Riding the waves: the ongoing impact of COVID-19 on a national surgical training cohort

Abstract Background The World Health Organisation declared a global pandemic on the 11 March 2020 resulting in implementation of methods to contain viral spread, including curtailment of all elective and non-emergent interventions. Many institutions have experienced changes in rostering practices and redeployment of trainees to non-surgical services. Examinations, study days, courses, and conferences have been cancelled. These changes have the potential to significantly impact the education and training of surgical trainees. Aim To investigate the impact of the COVID-19 pandemic on training, educational, and operative experiences of Irish surgical trainees. Methods Surgical trainees were surveyed anonymously regarding changes in working and educational practices since the declaration of the COVID-19 pandemic on 11 March 2020. The survey was circulated in May 2020 to both core and higher RCSI surgical trainees, when restrictions were at level five. Questions included previous and current access to operative sessions as well as operative cases, previous and current educational activities, access to senior-led training, and access to simulation-/practical-based training methods. A repeat survey was carried out in October 2020 when restrictions were at level two. Results Overall, primary and secondary survey response rates were 29% (n = 98/340) and 19.1% (n = 65/340), respectively. At the time of circulation of the second survey, the number of operative sessions attended and cases performed had significantly improved to numbers experienced pre-pandemic (p < 0.0001). Exposure to formal teaching and education sessions returned to pre-COVID levels (p < 0.0001). Initially, 23% of trainees had an examination cancelled; 53% of these trainees have subsequently sat these examinations. Of note 27.7% had courses cancelled, and 97% of these had not been rescheduled. Conclusion Surgical training and education have been significantly impacted in light of COVID-19. This is likely to continue to fluctuate in line with subsequent waves. Significant efforts have to be made to enable trainees to meet educational and operative targets.

Download Full-text

“Air pollution arrested not imprisoned”: The impact of laws invoked on Covid-19 city lockdowns

Journal of Clinical Images and Medical Case Reports ◽

10.52768/2766-7820/1275 ◽

2021 ◽

Vol 2 (4) ◽

Author(s):

Emmanuel Mensah Aboagye ◽

◽

Nana Osei Owusu ◽

Keyword(s):

Air Pollution ◽

Environmental Problem ◽

World Health Organisation ◽

Developed Countries ◽

World Health ◽

Economic Activities ◽

Global Pandemic ◽

Depth Study ◽

The Government ◽

The Impact

Air pollution continues to be an environmental problem that poses a lot of health risks to the young and aged. Developed countries have invested heavily to curb this environmental problem, causing severe threats to human lives, yet the results do not look convincing. In developing countries, the situation is difficult than they can imagine, resulting in governments borrowing to fight what looks like a lost battle [1-3]. The in-depth study of this environmental menace - air pollution, suggests that the government enacts stringent measures to help fight this battle. This is because air pollution has natural (volcanic eruption) and anthropogenic (human activities) causes. In December 2019, the deadly Coronavirus (Covid-19) outbreak was soon declared as a global pandemic by the World Health Organisation (WHO) [4]. Majority of countries have had their share of the impact of this outbreak. Many countries resorted to city lockdown to strictly control the movement of people and economic activities as recommended by WHO.

Download Full-text

Smallpox in the Post-Eradication Era

Viruses ◽

10.3390/v12020138 ◽

2020 ◽

Vol 12 (2) ◽

pp. 138 ◽

Cited By ~ 4

Author(s):

Hermann Meyer ◽

Rosina Ehmann ◽

Geoffrey L. Smith

Keyword(s):

