December 16, 2024 • 15 mins
In the final episode of "Going Macro on Micro," host Dr. Julie Ann Lough explores the key elements of a robust, One Health-informed infection control framework with experts Dr. Elaine Cloutman-Green and Dr. Simon Doherty. The experts emphasize the need for education, communication, and innovation as the cornerstones of effective infection control. The guests also address unique challenges, like pest control in hospital settings, and stress the need for flexibility, open dialogue, and interdisciplinary collaboration to find solutions. Both veterinary and medical professionals are encouraged to embrace the principles of One Health and forge a future of integrated, resilient infection control.
2024-13527
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:06):
Hello, and welcome to Going Macro and Micro, the podcast where we explore emerging themes in microbiology, brought to you by Beckman Coulter.
I am your host, Dr. Julie Ann Lough, a science communicator passionate about sharing stories, exploring the future of health and science.
This is the final episode of our series exploring One Health, an integrated approach that recognises that the health of people, animals and ecosystems are all interconnected.
(00:35):
When we think about the challenges facing our health from pandemics to antibiotic resistance, it's clear that no one exists in a vacuum.
We are all in this together.
In the last episode, we spoke about how the world needs to be prepared for the next pandemic.
You know, it will occur at some point and how preparedness needs to be equitable across the globe.
(00:57):
In this, our final episode in the series, we're going to talk about the key elements of an infection control process to help achieve the goals of One Health.
We continue our chat with our experts in human and animal health.
And on the human side, we continue to have Dr. Elaine Cloutman-Green, who is a consultant clinical scientist specialising in infection prevention and control, as well as the lead healthcare scientist at Great Ormond Street Hospital in London.
(01:24):
And on the animal side, we have Dr. Simon Doherty, an associate fellow at Queen's University Belfast and recently named the World Veterinary Association's World Vet of the Year.
Both of them are passionate about infection control and the principles of One Health.
Simon, I'll start off with you.
What are the key elements of a robust One Health informed infection control framework that can, I suppose, adequately address the risks to both humans and to animals as well?
(01:52):
And how can we ensure that these considerations are systematically integrated into infection control protocols?
It very much starts with the people.
And then it starts, you know, the next step then beyond that, I think, is very much them thinking about the services.
So how you're doing that local surveillance, how you're doing those local bits of diagnostics, how often those are carried out and the risk associated with that.
(02:21):
So in other words, if there was, you know, a breakdown in some part of the system, then how has the risk changed by looking at those sort of protocols separately where maybe the testing has been done less regularly or not as many tests around a particular setting are being done?
(02:44):
Looking then at the relative risk of the sampling in relation to the person, the animal versus the environment, you know, so you can swap down services.
But actually, is there a need for us to be taking appropriate samples from skin or hair or nasal or elsewhere?
(03:08):
And, do we need to put faeces samples in, you know, to laboratory or urine samples?
So it's making sure we've got the appropriate sampling regimen as well.
But then ultimately it comes down to communication and it comes down to how that is interpreted and communicated.
You know, the open farm setting where it's just like, well, you know, if you visit an open farm, you're bound to, you know, pretty much bound to go home with something.
(03:33):
Well, I mean, that's not the case.
The risk assessments are in place on an open farm and, you know, the educational benefit of going to an open farm and seeing where your milk comes from and your, you know, your lamb and so on comes from clearly outweighs hopefully any infectious disease risk.
But it is about that understanding that also is incumbent with washing your hands, washing your feet, any clothing becomes contaminated that it goes in the washing machine when you go home, you know, and so on and so forth.
(04:05):
And that's what farmers do and that's what visitors to a farm should do as well.
So, look, it's all of the things in context, but it's making sure that's communicated in the right way.
You know, if you're a member of the general public, you maybe don't think just so much about kicking off your wellies and taking your overalls off as you do whenever you're working on the farm.
And, you know, maybe you do need a bit of signage to warn people that they should wash their hands before they have their picnic.
(04:30):
I mean, I'm taking that as a sort of open farm situation, but, you know, the same applies if you're visiting a hospital ward.
You know, how often should you be cleaning your hands?
And I think we became, we generally became much more aware of that during COVID.
But for those people that are working in hospitals or in veterinary hospitals, they should be thinking about that as part of their infectious disease protocols anyway, you know, and how long they spend washing their hands.
(04:57):
And kids now all know that they sing happy birthday twice and it's making sure we get that information out.
I did a school visit recently where I had some hand gel, alcohol hand gel, and we put biodegradable, of course, glitter into it.
