What does it mean to be vulnerable? Vulnerable groups of people are those that are disproportionally exposed to risk, but who is included in these groups can change dynamically. A person not considered vulnerable at the outset of a pandemic can become vulnerable depending on the policy response. The risks of sudden loss of income or access to social support have consequences that are difficult to estimate and constitute a challenge in identifying all those who might become vulnerable. Certainly, amid the COVID-19 pandemic, vulnerable groups are not only elderly people, those with ill health and comorbidities, or homeless or underhoused people, but also people from a gradient of socioeconomic groups that might struggle to cope financially, mentally, or physically with the crisis.

Never has the “leave no one behind” pledge felt more urgent. As nations around the world implement measures to control the spread of SARS-CoV-2, including lockdowns and restrictions on individuals’ movements, they must heed their global commitments. When member states adopted the UN 2030 Agenda for Sustainable Development, they promised to ensure no one will be left behind. Chief among the world's most vulnerable people are refugees and migrants. The COVID-19 crisis puts these groups at enormous risk.

When the UK National Institute for Health and Care Excellence (NICE) released draft guidelines on the diagnosis and management of abdominal aortic aneurysms in May, 2018, it caused outcry. By recommending that endovascular aneurysm repair (EVAR) of unruptured aneurysms should not be offered—even in patients for whom open surgical repair was contraindicated—critics said that many patients would be denied life-saving treatment and that the guidelines were unworkable.

As of March 19, 2020, 191 127 cases of, including 7807 deaths attributed to, coronavirus disease 2019 (COVID-19) have been reported worldwide.1 The incidence of reported cases in China has dramatically reduced to tens per day as a result of strict social distancing measures; however, the pandemic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is now generating sustained transmission in many countries including the USA. In The Lancet, Isaac Ghinai, Tristan D McPherson, and colleagues2 report details of the first known human-to-human transmission of SARS-CoV-2 in the USA, which was identified in late January, 2020.

It is natural during the unfolding coronavirus disease 2019 (COVID-19) pandemic to focus on emergency response planning, including containment, treatment procedures, and vaccine development, and nobody would doubt the need for these measures. However, an emergency can also open a window of opportunity for reflection and learning. We live in increasingly global, interdependent, and environmentally constrained societies and the COVID-19 pandemic exemplifies these aspects of our world. We would therefore be wise to take a broad integrated perspective on this disease, the impacts of which are already spilling over into the realms of economics, international trade, politics, and inequality.

How should countries plan for the approaching health crisis caused by coronavirus disease 2019 (COVID-19)? In the UK, Prime Minister Boris Johnson, himself struck down with infection, has written to every household warning that, “we know things will get worse before they get better”. The UK Government is right to prepare the public for the coming human catastrophe. All governments have a responsibility to do the same. But this advice does not go far enough. Here are five critical actions that need to be considered immediately.

Laboratories and diagnostic companies are racing to produce antibody tests, a key part of the response to the COVID-19 pandemic. Anna Petherick reports.

On March 31, the Gairdner Foundation announced the winners of its annual prizes in biomedical science and global health. Talha Burki spoke with the laureates.

Masculinities: Liberation through Photography explores half a century of photographic representations of men—their bodies, their identities, and their social roles. Contemporary politics is full of powerful men—Donald Trump, Boris Johnson, Vladimir Putin, and Recep Tayyip Erdoğan—behaving in stereotypically dominant ways. You could be forgiven for thinking that the more things change, the more things remain the same. But #MeToo is here to say it can't go on like this, in the wake of the conviction of Harvey Weinstein.

In 2017 the face of Katie Stubblefield made headlines. Not the face she was born with or the face that emerged after 22 reconstructive surgeries. This was another face altogether: a transplant that Stubblefield would receive from Adrea Schneider. There have been 46 recorded face transplants in history. Katie's was the 40th—only the third to have taken place at the Cleveland Clinic in Ohio, which also undertook the first face transplant in the USA, on Connie Culp, in 2008. According to the Cleveland Clinic, it took 11 surgeons and staff from 15 specialties more than 31 hours to transplant Stubblefield's new face, including her jaw, teeth, facial nerves, muscles, and skin.