Public Health ◽

Human Population ◽

Health Benefit ◽

World Health Organisation ◽

World Health ◽

Viral Spread ◽

The World ◽

The Usa ◽

The Impact

Widespread vaccination programmes led to the global eradication of smallpox, which was certified by the World Health Organisation (WHO), and, since 1978, there has been no case of smallpox anywhere in the world. However, the viable variola virus (VARV), the causative agent of smallpox, is still kept in two maximum security laboratories in Russia and the USA. Despite the eradication of the disease smallpox, clandestine stocks of VARV may exist. In a rapidly changing world, the impact of an intentional VARV release in the human population would nowadays result in a public health emergency of global concern: vaccination programmes were abolished, the percentage of immunosuppressed individuals in the human population is higher, and an increased intercontinental air travel allows for the rapid viral spread of diseases around the world. The WHO has authorised the temporary retention of VARV to enable essential research for public health benefit to take place. This work aims to develop diagnostic tests, antiviral drugs, and safer vaccines. Advances in synthetic biology have made it possible to produce infectious poxvirus particles from chemicals in vitro so that it is now possible to reconstruct VARV. The status of smallpox in the post-eradication era is reviewed.

Download Full-text

The Impact of Ultraviolet Radiation on the Aetiology and Development of Uveal Melanoma

Cancers ◽

10.3390/cancers13071700 ◽

2021 ◽

Vol 13 (7) ◽

pp. 1700

Author(s):

Melissa Chalada ◽

Charmaine A. Ramlogan-Steel ◽

Bijay P. Dhungel ◽

Christopher J. Layton ◽

Jason C. Steel

Keyword(s):

Risk Factors ◽

Ultraviolet Radiation ◽

Uveal Melanoma ◽

World Health Organisation ◽

World Health ◽

Genetic Mutations ◽

High Incidence ◽

The World ◽

The Impact

Uveal melanoma (UM) is currently classified by the World Health Organisation as a melanoma caused by risk factors other than cumulative solar damage. However, factors relating to ultraviolet radiation (UVR) susceptibility such as light-coloured skin and eyes, propensity to burn, and proximity to the equator, frequently correlate with higher risk of UM. These risk factors echo those of the far more common cutaneous melanoma (CM), which is widely accepted to be caused by excessive UVR exposure, suggesting a role of UVR in the development and progression of a proportion of UM. Indeed, this could mean that countries, such as Australia, with high UVR exposure and the highest incidences of CM would represent a similarly high incidence of UM if UVR exposure is truly involved. Most cases of UM lack the typical genetic mutations that are related to UVR damage, although recent evidence in a small minority of cases has shown otherwise. This review therefore reassesses statistical, environmental, anatomical, and physiological evidence for and against the role of UVR in the aetiology of UM.

Download Full-text

The Impact of COVID-19 on Surgical Training: the Past, the Present and the Future

Indian Journal of Surgery ◽

10.1007/s12262-021-02964-2 ◽

2021 ◽

Author(s):

Marina Yiasemidou

Keyword(s):

Infection Control ◽

Surgical Training ◽

New Technologies ◽

Negative Impact ◽

Elective Surgery ◽

Control Measures ◽

Negative Consequences ◽

Surgical Services ◽

The World ◽

The Impact

AbstractThe COVID-19 pandemic and infection control measures had an unavoidable impact on surgical services. During the first wave of the pandemic, elective surgery, endoscopy, and ‘face-to-face’ clinics were discontinued after recommendations from professional bodies. In addition, training courses, examinations, conferences, and training rotations were postponed or cancelled. Inadvertently, infection control and prevention measures, both within and outside hospitals, have caused a significant negative impact on training. At the same time, they have given space to new technologies, like telemedicine and platforms for webinars, to blossom. While the recovery phase is well underway in some parts of the world, most surgical services are not operating at full capacity. Unfortunately, some countries are still battling a second or third wave of the pandemic with severely negative consequences on surgical services. Several studies have looked into the impact of COVID-19 on surgical training. Here, an objective overview of studies from different parts of the world is presented. Also, evidence-based solutions are suggested for future surgical training interventions.

