ABSTRACT
According to the World Tourism Organization, tourism is the largest industry in the world. The tourist activity with elements that refer to the mass model of tourism, emerges in many cases as the key activity for the economic development of a place. This phenomenon is constantly recorded during the last decades worldwide and not only in the wider Mediterranean but also in Greece. In this context and to serve as many guests as possible the quality of accommodation services was sacrificed on the altar of the ephemeral. Huge hotel units were built and areas of natural beauty were destroyed. Also, the primary sector was abandoned and rural areas were turned into tourist destinations. The need to move from mass tourism to quality tourism has been highlighted for many years and for many different reasons. The failure of this model and the shift to quality or alternative tourism has already begun. However, the current global crisis regarding the pandemic due to the COVID-19 has once again highlighted the weaknesses of this tourism model. The purpose of this paper is to investigate and assess the current situation and the reasons that led tourists may prefer small accommodation, apartments and houses to the standards of alternative tourism. It also aims to highlight the lack of flexibility in the event of a crisis, both in planning and programming, and to highlight another reason for the transition from mass to alternative tourism. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.
ABSTRACT
BACKGROUND: Healthcare workers (HCWs) represent a high-risk population for infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). AIM: To determine the seroprevalence of SARS-CoV-2 antibodies among HCWs, and identify the factors associated with this seroprevalence. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were applied for this systematic review and meta-analysis. Databases including PubMed/MEDLINE and preprint services (medRχiv and bioRχiv) were searched from inception to 24th August 2020. FINDINGS: Forty-nine studies including 127,480 HCWs met the inclusion criteria. The estimated overall seroprevalence of SARS-CoV-2 antibodies among HCWs was 8.7% (95% confidence interval 6.7-10.9%). Seroprevalence was higher in studies conducted in North America (12.7%) compared with those conducted in Europe (8.5%), Africa (8.2) and Asia (4%). Meta-regression showed that increased sensitivity of antibody tests was associated with increased seroprevalence. The following factors were associated with seropositivity: male gender; Black, Asian and Hispanic HCWs; work in a coronavirus disease 2019 (COVID-19) unit; patient-related work; front-line HCWs; healthcare assistants; shortage of personal protective equipment; self-reported belief of previous SARS-CoV-2 infection; previous positive polymerase chain reaction test; and household contact with suspected or confirmed cases of COVID-19. CONCLUSION: The seroprevalence of SARS-CoV-2 antibodies among HCWs is high. Excellent adherence to infection prevention and control measures; sufficient and adequate personal protective equipment; and early recognition, identification and isolation of HCWs infected with SARS-CoV-2 are imperative to decrease the risk of SARS-CoV-2 infection.