Psychological distress and moral injury to oncologists and their patients during COVID-19 pandemic.

The impact of the COVID-19 pandemic on healthcare systems has been unprecedented, and the psychological effects on cancer patients and health care professionals are likely to be significant and long-lasting. The traditional methods of face-to-face health care interactions have been replaced by virtual consultations to reduce exposure to COVID-19 infection. This has put the healthcare professional under tremendous psychological pressure and led to considerable anxiety and distress among cancer patients. Treatment decisions have had to be adjusted to account for a healthcare system that has been temporarily consumed by the care of people with COVID-19, and this has put cancer patients at risk of inferior outcomes. This has had the potential to cause moral injury and psychological distress to health care professionals as well as patients, who have had to deal with a range of stressors due to the uncertainty, sense of loss of control, reduced accessibility to medications and social support, changes to personal circumstances (e.g. financial pressures) and fear of death due to COVID-19 infection. Long term consequences also include post-traumatic responses and complex grief reactions. Cancer services in particular should gear themselves to recognize and monitor these effects and allocate adequate resources to combat them in the months and years to come.

COVID-19 vaccination-related hemophagocytic lymphohistiocytosis presenting as acute liver failure.

Acute liver failure following COVID-19 infection and/or vaccination is very rare and can be secondary to hemophagocytic lymphohistiocytosis (HLH). Liver injury in such cases appears to be extrinsic and thus treatment hinges on prompt diagnosis and reversal of the primary disease. We describe a patient who developed acute liver failure secondary to HLH after receiving a second dose of the Pfizer COVID-19 vaccine. Persistently elevated liver function tests, fevers, and cytopenia following COVID-19 vaccination should prompt clinicians to calculate an H-score to evaluate for the presence of HLH.

Impact of Covid-19 Pandemic on Higher Education and Research

COVID-19 outbreak has caused a downward spiral in the world economy and caused a huge impact on the higher education system. The sudden closure of campuses as a social distancing measure to prevent community transmission has shifted face-to-face classes to online learning systems. This has thrown the focus on utilising eLearning tools and platforms for effective student engagement which may have limitations of accessibility and affordability for many students. The pandemic has exposed the shortcomings of the current higher education system and the need for more training of educators in digital technology to adapt to the rapidly changing education climate of the world. In the post-pandemic situation, the use of eLearning and virtual education may become an integral part of the higher education system. The higher education institutions and universities need to plan the post-pandemic education and research strategies to ensure student learning outcomes and standards of educational quality.