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ImagineThe internet stops workingelectricity is cutthe many screens which connect you to the world turn blackyou no longer have access to your bank accountor functioning credits cardsthe walls behind which you retreated fade awayand you find yourself under the open skynow you are like menothing but a “dangerous body” on the streetwhat can you do now?what must you do now?out in the open where an invisible virus lurks?you roamroam the city forfoodinformationand means to protect those you love

Macrolides are among the most widely prescribed broad spectrum antibacterials, particularly for respiratory infections. It is now recognized that these drugs, in particular azithromycin, also exert time-dependent immunomodulatory actions that contribute to their therapeutic benefit in both infectious and other chronic inflammatory diseases. Their increased chronic use in airway inflammation and, more recently, of azithromycin in COVID-19, how-ever, has led to a rise in bacterial resistance. An addi-tional crucial aspect of chronic airway inflammation, such as chronic obstructive pulmonary disease, as well as other inflammatory disorders, is the loss of epithelial barrier protection against pathogens and pol-lutants. In recent years, azithromycin has been shown with time to enhance the barrier properties of airway epithelial cells, an action that makes an important contribution to its therapeutic efficacy. In this article, we review the background and evidence for various immunomodulatory and time-dependent actions of macrolides on inflammatory processes and on the epithelium and highlight novel nonantibacterial mac-rolides that are being studied for immunomodulatory and barrier-strengthening properties to circumvent the risk of bacterial resistance that occurs with macro-lide antibacterials. We also briefly review the clinical effects of macrolides in respiratory and other inflammatory diseases associated with epithelial injury and propose that the beneficial epithelial effects of nonan-tibacterial azithromycin derivatives in chronic inflammation, even given prophylactically, are likely to gain increasing attention in the future. Significance Statement——Based on its immuno-modulatory properties and ability to enhance the protective role of the lung epithelium against pathogens, azithromycin has proven superior to other macrolides in treating chronic respiratory inflammation. A non-antibiotic azithromycin derivative is likely to offer prophylactic benefits against inflammation and epithelial damage of differing causes while preserving the use of macrolides as antibiotics. Funding text Address correspondence to: Dr. Jennifer A. Kricker, EpiEndo Pharmaceuticals, Eidistorg 13-15, Innovation House, 170 Seltjarnarnes, Iceland. E-mail: jk@epiendo.com This work was supported by an Accelerator grant from the European Innovation Council [Grant 947081]. C.P.P. receives consultancy fees from EpiEndo Pharmaceuticals. J.A.K. and F.R.G. are full-time employees and M.J.P. and T.G. are part-time employees of EpiEndo Pharmaceuticals. Abstract submitted to 15th World Congress on Inflammation, 5–8 June, 2022, Rome, Italy. Jennifer A. Kricker, Bryndís Valdimarsdóttir, Jon Petur Joelsson, Sævar Ingthorsson, Mike J. Parnham, Snævar Sigurdsson, Ari Jón Arason, Ólafur Baldursson, Fridrik R. Gardarsson, Clive P. Page, Fredrik Lehmann, Thorarinn Gudjonsson. “Barriolides: Nonantibacterial compounds with epithelial barrier enhancing properties and anti-inflammatory effects in vitro.” Abstract submitted to 15th World Congress on Inflammation, 5–8 June, 2022, Rome, Italy. Jennifer A. Kricker, Sævar Ingthorsson, Michael J. Parnham, Bryndís Valdimarsdóttir, Jon Petur Joelsson, Snævar Sigurdsson, Fridrik R. Gardarsson, Clive P. Page, Ólafur Baldursson, Fredrik Lehmann, Thorarinn Gudjonsson. “Targeting the lung epithelial barrier to inhibit neutrophilic inflammation.” https://doi.org/10.1124/pharmrev.121.000300 Publisher Copyright: © 2021 by The Author(s). Peer reviewed

Funding Information: Funding/Support: This work was supported by the Landspitali University Hospital Research Fund (grant A-2021-051). Neither the authors nor their institutions received payment or services from a third party for any aspect of the submitted work. This cohort study estimates the proportion of persons who became reinfected with SARS-CoV-2 during the Omicron wave in Iceland. Peer reviewed

Currently, the coronavirus disease 2019 (COVID-19) severely influences physiotherapy education which is based mostly on face-to-face teaching. Thus, educators have been compelled to adapt their pedagogical approaches moving to digital education. In this commentary, we debate on digital education highlighting its effectiveness, the users’ perspectives, and its weakness in the context of physiotherapy teaching aimed at informing post-COVID-19 future directions in this educational field. Existing evidence on digital education produced before COVID-19 supports its implementation into entry-level physiotherapy education. However, some challenges (e.g. social inequality and evaluation of students) threaten its applicability in post-COVID-19 era, calling educators to take appropriate actions. Open access funding provided by Lund University. © The Author(s) 2021.

Background: We sought to provide a description of surge response strategies and characteristics, clinical management and outcomes of patients with severe COVID-19 in the intensive care unit (ICU) during the first wave of the pandemic in Denmark, Finland, Iceland, Norway and Sweden. Methods: Representatives from the national ICU registries for each of the five countries provided clinical data and a description of the strategies to allocate ICU resources and increase the ICU capacity during the pandemic. All adult patients admitted to the ICU for COVID-19 disease during the first wave of COVID-19 were included. The clinical characteristics, ICU management and outcomes of individual countries were described with descriptive statistics. Results: Most countries more than doubled their ICU capacity during the pandemic. For patients positive for SARS-CoV-2, the ratio of requiring ICU admission for COVID-19 varied substantially (1.6%–6.7%). Apart from age (proportion of patients aged 65 years or over between 29% and 62%), baseline characteristics, chronic comorbidity burden and acute presentations of COVID-19 disease were similar among the five countries. While utilization of invasive mechanical ventilation was high (59%–85%) in all countries, the proportion of patients receiving renal replacement therapy (7%–26%) and various experimental therapies for COVID-19 disease varied substantially (e.g. use of hydroxychloroquine 0%–85%). Crude ICU mortality ranged from 11% to 33%. Conclusion: There was substantial variability in the critical care response in Nordic ICUs to the first wave of COVID-19 pandemic, including usage of experimental medications. While ICU mortality was low in all countries, the observed variability warrants further attention. Funding: NordForsk (Nordic COVID-19 Activities), Finnish Society of Intensive Care. Publisher Copyright: © 2021 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd Peer reviewed

The original article has been corrected. Author “Dereks M. Yellon” should be “Derek M. Yellon.”. Publisher Copyright: © 2021, Springer Science+Business Media, LLC, part of Springer Nature.

Funding Information: Funding was provided from the Scandinavian Society of Anaesthesiology and Intensive Care Medicine and institutional and/or departmental sources. Publisher Copyright: © 2022 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation. The Clinical Practice Committee of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine endorses the Living WHO guideline on therapeutics and COVID-19. This trustworthy continuously updated guideline serves as a highly useful decision aid for Nordic anaesthesiologists caring for patients with COVID-19. Peer reviewed