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Sahoo KC, Sahay MR, Dubey S, Nayak S, Negi S, Mahapatra P, Bhattacharya D, Barrio MOD, Pati S. Community engagement and involvement in managing the COVID-19 pandemic among urban poor in low-and middle-income countries: a systematic scoping review and stakeholders mapping. Glob Health Action 2023; 16:2133723. [PMID: 36537837 PMCID: PMC9769144 DOI: 10.1080/16549716.2022.2133723] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Community engagement and involvement (CEI) was crucial for the COVID-19 pandemic response, particularly among the urban poor in low-and middle-income countries (LMICs). However, no evidence synthesis explores how CEI can benefit public health emergencies. OBJECTIVE We conducted a systematic scoping review of the CEI with an emphasis on stakeholder identification, accountability mapping, the support system, and the engagement process among urban poor populations in LMICs during the COVID-19 pandemic. METHODS We searched eleven databases, including PubMed, Embase, Web of Science, and CINAHL, following the PRISMA-2020 guidelines to find articles published between November 2019 and August 2021. PROSPERO registration No: CRD42021283599. We performed the quality assessment using a mixed-method appraisal tool. We synthesized the findings using thematic framework analysis. RESULTS We identified 6490 records. After the title and abstract screening, 133 studies were selected for full-text review, and finally, we included 30 articles. Many stakeholders were involved in COVID-19 support, particularly for health care, livelihoods, and WASH infrastructure, and their accountability mapping by adopting an interest - influence matrix. This review emphasizes the significance of meaningful CEI in designing and implementing public health efforts for pandemic management among urban slum populations. The interest - influence matrix findings revealed that specific community volunteers, community-based organizations, and civil society organizations had high interest but less influence, indicating that it is necessary to recognize and engage them. CONCLUSION Motivation is crucial for those with high influence but less interest, such as corporate responsibility/conscience and private food supply agencies, for the health system's preparedness plan among urban populations.
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Affiliation(s)
- Krushna Chandra Sahoo
- Health Technology Assessment in India (HTAIn), ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Mili Roopchand Sahay
- Health Technology Assessment in India (HTAIn), ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Shubhankar Dubey
- Health Technology Assessment in India (HTAIn), ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Subhasish Nayak
- Health Technology Assessment in India (HTAIn), ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Sapna Negi
- Health Technology Assessment in India (HTAIn), ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Pranab Mahapatra
- Department of Psychiatry, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Debdutta Bhattacharya
- Health Technology Assessment in India (HTAIn), ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Mariam Otmani Del Barrio
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
| | - Sanghamitra Pati
- Health Technology Assessment in India (HTAIn), ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India,CONTACT Sanghamitra Pati Health Technology Assessment in India (HTAIn), ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha751023, India
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Basile P. Vulnerability, neglect, and collectivity in Brazilian favelas: Surviving the threats of the COVID-19 pandemic and the state's necropolitics. Urban Stud 2023; 60:1690-1706. [PMID: 37416833 PMCID: PMC10311379 DOI: 10.1177/00420980221103342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
The COVID-19 pandemic has deepened existing inequities and injustices in Brazil, seen in the disproportionately detrimental impacts on favelas. State policy responses to the pandemic have disregarded favela residents' experiences. Recommendations such as 'shelter-in-place' ignore the reality of over 11.4 million favela residents who cannot work from home or afford to stop working, nor practise physical distancing from others. This study investigates the discourse of community organisations in favelas as they respond to the threats of the COVID-19 pandemic and the state's necropolitics. Community organisations in favelas have taken action to protect their residents from the virus, unemployment and hunger. I assess organisations' (1) justification to act as a collective in their communities, and (2) stances about the government's responses to the crisis. Through content analysis of social media, websites and media appearances of eight favela organisations and collectives in São Paulo and Rio de Janeiro, this study finds three main themes through which organisations justify their actions: vulnerability, neglect, and collectivity and care. More than survival strategies, the actions of favela organisations are counter-political acts as they oppose the decrepit necropolitics of the state by collectively enduring in the Brazilian context of the COVID-19 pandemic. Understanding favela organisations' actions in response to the pandemic is fundamental. It further illuminates the impact of public health emergencies in the lives of informal settlements' residents and the governance of public health emergencies in these communities.
