Impact of COVID-19 on global burn care.

BACKGROUND: Worldwide, different strategies have been chosen to face the COVID-19-patient surge, often affecting access to health care for other patients. This observational study aimed to investigate whether the standard of burn care changed globally during the pandemic, and whether country´s income, geographical location, COVID-19-transmission pattern, and levels of specialization of the burn units affected reallocation of resources and access to burn care. METHODS: The Burn Care Survey is a questionnaire developed to collect information on the capacity to provide burn care by burn units around the world, before and during the pandemic. The survey was distributed between September and October 2020. McNemar`s test analyzed differences between services provided before and during the pandemic, χ2 or Fisher's exact test differences between groups. Multivariable logistic regression analyzed the independent effect of different factors on keeping the burn units open during the pandemic. RESULTS: The survey was completed by 234 burn units in 43 countries. During the pandemic, presence of burn surgeons did not change (p = 0.06), while that of anesthetists and dedicated nursing staff was reduced (<0.01), and so did the capacity to manage patients in all age groups (p = 0.04). Use of telemedicine was implemented (p < 0.01), collaboration between burn centers was not. Burn units in LMICs and LICs were more likely to be closed, after adjustment for other factors. CONCLUSIONS: During the pandemic, most burn units were open, although availability of standard resources diminished worldwide. The use of telemedicine increased, suggesting the implementation of new strategies to manage burns. Low income was independently associated with reduced access to burn care.

Positive changes in sun-related behavior in Israel (1994-1998).

BACKGROUND: Current preventive measures against skin cancer focus on individual sun protection and early detection. Solar radiation in Israel is powerful, and about one-half of its population is fair skinned. We investigated whether public awareness efforts yielded changes in sun-related behaviors in Israel from 1994 to 1998. METHODS: The Department of Health Promotion in the Ministry of Health in Israel has been conducting an ongoing research on health knowledge, attitude, and practice, including six closed questions about sun-related behaviors in a general questionnaire. Independent samples of about 3,000 people representing the adult Jewish population (18 years old and above) were surveyed in 1994, 1996, and 1998. Response rates in 1994 and 1996 were about 85 and 80% in 1998. RESULTS: The number of people reporting sun protection behaviors increased from 34% in 1994 to 41% in 1996 and to 46% in 1998. Periodic medical skin examination increased from 9% of the responders in 1994, to 13% in 1996 and to 16% in 1998. The number of people reporting having fair skin increased from 28% in 1994 to 41% in 1996 and to 43% in 1998. CONCLUSIONS: There were positive changes in sun-related awareness and behaviors in Israel between 1994 and 1998. These findings support the conclusion that positive gains were associated with the health promotion efforts conducted by the Israel Cancer Society, Ministry of Health, and other Israeli organizations throughout these years.