Healthcare workers ‘should be screened for Covid-19 every week’ | World news

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Healthcare workers should be screened for Covid-19 every week to protect patients from asymptomatic infection, the head of the Francis Crick Institute’s testing facility has said.

The call comes amid concerns that hospitals are becoming hotspots for disease transmission and evidence that a significant fraction of those infected show few or no symptoms.

“For all our fuss about social distancing we’re ignoring one of the main routes of infection in front of our eyes,” said Prof Charles Swanton, who is leading the testing effort at the institute in London. “It’s almost untenable to argue you shouldn’t be screening and isolating healthcare workers.”

The institute is next week launching a pilot to screen staff at University College hospital to identify asymptomatic Covid-19 cases, but the approach has not been explicitly endorsed by the government and there have been no indications that this is being considered as a national strategy.

The institute’s testing lab has capacity to run 3,000 tests a day, so would be capable of running a screening operation for staff at UCH, if this approach were adopted.


A possible concern is that screening could lead to large numbers of doctors and nurses, who are otherwise well, being required to self-isolate. But the alternative – leaving asymptomatic, but potentially infectious staff on the wards – runs contrary to the principle of “do no harm”, Swanton said.

Patients were very aware of the risk, he added, and were staying at home due to justified fears that they could contract the virus by attending hospitals or seeing GPs. “They’re too scared to go to hospital and you can understand why,” Swanton said.

The situation appears to be causing fewer emergency calls from people who have suffered strokes or heart attacks, potentially fuelling the rise in non-coronavirus deaths seen in figures released this week. Those with other conditions may also be deterred from seeking medical help.

On Thursday the Guardian reported that London A&E chiefs were concerned that patients were staying away, saying in a meeting last week: “People don’t want to go near hospital. As a result salvageable conditions are not being treated.”

Swanton, who is also chief clinician at Cancer Research UK, said: “I’m concerned that cancer patients need to be able to have the confidence to come into wards. We’re in this for another month at least, probably two or three. That’s a very long time to have a delayed cancer diagnosis.”

What is Covid-19?

It is caused by a member of the coronavirus family that has never been encountered before. Like other coronaviruses, it has come from animals. The World Health Organization (WHO) has declared it a pandemic.

What are the symptoms this coronavirus causes?

According to the WHO, the most common symptoms of Covid-19 are fever, tiredness and a dry cough. Some patients may also have a runny nose, sore throat, nasal congestion and aches and pains or diarrhoea. Some people report losing their sense of taste and/or smell. About 80% of people who get Covid-19 experience a mild case – about as serious as a regular cold – and recover without needing any special treatment.

About one in six people, the WHO says, become seriously ill. The elderly and people with underlying medical problems like high blood pressure, heart problems or diabetes, or chronic respiratory conditions, are at a greater risk of serious illness from Covid-19.

In the UK, the National health Service (NHS) has identified the specific symptoms to look for as experiencing either:

  • a high temperature – you feel hot to touch on your chest or back
  • a new continuous cough – this means you’ve started coughing repeatedly

As this is viral pneumonia, antibiotics are of no use. The antiviral drugs we have against flu will not work, and there is currently no vaccine. Recovery depends on the strength of the immune system.

Should I go to the doctor if I have a cough?

Medical advice varies around the world – with many countries imposing travel bans and lockdowns to try and prevent the spread of the virus. In many place people are being told to stay at home rather than visit a doctor of hospital in person. Check with your local authorities.

In the UK, NHS advice is that anyone with symptoms should stay at home for at least 7 days. If you live with other people, they should stay at home for at least 14 days, to avoid spreading the infection outside the home.

How many people have been affected?

China’s national health commission confirmed human-to-human transmission in January. As of 6 April, more than 1.25m people have been infected in more than 180 countries, according to the Johns Hopkins University Center for Systems Science and Engineering.

There have been over 69,500 deaths globally. Just over 3,200 of those deaths have occurred in mainland China. Italy has been worst affected, with over 15,800 fatalities, and there have been over 12,600 deaths in Spain. The US now has more confirmed cases than any other country – more than 335,000. Many of those who have died had underlying health conditions, which the coronavirus complicated.

More than 264,000 people are recorded as having recovered from the coronavirus.

There is growing evidence that a significant proportion of people infected with Covid-19 show few or no symptoms and that up to half of transmission may take place before symptoms occur.

A study of people onboard the formerly quarantined Diamond Princess cruise ship, which was docked in Yokohama, Japan, found 328 of the 634 positive cases (52%) were asymptomatic at the time of testing, and other studies have found a range of 20-80% of people carrying the virus but showing no symptoms.

To identify such cases, healthcare workers had ideally to be screened weekly in high-risk areas, Swanton said.

Graham Cooke, professor of infectious diseases at Imperial College London, agreed that screening should be seriously considered as the testing capacity is increased this month.

“I do think we need to raise the conversation about large-scale testing in healthcare settings,” Cooke said. “Now we’ve got good evidence that there’s significant transmission in people who are pre-symptomatic. We’ve got concerns about transmission in hospitals and we’ve got much-improved capacity for testing. There are reasons to be cautious, but one of them is not to be afraid of what we might find.”


The government has not released figures on the rates of hospital-acquired Covid-19, but there are calls for this data to be collected and made public.

“In Sars onward transmission in hospitals was a huge problem,” said Carl Heneghan, a professor and director of the Centre for Evidence-Based Medicine, at the University of Oxford. “There’s a data crisis here. We don’t know what proportion are being admitted with Covid-19 and what proportion are getting it in hospital. I suspect it could be 20%.”