Event-based surveillance of poisonings and potentially hazardous exposures over 12 months of the COVID-19 pandemic

The COVID-19 pandemic has seen people and governments utilise an array of chemical and pharmaceutical substances in an attempt to prevent and treat COVID-19 infections. The Centre for Radiation, Chemicals and Environmental Hazards (CRCE) at Public Health England (PHE) rou-tinely undertakes Event-Based Surveillance (EBS) to monitor public health threats and incidents related to chemicals and poisons. From April 2020, EBS functions were expanded to screen international media for potentially hazardous exposures associated with the COVID-19 pandemic. Media sources reported that poisons centres were experiencing increased enquiries associated with the use and misuse of household cleaners and alcohol-based hand sanitiser (HS). There were also media reports of people self-medicating with over-the-counter supplements and traditional or herbal rem-edies. Public figures who directly or indirectly facilitated misinformation were sometimes reported to be associated with changes in poisoning trends. Border closures were also believed to have been associated with increasingly toxic illicit drug supplies in Canada, and record numbers of opioid-related deaths were reported. In other countries, where the sale of alcohol was banned or limited, home-brewing and methanol-based supplies resulted in a number of fatalities. At least two chemical incidents also occurred at industrial sites in India, after sites were left unattended or were closed and reopened due to lockdown measures. Reports of poisoning identified in the international media were provided to the UK National Poisons Information Service (NPIS) and contributed to the UK COVID-19 public health response.