COVID-19: opportunities for public health ethics?

Public health ethics is the discipline that ensures that public health professionals and policy makers explain what they do, and why. During the COVID-19 pandemic, ethical deliberations often did not feature explicitly in public health decisions, thus reducing transparency and consistency in decision-making processes, and resulting in loss of trust by the general public. A public health ethics framework based on principles would add to transparency and consistency in public health decision-making.

The impact of COVID-19 on different population subgroups: ethnic, gender and age-related disadvantage

Against a background of stalling UK life expectancy, the COVID-19 pandemic is a major crisis for public health with impacts differing markedly by ethnicity, gender, and age. Direct health impacts include mortality and long-term harms among survivors. Social disruption and lockdown measures arising from uncontrolled infection have destabilised healthcare and other essential services. The economic crisis resulting from the pandemic is already triggering job losses, which will in turn have their own adverse health effects.

COVID-19: decision-making in public health

Against a background of stalling UK life expectancy, the COVID-19 pandemic necessitated a different way of working for public health to respond quickly to new and many demands. At the same time, public health teams had to ensure they did not concentrate on the immediate crisis at the expense of mitigating longer-term impacts of the pandemic. This was, and is, a major challenge with additional demands on an already hard-pressed workforce.

Real-time monitoring of COVID-19 in Scotland

Background To manage the public health risk posed by COVID-19 and assess the impact of interventions, policymakers must be able to closely monitor the epidemic’s trajectory.

Methods Here we present a simple methodology based on basic surveillance metrics for monitoring the spread of COVID-19 and its burden on health services in Scotland.

Results We examine how the dynamics of the epidemic have changed over time and assess the similarities and differences between metrics.

UK internal medicine training in the time of COVID-19

COVID-19 has had a significant impact on internal medicine training in the UK. Many unprecedented changes have been made to prioritise the care of affected patients. The medical workforce was re-shaped, training programmes were disrupted, Membership of the Royal College of Physicians (MRCP) examinations were cancelled and their format changed on re-commencement, teaching programmes were suspended and delivery methods amended, out of programme (OOP) opportunities deferred, non-COVID related research halted, trainee progression impacted and trainee mental health and wellbeing suffered.

Utility of Simulation via Instant Messaging – Birmingham Advance (SIMBA) in medical education during COVID-19 pandemic

Background Simulation via Instant Messaging – Birmingham Advance (SIMBA) aimed to improve clinicians’ confidence in managing various clinical scenarios during the COVID-19 pandemic.

Methods Five SIMBA sessions were conducted between May and August 2020. Each session included simulation of scenarios and interactive discussion. Participants’ self-reported confidence, acceptance, and relevance of the simulated cases were measured.

Case of erythema multiforme/Stevens–Johnson syndrome: an unusual presentation of COVID-19

Dermatological manifestations of COVID-19 are rare, with fever ,dry cough, breathlessness, loss of taste and myalgia constituting most of the symptoms spectrum. However, these rare skin manifestations may be the only presentation of COVID-19 as in our presented patient. It is therefore prudent to be aware of such presentation in asymptomatic COVID-19 patients, as this is important for early diagnosis and hence taking appropriate preventive measures.

Drastic times need drastic measures: COVID-19 and widening access to medicine

In response to COVID-19, schools, colleges and universities across the world have closed or shifted to online/remote or blended teaching, learning and assessment. These changed ways of working pose challenges to students and will likely exacerbate existing educational attainment gaps between different societal groups. Our focus is the potential impact of COVID-19 on widening access to medicine. We provide an account of the process, in the form of comparative cases, of applying for medical school for two applicants from differing backgrounds.

Emerging pharmacotherapy for COVID-19

Broadly speaking, pharmacological treatments for COVID-19 can be divided into those acting on upstream pathways early on in the disease process via suppression of viral replication or by inhibiting cell entry, and those acting on downstream pathways later on via selective attenuation of the adaptive immune cytokine-mediated inflammatory response. The antiviral drug remdesivir has been shown to shorten duration of disease while interferon beta-1b may speed up viral clearance. The results with hydroxychloroquine have thus far been rather disappointing.