Redefinition of Social Ties During the COVID-19 pandemic: Narratives of People who Relate with Each Other in Gated Communities

This article describes the research process that revolves around the resignation of social ties in the narratives of two residential complexes: Arboleda I and Casablanca stage II of the city of Bogota D.C, during the COVID-19. To this end, the current situation is recognized by pointing out the basic conceptions oriented to the COVID-19, from the elements of its emergence, its expansion, the measures taken by the Colombian government, as well as the attitude of civil society in residential complexes. The article covers the understanding of the subjectivities of actors who with their voices relate their experiences around social ties, highlighting the uniqueness of the community, organizational aspects, and technological means, among others. The methodology used is qualitative, in the line of narrative research;Subsequently, a relational analysis leads to results that show the different modifications that the inhabitants have experienced in the way of linking at the branch level, selective, organic and citizen participation in times of health emergency.

Use of Non-Invasive Respiratory Support Strategies in pediatric patients with SARS-CoV-2. A Scoping Review

Introduction: The use of non-invasive respiratory support strategies (NIRS) has been shown to reduce the consumption of resources associated with the requirement of intensive care unit and hospital stay in pediatric patients with acute respiratory failure, however, it is considered important to identify their frequency of use in pediatric patients with SARSCoV-2 and its relationship with the hospital stay. Objective: To identify the frequency of use of noninvasive respiratory support strategies (NIRS) in pediatric patients with SARS-CoV-2. Material and methods: Scoping review of the frequency of use of NIRS in pediatric SARS-CoV-2 between January 2020 and September 2021. The search was executed in the Cochrane Library, PubMed, Scopus databases, and the bibliographic search engines Science Direct and Oxford. Results: It was found that conventional, follow-up, or high-flow oxygen therapy and noninvasive mechanical ventilation are used more frequently in hospital settings. Conclusion: The NIRS of greater implementation in the pediatric patient with SARS-CoV-2 was conventional oxygen therapy and as a finding of interest its association with higher hospital stays was evidenced. © 2023 Academia Nacional de Medicina. All rights reserved.

Multidisciplinary approach of the sequelae one month after hospital discharge in patients with severe bilateral COVID-19 pneumonia, are there differences depending on the respiratory therapy used during admission to intensive care?

OBJECTIVE: To describe the sequelae one month after hospital discharge in patients who required admission to Intensive Care for severe COVID 19 pneumonia and to analyze the differences between those who received therapy exclusively with high-flow oxygen therapy compared to those who required invasive mechanical ventilation. DESIGN: Cohort, prospective and observational study. SETTING: Post-intensive care multidisciplinary program. PATIENTS OR PARTICIPANTS: Patients who survived admission to the intensive care unit (ICU) for severe COVID 19 pneumonia from April 2020 to October 2021. INTERVENTIONS: Inclusion in the post-ICU multidisciplinary program. MAIN VARIABLES OF INTEREST: Motor, sensory, psychological/psychiatric, respiratory and nutritional sequelae after hospital admission. RESULTS: 104 patients were included. 48 patients received high-flow nasal oxygen therapy (ONAF) and 56 invasive mechanical ventilation (IMV). The main sequelae found were distal neuropathy (33.9% IMV vs 10.4% ONAF); brachial plexopathy (10.7% IMV vs 0% ONAF); decrease in grip strength: right hand 20.67kg (±8.27) in VMI vs 31.8kg (±11.59) in ONAF and left hand 19.39kg (±8.45) in VMI vs 30.26kg (±12.74) in ONAF; and limited muscle balance in the lower limbs (28.6% VMI vs 8.6% ONAF). The differences observed between both groups did not reach statistical significance in the multivariable study. CONCLUSIONS: The results obtained after the multivariate study suggest that there are no differences in the perceived physical sequelae one month after hospital discharge depending on the respiratory therapy used, whether it was high-flow nasal oxygen therapy or prolonged mechanical ventilation, although more studies are needed to be able to draw conclusions.

