AI, Epidemiology and Public Health in the Covid Pandemic

Epidemiology and public health are two closely related disciplines, and both rely in part on the quantification, the measurement of given characteristics-whether for the purpose of describing a health problem, researching the causes of this problem, or more broadly, any data and knowledge that may be useful for decision-making in the area of population health. The development of digital technology in all aspects of our lives and activities means that new sources of data are becoming available, presenting new or complementary qualities to those that could previously be collected in epidemiology. The processing capabilities of this data have also evolved hand in hand, and the resurgence of artificial intelligence (AI) techniques, in the broad sense, appears to be an opportunity to be explored for both epidemiologists and public health actors. The Covid19 pandemic has arisen as a textbook case addressed to epidemiology and public health, and for which it seems that any means were good to try. It is therefore both an opportunity to examine the practical application of these two disciplines in its classic aspects, and the proposals for the use of artificial intelligence in this context. The main question is then to know what types of use could have been suggested or employed. A targeted bibliographic search highlights six main types of uses of AI in epidemiology and public health in the context of the pandemic, as well as a seventh which appears more specific to the digital age: infodemics. We propose to examine to what extent these proposals have been reported in a reliable and documented manner, thus making it possible to assess the performance of the algorithms developed, as well as their degree of maturity. We conclude by placing the question of AI in epidemiology and public health in a broader context, to outline the main issues for the future. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Current status of tobacco use, cessation and control policy in Korea.

Background: Tobacco use is a leading cause of countless deaths and disabilities worldwide. An estimated 11 million Korean adults were still using tobacco in 2020, according to the Korea National Health and Nutrition Examination Survey. This review aims to explain the current trends in tobacco use, sales, cessation, and control policies in South Korea. Current Concepts: Heated tobacco products (HTPs), a hybrid between conventional and electronic cigarettes, were first launched in South Korea in June 2017. Advertisements stating that HTPs are odorless, tar-free, and less harmful to health have caused sales of HTPs to grow quickly over the past 5 years, such that they account for about 15% of the total tobacco market. According to national smoking rate statistics and tobacco sales trends, declines in current smoking rates have slowed and even risen in some groups, and declines in total tobacco sales have slowed but also risen again during the coronavirus 19 pandemic. In addition, the number of visitors to smoking cessation clinics decreased just after the advent of HTPs and social distancing policies triggered by the coronavirus. Nicotine replacement therapy can serve as a drug therapy for smoking cessation, or bupropion and varenicline can be prescribed. Korea's representative tobacco control policies include the tax increase policy, non-smoking area policy, cigarette pack warning picture policy, and support policy for visiting smoking cessation clinics. Discussion and Conclusion(s): There is a pressing need to reflect tobacco control policies in line with changes in tobacco user behaviors and tobacco company marketing strategies.Copyright © Korean Medical Association.

Searching for the Elusive "Covidiot”: Moral Governance, Policing and the Social Production of Ignorance in a (Post-) Pandemic World

This comment piece examines the social figure of the "covidiot”, which emerged at the beginning of the coronavirus pandemic and has been used for social and political purposes since then. We argue that the covidiot is a somewhat elusive figure whose formation actualizes wider symbolic struggles over moral and epistemological issues that speak to contemporary social anxieties. Firstly, the paper suggests that the covidiot is typically imagined as a figure of blame through which certain individuals and groups are moralized for their failure to follow social distance regulations. The covidiot is thereby constructed as a threat to the moral social order and subjected to forms of policing and governance. In these processes, attributions of covidiocy and their contestations can be read as struggles for moral hegemony which serve to construct moral boundaries between deserving and undeserving citizens. Secondly, the paper offers a preliminary critique of the social production of ignorance, pointing out how the political uses of the covidiot obscure the societal processes that produce systemic ignorance, allocate blame in individuals while undervaluing the responsibility of corporations, media outlets or the nation-state. This figure is therefore implicated in struggles over epistemic authority characteristic of our present post-truth era. © 2022 by Author's.

