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1.
PLoS One ; 16(9): e0255498, 2021.
Article in English | MEDLINE | ID: covidwho-1410655

ABSTRACT

BACKGROUND: Overcrowded housing, as well as inadequate sanitary conditions, contribute to making homeless people particularly vulnerable to the SARS-CoV-2 infection. We aimed to assess the seroprevalence of the SARS-CoV-2 infection among people experiencing homelessness on a large city-wide scale in Marseille, France, taking into account different types of accommodation. METHODS: A consortium of outreach teams in 48 different locations including streets, slums, squats, emergency or transitional shelters and drop-in centres participated in the inclusion process. All participants consented to have a validated rapid antibody assay for immunoglobulins M (IgM) and G (IgG) and to answer a questionnaire on medical health conditions, comorbidities, and previous COVID-19 symptoms. Information on their housing conditions since the COVID-19 crisis was also collected from the participants. RESULTS: From June 01 to August 05, 2020, 1,156 homeless participants were enrolled in the study and tested. The overall seroprevalence of SARS-CoV-2 IgG/IgM antibodies was 5.6% (95%CI 2.3-7.0), ranging from 2.2% in people living on the streets to 8.1% in people living in emergency shelters (P = 0.009). Around one third of the seropositive participants reported COVID-19 symptoms. Compared to the general population in Marseille (3.6%), the homeless population living in the same urban area experienced a significantly increased risk of SARS-CoV-2 infection (|z| = 3.65 > 1.96). CONCLUSION: These findings highlight the need for regular screening among the homeless to prevent clustering in overcrowded or inadequate accommodations. It is also necessary to provide essential resources to keep homeless people healthy, the vast majority of whom have cumulative risk factors for SARS-CoV-2 infection.


Subject(s)
Antibodies, Viral/immunology , COVID-19/diagnosis , Homeless Persons/statistics & numerical data , Housing/statistics & numerical data , SARS-CoV-2/immunology , Surveys and Questionnaires/statistics & numerical data , Adult , Aged , Antibodies, Viral/blood , COVID-19/epidemiology , COVID-19/virology , Cross-Sectional Studies , Epidemics/prevention & control , Female , France/epidemiology , Geography , Housing/standards , Humans , Immunoglobulin G/blood , Immunoglobulin G/immunology , Immunoglobulin M/blood , Immunoglobulin M/immunology , Male , Middle Aged , Population Surveillance/methods , SARS-CoV-2/physiology , Seroepidemiologic Studies
2.
PLoS One ; 16(9): e0256921, 2021.
Article in English | MEDLINE | ID: covidwho-1410627

ABSTRACT

Using a nationwide survey of primary grocery shoppers conducted in August 2020, we examine household food spending when the economy had partially reopened and consumers had different spending opportunities in comparison to when the Covid-19 lockdown began. We estimate the impact of Covid-19 on household spending using interval and Order Probit regressions. Income levels, age, access to grocery stores and farmers markets, household demographic information, along with other independent variables are controlled in the model. Findings show that middle-class households (with income below $50,000, or with income between $50,000 and $99,999) are less likely to increase their grocery expenditures during the pandemic. Households with children or elderlies that usually require higher food quality and nutrition intakes had a higher probability of increasing their spending during Covid-19 than before. Furthermore, consumers' spending behaviors were also significantly affected by their safe handing levels and the Covid-19 severity and food accessibility in their residences.


Subject(s)
COVID-19/prevention & control , Communicable Disease Control/economics , Family Characteristics , Food/statistics & numerical data , Surveys and Questionnaires/statistics & numerical data , Aged , COVID-19/epidemiology , COVID-19/virology , Child , Consumer Behavior/statistics & numerical data , Costs and Cost Analysis , Epidemics/prevention & control , Housing/standards , Housing/statistics & numerical data , Humans , Income/statistics & numerical data , SARS-CoV-2/physiology , Time Factors , United States
4.
BMJ Open Respir Res ; 8(1)2021 08.
Article in English | MEDLINE | ID: covidwho-1350028

