UK cancer specialist says it is unethical to leave potentially infected staff in hospitals

The head of the testing facility at the Francis Crick Institute said healthcare workers should be screened for Covid-19 every week to protect patients from asymptomatic infection.

The call comes amid fears that hospitals are becoming hot spots for disease transmission and evidence that a large portion of those infected is showing few or no symptoms.

“With all our hype about social distancing, we are somewhat ignoring one of the major routes of infection right before our very eyes,” said Professor Charles Swanton, who is leading testing efforts at the institute in London. “It is almost indefensible to say that you should not be screening and isolating healthcare workers.”

Next week, the institute is launching a pilot trial to screen staff at University College Hospital to identify asymptomatic cases of Covid-19, but the approach has not been explicitly approved by the government and there have been no indications that this is considered a national strategy.

The institute’s testing laboratory has the capacity to perform 3,000 tests per day, so it will be able to run a screening process for employees at UCH if this approach is adopted.

One potential concern is that screening could lead to large numbers of doctors and nurses, who are otherwise healthy, being asked to self-isolate. But Swanton said the alternative – leaving employees asymptomatic, but potentially infectious – goes against the “do no harm” principle.

They’re Too Scared to Go to Hospital and You Can Understand Why

He added that patients were well aware of the risks, and we’re staying at home due to well-founded fears that they might catch the virus by going to hospitals or visiting doctors.

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

The Guardian reported on Thursday that London’s emergency chiefs were concerned about patients staying away, saying at a meeting last week: “People don’t want to go anywhere near the hospital. As a result, salvageable cases are not being treated.”

Swanton, who is also the chief medical officer at Cancer Research UK, said: ‘I am concerned that cancer patients need to be able to have the confidence to come to the wards. We are in this for at least another month, maybe two or three. Too long to get a late diagnosis of cancer.”

There is mounting evidence that a significant proportion of people infected with Covid-19 have few or no symptoms and that up to half of the transmission may occur before symptoms appear.

A study of people on the previously quarantined Diamond Princess cruise ship, which docked in Yokohama, Japan, found that 328 of the 634 positive cases (52%) were asymptomatic at the time of testing, and other studies found a range of 20- 80% of people carry the virus but do not show symptoms.

To identify such cases, Swanton said, it is best to have healthcare workers screened weekly in high-risk areas.

Graham Cook, professor of infectious diseases at Imperial College London, agreed that screening should be considered seriously because testing capacity is increasing this month.

“I think we need to generate discussion about widespread testing in healthcare settings,” Cook said. “Now we have good evidence of significant transmission in asymptomatic people. We have concerns about hospital transmission and we have a much-improved capacity for testing. There are reasons to be careful, but one of them is not to be afraid of what we might find.”

– The Guardian –