Following the Fukushima nuclear disaster in 2011, investigators at Fukushima University have designed and rolled out an extensive community telephone consultation service focusing on firstly, identifying early, individuals susceptible to mental illness in the Fukushima prefecture and secondly implementing via telephone, appropriate psychological interventions, which facilitated easier access to a broad range of the population, who were resistant or unable to link in with established healthcare facilities.In previous published articles related to the Fukushima nuclear disaster, we have highlighted concerns related to inadequate healthcare resources in the region post-2011, the concern related to ‘fake news’ and the stigma associated with Fukushima residents who moved to other parts of Japan., We now highlight the extensive telephone support network in the prefecture which has supported over 30 000 affected people over recent years. In the challenging COVID times we live in—there are significant lessons to be learnt from our Japanese colleagues in relation to the effectiveness of such a cost-effective strategy.
Healthcare workers and asymptomatic COVID-19 carriers
There has been significant heightened interest within the media in asymptomatic COVID-19, the so-called ‘superspreader’, individuals within the community. This has led to heightened anxiety within the population and, in particular, workers working in front-line positions. The availability of frequent testing of healthcare workers (HCW’s) has helped identify these individuals early and limited their potential to infect their co-workers.Dr Olalla and colleagues report their findings of asymptomatic carriage in Southern Spain and report during the study period of a prevalence of 0.04% in HCWs. This is lower than might be expected and is certainly reassuring. One caveat being the lower general prevalence of COVID-19 in southern Spain of 30 cases/100 000 during the study period.
COVID-19 and pre-existing chronic renal disease
Continuing our series of articles on how COVID-19 specifically affects end-organ injury and consequently our practice of medicine, we welcome the paper by Dr Yang and colleagues from Tongji Medical College, Wuhan, China in which they describe the clinical characteristics and prognosis of COVID-19 hospital in-patients who had pre-existing chronic renal disease.This series builds on recent QJM publications related to COVID-19 and cardiac disease and rheumatological diseases. In this cohort of COVID-19 inpatients, those with pre-existing chronic renal disease not requiring renal replacement therapy (RRT) had an associated mortality of 50%, those who were on pre-existing RRT—66% and those inpatients with no pre-existing chronic renal disease of 9%. Of note, chronic renal diseasepatients had significantly more comorbidities, in particular hypertension, which would additionally contribute to this adverse prognosis.