Educational | Public Health and Wellbeing

COVID-19: still testing the wrong people

March 14, 2021 by Dr Mike Simmons 3 Comments

We need health professionals to raise the issue across the UK, to knock on the door of government to ask that the rest of this pandemic is managed using tried and tested health protection and outbreak control measures as it continues to decline.

Image by Luisella Planeta Leoni from Pixabay

The UK governments it would appear still seem to be in denial over mild symptoms that are associated with infection with COVID (SARS- CoV-19), continuing to maintain the line that to book a test via their portal (https://www.gov.uk/get-coronavirus-test) you can only do so if you have one of … Read the rest

COVID-19 testing: Wasting money on an industrial scale?

December 5, 2020 by Dr Mike Simmons 5 Comments

Image by Andrew Martin from Pixabay

I continue to be disturbed about the way we are driving the COVID-19 testing machine. I have been critical previously over the increased attention to testing asymptomatic individuals. The UK Government recently announced what I have dubbed their “Cuddles for Christmas” approach of rapid testing in care homes in England to allow relatives to visit their incarcerated loved ones without the need for social distancing. On the face of it, this sounds a wonderful idea but my worry is the results of these tests are taken as absolutes and nothing could be further from … Read the rest

COVID-19: The Missing Middle

October 4, 2020 by Dr Mike Simmons 2 Comments

On Wednesday, I Tweeted, “I’ve just been alerted to this statement by @WGHealthandCare @HywelDdaHB @PublicHealthW My head is metaphorically in my hands! This priority list is not designed to find the true positives. I’ll try and blog later . . . .” and linked to: https://gov.wales/written-statement-prioritisation-covid-19-testing

Image by Vesna Harni from Pixabay

There has been considerable media attention on the pressure being experienced by our testing services, both the demands for appointments for sampling and the laboratory capacity. Working in the three laboratories in the Hywel Dda University Health Board, I can confirm that the local demands have increased week … Read the rest

COVID, complexity and face-masks

May 17, 2020 by Dr Mike Simmons 1 Comment

Healthcare is a Complex Adaptive System, to quote Jeffrey Braithwaite. To be fair, I’d been aware of this for some considerable time, having first discussed the role of complexity science in healthcare associated infection is 2003. However, it was not until 2014 that we began to apply complexity science to our work, as discussed previously in this blog and in more detail in a BMJ blog. I could not think of a better video to offer a simple but relevant illustration of how a complex adaptive system works. If you have not viewed the video produced by the … Read the rest

Risk assessment on the fly

April 18, 2020 by Dr Mike Simmons 1 Comment

I’m currently detecting quite a bit of, “Shock, Horror!” on Twitter by the infection prevention and control community this evening by the release of a new government document daring to propose how we might consider the re-use of personal preventive equipment (PPE.)

“Considerations for acute PPE shortages” I view as a useful “thought piece,” issued this evening by a government seeking to try and answer some of the difficult questions we are all currently facing and rather than the shock and indignation, I prefer to read and think through how I feel about what is being proposed. I … Read the rest

Wales the wonderful

April 11, 2019 by Dr Mike Simmons Leave a Comment

This is a blatant plug to encourage you to consider coming, living and working in Wales. I’ve been based in west Wales covering the counties of Carmarthen, Ceredigion and Pembrokeshire since 1990. While I did spend a fascinating 10 years working in Cardiff and gaining a new set of skills, my home has always been just outside Carmarthen.

Today was one of my days when I work from our hospital in Aberystwyth and it was one of those gorgeous spring days where I can enjoy seeing the red kites overhead as I drive along the coast road between Aberaeron and … Read the rest

Catheter urine sampling

June 23, 2017 by Dr Mike Simmons 2 Comments

I had a call this morning from one of our very talented staff nurses who wanted to check out carefully her understanding of when it is appropriate to send a sample for urine in a catheterised patient. She explained that she had an elderly patient and the patients daughter had suggested that the catheter urine should be sent to our laboratory on a weekly basis to check for infection.

The patient did not have any symptoms or signs to suggest urinary infection and had therefore advised that sampling was inappropriate but was facing a series of questions and could I … Read the rest

Antibiotic suppression reducing

August 5, 2016 by Dr Mike Simmons Leave a Comment

In a previous article I promised that I would share a measure of the improvement we are seeing in the clinical information on our request forms. As you may know, the Hywel Dda University Health Board is committed to seeing reductions in all aspects of healthcare associated infections and has set themselves the target of reducing E coli bacteraemias by 20% as a global surrogate of all infections across our area.

Why is clinical information important?

Microbiology does not provide explicit answers to the question, “Does this patient have an infection?” Our laboratories will grow bacteria but are bodies are … Read the rest

Urine quality improves

July 17, 2016 by Dr Mike Simmons 1 Comment

In a previous post I discussed the two simple rules that I ask colleagues to use to test interventions around the management of infections:

First do no harm
Second, find and take the positive action

All well and good offering this advice to others, but the challenge was also to me as a clinical microbiologist. In discussions with my colleagues, we agreed that a large number of our E coli bacteramias were probably as a result of urinary associated infection and if we were to make a difference, we needed to take a closer interest in how we managed the … Read the rest