Download Full-text

COVID-19 pandemic: A review of the global lockdown and its far-reaching effects

Science Progress ◽

10.1177/00368504211019854 ◽

2021 ◽

Vol 104 (2) ◽

pp. 003685042110198

Author(s):

Helen Onyeaka ◽

Christian K Anumudu ◽

Zainab T Al-Sharify ◽

Esther Egele-Godswill ◽

Paul Mbaegbu

Keyword(s):

Mental Health ◽

Global Economy ◽

World Health ◽

Global Pandemic ◽

The World ◽

Education Delivery ◽

Environmental Air ◽

Health Organization ◽

Almost All ◽

The Impact

COVID-19, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), was declared a pandemic by the World Health Organization (WHO) on the 11th of March 2020, leading to some form of lockdown across almost all countries of the world. The extent of the global pandemic due to COVID-19 has a significant impact on our lives that must be studied carefully to combat it. This study highlights the impacts of the COVID-19 pandemic lockdown on crucial aspects of daily life globally, including; Food security, Global economy, Education, Tourism, hospitality, sports and leisure, Gender Relation, Domestic Violence/Abuse, Mental Health and Environmental air pollution through a systematic search of the literature. The COVID-19 global lockdown was initiated to stem the spread of the virus and ‘flatten the curve’ of the pandemic. However, the impact of the lockdown has had far-reaching effects in different strata of life, including; changes in the accessibility and structure of education delivery to students, food insecurity as a result of unavailability and fluctuation in prices, the depression of the global economy, increase in mental health challenges, wellbeing and quality of life amongst others. This review article highlights the impacts of the COVID-19 pandemic lockdown across the globe. As the global lockdown is being lifted in a phased manner in various countries of the world, it is necessary to explore its impacts to understand its consequences comprehensively. This will guide future decisions that will be made in a possible future wave of the COVID-19 pandemic or other global disease outbreak.

Download Full-text

Impact of the Emerging COVID-19 Pandemic on the Consumption of Multivitamins (C, D and Zinc) by the Saudi Arabian Population

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i26b31476 ◽

2021 ◽

pp. 11-20

Author(s):

Duaa Mohamed Bakhshwin ◽

Abdulaziz Bakhshwin

Keyword(s):

Vitamin D ◽

Vitamin C ◽

World Health ◽

Saudi Population ◽

Viral Spread ◽

Significant Difference ◽

Before And After ◽

Zinc Supplements ◽

Vitamin D Supplements ◽

The Impact

Background: On March 11, 2020, the World Health Organization (WHO) announced the Coronavirus outbreak officially as a pandemic. This pandemic has led to new measurements to prevent viral spread. The measures included decreasing the person’s mobility outside homes with subsequent changes in the lifestyles, particularly in physical activity and eating habits. It has been noticed that consumption of some vitamins may help in preventing or reducing the symptoms of viral infection. Those vitamins include vitamin C, D and zinc. There is a common observation that the general public believes that the use of vitamins, especially vitamins C, D and zinc, reduces the chance of acquiring COVID-19. Objectives: The aim of this study was to determine the impact of COVID-19 pandemic on taking vitamins supplements by the Saudi general population in order to explore their believes regarding the protective value of these vitamins against COVID-19 infection. Subjects and Methods: This cross-sectional study was conducted using a self-administrated questionnaire that was designed, uploaded to the Google form and distributed online to the general Saudi population through the social media (Whatsapp, Twitter) as well as through email between August and December 2020. Statistical Packaged of Social Sciences program (SPSS) for Windows (version 17.0., Chicago: SPSS Inc) was used to analyze the data. A significant difference was considered when the p value is < 0.05. Student t-test and Chi-square (χ2) test were used to compare the studied variables as appropriate. Results: A total of 1043 participants were included in this study (64.9% females, 35.1% males). The mean age for them was 35.3±14.78 years. Only 9.3% (97 participants) were diagnosed to have COVID-19. About 28% of the participants were in contact with COVID-19 cases. Among participants diagnosed to have COVID-19 infection, (13% versus 29%) were taking vitamin C and (2% versus 15%) were taking zinc supplements daily during the 6 months before and after the pandemic, respectively, while (20% versus 25%) were taking vitamin D supplements weekly during the 6 months before and after the pandemic, respectively. Among participants who were in contact with COVID-19 cases, (8% versus 20%) and (3% versus 11%) were taking vitamin C and zinc supplements daily during the 6 months before and after the pandemic, respectively, while (14% versus 16%) were taking vitamin D supplements weekly during the 6 months before and after the pandemic Conclusion: The interest of taking multivitamin by Saudi population, such as vitamins C and D, zinc increased during and after the pandemic compared to that before it. There is no scientific evidence based on previous studies confirmed the role of dietary supplementation and multivitamins in preventing COVID-19 infection, therefore, effective education on the rationale use of vitamins during COVID-19 pandemic should be emphasized at local and/or national levels.

