@leslore @EricCarroll

I think it's many factors interlocking, such as:

• Not wanting to go against the flow socially, or against the hierarchy, when so many colleagues have taken official advice at face value, such that disregarding infection control in this area is "normal".

• Lack of support from the system, and/or an expectation that infection control is organised from above, so that most individual staff aren't thinking in terms of "should we be getting air filters on the ward / in the room" etc.

• Lack of supplies, and/or people further up the hierarchy who will rebuke them for using the more expensive masks when the rule is none or baggy blues.

• Lack of correct info, because the info available to us geeks who read the research is not necessarily the same as the info reaching people who are working long busy days in healthcare!

• Trauma from death, stress and moral injury in 2020, and masking being a reminder of that time, so it's emotionally easier to act as if things are back to 2019-normal.

• An assumption that they themselves will be okay: perhaps selected for because you're more likely to think of doctoring/ nursing as an attractive job if you're a bit blasé about catching things.

• A sort of "sunk ethical cost" which would have to be acknowledged in relation to patients they infected and thereby harmed over the last few years, about which they're currently in denial. And this one of course also applies to management making funding decisions.

That's just based on stories I've heard and my own intuitions about human nature. Would be interesting to see some actual qualitative research on which of these factors or which others are most at play.

#medicine #InfectionControl #covid #CovidIsntOver #doctors #nurses #NHS

@Hellybootwader @pvonhellermannn

It is mind-boggling to me the level of misinformation and misapprehension about covid. I know you were talking about its effects, but it seems to me that even the basic "how not to catch it if you don't want to" is niche subculture knowledge.

Something I keep seeing: people who are quite happy to put on a mask if asked, yet _don't_ have the cognitive framework to evaluate the risks themself.

• They don't know that the virus comes out on the breath, no need for a cough.
• They don't know that you can be infectious while feeling fine.
• They don't know that it hangs in the air like smoke when no-one's there.

Even if you tell someone the facts, they haven't necessarily thought through the practical _consequences_ of it being like that: for example, they forget to take into account that air can move.

And this leads to faulty assumptions, like for example "it's okay to have a mask break in the corridor to eat my snack, no-one else was around".

So if you want to stay safe, e.g. with dentists or plumbers, you have to think ahead all the time to how a well-meaning person might accidentally infect you, because their own cognitive framework for it may have gaps. The level of necessary vigilance and negotiation is exhausting.

And I do blame the WHO and the UK government. They actively misled people, and then when they were proven wrong, they still never followed up "hey, everyone, we got this really wrong, please update your infection control policies as a matter of urgency".

It's like when newspapers print an untrue thing as their big headline on the front page, and then the correction weeks later is a tiny paragraph at the bottom of page 17!

From time to time, I still see old posters advocating handwashing as the main covid protection, not even mentioning air quality: a marker of where the info has never reached. And as far as I can tell, the NHS is basically not bothering any more with covid infection control - though maybe that could change somewhat from the Covid Inquiry conclusions?

Thinking about the perilous information landscape often reminds me of a friend of mine. There are quite a few things they believe that I don't believe (e.g. that the covid vax was some kind of nefarious plot), and those differences can be hard to navigate sometimes - but we find common ground in both having no trust in the government :-/

#CovidIsAirborne #CovidIsntOver