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3.
BMC Public Health ; 20(1): 1771, 2020 Nov 23.
Article in English | MEDLINE | ID: covidwho-1388748

ABSTRACT

BACKGROUND: Guaranteeing the sexual and reproductive health and rights (SRHR) of populations living in fragile and humanitarian settings is essential and constitutes a basic human right. Compounded by the inherent vulnerabilities of women in crises, substantial complications are directly associated with increased risks of poor SRHR outcomes for displaced populations. The migration of Venezuelans, displaced due to current economic circumstances, is one of the largest in Latin America's history. This study aims to provide an overview of the sexual and reproductive health (SRH) issues affecting migrant Venezuelan women in the state of Roraima, Brazil. METHODS: Face-to-face interviews were conducted from 24 to 30 November 2019. Data collection covered various issues involving access to and use of SRH services by 405 migrant Venezuelan women aged 18-49 years. The Minimum Initial Service Package readiness assessment tools, available from the Inter-Agency Working Group on Reproductive Health in Crises, were used in the data collection. RESULTS: Most commonly, the women reported unmet family planning needs. Of these, a significant proportion reported being unable to obtain contraceptive methods, particularly long-acting reversible contraceptives, either due to the woman's inability to access them or their unavailability at healthcare centres. Although a significant proportion of women were largely satisfied with the attention received at the maternity hospital, both before and during childbirth, 24.0% of pregnant or postpartum women failed to receive any prenatal or postnatal care. CONCLUSION: Meeting the essential SRHR needs of migrant Venezuelan women in Roraima, Brazil is a challenge that has yet to be fully addressed. Given the size of this migrant population, the Brazilian healthcare system has failed to adapt sufficiently to meet their needs; however, problems with healthcare provision are similar for migrants and Brazilian citizens. Efforts need to be encouraged not only in governmental health sectors, but also with academic, non-governmental and international organisations, including a coordinated approach to ensure a comprehensive SRHR response. Given the current high risks associated with the SARS-CoV-2 pandemic, meeting the SRHR needs of migrant populations has become more critical than ever.


Subject(s)
Maternal Health/statistics & numerical data , Transients and Migrants/statistics & numerical data , Brazil , Female , Health Services Needs and Demand , Humans , Pregnancy , Reproductive Health , Reproductive Rights , Sexual Health , Venezuela/ethnology
4.
J Travel Med ; 27(8)2020 12 23.
Article in English | MEDLINE | ID: covidwho-1387946

ABSTRACT

BACKGROUND: Numerous publications focus on fever in returning travellers, but there is no known systematic review considering all diseases, or all tropical diseases causing fever. Such a review is necessary in order to develop appropriate practice guidelines. OBJECTIVES: Primary objectives of this review were (i) to determine the aetiology of fever in travellers/migrants returning from (sub) tropical countries as well as the proportion of patients with specific diagnoses, and (ii) to assess the predictors for specific tropical diseases. METHOD: Embase, MEDLINE and Cochrane Library were searched with terms combining fever and travel/migrants. All studies focusing on causes of fever in returning travellers and/or clinical and laboratory predictors of tropical diseases were included. Meta-analyses were performed on frequencies of etiological diagnoses. RESULTS: 10 064 studies were identified; 541 underwent full-text review; 30 met criteria for data extraction. Tropical infections accounted for 33% of fever diagnoses, with malaria causing 22%, dengue 5% and enteric fever 2%. Non-tropical infections accounted for 36% of febrile cases, with acute gastroenteritis causing 14% and respiratory tract infections 13%. Positive likelihood ratios demonstrated that splenomegaly, thrombocytopenia and hyperbilirubinemia were respectively 5-14, 3-11 and 5-7 times more likely in malaria than non-malaria patients. High variability of results between studies reflects heterogeneity in study design, regions visited, participants' characteristics, setting, laboratory investigations performed and diseases included. CONCLUSION: Malaria accounted for one-fifth of febrile cases, highlighting the importance of rapid malaria testing in febrile returning travellers, followed by other rapid tests for common tropical diseases. High variability between studies highlights the need to harmonize study designs and to promote multi-centre studies investigating predictors of diseases, including of lower incidence, which may help to develop evidence-based guidelines. The use of clinical decision support algorithms by health workers which incorporate clinical predictors, could help standardize studies as well as improve quality of recommendations.


