Ecologic studies investigating COVID-19 mortality determinants, used to make predictions and design public health control measures, generally focused on population-based variable counterparts of individual-based risk factors. Influenza is not causally associated with COVID-19, but shares population-based determinants, such as similar incidence/mortality trends, transmission patterns, efficacy of non-pharmaceutical interventions, comorbidities and underdiagnosis. We investigated the ecologic association between influenza mortality rates and COVID-19 mortality rates in the European context. We considered the 3-year average influenza (2014–2016) and COVID-19 (31 May 2020) crude mortality rates in 34 countries using EUROSTAT and ECDC databases and performed correlation and regression analyses. The two variables – log transformed, showed significant Spearman's correlation ρ = 0.439 (P = 0.01), and regression coefficients, b = 0.743 (95% confidence interval, 0.272–1.214; R2 = 0.244; P = 0.003), b = 0.472 (95% confidence interval, 0.067–0.878; R2 = 0.549; P = 0.02), unadjusted and adjusted for confounders (population size and cardiovascular disease mortality), respectively. Common significant determinants of both COVID-19 and influenza mortality rates were life expectancy, influenza vaccination in the elderly (direct associations), number of hospital beds per population unit and crude cardiovascular disease mortality rate (inverse associations). This analysis suggests that influenza mortality rates were independently associated with COVID-19 mortality rates in Europe, with implications for public health preparedness, and implies preliminary undetected SARS-CoV-2 spread in Europe.

The objective of this study was to describe the epidemiology of COVID-19 in Nigeria with a view of generating evidence to enhance planning and response strategies. A national surveillance dataset between 27 February and 6 June 2020 was retrospectively analysed, with confirmatory testing for COVID-19 done by real-time polymerase chain reaction (RT-PCR). The primary outcomes were cumulative incidence (CI) and case fatality (CF). A total of 40 926 persons (67% of total 60 839) had complete records of RT-PCR test across 35 states and the Federal Capital Territory, 12 289 (30.0%) of whom were confirmed COVID-19 cases. Of those confirmed cases, 3467 (28.2%) had complete records of clinical outcome (alive or dead), 342 (9.9%) of which died. The overall CI and CF were 5.6 per 100 000 population and 2.8%, respectively. The highest proportion of COVID-19 cases and deaths were recorded in persons aged 31–40 years (25.5%) and 61–70 years (26.6%), respectively; and males accounted for a higher proportion of confirmed cases (65.8%) and deaths (79.0%). Sixty-six per cent of confirmed COVID-19 cases were asymptomatic at diagnosis. In conclusion, this paper has provided an insight into the early epidemiology of COVID-19 in Nigeria, which could be useful for contextualising public health planning.

Vitamin D deficiency is associated with an increased risk of acute respiratory infection. There is an excess of respiratory infections and deaths in schizophrenia, a condition where vitamin D deficiency is especially prevalent. This potentially offers a modifiable risk factor to reduce the risk for and the severity of respiratory infection in people with schizophrenia, although there is as yet no evidence regarding the risk of COVID-19. In this narrative review, we describe the prevalence of vitamin D deficiency in schizophrenia, report the research examining the relationship between vitamin D levels and COVID-19 and discuss the associations between vitamin D deficiency and respiratory infection, including its immunomodulatory mechanism of action.

The COVID-19 pandemic created an unprecedented situation, whereby essential services within child and adolescent mental health services (CAMHS) were suspended. This created a need to modify regular methods of treatment at a rapid pace, to avoid cessation of clinical intervention and prevent potential regression in mental health. Eighteen children with moderate-to-severe mental health disorders and their parents were attending weekly group cognitive behaviour therapy-based sessions (‘The Secret Agent Society’ programme) when the Irish Department of Health suspended face-to-face intervention. This report describes how the group sessions were adapted to individualised, online therapeutic triads between each child, his/her parent and their clinician. Whilst internet technology has emerged as a promising solution to shortfalls in therapy services, in-depth exploration is needed to confirm the efficacy of telehealth for children attending CAMHS.

The Coronavirus Disease 2019 (COVID-19) has accounted for more than 25 000 cases in Ireland with approximately 28% of the clusters in nursing homes as of June 2020. The older population is the most vulnerable to serious complications from this illness and over 90% of deaths due to COVID-19 to date have been in patients over the age of 65. Continuing to provide routine care within nursing homes in these challenging times is an essential part of ensuring that presentations to hospitals for non-essential reasons are minimized. In this article, we describe a project being undertaken by a rural Psychiatry of Old Age Service in the northwest of Ireland. We aim to provide ordinary care in extraordinary times by using mobile tablets within the nursing homes and long-stay facilities in our region for remote video consultations during the COVID-19 crisis.

