impact of that nationally since the first wave calmed down and patients returned.
“The rise is not as rapid as last time. We have got treatment and have a lot of systems in place that we just didn’t have in the first wave, which is good. But our staff are tired, anticipating the amount of work that this involves.
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“In the community, people are dealing with the personal impact of the second wave and everybody is struggling with this. It’s dark, we’re going into winter, warm summer evenings that would give you light relief are no longer there.”
“In the summer period, when we received very little in the way of Covid, we did a huge amount of work to organise the hospitals and created Covid risk managed areas, making it as safe as possible for patients to come on a planned basis but also adjusting emergency pathways and treatment.”
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How do the Covid risk management areas work and what happens when you are admitted?
“We do not assume that anyone has definitely not got Covid on admission,” said Magda,
As soon as patients are admitted, whether it’s A&E or intensive care, they have a test done. It takes 12-48 hours to get the results. If they are displaying Covid symptoms and staff think it’s highly likely they are there because of Covid, they will go to a “Covid cohort ward”.
If staff think it’s unlikely, because, for example, a patient comes in with a broken ankle and is not displaying any symptoms, they will be tested and put into a non-Covid zone. The beds in the non-Covid zone are separated by a transparent plastic curtain, as in the rest of the hospital, and if the patient tests positive they are immediately moved to the Covid ward.
The green zone is for scheduled procedures and patients are pre-tested and isolated prior to admission.
Should the non-Covid admissions not be completely isolated from one another while waiting for test results?
To ensure a transmission rate of zero, they would all need to be in separate rooms. Magda says there are not enough rooms and this issue is recognised nationally.
However, transmission rate is low in this zone as the large majority do not have Covid, staff use PPE and they are separated by plastic curtains.
Magda says: “We do find that some patients test negative on their first test and positive on the second. They will have been in a bay with other patients and some patients have had Covid transmitted, known as nosocomial infections. There is a huge national focus on this and we’re trying to reduce the risk of this to an absolute minimum.”
“You’re more likely to get Covid in the supermarket than the green zone”
This zone is for patients who have a scheduled procedure.
You’re asked to self-isolate for seven days and to do a test three days before admission. If it comes back positive, you’re not admitted, and Magda says if it’s really urgent, an alternative is found.
After hospital, you’re asked to self-isolate for another week to minimise the likelihood of transmission in the community.
If your test is negative, you are admitted into the green zone. The chances of having a positive patient in the green zone is very low, but not impossible.
Magda says: “We have had a few incidents where the patient has come in, has their operation, and it [Covid] has been picked up – usually just after the operation. If it appears they may not be as well as we thought we retest them and if they’re positive, they get immediately isolated. We’ve not had any evidence of patient-to-patient transmission in green zones.”
She adds: “It’s quite tough having to isolate at home for a week as well as a test and to continue isolation after an operation, that is quite a big ask so we do want to reassure that the pathway is as safe as we can possibly make it.”
“We have already begun to see some benefit from the Tier 2 requirement, we are really relying on this lockdown to work particularly in this part of London, where there is a lot of Covid in the community.”