I continue to be disappointed in the guidance provided by national and international authorities to prevent transmission in healthcare settings...
Today its the CDC and influenza
🧵
I never like a guideline on a topic that says go somewhere else. Here the CDC has deferred to a new document.
The page indicates that for "different types of flu" there are different instructions. If true, this means transmission of "seasonal flu" is less important and will not get full protection... Best get that vaccine because the hosp is not applying full prevention precautions
Since the nonsense yesterday when a public health body erroneously stated that 80% of infections diseases are spread by contact....
I promised a thread....
Lets start with the @WHO Hand hygiene guideline
@LazarusLong13
In Section 9 of WHO HH guideline the relationship of HCAI and hospital pathogens is revealed
2 assertions are made
A) Semmelweis used an antiseptic and it reduced puerperal fever.
B) Substantial evidence for hand antisepsis reducing HCAI is contained in citations 58, 179, 180
Assertion A
Semmelweis did not use nor recommend an antiseptic. He recommended and used a disinfectant. Excerpt from his univ web site.
The procedure reduced PF but was intolerable & burnt HCWs' skin.
NB IS knew it was coming from the PM room and should have stopped PM visits
When you make a Whopper of a mistake, e.g., "airborne infections are spread by sprayed on droplets", those in charge of PH guidance should have immediately identified whether other similar errors in MoTs are present.
Consider this.
An outbreak of cryptosporidium... 1/x
As @UKHSA tell us (as well as all PH agencies)... its contact
Default to contact is what is accepted for most MoTs.
Now if they are wrong - then all advice on prevention is at least incomplete. So, is there evidence of airborne? 2/x
Well lookie here....
There appears at the least the plausibility - lets look inside 3/x
Thoughts from yesterday's @KnowlexUK conference
Its not 2020. It is more akin to when harms from, the likes of "passive smoke", "lack of seat belts" & "asbestos" became undeniable - although not visible to all.
There are significant, persistent and undeniable harms.
1/6
So where are we now, and where do we ?need to be to negate the harms
[starter for 10]
2/6
We will never get to where we need to be in one leap or by 1 action.
What is needed first?
Diagnose the problem and acknowledge the risks 3/6
No exaggeration here - this is a major article. Forget your CERN collider, here is a method for obtaining mechanistic evidence of far-afield airborne transmission. It was undertaken in a facility designed to study TB.
1/10
The authors state that there should be evidence of the transmission route to inform guidance.
Could not agree more. If only...
"Unambiguous demonstration of transmission routes is important."
Yes, Yes, Yes
By the way this wont come from RCTs!
2/10
For all the implausibility of other routes, and the evidence during outbreak settings there were laggards...
3/10