Propofol and COVID-19 infusion syndrome. Case report

The severe form of SARS-CoV-2 pneumonia (COVID-19) occurs in most cases with acute respiratory distress syndrome (ARDS), requiring the use of sedation during mechanical ventilation, with propofol being the most widely used for its pharmacokinetics and pharmacodynamics. Propofol is a widely used anesthetic in intensive care units (ICU). Its use can cause an infrequent but extremely serious adverse effect, known as propofol infusion syndrome (PRIS), which is closely associated with the speed of infusion coupled with risk factors specific to the patient, the clinical features of PRIS are hemodynamic instability, lactic acidosis and with progression to multi-organ dysfunction. We present a case of SIP in a patient with acute respiratory distress syndrome (ARDS) secondary to SARS-CoV-2 who develops this complication associated with sedation, discusses clinical pathophysiology and considerations that should be taken into account when using it in continuous infusion. © 2023, Colegio Mexicano de Anestesiologia A.C.. All rights reserved.

Impact of COVID-19 in New-Onset Type 1 Diabetes Mellitus in a Large Portuguese Pediatric Diabetes Center

Introduction: Our aim was to characterize new-onset type 1 diabetes mellitus (T1D) cases in a pediatric population referred to a large pediatric diabetic center throughout the first year of the COVID-19 pandemic, comparing it to previous years. Methods: Retrospective study including patients under 18 years with new-onset T1D, from March 12th 2020 to March 11(th) 2021. A control group was defined using data on patients under 18 years with new-onset T1D referred to the same hospital in the 3 previous years (from March 2017 to March 2020). Data was analyzed using SPSS. A p value of 0.05 was used as threshold of significance. Results: Between March 12(th) 2020 and March 12(th) 2021, 44 patients were diagnosed with new-onset T1D. The control group included 96 patients, resulting in an incidence of 32 cases/year (37.5% rise). January 2021 was the month with the higher number of diagnosis, corresponding to the peak of novel SARS-CoV-2 infections. During the pandemic, new-onset T1D cases in children under 2 years-old doubled, when comparing to mean incidence in previous years. Median delay to diagnosis was not significantly different from previous years. Diabetic ketoacidosis (DKA) at presentation was present in 50% of cases that were diagnosed after lockdown, increasing substantially from previous years (38.5%). DKA's severity was also significantly higher (40.9%, p=0.04), as were Intensive Care Unit admission (13.6%, p=0.04). Conclusion: Despite the existance of molecular pathways that could lead to islet cell injury, the role of the new coronavirus in the pathogenesis of DKA and T1D onset is still unclear. Disease severity could also be related to a higher proportion of younger children.

[Multidisciplinary approach of the sequelae one month after hospital discharge in patients with severe bilateral COVID-19 pneumonia, are there differences depending on the respiratory therapy used during admission to intensive care?] / Valoración multidisciplinar de las secuelas al mes del alta hospitalaria por neumonía grave COVID-19, ¿existen diferencias en función de la terapia respiratoria empleada durante su ingreso en Cuidados Intensivos?

Objective: To describe the sequelae one month after hospital discharge in patients who required admission to intensive care for severe COVID-19 pneumonia and to analyze the differences between those who received therapy exclusively with high-flow oxygen therapy compared to those who required invasive mechanical ventilation. Design: Cohort, prospective and observational study. Setting: Post-intensive care multidisciplinary program. Patients or participants: Patients who survived admission to the intensive care unit (ICU) for severe COVID-19 pneumonia from April 2020 to October 2021. Interventions: Inclusion in the post-ICU multidisciplinary program. Main variables of interest: Motor, sensory, psychological/psychiatric, respiratory and nutritional sequelae after hospital admission. Results: One hundred and four patients were included. 48 patients received high-flow nasal oxygen therapy (ONAF) and 56 invasive mechanical ventilation (IMV). The main sequelae found were distal neuropathy (33.9% IMV vs. 10.4% ONAF); brachial plexopathy (10.7% IMV vs. 0% ONAF); decrease in grip strength: right hand 20.67 kg (± 8.27) in VMI vs. 31.8 kg (± 11.59) in ONAF and left hand 19.39 kg (± 8.45) in VMI vs. 30.26 kg (± 12.74) in ONAF; and limited muscle balance in the lower limbs (28.6% VMI vs. 8.6% ONAF). The differences observed between both groups did not reach statistical significance in the multivariable study. Conclusions: The results obtained after the multivariate study suggest that there are no differences in the perceived physical sequelae one month after hospital discharge depending on the respiratory therapy used, whether it was high-flow nasal oxygen therapy or prolonged mechanical ventilation, although more studies are needed to be able to draw conclusions.

