Experiences of the Migrant Farmworkers during the Syndemic Due to COVID-19 in Spain

The present article addresses the COVID-19 syndemic, that is, the interaction of SARS-CoV-2 with other diseases that interact and are determined by patterns of social inequality. The living and working conditions of migrant farmworkers increases the transmission of COVID-19. Descriptions of the experiences of migrant farmworkers provided by the professionals from different organizations that tend to them allowed the authors to discover the syndical nature of COVID-19. This study is based on qualitative descriptive research. Seventeen workers from different organizations participated in the study, through in-depth interviews between January and June 2022. A thematic analysis was performed to analyze the qualitative data. Two main themes emerged: Non-compliance with the collective labor agreement, and non-compliance with workplace health and safety standards. The results suggest that the adverse living and working conditions of the migrant farmworkers increased their risk of COVID-19 infection, due to the lack of compliance with the health measures decreed. The vulnerability experienced by migrant farmworkers increased work conflicts and prompted their mobilization to fight for their rights. © 2023 by the authors.

Increased prevalence of depression and anxiety among adults initiating antiretroviral therapy during the COVID-19 pandemic in Shinyanga region, Tanzania.

BACKGROUND: Concerns about the interconnected relationship between HIV and mental health were heightened during the COVID-19 pandemic. This study assessed whether there were temporal changes in the mental health status of people living with HIV presenting for care in Shinyanga region, Tanzania. Specifically, we compared the prevalence of depression and anxiety before and during COVID-19, with the goal of describing the changing needs, if any, to person-centered HIV services. METHODS: We analyzed baseline data from two randomized controlled trials of adults initiating ART in Shinyanga region, Tanzania between April-December 2018 (pre-COVID-19 period, n = 530) and May 2021-March 2022 (COVID-19 period, n = 542), respectively. We compared three mental health indicators that were similarly measured in both surveys: loss of interest in things, hopelessness about the future, and uncontrolled worrying. We also examined depression and anxiety which were measured using the Hopkins Symptom Checklist-25 in the pre-COVID-19 period and the Patient Health Questionnaire-4 in the COVID-19 period, respectively, and classified as binary indicators per each scale's threshold. We estimated prevalence differences (PD) in adverse mental health status before and during the COVID-19 pandemic, using stabilized inverse probability of treatment weighting to adjust for underlying differences in the two study populations. RESULTS: We found significant temporal increases in the prevalence of feeling 'a lot' and 'extreme' loss of interest in things ['a lot' PD: 38, CI 34,41; 'extreme' PD: 9, CI 8,12)], hopelessness about the future [' a lot' PD: 46, CI 43,49; 'extreme' PD: 4, CI 3,6], and uncontrolled worrying [' a lot' PD: 34, CI 31,37; 'extreme' PD: 2, CI 0,4] during the COVID-19 pandemic. We also found substantially higher prevalence of depression [PD: 38, CI 34,42] and anxiety [PD: 41, CI 37,45]. CONCLUSIONS: After applying a quasi-experimental weighting approach, the prevalence of depression and anxiety symptoms among those starting ART during COVID-19 was much higher than before the pandemic. Although depression and anxiety were measured using different, validated scales, the concurrent increases in similarly measured mental health indicators lends confidence to these findings and warrants further research to assess the possible influence of COVID-19 on mental health among adults living with HIV. Trial Registration NCT03351556, registered November 24, 2017; NCT04201353, registered December 17, 2019.

Diabetes and tuberculosis syndemic in India: A narrative review of facts, gaps in care and challenges.

Both diabetes mellitus (DM) and tuberculosis (TB) are prevalent all across in India. TB-DM comorbidity has emerged as a syndemic and needs more attention in India considering gaps in screening, clinical care, and research. This paper is intended to review published literature on TB and DM in India to understand the burden of the dual epidemic and its trajectory and to obtain perspectives on the gaps, constraints, and challenges in care and treatment of this dual epidemic. A literature search was carried out on PubMed, Scopus, and Google Scholar, using the key words 'Tuberculosis' OR 'TB' AND 'Diabetes' OR 'Diabetes Mellitus' AND 'India', focusing on the research published between the year 2000 to 2022. The prevalence of DM is high in patients with TB. Quantitative data on the epidemiological situation of TB/DM in India such as incidence, prevalence, mortality, and management are lacking. During the last 2 years convergence of TB-DM syndemic with the COVID-19 pandemic has increased cases with uncontrolled DM but also made coordinated control of TB-DM operationally difficult and of low effectiveness. Research regarding TB-DM comorbidity is required in the context of epidemiology and management. Detection and bidirectional screening are aggressively warranted. Management of DM in those with TB-DM comorbidity needs more efforts, including training and supervision of frontline workers.

