Black and Asian hospital trust staff's high coronavirus risk

Almost 10,000 staff at the John Radcliffe, Churchill, Nuffield Orthopaedic Centre and Banbury's Horton General were tested both for the presence of the virus and antibodies indicating they had already had it.

Also read: Half of pregnant women with coronavirus were from BAME background

The combination of tests gives an accurate picture of who has had Covid-19 to date in the trust's workforce and, unlike other studies, is the first to comprehensively investigate all staff groups, including data from both symptomatic and asymptomatic staff testing.

The results reveal that 11 per cent of staff at the hospitals had Covid-19 at some stage, compared with estimates of 6.8 per cent of the general UK population as of May 28.

This figure rose to 21 per cent of staff working on coronavirus wards, though the researchers noted that there had been 'sporadic outbreaks' in areas with few or no Covid-19 patients.

Staff working in acute medicine were most at risk based on their role (27.4 per cent) followed by porters and cleaners (18 per cent).

Intensive care staff at 9.9 per cent were found to be largely protected – researchers saying this was likely due to level-2 PPE (mask, eye protection, gown, gloves), training, space, supervision and staff levels.

The figures also show that black, Asian and minority ethnic (BAME) staff, independent of role or working location, were at greater risk of infection than their white colleagues.

The overall figure for Covid-19 infection among BAME staff was 14.7 per cent, compared to 8.7 per cent for white staff. The figure was even higher for black and Asian staff at 17 per cent.

Also read: Hospital message on Black Lives Matter and BAME coronavirus

Terry Roberts, 'chief people officer' for Oxford University Hospitals (OUH) trust which runs the hospitals, said: "This research, based on a comprehensive staff testing effort, has been useful in helping us to identify which staff groups are most at risk.

"From an early stage in the pandemic we have tried our best to put in place proactive measures to protect our all of our staff, whether through the provision of appropriate PPE, mandatory risk assessments by line managers and clear and timely communications – and this has included those working for outsourcing companies and agencies, such as porters, cleaners, catering and estates staff, whom we consider to be part of the OUH team, and whose health and wellbeing is just as important as that of staff employed directly by the trust."

Terry Roberts, OUH chief people officer

He added that, given the high rate among BAME staff, special steps had been put in place so such staff feel 'safe and supported'.

This has included adding them to the ‘at risk’ group and advising managers on how they can ensure any risks are mitigated.

Mr Roberts said: "We also set up listening sessions to ensure that BAME staff could highlight any concerns they had."

The first patients with Covid-19 were admitted to OUH in mid-March. Testing, initially reserved for in-patients, was extended to symptomatic staff and household contacts with fever or new-onset cough from March 27.

Also read: Hospital worker slams lack of social distancing at Cowley Tesco

A voluntary asymptomatic screening programme for all staff working anywhere on site started on April 23.

By June 8, 348 of 1,498 symptomatic staff tested (23 per cent) had tested positive (2.5 per cent of 13,800 OUH staff).

Across the trust 10 staff were admitted with Covid-19, with four dying.

These were porters Oscar King Jr and Elbert Rico, nurse Philomina Cherian and administration assistant Peter Gough.

Elbert Rico with his family

The report findings noted transmission between staff increased cases, based on high Covid-19 rates in several wards without large numbers of Covid-19 patients.

It added: "Given likely staff-to-staff transmission where Covid-19 patient pressure was low, there is a need to protect all staff regardless of role."

It also said the study suggested an earlier move to universal level-1 PPE (surgical mask, optional eye protection, apron, gloves)in acute medicine may have prevented some infections, which until April 1, in line with national guidance, was only worn for contact with patients with known or suspected Covid-19.

Though it stressed it was 'difficult to say' whether level-1 PPE was less protective than level-2.

OUH’s director of infection prevention and control, Dr Katie Jeffery, said: "It has been an invaluable exercise to have evidence of the varying patterns of infection across our four hospitals – not only to identify those staff who had the infection and so protect staff and patients, but also to identify those staff groups and departments that are at highest risk.

"We are continuing to offer testing to our staff to keep them and our patients safe.

"A whole bundle of measures were brought in to protect staff and patients, so it is difficult to know exactly which factors were most important in this outcome.

Also read: Coronavirus at Mini - 9 cases in a week

"This research will be useful as we move forward, as we assess whether those staff with antibodies retain their immunity to the virus."

An infection prevention and control plan was implemented across the trust as a result of the testing programme to try to minimise the spread of Covid-19 among staff and patients.

Professor Meghana Pandit, OUH’s chief medical officer, explained: “We have drawn up recommendations for all staff across our four hospital sites, including portering and cleaning colleagues.

“This has included staff continuing to use level-1 PPE for all patient contacts, and reinforcing PPE-focused training and safety huddles; ensuring strict social distancing and mask-wearing for patients and staff; continuing to triage patients according to symptoms of possible Covid, including atypical presentations in the elderly; reviewing cleaning procedures and maximising OUH’s rapid diagnostics and lab capacity.”

Trust chief executive Dr Bruno Holthof added: “Thanks to the infectious diseases and microbiology teams, research nurses and medical students who worked tirelessly to collect more than 20,000 samples, we now have a detailed view of the infection prevalence in our staff."