Despite the fact that nearly all legal Covid measures have been lifted in Wales, cases are continuing to rise and impact on the running of the NHS. In fact, latest figures show that there are more positive cases in hospitals now than there were at any point in the last year.
According to the Welsh Government, there were 1,473 people in general and acute beds with coronavirus on March 28, the highest amount since the beginning of March 2021 and a significant leap on the amount recorded just a month ago (837 on February 28).
Wales' largest health board, Betsi Cadwaladr UHB, had in excess of 400 coronavirus cases in its general and acute beds (418) on March 28, which is more than double the figure of 194 on February 28. Every health board in Wales has experienced a similar rise, and there are also a small number of positive cases among cancer services at Velindre University NHS Trust (nine).
However, it must be noted that the majority of Covid-positive patients in hospital are not being actively treated for the virus and were admitted for other reasons. As of March 28 there were 798 patients in acute hospitals with confirmed Covid, of whom just 99 (12%) were being treated specifically for the virus. Just a week earlier on March 21, 139 (20%) were being actively treated for Covid, so there has been a noticeable fall in recent days. You can keep up to date with the latest coronavirus news by subscribing to our daily briefing newsletter here.
It's also worth highlighting that there remains just a small fraction of people needing the highest form of treatment for Covid on invasive ventilated beds in intensive care, with just 19 recorded on March 28. Nine of them were based in Cardiff and Vale University Health Board (UHB), three were in Betsi Cadwaladr UHB, three were in Hywel Dda UHB, three were in Swansea Bay UHB, and one was in Aneurin Bevan UHB. Wales' vaccination programme has clearly reduced severe forms of the illness in most sections of society.
However, high levels of positive cases in Welsh hospitals inevitably has a knock-on effect for other NHS services. Not only are fewer beds and staff available for non-Covid related care, which can cause elective procedures to be postponed, the risk of Covid-19 being spread in hospitals increases.
Public Health Wales data revealed last week that 381 people either "probably" or "definitely" contracted the virus in hospital for the week ending March 20 - the most in a single week since the pandemic began. Previously the highest number ever recorded was the seven days to December 13, 2020, when 358 probably or definitely caught the virus in hospital settings.
Betsi Cadwaladr UHB had by far the highest number of probable and definite hospital infections for the latest week at 106, almost double the week before, followed by Cwm Taf Morgannwg UHB (71), Aneurin Bevan UHB (67), Cardiff and Vale UHB (56), Hywel Dda UHB (45), Swansea Bay UHB (32), and Powys (four). You can read more about that here.
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Commenting on the figures, Darren Hughes, director of the Welsh NHS Confederation, said: "As we know, Covid hospital admissions are rising, with almost 1,500 patients with Covid in our hospitals in Wales. This is roughly the equivalent of Wales' biggest hospital, the University Hospital of Wales, and the highest it's been since March 1, 2021. Pressure on GPs, the ambulance service and primary care is also extremely high.
"Although the percentage of patients primarily being treated for Covid is not as high as it previously was, the wider impact of having large numbers of Covid patients in hospitals is not to be underestimated and can also have implications on a patient's treatment options. Having to complete intensive infection prevention and control measures and ensure social distancing to minimise hospital-acquired infection is extremely time consuming, reducing staff's capacity to treat more patients at a time when the NHS is experiencing extremely high levels of demand.
"Numbers of Covid patients in critical care are relatively low with a slight rise in recent days, but even this small increase can have huge repercussions on other patients' treatment, including the ability to undertake planned operations where critical care facilities may be needed afterwards for a patient’s recovery."
With roughly one in 12 people in Wales currently with the virus, Darren added that the impact on staff absences is "unavoidable", further reducing capacity. He explained: "This not only causes considerable problems for the NHS but also social care, further impacting patient flow through hospitals and our ability to care for people in the community with other conditions.
On Monday, March 28 the legal requirement to wear masks in retail and on public transport was lifted but they will still be needed in hospitals and healthcare settings. The law to self-isolate after testing positive has also gone, but the advice remains to stay away from others. On the same day the Welsh Government also announced sweeping changes to testing including the closing of PCR testing sites and the scrapping of free lateral flow tests for asymptomatic people. You can find more details about it here.
"We're pleased to see the continuation of the requirement to wear face masks in health and care settings and regular lateral flow testing of staff who live and work in our communities," Darren added. "However, the reduction of testing in the community at a time of record high Covid rates is concerning. When Covid transmission escalates to these levels, that's when it's most likely new variants or subtypes will emerge. At a minimum it's vital we maintain testing infrastructure so we can scale up activity in the event of a new variant.
"Despite most legal Covid measures being lifted in Wales, we must all take responsibility for our actions and continue to take protective measures where possible, including taking up the offer of vaccination. The spring booster programme began two weeks ago in Wales and we urge those eligible to come forward to boost their immunity."