As ações profissionais da/o assistente social na atenção primária em saúde no contexto da pandemia de Covid-19

O artigo sistematiza as ações das/os Assistentes Sociais vinculadas/os a um curso de residência multiprofissional em saúde da família cuja atuação ocorreu na Atenção Primária em Saúde (APS), durante a pandemia do novo coronavírus, num contexto de reorganização dos serviços de saúde e do trabalho das/os profissionais do setor. Pretende-se contribuir com as reflexões sobre a dimensão técnico-operativa da Profissão abordando aspectos do trabalho no Núcleo Ampliado em Saúde da Família (NASF) neste período de excepcionalidade. A sistematização foi realizada a partir dos registros em diários de campo elaborados pelas/os profissionais entre os meses de março a setembro de 2020. Os principais resultados indicam que a crise sanitária aprofundou as desigualdades sociais demandando ações profissionais predominantemente socioeducativas voltadas ao acesso da população aos serviços e direitos sociais que amparam e oferecem condições de vida diante das mudanças provocadas pela pandemia. A reorganização requerida no processo coletivo de trabalho nos serviços de saúde implicou em alterações dos fluxos de acesso aos serviços e direitos sociais. Significa que, no período analisado, predominaram demandas profissionais de gestão e planejamento seja envolvendo a elaboração de materiais informativos de suporte às ações educativas, divulgação de informações pertinentes à população usuária do SUS, bem como de instrução às equipes multiprofissionais quanto aos benefícios sociais disponibilizados para mitigar os efeitos da pandemia. As ações socioeducativas voltadas para mobilização e assessoria político-organizativas apresentaram-se imprescindíveis para concretizar o acesso às práticas coletivas de controle social atentas à universalidade do direito à saúde.Alternate :This article systematizes the actions of social assistants associated to a multi-professional residency course in family health, undertaken within the Primary Healthcare System, during the new coronavirus pandemic, in a context of reorganization of healthcare services and the labor of professionals in the sector. Its objective is to contribute to reflections about the technical-operative dimension of the profession, addressing aspects of work by the Expanded Family Healthcare Nucleus in this exceptional period. The systematization was conducted through registers in field diaries prepared by the professionals from March to September 2020. The main results indicate that the sanitary crisis deepened social inequalities, requiring predominantly educational professional actions aimed at the population's access to social rights and services that support better living conditions, considering changes provoked by the pandemic. The reorganization required in the collective work process in healthcare services involved alterations in the flows of access to social services and rights. This means that, in the period analyzed, there was a predominance of professional demands related to administration and planning, that involved the elaboration of informative materials to support educational actions, the promotion of pertinent information to the population that uses Brazil's federal public single healthcare system, and providing instructions to multi-professional teams about social benefits available to mitigate the effects of the pandemic. The socio-educational actions aimed at mobilization and political-organizational assistance were essential to realizing access to collective practices of social control focused on the universal right to healthcare.

Ethics of digital contact tracing wearables.

The success of digital COVID-19 contact tracing requires a strategy that successfully addresses the digital divide-inequitable access to technology such as smartphones. Lack of access both undermines the degree of social benefit achieved by the use of tracing apps, and exacerbates existing social and health inequities because those who lack access are likely to already be disadvantaged. Recently, Singapore has introduced portable tracing wearables (with the same functionality as a contact tracing app) to address the equity gap and promote public health. We argue that governments have an ethical obligation to ensure fair access to the protective benefits of contract tracing during the pandemic and that wearables are an effective way of addressing some important equity issues. The most contentious issues about contact tracing apps have been the potential infringements of privacy and individual liberty, especially where the use of apps or other technology (such as wearables or QR codes) is required for access to certain spaces. Here we argue that wearables, as opposed to apps alone, will make a digital contact tracing mandate more practical and explain some conditions under which such a mandate would be justified. We focus on Singapore as a case study that has recently deployed contact tracing wearables nationally, but also reference debate about wearables in Australia and New Zealand. Our analysis will be relevant to counties trialling similar portable tracing wearables.

Rationality in social science: Foundations, norms, and prosociality

The concept of rationality and its significance for theory and empirical research in social science are key topics of scholarly discussion. In the tradition of an analytical as well as empirical approach in social science, this volume assembles novel contributions on methodological foundations and basic assumptions of theories of rational choice. The volume highlights the use of rational choice assumptions for research on fundamental problems in social theory such as the emergence, dynamics, and effects of social norms and the conditions for cooperation and prosociality. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Fachmedien Wiesbaden GmbH, part of Springer Nature 2021.

