Background: In emergencies, such as the COVID-19 pandemic, there is an increased need for contact with emergency medical services (EMS), and call volume might surpass capacity. The Copenhagen EMS operates two telephone line the 1-1-2 emergency number and the 1813 medical helpline. A separate coronavirus support track was implemented on the 1813 medical helpline and a web-based self-triage (web triage) system was created to reduce non-emergency call volume. The aim of this paper is to present call volume and the two measures implemented to handle the increased call volume to the Copenhagen EMS. Methods: This is a cross sectional observational study. Call volume and queue time is presented in the first month of the COVID-19 pandemic (27th

Primary ciliary dyskinesia (PCD) is a rare disease causing motile cilia dysfunction, recurrent airway infection, and bronchiectasis. Airway infection management strategies are borrowed from cystic fibrosis. The aim of this study is to describe the management of airway infection with Pseudomonas aeruginosa ( PA) in children and adults with PCD across European centers. An online survey questionnaire was sent electronically using SurveyMonkey® to 55 PCD centers in 36 European countries. Fifty-two responded from 43 centers in 26 countries, a response rate of 70%. Most (89%) countries did not have written guidelines for PCD management. Airway sampling for infection detection at each clinic visit was more likely when follow-up was frequent. Eighty-seven percent of centers chose to treat the first PA isolate, most prescribing combined oral ciprofloxacin and inhaled colistimethate sodium (43%, n = 18). The preferred treatment for chronic infection with PA was nebulized colistimethate in 51% ( n = 22). In summary, considerable variation exists across European centers in the frequency of patient follow-up and airway sampling for infection, treatment goals, and the management of PA infection. Few centers had written guidelines for PCD management. Clinical trials to determine optimal treatment of PA in PCD patients are urgently needed.

This is the first report indicating that cardiopulmonary fitness is equally and consistently reduced in both children with PCD and CF along with a consistent lower pulmonary function in PCD compared with CF. A certain reservation for possible selection bias and the small number of patients is necessary. However, increased focus on early diagnosis, evidence-based treatment regimens and close clinical monitoring in PCD are warranted.

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BackgroundIn emergencies, such as the COVID-19 pandemic, there is an increased need for contact withemergency medical services (EMS), and call volume might surpass capacity. Thus, the Copenhagen EMS in Denmark implemented a separate coronavirus hotline followed by a web-based self-triage system to reduce nonemergency call volume. The aim of this paper is to present the two measures implemented to handle the increased call volume to the Copenhagen EMSfromthose with mild or no relevant COVID-19 symptoms.MethodsThis is a cross sectional observational study monitoring call volume in the first month of the COVID-19 pandemic in accumulated callnumbers, compared to the equivalent numbers during one month from the year before (2019). A coronavirus hotline and web-based self-triage system arepresented in absolute numbers of users.ResultsIn the first month of the COVID-19 pandemic in Copenhagen, emergency medical dispatch centers were extensively overloaded with more than 10.800 calls, resulting in significantly prolonged queue time (mean time in minutes:12:02; CI: 11:55-12:09)) compared to 2019 (mean time in minutes02:23; CI: 02:22-02:25) and thereby limiting access to emergency assistance and triage for citizens. The introduction of the coronavirus hotline showed reduced call volume and queue time to the EMS. The web-based self-triage system was used more than 107.000 times. However, no correlation between call volume and the use of a web-based self-triage systemwas observed.ConclusionsCreating a coronavirus hotlinestaffed by healthcare personnelseemed to have an impact on call volume and potentially relieved the strain in resources, while the web-based self-triage system was widely used and could be further developed to reach itsfull potential. Other EMS organizations can implement these measures to enhance capacity in a future epidemic.

A well-structured transition programme for cystic fibrosis patients as young as 12 years of age proved to be both feasible and sustainable.

Objective Primary ciliary dyskinesia (PCD) is a congenital lung disease that leads to recurrent and chronic lung infection. The resulting inflammation causes lung damage and declines in lung function. Mannose‐binding lectin (MBL) is a first line host defense protein of importance for the innate immunity. Polymorphisms in the MBL gene named MBL2 result in unstable and low functional levels MBL proteins. MBL insufficiency is linked to an increased risk of lung infection and to declines in lung function in patients with cystic fibrosis. We investigated whether there is a similar link in patients with PCD. Methods This retrospective longitudinal study included 85 patients with PCD. Diagnostics and age at diagnosis were recorded, complete spirometry data starting at diagnosis, and Pseudomonas aeruginosa infection status over the last 2 years were collected, and the patients were grouped according to MBL2 genotype status (MBL2‐sufficient or MBL2‐deficient). Results MBL‐deficient patients were diagnosed almost 3 years earlier than MBL‐sufficient patients (median 6.1 vs 8.9 years, P  < 0.05). There were no differences in the first measured spirometry values, but MBL‐deficient patients showed greater declines in forced expiratory volume in one sec (FEV1) than patients with MBL sufficiency (z‐score: −0.049 per year [95% CI, −0.075; −0.021] vs −0.009 per year [95% CI, −0.033; 0.015]; P = 0.023). No differences were found in forced vital capacity (FVC), FEV1/FVC, or infection status. Conclusion MBL‐deficiency, which is associated with MBL2 mutations, was associated with a lower age at diagnosis and with steeper declines in FEV1 in patients with PCD. This suggests that the MBL genotype might be a disease modifier in PCD.

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