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Curty Pereira R, Elliott SJ, Llaguno Cárdenas P. Stepping into the Void: Lessons Learned from Civil Society Organizations during COVID-19 in Rio de Janeiro. Int J Environ Res Public Health 2023; 20:ijerph20085507. [PMID: 37107789 PMCID: PMC10138413 DOI: 10.3390/ijerph20085507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/03/2023] [Accepted: 04/12/2023] [Indexed: 05/11/2023]
Abstract
Brazil experienced some of the highest rates of COVID-19 globally. This was complicated by the fact that 35 million of its citizens have limited access to water, a primary resource necessary to stem the spread of infectious diseases. In many cases, civil society organizations (CSOs) stepped into this void left by responsible authorities. This paper explores how CSOs in Rio de Janeiro helped populations struggling with access to water, sanitation, and hygiene (WASH) during the pandemic, and what coping strategies are transferable to similar contexts. In-depth interviews (n = 15) were conducted with CSO representatives in the metropolitan region of Rio de Janeiro. Thematic analysis of the interviews revealed that COVID-19 exacerbated pre-existing social inequities among vulnerable populations, undermining their ability to protect their health. CSOs provided emergency relief aid but faced the counterproductive actions of public authorities who promoted a narrative that diminished the risks of COVID-19 and the importance of non-pharmacological interventions. CSOs fought this narrative by promoting sensitization among vulnerable populations and partnering with other stakeholders in networks of solidarity, playing a vital role in the distribution of health-promoting services. These strategies are transferrable to other contexts where state narratives oppose public health understandings, particularly for extremely vulnerable populations.
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Affiliation(s)
- Rodrigo Curty Pereira
- Geography and Environmental Management, University of Waterloo, Waterloo, ON N2L 3G1, Canada
- Correspondence:
| | - Susan J. Elliott
- Geography and Environmental Management, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Pablo Llaguno Cárdenas
- International Relations and Political Science, Tecnológico de Monterrey, Monterrey 64849, NL, Mexico
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Wirastri MV, Morrison N, Paine G. The connection between slums and COVID-19 cases in Jakarta, Indonesia: A case study of Kapuk Urban Village. Habitat Int 2023; 134:102765. [PMID: 36883042 PMCID: PMC9980904 DOI: 10.1016/j.habitatint.2023.102765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 02/01/2023] [Accepted: 02/04/2023] [Indexed: 06/18/2023]
Abstract
COVID-19 has spread world-wide, and with multiple health, social, and economic ramifications. These present a formidable challenge for those belonging to vulnerable communities, such as those living in slums. There is now a growing literature urging attention to this challenge. However, few studies have examined the actual lived realities within these areas using direct, observational research, notwithstanding commentary elsewhere that such close attention is necessary to ensure effective action. This study took this approach in relation to a particular case-study, Kapuk Urban Village, in Jakarta, Indonesia. Drawing on an existing schema involving three spatial scales of slum areas (environs, settlement, and object), the research confirms how different built and socio-economic features can exacerbate vulnerability, and COVID-19 transmission. We also add to the body of knowledge by contributing a dimension of 'ground-level' research engagement. We conclude by discussing related ideas around ensuring community resilience and effective policy implementation, and recommend an "urban acupuncture" approach to encourage government regulations and actions better tailored to such communities.
