A Pilot COVID-19 Surveillance Program at the Zendrini Center in Milan (Italy) for Unaccompanied Foreign Minors.

During the COVID-19 pandemic, not only crowded refugee camps and immigration detention centers, but also receptions were places in which outbreaks occurred. To date there has been no report of the application of a COVID-19 surveillance system in reception centers for unaccompanied foreign minors only, who most of all deserve the utmost attention. Aware of this critical issue, we implemented a pilot COVID-19 surveillance program at the Zendrini center in Milan. It was started in September 2021 and was carried out for 4 months. Nasopharyngeal antigenic swabs were adopted. One day a week, two forensic physicians performed the first antigenic swab to minors who had just entered the center, or a monitoring swab after 15 days to those who were still hosted at the center. Operators were also swabbed for surveillance. A total of 80 subjects were enrolled and divided into 68 (72.5%) unaccompanied foreign minors and 22 (27.5%) operators. A total of 178 antigenic nasopharyngeal swabs were performed and tested negative. Regarding the monitoring activities, it was found that the minimum number of swabs per subject was 1 and the maximum number was 7, with an average value of 2.2 per individual. Having been able to confirm the absence of SARS-CoV-2 within the community represented a way to protect individual and collective health that could not have been pursued otherwise. Only inclusive approaches can allow communities and societies to respond more effectively to this crisis, and reduce the risk of future ones, intended as both upcoming COVID-19 waves and new infectious diseases.

Evidence of SARS-CoV-2 Antibodies and RNA on Autopsy Cases in the Pre-Pandemic Period in Milan (Italy).

In this study, we analyzed blood samples obtained from 169 cadavers subjected to an autopsy from 1 October 2019 to 27 March 2020. The presence of anti-severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) antibodies was searched by lateral flow immunochromatographic assay (LFIA) and ELISA tests and the SARS-CoV-2 RNA was tested in blood and available lung tissues by real-time PCR (RT-PCR) and droplet digital PCR (ddPCR). Five cases resulted in positives at the serological screening for anti-SARS-CoV-2. Three results were weakly positive for IgM while only one showed strong reactivity for IgG antibodies. The fifth subject (who died in December 2019) resulted positive for the ELISA test. The detection of SARS-CoV-2 RNA resulted in positive only in the blood and lung tissues of such cases. These data suggest that cadaveric blood may be a suitable substrate for the assessment of SARS-CoV-2 infection; moreover, they extend the observations of sporadic cases of SARS-CoV-2 infection in North Italy prior to the first confirmed cases.

Intimate Partner Violence in the COVID-19 Era: A Health, Psychological, Forensic and Legal Perspective.

This commentary aims to provide a multidisciplinary framework on intimate partner violence (IPV) during the COVID-19 pandemic (with a specific focus on the most predominant form of gender-based violence, i.e., male violence towards women), commenting on the multiple negative consequences of the pandemic on gender violence and providing elements of effective practice. We searched literature for reports/studies on the issue of IPV during the COVID-19 pandemic, focusing on health, psychological, forensic, and legal aspects. The combined effects of lockdowns, isolation at home with abusive partners, quarantine, and economic worries/loss of a job could significantly facilitate violence against women and, at the same time, diminish women's chances to seek for help, with a strong negative impact on their life. The continued offer of clinical, psychological, forensic, and legal services for survivors of violence, despite the modifications to the provision of these services due to the new needs related to the COVID-19 pandemic, appears of utmost importance. All actions to support survivors of IPV are expected to be multidisciplinary, including the involvement of social and/or legal services and health systems, and woman-centred. Implementing these measures in the COVID-19 era appears challenging but is of primary importance.

Twenty years of femicide in Milan: A retrospective medicolegal analysis.

Femicide constitutes a leading cause of premature deaths for women, yet it has been the subject of limited research until recently. Enhanced data collection and analysis on killings of women and girls are necessary to understand and address this unrelenting phenomenon. This study examines all cases of female homicide encountered at the Institute of Legal Medicine of Milan (Italy) spanning from 1999 to 2019; data from 2020/2021 were shown separately given the bias that the forced cohabitation and stay at home during the lockdowns of the SARS-CoV-2 pandemic may represent regarding violence against women and femicide. In this study, specific factors were considered, including the age and nationality of the victims, the place of recovery of the bodies, the victim's relationship to the perpetrator and the injuries they suffered. As a result, 200 female killings were found among the over 15,000 autopsies and 535 homicides investigated at the Institute of Legal Medicine of Milan from 1999 to 2019, representing an average of 9.5 femicides yearly. The majority of victims were Italian (74%) and half were aged between 18 and 49 years old. The killings were overwhelmingly committed in the domestic setting (78.5%) by male perpetrators (at least 85%), related to the victims as intimate or ex-intimate partners and members of the family (73.5%). The homicides were mainly perpetrated with sharp (32%) or blunt instruments (21.5%), shooting (18.5%) and asphyxiation (16.5%). This study is part of a growing effort to enhance data collection and analysis on femicide. Studying and monitoring the rates of femicide (or "femicide watch") will permit to better understand, reduce, and finally end femicide globally.

COVID-19, Lockdown, and Intimate Partner Violence: Some Data from an Italian Service and Suggestions for Future Approaches.

Intimate partner violence (IPV)-defined as physical, psychological, sexual, and/or economic violence typically experienced by women at home and perpetrated by their partners or expartners-is a pervasive form of violence that destroys women's feelings of love, trust, and self-esteem, with important negative consequences on physical and psychological health. Many reports from several countries have underlined a remarkable increase in the cases of IPV during the COVID-19 emergency. In this opinion article, we discussed the hypothesis that such an increase may be related to the restrictive measures enacted to contain the pandemic, including women's forced cohabitation with the abusive partner, as well as the exacerbation of partners' pre-existing psychological disorders during the lockdown. In addition, we retrospectively analyzed some data derived from our practice in a public Italian referral center for sexual and domestic violence (Service for Sexual and Domestic Violence [SVSeD]). These data interestingly revealed an opposite trend, that is, a decrease in the number of women who sought assistance since the beginning of the COVID-19 outbreak. Such a reduction should be interpreted as a negative consequence of the pandemic-related restrictive measures. Although necessary, these measures reduced women's possibilities of seeking help from antiviolence centers and/or emergency services. Owing to the COVID-19 outbreak, there is an urgent need for developing and implementing alternative treatment options for IPV victims (such as online and phone counseling and telemedicine), as well as training programs for health care professionals, especially those employed in emergency departments, to facilitate early detection of IPV.