Prof. Martin Cormican, Clinical Lead, AMRIC Organisation

Title: WEEKLY HCAI COVID REPORT WEEK ENDING 18/04/2021

Author: Prof. Martin Cormican, Clinical Lead, AMRIC

Organisation: Health Service Executive

Date: 27/04/2021

Presentation Duration: 10 mins

Action required: ☐ For noting ☐✓ For discussion ☐ For decision pending NPHET discussion

1 | P a g e

Approved for future publication: YES

NPHET MEETING 28/04/2021

WEEKLY HCAI COVID REPORT FOR WEEK ENDING 18/04/2021 AMRIC NARRATIVE Healthcare associated COVID-19 is a major challenge in community and acute operations. Healthcare associated COVID-19 impacts of service users/patients and healthcare workers. Healthcare associated COVID-19 is also a central part of the overall public health response to COVID-19 because infection is introduced into the healthcare setting from the community and because infection, including novel variants, may be amplified in the healthcare setting and then disseminated widely within the community.

ACUTE OPERATIONS KEY POINTS Healthcare associated COVID-19 at 15 cases is the lowest since week 40 of 2020. The number of cases in acute hospital staff has increased from 10 to 21 but the numbers are likely to fluctuate somewhat from week to week.

Weekly no. of Hospital-Acquired Covid-19 National Totals No. of Currently Open Outbreaks of Covid-19 National Totals 21st June 2020-18th April 2021 Week ending 10/01/2021-18/04/2021

600 160 UL Hospitals Group 140 UL Hospitals Group 500 South / South South / South West West Hospital 120 Hospital Group Group 400 Saolta University 100 Saolta University Health Care Health Care Group Group Regional & National 300 80 Regional & Services National Services RCSI Hospitals Group 60 200 RCSI Hospitals Group Ireland East Hospital 40 Group 100 Ireland East Dublin Midlands Hospital Group 20 Hospital Group Children's Health Dublin Midlands 0 0 Ireland

Hospital Group

WEEK2 WEEK5 WEEK8

WEEK6 WEEK2 WEEK3 WEEK4 WEEK5 WEEK7 WEEK8 WEEK9

WEEK1

WEEK27 WEEK24 WEEK30 WEEK33 WEEK36 WEEK39 WEEK42 WEEK45 WEEK48 WEEK51 WEEK11 WEEK14

WEEK11 WEEK12 WEEK13 WEEK14 WEEK15 WEEK10 2

No. of New Laboratory Confirmed Cases of Covid-19 in Hospital Staff National Totals Week ending 10/01/2021-18/04/2021 1200

1000 UL Hospitals Group South / South West Hospital Group 800 Saolta University Health Care Group 600 Regional & National Services RCSI Hospitals Group 400 Ireland East Hospital Group 200 Dublin Midlands Hospital Group Children's Health Ireland 0 WEEK WEEK WEEK WEEK WEEK WEEK WEEK WEEK WEEK WEEK WEEK WEEK WEEK WEEK WEEK 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

COMMUNITY OPERATIONS KEY POINTS

There is a continued reduction in the number and severity of outbreaks. Overall, there were 19 open outbreaks in Older Persons Residential Care Facilities (RCF), 16 in Disability and 2 in Mental Health. These outbreaks represent approximately 1% of all facilities. There was one new outbreak notified during the reporting week, which related to an Older Persons RCF. Close to 3% of Older Persons RCFs were in outbreak (down from 6% in the previous reporting week).

Just under 15,600 tests were performed in the serial testing programme with an overall positivity rate of 0.16% in Older Persons RCFs and 0% in Mental Health. There was 1 new laboratory confirmed case in residents in Disability services and none in Older Persons and Mental Health services during this reporting week. Number of currently open outbreaks Number of new outbreaks 60 56 3 50 40 37 Older Persons RCF 2 2 Older Persons RCF 30 33 Disabilities 23 Disabilities 20 19 1 1 1 16 Mental Health Mental Health 10 4 3 0 2 0 0 0 0 W-E 04/04/21 W-E 11/04/21 W-E 18/04/21 W-E 04/04/21 W-E 11/04/21 W-E 18/04/21

ACUTE OPERATIONS UPDATE – COVID METRICS DATA WEEK ENDING 18/04/2021

Weekly COVID report summary Hospital acquired cases, outbreaks and new laboratory confirmed cases in hospital staff

WKCOVID1 WKCOVID1 WKCOVID1 WKCOVID2 WKCOVID3 WKCOVID3

No. new No. No. new laboratory Hospital Hospital Hospital currently laboratory confirmed Laboratory Acquired Acquired Acquired open confirmed cases in COVID-19 tests Provider COVID-19 COVID-19 COVID-19 outbreaks cases in hospital completed w/e 2020 w/e: YTD 2021 of covid 19 hospital staff YTD w/e: staff w/e: 2021

18/04/2021 YTD (from 18/04/2021 18/04/2021 18/04/2021 2020 Total Dec 28th (Jun - Dec) 2020) YTD National Total 789 15 2,243 21 21 3,588 29,090 Children's Health Ireland 0 0 0 0 1 129 386 Dublin Midlands Hospital Group 225 11 480 13 7 581 3,622 Ireland East Hospital Group 192 0 324 2 4 658 3,800 RCSI Hospitals Group 171 1 362 0 4 728 4,477 Saolta University Health Care Group 112 3 462 2 4 476 6,061 South / South West Hospital Group 34 0 410 1 0 546 8,104 UL Hospitals Group 55 0 204 3 1 469 2,640