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Affiliation(s)
| | - Nicky Morrison
- Western Sydney University, Kingswood, NSW, 2747, Australia
| | - Greg Paine
- Western Sydney University, Kingswood, NSW, 2747, Australia
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Marcassoli A, Leonardi M, Passavanti M, De Angelis V, Bentivegna E, Martelletti P, Raggi A. Lessons Learned from the Lessons Learned in Public Health during the First Years of COVID-19 Pandemic. Int J Environ Res Public Health 2023; 20:1785. [PMID: 36767152 PMCID: PMC9914715 DOI: 10.3390/ijerph20031785] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
(1) Objectives: to investigate the main lessons learned from the public health (PH) response to COVID-19, using the global perspective endorsed by the WHO pillars, and understand what countries have learned from their practical actions. (2) Methods: we searched for articles in PubMed and CINAHL from 1 January 2020 to 31 January 2022. 455 articles were included. Inclusion criteria were PH themes and lessons learned from the COVID-19 pandemic. One hundred and forty-four articles were finally included in a detailed scoping review. (3) Findings: 78 lessons learned were available, cited 928 times in the 144 articles. Our review highlighted 5 main lessons learned among the WHO regions: need for continuous coordination between PH institutions and organisations (1); importance of assessment and evaluation of risk factors for the diffusion of COVID-19, identifying vulnerable populations (2); establishment of evaluation systems to assess the impact of planned PH measures (3); extensive application of digital technologies, telecommunications and electronic health records (4); need for periodic scientific reviews to provide regular updates on the most effective PH management strategies (5). (4) Conclusion: lessons found in this review could be essential for the future, providing recommendations for an increasingly flexible, fast and efficient PH response to a healthcare emergency such as the COVID-19 pandemic.
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Affiliation(s)
- Alessia Marcassoli
- Neurology, Public Health, Disability Unit and Coma Research Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Matilde Leonardi
- Neurology, Public Health, Disability Unit and Coma Research Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Marco Passavanti
- Neurology, Public Health, Disability Unit and Coma Research Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Valerio De Angelis
- Department of Clinical and Molecular Medicine, Sapienza University, 00189 Rome, Italy
| | - Enrico Bentivegna
- Department of Clinical and Molecular Medicine, Sapienza University, 00189 Rome, Italy
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University, 00189 Rome, Italy
| | - Alberto Raggi
- Neurology, Public Health, Disability Unit and Coma Research Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
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Dubey S, Sahoo KC, Dash GC, Sahay MR, Mahapatra P, Bhattacharya D, del Barrio MO, Pati S. Housing-related challenges during COVID-19 pandemic among urban poor in low- and middle-income countries: A systematic review and gap analysis. Front Public Health 2022; 10:1029394. [PMID: 36211702 PMCID: PMC9540216 DOI: 10.3389/fpubh.2022.1029394] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 09/06/2022] [Indexed: 01/29/2023] Open
Abstract
The abysmal health of the urban poor or slum dwellers was attributed to structural inequities such as inadequate housing, water, and sanitation. This review aimed to assess housing-related opportunities and challenges during the COVID-19 pandemic among urban poor in low-and middle-income countries. For study identification, a comprehensive search was performed in 11 databases that yielded 22 potential studies. The inadequate housing infrastructure makes the lives of the urban poor more precarious during COVID-19. Typically, the houses lacked lighting, ventilation, and overcrowding. This review reflected that it is crucial to reimagine housing policy for the urban poor with an emphasis on pandemic/epidemic guidelines.
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Affiliation(s)
- Shubhankar Dubey
- Health Technology Assessment in India, ICMR-Regional Medical Research Centre, Bhubaneswar, India
| | - Krushna Chandra Sahoo
- Health Technology Assessment in India, ICMR-Regional Medical Research Centre, Bhubaneswar, India
| | - Girish Chandra Dash
- Health Technology Assessment in India, ICMR-Regional Medical Research Centre, Bhubaneswar, India
| | - Mili Roopchand Sahay
- Health Technology Assessment in India, ICMR-Regional Medical Research Centre, Bhubaneswar, India
| | - Pranab Mahapatra
- Health Technology Assessment in India, ICMR-Regional Medical Research Centre, Bhubaneswar, India
- Department of Psychiatry, Kalinga Institute of Medical Sciences, Bhubaneswar, India
| | - Debdutta Bhattacharya
- Health Technology Assessment in India, ICMR-Regional Medical Research Centre, Bhubaneswar, India
| | - Mariam Otmani del Barrio
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
| | - Sanghamitra Pati
- Health Technology Assessment in India, ICMR-Regional Medical Research Centre, Bhubaneswar, India
