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      Preparing medical students for global challenges beyond COVID‐19

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      Health Science Reports

      John Wiley and Sons Inc.

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          Abstract

          The Coronavirus disease (COVID‐19) pandemic has highlighted the globalisation of modern healthcare challenges. As medical issues become increasingly globalised, healthcare professionals face new obstacles. Global problems require global solutions, and modern‐day doctors must master collaboration across different countries and different disciplines, all whilst working in a world full of misleading information. As medicals students, we are convinced that these skills and attitudes will be even more crucial in the coming years. We believe that we must start developing them now, in order to shape the future role of a “globalised” doctor. COVID‐19 is reported to cause respiratory tract infection, and infected individuals can present with fever, cough, breathlessness, and potentially fatal complications including respiratory distress syndrome and renal failure.1, 2 Dissemination of respiratory droplets produced when patients cough or sneeze lead to person‐to‐person transmission. 3 Symptomatic patients are thought to be the most contagious; however, the disease can be spread even before obvious symptoms appear. 4 Consequently, the spread of infection has led to a pandemic and global panic, causing flight cancellations, stranded cruise ships, thousands of news headlines, and millions of social media posts. The severity of this issue led the World Health Organisation to declare COVID‐19 a global emergency in January, and as of April 3, 2020, there have been 972 640 confirmed cases worldwide and 50 325 deaths.5, 6 The spread of this virus has exemplified how rapidly future problems may similarly reach a global scale. In a changing landscape, filled with unpredictability, the role of a doctor must constantly evolve to fulfil the needs of society. Recent environmental protests, for example, have instigated wide debate on the impact of climate. Shifting weather patterns and excessive pollution will result in an increased incidence of cardiorespiratory disease, exerting more pressure on healthcare systems. Despite this, the potential health implications of global warming remained a minor focus of public discussion. It is important that doctors portray a medical perspective to policymakers and to the general public, thus ensuring the health ramifications of such topics are not under‐represented. Hence, medical students must prepare to engage in such matters in the future. In the current digital era, the general public receives a lot of medical information from unreliable sources, particularly through “click‐bait” headlines and posts shared via social media. COVID‐19 has led to widespread transmission of information (and misinformation) across these channels, spreading both useful and harmful messages. Modern doctors have to navigate patients through the complexities of evidence‐based medicine in the consultation room, but also across the Internet. Furthermore, to combat increasingly complex issues, many different professions will have to collaborate to formulate efficient solutions. Doctors must master working in interdisciplinary teams that may include politicians, engineers, environmentalists, and other professionals. Moreover, these teams may span across continents and thus, doctors must develop competencies in cross‐cultural communication to effectively cooperate with different communities. As medical students, we believe it is the role of the doctor to foresee and adapt to potential healthcare challenges. At medical school, we are equipped with the skills and attitudes that shape the doctors we will become. We believe that we should begin preparing for the globalisation of medical issues as early as possible. This will require us to learn and adapt; however, we need medical schools to educate us on the current barriers to developing worldwide solutions and support us in seeking opportunities to acquire the necessary experience. Global health modules, medical electives, research exchange programmes, and healthcare leadership courses are offered by some of the medical schools in the United Kingdom. However, the accessibility of these opportunities is still limited, and most exist as optional components, which are available predominantly towards the end of undergraduate education. Furthermore, topics such as digital health remain under‐represented in the current curriculum. Such modules could educate students on handling mass information from the Internet. We believe that earlier and better integrated access to these opportunities will prepare us for future challenges similar to COVID‐19. The coronavirus crisis has demonstrated the new challenges healthcare professionals must overcome in the future. COVID‐19 has required doctors around the world to work with local authorities and international bodies, as well as with each other, to limit the effects of the outbreak. This situation has also illustrated the importance of communication between the world of evidence‐based medicine and the general public. We believe the primary role of the doctor will always be to treat their patients, but we must prepare to be the generation that redefines the role of our profession in a globalised world. CONFLICT OF INTEREST The authors declare no conflict of interest. AUTHOR CONTRIBUTIONS Conceptualisation: Aleksander Dawidziuk, Rishikesh Gandhewar. Writing ‐ original draft: Aleksander Dawidziuk, Rishikesh Gandhewar. Writing ‐ review and editing: Aleksander Dawidziuk, Rishikesh Gandhewar.

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          Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

          Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.
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            Author and article information

            Contributors
            aleksander.dawidziuk16@imperial.ac.uk
            Journal
            Health Sci Rep
            Health Sci Rep
            10.1002/(ISSN)2398-8835
            HSR2
            Health Science Reports
            John Wiley and Sons Inc. (Hoboken )
            2398-8835
            23 April 2020
            June 2020
            : 3
            : 2 ( doiID: 10.1002/hsr2.v3.2 )
            Affiliations
            [ 1 ] Department of Medicine Imperial College London London UK
            Author notes
            [* ] Correspondence

            Aleksander Dawidziuk, Department of Medicine, Imperial College London, South Kensington Campus, London SW7 2AZ, UK.

            Email: aleksander.dawidziuk16@ 123456imperial.ac.uk

            Article
            HSR2162
            10.1002/hsr2.162
            7178824
            © 2020 The Authors. Health Science Reports published by Wiley Periodicals, Inc.

            This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

            Page count
            Figures: 0, Tables: 0, Pages: 2, Words: 1045
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            Custom metadata
            2.0
            June 2020
            Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.2 mode:remove_FC converted:19.05.2020

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