Families facing the Italian lockdown: Temporal adjustments and new caring practices in shared physical custody arrangements

Objective: This paper investigates the impact of the 2020 Covid-19 related Spring Lockdown in Italy on families practicing shared physical custody (SPC) arrangements for their children. Background: Those family configurations partly challenge the dominant 'mother as main carer model' that characterizes Italian society. Here, we consider the lockdown as a "challenge-trial" (Martucelli 2015) to analyze the strategies that these families have developed to cope with lockdown, and to reveal the overarching structures that contributed to shape this experience of lockdown. Method: We draw on semi-structured interviews with 19 parents (9 fathers and 10 mothers), part of 12 families practicing SPC. Results: We propose a typology of custody re-organizations during lockdown and how this affected the division of parental involvement based on a) change/no change in sleepover calendars in favor of mother/father;and b) similar/different arrangements for siblings - a new practice that emerged and also has implications for the division of childcare between parents. Four types are identified where we emphasize new parenting practices and the role played by material housing configurations, relations and tensions between family members, as well as balancing work, school and childcare. Conclusion: We highlight the usefulness of applying a "challenge-trial" lens to the study of family life under lockdown, and the need to complexify research on gender equality in shared parenting and on sibling relationships in post-divorce families.

Exploring Risks of Human Challenge Trials For COVID-19.

Human challenge trials (HCTs) are a potential method to accelerate development of vaccines and therapeutics. However, HCTs for COVID-19 pose ethical and practical challenges, in part due to the unclear and developing risks. In this article , we introduce an interactive model for exploring some risks of a severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) dosing study, a prerequisite for any COVID-19 challenge trials. The risk estimates we use are based on a Bayesian evidence synthesis model which can incorporate new data on infection fatality risks (IFRs) to patients, and infer rates of hospitalization. The model estimates individual risk, which we then extrapolate to overall mortality and hospitalization risk in a dosing study. We provide a web tool to explore risk under different study designs. Based on the Bayesian model, IFR for someone between 20 and 30 years of age is 15.1 in 100,000, with a 95% uncertainty interval from 11.8 to 19.2, while risk of hospitalization is 130 per 100,000 (100-160). However, risk will be reduced in an HCT via screening for comorbidities, selecting lower-risk population, and providing treatment. Accounting for this with stronger assumptions, we project the fatality risk to be as low as 2.5 per 100,000 (1.6-3.9) and the hospitalization risk to be 22.0 per 100,000 (14.0-33.7). We therefore find a 50-person dosing trial has a 99.74% (99.8-99.9%) chance of no fatalities, and a 98.9% (98.3-99.3%) probability of no cases requiring hospitalization.

Evaluating Use Cases for Human Challenge Trials in Accelerating SARS-CoV-2 Vaccine Development.

Human challenge trials (HCTs) have been proposed as a means to accelerate SARS-CoV-2 vaccine development. We identify and discuss 3 potential use cases of HCTs in the current pandemic: evaluating efficacy, converging on correlates of protection, and improving understanding of pathogenesis and the human immune response. We outline the limitations of HCTs and find that HCTs are likely to be most useful for vaccine candidates currently in preclinical stages of development. We conclude that, while currently limited in their application, there are scenarios in which HCTs would be extremely beneficial. Therefore, the option of conducting HCTs to accelerate SARS-CoV-2 vaccine development should be preserved. As HCTs require many months of preparation, we recommend an immediate effort to (1) establish guidelines for HCTs for COVID-19; (2) take the first steps toward HCTs, including preparing challenge virus and making preliminary logistical arrangements; and (3) commit to periodically re-evaluating the utility of HCTs.