NHS Lothian releases results of research into transmission of COVID-19 from hospitals into care homes

Scientists in NHS Lothian have helped to develop national infection controls after studying COVID-19 transmission between hospitals and care homes.

The teams found that 99 per cent of patients discharged from hospital into care homes during the first wave of the pandemic did not introduce COVID-19 into care homes.

The study, conducted with the University of Edinburgh, focused on patients in Lothian discharged from hospital into 130 care homes from 1st March 2020 to 31st May 2020. 

Of the 787 discharges in this time, the researchers found that the majority – a total of 776 – did not introduce COVID-19 into care homes as a result of their hospital stay.

Forty-one of the discharged patients had a positive COVID-19 test within two weeks of leaving hospital and genome sequencing was used to identify if these cases could be linked.

The study found that 30 patients likely contracted this in the care home or from the community.

The results of 10 patients were inconclusive and one patient was confirmed to have contracted COVID-19 during their stay in hospital.

Very sadly, this patient later passed away and a number of residents in their care home subsequently contracted COVID-19.

Dona Milne, Director of Public Health and Health Policy, NHS Lothian, said: “This study has shown that 99 per cent of hospital discharges didn’t introduce COVID-19 cases into Lothian care homes during the first wave of the pandemic.

“However, we’re able to say with certainty that one care home outbreak in this time originated from us. We are deeply saddened by this, and our heartfelt apologies and condolences are with the families and loved ones of those affected.

“We began testing symptomatic care home residents very early in the pandemic, so it’s been really important for us to use this information to find out what we can learn about how the virus was contracted and spread and how this linked to our hospitals.”

Before the nation went into its first lockdown when testing wasn’t widely available, NHS Lothian built capacity into its labs specifically to PCR test those who were symptomatic in hospitals and care homes.

Because of this early testing of symptomatic patients, in-depth data was available to the research team to enable them to genome sequence the transmission of the virus as part of the study.

Dr Kate Templeton, Head of Molecular Diagnostics for NHS Lothian who led the study, said: “Testing was a priority for us from the beginning and we were the first health board in Scotland to build capacity in our labs specifically for care home residents.

“This early testing has enabled us to genome sequence the virus and track where this was acquired and how this spread, leading to the creation of an outbreak methodology which has informed best practice at both Scotland and UK-level.

“This methodology not only has applications to COVID-19 but other viruses too and has been vital in learning lessons around infection control. It also clearly shows that the protection of the most vulnerable in society needs to involve not just health authorities but the community too.”

You can read the study in full here.