De-platforming disinformation: conspiracy theories and their control

Informed by two case studies of de-platforming interventions performed by Facebook against two high profile conspiracy theorists who had been messaging about Covid-19, this article investigates how de-platforming functions as an instrument of social control, illuminating the intended and unintended effects it induces. To help interpret the patterns in the data, two novel conceptual innovations are introduced. The concept of 'minion accounts' captures how following a de-platforming intervention, a series of secondary accounts are set up to continue the mission. Such accounts are part of a wider retinue of 're-platforming' behaviours. Overall, the empirical evidence reviewed suggests that whilst de-platforming can constrain transmission of conspiratorial disinformation, it does not eradicate it. [ FROM AUTHOR] Copyright of Information, Communication & Society is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Exploring the Social Dynamics of Public Stigmatization in China of Wuhanese During the Initial Outbreak of COVID-19: A Moral Panic Analysis

During the initial outbreak of COVID-19 in China in 2019 and 2020, the Wuhanese suffered tremendous public stigmatization. Why and how did the general public in China develop such strong feelings against the Wuhanese? To address these questions and understand the social forces underlying this phenomenon, a moral panic analysis was conducted. Using a mixed-method design, this research examined the scale and mechanisms of the public stigmatization of the Wuhanese as ‘the folk devil' of a moral panic and identified the social factors (social media, the collective memory of SARS, and the influence of close relations) which produced and facilitated the initial panic and subsequent public stigmatization. Through its presentation and analysis of quantitative and qualitative data, this article explains how public stigmatization has served as an effective social control instrument in China during the COVID-19 outbreak, used to contain the disease, garner strong public support for the government authorities, legitimize extreme methods used to implement containment policies, and monitor and restrict the population. [ FROM AUTHOR] Copyright of Journal of Contemporary China is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Pandemic and Desacralization: the New Political Order Founded on the Bare Life

This article aims to approach the COVID-19 health crisis through the category of precarity in two senses. On the one hand, in the face of power, a state of exception has been configured as the new form of political handling of the new normality. On the other hand, the loss of public space has meant that community ties have been broken, fostering greater atomisation and loneliness. Both processes were already present in modernity and post-modernity and foster an increasing uprooting of the individual through the loss of the symbolic axes of socialisation, as well as more intense social control. In short, the defining characteristic of the pandemic is the precarity of life. © 2023 Nicolaus Copernicus University. All rights reserved.

Parental care and family support as moderators on overlapping college student bullying and cyberbullying victimization during the Covid-19 pandemic

Purpose: The study examined whether parental care and family support moderate the association between school bullying victimization and cyberbullying victimization among college students by applying the social anthropological approach and social control theory Method: Data were collected for 261 college students (57.9% female) aged between 18 to 24 or older from a university in the Midwest region of the United States. A latent moderated structural equations approach was utilized Results: The data revealed that bullying victimization was positively associated with cyberbullying victimization. Moreover, parental care was a significant moderator between bullying victimization and cyberbullying victimization Discussion: These findings have implications of preventing victims of bullying becoming victims of cyberbullying. Parental involvement especially needs to be emphasized for college students' cyberbullying prevention and intervention programs. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Power and social control of youth during the COVID-19 pandemic

While people across the globe adapt to the COVID-19 pandemic, young people have been the center of many news stories. Millions of young people are required to stay home due to school closures, and adults are forced to consider alternative structures to support youths' needs. The COVID-19 pandemic has exposed multiple injustices and forms of oppression experienced by the most vulnerable in our country, which includes young people experiencing poverty, incarceration, foster care, homelessness, and those with marginalized identities. This article will discuss the role of power and social control in the lives of youth during the COVID-19 pandemic and present strategies leisure researchers and practitioners can adopt to overcome the loss of critical support structures and mitigate exponential effects of COVID-19 on our most vulnerable youth. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Time-Space Companions: Digital Surveillance, Social Management, and Abuse of Power During the Covid-19 Pandemic in China

Based on ethnographic research carried out during the 2022 Covid-19 surge in southern China, this paper examines the roll-out of a contact-tracing tool called the Time-Space Companion project. The project exemplifies a state effort to incorporate data-driven surveillance technology into the public health apparatus during the coronavirus outbreak. By exploring the definition, identification, and management of Time-Space Companions, the paper shows that the project was used to discipline Chinese citizens and shift public health responsibilities onto them by transforming daily life into sites of public health regulation, discipline, and criminalization. The project also exemplified an on-going state effort to leverage surveillance technologies for the purposes of social management. The paper draws attention to the social repercussions that resulted when technology offered a tempting tool to enhance the infrastructural and despotic powers of mundane state actors. © 2023 BCAS, Inc.