Subject(s)
COVID-19 , Communicable Disease Control/standards , Fever , Travel Medicine/methods , Tropical Medicine/methods , COVID-19/diagnosis , COVID-19/epidemiology , Diagnosis, Differential , Fever/diagnosis , Fever/etiology , Humans , Practice Guidelines as Topic , Transients and Migrants/statistics & numerical data
7.
Am J Epidemiol ; 190(8): 1510-1518, 2021 08 01.
Article in English | MEDLINE | ID: covidwho-1337248

ABSTRACT

Preliminary evidence points to higher morbidity and mortality from coronavirus disease 2019 (COVID-19) in certain racial and ethnic groups, but population-based studies using microlevel data are lacking so far. We used register-based cohort data including all adults living in Stockholm, Sweden, between January 31, 2020 (the date of the first confirmed case of COVID-19) and May 4, 2020 (n = 1,778,670) to conduct Poisson regression analyses with region/country of birth as the exposure and underlying cause of COVID-19 death as the outcome, estimating relative risks and 95% confidence intervals. Migrants from Middle Eastern countries (relative risk (RR) = 3.2, 95% confidence interval (CI): 2.6, 3.8), Africa (RR = 3.0, 95% CI: 2.2, 4.3), and non-Sweden Nordic countries (RR = 1.5, 95% CI: 1.2, 1.8) had higher mortality from COVID-19 than persons born in Sweden. Especially high mortality risks from COVID-19 were found among persons born in Somalia, Lebanon, Syria, Turkey, Iran, and Iraq. Socioeconomic status, number of working-age household members, and neighborhood population density attenuated up to half of the increased COVID-19 mortality risks among the foreign-born. Disadvantaged socioeconomic and living conditions may increase infection rates in migrants and contribute to their higher risk of COVID-19 mortality.


Subject(s)
COVID-19/ethnology , COVID-19/mortality , Health Status Disparities , Transients and Migrants/statistics & numerical data , Adult , Cohort Studies , Employment/statistics & numerical data , Female , Humans , Male , Middle Aged , Middle East/ethnology , Registries , Residence Characteristics/statistics & numerical data , Risk Factors , SARS-CoV-2 , Social Class , Sweden/epidemiology
8.
Ann Glob Health ; 87(1): 71, 2021.
Article in English | MEDLINE | ID: covidwho-1332318

ABSTRACT

Despite the pandemic, 34,154 migrants, refugees or asylum-seekers landed in Sicily (Italy) in 2020, representing the main point of entry by sea into Europe. The SARS-CoV-2 surveillance program among migrants arriving to Sicily via the Mediterranean Sea, made by the combination of clinical examination and molecular testing, has been integrated by full-genome sequencing strains using the NGS technology from the last week of February. To date, more than one hundred full-genome strains have been sequenced and 8 different lineages have been identified mostly belonging to the lineages B.1.1.7 and B.1.525. As global access to COVID-19 vaccines should be ensured, the need to provide more detailed information to inform policies and to drive the possible re-engineering of vaccines needed to deal with the challenge of new and future variants should be highlighted.