An Agenda for Advancing Research and Prevention at the Nexus of Work Organization, Occupational Stress, and Mental Health and Well-Being.

Work characteristics and worker well-being are inextricably connected. In particular, the characteristics of work organization shape and perpetuate occupational stress, which contributes to worker mental health and well-being outcomes. Consequently, the importance of understanding and addressing connections between work organization, occupational stress, and mental health and well-being-the focus of this Special Issue-increasingly demand attention from those affected by these issues. Thus, focusing on these issues in the long-haul truck driver (LHTD) sector as an illustrative example, the purpose of this commentary is as follows: (1) to outline current research approaches and the extant knowledge base regarding the connections between work organization, occupational stress, and mental health; (2) to provide an overview of current intervention strategies and public policy solutions associated with the current knowledge base to protect and promote worker mental health and well-being; and (3) to propose a two-pronged agenda for advancing research and prevention for workers during the 21st century. It is anticipated that this commentary, and this Special Issue more broadly, will both echo numerous other calls for building knowledge and engaging in this area and motivate further research within complementary current and novel research frameworks.

Reshaping Investor-State Dispute Settlement Before the Next Syndemic

In the midst of a legitimacy crisis in investor-State dispute settlement regime, COVID-19 syndemic may lead States to the perfect storm as a result of the enlargement of the national policy space in order to tackle health, social and economic impacts. Thus, this piece aims to identify measures adopted by Latin American States which may be challenged by foreign investors' claims. It also addresses the protection of national policy space and argues that the roadmap for reshaping the regime should include the following options: 1) moratorium on pending disputes and restriction on future claims related to COVID-19 measures;2) introduction of counterclaims as a general rule;3) reference to right to regulate in investment agreements;4) exclusion of protected areas or policies. © 2023 Universidad Nacional Autonoma de Mexico. All rights reserved.

Approaches to COVID-19: bioethics, empathy and the Spinozian perspective

COVID-19 is a sanitary and humanitarian crisis featured among the greatest pandemics humanity has ever known. This article highlights its syndemic character, taken on by encountering populations with greater economic, social, and environmental vulnerability. Before such contexts, the essay proposes an ontological reflection about the human being and how moral enhancement can facilitate empathetic dialogues that generate national and international solidary solutions during pandemic crises. For this purpose, it draws upon the concepts of syndemic, bioethics, ontology, moral enhancement, facilitator, dialogue, dialectics, empathy, conatus, affections, appetite, desire, and continuum and their potential for reducing harm during COVID-19. Finally, this paper will conclude with a brief discussion based on Spinoza's rationalist perspective. © 2023, Conselho Federal de Medicina. All rights reserved.

Moving forward: Words of wisdom from nurse leaders

Nurses were omnipresent during the COVID-19 pandemic, caring for patients in the ICU, helping with triage, working with children in schools, administering vaccines, running command centers, and so much more. The challenges have been formidable, but nurses stepped up to the plate, supported by nurse leaders. In this chapter, several nurse leaders reflect on lessons learned during this pandemic, including the critical importance of healthy work environments and the need for solidarity among nurses and all healthcare providers who make care for COVID-19 patients and programs of prevention possible. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022. All rights reserved.

A community psychology for migrant justice: Critically examining border violence and resistance during the COVID-19 syndemic.

This article explores the magnifying lenses of the COVID-19 syndemic to highlight how people racialized as migrants and refugees have been-and continue to be-disproportionally harmed. We use empirical evidence collected in our scholarly/activist work in Europe, Africa, South Asia, and the United States to examine migrant injustice as being produced by a combination of power structures and relations working to maintain colonial global orders and inequalities. This is what has been defined as "border imperialism." Our data, complemented by evidence from transnational solidarity groups, show that border imperialism has further intersected with the hygienic-sanitary logics of social control at play during the COVID-19 period. This intersection has resulted in increasingly coercive methods of restraining people on the move, as well as in increased-and new-forms of degradation of their lives, that is, an overall multiplication of border violences. At the same time, however, COVID-19 has provided a unique opportunity for grassroot solidarity initiatives and resistance led by people on the move to be amplified and extended. We conclude by emphasizing the need for community psychologists to take a more vigorous stance against oppressive border imperialist regimes and the related forms of violence they re/enact.