Propofol and COVID-19 infusion syndrome. Case report

The severe form of SARS-CoV-2 pneumonia (COVID-19) occurs in most cases with acute respiratory distress syndrome (ARDS), requiring the use of sedation during mechanical ventilation, with propofol being the most widely used for its pharmacokinetics and pharmacodynamics. Propofol is a widely used anesthetic in intensive care units (ICU). Its use can cause an infrequent but extremely serious adverse effect, known as propofol infusion syndrome (PRIS), which is closely associated with the speed of infusion coupled with risk factors specific to the patient, the clinical features of PRIS are hemodynamic instability, lactic acidosis and with progression to multi-organ dysfunction. We present a case of SIP in a patient with acute respiratory distress syndrome (ARDS) secondary to SARS-CoV-2 who develops this complication associated with sedation, discusses clinical pathophysiology and considerations that should be taken into account when using it in continuous infusion. Copyright © 2023, Colegio Mexicano de Anestesiologia A.C.. All rights reserved.

Multidisciplinary approach of the sequelae one month after hospital discharge in patients with severe bilateral COVID-19 pneumonia, are there differences depending on the respiratory therapy used during admission to intensive care? Valoración multidisciplinar de las secuelas al mes del alta hospitalaria por neumonía grave COVID-19, ¿existen diferencias en función de la terapia respiratoria empleada durante su ingreso en Cuidados Intensivos?

Graphical Objective To describe the sequelae one month after hospital discharge in patients who required admission to Intensive Care for severe COVID 19 pneumonia and to analyze the differences between those who received therapy exclusively with high-flow oxygen therapy compared to those who required invasive mechanical ventilation. Design Cohort, prospective and observational study. Setting Post-intensive care multidisciplinary program. Patients or participants Patients who survived admission to the intensive care unit (ICU) for severe COVID 19 pneumonia from April 2020 to October 2021. Interventions Inclusion in the post-ICU multidisciplinary program. Main variables of interest Motor, sensory, psychological/psychiatric, respiratory and nutritional sequelae after hospital admission. Results 104 patients were included. 48 patients received high-flow nasal oxygen therapy (ONAF) and 56 invasive mechanical ventilation (IMV). The main sequelae found were distal neuropathy (33.9% IMV vs 10.4% ONAF);brachial plexopathy (10.7% IMV vs 0% ONAF);decrease in grip strength: right hand 20.67 kg (+/- 8.27) in VMI vs 31.8 kg (+/- 11.59) in ONAF and left hand 19.39 kg (+/- 8.45) in VMI vs 30.26 kg (+/- 12.74) in ONAF;and limited muscle balance in the lower limbs (28.6% VMI vs 8.6% ONAF). The differences observed between both groups did not reach statistical significance in the multivariable study. Conclusions The results obtained after the multivariate study suggest that there are no differences in the perceived physical sequelae one month after hospital discharge depending on the respiratory therapy used, whether it was high-flow nasal oxygen therapy or prolonged mechanical ventilation, although more studies are needed to be able to draw conclusions.

Strengthening National Public Health: first steps towards the Spanish Public Health Agency : Manuel Franco

Issue/Problem The social, ecological, health and economic crisis exacerbated by COVID-19 is a challenge of extraordinary magnitude and complexity for global public health. Part of the response to these challenges requires strong public health institutions. Description of the problem Component 18 of the Government of Spain’s Recovery, Transformation and Resilience Plan proposes the creation of a Spanish Agency of Public Health (SAPH), a centre of excellence to perform surveillance and health system preparedness functions in the face of new or emerging public health threats. The government has opened the debate on what design and functions it should have. Results SESPAS, the Spanish Society of Public Health and Public Administration, set out a proposal for the design and organization of the future Spanish Agency for Public Health [SAPH]. A large working group, made up of experts from various fields of public health and from its ten federated scientific societies, has designed the SAPH proposal. The scope of the public health functions to be assumed include: the strategic planning of the State’s public health (including health security), the prioritisation of public health policies and communication strategies, the assessment of the population’s health status and social conditions, the guarantee of the transversality and horizontality of health policies (health and health equity in all State policies), as well as their verticality (serving as an enriching link between the European Union level and the administrations of the Autonomous Communities and local authorities). The proposal also include 11 recommendations on the main elements to be taken into account in the establishment of the future SAPH. Lessons COVID19 pandemic has highlighted the need of creating strong public health institutions. Spain is giving its first steps toward the creation of the SAPH, which constitute a key step in addressing the current and future challenges of public health in Spain. Key messages • Spanish Public Health Agency is an opportunity to transform health policies and to improve the health of the Spanish population. • Strengthening public health starts with building national institutions that ensure comprehensive and integrated health policies.