Molecular geneticist and genetic code breaker. He was born in Washington, DC, USA, on Nov 19, 1934, and died from complications of Parkinson's disease in Chestnut Hill, MA, USA, on Feb 2, 2020, aged 85 years.

Punitive social policy, encompassing the dismantling of the welfare state with the expansion of the penal state and its associated institutions, as nicely stated by Elias Nosrati and Michael Marmot in their Perspective,1 might indeed be considered an upstream social determinant of health. Nosrati and Marmot's analysis relates to the findings described by Navarro and colleagues,2 linking political ideology with policies aimed at reducing social inequalities such as welfare state and labour market policies.

Mass drug administration is the strategy recommended by WHO to control or eliminate many neglected tropical diseases that cause devastating consequences worldwide. This strategic approach, which has produced unquestionable benefits, consists of treating every person, infected or not, living in a defined geographical area at approximately the same time.1 In 2017, more than 1·7 billion treatments (mainly albendazole, mebendazole, ivermectin, azithromycin, and praziquantel) were delivered to 1·04 billion individuals.

Japan has achieved one of the most successful health-care systems in the world.1 Under the nation's insurance scheme, Japanese citizens have taken for granted that anyone can choose any health-care facility and receive the most advanced medical care across the nation. However, little attention has been paid to the fact that such a health system is supported by dedicated and self-sacrificing medical professionals. Such overloaded expectation is especially high in rural areas where the number of doctors remains low.

10 years after highlighting the health consequences for millions of people infected with Trypanosoma cruzi, a 2019 report from the Pan American Health Organization concluded that there has been little progress in the prevention and treatment of Chagas disease, a problem that now extends beyond Latin America.1

Yemen, known to many as the land of Sheba, and Manhattan of the desert, is now referred to only as one of the poorest countries on Earth. The name Yemen has become synonymous with cholera, famine, death, instability, and war. The war continues to erase the lives, history, and the future of Yemenis, and meaningful aid and peace have yet to reach Yemen.

Mease PJ, Rahman P, Gottlieb AB, et al. Guselkumab in biologic-naive patients with active psoriatic arthritis (DISCOVER-2): a double-blind, randomised, placebo-controlled phase 3 trial. Lancet 2020; 395: 1126–36—In this Article, the following sentence from the Participants section has been corrected as follows: “Patients were permitted, but not required, to continue stable use of selected standard treatments, including NSAIDs or other analgesics up to the regional marketed dose approved; oral corticosteroids (≤10 mg/day of prednisone or equivalent dose); or non-biologic DMARDs (limited to methotrexate ≤25 mg/week, sulfasalazine ≤3 g/day, hydroxychloroquine ≤400 mg/day, or leflunomide ≤20 mg/day).” This correction has been made to the online version as of April 2, 2020, and the printed version is correct.

Biswal S, Borja-Tabora C, Martinez Vargas L, et al. Efficacy of a tetravalent dengue vaccine in healthy children aged 4–16 years: a randomised, placebo-controlled, phase 3 trial. Lancet 2020; published online March 17. https://dox.doi.org/10.1016/S0140-6736(20)30414-1—The appendix of this Article has been corrected as of April 2, 2020.

In his Offline piece,1 Richard Horton asks whether touch has disappeared from medical consultations. As a doctor working in Norway, I witness the power of touch daily, from holding a patient's hand in the emergency room to giving them a hug after delivering a bad prognosis. Before going to work in the Democratic Republic of Congo during the Ebola outbreak, I reflected on how I would react under the strict no-touch policies that were in place for Ebola missions to prevent the transmission of communicable diseases.

We read with interest Richard Horton's Comment,1 in which he characterises the decline of the physical examination as “a vestigial remnant of clinical care”. He also acknowledges the transformative power of touch even as he sees its decline.