Calibration of the paediatric index of mortality in UK paediatric intensive care units Pearson et al should be congratulated on successfully collecting the data required for calculating the PIM Score on 7253 children admitted to 5 UK paediatric intensive care units (PICUs). 1 It is reassuring to note that the authors did not find any systematic differences between these five units in terms of their standardised mortality ratios. Leaving aside the controversies involved in cross country comparisons, it is further pleasing that they appear to conclude that mortality following admission for paediatric intensive care in 1998-99 is less than it was in 1994-95. 2 3 The current results imply that 78 more children have survived following treatment in these 5 PICUs than were predicted by the 1994-95 PIM derivation model. Before this can be considered a major clinical advance, it is important to consider the health status of the additional survivors. Very different conclusions might be drawn if the additional children who survived have a very poor health status than if they have a very good health status. The United Kingdom Paediatric Intensive Care Outcome Study (UK PICOS) was set up in response to the "Paediatric Intensive Care: A framework for the future" document and a joint United Kingdom Medical Research Council and Department of Health working paper. 4 5 Both these publications recognised that, as mortality following paediatric intensive care is less than 10%, morbidity or health status may be a more important outcome of paediatric intensive care than mortality. UK PICOS is currently collecting health status measurements of children who survive following admission for paediatric intensive care in a representative sample of 21 UK PICUs. By seeking to differentiate between the survivors of paediatric intensive care UK PICOS may lead to a risk adjustment method for health status in addition to mortality. Furthermore, UK PICOS has the potential to provide the methodology to enable cost effectiveness studies to be set up in paediatric intensive care. In the longer term this will allow organisational structures, service management, and new interventions in paediatric intensive care to be evaluated in a more rigorous manner than at present. Further details of UK PICOS are available at www.shef.ac.uk/∼scharr/ukpicos.

BACKGROUND: Since first confirmed case of coronavirus disease (COVID)-19 in December 2019 by Chinese health authorities and subsequent World Health Organization (WHO) declaration that COVID-19 is a global public health crisis, radical changes have occurred all over the world associating massive lockdown with increased numbers of infected cases and related mortalities. As health care workers (HCWs) are at a great risk to get COVID-19 infection and hence can be a dangerous source of spreading it to the community, it was important to assess HCWs knowledge, attitude, and practice toward COVID-19 infection prevention and control (IPC) to help limit the outcomes of COVID-19. AIM: The objectives of the study were to assess the knowledge, attitudes, and practices of physicians regarding COVID-19 IPC. METHODS: Research setting is “Kasr Al-Ainy” Faculty of Medicine, Cairo University Hospital. Design: A cross-sectional analytical observational hospital-based research in June 2020. Population: A convenient sample of 50 physicians working at Cairo University Hospital was included. Data collection: Self-administered questionnaires derived from the WHO IPC guide during health care when COVID-19 is suspected were used. RESULTS: Mean age of studied group was 30.5 ± 3.97, while their mean years of practice were 4.7 ± 3.55. Mean knowledge score among physicians was 5.6 (± 0.56), two-thirds of them had sufficient knowledge regarding COVID-19 IPC as their mean attitude score among 24.9 (± 2.8). While mean practice scores 5.6 (± 1.05), yet only 68% of the participating physicians use a new set of personal protective equipment when care is given to a different patient. CONCLUSION: Physician’s moderate knowledge, poor attitude, and modest practice toward COVID-19 IPC were found to be not sufficient, not favorable nor safe enough to expected standards.