I attended the @NHSGrampian public annual review today. As i...
Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic
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Nov 15, 2026
~5 min read
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I attended the @NHSGrampian public annual review today. As i understand it was recorded but I'm not sure when it will be available. I had several questions i wanted to ask but didnt want to be a mic hog so i focused on one question 🧵
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My question highlighted that one of the priorities written on a previous slide was about "preventing and mitigating disease" and referenced the fact that NHSG is not in a financially good position (though it sounds like progress is being made). Therefore I asked:
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Considering the impact of nosocomial infections on finances, resources, staff and patients have NHSG got any plans to follow best evidence on mitigating the spread of airborne disease?
And gave examples regarding air filtration/ventilation, and (staff) respirator use
And gave examples regarding air filtration/ventilation, and (staff) respirator use
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The response was pretty generic - expected for a brief Q&A session - but the person who answered my question did speak to me after, in which i accidentally went on a like 10 minute rant about infection prevention & control (IPC) 🙈
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The person was new to the role so some leniency is warranted but several concerning things were raised:
1. The evidence for airborne transmission isnt as strong as for (e.g.) fomite transmission. I corrected this
1. The evidence for airborne transmission isnt as strong as for (e.g.) fomite transmission. I corrected this
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I didnt mention but many other IPC protocols are not that evidence based, e.g. the use of alcohol swabs before venepuncture, cleaning chairs after people sat on them at the beginning years of covid, baggy blue masks(!!)
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2. NHSG follow government guidelines. I highlighted these are not based on best evidence & asked if theres a legal requirement to follow these as is or if the hospital can go above & beyond. This was kinda not directly answered but my inference is that theres no legal requirement
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3. She highlighted that if NHSG do things differently, it would be different to other hospitals. I said i know - that would be revolutionary!
4. She highlighted that outside the hospital such precautions arent taken. I said this was a false equivalency and doesnt make sense
4. She highlighted that outside the hospital such precautions arent taken. I said this was a false equivalency and doesnt make sense
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Theres no law requiring people to wash their hands after the toilet but hand hygiene is something we expect in hospital
5. She raised the issue of costs. I said there'd likely be savings from reduced infections, improved patient outcomes, no closing wards,
5. She raised the issue of costs. I said there'd likely be savings from reduced infections, improved patient outcomes, no closing wards,
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fewer staff newly getting post-infection sequelae.
Combined with the "lack of evidence" claim, the inference is that NHSG are willing to risk disabling, harming, even killing people (including staff) until the gov stay otherwise
Combined with the "lack of evidence" claim, the inference is that NHSG are willing to risk disabling, harming, even killing people (including staff) until the gov stay otherwise
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6. I discussed issues with baggy blues and why respirators are needed
7. I highlighted GMC guidance on not making patients sick if you're infectious and not making the risk judgement yourself. I highlighted that since diseases can be spread without symptoms, drs are by proxy
7. I highlighted GMC guidance on not making patients sick if you're infectious and not making the risk judgement yourself. I highlighted that since diseases can be spread without symptoms, drs are by proxy
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Not following this guidance
As a general comment, I find it interesting in medicine that sometimes guidelines are just that (guides for good practice) but other times guidelines are the absolute gospel of all truth, knowledge, & power that cannot be disobeyed even the slightest
As a general comment, I find it interesting in medicine that sometimes guidelines are just that (guides for good practice) but other times guidelines are the absolute gospel of all truth, knowledge, & power that cannot be disobeyed even the slightest
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In this case - the GMC is "just guidance" but the gov standard for IPC is gospel.
8. I discussed my own difficulties a bit and she asked if i had a red flag against my name to ensure appropriate mitigations are taken. I said this is missing the point
8. I discussed my own difficulties a bit and she asked if i had a red flag against my name to ensure appropriate mitigations are taken. I said this is missing the point
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Because non-disabled/high risk people can get disabled from infections. Healthcare should be safe for all
Im sure we discussed other things too. Shes going to speak to the ICP team and get back to me
Im sure we discussed other things too. Shes going to speak to the ICP team and get back to me
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As above, i did want to ask about other things too. My 2nd priority question i didnt get to ask but maybe @laura_skaife would like to make public comment on is about whether there are plans to address the huge problem of medical gaslighting - and how
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Of which i alone can give a thesis worth of examples & i know i am not unique, nor have i had the "worst" journey
I ended up chatting to some high up docs about this on the way out & genuinely i do think a lot of people do care & have good intentions which is at least promising
I ended up chatting to some high up docs about this on the way out & genuinely i do think a lot of people do care & have good intentions which is at least promising
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But medical gaslighting is both overt and covert, including structural problems that allow it to proliferate
I genuinely want to know how this could be addressed (i have some ideas)
I genuinely want to know how this could be addressed (i have some ideas)
Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic
Latest Letter: ‘Coercive control: Recognising relational patterns that affect patient wellbeing’; overlaps with patient healthcare experiences
In December, my friend & fellow patient, Jo sent me a paper. Despite being on opposite sides of Earth, it was like we read it in sync 🧵
In December, my friend & fellow patient, Jo sent me a paper. Despite being on opposite sides of Earth, it was like we read it in sync 🧵
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The chat also turned to IPC & i noted the docs weren't protecting themselves from a known neurotropic virus, & as doctors id expect they'd (a) want to protect their brain (b) would follow evidence based medicine—which shows infections = harm that's not always immediate or obvious
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They didnt really have an answer but maybe they will reconsider their risks 🤞🏻
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Lastly, air quality wasnt great 🙃 from memory, CO2 around 1200 is where cognitive function can start to be impacted...
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Oh i forgot when she mentioned cost, i highlighted that this wouldnt be valid for other forms of IPC, like not supplying gloves bar some very specific situations
Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic
Theres no law requiring people to wash their hands after the toilet but hand hygiene is something we expect in hospital
5. She raised the issue of costs. I said there'd likely be savings from reduced infections, improved patient outcomes, no closing wards,
5. She raised the issue of costs. I said there'd likely be savings from reduced infections, improved patient outcomes, no closing wards,
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Its very interesting that the NHS understood the precautionary principle at the beginning of the pandemic. There wasnt (strong/much/any) evidence that masks, excessive surface cleaning, ventilation, distancing was helpful but "better safe than sorry"
Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic
I didnt mention but many other IPC protocols are not that evidence based, e.g. the use of alcohol swabs before venepuncture, cleaning chairs after people sat on them at the beginning years of covid, baggy blue masks(!!)
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So even if we accept their (incorrect) line that airborne transmission hasnt been proven, why has the precautionary principle been dropped? Particularly considering the vax n relax wash your hands strategy clearly is not working...
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Its also weird that the evidence for baggy blue masks for airborne infections is weak at best yet whenever theres an outbreak, they reintroduce baggy blue use. Do they not see the inconsistencies in their evidentiary standards??
Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic
I didnt mention but many other IPC protocols are not that evidence based, e.g. the use of alcohol swabs before venepuncture, cleaning chairs after people sat on them at the beginning years of covid, baggy blue masks(!!)
