ABSTRACT
This article analyses the work experiences of Venezuelan migrant women in the Peruvian labour market in the context of the Covid-19 pandemic, beginning in March 2020, and the Peruvian state's ensuing public health measures. We argue that the Venezuelan case in Peru presents another example of how migration places women in labour positions that are segmented by gender and migrant status. Likewise, we find that a by-product of the economic crisis caused by the pandemic, is that women are further marginalized from the labour market because of their gender.
ABSTRACT
"BACKGROUND: Elexacaftor/tezacaftor/ivacaftor (ELX/ TEZ/IVA [Trikafta]) was approved in the US in October 2019 for people with cystic fibrosis (pwCF) aged >= 12 years with at least 1 copy of the F508del mutation in the CFTR gene. ELX/TEZ/IVA clinical trials demonstrated unprecedented improvements in lung function and dramatic reductions in pulmonary exacerbations (PEx), hospitalizations, and intravenous (IV) antibiotic use. While the impact of ELX/TEZ/ IVA on healthcare resource utilization (HCRU) in routine clinical practice has been reported, evidence of its associated impact on US healthcare costs is limited. OBJECTIVE(S): To evaluate the impact of ELX/TEZ/IVA on PEx, HCRU, and healthcare costs in routine clinical practice in the US. To minimize impact of the COVID-19 pandemic, outcomes were assessed prior to the March 2020 COVID-19 national emergency declaration. METHOD(S): Using the IBM MarketScan US Commercial Claims and Encounters (CCAE) database and the IBM Multi- State Medicaid Database (MDCD), we identified pwCF aged >= 12 years who filled >= 1 outpatient prescription for ELX/ TEZ/IVA between October 21, 2019 (ELX/TEZ/IVA US approval) and March 12, 2020. Baseline characteristics were examined during the 6-month period before ELX/TEZ/ IVA initiation (""pre-index""). Annualized all-cause HCRU (inpatient admissions, outpatient encounters, and outpatient prescriptions), PEx requiring hospitalization or IV antibiotics, and all-cause healthcare costs (estimated from reimbursed claims) were compared between pre-index and the period beginning with ELX/TEZ/IVA initiation through March 12, 2020 (""post-index"", up to 5 months). RESULT(S): 851 pwCF in the CCAE and 650 pwCF in the MDCD met the inclusion criteria with a mean age of 27.6 and 21.5 years and annualized rate of PEx pre-index of 0.83 and 1.24, respectively. Annualized mean PEx declined between the pre- and post-index periods in the CCAE (-57% [95% CI -67, -46]) and MDCD (-52% [-62, -40]). Annualized mean number of inpatient admissions were similarly reduced (-57% [-69, -44], CCAE;-55% [-65, -44], MDCD). Corresponding cost reductions for inpatient admissions were -60% (-74, -36) and -70% (-83, -52), yielding inpatient costs savings of $20,201/ year for CCAE and $31,038 for MDCD. Use of outpatient services and outpatient prescriptions were largely unchanged between the pre- and post-index periods. CONCLUSION(S): ELX/TEZ/IVA treatment was associated with substantial reductions in inpatient admissions and PEx, supporting the value of ELX/TEZ/IVA in reducing CF burden and associated inpatient costs."
ABSTRACT
Study Objectives: During the COVID-19 pandemic, the use of facemasks by the general population has become a significant issue despite evidence that shows that facemask use is associated with reduced transmission of SARS-CoV-2, the causative organism of COVID-19. We assessed beliefs, access, and practices of mask wearing across an ED population. Methods: This was a cross sectional survey of ED patients conducted from 12/14/20 - 2/22/21 at 15 geographically diverse safety net EDs. The survey asked questions regarding COVID-19 vaccine and the use of facemasks. In this analysis, the primary outcome was reporting the responses to survey questions regarding mask wearing practice and patient access to masks. Results: Of 2513 patients approached, 2239 (89.1%) agreed to participate. The median age of respondents was 48 years (IQR 34 - 62). The race and ethnicity reported for participants were: 40% White, 29% Black, 24% Latinx and 5% Asian. All other categories each accounted for 1% or less of the respondents. 14.8% reported that they had previously been diagnosed with COVID-19. Most respondents (81%) had primary care doctors or clinics. Of those without primary care, 64% used the ED as their usual source of health care. 78% of respondents reported wearing masks “all of the time” and 17% reported wearing masks >50% of the time. Subjects with primary care providers (PCPs) were more likely to report wearing masks at least most of the time as compared to subjects without primary care (97% vs 92%) Those with no PCP reported more difficulties obtaining masks compared to those who have a PCP (13% vs 6%, p < 0.001). The primary reasons respondents cited for not wearing masks were that they do not believe that masks work, masks are uncomfortable, and masks make it hard to breathe. Subjects with a PCP and those without a PCP both reported that the most common source of masks was through purchasing at a store or pharmacy. Subjects without a PCP were more likely to get masks from a shelter or food bank as compared to those without a PCP (6.5% vs 2.1%). Surveys were administered exclusively in urban EDs, and there may be response bias towards mask wearing in the hospital setting. Conclusion: Overall, respondents in the study reported a high rate of facemask wearing. Having a PCP was associated with higher proportion of respondents who reported wearing a mask at least 50% of the time. Respondents without a PCP also reported greater barriers in obtaining masks than those with a PCP. The results of this study inform on the acceptance rate of facemask usage in a large population of ED patients primarily in an urban setting. Having a PCP provides opportunities for education and distribution of facemasks. There is an opportunity to increase facemask usage through increased education and availability.