Critical medical ecology and SARS-COV-2 in the urban environment: a pragmatic, dynamic approach to explaining and planning for research and practice

Assessing eco-geographic influences on COVID-19 transmission: a global analysis

COVID-19 has been massively transmitted for almost 3 years, and its multiple variants have caused serious health problems and an economic crisis. Our goal was to identify the influencing factors that reduce the threshold of disease transmission and to analyze the epidemiological patterns of COVID-19. This study served as an early assessment of the epidemiological characteristics of COVID-19 using the MaxEnt species distribution algorithm using the maximum entropy model. The transmission of COVID-19 was evaluated based on human factors and environmental variables, including climate, terrain and vegetation, along with COVID-19 daily confirmed case location data. The results of the SDM model indicate that population density was the major factor influencing the spread of COVID-19. Altitude, land cover and climatic factor showed low impact. We identified a set of practical, high-resolution, multi-factor-based maximum entropy ecological niche risk prediction systems to assess the transmission risk of the COVID-19 epidemic globally. This study provided a comprehensive analysis of various factors influencing the transmission of COVID-19, incorporating both human and environmental variables. These findings emphasize the role of different types of influencing variables in disease transmission, which could have implications for global health regulations and preparedness strategies for future outbreaks.

Global narratives on unequal outcomes produced by lockdown in Africa: A social science perspective on the “one-size-fits all” COVID-19 response

Introduction

Lockdown measures were introduced worldwide to prevent the spread of COVID-19, and several studies showed the positive impacts of these policies in places such as China and Europe. Many African governments also imposed lockdowns at the beginning of the pandemic. These lockdowns met with mixed reactions; some were positive, but others focused on concerns about the consequences of lockdowns.

Methods

In this article, we use social listening to examine social media narratives to investigate how people balanced concerns about preventing the spread of COVID-19 with other priorities. Analyzing social media conversations is one way of accessing different voices in real time, including those that often go unheard. As internet access grows and social media becomes more popular in Africa, it provides a different space for engagement, allowing people to connect with opinions outside of their own conceptual frameworks and disrupting hierarchies of how knowledge is shaped.

Results

This article indicates which narratives were favored by different organizations, stakeholders, and the general public, and which of these narratives are most dominant in policy discourses. The range of narratives is found to be reflective of the blindness to inequality and social difference of much decision-making by policymakers.

Discussion

Thus, contrary to the “we are all in this together” narrative, diseases and public health responses to them clearly discriminate, accentuating long-standing structural inequalities locally, nationally, and globally, as well as interplaying with multiple, dynamic, and negotiated sources of marginalization. These and other insights from this article could play a useful role in understanding and interpreting how social media could be included in pandemic preparedness plans.

Sewage surveillance system using urological wastewater: Key to COVID-19 monitoring?

Since December 2019, the emergence of a new Severe Acute Respiratory Syndrome- coronavirus (SARS-CoV-2) has led to a global coronavirus pandemic disease (COVID-19), with devastating consequences for all healthcare worldwide, including urological care. COVID-19 has led to concern among urological healthcare workers about viral presence, detection and routes of transmission during routine clinical practice. The potential presence of (active) virus in bodily fluids of COVID-19 patients remains a continuing topic of debate. Therefore, we highlight viral detection methods and review the presence of SARS-CoV-2 in urine, feces, and semen. Finally, we discuss how excretion of virus particles through urological bodily fluids might be pivotal to epidemiologic monitoring and control of the disease.

Piling it on: Perceived stress and lack of access to resources among US-based LGBTQ+ community members during the COVID-19 pandemic

OBJECTIVES

While the LGBTQ+ community has been disproportionally impacted by COVID-19 medical complications, little research has considered non-medical impact.

METHODS

We conducted a secondary analyses of USA-based respondents from a global cross-sectional online mixed-methods survey collecting sexual orientation, gender identity, and the perceived stress scale (PSS). Bivariate and multivariate ordinal regression statistics were performed.

