Spread of COVID-19 mapped in hospitals to ‘break the chain’ of transmission

UCLH will be part of a first-of-its kind clinical trial, led by scientists at UCL, that will evaluate the use of ‘real time’ viral genomic data to reduce the spread of COVID-19 within hospitals.

The UK-wide study’s findings could help the NHS reduce further transmission of the virus by determining if an individual caught the virus from someone else within the same hospital.

The trial, led overall by Professor Judith Breuer, Director of the UCLH/GOSH Biomedical Research Centres funded Pathogen Genomics Unit (PGU/UCLG), is part of the Government’s £20 million COVID-19 Genomics UK Consortium (COG-UK). COG-UK has established a network of rapid genome sequencing centres across the UK – allowing scientists to map the virus’ spread across the country.

Professor Breuer said: “Spread of COVID-19 infections in hospitals is now recognised to be a major problem for both healthcare workers and patients, and ‘breaking the chain’ of these transmissions is critical.

“Tried and tested procedures to minimise infection spread in hospitals are already in use, including separating COVID-19 infected patients from uninfected patients, extensive cleaning, the use of PPE, and continual hand washing.

“Despite these measures, COVID-19 transmission to patients and staff is still occurring and has sadly proven fatal. So it is essential that we try out new tools such as viral sequencing to find out why this is happening and to help reduce hospital spread.”

This study is one of a number of COVID-19 studies that have been given urgent public health research status by the Department of Health and Social Care.

The COG-UK Hospital Onset COVID-19 Infection (HOCI) trial will involve over 15 hospitals linked to COG-UK sequencing hubs across the UK, including UCLH. UCLH Consultant Virologist Dr Gee Yen Shin will lead the UCLH portion of the trial, alongside Dr Eleni Nastouli, Dr Catherine Houlihan, Gema Martinez-Garcia and Leila Hail from virology.

Each site will analyse the COVID-19 sequences in nasal and throat samples from all known COVID-19 patients in the hospital, along with newly infected hospital patients and frontline NHS staff. The trial will evaluate whether results from whole virus genome sequencing of all COVID-19 samples (now available within 24-48 hours) reduces the number of hospital outbreaks compared with standard methodologies. Specifically, the genomic data is likely to enable clinical teams in each hospital to see if newly infected patients have picked up the virus from a known positive COVID-19 patient within the hospital, or from outside the hospital.

There is already evidence emerging from COG-UK that COVID-19 sequences can help teams to control hospital infections better. The COG-UK HOCI trial will quantify by how much sequencing helps, how important it is to return results rapidly, what is the best way to implement COVID-19 sequencing across the NHS, and how much it costs. This information will help to make more precise plans as to how to use COVID-19 sequencing in the future.

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