Politics During and After Covid-19: Science, Health and Social Protest

Covid-19 represented a total social fact, especially for that part of the world (the so-called Global North and in particular its wealthier component) which is less used to face dramatic crises able to affect fundamental rights and provoke health threats on a daily basis. While acknowledging its enormous impact on individual biographies, political systems and socio-economic equilibria around the planet, however we contrast those interpretations that have tended to naturalize the pandemic event, reading it as unpredictable, unique, disconnected from the dynamics that guide the (mainstream) Western lifestyle and mode of production. On the contrary, the genesis and above all the management of Covid-19 are the result and the mirror of broader dynamics linked to modernity, colonialism, capitalism, in one word of the Capitalocene. For this reason, it is even more correct to speak of a syndemic, to underline the environmental determinants of health, and the social and economic inequalities (re)produced by Covid-19. We therefore consider that interpreting the pandemic/syndemic (and its governance) as a state of exception is at least partial, being instead more useful to identify its unveiling function, able to make some latent or less visible dynamics manifest. Based on such premises, we focus on some nodes of the syndemic governance, highlighting how this contributed to give continuity and accelerate typical dynamics of a neoliberal governance and worldvision. We deal in particular with four key issues: the treatment of "science " by the media;the political history of "public health " and its relationship to the modern state;the construction of legitimate dissent vs. the constructed irrationality of "conspiracy theory ";the outcomes of social protests and in particular their pathologization in the mediatic and public debate. These are also among the main topics which are critically discussed in the thirteen papers that compose this Special Issue, from a variety of disciplinary fields, and with diverse epistemological perspectives and methodological tools.

Redefinition of Social Ties During the COVID-19 pandemic: Narratives of People who Relate with Each Other in Gated Communities

This article describes the research process that revolves around the resignation of social ties in the narratives of two residential complexes: Arboleda I and Casablanca stage II of the city of Bogota D.C, during the COVID-19. To this end, the current situation is recognized by pointing out the basic conceptions oriented to the COVID-19, from the elements of its emergence, its expansion, the measures taken by the Colombian government, as well as the attitude of civil society in residential complexes. The article covers the understanding of the subjectivities of actors who with their voices relate their experiences around social ties, highlighting the uniqueness of the community, organizational aspects, and technological means, among others. The methodology used is qualitative, in the line of narrative research;Subsequently, a relational analysis leads to results that show the different modifications that the inhabitants have experienced in the way of linking at the branch level, selective, organic and citizen participation in times of health emergency.

Corrigendum: Cardio-oncology in the COVID Era (Co & Co): The never-ending story.

[This corrects the article DOI: 10.3389/fcvm.2022.821193.].

The Syndemic of Inequity and COVID-19 in Virtual Care.

The critical intersections of structural inequities and vulnerabilities of marginalized populations, particularly those engaging the social gradient of minority ethnic communities, are revealed in the syndemic approach to COVID-19. Although proposals for cultural interventions to improve virtual care provide relevant measures, they may not address the root cause of the disparate impacts of a pandemic on population subgroups. The common misperception of equality as synonymous with equity further impedes the efficacy of digital health in quality-of-care initiatives, as it systemically fails to acknowledge the disparate realities of marginalized populations, while intending to benefit all. This commentary suggests that an alignment of the health care system with Canada's pluralist principles would support a paradigm shift in transforming virtual care into an equitable standard as envisioned by Pham and colleagues in their paper, "The Future of Virtual Care for Older Ethnic Adults Beyond the COVID-19 Pandemic."

Epidemics of Neglect

The COVID-19 pandemic has exposed multiple fault lines in the performances of health services at every level – from community to national to global – in ensuring universal, equitable access to preventive and curative care. Tragically, this has been to the detriment of those who have suffered and died not only from COVID-19, but also from the myriad other ailments affecting people around the world. Of those, we wish to highlight here some key categories of diseases that have caused a greater burden of illness and deaths as a consequence of the policies and political decisions made in relation to the COVID-19 pandemic. In our view, these should be considered epidemics or, more accurately, syndemics – the clustering and interactions of two or more diseases or health conditions and socio-environmental factors – of neglect.

Agribusiness and the COVID-19 syndemic: The unsustainable pathways.