COMMUNITY OPERATIONS UPDATE – COVID METRICS DATA WEEK ENDING 18/04/2021 Column No. 1 2 3 4 5 6 7 8 Number of Number of Number of Number of Staff serial Number of Number of Number of centres* centres of new laboratory laboratory testing new laboratory currently open new outbreaks Community significant confirmed tests positivity rate* confirmed outbreaks in in these Services* concern* cases reported conducted as % cases in these settingse settings in staff as part part of staff patients/ of serial serial testing* residents in testing* these settingsd Data Source: HSE Health HSE Comm HSE Serial HSE Serial HSE Serial HPSC/CIDR HPSC/CIDR HPSC/CIDR Directory Operations Testing Testing Testing Older Persons 588 0 24 15,031 0.16% 0 19 1 Residential Care Facilitiesa CHO 1 55 0 2 777 0.26% 0 0 0 CHO 2 82 0 0 960 0.00% 0 0 0 CHO 3 56 0 1 1,380 0.07% 0 9 0 CHO 4 93 0 3 3,229 0.09% 0 1 0 CHO 5 77 0 0 1,385 0.00% 0 1 0 CHO 6 55 0 1 1,261 0.08% 0 2 0 CHO 7 49 0 4 1,749 0.23% 0 5 1 CHO 8 65 0 11 2,867 0.38% 0 0 0 CHO 9 56 0 2 1,423 0.14% 0 1 0 Disabilitiesb 2,467 2 - - - 1 16 0 CHO 1 188 0 *Once Off Targeted Testing Cycle of Disability Facilities 0 0 0 CHO 2 273 0 concluded Tuesday 16th March 2021. 0 0 0 CHO 3 267 0 0 7 0 CHO 4 287 0 0 0 0 CHO 5 300 0 0 2 0 CHO 6 160 0 0 0 0 CHO 7 326 1 0 1 0 CHO 8 386 0 0 1 0 CHO 9 280 1 1 5 0 Mental Healthc 431 0 0 560 0.00% 0 2 0 CHO 1 42 0 0 0 0.00% 0 0 0 CHO 2 82 0 0 109 0.00% 0 0 0 CHO 3 30 0 0 10 0.00% 0 0 0 CHO 4 56 0 0 77 0.00% 0 0 0 CHO 5 65 0 0 117 0.00% 0 0 0 CHO 6 21 0 0 236 0.00% 0 0 0 CHO 7 47 0 0 0 0.00% 0 1 0 CHO 8 36 0 0 11 0.00% 0 0 0 CHO 9 52 0 0 0 0.00% 0 1 0 5

* Data gaps can be documented in part C. Where numbers are less than 5 this should be indicated.

Number of centres (Column 1). Primary data source is HSE Health Directory Number of centres of significant concern (Column 2). Primary data source is Community Operations, based on a qualitative assessment of a number of factors, including infection rates among staff and residents, and requirement for enhanced monitoring and support from the HSE. For Older Persons Residential Care Facilities data reflects status as of 14/04/21. Number of new laboratory confirmed cases detected by serial testing, number of laboratory tests conducted as part of serial testing and Staff serial testing positivity rate (Columns 3 – 5). Primary data source is the Community Testing Service. Please note with regards to Mental Health, fortnightly serial testing of facilities continues with those on the programme. We do not currently have any MH facilities in CHO1 or CHO7 on the programme; hence the swab data is blank. There is 1 facility in CHO9, however, they were not tested the week of 12th – 18th April. Number of new laboratory confirmed cases in patients/residents, number of currently open outbreaks, number of new outbreaks (Columns 6 – 8). Primary data source is the HPSC/CIDR. aOutbreaks and outbreak cases among non-HCWs on CIDR linked to Nursing Homes OR Community Hospitals OR Residential Institutions with Type of Residential facility recorded as ‘Centre for older people’. bOutbreaks and outbreak cases among non-HCWs on CIDR linked to Residential Institutions where the Type of Facility was recorded as ‘Centre for Disabilities’. cOutbreaks and cases among non-HCWs on CIDR linked to Residential Institutions where the Type of Facility was recorded as ‘Mental health facility’. dNumber of cases among non-HCWs linked to outbreaks reflect confirmed COVID-19 cases notified during week 15 (April 11th -17th) according to data extracted from CIDR Monday April 26th 2021. eNumber of Open outbreaks reflect Open/Closed status according to data extracted from CIDR Monday April 19th 2021. Programme Summaries for Serial Testing: 1) Older Persons Residential Care Facilities NPHET requested a planned programme of Serial Testing of all Staff in Residential Care Facilities (RCFs) for older people, with the first Cycle of Testing commencing on June 20th, 2020. A process has been developed to ensure that all Staff from these facilities were appropriately referred, tested, tracked and traced. Each RCF is assigned a testing date once every fortnight, and results are reported in cycles of 4 week duration. 2) Disability A decision was made by NPHET and Public Health to commence Once Off Targeted Testing of Staff in Congregated Residential Disability Settings Requiring 24 Hour Nursing Care. Testing of these Facilities commenced Monday 25th January 2021 and concluded Tuesday 16th March 2021. Public Health advised no further testing required. 3) Mental Health A decision was made by NPHET and Public Health to commence once off and serial testing of Staff in Congregated Residential Mental Health Facilities requiring 24 hour Nursing Care: • Continuing Care Facilities (Serial Testing) • High Support Facilities (Once Off) Testing of these Facilities commenced on Monday 25th January 2021. The Testing of High Support Facilities will take place on a once-off basis. The Testing of Continuing Care Facilities will take place once every fortnight in a 4 week Cycle of Testing, similar to the cadence of Older Persons Residential Care Facilities.

ENDS