The Masks We Wear: Watchmen, Infrastructural Racism, and Anonymity

As COVID-19 has led to the politicization of masks and the donning of masks, the prescient commentary that emerges from HBO's Watchmen speaks to our contemporary moment, replete with animosity, distrust, and wounding. Race, the legacy of racial injustice, and anonymity are major themes found throughout the series, which highlight the complicated nature of social control and the infrastructural legacy of racism. The mask itself is a site of struggle with polarizing calls for freedom from the mask as tyranny and freedom through the mask as safety, all during a public health crisis. In Watchmen, the deployment of infrastructural control and the implications of masking and unmasking are enacted through racist ideologies and promises of safety through anonymity. [ FROM AUTHOR] Copyright of Television & New Media is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Sécurité et proximité: Conversation pratique et théorique pour sortir du cure et s'approcher du care en itinérance

Les pratiques d'intervention destinées aux personnes en situation d'itinérance (PSI) ont longtemps été des pratiques de contrôle social. À ces pratiques asilaires se sont superposées dans les dernières années de nouvelles approches de soin (care) (Aranguiz et Fecteau, 2000 ;Astier, 2007 ;Paperman et Laugier, 2011 ;Tronto, 1993). Parmi celles-ci, les pratiques de proximité se démarquent dans la création de liens d'intervention significatif auprès des PSI (Fontaine et al., 2019). Toutefois, dans le contexte actuel de la pandémie de la COVID-19, avec la fermeture des services et les éclosions, les relations de proximité ont été mises à l'épreuve. De l'automne 2020, jusqu'au printemps 2021, de nouvelles super structures ont vu le jour afin de répondre aux besoins des PSI qui ne pouvaient plus être comblés pour diverses raisons, entre autres liées à la pandémie. Rappelant les formes de prises en charge asilaires d'un autre siècle, ces dispositifs s'éloignent de façon draconienne des pratiques d'intervention de proximité. En parallèle, les pratiques de care tendent aussi à être de moins en moins reconnues, voire remplacées. Cet article se veut une réflexion pratique et théorique sur la manière dont la pandémie a affecté les pratiques d'intervention de proximité destinées aux PSI.Alternate :Intervention practices for people experiencing homelessness have long been practices of social control. In recent years, care approaches have been superimposed on asylum practices (Aranguiz & Fecteau, 2000;Astier, 2007;Paperman & Laugier, 2011;Tronto, 1993). Among these, proximity practices stand out in the creation of significant intervention relationship with homeless people (Fontaine et al., 2019). However, in the current context of the COVID-19 pandemic, with the shutdown of services and outbreaks, close relationships have been strained. From the Fall of 2020 until Spring 2021, new super structures have emerged to meet the needs of the homeless people that could no longer be met for various reasons, among others related to the pandemic. Reminiscent of the forms of asylum care from another century, these devices are drastically different from local intervention practices. At the same time, care practices also tend to be less and less recognized and are even sometimes replaced. This article is intended to reflect on how the pandemic has affected community intervention practices for PSI.

Psychology and Social Control: Milgram Experiment during Covid-19 Pandemic

As preventive measures have been applied by authorities to reduce exposure to, and the spread of, COVID-19 pandemic, it would be extremely important to understand how individuals respond to these new rules, especially the extent to which they are likely to follow or violate them. The exploration of social obedience is extremely important nowadays, due to the severity of the pandemic and the intense concern for the future, bringing to light one of the most famous experiments in the history of psychology, the Milgram experiment. The purpose of the experiment was to explore individuals' behavior, when they were requested to obey authorities/experts' orders/instructions, considering that these orders were opposed to their will, personal values, or conscience. Following the outbreak of the coronavirus pandemic, the conditions of social reality have tested individuals' limits of endurance and tolerance in terms of social obedience to power. Thoughts and reflections related to factors that could possibly affect social compliance and obedience are recorded in the present article. When do people choose not to comply with guidelines or regulations? Which could have been the effects of stressful situations, such as pandemics, on human behavior? Undoubtedly, the conflict between personal autonomy and protection of others always arises in periods of great threat to public health. Many people may disagree with some of the measures taken by authorities. Voluntary obedience to power and social compliance for the sake of the society may impose restrictions to individuals' freedoms, especially in the case of a pandemic. © 2022, Hellenic Nurses Association. All rights reserved.

