The vulnerability of migrants living in large urban areas to COVID-19: Exacerbators and mitigators

Background

Even though large urban areas have been researched in the context of COVID-19, evidence on how COVID-19 impacted migrants -a particularly vulnerable group- in these settings is still limited.

Objective: To explore exacerbating and mitigating factors of large urban areas on migrants’ vulnerabilities during the COVID-19 pandemic.

Methods

We conducted a systematic review of peer-reviewed literature published between 2020-2022 and focused on migrants (foreign-born individuals who have not been naturalized in the host country, regardless of immigration status) in urban areas with a population >500.000. After screening 880 studies, 29 studies were included and categorized within the following thematic framework: 1) Underlying structural inequities, 2) governance and economic structure, 3) urban design, and 4) engagement of civil society organizations (CSO).

Results

Exacerbating factors include pre-existing inequities (e.g., unemployment, financial precarity, and barriers to healthcare access), exclusionary government responses (e.g., relief funds or unemployment benefits), and residential segregation. Mitigating factors include the engagement of CSOs and the implementation of innovative governance strategies such as e-governance and use of teleservices. Recommendations: We recommend increased attention to pre-existing social inequities faced by migrants, inclusive governance strategies, and partnerships between government and CSOs to improve the design and delivery of services to migrants in large urban areas. More research is needed on how urban design can be utilized to mitigate the COVID-19 impacts on migrant communities.

Conclusions

The factors identified in this systematic review should be considered as part of migrant-inclusive emergency preparedness to address the disproportionate impact of similar public health crises on migrant communities.

Key messages

Ovine adenovirus serotype 7-associated mortality in lambs in the United States

Adenoviral infections were diagnosed in three neonatal lambs that died spontaneously, and no other etiologic agents were identified. Clinical signs were anorexia, weakness, abdominal distention, and sudden death. Microscopic lesions consisted of multifocal necrotizing hepatitis, multifocal subacute interstitial nephritis, and loss of enterocytes from intestinal villi. Adenovirus inclusions were identified by light microscopy in the kidneys only. Adenoviral antigen, however, was identified in the liver, kidney, and intestine of the lambs by immunohistochemical techniques. An ovine adenovirus serotype 7, not previously isolated from sheep in the United States, was characterized from these lambs.

Characterization of a new adenovirus isolated from black-tailed deer in California

An adenovirus associated with systemic and localized vascular damage was demonstrated by transmission electron microscopy and immunohistochemistry in a newly recognized epizootic hemorrhagic disease in California black-tailed deer. In this study, we describe the cultural, physicochemical and serological characteristics of a virus isolated from lung using neonatal white-tail deer lung and turbinate cell cultures. The virus had the cultural, morphological and physicochemical characteristics of members of the Adenoviridae family. The virus would not replicate in low passage fetal bovine, caprine or ovine cells. Antiserum to the deer adenovirus, strain D94-2569, neutralized bovine adenovirus type-6 (BAdV-6), BAdV-7, and caprine adenovirus type-1 (GAdV-1). Antiserum to BAdV-6 did not neutralize the deer adenovirus but antiserum to BAdV-7 and GAdV-1 neutralized the deer adenovirus. Cross-neutralization with the other bovine, caprine and ovine adenovirus species was not observed. Restriction endonuclease patterns generated for the deer adenovirus were unique compared to those for the currently recognized bovine, caprine and ovine adenovirus types. Amino acid sequence alignments of the hexon gene from the deer adenovirus strain D94-2569 indicate that it is a member of the proposed new genus (Atadenovirus) of the Adenoviridae family. While closely related antigenically to BAdV-7 and GAdV-1, the deer adenovirus appears sufficiently distinct culturally and molecularly to justify consideration as a new adenovirus type.