Sensitive practice in general baccalaureate arts subjects

Art education provides the human experience with sensitive practices that are signified through internal expressions promoted by emotions, personality, and ability. The research in question analyzes the teaching narratives about the sensitive practice in the educational experiences in an arts subject of the baccalaureate level (upper secondary) in a Mexican public school. The research approach is of a hermeneutic type, whose central research questions are: how is sensitive practice? What is its essence and its way of being? Is it possible to be shown and demonstrated? Sensitive practice is objectified from theater, dance, visual arts, and music, which are instructed through a subject of artistic exploration. The data collection was carried out during July-December 2020, from the virtual mode, due to the context of confinement due to the Covid-19 pandemic. It is recognized that both teachers and students have dispensed with the process of socialization face to face with their peers, so that part of the findings demonstrate the sensitive practice from the current environment and the objective situations in it are determined. Teachers assume their artistic training and objectify themselves in their educational practice.

Evaluation of medical student's sleep quality in covid-19 pandemic

Introduction: Sleep quality is influenced by several aspects, including factors related to the environment as well as psychological causes. In this context, the pandemic caused by the new SARS-Cov2 (severe acute respiratory syndrome coronavirus 2) had a large influence on the population's mental health, increasing levels of anxiety and stress, consequently reflected on the sleep quality. This is so also true for medical students;as a result of the scenario generated by the pandemic, in-person classes were replaced by distance education, which, added to the chaotic situation of fear, anxiety, frustration and social isolation, is interfering negatively in students' lives, and in their sleep. Objective: To analyze the sleep quality of medical students at a medical school in the interior of São Paulo state during the covid-19 pandemic. Methods: This is a crosssectional study that invited 544 students from De six years of the course, from a medical school in the interior of the state of São Paulo, to answer the Pittsburgh Sleep Quality Index (PSQI) and a questionnaire on aspects that may influence sleep. The REDCap platform was used to send, via email, the link to the questionnaires, which were available from September 28th to October 5th, 2020. Results: Of the 544 students invited, 375 answered the questionnaires. The mean score of PSQI was 8.63 (SD=3.16), with 82.4% (309 out of 375) of students having a poor sleep quality (PSQI>5). We observed an association between the quality of sleep given by the PSQI and the student's perception of anxiety (P<0.001), stress (P<0.001) and adaptation to distance education (P<0.001). The results for the seven components of the PSQI were analyzed for three study groups (1-2-year student, 3-4-year student and 5-6-year student) and associations were observed between the three studied groups and sleep duration, with students in the last two years sleeping less (<5/5-6h) than the remaining students, and with daytime dysfunction, with students in the first two years showing the highest percentage (75.5%). Conclusion: Sleep quality is poor in medical students, being associated with student's perception of anxiety, stress and difficulties in adapting to distance education. Active interventions should be implemented to improve sleep hygiene in medical students.

Analysis of the Economic, Labour, and Management Effects of COVID-19 on Rural Accommodation: An Application to a Rural European Province (Caceres, Spain)

The COVID-19 pandemic has changed the consumption habits of tourists to benefit sustainable destinations that are not overcrowded, such as rural tourism destinations. However, the periods of compulsory lockdown have had devastating effects on tourism businesses operating in rural areas and have even jeopardised their economic viability. The aim of this article is to quantify in relative terms the effects that the period of compulsory lockdown in a markedly tourist country, such as Spain, between March and May 2020 has had on rural accommodation in one of the most rural provinces of Spain (Caceres). Based on a random sample of 225 rural accommodation establishments and the consideration of various factors, statistical techniques of comparison of means and proportions were used to detect differences in the intensity of the effects of the compulsory lockdown on the economic-financial management, bookings, facilities, and input of rural accommodation establishments in the province. The results obtained show that the economic, labour, and management effects of the COVID-19 pandemic on rural tourism businesses in the province of Caceres have been very substantial. In particular, the businesses with the highest level of tourist services on supply, i.e., those that, in addition to accommodation, also offer other tourist activities, have been the most affected. In view of this situation, urgent emergency measures have been put in place at a provincial level to alleviate the economic loss and the destruction of jobs caused by this pandemic.