ABSTRACT

BACKGROUND: Ethnic minorities account for 34% of critically ill patients with COVID-19 despite constituting 14% of the UK population. Internationally, researchers have called for studies to understand deterioration risk factors to inform clinical risk tool development. METHODS: Multicentre cohort study of hospitalised patients with COVID-19 (n=3671) exploring determinants of health, including Index of Multiple Deprivation (IMD) subdomains, as risk factors for presentation, deterioration and mortality by ethnicity. Receiver operator characteristics were plotted for CURB65 and ISARIC4C by ethnicity and area under the curve (AUC) calculated. RESULTS: Ethnic minorities were hospitalised with higher Charlson Comorbidity Scores than age, sex and deprivation matched controls and from the most deprived quintile of at least one IMD subdomain: indoor living environment (LE), outdoor LE, adult skills, wider barriers to housing and services. Admission from the most deprived quintile of these deprivation forms was associated with multilobar pneumonia on presentation and ICU admission. AUC did not exceed 0.7 for CURB65 or ISARIC4C among any ethnicity except ISARIC4C among Indian patients (0.83, 95% CI 0.73 to 0.93). Ethnic minorities presenting with pneumonia and low CURB65 (0-1) had higher mortality than White patients (22.6% vs 9.4%; p<0.001); Africans were at highest risk (38.5%; p=0.006), followed by Caribbean (26.7%; p=0.008), Indian (23.1%; p=0.007) and Pakistani (21.2%; p=0.004). CONCLUSIONS: Ethnic minorities exhibit higher multimorbidity despite younger age structures and disproportionate exposure to unscored risk factors including obesity and deprivation. Household overcrowding, air pollution, housing quality and adult skills deprivation are associated with multilobar pneumonia on presentation and ICU admission which are mortality risk factors. Risk tools need to reflect risks predominantly affecting ethnic minorities.


Subject(s)
Air Pollution/analysis , Benchmarking/methods , COVID-19/therapy , Housing/standards , Patient Admission , Risk Assessment/methods , Age Distribution , Age Factors , Aged , COVID-19/ethnology , Comorbidity , Crowding , Female , Follow-Up Studies , Humans , Male , Middle Aged , Multimorbidity , Risk Factors , SARS-CoV-2 , United Kingdom/epidemiology
7.
J Public Health Manag Pract ; 27(3): 285-294, 2021.
Article in English | MEDLINE | ID: covidwho-1150043

ABSTRACT

CONTEXT: Local agencies across the United States have identified public health isolation sites for individuals with coronavirus disease 2019 (COVID-19) who are not able to isolate in residence. PROGRAM: We describe logistics of establishing and operating isolation and noncongregate hotels for COVID-19 mitigation and use the isolation hotel as an opportunity to understand COVID-19 symptom evolution among people experiencing homelessness (PEH). IMPLEMENTATION: Multiple agencies in Atlanta, Georgia, established an isolation hotel for PEH with COVID-19 and noncongregate hotel for PEH without COVID-19 but at risk of severe illness. PEH were referred to the isolation hotel through proactive, community-based testing and hospital-based testing. Daily symptoms were recorded prospectively. Disposition location was recorded for all clients. EVALUATION: During April 10 to September 1, 2020, 181 isolation hotel clients (77 community referrals; 104 hospital referrals) were admitted a median 3 days after testing. Overall, 32% of community referrals and 7% of hospital referrals became symptomatic after testing positive; 83% of isolation hotel clients reported symptoms at some point; 93% completed isolation. Among 302 noncongregate hotel clients, median stay was 18 weeks; 61% were discharged to permanent housing or had a permanent housing discharge plan. DISCUSSION: Overall, a high proportion of PEH completed isolation at the hotel, suggesting a high level of acceptability. Many PEH with COVID-19 diagnosed in the community developed symptoms after testing, indicating that proactive, community-based testing can facilitate early isolation. Noncongregate hotels can be a useful COVID-19 community mitigation strategy by bridging PEH at risk of severe illness to permanent housing.


