Sent on behalf of Welsh Government
Saesneg yn isod / English below
Profion i atal COVID-19 mewn cartrefi gofal
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Dr Frank Atherton
Prif Swyddog Meddygol/Cyfarwyddwr Meddygol GIG Cymru
Chief Medical Officer/Medical Director NHS Wales &
Albert Heaney
Dirprwy Gyfarwyddwr Cyffredinol / Deputy Director General
Y Grŵp Iechyd a Gwasanaethau Cymdeithasol
Health and Social Services Group
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20 Gorffennaf 2020
Annwyl Gydweithwyr
Hoffem ddiolch ichi am eich holl waith caled i sicrhau bod cartrefi gofal yng Nghymru yn cael y cymorth sydd ei angen arnynt i leihau niwed COVID-19 cymaint â phosibl i'r preswylwyr agored i niwed yn eu gofal. Nod y llythyr hwn yw rhoi gwybod ichi am y trefniadau profi arfaethedig ar gyfer cartrefi gofal o hyn ymlaen.
Wrth gwrs, eich blaenoriaeth fydd ymateb yn brydlon i'r cartrefi gofal hynny sy'n rhoi gwybod am achos posibl, gan mai hyn a fydd fwyaf buddiol o ran lleihau'r risg o drosglwyddo'r feirws. Gwnaethom ysgrifennu atoch o'r blaen i roi gwybod ichi y byddai holl staff cartrefi gofal yn cael cynnig prawf wythnosol am gyfnod o bedair wythnos o ddydd Llun 15 Mehefin ymlaen. Mae'r profion ar gael ar ffurf swabiau y gall pobl eu cymryd eu hunain, a gallant eu cael drwy'r Porth Gofal Cartref neu'n uniongyrchol gan y bwrdd iechyd. Rhoesom wybod yn ein gohebiaeth ddiwethaf ein bod yn adolygu'r angen i brofi staff cartrefi gofal yn barhaus oherwydd, wrth i gyffredinrwydd yr haint leihau, bydd y Gwerth Rhagfynegol Positif ar gyfer unrhyw brawf penodol yn lleihau oherwydd bydd mwy o ganlyniadau positif anghywir am bob canlyniad positif cywir.
Diolch i'ch holl waith caled, mae nifer yr heintiau newydd ymhlith staff cartrefi gofal yn isel iawn – tua un achos o COVID-19 ym mhob mil o aelodau o staff a gaiff eu sgrinio. Fe'n cynghorir gan y Gell Cyngor Technegol y bydd sgrinio pobl nad oes ganddynt symptomau pan fydd cyffredinrwydd haint COVID-19 mor isel â hyn yn cynyddu'r tebygolrwydd o ganlyniadau prawf positif anghywir. Rydym yn cydnabod y bydd canlyniad positif ar gyfer COVID-19 i aelod o staff yn cael effaith ddifrifol ar gartrefi gofal. Yn achos aelodau unigol o staff sy'n cael canlyniad prawf positif ond nad oes ganddynt symptomau ar adeg y prawf, rydym yn argymell y dylent hunanynysu ar unwaith. Os byddant yn parhau i beidio ag arddangos symptomau dros y 48 awr nesaf, dylid cynnal ail brawf. Os bydd canlyniad yr ail brawf yn negatif ac nad oes gan yr unigolyn symptomau o hyd, gellir tybio nad oes gan yr unigolyn COVID-19.
Nid ydym yn argymell y dylai unigolion sydd wedi gwella o haint COVID-19 ac sy'n dal heb symptomau gael ail brawf fel rhan o'r rhaglen hon am chwe wythnos ar ôl eu canlyniad positif cyntaf. Dylai unigolion sydd wedi cael prawf positif o'r blaen ac sy'n datblygu symptomau yn ystod y cyfnod chwe wythnos gael ail brawf.
Bydd profion yn parhau i fod ar gael i staff cartrefi gofal drwy'r Porth Cartrefi Gofal. Wrth ryddhau Strategaeth Brofi newydd Llywodraeth Cymru ar 15 Gorffennaf, cyhoeddodd y Gweinidog Iechyd a Gwasanaethau Cymdeithasol y byddai'r polisi o brofi staff cartrefi gofal bob wythnos yn parhau am gyfnod pellach o bedair wythnos, tan 9 Awst, er mwyn rhoi tawelwch meddwl o hyd i staff cartrefi gofal, ac i breswylwyr a'u teuluoedd; ac y caiff staff eu profi bob pythefnos o 10 Awst os bydd cyffredinrwydd yr haint yn aros yn isel.
Byddwn yn parhau i fonitro lefel haint COVID-19 yn fanwl iawn a byddwn yn cyfathrebu unwaith eto ar ddiwedd y cyfnod pellach o brofi wythnosol.