Download Full-text

The Impact of COVID-19 on Gastric Cancer Surgery: A Single-Center Retrospective Study

10.21203/rs.3.rs-35676/v3 ◽

2020 ◽

Author(s):

Yu-xuan Li ◽

Chang-zheng He ◽

Yi-chen Liu ◽

Peng-yue Zhao ◽

Xiao-lei Xu ◽

...

Keyword(s):

Gastric Cancer ◽

Waiting Time ◽

World Health ◽

Abdominal Ct ◽

Surgical Strategies ◽

Patients With Cancer ◽

Global Pandemic ◽

Health Organization ◽

Gastric Cancer Patients ◽

The Impact

Abstract Background: The coronavirus disease 2019 (COVID-19) has been declared a global pandemic by the World Health Organization. Patients with cancer are more likely to incur poor clinical outcomes. Due to the prevailing pandemic, we propose some surgical strategies for gastric cancer patients. Methods: The ‘COVID-19’ period was defined as occurring between 2020-01-20 and 2020-03-20. The enrolled patients were divided into two groups, pre-COVID-19 group (PCG) and COVID-19 group (CG). A total of 109 patients with gastric cancer were enrolled in this study. Results: The waiting time before admission increased by 4 days in the CG (PCG: 4.5 [IQR: 2, 7.8] vs. CG: 8.0 [IQR: 2,20]; p=0.006). More patients had performed chest CT scans besides abdominal CT before admission during the COVID-19 period (PCG: 22 [32%] vs. CG: 30 [73%], p=0.001). After admission during the COVID period, the waiting time before surgery was longer (PCG: 3[IQR: 2,5] vs. CG: 7[IQR: 5,9]; p<0.001), more laparoscopic surgeries were performed (PCG: 51[75%] vs. CG: 38[92%], p=0.021), and hospital stay period after surgery was longer (7[IQR: 6,8] vs.9[IQR:7,11]; p<0.001). In addition, the total cost of hospitalization increased during this period, (PCG: 9.22[IQR:7.82,10.97] vs. CG: 10.42[IQR:8.99,12.57]; p=0.006). Conclusion: This study provides an opportunity for our surgical colleagues to reflect on their own services and any contingency plans they may have to tackle the COVID-19 crisis.

Download Full-text

Live wildlife trade in markets - a scoping review to inform risk assessment of emerging infectious diseases

10.1101/2021.09.13.21263377 ◽

2021 ◽

Author(s):

Victoria J Brookes ◽

Okta Wismandanu ◽

Etih Sudarnika ◽

Justin A Roby ◽

Lynne Hayes ◽

...

Keyword(s):