It has been suggested that it would be more appropriate to term the COVID-19 pandemic a syndemic, as the infection interacts synergistically with pre-existing chronic conditions such as obesity. Both conditions occur with steep socio-economic inequalities, and Brazil is suffering a heavy burden from both. What and who drives the clustering and interaction of these disorders? In this commentary, we examine the pathways leading to the COVID-19 syndemic. Deforestation, declining biodiversity and factory farming are promoting the emergence of new pathogens. Widespread use of pesticides influences immune, endocrine and metabolic systems. The ingestion of ultra-processed food promotes malnutrition and obesity in a country where at the same time poverty and food insecurity is rising. Brazilian agribusiness is focused on the production and global export of agricultural commodities, mainly for animal food and meat production. It is made possible through a combination of expanded land use, with deforestation in Amazonas and other Brazilian biomes, and the intensification of land use and cultivation of genetically modified crops with fertilizers and pesticides. This development is not sustainable for either population health or the environment.

PURITY AND DANGER IN SPANISH AGRICULTURE: FARM WORKERS DURING THE PANDEMIC

The aim of this paper is to carry out a sociological analysis of the implications of what could be referred to as the paradox of farm labourers during the pandemic. That is, their designation as essential workers turned them simultaneously into high-risk workers and a source of public alarm. Based on the analysis of the logics of purity and danger of Mary Douglas (1991), this article analyses how some of the public health strategies developed by the institutions during the pandemic contributed to reinforcing the invisibility and vulnerability of migrant workers. The article shows how, being placed in the realm of the impure and dangerous, foreign agricultural workers were not able to receive the health care they required, and their living spaces thus became environments conducive to the spread of the virus. Through an exploration of secondary sources, a review of pertinent documents and in-depth interviews with key informants, this article firstly offers a description of the institutional process by which foreign agricultural workers in the Region of Murcia were converted into essential workers facilitated the spread of infections. Secondly, it explores the link between the precariousness of the working and living conditions of farm labourers and the absence of the ethics of self-care, which was at the heart of the chain of Covid-19 infections suffered by this population. Finally, it focuses on institutional responses to the threat posed by the threat posed by increased infections among immigrant farm workers. Copyright ©2022 CSIC.

[Syndemics and non infectious diseases]

The concept of "syndemics" is getting more and more popularity in scientific journals, especially since the end of the first decade of the current century. It relates to the dynamic interaction of synchronous or sequential diseases (whether communicable or not, also including mental diseases), with social and environmental factors, resulting at the end in a worse global outcome. A first article in the same Journal (1) was devoted to infectious diseases, especially COVID-19 and HIV infections. In this second article, we highlight the fact that the concept is also applicable on diseases which are not transmitted by infectious pathogens. The importance of considering action within the field of social determinants of care will be illustrated by a limited selection of examples.

From pandemic to syndemic: microbiota, pregnancy, and environment at a crossroad.

Aim: SARS-CoV2 is the latest pandemic that have plagued the socio-health system as an epiphenomenon resulting from planetary resources abuse, crucial for biodiversity. The Anthropocene best defines the present epoch in which human activity irreversibly manipulates intricate and delicate geological and biological balances established over eons. The devastating ecological and socio-economic implications of COVID-19, underline the importance of updating the present pandemic framework to a syndemic. This paper stems from the need to suggest to scientists, doctors, and patients a mission that integrates responsibility from individual to collective health, from present to trans-generational, from human to the entire biotic network. Today's choices are crucial for the perspective on all levels: political, economic, and health as well as cultural.Methods: Research on PubMed and other specific web-sites journal was performed on the topic "Microbiota", "Covid-19", "Pandemic", "Zoonosis", "SARS-CoV-2", "Environmental Pollutants", "Epigenetics", "Fetal Programming", "Human Extinction". Data collected were analysed for an integrative model of interconnection between environment, pregnancy, SARS-CoV-2 infection, and microbiota. Moreover, systematic literature review allowed to summarise in a table information about the worst pandemics that afflicted the human species recently.Results: This paper offers a broad view of the current pandemic starting with pregnancy, the moment when a new life begins and the health trajectories of the unborn child are defined, which will inevitably have repercussions on his well-being. The fundamental role of the biodiversity-rich microbiota in avoiding the development of severe infectious diseases, is therefore highlighted. It is imperative to adjust the current reductionist paradigm based on mostly immediate symptom management towards a broader understanding of the spatial interconnection of ecological niches with human health and the impacts of today's choices on the future. Health and healthcare are elitist rather than egalitarian, therefore focusing on environmental health forces us to make a concerted and systemic effort that challenges political and economic barriers, which are biologically senseless. A healthy microbiota is essential to well-being, both by preventing chronic degenerative conditions, the infectiousness and pathogenicity of bacterial and viral diseases. SARS-CoV-2 should not be an exception. The human microbiota, forged by the first 1,000 days of life, is fundamental in shaping the health-disease trajectories, and by the everlasting exposome that is dramatically affected by the ecological disaster. Individual health is one world health whereas single and global well-being are interdependent in a space-time perspective.Conclusions: Is it not a convenient reductionism not to consider the COVID-19 emergency as a bio-social epiphenomenon of a far more devastating and multi-faceted crisis whose common denominator is the global biotic network loss of which humans are still part?

