Public Health and Wellbeing

A collaboration between professionals in Microbiology and Infection Control serving West Wales

COVID-19: still testing the wrong people

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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

Rurality revisited

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Image by Ch AFleks from Pixabay

Prompted by Aled Scourfield, BBC Wales reporter for West Wales who read a previous post and interviewed me last Friday for the evening news, I decided I better get on and do what I promised to do and try and look at the rural distancing effect a bit more. Geographical distancing may be a better phrase. What I was thinking about was what effect does population density have on the spread of an infectious organism in the Welsh community. I downloaded a copy of the daily data published by my colleagues in Public Health … Read the rest

COVID-19: Where next?

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I live in west of Wales, a wonderful part of the world to live and during the current season, my three consultant colleagues and I decided the best way to help our colleagues is to try and maintain a consistent presence in each of our four hospitals. As a result, I have spent most of my days during the UK “lockdown” season in Bronglais General Hospital in Aberystwyth.

This has allowed me to reflect on the pandemic through the interactions with colleagues in this part of mid Wales. In my first presentation to the Bronglais “house” on 16th March, I … Read the rest

Creating a new normal

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Defence Imagery - Missiles 10


Yesterday’s blog prompted a fascinating debate over Twitter, as a result of a discussion by Public Health England (PHE) over considerations to prolong the use of Personal Protective Equipment (PPE.) Colleagues highlighted a blog post by Mike Edmond. He discussed the option of abandoning the fluid repellent surgical mask as part of PPE and instead make use of a full face visor only. The PHE document included ways of increasing capacity for single use and reusable gowns and I suggested we might also abandon the use of gloves for what after all is a respiratory virus and hand hygiene is … Read the rest

A Question of Scale

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Image by Rolf Johansson from Pixabay

Staff in healthcare are worried about the novel coronavirus responsible for the worldwide pandemic. Many of the public also express similar concerns and with the media emphasis on the impact on healthcare and the daily count of thousands of cases and deaths, it is hardly surprising.

However, as I have continued to remind everyone who is prepared to listen, as all the data from every country continues to show, most people will not experience any disease with this virus and those that do, for the vast majority it will be a mild illness.

This … Read the rest

Demonstrating sepsis detection in Hywel Dda

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totalbcMedicine is a serious business and when you hear harrowing stories of sepsis, how do you respond?  Certainly, many of the accounts you will read, or perhaps you have witnessed through personal exposure to family or friends who have had some form of sepsis, can be very disturbing.  Survivor accounts can be as equally distressing to all those allied to the caring professions and for all of us beg the question, what more can we do to improve diagnosis?  In Wales, as in other parts of the UK early recognition and detection of sepsis is key to early interventions.  The … Read the rest

Catheter urine sampling

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Urine labI 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

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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

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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

Who’s taking the urine?

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UrinaryIsolatesOr who is responsible for sending urine samples to the laboratory and why?

I’ve used a variation of that title as part of the title for a number of presentations I’ve been giving across our local health board area, in an attempt to grab my audience attention.

What’s the issue?

Innapropriate use of antibiotics, particularly in our older population, to treat alledged urinary tract infection.  Indeed, this article is prompted by a conversation this morning with one of my biomedical scientists in the lab.  We were discussing the whole issue of interpretation of microbiology results and management of infection.  She … Read the rest