@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

@zeblarson

Great piece of writing - thanks for sharing.

This part in particular...

"The failure of trusted institutions to do what we expect them to — keep people safe, protect them, hold bad actors accountable — deepens trauma and its costs to individuals and collectives by eviscerating social trust. The trauma stems not only from interpersonal violence but also from the awareness that a collective body purporting to be just and protective is the opposite, instead more likely to punish the vulnerable than to help them."

Now I'm thinking of the abdication of infection control around covid, currently being perpetrated by the NHS and most dentists.

I thought, are we being actively _punished_ rather than abandoned though? And then I thought of things I've heard (heard firsthand but not experienced firsthand) about how wearing a fitted respi mask in hospital marks you as a troublemaker, whereas using a non-fitted baggy blue signals compliance and leads to kinder treatment.

#NHS #systems #InfectionControl #covid #stigma #CovidIsntOver