Subject(s)
COVID-19/prevention & control , Guidelines as Topic , Homeless Persons/statistics & numerical data , Housing/standards , Public Health/standards , Quarantine/standards , Social Isolation , Adolescent , Adult , Aged , Aged, 80 and over , Disease Management , Female , Georgia/epidemiology , Housing/statistics & numerical data , Humans , Male , Middle Aged , Public Health/statistics & numerical data , Quarantine/statistics & numerical data , SARS-CoV-2 , Young Adult
8.
J R Soc Med ; 114(4): 182-211, 2021 04.
Article in English | MEDLINE | ID: covidwho-1148193

ABSTRACT

OBJECTIVE: To estimate the proportion of ethnic inequalities explained by living in a multi-generational household. DESIGN: Causal mediation analysis. SETTING: Retrospective data from the 2011 Census linked to Hospital Episode Statistics (2017-2019) and death registration data (up to 30 November 2020). PARTICIPANTS: Adults aged 65 years or over living in private households in England from 2 March 2020 until 30 November 2020 (n=10,078,568). MAIN OUTCOME MEASURES: Hazard ratios were estimated for COVID-19 death for people living in a multi-generational household compared with people living with another older adult, adjusting for geographic factors, socioeconomic characteristics and pre-pandemic health. RESULTS: Living in a multi-generational household was associated with an increased risk of COVID-19 death. After adjusting for confounding factors, the hazard ratios for living in a multi-generational household with dependent children were 1.17 (95% confidence interval [CI] 1.06-1.30) and 1.21 (95% CI 1.06-1.38) for elderly men and women. The hazard ratios for living in a multi-generational household without dependent children were 1.07 (95% CI 1.01-1.13) for elderly men and 1.17 (95% CI 1.07-1.25) for elderly women. Living in a multi-generational household explained about 11% of the elevated risk of COVID-19 death among elderly women from South Asian background, but very little for South Asian men or people in other ethnic minority groups. CONCLUSION: Elderly adults living with younger people are at increased risk of COVID-19 mortality, and this is a contributing factor to the excess risk experienced by older South Asian women compared to White women. Relevant public health interventions should be directed at communities where such multi-generational households are highly prevalent.


Subject(s)
COVID-19 , Family Characteristics/ethnology , Housing , Mortality/ethnology , Residence Characteristics/statistics & numerical data , Age Factors , Aged , COVID-19/mortality , COVID-19/prevention & control , Child , England/epidemiology , Family , Female , Health Status Disparities , Housing/standards , Housing/statistics & numerical data , Humans , Male , Risk Assessment , SARS-CoV-2 , Sex Factors , Socioeconomic Factors
9.
Ciênc. Saúde Colet ; 26(3): 1023-1033, mar. 2021. tab, graf
Article in Portuguese | LILACS (Americas) | ID: covidwho-1138614

ABSTRACT

Resumo A vulnerabilidade é um fator chave no enfrentamento da COVID-19 tendo em vista que pode influenciar no agravamento da doença. Desse modo, ela deve ser considerada no controle da COVID-19, prevenção e promoção da saúde. O objetivo deste artigo é analisar a distribuição espacial da incidência de casos de COVID-19 em uma metrópole brasileira e sua associação com indicadores de vulnerabilidade social. Estudo ecológico. Foi utilizada a análise de varredura espacial (scan) para identificar aglomerados de COVID-19. As variáveis para identificação da vulnerabilidade foram inseridas em um modelo de Regressão Espacial Geograficamente Ponderado (GWR) para identificar sua relação espacial com os casos de COVID-19. A incidência de COVID-19 em Fortaleza foi de 74,52/10 mil habitantes, com notificação de 3.554 casos, sendo pelo menos um caso registrado em cada bairro. A regressão espacial GWR mostrou relação negativa entre incidência de COVID-19 e densidade demográfica (β=-0,0002) e relação positiva entre incidência de COVID-19 e percentual de ocupados >18 anos trabalhadores autônomos (β=1,40), assim como, renda domiciliar per capita máxima do quinto mais pobre (β=0,04). A influência dos indicadores de vulnerabilidade sobre a incidência evidenciou áreas que podem ser alvo de políticas públicas a fim de impactar na incidência de COVID-19.


