Psychiatry is facing major challenges during the current coronavirus disease 2019 (COVID)-19 pandemic. These challenges involve its actual and perceived role within the medical system, in particular how psychiatric hospitals can maintain their core mission of attending to people with mental illness while at the same time providing relief to overstretched general medicine services. Although psychiatric disorders comprise the leading cause of the global burden of disease, mental healthcare has been deemphasised in the wake of the onslaught of the pandemic: to make room for emergency care, psychiatric wards have been downsized, clinics closed, psychiatric support systems discontinued and so on. To deal with this pressing issue, we developed a pandemic contingency plan with the aim to contain, decelerate and, preferably, avoid transmission of COVID-19 and to enable and maintain medical healthcare for patients with mental disorders.

To describe our plan as an example of how a psychiatric hospital can share in providing acute care in a healthcare system facing an acute and highly infectious pandemic like COVID-19 and at the same time provide support for people with mental illness, with or without a COVID-19 infection.

This was a descriptive study.

The plan was based on the German national pandemic strategy and several legal recommendations and was implemented step by step on the basis of the local COVID-19 situation. In addition, mid- and long-term plans were developed for coping with the aftermath of the pandemic.

The plan enabled the University Hospital to maintain medical healthcare for patients with mental disorders. It has offered the necessary flexibility to adapt its implementation to the first and second waves of the COVID-19 pandemic in Germany. The plan is designed to serve as an easily adaptable blueprint for psychiatric hospitals around the world.

To assess the influence of prophylactic selective bowel decontamination (SBD) on the spectrum of microbes causing bloodstream infection (BSI).

The microbes causing BSI in neutropenic patients of a hematologic ward (HW) and a bone marrow transplantation unit (BMTU), respectively, were compared by retrospective analysis of blood culture results from January 1996 to June 2003.

A 30-bed HW (no SBD) and a BMTU including a 7-bed normal care ward and an 8-bed intensive care unit (SBD used) of a 2,200-bed university teaching hospital.

The overall incidences of bacteremia in the HW and the BMTU were similar (72.6 vs 70.6 episodes per 1,000 admissions; P = .8). Two hundred twenty episodes of BSI were recorded in 164 neutropenic patients of the HW and 153 episodes in 127 neutropenic patients of the BMTU. Enterobacteriaceae (OR, 3.14; CI95, 1.67–5.97; P = .0002) and Streptococcus species (OR, 2.04; CI95, 1.14–3.70; P = .015) were observed more frequently in HW patients and coagulase-negative staphylococci more frequently in BMTU patients (OR, 0.15; CI95, 0.09–0.26; P< .00001). No statistically significant differences were found for gram-negative nonfermentative bacilli (P = .53), Staphylococcus aureus (P = .21), Enterococcus species (P = .48), anaerobic bacteria (P = .1), or fungi (P = .50).

SBD did not lead to a significant reduction in the incidence of bacteremia, but significant changes in microbes recovered from blood cultures were observed. SBD should be considered when empiric antimicrobial therapy is prescribed for suspected BSI.

To establish the concentration of isopropanol that exerts the same immediate and sustained effects as n-propanol 60% v/v in surgical scrubbing, and to assess the performance of the test method proposed as the European standard in parallel experiments.

Isopropanol at concentrations of 70%, 80%, and 90% v/v was tested in comparison with n-propanol 60%, the proposed reference preparation, in the draft method proposed by the European standard. A Latin square design was used with four balanced blocks of five volunteers each in four experimental runs that were spaced by intervals of 1 week each. Volunteers were allotted randomly to one of the four blocks. Independently, the volunteers' right and left hands also were randomized into two groups for the assessment of either immediate or sustained effects.

Two laboratories supervised by two investigators, one from Vienna, Austria, and one from London, The United Kingdom.

The release of skin flora from the fingertips of clean hands was assessed before and after treatment by immediate sampling from one hand and by sampling of the other, gloved hand after 3 hours. The mean log10 reductions (RF) of bacterial release achieved by rubbing the alcoholic preparations for 3 minutes onto the hands were established.

For both experiments, the immediate effects of isopropanol 70% (RF, 2.0 and 2.1, respectively) were significantly smaller than those of the reference n-propanol 60% (RF, 2.4 and 2.6, respectively). This also was found with the sustained effects (RF, 0.7 and 1.1 vs 1.0 and 1.6, respectively). At 90%, isopropanol equalled the immediate effect of n-propanol 60%, whereas at 80% it proved slightly (although not significantly) less active. There were no significant differences in the results of both investigators. The sustained effects of isopropanol 80% and 90% were both larger than the reference in Vienna but were found smaller by the London investigator; none of the differences were significant. Mean RFs were significantly different between Vienna and London with n-propanol 60% and isopropanol 70%, but not with isopropanol at 80% or 90%.

At 90%, isopropanol is as effective as n-propanol 60%, which was proposed by the European Committee for Standardization as a reference in testing :products for surgical hand disinfection. It could, therefore, serve as an alternative if the proposed agent is undesirable for any reason. In parallel experiments by two investigators, the proposed test method proved well workable; the results were very similar and the conclusions identical