Introduction: The Royal Melbourne Hospital (RMH) experienced a significant number of staff COVID-19 infections during July and August 2020 concurrent with a state-wide surge in cases. We describe the epidemiology of the infections and the interventions associated with outbreak control.
Methods: The RMH is a large tertiary hospital on multiple sites including geriatric and rehabilitation beds at the Royal Park Campus (RPC). The Infection Prevention service managed the outbreaks and exposures, including staff and patient contact tracing, in conjunction with the Victorian Department of Health and Human Services using their COVID-19 guidelines and definitions. A staff well-being service was set up to manage infected and furloughed staff. Data were entered into a REDCap database and analysed using Stata 16.
Results: Between 1 July and 31 August 2020, 262 COVID-19 cases occurred in RMH staff including 179 (68.3%) nurses and 38 (14.5%) support staff. 107 (40.8%) were at RPC and coincided with a large number of patient infections (peak of 60). 57 (21.8%) infections occurred on COVID-19 wards, the emergency department and intensive care unit. Twenty (7.6%) occurred on “cold” wards which experienced unexpected outbreaks. Mitigation strategies according to a hierarchy of controls were introduced. These included elimination, engineering and administrative controls and personal protective equipment as well as frequent testing of staff and patients with rapid access to results under a previously established governance structure.
Discussion: A large institutional outbreak of COVID-19 was controlled using a pragmatic and iterative suite of interventions.
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