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@dresmerelda

ID/Micro Academic Doctor & Smiley-faced lover of purple

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First few days back in clinical for 7 months. The sense of teamwork is incredible. And that feeling doesn’t just come from inside the hospital- we’re really feeling the love from all of you outside too: gifts of food, offers of support and skills, claps from your doorstep. ❤️ • As things inevitably get busier, as staff and patients and relatives feel more of the strain, as we celebrate successes and mourn losses in this pandemic, please remember how much we’ve already appreciated this support from you at home- one of us has said so at least once each day. It’s incredibly moving for us and it’s saved us time when we’re busy but need to eat!! 🤪 • But more than anything, it feels like we’re all in this together. Weirdly distant but incredibly united. So thank you and feel free to spread this thanks (by social media/phone!!!) to everyone you know. Keep doing your part and if you can, #staysafe #stayhome 🥰 • PS: in the next 24hours or so, @dan_the_biology_man, @kennenhutchison and I are hoping to do our @thescicommunity live chat about Covid-19. Keep an eye on our stories for the date/time but please do join us. Thanks for your questions so far and feel free to ask some on the day and we’ll answer what we can. 🙌 • #instascience #medic #thankyou #thankful #stayhealthy #inhospital #staystrong #healthheroes #saveournhs #nhsheroes #infection #biscuits #feelingthelove #virology #saturdayvibes #thankahealthcareworker
Back on clinical as the upsurge in the UK continues. 😷 • Whilst packing up to move (packing for the “pseudo-apocalypse” is hard- how many shoes do I need?!) I amused myself 🤪 In actuality I still need to try to keep up my academic work too so the laptop isn’t quite going away! 👩🏻‍💻 • In all seriousness, humour and good spirits ARE what are needed. Because we all know that the next few months are going to be tough. Both in and out of hospital. Both for healthcare and non healthcare staff. So look after each other, laugh when you can, support each other when you’re stressed. But more than anything right now in the UK and many other places, if you can, stay the MUFFINS at home. 😘 • PS: again, the mask was privately bought a year ago for other reasons. But I am keeping it safe! 😷 • #doctorsofinstagram #oncalllife #virus #covidfighters #instascience #medicallife #scrubslife #saveournhs #academiclife #phdchat #microbiologist #infection #infectiousdisease #dresmerelda #funny #vlogger #stayhome #stayhealthy #montage #clinicalresearch #fightingfit #nhs #virology #scicomm #mentalhealth #mindfulness #bekind
Covid-19: can if effect your bowels? 🤔 • There was a lot in the media recently about a paper that’s in pre-print (swipe next; inset= PHE Guidance). The paper looked at 204 patients in China with confirmed Covid-19. They found that nearly half had some bowel symptoms- non-severe diarrhoea/tummy ache. 💩 • Q: Is this surprising given that everyone is concentrating on cough and fever? 🤔 • A: no. We know that bowel symptoms were more common in SARS-CoV-1 but in SARS-CoV-2 (and in this study) cough was still the predominant symptom. We know that SARS-CoV-2 (Covid-19 virus) can be found in 💩 samples. There is a suggestion in this paper that people with bowel symptoms were sicker overall. But it’s not clear (it may be in the final print) if these patients had underlying illnesses- many infections behave less “typically” in patients with a weak immune system for example and these patients may do worse 🩺 • Q2: Why is it important? 🌡 • A2: 👇 1️⃣ Medical staff need to keep aware that patients presenting with loose stool may have Covid-19. It’s particularly important if it helps us work out early who might get sicker (also see point 2) 2️⃣ Patients in this study took longer to seek medical attention but 97% still had lung symptoms. This may have been why they were more poorly in this study- because they didn’t contact medics sooner. So if you’re unwell during this distancing time and you’re not getting better then you should contact your medical teams as your country advises. 🩺 3️⃣ As our UK guidance suggests, people with weakened immune systems might have more unusual symptoms. Bear this in mind if you’re in the “high risk” group and follow the advice in point 2. 👍 4️⃣ If you can let a vulnerable house member have their own bathroom, this is a good idea. If not, follow the stay at home guidance (inset on swipe). If you have any symptoms, again, try to use your own bathroom or go last, put the lid down when you flush, and clean after use 💩👍 • Otherwise: stay healthy, stay home 🏠 • #nhs #research #evidencebasedmedicine #scicomm #instascience #phd #doctorsofinstagram #doctorslife #dresmerelda #stayhome #stayhealthy #medicine #stem #infectiousdisease
The UK #covid response: thoughts from an ID doctor 👩🏻‍⚕️ • 1️⃣ Our Chief Medical Officer is a PROFESSOR of Public Health & Infectious Disease- this couldn’t be better for us right now! 👍 2️⃣ They’re trying to avoid a 2nd peak of infections when everyone thinks it’s “safe”- a staggered response to social isolation may help flatten that curve (though admittedly, the use of the phrase “herd immunity” was a little unwise in communicating this) 🧐 3️⃣ Shutting schools right now may mean a reduction in the work forces we need and the risk that grandparents will try to help out with child care...! 😕 4️⃣ We medical staff have been being preparing increasingly for this since January- we’ve been kept informed from the bosses throughout. 