And what we did was we got the kids, you know, I put some on my hands, shook hands, it was my
(05:18):
daughter's class, shook hands with my daughter, she shook hands, shook hands, shook hands, and we
see how far down the line we could go and still see the glitter, you know, and that kind of gave
an indication that if you imagine that those were bugs on your hand, that's how transmissible things
are in the classroom or, you know, the teacher was horrified.
But it's part of that storytelling, you know, and this is why we wash our hands and then we go to the sink and we all sing happy birthday.
(05:44):
There were two kids in the class, fortuitously, whose birthdays it was that week, and so we sang happy birthday twice and, you know, to the two kids in the class.
That's teaching kids in a classroom setting, but we have to also do that in A&E, we have to do that on a ward, we have to do that in a veterinary hospital, and we need to share that knowledge the best that we possibly can and share those protocols with one another, you know, about how we control C.
(06:13):
diff in a veterinary setting and learn from our colleagues in human medicine who are dealing with that probably more than we are.
I mean, Simon has spoken there about the need to share protocols and knowledge around infection control, and for you, I guess, vermin's a big part of infection control for you and something you probably have to think about quite a bit.
So what does it mean in terms of your infection control planning?
(06:36):
Yeah, I mean, my hospital's in London, you're not far from a rat or a mouse, to be honest.
And so more time, money and thought than I had believed possible goes into pest control in any hospital building, especially somewhere like mine, we're a Victorian building, we've been in the same site since 1862 or something like that.
(07:04):
And so we've been in the same place for a long time, we're surrounded by small parks, and other buildings and close neighbours.
And so there's a lot of thought about what happens, especially at the moment.
So at the moment, we're having a new building built.
And of course, all of that disruption, all of those vibrations then drive all of the animals that have been living quite happily into new buildings and new areas.
(07:34):
And so a lot of time goes into kind of how you find holes, cover holes, stop things, how you kind of make sure that you are never, hopefully ever going to see, I'm crossing my fingers, you won't be able to see that, a mouse running across the hospital floor.
But it's a real challenge.
And obviously, that challenge is different if you're in a community hospital in the middle of the countryside.
(07:58):
And so all of those things are something to be worried about.
But actually, I think most people have those things, mostly protocolised and under control.
And you know, there's a reason that most hospital healthcare doesn't take place in basements.
If you're staying overnight, it happens in floors that are higher up, because all of those things do help.
(08:25):
Our biggest challenge is pigeons, I have to say.
And the Cryptococcus neoformans risk of pigeons flying in, which obviously isn't the kind of thing that most people have to think about.
But our pigeons are incredibly smart.
They learn as groups, and they will work out where there is an open window that's open a crack that they can get in.
(08:49):
And so there's almost kind of continuous warfare between us and the pigeons, especially when we're going to a heatwave.
So most of our new buildings are built without windows open, which obviously from a sustainability point of view, people don't like so much because you have to have mechanical ventilation.
But also having a pigeon flying around your hospital ward is less good in terms of what you want to have going on.
(09:14):
And so, yeah, it's something that you have to think about more than I would probably have imagined before I got into the role that I'm in now.
You know, in this podcast series, we have covered so many different topics from horses to pigeons and vermin as well.
So to summarise this for the audience, Elaine, what do you think are the key takeaways around the alignment of infection control and One Health principles?
(09:41):
And maybe the challenges coming down the line.
So I think the key thing is to be brave, actually, and know that none of us know everything.
And actually, none of us can ever know everything.
And the best things happen when you step outside your little box in order to have a conversation with somebody else and are okay with the fact that it's not something that you know everything about, because that's the best way that we make change.
(10:10):
And I think that the future is going to be challenging, there will be another pandemic, there is going to be more and more of us that are impacted by things like antimicrobial resistance, we are going to have to think differently.
But that's okay, because actually, that's what we've been doing as a society for the last 100 years, if things crop up, we evolve, we change, we manage things differently.
(10:38):
And I think that as long as we keep open dialogue and discussion about those things, then we can find solutions.
We just have to be saying yes to things rather than no.
And Simon, what would you want, particularly a veterinary audience to take away from this?
Yeah, look, it's got to be education, communication, innovation.
(11:02):
I think those are the really kind of core elements.
