Special unit for kidney patients ‘saved lives from coronavirus'

Infected patients needing dialysis isolated from others in vulnerable group
A projection on the side of St. Thomas Hospital
Getty Images

Hundreds of vulnerable Londoners have been successfully shielded from coronavirus while continuing to receive life-saving NHS care three times a week.

Guy’s and St Thomas’ trust established a “Covid-positive” site for kidney dialysis patients with coronavirus, preventing them coming into contact with other dialysis patients.

The trust operates six “satellite” dialysis units in south-east London and Kent which are used by 670 patients three times a week.

Staff feared that about half would contract Covid-19, which would place them in grave danger as dialysis patients have a compromised immune system.

But by treating Covid-positive patients only at its New Cross Gate unit, the number contracting the virus was kept under 100.

Several patients died but the mortality rate was said to be among the lowest in the UK for dialysis patients when the higher prevalence of the virus in the capital is factored in.

Matthew Bultitude, clinical director for transplant, renal and urology at Guy’s and St Thomas’ and a consultant urological surgeon, said: “In a hospital situation, we know what to do — we have a dedicated ward, or we use side rooms. That is just not possible in a dialysis unit. It has worked very well. I think it has prevented cross-transmission.”

The approach contrasted with other NHS trusts, which separated patients within the same unit.

Dialysis patients often have diabetes, high blood pressure and heart disease. Many are awaiting transplants, but these were halted during the pandemic, so patients had no route off dialysis.

Patients often have a chronic cough, increasing the risk of spreading the virus. They wear face masks while being transported to clinic and during dialysis. Patients at the trust are being regularly swabbed, but less than two per cent of asymptomatic patients are being found to have the virus.

About a dozen patients are still using the “Covid-positive” unit at New Cross but it may be wound down next week. At its peak, the number was about 50.

Glenda Baillie, head of nursing for the directorate, said: “They are very vulnerable and they are a shielded group — but, by the nature of needing to come into a healthcare setting three times a week to sustain their lives they cannot be shielded.

We think that what we have done around the cohorting and triaging in the units means we have potentially reduced our numbers by what could have been another 200.”

David Game, the lead for nephrology, said: “We are quite surprised how resilient this population has been. We were expecting a higher mortality rate. We were very worried early on when we could see what had gone on elsewhere.

“The commonest cause of death for a dialysis patient in China was not having dialysis. We were very keen that that should not be the case, and that we would offer everyone as much dialysis as they were getting before.”

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