RESULTS

Fourteen percent (n = 193,14.2%) identified as LGBTQ+. Variables significantly associated with LGBTQ+ included: COVID testing/treatment affordability, canceled activities, stocking food/medications, quitting job, lost income, and inability to procure groceries/cleaning supplies/medications. Adjusting for Hispanic ethnicity and income, BIPOC LGBTQ+ individuals had twice the odds (OR:2.02;95%CI:1.16-3.53) of moderate compared to low PSS scores, and high compared to moderate PSS scores, compared to white non-LGBTQ+ individuals. Adjusting for Hispanic ethnicity, income, age, and education, deaf LGBTQ+ individuals had twice the odds (OR:2.00;95%CI:1.12-3.61) of moderate compared to low PSS scores, and high compared to moderate PSS scores, compared to hearing non-LGBTQ+ individuals.

CONCLUSION

The LBGTQ+ community has increased stress due to COVID-19. Public health interventions must mitigate stress in BIPOC and deaf LGBTQ+ communities, addressing their intersectional experiences.

THE ZOONOTIC CITY: Urban Political Ecology and the Pandemic Imaginary

In the context of the Covid-19 pandemic this article takes a longer view of the evolving relationship between urbanization and the range of zoonotic diseases that have spread from animals to humans. I suggest that the existing interpretation of epidemiological transitions remains overly Eurocentric and requires a more nuanced conception of global environmental history. Similarly, the conceptualization of urban space within these teleological schemas has relied on a narrow range of examples and has failed to fully engage with networked dimensions to urbanization. At an analytical level I consider the potential for extending the conceptual framework offered by urban political ecology to take greater account of the epidemiological dimensions to contemporary urbanization and its associated pandemic imaginary. I examine how contemporary health threats intersect with complex patterns of environmental change, including the destruction of biodiversity (and trade in live animals), the co-evolutionary dynamics of viruses and other pathogens, and wider dimensions to the global technosphere, including food production, infrastructure networks, and the shifting topographies of peri- or ex-urban contact zones.

Sample size effects for Lévy flight of photons in atomic vapors

Lévy flight superdiffusion consists of random walks characterized by very long jumps that dominate the transport. However, the finite size of real samples introduces truncation of long jumps and modifies the transport properties. We measure typical Levy flight parameters for photon diffusion in atomic vapor characterized by a Voigt absorption profile. We observe the change of Lévy parameter as a function of truncation length. We associate this variation with size-dependent contributions from different spectral regions of the emission profile with the Doppler core dominating the transport for thin samples and Lorentz wings for thick samples. Monte Carlo simulations are implemented to support the interpretation of results.

Science, healthcare system, and government effectiveness perception and COVID-19 vaccination acceptance and hesitancy in a global sample: an analytical cross-sectional analysis

BACKGROUND

Determinants of COVID-19 vaccine acceptance are complex; how perceptions of the effectiveness of science, healthcare and government impact personal COVID-19 vaccine acceptance is unclear, despite all three domains providing critical roles in development, funding and provision, and distribution of COVID-19 vaccine.

OBJECTIVE

To estimate impact of perception of science, healthcare systems, and government along with sociodemographic, psychosocial, and cultural characteristics on vaccine acceptance.

DESIGN

We conducted a global nested analytical cross-sectional study of how the perceptions of healthcare, government and science systems have impacted COVID-19 on vaccine acceptance.

SETTING

Global Facebook, Instagram and Amazon Mechanical Turk (mTurk) users from 173 countries.

PARTICIPANTS

7411 people aged 18 years or over, and able to read English, Spanish, Italian, or French.

MEASUREMENTS

We used Χ2 analysis and logistic regression-derived adjusted Odds Ratios (aORs) and 95% CIs to evaluate the relationship between effectiveness perceptions and vaccine acceptance controlling for other factors. We used natural language processing and thematic analysis to analyse the role of vaccine-related narratives in open-ended explanations of effectiveness.