Abstract Vulnerability is a crucial factor in addressing COVID-19 as it can aggravate the disease. Thus, it should be considered in COVID-19 control and health prevention and promotion. This ecological study aimed to analyze the spatial distribution of the incidence of COVID-19 cases in a Brazilian metropolis and its association with social vulnerability indicators. Spatial scan analysis was used to identify COVID-19 clusters. The variables for identifying the vulnerability were inserted in a Geographically Weighted Regression (GWR) model to identify their spatial relationship with COVID-19 cases. The incidence of COVID-19 in Fortaleza was 74.52/10,000 inhabitants, with 3,554 reported cases and at least one case registered in each neighborhood. The spatial GWR showed a negative relationship between the incidence of COVID-19 and demographic density (β=-0,0002) and a positive relationship between the incidence of COVID-19 and the percentage of self-employed >18 years (β=1.40), and maximum per capita household income of the poorest fifth (β=0.04). The influence of vulnerability indicators on incidence showed areas that can be the target of public policies to impact the incidence of COVID-19.


Subject(s)
Humans , Male , Female , Adult , Coronavirus Infections/epidemiology , Vulnerable Populations , Spatio-Temporal Analysis , Socioeconomic Factors , Brazil/epidemiology , Poverty Areas , Comorbidity , Incidence , Bayes Theorem , Age Factors , Population Density , Cities/epidemiology , Suburban Health/statistics & numerical data , Educational Status , Employment/statistics & numerical data , Housing/standards , Income , Middle Aged
10.
J Agromedicine ; 26(2): 256-265, 2021 04.
Article in English | MEDLINE | ID: covidwho-1104623

ABSTRACT

Objectives This paper examines health profiles and work environments of hired U.S. farmworkers to understand the risk to essential workers and their employers, to the food supply, and to rural health systems such as what is possible with the COVID-19 pandemic. Methods Large-sample statistical methods and proprietary data from the National Agricultural Workers Survey from 2000 to 2018 were used to assess factors associated with exposure to COVID-19 and vulnerabilities associated with medical complications. Results An aging workforce and increased access to health care within the crop worker population has been associated with a higher reported incidence of diabetes, asthma, and heart disease among workers over time. These trends confirm a vulnerable, but essential, workforce with higher risks for COVID-19 complications than would have been true of U.S. farmworkers as a group in earlier years. Conclusions Increasing age and disease burden in the U.S. agricultural labor force puts workers at increased risk for developing COVID-19 complications. Limits to field sanitation and housing quality inflate the probability of the development of COVID-19 hotbeds in rural communities that could further compromise the physical health of workers, the economic health of farm establishments, the agricultural supply-chain, and rural health capacities. Additional and more targeted worker protections may minimize public health and economic costs in the long run.


Subject(s)
COVID-19/epidemiology , Farmers/statistics & numerical data , Occupational Exposure/statistics & numerical data , Age Factors , Asthma/epidemiology , COVID-19/complications , COVID-19/transmission , Diabetes Mellitus/epidemiology , Heart Diseases/epidemiology , Housing/standards , Humans , Risk Factors , SARS-CoV-2 , Sanitation/standards , Transients and Migrants/statistics & numerical data , United States , Workplace
11.
Eur Rev Med Pharmacol Sci ; 25(3): 1738-1742, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1102760

ABSTRACT

OBJECTIVE: Since the beginning of the COVID-19 pandemic it has been recommended that chemical disinfectants are used to protect surfaces. This study aimed to determine whether the number of exposure calls related to household disinfectants (HD) received between January 30, 2020 to May 18, 2020 varied from the same time period in the previous year. MATERIALS AND METHODS: A retrospective review of the poison control center database from the Fondazione Universitario Policlinico Agostino Gemelli IRCCS, Rome, Italy, was conducted. Calls from Italian citizens, hospitals, and general practitioners received during the same time period in 2019 and 2020 were compared. RESULTS: The center received 1972 exposure calls during the study period. A 5% increase in calls regarding exposure to HDs was noted from 2019 to 2020 (9.8% to 15.2%, p<0.001). The majority of enquiries regarded bleach-containing products, hand sanitizers, ethanol, and hydrogen peroxide. Most calls were received from patients in their homes (n, 259; prevalence, 86%; increase, 107%) and concerned accidental exposure (n, 280; prevalence, 93%; increase, 76%), while cases of intentional exposure decreased (n, 14; prevalence, 5%; decrease, 33%). The main route of exposure was ingestion (n, 170; prevalence, 57%; increase, 45%), but the highest increase was observed in inhalation cases (n, 82; prevalence, 27%; increase, 122%). CONCLUSIONS: As the incidence of enquiries regarding products that can represent an important health hazard, when improperly used, increased in 2020 suggests that the COVID-19 public health messaging on the proper use of HDs should be improved.