And I mean,
when I say education, I'm talking about the stuff that we do with kids, you know, the stuff that we
embed within science curricula, then the stuff that we embed at university level in terms of
cross-disciplinary teaching, you know, encouraging that sort of interdisciplinarity from an early
(11:27):
stage in careers, encouraging that through our, you know, a sort of advocacy within our
professional organisations, within our scientific organisations, within our publishers, you know,
and we mentioned that before.
That again, then sort of comes back to communication, it's our ability to do case study, develop case studies, do a bit of storytelling.
(11:51):
And the innovation piece, I think, is where we have the opportunity not just to develop things from science, life sciences, into human medicine, or, you know, to think in terms of innovation within animal health or innovation within the environment, but it's just having that mindfulness right across the board, that we've got the ability to innovate together.
(12:16):
Some really good stuff going on in the digital
space around, you know, we always hear about artificial intelligence, machine learning,
big data, taking stuff out of one sector and utilising that technology elsewhere, you know,
whether it is, you know, in human health, whether it's an animal health, whether it is in environmental
(12:37):
health, but taking some of those principles of how we hold, handle and share data, I think is going
to be really, really important going forward.
And certainly for a veterinary audience, I would just encourage them to really sort of think about the human owners of the animals that we work with.
(12:57):
You know, I think that's a really good place to end on.
So we should think about the humans with the animals and the animals with the humans.
And that brings us to the end of not only this episode, but this series about One Health and the importance of infection control and preparedness.
They are vital to achieve the goals of One Health.
(13:17):
It has been really great to hear about the importance of communication, to reach out to stakeholders and getting them on board.
And it is by getting out of our silos and talking to others in different fields, be that vets, clinical scientists, social scientists or medical staff, that we can innovate together and come up with the solutions to health issues coming down the line by sharing principles from one sector into another field.
(13:43):
Vets, consider the human owners of the animals you're treating.
And medical teams, think about the animals that your patients interact with.
And together we can all achieve the goals of One Health.
That's all for this series.
Again, let me thank Dr. Elaine Cloutman-Green and Dr. Simon Doherty for their truly enlightening insights and for being so open with sharing their knowledge.
(14:06):
Thanks again to Beckman Coulter for supporting the production of this podcast, Going Macro on Micro.
And to you, the audience, for listening and good luck in all your endeavours to embrace the principles of One Health and to bring your colleagues, patients and other stakeholders on the road with you.
We hope to bring you more series of Going Macro on Micro, so please subscribe to the podcast wherever you listen to stay up to date with each new episode as it's released.
(14:34):
You can also join our online professional community by searching Beckman Coulter Microbiology on LinkedIn.
There you'll find discussions on a variety of interesting microbiology topics.
Until next time, when we go macro on micro, goodbye.
Hello, and welcome to Going Macro and Micro, the podcast where we explore emerging themes in microbiology, brought to you by Beckman Coulter.
I am your host, Dr. Julie Ann Lough, a science communicator passionate about sharing stories, exploring the future of health and science.
This is the final episode of our series exploring One Health, an integrated approach that recognises that the health of people, animals and ecosystems are all interconnected.
(00:35):
When we think about the challenges facing our health from pandemics to antibiotic resistance, it's clear that no one exists in a vacuum.
We are all in this together.
In the last episode, we spoke about how the world needs to be prepared for the next pandemic.
You know, it will occur at some point and how preparedness needs to be equitable across the globe.
(00:57):
In this, our final episode in the series, we're going to talk about the key elements of an infection control process to help achieve the goals of One Health.
We continue our chat with our experts in human and animal health.
And on the human side, we continue to have Dr. Elaine Cloutman-Green, who is a consultant clinical scientist specialising in infection prevention and control, as well as the lead healthcare scientist at Great Ormond Street Hospital in London.
(01:24):
And on the animal side, we have Dr. Simon Doherty, an associate fellow at Queen's University Belfast and recently named the World Veterinary Association's World Vet of the Year.
Both of them are passionate about infection control and the principles of One Health.
Simon, I'll start off with you.
What are the key elements of a robust One Health informed infection control framework that can, I suppose, adequately address the risks to both humans and to animals as well?
(01:52):
And how can we ensure that these considerations are systematically integrated into infection control protocols?
It very much starts with the people.
And then it starts, you know, the next step then beyond that, I think, is very much them thinking about the services.
So how you're doing that local surveillance, how you're doing those local bits of diagnostics, how often those are carried out and the risk associated with that.
(02:21):
So in other words, if there was, you know, a breakdown in some part of the system, then how has the risk changed by looking at those sort of protocols separately where maybe the testing has been done less regularly or not as many tests around a particular setting are being done?