We describe the adaptation of services to allow flexible and practical responses to the coronavirus-19 (COVID-19) public health crisis by four Consultation–Liaison Psychiatry (CLP) services; Galway University Hospital (GUH), Beaumont Hospital, University Hospital Waterford and St Vincent’s University Hospital (SVUH) CLP services. This article also illustrates close collaboration with community adult mental health services and Emergency Department (ED) colleagues to implement effective community diversion pathways and develop safe, effective patient assessment pathways within the EDs. It highlights the high levels of activity within each of the CLP services, while also signposting that many of the rapidly implemented changes to our practice may herald improvements to mental health patient care delivery in the post-COVID-19 world, if our psychiatry services receive appropriate resources.

COVID-19 has spread across the globe with higher burden placed in Europe and North America. However, the rate of transmission has recently picked up in low- and middle-income countries, particularly in the Indian subcontinent. There is a severe underreporting bias in the existing data available from these countries mostly due to the limitation of resources and accessibility. Most studies comparing cross-country cases or fatalities could fail to account for this systematic bias and reach erroneous conclusions. This paper provides several recommendations on how to effectively tackle these issues regarding data quality, test coverage and case counts.

The coronavirus disease 2019 (COVID-19) pandemic spread throughout the globe, with an alarming amount of new cases daily. To prepare for the inevitable patient surge, 1 hospital set up outdoor triage tents to assist with increased volume. Using the paradigm of space, staff, and stuff, an outdoor treatment area was designed and placed into operation. The patient volume in the treatment tents quickly grew with a 1-d max volume of 88 patients. Through the end of May 2020, a total of 2473 patients were seen and evaluated. As COVID-19 continues to spread and new areas of the United States and the world see spikes, it is imperative for the hospitals that previously dealt with a surge to disseminate the best practices they have learned during the pandemic.

The authors describe Taiwan’s successful strategy in achieving control of coronavirus disease (COVID-19) without economic shutdown, despite the prediction that millions of infections would be imported from travelers returning from Chinese New Year celebrations in Mainland China in early 2020. As of September 2, 2020, Taiwan reports 489 cases, 7 deaths, and no locally acquired COVID-19 cases for the last 135 days (greater than 4 months) in its population of over 23.8 million people. Taiwan created quasi population immunity through the application of established public health principles. These non-pharmaceutical interventions, including public masking and social distancing, coupled with early and aggressive identification, isolation, and contact tracing to inhibit local transmission, represent a model for optimal public health management of COVID-19 and future emerging infectious diseases.

The 2019 coronavirus disease (COVID-19) infection had newly emerged with predominant respiratory complications. Other extrapulmonary features had been recently described. Here, we describe a COVID-19 patient presenting with multiorgan involvement mimicking systemic lupus erythematosus. He was successfully treated with glucocorticoids and tocilizumab.

An impressive reduction in emergency department patient attendance was observed during the coronavirus disease (COVID-19) pandemic coupled with an increase in the burden of patients with respiratory failure compared with the same period in 2019. These data are in line with the reduction in the hospital admissions rate for acute coronary syndrome observed during the COVID-19 outbreak, probably due to the patients’ fears of being infected during a hospital stay. All these factors may have contributed to the out-of-hospital cardiac arrest (OHCA) occurrence increase observed during the same period. The OHCAs rate increase can recognize 2 great sets of causes: the infection-related and the pandemic-related ones. If the first recognizes different underlying mechanisms that can be dealt with more and more effectively as evidence accumulates, we must remember also the latter: the fear of in-hospital contagion and the willingness not to further burden the health system, which can prevent some citizens from the activation of the emergency medical services (EMS) even in the case of symptoms suspected for time-dependent diseases, resulting in at-home deterioration until the OHCA occurrence. Information campaigns during pandemic must focus also on the importance of EMS early activation in case of real need to prevent COVID-19 from being a disease that kills at home.

Between December 31, 2019, and August 30, 2020 (date of this article), the novel coronavirus and its corresponding infection, coronavirus disease (COVID-19), increased to more than 25 million cases, and 843 158 deaths have been registered. Countries around the world have been affected, albeit in different levels and intensities.

Despite implementations of preventive public health measures, most countries are seriously preparing for 1 or more waves. The threat of this surge is likely to persist until herd immunity is acquired either by natural infection or through vaccination. However, given the time frame needed for herd immunity to occur and the low probability that a vaccine will be available on a global scale by the coming fall and winter seasons, contingency preparedness plans should be established and put in place for the coming days or months. These plans should help mitigate new peaks of the pandemic while relaxing the social isolation rules, patient, public health, and hospital levels.

In this article, we discuss recommendations that practicing physicians and public health agencies should provide to individuals, especially those at risk of infection, to take and implement pre-emptive measures in anticipation of the potential next peak of the pandemic.