Inequalities in health have existed for many decades and have led to unjust consequences in morbidity and mortality. These have become even more apparent during the COVID-19 pandemic with individuals from black and minority ethnic groups, poorer socioeconomic backgrounds, urban and rurally deprived locations, and vulnerable groups of society suffering the full force of its effects. This review is highlighting the current disparities that exist within different societies, that subsequently demonstrate COVID-19, does in fact, discriminate against disadvantaged individuals. Also explored in detail are the measures that can and should be taken to improve equality and provide equitable distribution of healthcare resources amongst underprivileged communities.

Purpose of review To summarize current literature evidence on the role of computed tomography (CT) scan in the diagnosis and assessment of coronavirus disease 2019 (COVID-19) pneumonia. Recent findings Recent guidelines on the use of CT scans in COVID-19 vary between countries. However, the consensus is that it should not be used as the first line; a notion supported by the WHO. Currently, several investigations are being used including reverse transcription PCR testing, chest radiographs, and ultrasound scans, and CT scans. They are ideally performed later during the disease process as the sensitivity and specificity are highest by that time. Typical COVID-19 features on CT scans vary but include vascular enlargement, ground-glass opacities, and ground glass opacification together with consolidation. Summary Since COVID-19 was declared as a global pandemic, there was a push towards identifying appropriate diagnostic tests that are both reliable and effective. There is a general agreement that CT scans have a high sensitivity but low specificity in diagnosing COVID-19. However, the quality of available studies is not optimal, so this must always be interpreted with the clinical context in mind. Clinicians must aim to weigh up the practicalities and drawbacks of CT scans when considering their use for a patient. The ease and speed of use of CT scans must be balanced with their high radiation doses, and infection control considerations.

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We read with great interest the article published by AlSaif et al 1 investigating the relationship between the willingness of final-year medical students to participate in the response towards COVID-19, and their perceived clinical competence. The pandemic has resulted in significant staff shortages requiring the help of volunteers to compensate for professionals lost to the outbreak. 2 Therefore, this article comes at a critical time to allow for a better understanding of the influences that would impact final-year medical students' willingness to contribute to the response. Although the authors have attempted to correlate perceived clinical competence and willingness to volunteer during the pandemic, the questionnaire used address general competencies, rather than ones that are relevant to the COVID-19 response. These general competencies encompass a wide array of skills that are not necessarily needed, or expected, from a volunteering student. For example, the authors ask about the perceived competence in "essential clinical procedures" which can vary from complex intubation to simple venepuncture. As medical students, we would expect the questionnaire to include specific tasks required, eg performing nasopharyngeal swabs, to successfully judge our competence. The questionnaire also includes skills that are unlikely to be needed, such as "select and apply the most appropriate and cost-effective diagnostic procedures" which would generally be expected from senior doctors rather than the students. The general nature of the questions has therefore likely influenced the results of the study, providing an inaccurate reflection about the true willingness of students to help during large-scale outbreaks. Various studies such as that of Miller et al 3 demonstrate that volunteering students were asked to perform simpler tasks, and often non-COVID-19 related, such as routine outpatient clinical care, hosting PPE drives and calling patients with lab results. These tasks although play a critical role in patients' outcomes and ease the stress of healthcare systems, they do not require extensive expertise, nor do they pose a high risk of COVID-19 transmission. Therefore, it would be more appropriate for the questionnaires to include such tasks when assessing for willingness.

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