(02:44):
Looking then at the relative risk of the sampling in relation to the person, the animal versus the environment, you know, so you can swap down services.
But actually, is there a need for us to be taking appropriate samples from skin or hair or nasal or elsewhere?
(03:08):
And, do we need to put faeces samples in, you know, to laboratory or urine samples?
So it's making sure we've got the appropriate sampling regimen as well.
But then ultimately it comes down to communication and it comes down to how that is interpreted and communicated.
You know, the open farm setting where it's just like, well, you know, if you visit an open farm, you're bound to, you know, pretty much bound to go home with something.
(03:33):
Well, I mean, that's not the case.
The risk assessments are in place on an open farm and, you know, the educational benefit of going to an open farm and seeing where your milk comes from and your, you know, your lamb and so on comes from clearly outweighs hopefully any infectious disease risk.
But it is about that understanding that also is incumbent with washing your hands, washing your feet, any clothing becomes contaminated that it goes in the washing machine when you go home, you know, and so on and so forth.
(04:05):
And that's what farmers do and that's what visitors to a farm should do as well.
So, look, it's all of the things in context, but it's making sure that's communicated in the right way.
You know, if you're a member of the general public, you maybe don't think just so much about kicking off your wellies and taking your overalls off as you do whenever you're working on the farm.
And, you know, maybe you do need a bit of signage to warn people that they should wash their hands before they have their picnic.
(04:30):
I mean, I'm taking that as a sort of open farm situation, but, you know, the same applies if you're visiting a hospital ward.
You know, how often should you be cleaning your hands?
And I think we became, we generally became much more aware of that during COVID.
But for those people that are working in hospitals or in veterinary hospitals, they should be thinking about that as part of their infectious disease protocols anyway, you know, and how long they spend washing their hands.
(04:57):
And kids now all know that they sing happy birthday twice and it's making sure we get that information out.
I did a school visit recently where I had some hand gel, alcohol hand gel, and we put biodegradable, of course, glitter into it.
And what we did was we got the kids, you know, I put some on my hands, shook hands, it was my
(05:18):
daughter's class, shook hands with my daughter, she shook hands, shook hands, shook hands, and we
see how far down the line we could go and still see the glitter, you know, and that kind of gave
an indication that if you imagine that those were bugs on your hand, that's how transmissible things
are in the classroom or, you know, the teacher was horrified.
But it's part of that storytelling, you know, and this is why we wash our hands and then we go to the sink and we all sing happy birthday.
(05:44):
There were two kids in the class, fortuitously, whose birthdays it was that week, and so we sang happy birthday twice and, you know, to the two kids in the class.
That's teaching kids in a classroom setting, but we have to also do that in A&E, we have to do that on a ward, we have to do that in a veterinary hospital, and we need to share that knowledge the best that we possibly can and share those protocols with one another, you know, about how we control C.
(06:13):
diff in a veterinary setting and learn from our colleagues in human medicine who are dealing with that probably more than we are.
I mean, Simon has spoken there about the need to share protocols and knowledge around infection control, and for you, I guess, vermin's a big part of infection control for you and something you probably have to think about quite a bit.
So what does it mean in terms of your infection control planning?
(06:36):
Yeah, I mean, my hospital's in London, you're not far from a rat or a mouse, to be honest.
And so more time, money and thought than I had believed possible goes into pest control in any hospital building, especially somewhere like mine, we're a Victorian building, we've been in the same site since 1862 or something like that.
(07:04):
And so we've been in the same place for a long time, we're surrounded by small parks, and other buildings and close neighbours.
And so there's a lot of thought about what happens, especially at the moment.
So at the moment, we're having a new building built.
And of course, all of that disruption, all of those vibrations then drive all of the animals that have been living quite happily into new buildings and new areas.
(07:34):
And so a lot of time goes into kind of how you find holes, cover holes, stop things, how you kind of make sure that you are never, hopefully ever going to see, I'm crossing my fingers, you won't be able to see that, a mouse running across the hospital floor.
But it's a real challenge.
And obviously, that challenge is different if you're in a community hospital in the middle of the countryside.
(07:58):
And so all of those things are something to be worried about.
But actually, I think most people have those things, mostly protocolised and under control.
And you know, there's a reason that most hospital healthcare doesn't take place in basements.
If you're staying overnight, it happens in floors that are higher up, because all of those things do help.
(08:25):
Our biggest challenge is pigeons, I have to say.
And the Cryptococcus neoformans risk of pigeons flying in, which obviously isn't the kind of thing that most people have to think about.
