5.1 Introduction

This guidance has been developed during the ongoing COVID-19 pandemic recognising the likelihood of a surge in other respiratory viruses in addition to COVID-19 over the winter season of 2021/22 and supersedes the 3 COVID-19 addenda (Acute, Care home and Community health and care settings) first published in October 2020.  This guidance is aligned with the UK Infection Prevention and Control for Seasonal Respiratory Infections in Health and Care settings including SARS-CoV-2 for Autumn Winter 2021/2022. High consequence infection diseases (HCIDs) transmitted by the airborne route such as emerging pandemic influenza or other novel respiratory viruses are out of scope for this guidance.

Key changes as we move from the COVID-19 addenda to Winter (21/22), Respiratory Infections in Health and Care Settings Infection Prevention and Control (IPC) Addendum are;

summary of changes compared with the previous COVID-19 addenda is available. It should be noted that the principles of applying TBPs for service users presenting with a suspected/confirmed respiratory virus apply at all times throughout the year however the purpose of this guidance is to support health and care settings when cases of respiratory viruses/infections increase impacting on flow and service delivery. 

NHS Scotland boards are preparing for an increase in service demand as a result of respiratory virus this winter season (21/22) and this guidance should be implemented to minimise risk and harm to staff, service users and visitors during this period of increased admissions and whilst the COVID-19 pandemic continues. It is intended that this guidance will be reviewed regularly and adapted for use routinely on an annual basis.

IPC measures required for COVID-19 are incorporated within this guidance and IPC principles are applied consistently across all respiratory pathogens wherever possible.  Some pandemic measures specific to COVID-19 remain at this time and these will be highlighted within this guidance.

Although many of the COVID-19 pandemic measures within the general community are relaxing, there remains a very real risk within healthcare settings of COVID-19 transmission and transmission of other respiratory pathogens e.g Influenza, Respiratory Syncytial Virus (RSV), Rhinovirus.  This is due to compounding factors such as vulnerability of the service users, the communal nature of many of the care facilities and within primary and secondary care settings, the very nature of the service provided in treating respiratory infections which facilitates the presence of high numbers of symptomatic individuals in the setting.

The term ‘service users’ will be used in generic sections to describe patients, residents and individuals.

This guidance is intended for use by all those involved in health and care provision and applies to the following settings;

This guidance is generic amd applies across all the settings described above however, where specific sector guidance exists it will be highlighted as follows;

Guidance specific to Secondary care settings or particular services within secondary care will be highlighted in blue.

Guidance specific to Primary care and Community Health and Social Care settings or particular services within primary care or health and social care (excluding care homes) will be highlighted in green.

Guidance specific to Care home settings or particular services within the care home settings will be highlighted in pink.

Guidance specific to Dental settings or particular services within dental settings will be highlighted in lilac. (Dental services operating in secondary care settings may also choose to refer to guidance specific to secondary care)