Two wards have been closed at the Royal Glamorgan Hospital in Llantrisant after an outbreak of coronavirus

Cwm Taf Morgannwg University Health Board announced on Wednesday, September 23, that it was now taking "robust action" following the identification of 34 cases of Covid-19 at the hospital.

A spokeswoman said the infections were linked "mainly" to transmission within the hospital and that "significant work" was underway to understand and control the outbreak.

A specialist team is said to be meeting daily and a number of key measures have been put in place to respond to and manage these cases, including:

Dr Kelechi Nnoaham, director of public health for Cwm Taf Morgannwg University Health Board, said: "The health and wellbeing of our patients and staff is our number one priority and we take infection prevention and control measures extremely seriously.

"I would like to reassure the public that immediate action has been taken to address this outbreak, and although it is too early to confirm the end of the outbreak, early evidence suggests that this has resulted in the number of infections transmitted within the hospital being contained.

"Cases of Covid-19 have been steadily rising across our communities and it is vital is that we all play our part in helping to reduce the spread of the virus through social distancing, good hand hygiene, the wearing of masks and PPE in appropriate settings and following the latest government measures on further restrictions."

Meanwhile, a doctor at the Royal Glamorgan has admitted he was surprised by the sharp rise in Covid-19 patients at the hospital over recent days.

Dr Raja Biswas, a consultant physician, said he was concerned by the volumes of unwell patients with the virus now coming through the doors.

On Monday, Health Minister Vaughan Gething confirmed that there were 34 Covid-positive patients at the Royal Glamorgan - a figure he described as "particularly worrying".

Rhondda Cynon Taf (RCT), where the hospital is based, now has one of the highest cases of coronavirus per head of population anywhere in the UK.

A local lockdown was introduced for the county borough last week which has limited the freedoms of its residents.

Dr Raja Biswas, a consultant physician at the Royal Glamorgan Hospital

"Even at the beginning of last week we didn't have too many cases at all. But to then get so many cases so quickly is a definite matter of concern," said Dr Biswas, who contracted Covid-19 himself in May but has since recovered.

"As part of my management role I have been trying to get some clinical planning in place. We certainly weren't expecting this degree of a second wave at this stage. We are almost at the point we were at in around April time.

"But the good thing is we are much more aware, better prepared and have much more knowledge of the virus than we did before which is always a positive thing."

But Dr Biswas, a dad-of-one who lives in Cardiff, claimed that trying to staff the wards at the hospital remains an issue.

"The problem is that there is no more staff. It's not a question of money," he said.

"At the moment people are starting to have colds, sniffles and a rise in temperature as the weather is changing.

"Obviously a lot of staff have to self-isolate with these symptoms until they get their results back. With the schools opening, and with children getting these symptoms, then you have to wait for your child to be swabbed and to be negative before you can be sure to come back to work.

"This is obviously a major factor in the reduction of the workforce."

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When the first wave came, Dr Biswas said the health board had to act as if it was an "emergency situation".

"We had to transfer a lot of outpatient work because the estimations [of Covid infections] were so high," he said.

"But this time around we can be more measured in our approach, bringing in a planned escalation policy so we can run a normal service for as long as possible."

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Dr Biswas admitted that the hospital had not been able to catch up on all its routine, non-Covid-19 work due to the outbreak, leading to longer waiting lists.

"The waiting lists have to be prioritised for those in the most urgent need. Those kind of things have to be done first.

"A lot of my colleagues would like to do more remote consultations so that we can see the patients who desperately need to be seen as much as possible.

"But a lot of this has to be done in our own time, in addition to tackling Covid."

When it came to introducing a local lockdown for RCT and for Cwm Taf University Health Board as a whole, Dr Biswas said he hoped it would help to reduce hospital admissions.

He said: "At the end of the day, we as medics can only do so much. We cannot stop the infection rate from going down. That is not in our control. It's only the general public who can do that.

"What I think is frustrating is that some people are seeing memes and posts on social media and have started thinking 'this is not something I need to be worried about anymore'.

"A lot of people have started feeling that they need to live their lives and will just take the chance. Yes, you might not get it, but your elderly relative might get it and die."

However, he said he did understand the frustrations of the public due to the mixed messages being given to them by government.

He added: "What is the point in saying to people that they should socially distance, and then have three days a week when you can get a half price meal?

"Why are the pubs being kept open until 10pm? People will see that 10pm is approaching and quickly order more drinks.

"I understand that the hospitality industry and the economy are in a bad state, but if you want to really address it wouldn't it be better to take a sharp measure [shutting pubs and bars] for a short period than saying it will last for six months?

"If you need to break the cycle then that could be preferable. However, I'm not a scientist or an epidemiologist. I'm a clinician. But I feel it makes sense."

Dr Biswas said most of the patients being admitted with Covid-19 in the Royal Glamorgan Hospital were elderly and with comorbidities (other pre-existing conditions).

He said this would inevitably lead to patients spending considerable amounts of time on wards before returning to their care settings.

"They have to be in a hospital until at least they are negative which puts increased pressure on the hospital," he said.

"We only have a finite number of hospital beds. And it's not just a question of putting in a bed, you need oxygen, connections, along with the appropriate numbers of staff to look after them."

Despite the pressures facing the hospital, the experienced medic said he was confident the Welsh NHS would not be overwhelmed.

"I think we will manage because NHS staff are incredibly dedicated, motivated people. That's the main reason this whole system works.

"But for staff [looking after Covid patients] they don't know whether they will be the one lying in that hospital bed in the next 24 to 48 hours. That can be very scary and mentally very draining."

The Royal Glamorgan Hospital in Llantrisant

Rhondda Cynon Taf (RCT) is now one of six local authorities in south Wales to be placed under local restrictions.

These restrictions include:

Andrew Morgan, leader of Rhondda Cynon Taf Council

Cllr Andrew Morgan, leader of RCT Council said: "Health professionals, from nurses through to doctors, are now facing the reality of the significant increase in the number of cases over the last 14 days which led the Welsh Government to apply additional restrictions in Rhondda Cynon Taf, and which is now sadly resulting in a continued increase in Covid-19 positive hospital admissions.

"The evidence highlights the rise in cases in the 40-plus age group and shows that the virus is not just affecting the elderly or vulnerable.

"It is clear that our social behaviours need to change, as transmission continues to occur between close contacts, and friends and family members, who are not adhering to social distancing requirements.

"Unless we all take responsibility and act now, this situation will worsen and will place further pressures upon our NHS at a time of year which in normal circumstances automatically creates additional pressures for the NHS.

"It is not inevitable that this increase will continue, if we all take responsibility to avert the community transmission of the virus in RCT by following social distancing and the recently introduced restrictions.

"It is everyone’s responsibility to turn this situation around.  

"We urge people to consider their behaviour over these coming days or possibly weeks, and to think about whether they can honestly answer whether they have played their part in protecting our communities and keeping everyone safe. 

"We can turn this around together."