A recent outbreak of Covid-19 at Ipswich Hospital grew at an "alarming" speed, its chief executive has said - with fears "vaccine complacency" could have helped the virus to spread.
Nick Hulme, chief executive of the East Suffolk and North Essex NHS Foundation Trust (ESNEFT) - which runs Ipswich and Colchester hospitals - confirmed the outbreak during a meeting of the Suffolk Local Outbreak Engagement Board on Friday.
Mr Hulme said the "rapid" increase came two weeks ago, with the number of infections among inpatients increasing from three to 29 in less than 48 hours.
At its peak, the number of infected patients reached 54, although the numbers are now declining and currently stand at 45. No patients are in intensive care.
Public health officials are linking the outbreak with a rise in infection rates among the over-60s, which has put Suffolk above the England average.
Mr Hulme called the outbreak an "unfortunate and disappointing situation", but stressed the vast majority of patients were asymptomatic.
He said: "For me, what was so alarming was the speed at which over a weekend it went from very low numbers that most other organisations have got – literally single numbers of two or three patients – into what was a significant impact on the whole organisation, as these patients were spread across many parts of the hospital.
"The good news is the overwhelming number of patients are asymptomatic with Covid. They were admitted for other reasons and haven't been made significantly worse or sicker because of their Covid infection.
"But I do recognise that in terms of the overall prevalence across the borough, across the town and indeed for the county, it does represent quite a significant uptick in terms of those numbers."
An independent review of the hospital's practices has since taken place with the regional NHS and local clinical commissioning groups.
The review found issues over social distancing on site and the rigour of handwashing, as well as concerns over engagement with patients over the use of face masks.
Strict daily audits are now taking place across the hospital to ensure guidelines are being followed, Mr Hulme said.
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Mr Hulme said he was almost certain the source was not a member of staff – with only two having tested positive – but said staff acting as a vector for infection through their hands or clothing is a possibility.
He said: "I think the question as to why is absolutely pertinent, and of course we have been asking ourselves that for the past fortnight.
"I don't think there is any one answer to it – but the one thing we are doing is sending all the specimens away for genotyping and sequencing.
"It is really to find out whether or not there was a specific strain, whether it was a new strain, or whether there is evidence of cross-contamination within patients groups or staff groups."
Mr Hulme added he believes the infections may be due to what he called "vaccine complacency" – those who have been vaccinated letting their guard down against the infection, or those who see increased vaccination numbers as a means to relax their adherence to guidelines.
Mr Hulme said: "My hunch – and it is no more than that – is that across the county and the country, there is a degree of what I'm calling vaccine complacency.
"We have been incredibly good at vaccinating both staff and vulnerable patients and high risk groups, but I think that has led to a degree of complacency in terms of the basic hands, face, space and fresh air message.
"We have seen that in the public generally and sadly, within the hospital."
Mr Hulme added it is "absolutely safe" for people to come to the hospital and said all Covid-positive patients are isolated from the rest of the site.
Earlier this month, the Trust announced it is now asking visitors to the hospital to test themselves for Covid-19 before arriving on site.
The announcement comes as a shift towards moving lateral flow tests away from centres begins, with rapid test kits available for free via the NHS.
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