Provision of responsible healthcare to patients by healthcare professionals (HCP) during the COVID‐19 pandemic has lead to the development of symptoms of stress, anxiety, fear, and other strong emotions that has predisposed HCP to significant potential for mental health diagnosis including Post Traumatic Stress Disorder (PTSD). In a metanalysis, Mealer et al (2009) and others reported that how one copes with these emotions and stressful conditions may affect the quality of healthcare provided to others, and the well‐being of the people they care about both within and outside of their work environment. The recent emergence of more highly infective mutations of SARS‐CoV‐2 [COVID‐19], identified as SARS‐CoV‐2 VUI 202012/01 in the USA with a reportedly 50‐70% greater contagious potential than the novel strain has sparked great concern throughout Europe, the United Kingdom and the USA, resulting in both International and Domestic travel limitations attempts to slow the continued spread of the coronavirus pandemic in attempts to contain the mutations, albeit it unsuccessful so far. PTSD and other mental health disorders may develop in individuals following exposure to a traumatic event or ongoing circumstances as has occurred among healthcare workers in the current pandemic as well as among returning combat veterans and disaster stricken regions and may be a precipitating cause of PTSD among HCPs and may contribute to their symptoms following prolonged exposure to their seemingly unending and highly stressful patient care responsibilities, and which symptoms may escape observation by others similarly affected in the treatment chain. The results of this metanalysis study indicate that according to Tang et al (2017), healthcare providers that were exposed to Avian Influenza virus (H7N9) patients were significantly prone (p=<0.05) to developing severe anxiety, PTSD stress and burnout symptoms, indicating a need for greater pre‐exposure training in traumatic illness stress management to better prepare them for early‐stage career management, particularly during the early stages of their careers. The recent emergence of SARS‐CoV‐2 VUI 202012/01 and more recent variants, potentially 50% or more contagious strains of the SARS‐CoV‐2 virus with as yet unknown risks for morbidity and mortality particularly among smokers may pose such a threat among the general population and the among the HCP who may be tasked for their healthcare, wellbeing, and all to often, palliative supportive care, despite the best efforts of epidemiologic surveillance and containment via application of conventional public health measures and available resources. References:1) Tang, L. et al. (2017). . Intl J Nur Sci, 4(1), 63‐67. 2) Lai, J., Ma, S. & Wang, Y. (2020) JAMA Network. 3) Lasalvia, A. et al. (2009). Br J Psych, 195(6), 537‐544. 4)Mealer, M. et al (2009). Depr Anx, 26(12), 1118‐1126. 5) Sampaio, F., Sequeira, C. & Teixeira, L. (2020). 6) J Occup Environ Med, 62(10), 783‐787. 7) “http://journalistsresource.org/studies/government/federalstate/psych...

Emergence of the 2019 Coronavirus pandemic posed new challenges for the delivery of medical and graduate education by Institutions throughout most of the world, as travel restrictions and regional lockdowns placed new demands never previously imposed on higher education. The University of Science Arts and Technology [USAT], located on the volcanic island of Montserrat, British West Indies began to prepare for such an eventuality since 2007 due to new volcanic eruptions. Despite 24/7 monitoring from the nearby state‐of‐the‐art Montserrat volcano observatory, with little warning, the Soufriere Hills Volcano, located a distant 5 miles Southeast of the Campus spontaneously roared back to life in January 2007, venting clouds of volcanic ash and gas 8 kilometers (5 miles) into the sky with overflow lava and debris reaching the sea to the East and West; the volcano's lava dome continued to grow as it had since 2006, and local volcano experts worried that the rapidly growing lava dome, the mounting pressure building inside the dome could cause a catastrophic explosive eruption, and the renewed volcanic activity indicates that the volcano is now predicted to remain active well into the future. The volcanic activity caused the partial evacuation of the Island, including areas bordering the campus, resulting in the establishment of the USAT Campus satellite transmitter system [CST] in 2007. The CST enabled USAT the establishment of the first secure network on Island for the Secure Small Platform Online Course delivery network [SSPOC] and which enabled USAT to continue lecture operations uninterrupted with faculty that are highly experienced in the delivery of high quality Medical and Graduate education from both on‐Island and remote locations in an efficient, timely, cost effective and highly productive and timely manner, while enabling students an on‐island campus experience during periods of volcanicactivity including options for lectures, public health, epidemiology and environmental research, and selected experiences in areas of family and tropical medicine. During the current COVID pandemic and travel restriction imposed we further enhanced our on‐line teaching system and secure SSPOC model, expanded International options, and as professors and students could not travel to the campus but all lectures were delivered online with absolutely no disruption or compromise in delivery of exceptional quality lectures and teaching experiences continued as if they occurred on campus.

