'Isolation hospitals' were 'too difficult' for the UK's health service to achieve

NHS chiefs were urged to consider grouping Covid-19 patients in separate "isolation hospitals" in order to curb the spread of the virus, but scientists were told that the move adopted by other countries was "too difficult" for the UK's health service to achieve, the Telegraph can disclose.

Three months ago, scientists privately raised concerns that those infected with coronavirus were "not being separated sufficiently", with Professor Jonathan Van Tam, the deputy chief medical officer, pointing out that many of the countries controlling the virus most effectively were "cohorting" patients in specialist hospitals or units.

Minutes of a meeting of the Department of Health's New and Emerging Respiratory Virus Threats Advisory Group (Nervtag) show that members were concerned about the risk of Covid-19-positive patients infecting healthcare workers, "introducing infection to other staff and the community".

Prof Van Tam "noted that many of the countries who are performing well at controlling the pandemic utilise this strategy."

However, he added that "this had been raised previously with NHS England, but was considered to be too difficult for the NHS to achieve." (See video below highlighting Prof Van Tam's concerns over the coronavirus's continued spread).

Following the meeting, the committee wrote a letter stating its view that "re-consideration should be given to the implementation of structural changes for management of Covid-19 cases within the NHS, such as isolation-type hospitals or units to cohort Covid-19 patients".

However, this weekend NHS England was unable to point to plans for dedicated Covid-19 hospitals, or particular new units for Covid-positive patients introduced since the warnings were issued.

Officials instead highlighted processes introduced during the first wave of infections, including the designation of Covid-19 areas and non-Covid-19 areas in many hospitals. It has also been reported that some hospitals will be designated as coronavirus-free zones during the second wave, in order to ensure that the NHS continues treatment for cancer and other conditions.

Prof Van Tam said the NHS had been "working very hard to act on the Nervtag advice."

Newly-released minutes of a Nervtag meeting on June 10 record that John Edmunds, professor of infectious disease modelling at the London School of Hygiene and Tropical Medicine, "raised concerns that Covid-19 patients are not being separated sufficiently, for example by cohorting within separate isolation hospitals."

Following the intervention by Prof Edmunds, a prominent attendee of the Scientific Advisory Group for Emergencies (Sage), "the committee noted that whilst staff may be driving the transmission in hospitals, Covid-19 positive patients may act as a source for infection to healthcare workers, introducing infection to other staff and the community.

"It was suggested that cohorting patients in specialist Covid-19 hospitals or units could reduce the incidence of hospital transmission."

"The Committee noted that the scale of the epidemic means that structural changes to the NHS might be necessary to control transmission and manage winter pressures."

During the first wave of infections earlier this year, nine 'Nightingale' hospitals (see the first recovered patients leaving one, below) were set up to help the health service cope with the pandemic, including a 4,500-bed field hospital in London.

But much of the additional capacity was for intensive care facilities, rather than A&E, high dependency units, and acute wards.

Statistics from the Intensive Care National Audit & Research Centre ( ICNARC) have consistently shown that just 10 per cent people who have died from coronavirus were admitted to intensive care.

This weekend, Professor Stephen Powis, NHS England's medical director, said: “Isolation facilities and processes are in full use across the health service, separating non-Covid-19 patients from suspected or confirmed cases, including Covid-19 free sites and surgery hubs and separate pathways for urgent care, which will help ensure safety as well as help to keep other routine services going.”

Professor Peter Horby, who chairs Nervtag, later issued a statement which said: “Back in June Nervtag recommended a review of how best to structure NHS services to protect patients from Covid-19.

"I discussed our recommendations with NHS leaders, they were taken on board, and I am satisfied that the extensive planning that is now taking place will ensure that all patients – whether they have coronavirus or not – can get the care they need in the safest and most clinically-appropriate way.”

Prof Van Tam said: “The NHS moved with urgency to isolate patients with Covid-19 within its estate during the first wave, whether that was by creating designated areas of the hospital or, where buildings allowed, separate units or facilities.

"The NHS has been working very hard to act on the Nervtag advice, planning to safely keep Covid-19 and non-Covid-19 patients apart over what looks like a challenging winter period ahead.”