🤓 5️⃣ Panic is unhelpful- it results in panic-buying of goods that those at higher risk who need to self-isolate then can’t get access to 😔 6️⃣ The ideal would be to swab everyone and have death rates that look like as low as those in South Korea- but upscaling is resource intensive. You WILL see the UK death rate increase but some of this will be because we’re currently not swabbing mild, community cases. Keep this in mind. The majority of cases will be fine overall- think of others. Also, note possible new tests (see stories)👩🏻‍⚕️ 7️⃣ The lovely Emily from @mothergoodco interviewed me the other day- UK is now advising pregnant women to be cautious, but risk of mum to baby transmission in the womb *seems* low; the risk may still be higher for mum though. HOWEVER, we are learning more all the time! Please follow the latest guidance from your local health ministries & WHO 🤰🏿 8️⃣ Keep alert to increasing social distance measures in YOUR country- rates are slightly different depending on testing and may not be directly comparable- it’s not just about the absolute number so STOP BEING ARMCHAIR EPIDEMIOLOGISTS AND DO AS YOUR COUNTRY ADVISES!!! 💪 9️⃣ Further post on this later this week but WHO have released guidance on dealing with anxiety over this. Pubs may close but keep calm and carry on 🙌 🔟 #bekind - people are scared • #scicomm #instascience #publichealth #research #doctorsofinstagram #infectioncontrol #infectiousdisease
If I could just absorb the knowledge of this book by sticking it on my head, that would be ace! 🙌 But I’m already a medical doctor, so why do I need to? 👩🏻‍⚕️ • BECAUSE THE LEARNING NEVER STOPS, folks!! After we graduate from medical school in the UK we: 📚 • Have to pass our first year of work with the GMC to make sure we’re safe 👍 • we then do another year of hospital work before we apply for the next stage of specialising- generally choosing between medical or surgical routes- and then being interviewed and ranked 👩🏻‍💼 • During these next working years we also sit our “general” exams for medicine or surgery (2 writtens and a practical for medicine) 👩🏻‍🏫 • And then we do our specialty exams- in my case there are 2 specialty exams I need to do. 👩🏻‍⚕️ • The structure differs between specialties and pathways. GPs/family doctors have a separate path for example. Unfortunately, this is unlikely to go brilliantly for me as for personal reasons I haven’t been able to focus as well as I’d like. Don’t wanna pull out though. I don’t mind (an expensive!) practice run! It may even be cancelled with coronavirus 🤷🏻‍♀️ • Meanwhile, I’m ploughing through practice questions, guidelines and making small notes in a pretty notebook- I find it really helps to have nice stationery!!! It’s also important to have a good work space and non-distracting music helps, like classical (except when they start doing versions of “Riders of the Storm” that I join in singing with!!) or rain sounds. What are your cramming tips? 👇 • Swipe for a laugh when posing goes wrong 😂 • #womeninscience #womeninmedicine #medicallife #studygram #studytips #doctorslife #infection #infectioncontrol #studying #revisiontips #bookstagram #purplehair #dresmerelda #workhardplayhard #stationery #phdlife #iwd2020 #thedoors #instastudy #doctorsofinstagram #medicine #medstudent #alwayslearning #microbiology #microbiologia #microbiologist #infectiousdiseasedoctors #infectiousdiseases #virology #parasitology
Alright, fed up of this virus business?? Let’s go back to bacteria for a bit. LOOK AT THE GLOOOOP! 😅 • This is a test to identify bacteria (science below 👇) and can be a bit quicker and cheaper than performing Gram stains and looking down a scope. Knowing roughly what type of bug someone’s growing (a Gram positive or Gram negative bug) can help us doctors work out what antibiotics to use and where the cause of the infection might be. 👩🏻‍⚕️ • It’s the KOH String test. A bit of the growing bacteria is mixed with 3% Potassium hydroxide (KOH) and if the bacteria is Gram negative (stains pink; type of bugs that cause urine infections a lot) then the bacteria burst and spill their insides, making the KOH gloopy. Gram positives (stain purple, often found on the skin) have thick walls that don’t break down in KOH. 💪 • Anyone know any antibiotics that treat Gram negative infections like urine infections? 👇 • #motivationmonday #mondayvibes #inthelab #microbes #scicomm #bacteria #slides #antibiotics #stemgirls #microscope #microscopy #biomedicalscience #labcoat #instascience #doctorsofinstagram #medical #dresmerelda #healthcareprofessional #gramstain
Covid-19: UK Infection Testing 👩🏻‍⚕️ • See blog post (link on bio) for how we’ve handled things in the UK and the clinical aspect of what’s being done. And no, this isn’t only what we wear, although the mask is part of it. 👍 • #covid19 #coronavirus #infectiousdiseases #science #doctors #ppe #outbreak #epidemiology #globalhealth #womeninmedicine #microbiologia #virology #virología #facemasks #clinical #doctorslife #medic #research #blogger #instablog #dresmerelda #stethoscope #steminist #studygram #lablife #friyay
So as well as my PhD work, I’m also writing up my last microbiome project. We’ve been making some exciting process, looking to see if changes in the gut are reflected in the breath. In a bit of a #throwbackthursday I will be heading back to my old uni to chat with the team about taking this forward for write up 🙌 • In the meantime, although the risk to the UK remains low, I still need to make sure I’m prepared to step up to help with any possible Covid-19 cases in the future. It felt like things were settling but with the outbreak in Italy, it seems sensible to be thinking ahead to support the workforce. There’s lots of info on social media about it but I’ll aim to give a clinical perspective again later this week. Let me know if you have any questions and I’ll try to answer them 👇 •

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