But our pigeons are incredibly smart.
They learn as groups, and they will work out where there is an open window that's open a crack that they can get in.
(08:49):
And so there's almost kind of continuous warfare between us and the pigeons, especially when we're going to a heatwave.
So most of our new buildings are built without windows open, which obviously from a sustainability point of view, people don't like so much because you have to have mechanical ventilation.
But also having a pigeon flying around your hospital ward is less good in terms of what you want to have going on.
(09:14):
And so, yeah, it's something that you have to think about more than I would probably have imagined before I got into the role that I'm in now.
You know, in this podcast series, we have covered so many different topics from horses to pigeons and vermin as well.
So to summarise this for the audience, Elaine, what do you think are the key takeaways around the alignment of infection control and One Health principles?
(09:41):
And maybe the challenges coming down the line.
So I think the key thing is to be brave, actually, and know that none of us know everything.
And actually, none of us can ever know everything.
And the best things happen when you step outside your little box in order to have a conversation with somebody else and are okay with the fact that it's not something that you know everything about, because that's the best way that we make change.
(10:10):
And I think that the future is going to be challenging, there will be another pandemic, there is going to be more and more of us that are impacted by things like antimicrobial resistance, we are going to have to think differently.
But that's okay, because actually, that's what we've been doing as a society for the last 100 years, if things crop up, we evolve, we change, we manage things differently.
(10:38):
And I think that as long as we keep open dialogue and discussion about those things, then we can find solutions.
We just have to be saying yes to things rather than no.
And Simon, what would you want, particularly a veterinary audience to take away from this?
Yeah, look, it's got to be education, communication, innovation.
(11:02):
I think those are the really kind of core elements.
And I mean,
when I say education, I'm talking about the stuff that we do with kids, you know, the stuff that we
embed within science curricula, then the stuff that we embed at university level in terms of
cross-disciplinary teaching, you know, encouraging that sort of interdisciplinarity from an early
(11:27):
stage in careers, encouraging that through our, you know, a sort of advocacy within our
professional organisations, within our scientific organisations, within our publishers, you know,
and we mentioned that before.
That again, then sort of comes back to communication, it's our ability to do case study, develop case studies, do a bit of storytelling.
(11:51):
And the innovation piece, I think, is where we have the opportunity not just to develop things from science, life sciences, into human medicine, or, you know, to think in terms of innovation within animal health or innovation within the environment, but it's just having that mindfulness right across the board, that we've got the ability to innovate together.
(12:16):
Some really good stuff going on in the digital
space around, you know, we always hear about artificial intelligence, machine learning,
big data, taking stuff out of one sector and utilising that technology elsewhere, you know,
whether it is, you know, in human health, whether it's an animal health, whether it is in environmental
(12:37):
health, but taking some of those principles of how we hold, handle and share data, I think is going
to be really, really important going forward.
And certainly for a veterinary audience, I would just encourage them to really sort of think about the human owners of the animals that we work with.
(12:57):
You know, I think that's a really good place to end on.
So we should think about the humans with the animals and the animals with the humans.
And that brings us to the end of not only this episode, but this series about One Health and the importance of infection control and preparedness.
They are vital to achieve the goals of One Health.
(13:17):
It has been really great to hear about the importance of communication, to reach out to stakeholders and getting them on board.
And it is by getting out of our silos and talking to others in different fields, be that vets, clinical scientists, social scientists or medical staff, that we can innovate together and come up with the solutions to health issues coming down the line by sharing principles from one sector into another field.
(13:43):
Vets, consider the human owners of the animals you're treating.
And medical teams, think about the animals that your patients interact with.
And together we can all achieve the goals of One Health.
That's all for this series.
Again, let me thank Dr. Elaine Cloutman-Green and Dr. Simon Doherty for their truly enlightening insights and for being so open with sharing their knowledge.
(14:06):
Thanks again to Beckman Coulter for supporting the production of this podcast, Going Macro on Micro.
And to you, the audience, for listening and good luck in all your endeavours to embrace the principles of One Health and to bring your colleagues, patients and other stakeholders on the road with you.
We hope to bring you more series of Going Macro on Micro, so please subscribe to the podcast wherever you listen to stay up to date with each new episode as it's released.
(14:34):
You can also join our online professional community by searching Beckman Coulter Microbiology on LinkedIn.
There you'll find discussions on a variety of interesting microbiology topics.
Until next time, when we go macro on micro, goodbye.
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