ABSTRACT
Background Migrants who reach host countries irregularly are often perceived as increasing the COVID-19 burden. Italy is a transit and destination country for migrants who cross the Central Mediterranean route. During the pandemic, all migrants who disembarked on the Italian shores have been COVID-19 tested and quarantined. To investigate the incidence of SARS-CoV-2 infection in this population, the INMP, together with the Italian Ministry of the Interior, set a specific information flow collecting data about the infection and possible outcomes. Methods The observation period was from January 2021 to January 2022. COVID-19 tests used were molecular and antigenic. Positive cases detected both at the arrival and during the quarantine period, have been registered on an ad hoc INMP online platform. Migrants’ SARS-CoV-2 incidence rate (per 1,000) - with 95% CI - was therefore calculated. The Incidence Ratio (IR) was used to compare the migrants’ incidence rate with that of the resident population in Italy, in the same period and corresponding age group. Results Among 70,512 migrants (91% males and 9% females, all <60years old) who landed in Italy during the observation period, 2,861 tested positive, with an incidence rate of 40.6 (39.1-42.1) cases per 1,000. In the same period, an incidence rate of 177.6 (177.5-177.8) has been recorded in the resident population, with an IR of 0.22 (0.22-0.23). 89.9% of cases were males and almost half (49.6%) belonged to the age group 25-39years old. 99% of cases reported no symptoms, no relevant comorbidity has been reported and no cases have been hospitalized. Conclusions Our findings clearly highlight the low rate of SARS-CoV-2 infection in migrants reaching Italy by sea with an incidence rate that is roughly a quarter of that of the resident population, encouraging the opportunity to investigate the reasons for such an observation. Moreover, our study confirms the “healthy migrant effect” in migrants reaching Italy by sea. Key messages Irregular migrants arriving in Italy did not increase the COVID-19 burden in the country, thus alarmism is not justified. Further studies are needed to investigate the reasons for the lower incidence observed.
ABSTRACT
Background Religious and cultural beliefs strongly influence people's attitudes and behaviors that, in turn, may positively or negatively affect both individual and public health. In this regard, we aimed to collect and analyze evidence on the impact of religion in the current COVID-19 pandemic. Methods We performed a scoping review investigating both scientific and grey literature available on the topic from the onset of the pandemic to September 2021. Pubmed, Web of Science and Google Scholar were investigated and a hand-search on Google was also performed. Studies dealing with religion and COVID-19 were included and narratively summarized according to topics. Results 46 articles were included in the review. Predominant topics emerged were 1) religious pilgrimages and rituals worldwide being relevant to COVID-19 outbreaks, especially in the first pandemic wave 2) difficulties to engage the Closed Religious Communities (e.g. Haredi, Amish, etc.) in which community way of life, restrictions in using media and resistance to comply to preventive measures were identified as significant COVID-19 risk 3) COVID-19 unofficial treatments and vaccine hesitancy also supported by concerns on the religious acceptability of vaccine composition or firm interpretation of the Ramadan fasting 4) a fuel of religious discrimination 5) religious communities and leaders strongly trusted in conveying COVID-19 information. Conclusions Our findings highlighted how religion has represented both a risk for the spreading of the virus and a precious opportunity to convey evidence-based and culturally-sensitive COVID-19 information engaging people in fighting the pandemic. To be prepared for similar future challenges, scientists, politicians and health professionals need to acknowledge the role that culture and religion have in influencing people's lives to design specific health policies and strategies to ensure that all people are effectively engaged in health production and protection. Key messages Religion has represented both a risk factor for COVID-19 outbreaks and a resource to convey evidence-based information and overcome resistance to implementing COVID-19 preventive measures. Health policy should become more sensitive to religious and cultural issues acknowledging the role played by religion in facing complex global health challenges.
ABSTRACT
Background Emotional distress increasingly represents a major burden in children and adolescents (C&A), especially in conflict zones where its prevalence is estimated to reach 70%. Resilience training programmes (RTPs) are interventions that seek to enhance resilience in individuals or groups pursuing mental distress prevention. Literature suggests RTPs be particularly effective in C&A;however, their effectiveness and value for public health are still unclear. Methods A scoping review was performed in order to summarize evidence regarding the implementation and effectiveness of RTPs in children and adolescents. A search string has been built according to the PICO model and launched on PubMed, PsycInfo, Academia databases. Additional references were identified by a hand-search in Google Scholar. Studies included were narratively summarized according to topics that emerged. Results 18 articles were finally included in the review. Main issues were 1) RTPs seem to be more effective in adolescents rather than in children;2) COVID-19 pandemic has raised the attention towards RTPs in C&A;3) beyond conflict zones their implementation is increasingly recognized in supporting C&A management of daily stressors and traumas also in C&A with disabilities;4) school is identified as the key setting for RTPs;5) the high heterogeneity in RTPs approaches, contexts and study samples limits a conclusive effectiveness assessment. Conclusions Our findings highlighted how RTPs are increasingly recognized as a tool to improve C&A cognitive and behavioral functioning and resilience to external stressors, getting greater interest in the COVID-19 pandemic. Despite relevant theoretical support and promising study results, RTPs still lack strong evidence supporting their embracement by policymakers and effective implementation in public health policy. In order to not miss this chance, more efforts are needed in strengthening RTPs conceptualization and cost-effectiveness studies. Key messages • RTPs are a promising tool to enhance the resilience of children and adolescents gaining increasing interest due to the COVID-19 pandemic. • More studies are needed to provide a strong evidence base that supports their acknowledgment by policymakers and their implementation in public health policies.
ABSTRACT
Issue Italy represents a well-known European transit and destination country for Migrants and Refugees (M&Rs) with more than 77.000 migrants currently hosted in the reception system. Pandemic did not impact the M&Rs' influx with more than 30.000 disembarked in 2020. In line with the WHO and international organizations alerts to protect the health of M&Rs, Italy included M&Rs in its pandemic response. Description of the practice With the mandate of the Ministry of Health and thanks to the collaboration with the Ministry of the Interior and other institutional and governmental bodies, the Italian National Institute for Health, Migration and Poverty developed a comprehensive strategy to protect M&Rs' health in Italy during the COVID-19 pandemic, either into the reception system and outside. Results Interim evidence - based operating procedures including instructions regarding the early detection and the management of potential suspected and confirmed COVID-19 cases, from the first arrival throughout the entire reception system path, have been published. A national survey on the incidence of COVID-19 cases in the reception system has been performed in 2020. Dedicated information flows on the incidence of COVID-19 cases at the arrival in Italy and in the reception system and a periodic monitoring of the implementation of the afore-mentioned operating procedures have been established in 2021. Data collected have shown a daily mean incidence ratio lower for migrants hosted in the reception system than for the general population, as well as the same regarding the new COVID-19 cases among newly arrived migrants. Lessons The strategy adopted was found to be effective in protecting M&Rs' health during the pandemic. In particular, the Italian reception system has globally shown a good performance in limiting the COVID-19 spread. Moreover, the influx of newly arrived migrants did not represent an additional epidemiological risk in terms of burden of infection. Key messages The production of evidence-based procedures and the establishment of effective information flows have proved to be effective in managing and monitoring the pandemic in regards to M&Rs. The Italian reception system has turned to play as a protective factor in limiting the COVID-19 spread and the systematic screening of newly arrived M&Rs did not shown an additional COVID-19 burden.