Subject(s)
COVID-19/prevention & control , Disinfectants/poisoning , Disinfection , Housing/standards , Poison Control Centers/statistics & numerical data , SARS-CoV-2 , COVID-19/transmission , Humans , Italy , Retrospective Studies , SARS-CoV-2/drug effects
12.
J Urban Health ; 98(1): 1-12, 2021 02.
Article in English | MEDLINE | ID: covidwho-1014198

ABSTRACT

The COVID-19 pandemic precipitated catastrophic job loss, unprecedented unemployment rates, and severe economic hardship in renter households. As a result, housing precarity and the risk of eviction increased and worsened during the pandemic, especially among people of color and low-income populations. This paper considers the implications of this eviction crisis for health and health inequity, and the need for eviction prevention policies during the pandemic. Eviction and housing displacement are particularly threatening to individual and public health during a pandemic. Eviction is likely to increase COVID-19 infection rates because it results in overcrowded living environments, doubling up, transiency, limited access to healthcare, and a decreased ability to comply with pandemic mitigation strategies (e.g., social distancing, self-quarantine, and hygiene practices). Indeed, recent studies suggest that eviction may increase the spread of COVID-19 and that the absence or lifting of eviction moratoria may be associated with an increased rate of COVID-19 infection and death. Eviction is also a driver of health inequity as historic trends, and recent data demonstrate that people of color are more likely to face eviction and associated comorbidities. Black people have had less confidence in their ability to pay rent and are dying at 2.1 times the rate of non-Hispanic Whites. Indigenous Americans and Hispanic/Latinx people face an infection rate almost 3 times the rate of non-Hispanic whites. Disproportionate rates of both COVID-19 and eviction in communities of color compound negative health effects make eviction prevention a critical intervention to address racial health inequity. In light of the undisputed connection between eviction and health outcomes, eviction prevention, through moratoria and other supportive measures, is a key component of pandemic control strategies to mitigate COVID-19 spread and death.


Subject(s)
COVID-19/prevention & control , Delivery of Health Care/standards , Health Policy , Housing/standards , Pandemics/prevention & control , Public Health/standards , Quarantine/standards , Comorbidity , Guidelines as Topic , Humans , Poverty , SARS-CoV-2 , United States
13.
Eur J Public Health ; 30(6): 1186-1188, 2020 Dec 11.
Article in English | MEDLINE | ID: covidwho-915870

ABSTRACT

Despite concern on the impact of coronavirus disease 2019 (COVID-19) pandemic on undocumented immigrants, quantitative evidence on the issue is scant. We analyze socioeconomic and health conditions of 1590 undocumented immigrants in Milan, Lombardy, one of the regions with the highest COVID-19 clinical burden in the world that does not guarantee access to primary care for these individuals. We document a sharp reduction in visit number after lockdown, with 16% frequency of acute respiratory infections, compatible with COVID-19. Moreover, housing conditions make it difficult to implement public health measures. Results suggest the need to foster primary care by undocumented immigrants to face COVID-19 emergency.


Subject(s)
COVID-19/epidemiology , Health Services Accessibility/statistics & numerical data , Undocumented Immigrants/statistics & numerical data , Adult , Age Factors , Health Status , Housing/standards , Humans , Italy/epidemiology , Middle Aged , Pandemics , Primary Health Care/organization & administration , SARS-CoV-2 , Sex Factors , Socioeconomic Factors
14.
Health Educ Behav ; 47(6): 845-849, 2020 12.
Article in English | MEDLINE | ID: covidwho-858382

ABSTRACT

The COVID-19 pandemic has exposed, and intensified, health inequities faced by Latinx in the United States. Washington was one of the first U.S. states to report cases of COVID-19. Public health surveillance shows that 31% of Washington cases are Latinx, despite being only 13% of the state population. Unjust policies related to immigration, labor, housing, transportation, and education have contributed to both past and existing inequities. Approximately 20% of Latinx are uninsured, leading to delays in testing and medical care for COVID-19, and early reports indicated critical shortages in professional interpreters and multilingual telehealth options. Washington State is taking action to address some of these inequities. Applying a health equity framework, we describe key factors contributing to COVID-19-related health inequities among Latinx populations, and how Washington State has aimed to address these inequities. We draw on these experiences to make recommendations for other Latinx communities experiencing COVID-19 disparities.


