Community policing and COVID-19 management: Household duties of street-level enforcers in Taiwan

Taiwan has been a few of the exceptions recording very low infection figures in the worldwide pandemic COVID-19 since early 2020. The island was regarded as 'abnormally normal' during the public health crisis. This study analysed the management of COVID-19 in two cities in Taiwan-Taipei City and New Taipei City, by exploring the roles of two groups of easily forgotten, street-level personnel who were indispensable-the village chiefs and police constables in field stations. We argued the effectiveness of infection control could partly be explained by the well-developed community policing practices. A close cooperation among public officers could be seen in the enforcement of home quarantine order for the Taiwan resident returnees in the early days of the anti-pandemic fight. This government-society collegiality in Taiwan is merely a continuation of the institutionalized practice of community policing evolving from the colonial and authoritarian regimes.

Acute Hemorrhagic Leukoencephalitis in a Pediatric Patient with COVID-19 Infection: A Case Report

Case Diagnosis: This is a pediatric case of acute hemorrhagic leukoencephalitis (AHLE). Case Description or Program Description: A 6-yearold female with history of Hemoglobin SC disease presented to the hospital with a two-day history of fever, cough, congestion, and positive COVID PCR test. She became apneic with oxygen saturations in the 70s, hypotensive, and incontinent of urine, ultimately requiring intubation and an intensive care unit stay. MRI brain revealed innumerable microhemorrhages within the superior greater than infratentorial periventricular and subcortical white matter. Blood and urine cultures and extensive workup including cerebrospinal fluid studies were negative, other than elevated myelin basic protein. The patient underwent treatment with intravenous steroids and IVIG with subsequent clinical improvement. Setting(s): Acute care hospital and acute inpatient rehabilitation hospital. Assessment/Results: Neurology concluded that the brain MRI findings were likely due to AHLE in the setting of acute COVID infection. The patient was ultimately extubated and transitioned from tube feeds to a regular diet with thin liquids. She discharged from acute rehabilitation ambulating 150 feet and walking up stairs. She displayed deficits in cognition and communication that improved throughout her rehabilitation stay. Discussion (relevance): AHLE is typically seen in adults and mortality is reported as high as 70%. Here we present a case in a pediatric patient with favorable neurological outcomes. Conclusion(s): Although AHLE is more common in the adult population, it may present in the pediatric patient in the setting of COVID infection. Increased awareness can lead to early diagnosis and may contribute to positive functional outcomes.

Risk and Assessment of COVID-19 in a Retina Ophthalmologic Setting

Purpose : To evaluate the risks and impact of COVID-19, SARS-CoV-2, on a private ophthalmology practice in Ohio and analyze the fluctuation in patient visits and surgeries before and during the COVID-19 pandemic. Methods : A retrospective analysis was performed using outpatient clinic logs for patients seen during the first 10 weeks of 2020 and compared to outpatient clinic logs for 10 weeks during the COVID-19 pandemic. During the twenty-week period, the number of appointments, intravitreal injections, and surgeries, most commonly retinal detachments, epiretinal membrane (ERM), and vitreous hemorrhages, were compared. Additionally, consideration was given to potential measures to reduce the spread and maintain prepandemic clinical care levels. The number of appointments, injections administered, and surgeries completed or postponed were analyzed before and during the COVID-19 pandemic. The practice implemented additional precautions for patients and staff. These included, but were not limited to, temperature checks, hand sanitizer availability, required use of face masks, and asking patients to come alone to appointments;with the exception of patients that were wheelchair bound, suffered from dementia, were under the age of 18, or required a translator. Results : During the first 10 weeks of 2020, the practice saw an average of 2,205 visits a week. In week one of the pandemic, the average was 1,147 patients per week, a 54% drop. An overall 40% drop was seen in surgical cases;vitreous hemorrhage surgeries decreased by 35%, retinal detachment surgeries decreased 25%, and ERM peels reduced by 60%. The drop in ERM's were mostly due to rescheduling. Intravitreal injections during the first 10 weeks averaged 1,025 (SD±112) per week. During the start of the 10 COVID-19 weeks, intravitreal injections averaged 852 (SD±122) per week and by the last weeks injections averaged 972 (SD±142) per week. Conclusions : In the early stages, the initial number of outpatient visits declined by 54%, the average number of intravitreal injections did not change in a similar pattern. This represents the importance of patients' triage and prioritizing urgent cases.