A novel use of telemedicine during the COVID-19 pandemic.

OBJECTIVE: The coronavirus disease-2019 (COVID-19) global pandemic brought with it many challenges but possibly the biggest was the best use of national hospital resources. With the aim to protect the hospital healthcare resources in the country whilst simultaneously safeguarding the health of COVID-19-infected patients, a telemedicine system led by experts was set up in Malta. METHODS: A team of local experts, called the 'Community COVID-19 Initial Assessment team' (CCIAT), co-ordinated the initial medical assessment and decisions for all newly diagnosed community patients. Data of all patients were collected prospectively and stored in one database. These data were then analysed to extract the demographics and outcomes of all these patients. RESULTS: Through telemedicine, the majority (91%) of 369 infected patients were managed safely in the community. Only a minority of patients (6%) was admitted to the main acute hospitals and there was no increased morbidity or mortality related to the medical decisions made using this telemedicine tool. CONCLUSIONS: This population-based study proves that this particular COVID-19 telemedicine project in Malta achieved its main goals, which were namely that of relieving the burden on the main local acute hospitals whilst ensuring the optimal medical management to infected patients.

Scurvy is Back.

BACKGROUND AND OBJECTIVE: Scurvy, caused by vitamin C deficiency, first described by Hippocrates, is known to many as 'The Pirates' Disease'. Although a disease rarely acknowledged in modern medicine, we present 2 cases of elderly gentlemen found to have scurvy, who improved significantly on treatment. METHODS: This study presents a case report of 2 patients undergoing rehabilitation at Karin Grech Hospital in Malta, noted to have signs and symptoms of vitamin C deficiency. Vitamin C levels were found to be low and thus supplementation was administered. RESULTS: After a few weeks, a significant improvement was noted in level of frailty, mood, bleeding tendency, and gum health. CONCLUSIONS: The modern doctor must keep this ancient disease in mind, as it presents insidiously with debilitating repercussions, particularly in older people who are at a higher risk. It is easily treatable once detected.