Risk Assessment ◽

Infectious Diseases ◽

Scoping Review ◽

Epistemic Uncertainty ◽

Mammalian Species ◽

Emerging Infectious Diseases ◽

World Health Organisation ◽

World Health ◽

Wildlife Trade ◽

The Impact

Wet markets are important for food security in many regions worldwide but have come under scrutiny due to their potential role in the emergence of infectious diseases. The sale of live wildlife has been highlighted as a particular risk, and the World Health Organisation has called for the banning of live, wild-caught mammalian species in markets unless risk assessment and effective regulations are in place. Following PRISMA guidelines, we conducted a global scoping review of peer-reviewed information about the sale of live, terrestrial wildlife in markets that are likely to sell fresh food, and collated data about the characteristics of such markets, activities involving live wildlife, the species sold, their purpose, and animal, human, and environmental health risks that were identified. Of the 59 peer-reviewed records within scope, only 25% (n = 14) focussed on disease risks; the rest focused on the impact of wildlife sale on conservation. Although there were some global patterns (for example, the types of markets and purpose of sale of wildlife), there was wide diversity and huge epistemic uncertainty in all aspects associated with live, terrestrial wildlife sale in markets such that the feasibility of accurate assessment of the risk of emerging infectious disease associated with live wildlife trade in markets is limited. Given the value of both wet markets and wildlife trade and the need to support food affordability and accessibility, conservation, public health, and the social and economic aspects of livelihoods of often vulnerable people, there are major information gaps that need to be addressed to develop evidence-based policy in this environment. This review identifies these gaps and provides a foundation from which information for risk assessments can be collected.

Download Full-text

The Impact of Covid-19 Public Health Policies on Persons with Disability and their Caregivers in Malta

International Journal of Social Science Research and Review ◽

10.47814/ijssrr.v4i2.88 ◽

2021 ◽

Vol 4 (2) ◽

pp. 25-37

Author(s):

Andrew Camilleri ◽

Samantha Pace Gasan ◽

Andrew Azzopardi

Keyword(s):

Public Health ◽

World Health Organisation ◽

World Health ◽

Persons With Disabilities ◽

Health Authorities ◽

Essential Services ◽

Public Health Authorities ◽

Novel Coronavirus ◽

Restrictive Measures ◽

The Impact

On March 11, 2020, the World Health Organisation (WHO) declared a global health pandemic, due to the spread of a novel coronavirus, later named “Covid-19”. The spread of Covid-19 led to social isolation, distancing and a number of restrictive measures in Malta. The aim of this paper is to analyse the impact of Covid-19 and the subsequent restrictive measures on persons with disability and their caregivers and families in Malta. Using thematic analysis, the study found that a variety of impacts ranging from a sense of isolation, lack of essential services being provided, additional difficulties encountered at the place of work and education and measures that were not sufficiently tailored for persons with disability issued by public health authorities. Underlying the additional difficulties brought about by Covid-19, structural difficulties to access essential services as well as ignorance from policy makers and politicians and the added “vulnerable-ization” of persons with disabilities were found to be highly impacting factors that pervade the experience of persons with disabilities and their caregivers.

Download Full-text

982 Higher General Surgical Trainee preferences for Annual Review of Competency Progression during COVID-19 Pandemic

British Journal of Surgery ◽

10.1093/bjs/znab259.884 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

K Khan ◽

G Torpiano ◽

N Galbraith ◽

M McLellan ◽

A Lannigan

Keyword(s):

Surgical Training ◽

Annual Review ◽

Surgical Trainee ◽

Training Groups ◽

Surgical Trainees ◽

The Impact

Abstract Aim The COVID-19 pandemic has caused significant disruption in surgical training. We aim to explore the preferences of higher general surgical trainees for Annual Review of Competency Progression (ARCP) also compare the responses across different training grades. Method All higher general surgical trainee in a single deanery were invited to participate in an online voluntary anonymous survey. The respondents were divided in two groups: junior (ST3-ST5) and senior higher surgical trainees (ST6-ST8) and responses compared. Results Sixty-four of 88 trainees responded. Thirty-three (51.6%) were ST3–ST5, 24 (37.5%) were ST6–ST8 and 7 (10.9%) were out-of-training. More trainees in ST3–ST5 group preferred to defer the next rotation for 12 months (18.2% vs 0%, p = 0.034), repeat current sub-specialty (33.3% vs 4.2%, p = 0.009), or add 12 months to training and delay predicted CCT date by 12 months (18.2% vs 0%, p = 0.034). Most trainees in both groups preferred the option of prolonging training should be offered to all trainees with an option to decline extension if ARCP competencies met (66.7% vs 50.0%, p = 0.276). Conclusions The preference for ARCP and length of training was different between two training groups, hence the need of trainees should be considered by training committees when addressing the impact of COVID-19.

Download Full-text