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Dr Evonne T Curran NursD 💙🇺🇦 Profile picture
@EvonneTCurran
Nov 17, 2023 • 1 tweets • 1 min read • Read on X
Serious question:

Who owns (which specialty) owns covid, its complications, its prevention, its treatment, its long-term sequalae?

Who is doing / leading on the guideline, surveillance, prevention, treatment, and complications?

The answers are absent in the NIPCM.

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More from @EvonneTCurran

Dr Evonne T Curran NursD 💙🇺🇦 Profile picture
May 12
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 Image
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 Image
Well lookie here....
There appears at the least the plausibility - lets look inside
3/x Image
Read 10 tweets
Dr Evonne T Curran NursD 💙🇺🇦 Profile picture
May 1
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 Image
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 Image
Read 7 tweets
Dr Evonne T Curran NursD 💙🇺🇦 Profile picture
Apr 21
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 Image
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 Image
For all the implausibility of other routes, and the evidence during outbreak settings there were laggards...
3/10 Image
Read 10 tweets
Dr Evonne T Curran NursD 💙🇺🇦 Profile picture
Apr 17
After yesterday's 17:1 (one case of community acquired CVD leading to 17 others a driver diagram to reduce nosocomial transmission.

Let's start by agreeing that nosocomial transmission is unsafe.
1/8 Image
Action 1 is to prevent transmission to patients, staff and visitors, i.e., everyone in the care environment.

2/8 Image
Next the only 3 actions that can prevent inhalation of virus. Segregation of people who are infectious, IAQ, and respiratory protection.
Also there must be ongoing analysis of where and why transmission is happening in the care setting to identify further safer options
3/8 Image
Read 8 tweets
Dr Evonne T Curran NursD 💙🇺🇦 Profile picture
Feb 18
I have a patient with SARS and I want to keep my other patients and staff safe.
I look up the NIPCM Scotland and find that the Main (singular) mode of transmission is both Droplet / Airborne

@P_H_S_Official this thread merits "immediate action" Image
The Transmission Based Precautions Section tells me there are 3 modes of transmission.

It tells me what the different precautions are aiming to achieve
Of note the definitions of respiratory infections are erroneous Image
In the respiratory section
It tells me you only need RPE if the pathogen is "wholly" transmitted by the airborne route, i.e., not droplet / airborne, or AGP

Off for the literature review to find the evidence for this statement Image
Read 9 tweets
Dr Evonne T Curran NursD 💙🇺🇦 Profile picture
Nov 4, 2024
I honestly believe IPC as a profession will NOT survive intact if it fails to accept airborne transmission as a significant ubiquitous risk and erroneously considers hand hygiene the single most important measure to prevent infection - it is not.
See below
Most important measures to prevent 🫁 non VAP pneumonia - patient positioning, mobility, oral hygiene
Most important measures to prevent surgical site infection 🩹: sterile instruments & theatre air quality
Read 20 tweets

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