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Sustainability Sci. Pract. Policy ; 1(16): 29-36, 20201210.
Article in English | WHO COVID, ELSEVIER | ID: covidwho-1319103


This policy brief argues that the COVID-19 pandemic exposes the fractures in the contemporary global socio-technical order and offers the prospects of several different alternative futures. The policy brief explores the pandemic through the lens of the multi-level perspective on socio-technical transitions. The pandemic is framed as a meta-transition event at the landscape level of unprecedented scale, pace, and pervasiveness such that it permeates all socio-technical regimes simultaneously. The prospects for the future are then defined on a matrix that compares the strength of civil society and that of economic structures. The result is four distinct scenarios that are linked to contemporary discourses on socio-economic futures: business as usual; managed transition; chaotic transition; and managed degrowth. The scenarios are presented as a starting point for policy discussion and the engagement of societal actors to define social and economic possibilities for the future, and the implications that the different futures would have for ecological burdens. It is concluded that the COVID 19 pandemic can act as a catalytic event in which the legitimacy and efficacy of existing economic and political structures will be challenged and reshaped, and hence is an opportunity to redefine the ecological burdens our activities create.

Eur Heart J Case Rep ; 4(6): 1-6, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1030295


BACKGROUND: COVID-19 can present with cardiovascular complications. CASE SUMMARY: We present a case report of a 43-year-old previously fit patient who suffered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with thrombosis of the coronary arteries causing acute myocardial infarction. These were treated with coronary stenting during which the patient suffered cardiac arrest. He was supported with automated chest compressions followed by peripheral veno-arterial extracorporeal membrane oxygenation (VA ECMO). No immediate recovery of the myocardial function was observed and, after insufficient venting of the left ventricle was diagnosed, an Impella 5 pump was implanted. The cardiovascular function recovered sufficiently and ECMO was explanted and inotropic infusions discontinued. Due to SARS-CoV-2 pulmonary infection, hypoxia became resistant to conventional mechanical ventilation and the patient was nursed prone overnight. After initial recovery of respiratory function, the patient received a tracheostomy and was allowed to wake up. Following a short period of agitation his neurological function recovered completely. During the third week of recovery, progressive multisystem dysfunction, possibly related to COVID-19, developed into multiorgan failure, and the patient died. DISCUSSION: We believe that this is the first case report of coronary thrombosis related to COVID-19. Despite the negative outcome in this patient, we suggest that complex patients may in the future benefit from advanced cardiovascular support, and may even be nursed safely in the prone position with Impella devices.