There are many processes in place to be able to manage an outbreak effectively, but it can become more problematic when the source of an outbreak is unknown. It is also dependent upon the setting of an outbreak as to what steps are needed.
Motolani Awokoya, Health Protection Practitioner at Public Health England was able to share his expertise of managing an outbreak, discussing the main talking points ahead of the NHE365 event on 23 June. He will be on the final Leader’s Debate discussion for managing outbreaks and major incidents.
The main areas Mr Awokoya will highlight are:
- How outbreaks are notified to Public Health England
- Why outbreaks are investigated
- Steps involved in outbreak management
He talked through the processes undertaken when first finding out about an outbreak, using a care home as an example, as well as how this has to initially meet the definition of an outbreak.
Mr Awokoya explained: “In a care home, if a resident has tested positive for Covid, then legally the care home is mandated to report it to the local health protection team, and when it is reported, of course we look at the case destination. If it meets the criteria or definition of an outbreak, then we treat it as an outbreak.
“So, when we enter the cases into the local software when collecting the data, we have to see if the data matches what is defined as an outbreak, then we can also declare an outbreak in that setting and we can manage it as it were. You also want to ring the setting, and ask them about their local infection prevention measures, and find out what their policies are like locally.”
When discussing some of the reasoning behind investigating an outbreak, he highlighted two major reasons, and detailed how important finding out the source of an outbreak was, because of the challenges involved when not knowing the source.
“First of all, we want to ensure that the outbreak comes to an end in the quickest possible way, and that takes a lot of processes, and in doing that, we also want to find out the source of the outbreak. Because once the source of the outbreak has been identified it is easy to look out for the contact, which is also very important in outbreak management.
“You want to identify the contact, and assess whether they are getting further testing, and if they have to isolate. Then the contact tracing process is going to inform the outbreak management team of what to do.
“It is to ensure that there is no further spread to the wider public or to the wider community.
“More times than not we can find the source of the outbreak, and then it becomes easy to manage. But in some instances, it is difficult to find out the source of the outbreak.”
Mr Awokoya shared the fact that depending on whether something is defined as an outbreak will determine whether this warrants further investigation or advice, and how the steps taken are very much dependent on the setting.
“When you generate data, and you see that it’s a setting with a very high risk, you want to do a further investigation, or take further action, like getting more people tested, you can then know if there’s an increase amongst transmission within the home.
“For example, in a care home, if they’re a suspected contact, and are included amongst transmission in a home, you want to be on high alert, you want to make sure that there’s no other transmission.
“If it is in tandem with the definition of an outbreak, then depending on the setting, there are various ways to manage an outbreak in the workplace, in a factory, in a care home, or in a hospital setting.”
He also highlighted how the data hasn’t always been accurate, and what solutions are given if the setting doesn’t meet the definition of an outbreak, as well as reiterating the need to find the source and some of the challenges involved.
Mr Awokoya concluded: “If it does meet the definition of an outbreak then we will investigate. We want to find out the source of the outbreak. It’s very important to find out the source of the outbreak, whether it is a staff member, or a resident who went to the hospital where they could have acquired Covid and spread it in the home.
“Now sometimes you may find out that there’s a breach in the local policy. I mean the ownness is not to condemn them, but to advise, and work hand in hand with the local authorities, and with the care home managers, or the care home management to ensure that there is enough support to manage the outbreak.
“It’s a challenge for the team, because we are trying to look for the best possible ways of managing the situation on the ground. But sometimes it goes out of your hands.”
Join Mr Awokoya and many other healthcare professionals at NHE365’s Infection Prevention & Decontamination event on 23 June. You can register for the event here.