Satisfaction Level of Engineering Students in Face-to-Face and Online Modalities under COVID-19-Case: School of Engineering of the University of Leon, Spain

University education in times of COVID-19 was forced to seek alternative teaching/learning methods to the traditional ones, having to abruptly migrate to the online modality, changes that have repercussions on student satisfaction. That is why this study aims to compare the level of student satisfaction in face-to-face and "forced" online modalities under COVID-19. A quantitative, cross-sectional methodology was applied to two groups of students: Under a face-to-face modality (n = 116) and under an online modality (n = 120), to which a questionnaire was applied under a Likert scale, with four dimensions: Course design structure, content, resources, and instructor. Non-parametric statistics, specifically the Mann-Whitney U-test, were used to compare the groups. The results showed that there are significant differences in the level of satisfaction of students in the face-to-face and online "forced" modalities (p = 0.01984 < 0.05), and the dimensions of the level of satisfaction that presented significant differences were course design structure (p = 0.04523 < 0.05) and content (p = 0.00841 < 0.05). The research shows that students in the face-to-face modality express a higher level of satisfaction, which is reflected in the dimension design structure of the course, specifically in its workload indicator, as well as in the dimension content, in its indicators, overlapping with other courses and materials.

Let's work together: Online and synchronous coworking on Twitch to demonstrate the collaborative potential of live-streaming

The migration of creators from other platforms and the emergence of new lines of content are contributing to the thematic diversification of Twitch.tv beyond its leadership in gaming. This article explores the potential for collaboration, education, and creation of live-streaming platforms by analyzing the online coworking experience of the JaimeAltozano 'working room' on Twitch, launched after the outbreak of the Covid-19 pandemic. An initiative that gathered 222,172 hours worked by the community in three months. Using a mixed methods research design, the experience was studied on the basis of quantitative data, 67 in-depth interviews with users and ethnographic techniques for content analysis. The results obtained in the three phases of the research process show that experiences like the JaimeAltozano 'working room' are useful virtual spaces for productivity. Based on these results, a map of the phenomenon was drawn using six key concepts: gamification, synchronicity, community, participation, free operability, and common atmosphere. In the face of the growing platformization of cultural goods, our research delves into the media reality of Twitch beyond videogaming to explore the possibilities of live-streaming for the digital community's media empowerment.

Diagnostic Challenge in a Sickle Cell Disease Patient with COVID-19

Acute chest syndrome is a life-threatening complication in sickle cell disease. Infections are frequently implied, and like other viruses, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be a trigger. In addition, due to their inflammatory status, they may present a higher risk for severe coronavirus disease 2019 (COVID-19). Pneumonia and acute chest syndrome share clinical, laboratory, and radiological features and may overlap, which makes their differential diagnosis especially challenging. We describe a case of an adolescent with homozygous sickle cell disease that developed acute chest syndrome in the context of COVID-19. With it, we intend to bring awareness to the potential role of imaging in the differential diagnosis and in establishing the best approach for the patient. Chest computed tomography findings were suggestive of an alternative diagnosis to COVID-19 pneumonia and red cell transfusion, fluid management, analgesics, and antibiotics were administered with favorable outcome. © Author(s) (or their employer(s)) and Portuguese Journal of Pediatrics 2022.

The full (and necessary) integration of Occupational Health into Public Health

The COVID-19 pandemic is clearly showing the importance for the surveillance and protection of human health of acting in all settings of life: family, community, education, leisure or work, among others, as well as addressing the multiple determinants that influence the health and well-being of the population: demographic, healthcare, environmental, social, economic, cultural or occupational, among others. With respect to occupational health and the work-related determinants of health, the potential of occupational health services acting at the company level is clear, and could be generalized to almost any public health action setting. This article reflects on the opportunities for coordination between the occupational health system in Spain (including resources from mutual insurance companies, companies themselves and administrations) and the public health system, including both health care (primary care, hospital) and public health services. We examine this in the context of health crises, like the present one, but also with a broader vision, commensurate with the necessary comprehensive care for human health, guaranteeing health as a fundamental and universal right in all life circumstances. To advance along these lines, we propose the incorporation of the "occupational health perspective" in all actions and services of the public healthcare system, especially with respect to public health services under the purview of the health administration.

