Background As a result of the continuing surge of COVID-19, many patients have delayed or missed routine screening and preventive services. Medical conditions, such as coronary heart disease, mental health issues, and substance use disorder, may be identified later, leading to increases in patient morbidity and mortality. Methods The National Emergency Medical Services Information System (NEMSIS) data were used to assess 911 Emergency Medical Services (EMS) activations during 2018–2020. For specific activation types, the percentage of total activations was calculated per week and joinpoint analysis was used to identify changes over time. Results Since March 2020, the number of 911 emergency medical services (EMS) activations has decreased, while the percentages of on-scene death, cardiac arrest, and opioid use/overdose EMS activations were higher than pre-pandemic levels. During the early pandemic period, percentages of total EMS activations increased for on-scene death (from 1.3% to 2.4% during weeks 11–15), cardiac arrest (from 1.3% to 2.2% during weeks 11–15), and opioid use/overdose (from 0.6% to 1.1% during weeks 8–18); the percentages then declined, but remained above pre-pandemic levels through calendar week 52. Conclusions The COVID-19 pandemic has indirect consequences, such as relative increases in EMS activations for cardiac events and opioid use/overdose, possibly linked to disruptions is healthcare access and health-seeking behaviors. Increasing telehealth visits or other opportunities for patient-provider touch points for chronic disease and substance use disorders that emphasize counseling, preventive care, and expanded access to medications can disrupt delayed care-seeking during the pandemic and potentially prevent premature death.

Inadequate compliance despite knowledge and false sense of security by alcohol based rubs was seen. A multi disciplinary, multifaceted approach is required to tackle issues of non-compliance.

a b s t r a c tBackground: Compliance and implementation of infection control guidelines have been recognized as efficient means to prevent and control hospital acquired infections. Objectives: To evaluate knowledge and practices about infection control guidelines amongst medical students and to explore their education needs as perceived by them and faculty. Methods: A total of 160 final year students and 100 faculty members of one of the top medical colleges in India were selected by simple random sampling in each group as per sample size of 143 students (alpha 0.05, error 7%, prevalence 60%) and 99 (error 7.5%) faculty. Data collected by pilot-tested, unlinked, anonymous questionnaire. Results: Amongst students, knowledge (77.50%; 95% CI, 70.24e83.72) was mixed with misconceptions. Only 31.25% always followed hand hygiene procedure; 50% recapped needles; disposal of hazardous material into designated containers always was low (sharps 20%, contaminated items 25%). Despite experiencing needle stick injury (6.25%) and splashes (40%), less than 30% reported these as 44% were unaware of reporting procedure. The discord between the perceptions of faculty regarding students and students' own perceptions was clearly evident (all Kappa values less than 0.50). Students and faculty agreed on workshops (58.13% and 58%) and reinforcement by colleagues (51% and 54%) but not on on-job training (51% and 34%) and part of curriculum (48% and 40%) for teachingelearning infection control. Conclusion: Tackling disconnect between students and faculty perceptions and empowering students with knowledge and skills in infection control is important. Approach needs to be researched and formulated as current methods seem to be inadequate. Available online at www.sciencedirect.com journal homepage: w ww.el sevier.com/locate/mjafi m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 6 9 ( 2 0 1 3 ) 1 0 7 e1 1 2

The study highlights the importance of Streptococcus pneumoniae as a causative organism for outbreaks of community acquired pneumonia (CAP) in large residential training institutions and reiterates the need for formulating a policy for continuous surveillance. It also highlights the importance of the novel method of using chemoprophylaxis for control of an ongoing outbreak of CAP.

Health status of any country is represented by health care & demographic indicators which also measure government‟s efficiency and performance in health sector. Also, it has relevance in national progress. Governments have the responsibility for the health of the people which can be fulfilled only by the provision of adequate health & social measures”. Role of government in public health issues is multi-disciplinary and multi-directional, fulfilling roles of insurer, provider and regulator of health care. The National Rural Health Mission (NRHM) launched in 2005 has major innovations in the creation of a cadre of Accredited Social Health Activists (ASHA) and improved hospital care, decentralization at district level to improve intra and intersectoral convergence and effective utilization of resources. The various challenges government is facing include population growth, poverty, unexpected natural and manmade disasters, global pandemic of AIDS or influenza (H1N1), poor coverage in rural and remote areas and the constant threat of biomedical warfare. Lifestyle diseases are emerging to a great extent. Various solutions can be sought like prompt and effective health service delivery, health care financing and health legislative measures which are important to safeguard and to protect health of public. These must be strict and should clarify and articulate the role and functions of public health. To improve the purchasing power of community, government should focus on the creation of various job opportunities at individual local places wherever it is possible. For the industries, safe occupational environment must be ensured. Government should aim at ensuring highest possible level of physical, social and psychological wellbeing amongst the workers of all the populations. Thus role of government remains to ensure the availability, accessibility, quality and accountability of medical care to the community following the principle of equity. Thus, an organized and decentralized public health service system which will use the resources adequately with prioritization and by ensuring the strong political commitment, community participation, health legislation, health investment and more importantly bringing health care as a priority is the need of the hour.