Flattening the curve in 52 days: characterisation of the COVID-19 pandemic in the Principality of Liechtenstein - an observational study.

BACKGROUND: The principality of Liechtenstein had its first COVID-19 case at the beginning of March 2020. After exponential growth, the pandemic’s first wave was contained, with the last case being diagnosed 52 days after the initial occurrence. AIM: To characterise the COVID-19 pandemic in Liechtenstein. METHODS: All patients diagnosed in Liechtenstein were followed up until recovery and again 6–8 weeks after symptom onset. They were contacted every 2 days to record their clinical status until the resolution of their symptoms. The diagnosis of COVID-19 was based on clinical symptoms and molecular testing. Household and close workplace contacts were included in the follow-up, which also comprised antibody testing. In addition, public health measures installed during the pandemic in Liechtenstein are summarised. RESULTS: During the first wave, 5% of the population obtained a reverse transcriptase polymerase chain reaction test. A total of 95 patients (median age 39 years) were diagnosed with COVID-19 (82 who resided in Liechtenstein), resulting in an incidence in Liechtenstein of 0.211%. One patient, aged 94, died (mortality rate 1%). Only 62% of patients could retrospectively identify a potential source of infection. Testing the patients’ household and close workplace contacts (n = 170) with antibody tests revealed that 25% of those tested were additional COVID-19 cases, a quarter of whom were asymptomatic. Those households which adhered to strict isolation measures had a significantly lower rate of affected household members than those who didn’t follow such measures. The national public health measures never restricted free movement of residents. Masks were only mandatory in healthcare settings. The use of home working for the general workforce was promoted. Gatherings were prohibited. Schools, universities, certain public spaces (like sports facilities and playgrounds), childcare facilities, nonessential shops, restaurants and bars were closed. Social distancing, hygienic measures, solidarity and supporting individuals who were at risk were the main pillars of the public health campaigns. CONCLUSION: The close collaboration of all relevant stakeholders allowed for the complete workup of all COVID-19 patients nationwide. A multitude of factors (e.g., young age of the patients, low-threshold access to testing, close monitoring of cases, high alertness and adherence to public health measures by the population) led to the early containment of the first wave of the pandemic, with a very low rate of serious outcomes. Antibody testing for SARS-CoV-2 revealed a substantial proportion of undiagnosed COVID-19 cases among close contacts of the patients.

Nickel allergies: implications for practice.

The increasingly popular trend of body piercing has led to an increase in allergic reactions to nickel. The most common symtom of a nickel allery is symptom of a nickel allery is contact dermatitis. This may manifest in various degrees ranging from minor itching and redness of the skin to the site of contact. Dermatology nurses play a pivotal role in pre and postoperative assessments, thorough skin important, patient education related to sources of nickel and complications resulting from long-term exposures.

Amyloidosis and its impact on patients with ESRD.

Patients, like those with ESRD, who have lost the ability to filter excess proteins from their bodies are at risk to develop beta-2-microglobin amyloidosis, also known as dialysis-related amyloidosis (DRA). When the kidneys do not work efficiently, a protein called beta-2-microglobulin can build up in the blood. Eventually, these molecules can form large deposits and potentially damage surrounding tissues. Currently, dialyzer membranes do not effectively remove these large molecules and, as the blood levels become elevated, deposits begin forming in bone, joints, and tendons resulting in pain and/or stiffness. Unfortunately, there is no known cure for DRA, although attempts are being made to develop dialyzer membranes that can more efficiently remove beta-2-microglobulin from the blood. Implications for practice include early diagnosis, patient teaching, optimal pain management and fall risk management.

Innovative ways to promote recruitment, retention, collegiality, and professionalism using continuing education plans.

Technological advances in health care, coupled with the crisis of a nursing shortage, make recruitment and retention of well-educated nurses a key factor for the viability and growth of any healthcare organization. In the past, symbiotic alliances have been formed solely between healthcare organizations and nurses. Professional nursing organizations were rarely involved in the alliance. Using the Magnet Recognition Program, one local chapter of Sigma Theta Tau International has found a way to unite nurses, healthcare organizations, and professional nursing organizations to encourage nursing education, promote positive patient outcomes, and help find a solution to the problem.