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Sahoo KC, Dubey S, Dash GC, Sahoo RK, Sahay MR, Negi S, Mahapatra P, Bhattacharya D, Sahoo B, Pani SP, del Barrio MO, Pati S. A Systematic Review of Water, Sanitation, and Hygiene for Urban Poor in Low- and Middle-Income Countries during the COVID-19 Pandemic through a Gendered Lens. Int J Environ Res Public Health 2022; 19:ijerph191911845. [PMID: 36231147 PMCID: PMC9565771 DOI: 10.3390/ijerph191911845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 05/10/2023]
Abstract
Inadequate water, sanitation, and hygiene (WASH) among urban poor women is a major urban policy concern in low- and middle-income countries (LMICs). There was a paucity of systematic information on WASH among the urban poor during the pandemic. We reviewed the opportunities and challenges faced by the urban poor in LMICs during the COVID-19 pandemic. We used the PRISMA guidelines to conduct a comprehensive search of 11 databases, including MEDLINE, Embase, Web of Science, and CINAHL, between November 2019 and August 2021. We used thematic analysis to synthesize the qualitative data and meta-analyses to estimate the pooled prevalence. We screened 5008 records, conducted a full-text review of 153 studies, and included 38 studies. The pooled prevalence of shared water points was 0.71 (95% CI 0.37-0.97), non-adherence to hygiene practices was 0.15 (95% CI 0.08-0.24), non-adherence to face masks was 0.27 (95% CI 0.0-0.81), and access to shared community toilets was 0.59 (95% CI 0.11-1.00). Insufficient facilities caused crowding and long waiting times at shared facilities, making physical distancing challenging. Women reported difficulty in maintaining privacy for sanitation, as men were present due to the stay-at-home rule. Due to unaffordability, women reported using cloth instead of sanitary pads and scarves instead of masks.
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Affiliation(s)
- Krushna Chandra Sahoo
- Health Technology Assessment in India (HTAIn), ICMR-Regional Medical Research Centre, Bhubaneswar 751023, India
| | - Shubhankar Dubey
- Health Technology Assessment in India (HTAIn), ICMR-Regional Medical Research Centre, Bhubaneswar 751023, India
| | - Girish Chandra Dash
- Health Technology Assessment in India (HTAIn), ICMR-Regional Medical Research Centre, Bhubaneswar 751023, India
| | - Rakesh Kumar Sahoo
- Health Technology Assessment in India (HTAIn), ICMR-Regional Medical Research Centre, Bhubaneswar 751023, India
| | - Mili Roopchand Sahay
- Health Technology Assessment in India (HTAIn), ICMR-Regional Medical Research Centre, Bhubaneswar 751023, India
| | - Sapna Negi
- Health Technology Assessment in India (HTAIn), ICMR-Regional Medical Research Centre, Bhubaneswar 751023, India
| | - Pranab Mahapatra
- Department of Psychiatry, Kalinga Institute of Medical Sciences, Bhubaneswar 751024, India
| | - Debdutta Bhattacharya
- Health Technology Assessment in India (HTAIn), ICMR-Regional Medical Research Centre, Bhubaneswar 751023, India
| | - Banamber Sahoo
- Health Technology Assessment in India (HTAIn), ICMR-Regional Medical Research Centre, Bhubaneswar 751023, India
| | - Subhada Prasad Pani
- Department of Research and Development, Sri Balaji Vidyapeeth Deemed to be University, Puducherry 605007, India
| | - Mariam Otmani del Barrio
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, 1211 Geneva, Switzerland
| | - Sanghamitra Pati
- Health Technology Assessment in India (HTAIn), ICMR-Regional Medical Research Centre, Bhubaneswar 751023, India
- Correspondence:
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Jevtic M, Matkovic V, Paut Kusturica M, Bouland C. Build Healthier: Post-COVID-19 Urban Requirements for Healthy and Sustainable Living. Sustainability 2022; 14:9274. [DOI: 10.3390/su14159274] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The COVID-19 pandemic has brought a renewed interest in urban environment and healthy living and the changes in urban environments which can make for a healthier living. Today, more than 50% of the global population lives in urban areas, and in Europe the number is 75%. We present a narrative review to explore considerations and necessary requirements to achieve health and well-being within strategies for healthy design and urban planning whilst rethinking urban spaces for a post-COVID-19 and carbon-neutral future. The achievement of health and well-being demands healthy design strategies, namely, (1) moving from the concept of infrastructure for processes to the infrastructure for healthy living—requirements for healthy places, cycling, walking, disintegrating the role of polluting traffic from the urban environments, social vulnerability and equality; (2) physical space that will achieve standards of ‘liveable communities’—open, green space requirements and standards for any built environment; (3) mainstreaming ‘in-the-walking distance’ cities and neighbourhoods for healthy physical activities for daily living; (4) exploring any of the new concepts that connect the nexus of urban spaces and public health and improving of the population’s well-being. Public health needs to be prioritised systematically in planning of built environments, energy generations, sustainable food production, and nutrition.