Subject(s)
COVID-19 , Genome, Viral , SARS-CoV-2 , Transients and Migrants/statistics & numerical data , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/classification , COVID-19 Vaccines/standards , Humans , Molecular Diagnostic Techniques/methods , Molecular Diagnostic Techniques/statistics & numerical data , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purification , Sicily/epidemiology
10.
Int Marit Health ; 72(2): 99-109, 2021.
Article in English | MEDLINE | ID: covidwho-1296140

ABSTRACT

BACKGROUND: Since 2014, the number of migrants and refugees crossing the Mediterranean towards Europe has risen significantly due to various reasons. Both state agencies and non-governmental organizations (NGOs) have launched rescue missions in the Central Mediterranean in accordance with international legal obligations for search and rescue (SAR) operations for those under distress at sea. Our aim is to summarise the specific qualifications needed for maritime SAR in the Mediterranean both in terms of the population at risk, the equipment and the medical support required, especially during the coronavirus disease 2019 (COVID-19) pandemic and the operational legal framework. MATERIALS AND METHODS: This article aims to summarise the key points of SAR efforts from a medical perspective as depicted in the relevant literature during a specific timeline period (2014-2020) in a specific part of the Mediterranean Sea (Central Mediterranean route). Only papers published in English and whose full text was available were included in this study. The inclusion criteria were: a) articles referring to sea rescue operations between 2014 and 2020, b) research that focused on medical preparedness and assistance during rescue operations in the Central Mediterranean route, c) studies concerning demographic and clinical features of the rescue population, d) guidelines on the rule of conduct of persons and states participating in rescue activities. The exclusion criteria were: a) studies describing SAR operations in different regions of the world and b) studies focusing on routes, demographics and medical support of migrants/refugees on land. RESULTS: Three major themes were identified: a) characteristics of the population in distress at sea: country of origin, age groups, presence of communicable and non-communicable diseases were identified in the relevant literature. Our research shows that dermatological and respiratory issues were the major concerns among sea migrants, coming from different countries of both Africa and Asia, being relatively young and mostly males; b) medical preparedness and equipment needed for rescue: according to current guidelines, revised during the COVID-19 pandemic, infrastructure needed during SAR operations includes both equipment for resuscitation, personal protective equipment, deck adjustments, medical personnel trained to function in an austere setting and able to handle vulnerable patient groups such as children and pregnant women; c) medico-legal implications of SAR operations: knowledge of the legal framework encompassing SAR operations seems necessary, as European Union and state led initiatives seem to withdraw from proactive SAR, while criminalising NGO led rescue efforts. Operating with the imperative to save lives seems to be the only way of respecting international law and human values, thus, a summary of what the law dictates was made in an effort to keep medical workers participating in such operations updated. CONCLUSIONS: Investigation aims to shed light on the special clinical features of sea migrants, the skills, equipment and organizational structure needed by medical workers participating in SAR operations as well as the legal framework under which they will be asked to operate. Special consideration will be given to the difficulties that emerged due to the COVD-19 pandemic.


Subject(s)
Emergency Medical Services/statistics & numerical data , Refugees/statistics & numerical data , Relief Work/organization & administration , Transients and Migrants/statistics & numerical data , Female , Humans , Male , Mediterranean Sea , Security Measures/organization & administration , Socioeconomic Factors
11.
PLoS One ; 16(6): e0252712, 2021.
Article in English | MEDLINE | ID: covidwho-1264217