Mass hysteria, manufacturing crisis and the legal reconstruction of acceptable exercise during a pandemic

There is a saying in that every crisis is an opportunity. Unfortunately, this seems to be applied more to politicians seeking to extend their powers over citizens, and less to citizens attempting to imagine new forms of accountable government. The Covid-19 pandemic has created an extraordinary shift in people's freedoms in a short space of time, with little interrogation or apparent concern with the legal basis of this shift. Exercise has been one area where citizens otherwise required to stay at home can perform some freedom. Yet many of the directives are confused and contradictory in explaining what exercise is permitted. Australian examples are used to illustrate these points and question whether the law is redefining exercise in ways that are arbitrary and discriminatory for a crisis now that may impact on the future practice of exercise. Is this legal control of exercise the harbinger of new forms of social control? (PsycInfo Database Record (c) 2023 APA, all rights reserved)

COVID-19, drug use and harm reduction: A comparative perspective from stakeholders in France and Quebec

People who use psychoactive substances and who attend drug treatment and harm reduction services represent groups whose vulnerabilities are exacerbated during a pandemic. We study the pandemic experience of people with problematic substance use and its impact on professional practices and policies, with an eye towards vulnerability and innovations. This comparative study was conducted in France and Quebec via semi-structured interviews with substance users (France, n=25;Quebec, n=15) and care and harm reduction providers (France, n=25;Quebec, n=18). We employ a pragmatist theoretical approach that reflexively analyzes the macro and micro levels together. During the first lockdown, professionals tried their best to organize a continuity of service to meet the needs of people in a context of a health emergency via the deployment of access to accommodation and the development of teleconsultation to ensure continuity of care. Innovative collaborations between actors occurred related to accommodation or the inclusion of harm reduction (alcohol and safe supply) in shelters. Difficulties were observed stemming from organizational constraints. Individuals adopted the preventive measures and had to endure social control both in the health and repressive fields. Beyond the vulnerabilities produced by COVID-19, adaptations also constitute opportunities for: solidarity between users and professionals, professional innovations, as well as new modes of collaboration and inter-actor organization. © 2022 Criminologie. All rights reserved.

The Formal-Informal Control Nexus During COVID-19: What Drives Informal Social Control of Social Distancing Restrictions During Lockdown?

The public rely on the police to enforce the law, and the police rely on the public to report crime and assist them with their enquiries. Police action or inaction can also impact on public willingness to informally intervene in community problems. In this paper we examine the formal-informal control nexus in the context of the COVID-19 pandemic. Drawing on a survey sample of 1,595 Australians during COVID-19 lockdown restrictions, we examine the relationship between police effectiveness, collective efficacy, and public willingness to intervene when others violate lockdown restrictions. We find that perceptions of police effectiveness in handling the COVID-19 crisis has a positive impact on the public's willingness to intervene when others violate lockdown restrictions.

Research on paths of opportunistic behavior avoidance and performance improvement in food supply chain from the perspective of social control.

It is essential to avoid opportunistic behaviors of food supply chain members to guarantee food safety and sustainable supply. This research adopted the perspective of supply chain membership governance to discuss the critical mechanisms of opportunistic behavior avoidance and performance improvement in the food supply chain. Two information-sharing mechanisms (information sharing with customers and information sharing with suppliers) were used as mediating variables to explore the mechanisms of how social control, information sharing, and opportunistic behavior worked on supply chain performance. Furthermore, an online questionnaire survey was conducted to collect 210 data samples from the food manufacturing industry in China, and the structural equation model method was applied to test the research hypotheses. According to the empirical research findings, social control can directly reduce opportunistic behaviors of supply chain members and reduce such behaviors indirectly via the mediating factor of information sharing; social control affects the supply chain performance via the mediating factors of information sharing and opportunistic behavior, instead of directly improving supply chain performance. Two information sharing mechanisms vary in their mechanism of influence. Information sharing with customers reduces opportunistic behaviors, but does not directly improve supply chain performance. Information sharing with suppliers enhances supply chain performance and reduces opportunistic behaviors. This research offers theoretical and practical suggestions for performance improvement and opportunistic behavior avoidance to promote food supply chain management.