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Jiao J, Shi L, Chen H, Wang X, Yang M, Yang J, Liu M, Yi X, Sun G. Containment strategy during the COVID-19 pandemic among three Asian low and middle-income countries. J Glob Health 2022; 12:05016. [PMID: 35596570 PMCID: PMC9123341 DOI: 10.7189/jogh.12.05016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background COVID-19 has not been effectively controlled, seriously threatening people’s health and socioeconomic development. This study aims to summarise the successful experiences and lessons in containment strategy learned from Asian Low- and Middle-Income Countries (LMICs) during the COVID-19 pandemic and analyse the effectiveness of their measures to provide lessons for LMICs in general. Methods This is a retrospective study on the effectiveness of China, India, and Vietnam’s containment strategies. The objective was to assess the effectiveness of measures taken for COVID-19 and provide lessons for wider LMICs in controlling and preventing the COVID-19 pandemic. Results As of June 16, 2021, the Indian epidemic was in the declining part of the rebound stage, with a total of 21 521.900 cases per million and 276.740 deaths per million – both the highest among the three countries. Entering the normalised prevention and control stage, China stably remained at a total of 63. 615 cases per million and 3.211 deaths per million. Vietnam's number of new cases per million was very low in the first stage and almost stagnant except for cluster epidemics. In May 2021, the number of new cases per million started to rapidly increase, but the total of deaths per million was at the low level of 0.627. Conclusions A high attention to epidemics at early stages, strict border control measures, and synchronization of government and population on COVID-19 prevention and control opinions and behaviours play important roles in designing containment strategies. In addition, rapid close contact tracing and large-scale nucleic testing are good options for response to cluster epidemics.
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Affiliation(s)
- Jun Jiao
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Leiyu Shi
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Haiqian Chen
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiaohan Wang
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Manfei Yang
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Junyan Yang
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Meiheng Liu
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Xianchun Yi
- Yichun Hospital of Traditional Chinese Medicine, Yichun, Jiangxi, China
| | - Gang Sun
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, Guangdong, China.,Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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Ramani S, Bahuguna M, Tiwari A, Shende S, Waingankar A, Sridhar R, Shaikh N, Das S, Pantvaidya S, Fernandez A, Jayaraman A. Corona was scary, lockdown was worse: A mixed-methods study of community perceptions on COVID-19 from urban informal settlements of Mumbai. PLoS One 2022; 17:e0268133. [PMID: 35522676 PMCID: PMC9075633 DOI: 10.1371/journal.pone.0268133] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 04/23/2022] [Indexed: 11/19/2022] Open
Abstract
The COVID-19 pandemic has magnified the multiple vulnerabilities of people living in urban informal settlements globally. To bring community voices from such settlements to the center of COVID-19 response strategies, we undertook a study in the urban informal settlements of Dharavi, Mumbai, from September 2020-April 2021. In this study, we have examined the awareness, attitudes, reported practices, and some broader experiences of the community in Dharavi with respect to COVID-19. We have used a mixed-methods approach, that included a cross-sectional survey of 468 people, and in-depth interviews and focus group discussions with 49 people living in this area. Data was collected via a mix of phone and face-to-face interviews. We have presented here the descriptive statistics from the survey and the key themes that emerged from our qualitative data. People reported high levels of knowledge about COVID-19, with television (90%), family and friends (56%), and social media (47%) being the main sources of information. The knowledge people had, however, was not free of misconceptions and fear; people were scared of being forcefully quarantined and dying alone during the early days of COVID-19. These fears had negative repercussions in the form of patient-related stigma and hesitancy in seeking healthcare. A year into the pandemic, however, people reported a shift in attitudes from ‘extreme fear to low fear’ (67% reported perceiving low/no COVID risk in October 2020), contributing to a general laxity in following COVID-appropriate behaviors. Currently, the community is immensely concerned about the revival of livelihoods, that have been adversely impacted due to the lockdown in 2020 as well as the continued ‘othering’ of Dharavi for being a COVID hotspot. These findings suggest that urban informal settlements like Dharavi need community-level messaging that counters misinformation and denial of the outbreak; local reinforcement of COVID-appropriate behaviours; and long-term social protection measures.