RESULTS

After controlling for confounding, attitude toward science was a strong predictor of vaccine acceptance, more so than other attitudes, demographic, psychosocial or COVID-19-related variables (aOR: 2.1; 95% CI: 1.8 to 2.5). The rationale for science effectiveness was dominated by vaccine narratives, which were uncommon in other domains.

LIMITATIONS

This study did not include participants from countries where Facebook and Amazon mTurk are not available, and vaccine acceptance reflected intention rather than actual behaviour.

CONCLUSIONS

As our findings show, vaccine-related issues dominate public perception of science's impact around COVID-19, and this perception of science relates strongly to the decision to obtain vaccination once available.

Household SARS-CoV-2 transmission and children: a network prospective study

Background

The role of children in household transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains uncertain. Here, we describe the epidemiological and clinical characteristics of children with COVID-19 in Catalonia (Spain) and investigate the dynamics of household transmission.

Methods

Prospective, observational, multicenter study performed during summer and school periods (1 July-31 October, 2020), in which epidemiological and clinical features, and viral transmission dynamics were analyzed in COVID-19 patients <16 years. A pediatric index case was established when a child was the first individual infected within a household. Secondary cases were defined when another household member tested positive for SARS-CoV-2 before the child. The secondary attack rate (SAR) was calculated, and logistic regression was used to assess associations between transmission risk factors and SARS-CoV-2 infections.

Results

The study included 1040 COVID-19 patients <16 years. Almost half (47.2%) were asymptomatic, 10.8% had comorbidities, and 2.6% required hospitalization. No deaths were reported. Viral transmission was common among household members (62.3%). More than 70% (756/1040) of pediatric cases were secondary to an adult, whereas 7.7% (80/1040) were index cases. The SAR was significantly lower in households with COVID-19 pediatric index cases during the school period relative to summer (p=0.02), and when compared to adults (p=0.006). No individual or environmental risk factors associated with the SAR were identified.

Conclusions

Children are unlikely to cause household COVID-19 clusters or be major drivers of the pandemic even if attending school. Interventions aimed at children are expected to have a small impact on reducing SARS-CoV-2 transmission.

Lévy flights of photons with infinite mean free path

Multiple scattering of light by resonant vapor is characterized by Lévy-type superdiffusion with a single-step size distribution p(x)∝1/x^{1+α}. We investigate Lévy flight of light in a hot rubidium vapor collisional-broadened by 50 torr of He gas. The frequent collisions produce Lorentzian absorptive and emissive profiles with α<1 and a corresponding divergent mean step size. We extract the Lévy parameter α≈0.5 in a multiple-scattering regime from radial profile of the transmission and from violation of the Ohm's law. The measured radial transmission profile and the total diffusive transmission curves are well reproduced by numerical simulations for Lorentzian line shapes.

Increased Risk of Death Triggered by Domestic Violence, Hunger, Suicide, Exhausted Health System during COVID-19 Pandemic: Why, How and Solutions

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, just like many other public health emergencies, is a well-established global health burden that has resulted in several changes in routines and lifestyles of people globally. The coronavirus disease (COVID-19) pandemic, caused by SARS-CoV-2, has directly or indirectly involved in the loss of lives of more than 3.24 million as of 6th May, 2021. The increasing threats posed by this pandemic were subsided by the swift and drastic measures put in place by different countries. As other causes of death before the emergence of COVID-19 still exist, the pandemic has further worsened their impact. The increased risks of COVID-19 deaths are not only due to the health burden it possesses, but also due to some other factors. These factors include domestic violence that becomes rampant, especially during lockdowns; hunger due to low economic development, unemployment, and loss of jobs; suicide due to depression; exhausted health system due to high level of COVID-19 cases and inability to contain it. As we move from the response phase into recovery, the pandemic's direct and broader impacts on individuals, households, and communities will influence the capacity to recover. An understanding of these impacts is therefore required to develop priorities to support recovery. This paper identifies other causes of death amidst the pandemic, such as domestic violence, hunger, suicide, and exhausted health system, and how to minimize their effects.