Subject(s)
Coronavirus Infections/ethnology , Healthcare Disparities/ethnology , Pneumonia, Viral/ethnology , Betacoronavirus , COVID-19 , Communication Barriers , Health Policy , Health Services Accessibility/organization & administration , Housing/standards , Humans , Pandemics , SARS-CoV-2 , Translating , United States/epidemiology , Washington/epidemiology , Work/statistics & numerical data
15.
J Racial Ethn Health Disparities ; 8(4): 1012-1025, 2021 08.
Article in English | MEDLINE | ID: covidwho-778223

ABSTRACT

OBJECTIVES: This research offers an alternative to the singular focus on improving health services to the African American community to increase their resilience to health-related co-morbidities associated with Covid-19 deaths. METHODS: This study employs a participatory action research (PAR) approach, where local non-profit organizations and researchers partnered with a challenged community in a self-study of intergenerational poverty related to health issues and the various obstacles to breaking this cycle. RESULTS: A quantitative and qualitative analysis of interview and focus group data suggests that the majority of those living in poor neighborhoods report reducing intersectional factors that are the cause and function of intergenerational poverty would reduce poverty and by extension increase African Americans' resilience to health-related mortality. CONCLUSIONS: Analysis of data related to overlapping obstacles like lack of access to safe housing and quality health services offers both context and insight about how policies addressing poverty reduction may offer pathways for reducing the co-morbidities associated with pandemic risk for African Americans.


Subject(s)
African Americans/statistics & numerical data , COVID-19/ethnology , Health Status Disparities , Pandemics , Poverty/ethnology , Social Determinants of Health/ethnology , Adolescent , Adult , Aged , Child , Child, Preschool , Comorbidity , Female , Health Services Accessibility/statistics & numerical data , Housing/standards , Humans , Male , Middle Aged , Residence Characteristics/statistics & numerical data , Risk Assessment , Safety , United States/epidemiology , Young Adult
16.
Acta Biomed ; 91(9-S): 61-75, 2020 07 20.
Article in English | MEDLINE | ID: covidwho-670138

ABSTRACT

BACKGROUND AND AIM OF THE WORK: The ongoing pandemic of COVID-19 is a strong reminder that the lockdown period has changed the way that people and communities live, work, and interact, and it's necessary to make resilient the built environment, both outdoor and mainly the indoor spaces: housing, workplaces, public buildings, and entertainment facilities. How can we re-design the concept of Well-being and Public Health in relation to the living places of the future? METHODS: According to the previous statements and scenario, this paper aims to integrate the building hygiene and well-being, focusing the possible responses, both existing and for the new buildings, taking home a strong message from this "period" of physical distancing. RESULTS: The Well-being and Public Health recommendations for a healthy, safe, and sustainable housing are framed into the following key points: 1. Visible and accessible green elements and spaces; 2. Flexibility, adaptability, sharing, and crowding of living spaces, and compliant functions located into the buildings; 3. Re-appropriation of the basic principles and archetypes of sustainable architecture, thermal comfort and Indoor Air Quality (IAQ); 4. Water consumption and Wastewater Management; 5. Urban Solid Waste Management; 6. Housing automation and electromagnetic fields; 7. Indoor building and finishing materials. CONCLUSIONS: The Well-being and Public Health recommendations for a healthy, safe and sustainable housing may provide a useful basis for Designers, Policy Makers (fostering tax incentives for building renewal), Public Health experts and Local Health Agencies, in promoting actions and policies aimed to transform living places in healthier and Salutogenic spaces.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Housing/standards , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Public Health , Air Pollution, Indoor , COVID-19 , Construction Materials , Electromagnetic Fields , Humans , SARS-CoV-2 , Waste Management
17.
Occup Environ Med ; 77(9): 634-636, 2020 09.
Article in English | MEDLINE | ID: covidwho-591446