ABSTRACT

BACKGROUND: Tuberculosis (TB) in migrants is of concern to health authorities worldwide and is even more critical in Brazil, considering the country´s size and long land borders. The aim of the study was to identify critical areas in Brazil for migrants diagnosed with TB and to describe the temporal trend in this phenomenon in recent years. METHODS: This is an ecological study that used spatial analysis and time series analysis. As the study population, all cases of migrants diagnosed with TB from 2014 to 2019 were included, and Brazilian municipalities were considered as the unit of ecological analysis. The Getis-Ord Gi* technique was applied to identify critical areas, and based on the identified clusters, seasonal-trend decomposition based on loess (STL) and Prais-Winsten autoregression were used, respectively, to trace and classify temporal trend in the analyzed series. In addition, several municipal socioeconomic indicators were selected to verify the association between the identified clusters and social vulnerability. RESULTS: 2,471 TB cases were reported in migrants. Gi* analysis showed that areas with spatial association with TB in immigrants coincide with critical areas for TB in the general population (coast of the Southeast and North regions). Four TB clusters were identified in immigrants in the states of Amazonas, Roraima, São Paulo, and Rio de Janeiro, with an upward trend in most of these clusters. The temporal trend in TB in immigrants was classified as increasing in Brazil (+ 60.66% per year [95% CI: 27.21-91.85]) and in the clusters in the states of Amazonas, Roraima, and Rio de Janeiro (+1.01, +2.15, and + 2.90% per year, respectively). The cluster in the state of São Paulo was the only one classified as stationary. The descriptive data on the municipalities belonging to the clusters showed evidence of the association between TB incidence and conditions of social vulnerability. CONCLUSIONS: The study revealed the critical situation of TB among migrants in the country. Based on the findings, health authorities might focus on actions in regions identified, stablishing an intensive monitoring and following up, ensuring that these cases concluded their treatment and avoiding that they could spread the disease to the other regions or scenarios. The population of migrants are very dynamic, therefore strategies for following up them across Brazil are really urgent to manage the tuberculosis among international migrants in an efficient and proper way.


Subject(s)
Emigrants and Immigrants/statistics & numerical data , Transients and Migrants/statistics & numerical data , Tuberculosis/epidemiology , Brazil , Humans , Space-Time Clustering
12.
Ann Glob Health ; 87(1): 45, 2021 05 19.
Article in English | MEDLINE | ID: covidwho-1248345

ABSTRACT

This Covid-19 pandemic has been a trying time for all countries, governments, societies, and individuals. The physical, social, and organizational infrastructure of healthcare systems across the world is being stressed. This pandemic has highlighted that the healthcare of the country is as strong as its weakest link and that no aspect of life, be it social or economic, is spared from this pandemic. The authors would like to highlight some of the lessons learned from Singapores management of the Covid-19 pandemic. During the Singaporean Covid-19 pandemic, public health policy planning was all encompassing in its coverage, involving various stakeholders in government and society. The important role of individuals, governments, industry, and primary healthcare practitioners when tackling COVID-19 are highlighted. Singapores management of the Covid-19 pandemic involved an approach that involved the whole of society, with a particular focus on supporting the vulnerable foreign worker population, which formed the majority of Covid-19 cases in the country. Hopefully amidst the trying times, valuable lessons are learnt that will be etched into medical history and collective memory. We hope to highlight these lessons for future generations, both for members of the public and fellow healthcare practitioners.


Subject(s)
COVID-19 , Public Health , Public Policy , Social Marginalization , COVID-19/epidemiology , COVID-19/prevention & control , Civil Defense/standards , Government Regulation , Health Services Needs and Demand/organization & administration , Humans , Public Health/methods , Public Health/standards , SARS-CoV-2 , Singapore/epidemiology , Transients and Migrants/statistics & numerical data
13.
Am J Public Health ; 111(1): 110-115, 2021 01.
Article in English | MEDLINE | ID: covidwho-1216985

ABSTRACT

Immigration detention centers are densely populated facilities in which restrictive conditions limit detainees' abilities to engage in social distancing or hygiene practices designed to prevent the spread of COVID-19. With tens of thousands of adults and children in more than 200 immigration detention centers across the United States, immigration detention centers are likely to experience COVID-19 outbreaks and add substantially to the population of those infected.Despite compelling evidence indicating a heightened risk of infection among detainees, state and federal governments have done little to protect the health of detained im-migrants. An evidence-based public health framework must guide the COVID-19 response in immigration detention centers.We draw on the hierarchy of controls framework to demonstrate how immigration detention centers are failing to implement even the least effective control strategies. Drawing on this framework and recent legal and medical advocacy efforts, we argue that safely releasing detainees from immigration detention centers into their communities is the most effective way to prevent COVID-19 outbreaks in immigration detention settings. Failure to do so will result in infection and death among those detained and deepen existing health and social inequities.


