Stand-alone air decontamination units: some questions…

I’ve been involved recently in a comparative evaluation of several stand-alone air decontamination units. Please feel free to take a look at our (very!) preliminary findings here. I also attended the HIS Spring Meeting today, which was all about ventilation in healthcare settings. Whilst I found the day interesting and thought provoking, I’ve left with more questions than I had before!

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COVID-19 – what have we learned?

I did a talk at an IPC conference the other day trying to summarise what we’ve learned from the COVID-19 pandemic. You can see my slides here. I think (hope) we have learned a lot – and still have more to learn – about (in no particular order): PPE, transmission routes, testing and laboratory factors, vaccination, organizational transformation, guidelines and policy development, regulatory framework, outbreaks, non-COVID pathogens, antimicrobial stewardship, digital transformation, applied research, and the mental health of our workforce.

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We need to talk about gloves…

As we warm up for world hand hygiene day tomorrow, it’s a good time to have a talk about gloves. I challenge you to go onto a hospital ward and time how long it takes before you see some questionable glove practice. It won’t be long before you see somebody coming out of a room used by a patient on some transmission based precautions with gloves on. Or somebody commuting around the ward with gloves on. Or somebody putting gloves on in preparation for patient care who can’t quite articulate why. So, as many of us launch new patient care pathways in the next phase of the pandemic, and as the national IPC manual has just been published in England, it’s a really good time to talk about when we don’t need to use gloves, which is most of the time!

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Do stand-alone air disinfection units reduce HCAI?

Wow, it’s been ages since I’ve posted – sorry about that. I’m blaming the Omicron wave and my own personal dose of COVID-19 recently (you can see my reflections about that on Twitter…)

And so to today’s blog. Lots of interest in air disinfection systems. And some important research articles coming through. This one in JHI caught my attention, because there’s a suggestion of a link between improved air hygiene and reduced HCAI. However, I am unconvinced (from this study) that this link has been demonstrated – so a key opportunity for applied research!

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Lateral flow or PCR?

As England moves away from confirmatory PCR testing following a positive lateral flow test in the absence of COVID-19 symptoms, it’s a good time to look at what these two different testing strategies can offer us. There’s an excellent short review in NEJM combined with a case study to help illustrate the impact of pre-test probability plays out. Both lateral flow testing and PCR testing have their place, and in some ways lateral flow testing is a better correlate for infectivity (as well as being cheaper and easier!).

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Omicron: things are moving quickly and looking better…but we’re not there yet

My last post on Omicron was on 22/12/2021, 15 days ago, which seems like a lifetime ago! Back then, there was a great deal of uncertainty about how Omicron would manifest clinically, and how this would translate into hospitalisations and deaths. We now known more, but there is still considerable uncertainty. The latest technical briefing from UKHSA provides additional epidemiological updates. And the latest ONS study on prevalence in the UK gives us some eye-watering figures: in the week ending 31/12/2021, 1 in 25 people in England were infected with COVID-19, and 1 in 15 people in London. There’s a lot of it about. Overall, the outlook is looking better, but it’s going to be a very bumpy ride for those working in healthcare over the next month or so.

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Omicron: buckle up for a bumpy ride

I’ve been meaning to write an update on the Omicron variant of concern for a few weeks’ now and it’s now or never, so here we go! The Omicron variant has a host of mutations compared with previous variants, which seems to have given it the ability to spread much more rapidly. This may well be due in part to the ability to side-step antibody mediated immunity obtained through previous infection and vaccination. Omicron is spreading rapidly in the community. We don’t yet know what impact the current rapid community spread will have on hospitalisations and ultimately deaths, so time will tell.  

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The ‘thorny 5th Moment for Hand Hygiene’: hands and surfaces collide

We talk often about the 5 Moments for Hand Hygiene but frequently neglect the 5th moment (after contact with a patient’s environment). So much so, that you might even describe this as the “Cinderella moment for hand hygiene”! Could it be that the Cinderella moment is actually the most important in the transmission of pathogens that cause HCAI? Maybe sometimes. But that’s missing the point. If we don’t focus our attention on all moments for hand hygiene, we won’t be as effective as we could be in preventing cross-transmission.

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ESPAUR report to kick of WAAW 2021

It’s great to see the latest ESPAUR report published at the start of World Antibiotic Awareness Week 2021. There’s some good news in the report, but also some warning shots about our need to refocus on the risks attached to antimicrobial resistance as we move into the Covid endemic.

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COVID-19 and PPE: don’t forget your eyes!

One of the questions I get asked a lot is “where is the evidence that wearing eye protection reduces the risk of exposure to SARS-CoV-2, because it’s really annoying to wear and creates other risks related to reduced vision”. A new systematic review examines the effect of eye protection on reducing healthcare worker exposure to SARS-CoV-2. The short answer is that there is enough evidence to convince me that eye protection should be part of our SARS-CoV-2 PPE ensemble.

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