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Pandey G, Moghal S, Barodia R, Carey W. COVID-19 and Its Effects on the Mental Health of People Living in Urban Slums in India. J Info Know Mgmt 2022. [DOI: 10.1142/s0219649222400032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The COVID-19 pandemic has had a devastating effect on the mental health of people from different backgrounds; these effects have been particularly acute among the lower-income households and in slums. There has been a steep rise in mental illness and behaviours associated with it since 2020, especially in the slums characterised by poverty, poor housing, high density and unhealthy environments. This paper aims to examine the effect of COVID-19 on the mental health of people living in the slums of Vijayawada and Visakhapatnam in the state of Andhra Pradesh in India. The results of the study confirm that more than three-fourth of people suffer from mental stress due to the spread of COVID-19 and the lockdown imposed by the government. Also, 80% of those surveyed stated that stress affected their decision-making. The study also confirms that the number of dependents, monthly income, number of living rooms, maintenance of physical distancing norms, avoidance of social gatherings, government support, health insurance and living in a rented house are significantly related to the mental stress of people living in the slums in Andhra Pradesh in India.
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Affiliation(s)
- Ghanshyam Pandey
- Department of Economics, School of Liberal Arts and Social Sciences (SLASS), SRM University, Mangalagiri, Guntur 522240, Andhra Pradesh, India
| | - Sheeba Moghal
- Department of Economics, School of Liberal Arts and Social Sciences (SLASS), SRM University, Mangalagiri, Guntur 522240, Andhra Pradesh, India
| | - Rakshit Barodia
- Department of Economics, School of Liberal Arts and Social Sciences (SLASS), SRM University, Mangalagiri, Guntur 522240, Andhra Pradesh, India
| | - William Carey
- Department of Economics, School of Liberal Arts and Social Sciences (SLASS), SRM University, Mangalagiri, Guntur 522240, Andhra Pradesh, India
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Eliakimu ES, Mans L. Addressing Inequalities Toward Inclusive Governance for Achieving One Health: A Rapid Review. Front Public Health 2022; 9:755285. [PMID: 35127612 PMCID: PMC8811029 DOI: 10.3389/fpubh.2021.755285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 12/27/2021] [Indexed: 12/03/2022] Open
Abstract
Sustainable development goals (SDGs) adopted in 2015 are geared toward sustainable development through various pathways, one being reducing inequality as covered in SDG 10. Inequalities are a threat to health and wellbeing of populations and a planet Earth in which we live. This rapid review aims to identify key issues that are likely to exacerbate inequalities around the six SDGs directly related to One Health, which are SDG 3, 6, 11, 13, 14 and 15, and suggest some actions that may help to address them using inclusive governance taking into account the coronavirus disease of 2019 (COVID-19) pandemic. Informed by the literature on SDGs and using the “inclusive development concept” by Gupta and Vegelin, literature search was done in Google Scholar, PubMed Central, as well as, searching of references in the relevant articles identified using search terms from the six SDGs that are directly related to One Health. In the context of the SDGs, in order to achieve One Health through inclusive governance, and tackle inequalities, the following needs to be considered and addressed: increasing number of armed conflicts; ongoing COVID-19 pandemic; ensuring availability of water and sanitation facilities; improving city and urban areas planning to cope with climate change; improving governance arrangements for addressing climate change factoring gender and human rights; multisectoral planning for conservation of oceans, seas, and marine resources; balancing trade regulation of wildlife trade with conservation efforts; need for a research collaborative involving experts from environmental sciences, wildlife, agriculture and human health to study and develop scientific evidence on contribution of changes in land use practices to occurrence of zoonotic diseases; and need of a legislation for promoting animal welfare to protect public health. Also, inclusion of people with disabilities in the use of digital technologies is critical.
