Older adults living in nursing homes are the most vulnerable group of the COVID-19 pandemic. There are many difficulties in isolating residents and limiting the spread in this setting. We have developed a simple algorithm with a traffic light shape for resident classification and sectorization within nursing homes, based on basic diagnostic tests, surveillance of symptoms onset and close contact monitoring. We have implemented the algorithm in several centers with good data on adherence. Suggestions for implementation and evaluation are discussed.

Background: Delayed leukoencephalopathy (DL) is a rare entity associated with cerebral hypoxia and heroin consumption. We describe the clinical course of three cases of DL due to non-heroin drug use. Material and methods:We describe the cases of three DL patients admitted to our hospital in 2012. Discussion: These cases contribute to the aetiological spectrum of DL since multifactorial causes could account for the clinical symptoms. LEARNING POINTS• Substances toxic to the CNS can damage the CNS directly (direct toxicity) or by depressing the respiratory centre (cerebral hypoxia).• As clinical manifestations can appear after a time lag, we recommend a period of initial monitoring.• Histological and radiological findings can contribute to better understanding of the pathophysiological mechanisms and causes involved. KEYWORDS delayed leukoencephalopathy, globus pallidus, methadone BACKGROUND Delayed leukoencephalopathy (DL) is caused by structural injury to the white matter of the central nervous system (CNS), with a characteristic two-phase clinical course: recovery from an episode of low level of awareness, caused by acute or chronic neurological damage, is followed by neuropsychiatric symptoms which include cognitive and level of consciousness disorders, behavioural disorders and dysautonomy. The disorder is associated with parkinsonism when grey matter basal nuclei are involved

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