COVID-19 vaccinations among Black Asian and Minority Ethnic (BAME) groups: Learning the lessons from influenza.

BACKGROUND: The COVID-19 vaccination roll-out continues to grow at significant pace around the world. There is, however, growing concern regarding vaccine hesitancy amongst Black, Asian and Minority Ethnic (BAME) populations. Such inequalities have the potential for exposing, an already at-risk population, further. Whilst the COVID-19 vaccination programme is in its infancy, influenza programmes have been undertaken for over 50 years, and may provide invaluable insights. In this commentary, we aim to examine the lessons from influenza vaccinations, and how this can help reduce inequalities with COVID-19 vaccinations. MAIN TEXT: Several factors have been associated with both seasonal and pandemic influenza vaccine hesitancy amongst BAME groups. One of the most prevalent barriers in both types of immunisation programmes is the mistrust of medical organisations. This is often a multi-faceted issue, with previous negative healthcare discrimination, and historical unethical practices contributing towards this scepticism. This mistrust, however, is predominantly aimed towards healthcare systems, as opposed to individual physicians. In fact, physician endorsement is often a strong driver to vaccination, with Black patients who receive this support 8 times more likely to receive seasonal influenza vaccination. On the other hand, with H1N1 pandemic influenza vaccination, social norms or community influence, was an important determinant. In both seasonal and pandemic immunisation programmes, a significant amount of concern regarding side-effects, including misinformation, was reported amongst BAME groups. CONCLUSIONS: The use of community-based approaches, with local advocacy, has the potential to counteract misinformation, and concerns regarding side-effects. Moreover, using consistent physician endorsement not only in media campaigns but also through messaging would potentially help to address longstanding healthcare mistrust amongst minority ethnic groups. Close attention regarding how the vaccination programme, and the health policies introduced as a consequence, affect BAME communities in order to prevent widening inequalities in the future.

The Ethical Digital Surgeon.

This viewpoint explores the ethical and regulatory consequences of the digital transformation of the operating room. Surgical robotics is undergoing significant change and future advances will center around the capture and use of data. The consequences of creating this surgical data pipeline must be understood and digital surgical systems must prioritize the safeguarding of patient data. Moreover, data protection laws and frameworks must adapt to the changing nature of surgical data. Finally, digital surgeons must understand changing data legislation and best practice on data governance to act as guardians not only for their own but also for their patients' data.

Characteristics and predictors of acute and chronic post-COVID syndrome: A systematic review and meta-analysis.

BACKGROUND: A significant proportion of individuals experience lingering and debilitating symptoms following acute COVID-19 infection. The National Institute for Health and Care Excellence (NICE) have coined the persistent cluster of symptoms as post-COVID syndrome. This has been further sub-categorised into acute post-COVID syndrome for symptoms persisting three weeks beyond initial infection and chronic post-COVID syndrome for symptoms persisting beyond twelve weeks. The aim of this review was to detail the prevalence of clinical features and identify potential predictors for acute and chronic post-COVID syndrome. METHODS: A systematic literature search, with no language restrictions, was performed to identify studies detailing characteristics and outcomes related to survivorship of post-COVID syndrome. The last search was performed on 6 March 2021 and all pre-dating published articles included. A means of proportion meta-analysis was performed to quantify characteristics of acute and chronic post-COVID syndrome. Study quality was assessed with a specific risk of bias tool. PROSPERO Registration: CRD42020222855. FINDINGS: A total of 43 studies met the eligibility criteria; of which, 38 allowed for meta-analysis. Fatigue and dyspnoea were the most prevalent symptoms in acute post-COVID (0·37 and 0·35) and fatigue and sleep disturbance in chronic post-COVID syndrome (0·48 and 0·44), respectively. The available evidence is generally of poor quality, with considerable risk of bias, and are of observational design. INTERPRETATION: In conclusion, this review highlights that flaws in data capture and interpretation, noted in the uncertainty within our meta-analysis, affect the applicability of current knowledge. Policy makers and researchers must focus on understanding the impact of this condition on individuals and society with appropriate funding initiatives and global collaborative research.