The impact of testing and infection prevention and control strategies on within-hospital transmission dynamics of COVID-19 in English hospitals

Stephanie Evans; Emily Agnew; Emilia Vynnycky; James Stimson; Alex Bhattacharya; Christopher Rooney; Ben Warne; Julie Robotham

doi:10.1098/rstb.2020.0268

The impact of testing and infection prevention and control strategies on within-hospital transmission dynamics of COVID-19 in English hospitals

Stephanie Evans, Emily Agnew, Emilia Vynnycky, James Stimson, Alex Bhattacharya, Christopher Rooney, Ben Warne, Julie Robotham

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Abstract

Nosocomial transmission of SARS-CoV-2 is a key concern, and evaluating the effect of testing and infection prevention and control strategies is essential for guiding policy in this area. Using a within-hospital SEIR transition model of SARS-CoV-2 in a typical English hospital, we estimate that between 9 March 2020 and 17 July 2020 approximately 20% of infections in inpatients, and 73% of infections in healthcare workers (HCWs) were due to nosocomial transmission. Model results suggest that placing suspected COVID-19 patients in single rooms or bays has the potential to reduce hospital-acquired infections in patients by up to 35%. Periodic testing of HCWs has a smaller effect on the number of hospital-acquired COVID-19 cases in patients, but reduces infection in HCWs by as much as 37% and results in only a small proportion of staff absences (approx. 0.3% per day). This is considerably less than the 20-25% of staff that have been reported to be absent from work owing to suspected COVID-19 and self-isolation. Model-based evaluations of interventions, informed by data collected so far, can help to inform policy as the pandemic progresses and help prevent transmission in the vulnerable hospital population. This article is part of the theme issue 'Modelling that shaped the early COVID-19 pandemic response in the UK'.

Original language	English
Article number	20200268
Number of pages	10
Journal	Philosophical transactions of the Royal Society of London. Series B, Biological sciences
Volume	376
Issue number	1829
Early online date	31 May 2021
DOIs	https://doi.org/10.1098/rstb.2020.0268
Publication status	Published - 19 Jul 2021

Bibliographical note

Funding Information: J.R. was supported by the National Institute for Health Research (NIHR) Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford (NIHR200915) in partnership with Public Health England (PHE).

Open Access: Published by the Royal Society under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, provided the original author and source are credited.

Publishers Copyright: © 2021 The Authors.

Citation: Evans Stephanie, Agnew Emily, Vynnycky Emilia, Stimson James, Bhattacharya Alex, Rooney Christopher, Warne Ben and Robotham Julie 2021The impact of testing and infection prevention and control strategies on within-hospital transmission dynamics of COVID-19 in English hospitals Phil. Trans. R. Soc. B37620200268

DOI: http://doi.org/10.1098/rstb.2020.0268

Keywords

SARS-CoV-2
coronavirus
mathematical model
nosocomial transmission
HEALTH-CARE WORKERS
EPIDEMIC

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Evans2021TheImpactOfTestingAndInfectionPrevention Phil.Trans.R.Soc.BFinal published version, 867 KBLicence: CC BY

Cite this

Evans, S., Agnew, E., Vynnycky, E., Stimson, J., Bhattacharya, A., Rooney, C., Warne, B., & Robotham, J. (2021). The impact of testing and infection prevention and control strategies on within-hospital transmission dynamics of COVID-19 in English hospitals. Philosophical transactions of the Royal Society of London. Series B, Biological sciences, 376(1829), Article 20200268. https://doi.org/10.1098/rstb.2020.0268

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abstract = "Nosocomial transmission of SARS-CoV-2 is a key concern, and evaluating the effect of testing and infection prevention and control strategies is essential for guiding policy in this area. Using a within-hospital SEIR transition model of SARS-CoV-2 in a typical English hospital, we estimate that between 9 March 2020 and 17 July 2020 approximately 20% of infections in inpatients, and 73% of infections in healthcare workers (HCWs) were due to nosocomial transmission. Model results suggest that placing suspected COVID-19 patients in single rooms or bays has the potential to reduce hospital-acquired infections in patients by up to 35%. Periodic testing of HCWs has a smaller effect on the number of hospital-acquired COVID-19 cases in patients, but reduces infection in HCWs by as much as 37% and results in only a small proportion of staff absences (approx. 0.3% per day). This is considerably less than the 20-25% of staff that have been reported to be absent from work owing to suspected COVID-19 and self-isolation. Model-based evaluations of interventions, informed by data collected so far, can help to inform policy as the pandemic progresses and help prevent transmission in the vulnerable hospital population. This article is part of the theme issue 'Modelling that shaped the early COVID-19 pandemic response in the UK'.",

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Evans, S, Agnew, E , Vynnycky, E, Stimson, J, Bhattacharya, A, Rooney, C, Warne, B & Robotham, J 2021, 'The impact of testing and infection prevention and control strategies on within-hospital transmission dynamics of COVID-19 in English hospitals', Philosophical transactions of the Royal Society of London. Series B, Biological sciences, vol. 376, no. 1829, 20200268. https://doi.org/10.1098/rstb.2020.0268

The impact of testing and infection prevention and control strategies on within-hospital transmission dynamics of COVID-19 in English hospitals. / Evans, Stephanie; Agnew, Emily ; Vynnycky, Emilia et al.
In: Philosophical transactions of the Royal Society of London. Series B, Biological sciences, Vol. 376, No. 1829, 20200268, 19.07.2021.

Research output: Contribution to journal › Article › peer-review

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Evans S, Agnew E , Vynnycky E, Stimson J, Bhattacharya A, Rooney C et al. The impact of testing and infection prevention and control strategies on within-hospital transmission dynamics of COVID-19 in English hospitals. Philosophical transactions of the Royal Society of London. Series B, Biological sciences. 2021 Jul 19;376(1829):20200268. Epub 2021 May 31. doi: 10.1098/rstb.2020.0268

The impact of testing and infection prevention and control strategies on within-hospital transmission dynamics of COVID-19 in English hospitals

Abstract

Bibliographical note

Keywords

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