Title: WEEKLY HCAI COVID REPORT WEEK ENDING 28/03/2021

Author: Prof. Martin Cormican, Clinical Lead, HSE AMRIC

Organisation:

Date: 07/04/2021

Presentation Duration: NA

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

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NPHET MEETING 08/04/2021

WEEKLY HCAI COVID REPORT FOR WEEK ENDING 28/03/2021

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 The number of cases of hospital acquired COVID-19 in inpatients has declined in the week ending 28 March but remains a significant concern. Cases are highly concentrated in a small number of hospitals in or near Dublin. The number of cases in reported in acute hospital healthcare workers remains low and without a clear pattern of concentration in any hospitals.

Weekly no. of Hospital-Acquired Covid-19 National Totals No. of Currently Open Outbreaks of Covid-19 National Totals 21st June 2020-28th March 2021 Week ending 10/01/2021-28/03/2021 600 UL Hospitals Group 160 UL Hospitals Group South / South West 140 500 Hospital Group South / South West Saolta University 120 Hospital Group Health Care Group 400 Saolta University Health Regional & National 100 Services Care Group RCSI Hospitals Group 300 80 Regional & National Ireland East Hospital Services Group 60 RCSI Hospitals Group 200 Dublin Midlands Hospital Group 40 Children's Health Ireland East Hospital 100 Group Ireland 20 Dublin Midlands Hospital 0 0 Group Children's Health Ireland

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No. of New Laboratory Confirmed Cases of Covid-19 in Hospital Staff National Totals 1200 Week ending 10/01/2021-28/03/2021 UL Hospitals Group 1000 South / South West Hospital 800 Group Saolta University 600 Health Care Group Regional & 400 National Services RCSI Hospitals 200 Group

0 Ireland East Hospital Group

Continued

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COMMUNITY OPERATIONS KEY POINTS The number and severity of outbreaks has further reduced. Overall, there were 74 open outbreaks in Older Persons Residential Care Facilities (RCF), 48 in Disability and 4 in Mental Health. These outbreaks represent approximately 4% of all facilities. There were 4 new outbreaks notified during the reporting week. Close to 13% of Older Persons RCFs were in outbreak.

Just over 16,000 tests were performed in the serial testing programme with an overall positivity rate of 0.1% in residential facilities for older people and 0.0% in Mental Health. There was one new laboratory confirmed case in residents in Older Persons RCFs and none in Disability and Mental Health services during this reporting week.

Number of currently open outbreaks Number of centres of significant concern 140 6

120 119 5 5 100 90 4 80 Older Persons RCF Older Persons RCF 73 74 3 60 Disabilities Disabilities 53 48 Mental Health 2 2 2 2 Mental Health 40

20 1 5 0 4 4 0 0 0 0 W-E 14/03/21 W-E 21/03/21 W-E 28/03/21 W-E 14/03/21 W-E 21/03/21 W-E 28/03/21

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ACUTE OPERATIONS UPDATE – COVID METRICS DATA WEEK ENDING 28/03/2021 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 Laboratory Hospital Hospital Hospital currently laboratory confirmed COVID-19 Acquired Acquired Acquired open confirmed cases in tests Provider COVID-19 COVID-19 COVID-19 outbreaks cases in hospital completed 2020 w/e: YTD 2021 of covid 19 hospital staff YTD w/e w/e: staff w/e: 2021

28/03/2021 YTD (from 28/03/2021 28/03/2021 28/03/2021 2020 Total Dec 28th (Jun - Dec) 2020) YTD National Total 789 51 2,180 29 20 3,544 29,090 Children's Health Ireland 0 0 0 0 0 127 386 Dublin Midlands Hospital Group 225 33 449 14 5 565 3,622 Ireland East Hospital Group 192 2 320 2 5 652 3,800 RCSI Hospitals Group 171 13 344 3 3 720 4,477 Saolta University Health Care Group 112 3 459 5 5 466 6,061 South / South West Hospital Group 34 0 410 3 1 545 8,104 UL Hospitals Group 55 0 197 2 0 468 2,640

Notes: The Hospital acquired COVID YTD is based on week ending 03/01/21 onwards (therefore will includes four days during 2020) The outbreak and number of new laboratory confirmed cases in hospital staff commenced from w/e 10/01/21 onwards, therefore the YTD is based on this point onwards

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COMMUNITY OPERATIONS UPDATE – COVID METRICS DATA WEEK ENDING 28/03/2021 Column No. 1 2 3 4 5 6 7 8 Number of Number of Number of new Number of Staff serial Number of new Number of Number of centres* centres of lab confirmed laboratory tests testing lab confirmed currently new Community significant cases reported in conducted as positivity cases in open outbreaks in Services* concern* staff as part of part of staff rate* patients/ outbreaks in these serial testing* serial testing* % residents in these settingse settings these settingsd Data Source: HSE Health HSE Comm. HSE Serial Testing HSE Serial HSE Serial HPSC/CIDR HPSC/CIDR HPSC/CIDR Directory Operations Testing Testing Older Persons 588 0 20 15,842 0.1% 1 74 2 Residential Care Facilitiesa CHO 1 55 0 5 1,510 0.3% 0 9 0 CHO 2 82 0 0 2,634 0.0% 0 1 0 CHO 3 56 0 5 1,182 0.4% 0 14 0 CHO 4 93 0 2 1,609 0.1% 0 29 0 CHO 5 77 0 0 2,295 0.0% 0 1 0 CHO 6 55 0 0 1,761 0.0% 1 3 0 CHO 7 49 0 3 1,809 0.2% 0 7 2 CHO 8 65 0 0 715 0.0% 0 3 0 CHO 9 56 0 5 2,327 0.2% 0 7 0 Disabilitiesb 2,467 2 - - - 0 48 2 CHO 1 188 1 *Once Off Targeted Testing Cycle of Disability Facilities concluded 0 7 0 CHO 2 273 0 Tuesday 16th March 2021. 0 1 0 CHO 3 267 0 0 7 0 CHO 4 287 0 0 12 0 CHO 5 300 1 0 2 1 CHO 6 160 0 0 0 0 CHO 7 326 0 0 8 1 CHO 8 386 0 0 5 0 CHO 9 280 0 0 5 0 Not reported - - 0 1 0 Mental Healthc 431 0 0 183 0.0% 0 4 0 CHO 1 42 0 0 0 0.0% 0 0 0 CHO 2 82 0 0 48 0.0% 0 0 0 CHO 3 30 0 0 3 0.0% 0 0 0 CHO 4 56 0 0 0 0.0% 0 1 0 CHO 5 65 0 0 63 0.0% 0 0 0 CHO 6 21 0 0 43 0.0% 0 0 0 CHO 7 47 0 0 0 0.0% 0 1 0 CHO 8 36 0 0 0 0.0% 0 0 0 CHO 9 52 0 0 26 0.0% 0 2 0 * Data gaps can be documented in part C. Where numbers are less than 5 this should be indicated. 6

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 24/03/21. For Disabilities data reflects status as of 29/03/21. 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. 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 10 (21st -27th March) according to data extracted from CIDR Monday April 6th 2021. eNumber of Open outbreaks reflect Open/Closed status according to data extracted from CIDR Monday March 29th 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

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