The pandemic caused by SARS-CoV-2 (COVID-19) and the recent emergence of the B.1.1.7 and other variant mutations including the recently discovered SARS-CoV-2 VUI 202012/01 in the USA have wreaked intense anxiety and apprehension among the general population and the healthcare professionals who are tasked with the care and well-being of their patients. Health care professionals often have limited availability of essential personal protective equipment resources, and few reliable or time-proven treatments and protocols readily available. As the COVID-19 pandemic rapidly approaches the one-year mark, lockdowns and travel restrictions continue, reports of domestic abuse and other human failures are reportedly on the rise in the general population, and cases of posttraumatic stress related disorders are increasing within the healthcare professionals workforce, particularly among the more junior and less experienced members of the medical staff. Thus, these observations indicate a need for increasing emphasis on pre-stress and preventive post traumatic stress disorder training and teamwork education and support at all levels of medical education involving patient care, including first responders, nursing, allied healthcare professionals, and medical student and residency training. Historically pandemics have occurred about three times each century, so the time to address the situation is now critically close at hand; not only is it essential to enhance the preparedness of our current medical workforce, but it is also the time to begin preparing for the next generation of healthcare professionals such that the next generation of healthcare professionals may have a grasp on the next pandemic in advance of its appearance. SARS-CoV-2 and most recent offspring in the USA, the B.1.1.7 variant (SARS-CoV-2 VUI 202012/01) arrived without warning: this is not a dress rehearsal and is likely here to stay at least until a vaccine and/or herd immunity becomes effective in the population. While the morbidity and mortality of SARS-CoV-2 VUI 202012/01 is predicted to be of similar magnitude to that of its parent virus at around 0.14%, the variant mutation is believed to be more highly contagious than SARS-CoV-2 and may be responsible at least in part for the recent spike in positive cases in the US, UK and elsewhere. Introduction of additional stress prevention training such as facial recognition signs among co-workers may hold the cue to address this concern and reduce the incidence of stress-related morbidity among medical staff. Now as never before, an ounce of prevention in the way of pre-stress and environmental stress preparedness may be worth a pound of cure.

The advents of child abuse and human trafficking in their various forms represent a serious crime and affects virtually every country in the world, where they not only represent an issue of the violation of the basic human rights and dignity of those persons affected but also impacts their families and loved ones who may be inadvertently left behind. While most instances of human trafficking have traditionally involved humans being coercively forced to enter into areas of sex and labor violations, the emerging area of illegal organ trafficking to support a growing need for organ transplantation procedures can now be included. While children and younger adults are the most commonly affected segments of the population for some categories of trafficking, globally human trafficking may impact victims of diverse backgrounds of any age, gender, race, ethnicity, culture, or persuasion, and may present in the clinic accompanied or unaccompanied for urgent care. When presenting, a patient may exhibit cardinal signs, symptoms and clinical stigmata that may be of a suspicious nature and be indicative of further investigation to include reporting the issues to competent authorities especially when the victim is an infant or considered a minor, less than 18 years of age in most countries. Since the health care professional is often in a position to become the first point of contact where symptoms and stigmata of human trafficking, child abuse, and other signs indicative of abuse are apparent, additional modules in health care forensics would be a welcome addition to medical curricula and public health perspectives for physicians and other members of the healthcare team. Thus, the purpose of the present paper was to review the characteristics of human trafficking and abuse, to summarize key areas of legal, medical, and administrative responsibility in order to ensure availability of optimal and appropriate patient-centered care of victims, and to emphasize the need for inclusion of modules in forensic medical education in medical curricula.

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