Risk factors for diabetic ketoacidosis through eight years of new-onset type 1 diabetes mellitus in a large Portuguese pediatric diabetes center: A shift towards younger age

Introduction: The rate of diabetic ketoacidosis (DKA) in new-onset type 1 diabetes mellitus (T1D) is multifactorial. There seems to be an inverse relationship between T1D's incidence and DKA's frequency. DKA has been reported to be more common among young children. Recently, the COVID-19 pandemic has posed additional challenges as to diagnosing T1D. Objectives: We aimed to assess the rate of DKA and associated risk factors in pediatric new-onset T1D in a large pediatric diabetes center in Portugal. Methods: Retrospective analysis of data of patients referred to a level III pediatric hospital between January 1st, 2013 and December 31th, 2020 (8 years). Results: We included 276 children and adolescents with a median age of 9,6 years, 20,1% under 5 years old. A mean incidence of 35 new cases/year was observed, with an upward trend. Newonset T1D cases under 5 years old raised progressively, having more than tripled throughout the study period (n=3 in 2013 vs. n=10 in 2020). In total, 38% children and adolescents presented with DKA, ranging from 23,3% in 2013 to 43,2% in 2020, while remaining stable (37,2%-40,9%) in the period in-between. Overall, DKA was considered severe in 24,8% of cases, ranging from 6% in 2017 to 47% in 2020. 20 (7,2%) patients were admitted to the intensive care unit. DKA at presentation was more frequent in the age group under 2 years old (p=0,016), in which 80% of patients presented with DKA. Non-DKA presentation was associated with family history of T1D (p=0,005). Conclusions: Our study shows an upward trend in T1D's incidence in children under 5 years old and a high DKA rate at disease onset, which was more frequent in patients under 2 years of age. In the first year of COVID-19 pandemic, 43% of DKA was considered severe. It is urgent to implement educational programs to promote earlier diagnosis. Broader studies are required to provide a representative national landscape of the epidemiology of T1D in pediatric population in Portugal.

COVID-19 and new-onset type 1 diabetes mellitus in a large Portuguese pediatric diabetes center: What changed?

Introduction: On 12th March 2020, a national lockdown was imposed in Portugal, as a response to rising COVID-19 cases. Since then healthcare access patterns were deeply modified. Objectives: In this study, we tried to understand what shifted from prior years in new-onset type 1 diabetes mellitus (T1D). Methods: It was performed a retrospective analysis of patients referred to a level III pediatric hospital from March 2020 until March 2021. Patients admitted during the same period in the 3 previous years were set as control group. Results: Since lockdown imposition, 44 children and adolescents were diagnosed T1D, contrasting with prior mean incidence of 32 cases/ year. Median age was 9,9 years (min. 0,5 - max. 15,8). Children under 2 years-old represented 4,9% of cases, contrasting with only 2,1% in previous years. All subjects were tested for SARS CoV-2 but only 2 were positive. When comparing to prior years, subjects presenting with less than one week of symptoms almost doubled in 2020, (19,5% vs. 10,4%), and a higher rate of diabetic ketoacidosis (DKA) was also observed (53,7%, vs. 38,5%). DKA severity was also higher (40,9% vs. 21,6%;p=0,02 and 14,6% subjects required admission to intensive care unit. Conclusions: Similarly to other reports, a higher number of new-onset T1D was observed, with a comparable increase in severity. In contrast to what might have been expected, DKA prevalence and severity was not necessarily linked to delayed diagnosis. We estimate that such severity may be related to a higher proportion of younger patients. While the role of SARS CoV-2 exposure in pancreatic islet cells destruction is still under investigation, antibody assessment and detailed contact history could help to explain the increased prevalence and severity of new-onset T1D during the pandemic period.

[The full (and necessary) integration of Occupational Health into Public Health.]

The COVID-19 pandemic is clearly showing the importance for the surveillance and protection of human health of acting in all settings of life: family, community, education, leisure or work, among others, as well as addressing the multiple determinants that influence the health and well-being of the population: demographic, healthcare, environmental, social, eco-nomic, cultural or occupational, among others. With respect to occupational health and the work-related determinants of health, the potential of occupational health services acting at the company level is clear, and could be generalized to almost any public health action setting. This article reflects on the opportunities for coordination between the occupational health system in Spain (including resources from mutual insurance companies, companies themselves and administrations) and the public health system, including both health care (primary care, hospital) and public health services. We examine this in the context of health crises, like the present one, but also with a broader vision, commensurate with the necessary comprehensive care for human health, guaranteeing health as a fundamental and universal right in all life circumstances. To advance along these lines, we propose the incorporation of the "occupational health perspective" in all actions and services of the public healthcare system, especially with respect to public health services under the purview of the health administration.