Subject(s)
COVID-19 , Emigration and Immigration/legislation & jurisprudence , Jails/statistics & numerical data , Transients and Migrants/statistics & numerical data , Adult , COVID-19/mortality , COVID-19/transmission , Child , Humans , United States
14.
Indian J Med Ethics ; VI(2): 1-24, 2021.
Article in English | MEDLINE | ID: covidwho-1206582

ABSTRACT

The Indian media's reportage of the Covid-19 pandemic has exposed the State's long-standing apathy towards low-income migrants and the structural neglect and violence faced by them in society. But how consistent were the country's print media in reporting on this population group before the crisis? This paper reports the findings of a study that examines the representation of migrants and refugees and their health in the Indian print media prior to the pandemic. A secondary objective was to examine any variations in their representation based on their social positions (for example, ethnicity, nationality, gender, religion). Using frame and content analyses, three English language newspapers were examined for the period January 1, 2017 to December 31, 2018. A total of 1,111 articles were retrieved. Analysis revealed that migrants were most frequently framed as "villains", posing a threat to the security, culture, health and economy in their destination states/cities, and less often as victims. On health coverage, the study found that the media frequently pathologised migrants and projected them as carriers of infection. Migrants' religion, ethnicity and class, and their proximity to the majoritarian population appeared most prominent in determining the frame imposed. The articles mostly relied on accounts of state officials and political leaders, whereas migrants' voices comprised less than a quarter of the sources of information. The media thus play a vital role in crystallising these disparities and, through acts of both omission and commission, end up vilifying migrants.


Subject(s)
Apathy , COVID-19/epidemiology , Health Status , Mass Media/statistics & numerical data , Pandemics/statistics & numerical data , Refugees/statistics & numerical data , Transients and Migrants/statistics & numerical data , Adult , Aged , Aged, 80 and over , Female , Humans , India/epidemiology , Male , Middle Aged , SARS-CoV-2 , Socioeconomic Factors
15.
PLoS One ; 16(4): e0250621, 2021.
Article in English | MEDLINE | ID: covidwho-1206198

ABSTRACT

Farmers and farm workers are critical to the secure supply of food, yet this population is potentially at high risk to acquire COVID-19. This study estimates the prevalence of COVID-19 among farmers and farmworkers in the United States by coupling county-level data on the number of farm workers relative to the general population with data on confirmed COVID-19 cases and deaths. In the 13 month period since the start of the pandemic (from March 1, 2020 to March 31, 2021), the estimated cumulative number of COVID-19 cases (deaths) was 329,031 (6,166) among agricultural producers, 170,137 (2,969) among hired agricultural workers, 202,902 (3,812) among unpaid agricultural workers, and 27,223 (459) among migrant agricultural workers. The cases amount to 9.55%, 9.31%, 9.39%, and 9.01% of all U.S. agricultural producers, hired workers, unpaid workers, and migrant workers, respectively. The COVID-19 incidence rate is significantly higher in counties with more agricultural workers; a 1% increase in the number of hired agricultural workers in a county is associated with a 0.04% increase in the number of COVID-19 cases per person and 0.07% increase in deaths per person. Although estimated new cases among farm workers exhibit similar trends to that of the general population, the correlation between the two is sometimes negative, highlighting the need to monitor this particular population that tends to live in more rural areas. Reduction in labor availability from COVID-19 is estimated to reduce U.S. agricultural output by about $309 million.


