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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
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
Dr Evonne T Curran NursD 💙🇺🇦 Profile picture
Nov 20, 2023
Great. Can we start with the pandemic.
The mental models for transmission have been done by world experts in aerosols (not IPC).

Here is of @trishgreenhalgh 's evidence on the virus being airborne.
Image
Here is one by Marr & Tang
Their comment on the <5 >5 IPC paradigm is it defies physics.
Its from 2021 pubmed.ncbi.nlm.nih.gov/34415335/

Image
Image
A simple one illustrating a critical error (also 2021) Image
Read 13 tweets
Dr Evonne T Curran NursD 💙🇺🇦 Profile picture
May 24, 2023
They have withdrawn masks in Scotland's Healthcare system and referred 'concerned staff' to complete a risk assessment. healthyworkinglives.scot/resources/form…

Lets fill out their risk assessment...
I am (for the form) a ward manager
Describe the task:

Any patient-to-HCW, HCW-to-HCW, patient-to-patient, or visitor-to-patient or HCW interaction in any close space, e.g. conversation or stethoscope range

or when ventilation poor just being on the ward.
Where is the task to be carried out?

Every minute of every day on this ward we are continuously interacting and at risk of inhaling someone else's exhaled air + virus.
Inhalation at distance is also a risk because we have no idea of the indoor air quality - no indicators.
Read 11 tweets
Dr Evonne T Curran NursD 💙🇺🇦 Profile picture
Oct 29, 2022
Considering how the 'collective we' made Mode of Transmission Errors - some possibilities

a) we turned doubt in to certainty, the use of qualifiers in original work were turned into fact, eg.

'droplets have traditionally been defined as ...'
became
'droplets are defined as '
a) More doubt to certainty
Dr X et al showed that viruses can get in to the eyes, nose and mouth

was translated to

Dr X et al showed that all droplets get in via the eyes nose and mouth
b) We interpreted transmission in a 'close space' as evidence of droplets; actually it was evidence of close space respiratory transmission - not evidence for droplets
Read 25 tweets
Dr Evonne T Curran NursD 💙🇺🇦 Profile picture
Oct 15, 2022
7 slides showing that neither CDC nor WHO presented evidence for the existence of droplet transmission
You may have seen this from the WHO most pandemic refs refer to it - note lack of evidence (its not in 5), and in the def or aerosols it says 'its not yet clear'
This is from the CDC which cites references showing 'outbreak evidence', 'experimental evidence' and 'aerosol dynamics'....
Only relevant outbreak reference is 101 - lets get it...
Here it is. Med students walk in to 8-bedded bays interview pts and leave. Index case (SARS) bed 11.
3 in droplet range get SARS; 4 outwith droplet range also get it. Authors conclude close = droplets but aerosols were not excluded.
CDC cites this as evidence for droplets...
Read 9 tweets

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