Nuclear Cardiology in the Post-COVID Era: What Will Be Its Legacy?

The pandemic of Coronavirus disease 2019 (COVID-19) caused a substantial negative impact on patients with cardiovascular disease. The negative impact of the pandemic on daily clinical practices for cardiovascular diseases (CVD) cannot be underestimated. The CVD patients (without COVID-19 infection), whose diagnosis and treatment have been delayed or postponed by the pandemic, are victims of COVID-19. In this context, COVID-19 is a "syndemic" disease. Several studies already revealed that negative changes already occurred in CVD patient management, such as increased in-hospital death, supply shortage of 99mTc/99Mo generator, etc. To clarify the impact of COVID-19 on the management of CVD, a global survey named "INCAPS-COVID" was conducted. This study revealed a substantial reduction (around 50%) of cardiovascular imaging practice in the early stage of the pandemic during March and April 2020. This pandemic has necessitated changes in cardiovascular management practices to adopt this condition. Some of those changes will become the legacy of the pandemic. Possible legacy will be; 1) Use of telemedicine; 2) Shift from exercise to pharmacological stress; 3) Shift from single photon emission computed tomography (SPECT) to positron emission tomography (PET). By adapting and changing to the challenges caused by the COVID-19 pandemic, nuclear cardiology will survive and will rise as an improved cardiovascular practice, even after the pandemic.

Purity, Danger, and Patriotism: The Struggle for a Veteran Home during the COVID-19 Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic rendered congregate shelter settings high risk, creating vulnerability for people experiencing homelessness (PEH). This study employed participant observation and interviews over 16 months in two Veteran encampments, one located on the grounds of the West Los Angeles Veteran Affairs Medical Center (WLAVA) serving as an emergency COVID-19 mitigation measure, and the other outside the WLAVA gates protesting the lack of onsite VA housing. Study participants included Veterans and VA personnel. Data were analyzed using grounded theory, accompanied by social theories of syndemics, purity, danger, and home. The study reveals that Veterans conceptualized home not merely as physical shelter but as encompassing a sense of inclusion and belonging. They sought a Veteran-run collective with a harm reduction approach to substance use, onsite healthcare, and inclusive terms (e.g., no sobriety requirements, curfews, mandatory treatment, or limited lengths of stay). The twin encampments created distinct forms of community and care that protected Veterans from COVID-19 infection and bolstered collective survival. The study concludes that PEH constitute and belong to communities that provide substantial benefits even while amplifying certain harms. Housing interventions must consider how unhoused individuals become, or fail to become, integrate into various communities, and foster therapeutic community connections.

Syndemic health crises-The growing role of National Public Health Institutes in shaping a coordinated response.

Countries across the world are experiencing syndemic health crises where infectious pathogens including COVID-19 interact with epidemics of communicable and non-communicable diseases. Combined with war, environmental instability and the effects of soaring inflation, a public health crisis has emerged requiring an integrated response. Increasingly, national public health institutes (NPHIs) are at the forefront of leading this, as demonstrated at the 2022 Annual Meeting of the International Association of National Public Health Institutes (IANPHI). These effects are particularly evident where conflict is exacerbating health crises in Ukraine and Somalia. In Ukraine, medical and public health workers have been killed and infrastructure destroyed, which require major efforts to rebuild to international standards. In Somalia, these crises are magnified by the effects of climate change, leading to greater food insecurity, heat-related deaths and famine. National public health institutes are crucial in these contexts and many others to support integrated political responses where health challenges span local, national and international levels and involve multiple stakeholders. This can be seen in strengthening of Integrated Disease Surveillance and work towards the Sustainable Development Goals. National public health institutes also provide integration through the international system, working jointly to build national capacities to deliver essential public health functions. In this context, the 2022 IANPHI Annual meeting agreed the Stockholm Statement, highlighting the role that NPHIs play in tackling the causes and effects of interconnected global and local challenges to public health. This represents an important step in addressing complex health crises and syndemics which require whole-of-society responses, with NPHIs uniquely placed to work across sectors and provide system leadership in response.