Wrth inni ysgrifennu'r llythyr hwn, mae mater newydd godi mewn perthynas â chynnal profion mewn cartrefi gofal na ddylai effeithio ar gartrefi gofal yng Nghymru, ond roeddem am roi gwybod ichi amdano. Ar 15 Gorffennaf, cyhoeddodd Llywodraeth y DU ddatganiad ar gov.uk yn hysbysu cartrefi gofal sydd wedi cael pecynnau profi Randox y dylent roi'r gorau i'w defnyddio. Ni ddylai hyn effeithio ar gartrefi gofal yng Nghymru, oherwydd nid yw pecynnau Randox wedi cael eu harchebu ar gyfer cartrefi gofal yng Nghymru ers 16 Mehefin, a phecynnau profi Kingfisher yw'r holl becynnau profi sydd wedi cael eu cyflenwi drwy borth y DU ers hynny. Mae'r mater hwn yn gyfle defnyddiol i ofyn i gartrefi gofal yn eich ardaloedd waredu unrhyw becynnau profi Randox sydd heb eu defnyddio ac sydd â'r enw hwnnw wedi'i nodi'n glir arnynt, oherwydd ni ddylai cartrefi gofal eu defnyddio.
Diolch am eich cefnogaeth barhaus
Cofion gorau
 Dr Frank Atherton Albert Heaney
Prif Swyddog Meddygol Dirprwy Gyfarwyddwr Cyffredinol
Testing to prevent COVID-19 in care homes in Wales
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Dr Frank Atherton
Prif Swyddog Meddygol/Cyfarwyddwr Meddygol, GIG Cymru
Chief Medical Officer/Medical Director NHS Wales &
Albert Heaney
Dirprwy Gyfarwyddwr Cyffredinol / DeputyDirector General
Y Grŵp Iechyd a Gwasanaethau Cymdeithasol
Health and Social Services Group
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20 July 2020
Dear Colleagues
We want to thank you for all your hard work to ensure that care homes in Wales are provided with the support they need to minimise harm of COVID-19 on the vulnerable residents in their care. This letter is to advise you on the proposed testing arrangements for care homes going forward.
Your priority of course will be to provide a prompt response to those care homes who report a possible case as this will have the greatest benefit in terms of reducing transmission risk. We wrote to you previously to advise that from Monday 15th June all care home staff would be offered a weekly test for a four week period. Testing was made available by self-administered swabs acquired either through the Care Home Portal or directly from the health board. We advised in our last communication that we were keeping the need for testing of care home staff under review because for any given test as prevalence of infection decreases, the Positive Predictive Value decreases because there will be more false positives for every true positive.
Thanks to all your hard work the number of new infections diagnosed in care home staff is very low - approximately one case of COVID-19 in every thousand staff members screened. We are advised by the Technical Advisory Cell that when the prevalence of infection of COVID-19 is this low screening asymptomatic people increases the likelihood of a false positive test result. We recognise the identification of a positive COVID-19 staff member will have a serious impact on care homes. In individuals who test positive but are asymptomatic at the time of the test we recommend that the individual staff member immediately self isolates. If they remain asymptomatic over the following 48 hours then a second test should be taken, if this result second test is negative and the individual has remained asymptomatic then it can be assumed that the individual does not have COVID-19.
We do not recommend that individuals who have recovered from Covid-19 infection and who remain asymptomatic are re-tested as part of this programme for 6 weeks following their initial positive result. Individuals who have previously had a positive test and who become symptomatic within the 6 week period should be re-tested.
The availability of testing for care home staff through the Care Home Portal remains in place. When releasing the Welsh Government’s new Testing Strategy on 15 July, the Minister for Health and Social Services announced that the policy to test care home staff on a weekly basis would continue for a further period of four weeks, to 9 August, to provide ongoing reassurance to care home staff, and residents and their families; and that testing of staff will be undertaken every two weeks from 10 August if prevalence remains low.
We will continue to monitor the level of COVID-19 infection very closely and will communicate again at the end of the further period of weekly testing.
While writing, an issue has just arisen relating to testing in care homes which should not impact on care homes in Wales, but we wanted to make you aware of it. On the 15 July the UK Government issued a statement on gov.uk and notified care homes that have been supplied with Randox testing kits to instruct them to pause using them. This should not affect care homes in Wales as the last order for Randox kits for care homes in Wales was on 16 June, and all the testing kits supplied through the UK portal since have been Kingfisher testing kits. This issue provides a useful opportunity to ask care homes in your areas to dispose of any unused Randox testing kits which are clearly marked with that name as care homes should not be using them.
Many thanks for your ongoing support.
Kind regards
Dr Frank Atherton Albert Heaney
Chief Medical Officer Deputy Director General
Hawlfraint y Goron / Copyright © 2020 Arolygiaeth Gofal Cymru / Care Inspectorate Wales. Cedwir pob hawl / All rights reserved.
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