Subject(s)
Agriculture/trends , COVID-19/economics , COVID-19/epidemiology , Agricultural Workers' Diseases/epidemiology , Agriculture/economics , COVID-19/transmission , Farmers/statistics & numerical data , Food Supply/economics , Humans , Pandemics/prevention & control , Prevalence , SARS-CoV-2/pathogenicity , Transients and Migrants/statistics & numerical data , United States
16.
J Soc Psychol ; 161(4): 477-491, 2021 Jul 04.
Article in English | MEDLINE | ID: covidwho-1205474

ABSTRACT

What mitigates prejudice against migrants in situations of uncertainty? Addressing this question, we explored how individuals with greater COVID-19 concern perceive migrants as a greater threat and show prejudice against them, indirectly through the mechanism of need for cognitive closure and binding moral foundations.This study was conducted in two European countries: Malta and Italy. Six hundred and seventy-six individuals participated in this quantitative study (Malta: N = 204; Italy N = 472). Results from this study showed that the need for cognitive closure and binding moral foundations mediate the relationship between COVID-19 concern and prejudice against migrants in both countries. When testing the three binding moral foundations (loyalty, authority, and purity), the authority foundation seems to be the most consistent predictor.The implications of the findings contribute to theories about how situational uncertainty caused by COVID-19, together with the need for epistemic certainty and binding morality, contribute to increased prejudiced attitudes against migrants.


Subject(s)
COVID-19/psychology , Morals , Prejudice/psychology , Transients and Migrants/psychology , Uncertainty , Adolescent , Adult , Aged , Aged, 80 and over , Cognition , Evaluation Studies as Topic , Female , Humans , Italy , Male , Malta , Middle Aged , Prejudice/statistics & numerical data , SARS-CoV-2 , Transients and Migrants/statistics & numerical data , Young Adult
17.
JAMA Netw Open ; 4(4): e217498, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1196364

ABSTRACT

Importance: Acute ischemic stroke (AIS) is a known neurological complication in patients with respiratory symptoms of COVID-19 infection. However, AIS has not been described as a late sequelae in patients without respiratory symptoms of COVID-19. Objective: To assess AIS experienced by adults 50 years or younger in the convalescent phase of asymptomatic COVID-19 infection. Design, Setting, and Participants: This case series prospectively identified consecutive male patients who received care for AIS from public health hospitals in Singapore between May 21, 2020, and October 14, 2020. All of these patients had laboratory-confirmed asymptomatic COVID-19 infection based on a positive SARS-CoV-2 serological (antibodies) test result. These patients were individuals from South Asian countries (India and Bangladesh) who were working in Singapore and living in dormitories. The total number of COVID-19 cases (54 485) in the worker dormitory population was the population at risk. Patients with ongoing respiratory symptoms or positive SARS-CoV-2 serological test results confirmed through reverse transcriptase-polymerase chain reaction nasopharyngeal swabs were excluded. Main Outcomes and Measures: Clinical course, imaging, and laboratory findings were retrieved from the electronic medical records of each participating hospital. The incidence rate of AIS in the case series was compared with that of a historical age-, sex-, and ethnicity-matched national cohort. Results: A total of 18 male patients, with a median (range) age of 41 (35-50) years and South Asian ethnicity, were included. The median (range) time from a positive serological test result to AIS was 54.5 (0-130) days. The median (range) National Institutes of Health Stroke Scale score was 5 (1-25). Ten patients (56%) presented with a large vessel occlusion, of whom 6 patients underwent intravenous thrombolysis and/or endovascular therapy. Only 3 patients (17%) had a possible cardiac source of embolus. The estimated annual incidence rate of AIS was 82.6 cases per 100 000 people in this study compared with 38.2 cases per 100 000 people in the historical age-, sex-, and ethnicity-matched cohort (rate ratio, 2.16; 95% CI, 1.36-3.48; P < .001). Conclusions and Relevance: This case series suggests that the risk for AIS is higher in adults 50 years or younger during the convalescent period of a COVID-19 infection without respiratory symptoms. Acute ischemic stroke could be part of the next wave of complications of COVID-19, and stroke units should be on alert and use serological testing, especially in younger patients or in the absence of traditional risk factors.