Risk of COVID-19-related bullying, harassment and stigma among healthcare workers: an analytical cross-sectional global study

OBJECTIVES

Essential healthcare workers (HCW) uniquely serve as both COVID-19 healers and, potentially, as carriers of SARS-CoV-2. We assessed COVID-19-related stigma and bullying against HCW controlling for social, psychological, medical and community variables.

DESIGN

We nested an analytical cross-sectional study of COVID-19-related stigma and bullying among HCW within a larger mixed-methods effort assessing COVID-19-related lived experience and impact. Adjusted OR (aOR) and 95% CIs evaluated the association between working in healthcare settings and experience of COVID-19-related bullying and stigma, controlling for confounders. Thematic qualitative analysis provided insight into lived experience of COVID-19-related bullying.

SETTING

We recruited potential participants in four languages (English, Spanish, French, Italian) through Amazon Mechanical Turk's online workforce and Facebook.

PARTICIPANTS

Our sample included 7411 people from 173 countries who were aged 18 years or over.

FINDINGS

HCW significantly experienced more COVID-19-related bullying after controlling for the confounding effects of job-related, personal, geographic and sociocultural variables (aOR: 1.5; 95% CI 1.2 to 2.0). HCW more frequently believed that people gossip about others with COVID-19 (OR: 2.2; 95% CI 1.9 to 2.6) and that people with COVID-19 lose respect in the community (OR: 2.3; 95% CI 2.0 to 2.7), both which elevate bullying risk (OR: 2.7; 95% CI 2.3 to 3.2, and OR: 3.5; 95% CI 2.9 to 4.2, respectively). The lived experience of COVID-19-related bullying relates frequently to public identities as HCW traverse through the community, intersecting with other domains (eg, police, racism, violence).

INTERPRETATION

After controlling for a range of confounding factors, HCW are significantly more likely to experience COVID-19-related stigma and bullying, often in the intersectional context of racism, violence and police involvement in community settings.

Conducting an immersive community-based assessment of post-hurricane experience among Puerto Ricans: lived experience of medical ecology in an environmental disaster and migration

Background

Two devastating sequential hurricanes impacted Puerto Rico during September of 2017. The hurricanes were traumatic and created social and ecological upheaval throughout Puerto Rico, and subsequently in communities of Central Florida where affected Puerto Ricans migrated. The 2017 hurricane season exposed and exacerbated previous long-standing socio-political, economic, environmental, and health crises, generating a humanitarian emergency in the country. The consequences of these human-ecological disasters destroyed much of Puerto Rico’s residential and environmental infrastructure, displacing thousands of people and resulting in an unprecedented migration to the United States. We report on the lived experience of the investigator team and partnership in conducting community-based formative research subsequent to this disaster, research that aimed to identify salient issues relating to the impact of Hurricanes Irma and María on Puerto Rican communities both in Puerto Rico and in Central Florida.

Discussion

The challenges faced during the conduct of this research include but are not limited to (1) emotional distress of participants and team members, (2) access to affected populations, and (3) precarious environmental factors, such as unstable infrastructure. To address these challenges, the researchers applied a Critical Medical Ecological paradigm along with qualitative methods to assist constructing explanatory models while obtaining internally-valid (from the community perspective), cathartic narrative accounts of the lived experience of hurricane survivors. The experience of the research team may help inform other investigators conducting applied research during a humanitarian crisis.

Conclusion

Lessons learned in this research included: (1) usefulness of applying the Critical Medical Ecological model in the development of the project, (2) incorporating participation and methods that prioritize authenticity, (3) understanding the trauma experience and using study methods sensitive to it, and (4) innovating with best approaches to conduct the study given the challenges in post-hurricane Puerto Rico. These lessons could provide new insights on how to conduct in-depth participatory health research with community members who have been traumatized and – often – displaced. This research also demonstrates the value of pre-existing partnerships, critical consciousness in the field team, and medical ecological modeling as experiential for organizing complex, inter-related, multi-level variables that explain community and individual impact of environmental disasters.