COVID-19, usages de drogues et réduction des risques Analyse croisée des expériences et de l'impact de la pandémie en France et au Québec

Les personnes utilisatrices de substances qui fréquentent les services d'addictologie et de réduction des risques font partie des publics en situation de précarité dont les vulnérabilités sont aggravées en temps de pandémie. Notre article étudie l'expérience de la pandémie par ces personnes et l'impact de celle-ci sur les pratiques professionnelles et l'action publique, comme productrice d'inégalités mais aussi d'innovations et de solidarités. La collecte de données a été réalisée en France et au Québec, incluant des entretiens semi-directifs auprès de personnes usagères de substances (France, n = 25 ;Québec, n = 15) et de professionnels en addictologie et réduction des risques (France, n = 25 ;Québec, n = 18). Une approche théorique pragmatiste a été mise en oeuvre et analyse les niveaux macro et micro ensemble et de manière réflexive. Dès le premier confinement, les dispositifs professionnels ont tenté au mieux d'organiser une continuité de services afin de répondre aux besoins des usagers dans un contexte d'urgence sanitaire : par le déploiement de l'accès à l'hébergement, le développement de la téléconsultation afin d'assurer la continuité des soins. Des innovations ont été réalisées par des collaborations entre acteurs sur l'hébergement ou sur l'inclusion accélérée de la réduction des risques (alcool et approvisionnement sécuritaire) dans les centres d'hébergement. Des difficultés ont été également observées en lien avec des contraintes organisationnelles. Les usagers se sont bien approprié les mesures de prévention. Ils ont subi des logiques de contrôle social dans les champs sanitaire et répressif. Au-delà des vulnérabilités apportées par la COVID-19, des adaptations peuvent également constituer des opportunités de création de solidarités entre usagers et professionnels, des espaces favorables aux innovations professionnelles, et des nouveaux modes de collaboration et d'organisation entre acteurs.Alternate :People who use psychoactive substances and who attend drug treatment and harm reduction services represent groups whose vulnerabilities are exacerbated during a pandemic. We study the pandemic experience of people with problematic substance use and its impact on professional practices and policies, with an eye towards vulnerability and innovations. This comparative study was conducted in France and Quebec via semi-structured interviews with substance users (France, n=25 ;Quebec, n=15) and care and harm reduction providers (France, n=25 ;Quebec, n=18). We employ a pragmatist theoretical approach that reflexively analyzes the macro and micro levels together. During the first lockdown, professionals tried their best to organize a continuity of service to meet the needs of people in a context of a health emergency via the deployment of access to accommodation and the development of teleconsultation to ensure continuity of care. Innovative collaborations between actors occurred related to accommodation or the inclusion of harm reduction (alcohol and safe supply) in shelters. Difficulties were observed stemming from organizational constraints. Individuals adopted the preventive measures and had to endure social control both in the health and repressive fields. Beyond the vulnerabilities produced by COVID-19, adaptations also constitute opportunities for : solidarity between users and professionals, professional innovations, as well as new modes of collaboration and inter-actor organization.Alternate :Las personas que consumen sustancias y acuden a los servicios de adicción y reducción de riesgos se encuentran entre los grupos de población en situación de precariedad cuya vulnerabilidad se ha agravado durante la pandemia. Nuestro artículo estudia cómo estas personas han vivido la pandemia y el impacto de ésta en las prácticas profesionales y la acción pública, como productora de desigualdades, pero también de innovaciones y de solidaridad. La recogida de datos se llevó a cabo en Francia y en Quebec, incluyendo e trevistas semidirectivas con usuarios de sustancias (Francia, n=25 ;Quebec, n=15) y con profesionales del ámbito de la adicción y la reducción de riesgos (Francia, n=25 ;Quebec, n=18). Se utilizó un enfoque teórico pragmático, analizando conjuntamente los niveles macro y micro de forma reflexiva. Desde el primer confinamiento, los dispositivos profesionales trataron de organizar una continuidad de los servicios para responder a las necesidades de los usuarios en un contexto de emergencia sanitaria : se impulsó el acceso al alojamiento y se desarrolló la teleconsulta para garantizar la continuidad de los cuidados. Las innovaciones se han producido a través de la colaboración de los actores del sector del alojamiento o mediante la inclusión acelerada de la reducción de riesgos (alcohol y suministro seguro) en los centros de alojamiento. También se observaron dificultades en relación con las limitaciones organizativas. Los usuarios han integrado las medidas de prevención. Han sido sometidos a lógicas de control social en el ámbito sanitario y represivo. Más allá de las vulnerabilidades producidas por el COVID-19, las adaptaciones también pueden constituir oportunidades para la solidaridad entre usuarios y profesionales, espacios favorables a las innovaciones profesionales y nuevos modos de colaboración y organización entre los actores.