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The COVID-19 pandemic continues to spread rapidly and overwhelm health systems around the world. To cope with this unprecedented usage of healthcare resources, increasingly novel solutions are being brought into the fray. Telemedicine has been thrust into the spotlight in the fight against COVID-19 and is being employed in many different ways to better tackle the challenges. Telemedicine will likely have a more permanent place in traditional healthcare delivery long after COVID-19 is over as users and providers recognise its utility.

Situation Report -51 SITUATION IN NUMBERS total and new cases in last 24 hours Globally 118 319 confirmed (4620 new) 4292 deaths (280 new) China 80 955 confirmed (31 new) 3162 deaths (22 new) Outside of China 37 364 confirmed (4589 new) 1130 deaths (258 new) 113 countries/territories/ areas (4 new) WHO RISK ASSESSMENT China Very High Regional Level Very High Global Level Very High HIGHLIGHTS SUBJECT IN FOCUS: Risk Communication guidance -COVID-19, older adults and people with underlying medical conditionsThe virus that causes COVID-19 infects people of all ages. However, evidence to date suggests that two groups of people are at a higher risk of getting severe COVID-19 disease. These are older people (that is people over 60 years old); and those with underlying medical conditions (such as cardiovascular disease, diabetes, chronic respiratory disease, and cancer). The risk of severe disease gradually increases with age starting from around 40 years. It's important that adults in this age range protect themselves and in turn protect others that may be more vulnerable.WHO has issued advice for these two groups and for community support to ensure that they are protected from COVID-19 without being isolated, stigmatized, left in a position of increased vulnerability or unable to access basic provisions and social care. This advice covers the subject of receiving visitors, planning for supplies of medication and food, going out safely in public and staying connected with others through phone calls or other means. It is essential that these groups are supported by their communities during the COVID-19 outbreak. WHO emphasizes that all people must protect themselves from COVID-19, which will also protect other.

Gout is characterized by high serum uric acid (SUA) levels and arthritis. It is associated with obesity and metabolic syndrome. Bariatric surgery has been associated with decreased SUA levels and overall gout incidence. This meta-analysis aims to summarize the current evidence on bariatric surgery, gout and SUA levels. A literature review was performed on papers published from 2000 up till December 2018.Original studies investigating the impact of bariatric surgery on SUA levels or gout incidence were evaluated. Twenty studies with a total of 5,233 patients were analysed. Majority (n=14) had a follow-up duration of at least 12 months. The mean preoperative body mass index (BMI) was 45.2kg m −2 . The mean preoperative SUA level was 6.5mg dL −1 . Subgroup analysis demonstrated a mean decrease in SUA levels (−0.73mg dL −1 ) from the third postoperative month onwards, which was sustained until the third postoperative year (−1.91mg dL −1 ). There was a rise in SUA levels in the first post-operative month. Meta-regression analyses demonstrated a proportionate linear relationship between the change in BMI and SUA levels. Postbariatric surgery weight loss is associated with reduced SUA levels and decreased incidence of gout attacks. However, this is only evident from the third postoperative month onwards.

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