ABSTRACT

OBJECTIVES: Daily numbers of COVID-19 in Singapore from March to May 2020, the cause of a surge in cases in April and the national response were examined, and regulations on migrant worker accommodation studied. METHODS: Information was gathered from daily reports provided by the Ministry of Health, Singapore Statues online and a Ministerial statement given at a Parliament sitting on 4 May 2020. RESULTS: A marked escalation in the daily number of new COVID-19 cases was seen in early April 2020. The majority of cases occurred among an estimated 295 000 low-skilled migrant workers living in foreign worker dormitories. As of 6 May 2020, there were 17 758 confirmed COVID-19 cases among dormitory workers (88% of 20 198 nationally confirmed cases). One dormitory housing approximately 13 000 workers had 19.4% of residents infected. The national response included mobilising several government agencies and public volunteers. There was extensive testing of workers in dormitories, segregation of healthy and infected workers, and daily observation for fever and symptoms. Twenty-four dormitories were declared as 'isolation areas', with residents quarantined for 14 days. New housing, for example, vacant public housing flats, military camps, exhibition centres, floating hotels have been provided that will allow for appropriate social distancing. CONCLUSION: The COVID-19 pandemic has highlighted migrant workers as a vulnerable occupational group. Ideally, matters related to inadequate housing of vulnerable migrant workers need to be addressed before a pandemic.


Subject(s)
Coronavirus Infections/epidemiology , Housing/standards , Pneumonia, Viral/epidemiology , Transients and Migrants/statistics & numerical data , Betacoronavirus , COVID-19 , Coronavirus Infections/transmission , Female , Health Policy , Humans , Male , Pandemics , Pneumonia, Viral/transmission , SARS-CoV-2 , Singapore/epidemiology , Socioeconomic Factors , Vulnerable Populations
18.
J Urban Health ; 97(3): 348-357, 2020 06.
Article in English | MEDLINE | ID: covidwho-116781

ABSTRACT

The informal settlements of the Global South are the least prepared for the pandemic of COVID-19 since basic needs such as water, toilets, sewers, drainage, waste collection, and secure and adequate housing are already in short supply or non-existent. Further, space constraints, violence, and overcrowding in slums make physical distancing and self-quarantine impractical, and the rapid spread of an infection highly likely. Residents of informal settlements are also economically vulnerable during any COVID-19 responses. Any responses to COVID-19 that do not recognize these realities will further jeopardize the survival of large segments of the urban population globally. Most top-down strategies to arrest an infectious disease will likely ignore the often-robust social groups and knowledge that already exist in many slums. Here, we offer a set of practice and policy suggestions that aim to (1) dampen the spread of COVID-19 based on the latest available science, (2) improve the likelihood of medical care for the urban poor whether or not they get infected, and (3) provide economic, social, and physical improvements and protections to the urban poor, including migrants, slum communities, and their residents, that can improve their long-term well-being. Immediate measures to protect residents of urban informal settlements, the homeless, those living in precarious settlements, and the entire population from COVID-19 include the following: (1) institute informal settlements/slum emergency planning committees in every urban informal settlement; (2) apply an immediate moratorium on evictions; (3) provide an immediate guarantee of payments to the poor; (4) immediately train and deploy community health workers; (5) immediately meet Sphere Humanitarian standards for water, sanitation, and hygiene; (6) provide immediate food assistance; (7) develop and implement a solid waste collection strategy; and (8) implement immediately a plan for mobility and health care. Lessons have been learned from earlier pandemics such as HIV and epidemics such as Ebola. They can be applied here. At the same time, the opportunity exists for public health, public administration, international aid, NGOs, and community groups to innovate beyond disaster response and move toward long-term plans.


Subject(s)
Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Poverty Areas , Urban Population , Betacoronavirus , COVID-19 , Health Services Accessibility/organization & administration , Housing/standards , Humans , SARS-CoV-2 , Sanitation/methods , Urban Health , Vulnerable Populations
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