Subject(s)
Asymptomatic Infections/epidemiology , COVID-19 , Ischemic Stroke , SARS-CoV-2 , Thrombectomy/methods , Thrombolytic Therapy/methods , Adult , COVID-19/complications , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19 Serological Testing/methods , Convalescence , Electronic Health Records/statistics & numerical data , Endovascular Procedures/methods , Humans , Incidence , Ischemic Stroke/diagnosis , Ischemic Stroke/ethnology , Ischemic Stroke/etiology , Male , Middle Aged , Outcome and Process Assessment, Health Care , Risk Factors , SARS-CoV-2/isolation & purification , SARS-CoV-2/pathogenicity , Singapore/epidemiology , Transients and Migrants/statistics & numerical data
18.
Am J Public Health ; 111(8): 1497-1503, 2021 08.
Article in English | MEDLINE | ID: covidwho-1186643

ABSTRACT

Under international law, the United States is obligated to uphold noncitizens' fundamental rights, including their rights to health. However, current US immigration laws-and their enforcement-not only fail to fulfill migrants' health rights but actively undermine their realization and worsen the pandemic's spread. Specifically, the US immigration system's reliance on detention, which precludes effective social distancing, increases risks of exposure and infection for detainees, staff, and their broader communities. International agreements clearly state that the prolonged, mandatory, or automatic detention of people solely because of their migration status is a human rights violation on its own. But in the context of COVID-19, the consequences for migrants' right to health are particularly acute. Effective alternatives exist: other countries demonstrate the feasibility of adopting and implementing immigration laws that establish far less restrictive, social services-based approaches to enforcement that respect human rights. To protect public health and realize its global commitments, the United States must shift away from detaining migrants as standard practice and adopt effective, humane alternatives-both amid COVID-19 and permanently.


Subject(s)
COVID-19/prevention & control , Emigration and Immigration/statistics & numerical data , Health Services Accessibility/statistics & numerical data , Social Determinants of Health/statistics & numerical data , Transients and Migrants/statistics & numerical data , Undocumented Immigrants/statistics & numerical data , COVID-19/epidemiology , Emigration and Immigration/legislation & jurisprudence , Health Services Accessibility/legislation & jurisprudence , Human Rights/statistics & numerical data , Humans , Right to Health/statistics & numerical data , Social Determinants of Health/legislation & jurisprudence , Social Justice , Transients and Migrants/legislation & jurisprudence , Undocumented Immigrants/legislation & jurisprudence , United States
20.
J Agromedicine ; 25(4): 413-416, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-1174770

ABSTRACT

Facing the onset of the COVID-19 pandemic and increasing outbreaks among farmworkers and food processing workers across the nation, the Oregon Occupational Health and Safety Administration (OR OSHA) issued temporary regulations, in contrast to optional recommendations, in late spring. These regulations aimed to reduce the risk of COVID-19 transmission among farmworkers, but made compromises that may fail to reduce the risk of further outbreaks among Oregon's agricultural workers, particularly those living in agricultural labor housing. Instead of considering the scientific literature that called for attention to space and length of time for social distancing among unrelated persons in indoor areas, the agency accepted the 6-foot social distancing rule of thumb and allowed even shorter distances between beds with the installation of plastic or plywood barriers. The 6-foot distance (or less with a barrier) between people sleeping next to each other in poorly ventilated housing has proved disastrous. Additionally, testing for migrant and seasonal farmworkers is neither uniform nor thorough, and little data have been collected to assess the success of existing testing efforts. New regulations must be adopted for farm labor housing that limit occupancy to at most two unrelated individuals for a room of 200 square feet; include expanded specification on the provision of fresh air in shared living spaces; and support increased access to testing, surveillance testing, and alternative safe housing at labor housing sites for identified cases.


Subject(s)
COVID-19/prevention & control , COVID-19/transmission , Housing , Physical Distancing , COVID-19/epidemiology , COVID-19/physiopathology , Farmers , Humans , Occupational Health , Oregon/epidemiology , Sleep , Transients and Migrants/statistics & numerical data
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