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Affiliation(s)
- Eliudi S. Eliakimu
- Health Quality Assurance Unit, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
- *Correspondence: Eliudi S. Eliakimu ;
| | - Linda Mans
- An Independent Consultant and Researcher in Support of Healthy People and a Healthy Planet, Manskracht, Nijmegen, Netherlands
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Kalpana P, Patel K, Yasobant S, Saxena D. Water, Sanitation, and Hygiene (WASH) during COVID19 pandemic in India: Practicability in poor settings! ACTA ACUST UNITED AC 2021; 4:100195. [PMID: 34308337 DOI: 10.1016/j.ssaho.2021.100195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 09/11/2020] [Accepted: 06/21/2021] [Indexed: 01/14/2023]
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Valdés Salgado M, Smith P, Opazo MA, Huneeus N. Long-Term Exposure to Fine and Coarse Particulate Matter and COVID-19 Incidence and Mortality Rate in Chile during 2020. Int J Environ Res Public Health 2021; 18:7409. [PMID: 34299859 PMCID: PMC8305128 DOI: 10.3390/ijerph18147409] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/30/2021] [Accepted: 07/06/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Several countries have documented the relationship between long-term exposure to air pollutants and epidemiological indicators of the COVID-19 pandemic, such as incidence and mortality. This study aims to explore the association between air pollutants, such as PM2.5 and PM10, and the incidence and mortality rates of COVID-19 during 2020. METHODS The incidence and mortality rates were estimated using the COVID-19 cases and deaths from the Chilean Ministry of Science, and the population size was obtained from the Chilean Institute of Statistics. A chemistry transport model was used to estimate the annual mean surface concentration of PM2.5 and PM10 in a period before the current pandemic. Negative binomial regressions were used to associate the epidemiological information with pollutant concentrations while considering demographic and social confounders. RESULTS For each microgram per cubic meter, the incidence rate increased by 1.3% regarding PM2.5 and 0.9% regarding PM10. There was no statistically significant relationship between the COVID-19 mortality rate and PM2.5 or PM10. CONCLUSIONS The adjusted regression models showed that the COVID-19 incidence rate was significantly associated with chronic exposure to PM2.5 and PM10, even after adjusting for other variables.
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Affiliation(s)
- Macarena Valdés Salgado
- Center for Climate and Resilience Research CR2, FONDAP N°15110009, Santiago 8370449, Chile; (M.V.S.); (M.A.O.); (N.H.)
- Programa de Epidemiología, Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
- Red de la Pobreza Energética—RedPE, Santiago 8320000, Chile
| | - Pamela Smith
- Center for Climate and Resilience Research CR2, FONDAP N°15110009, Santiago 8370449, Chile; (M.V.S.); (M.A.O.); (N.H.)
- Red de la Pobreza Energética—RedPE, Santiago 8320000, Chile
- Departamento de Geografía, Universidad de Chile, Santiago 8331051, Chile
- Project FONDECYT-INITIATION N°11180990 Social Construction of the Urban Climate: towards Quality and Climate Justice in Chilean Cities, Santiago 8320000, Chile
| | - Mariel A. Opazo
- Center for Climate and Resilience Research CR2, FONDAP N°15110009, Santiago 8370449, Chile; (M.V.S.); (M.A.O.); (N.H.)
| | - Nicolás Huneeus
- Center for Climate and Resilience Research CR2, FONDAP N°15110009, Santiago 8370449, Chile; (M.V.S.); (M.A.O.); (N.H.)
- Red de la Pobreza Energética—RedPE, Santiago 8320000, Chile
- Chile Departamento de Geofísica, Facultad de Cs Físicas y Matemáticas, Universidad de Chile, Santiago 8370449, Chile
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Mishra J, Mishra P, Arora NK. Linkages between environmental issues and zoonotic diseases: with reference to COVID-19 pandemic. Environ Sustain (Singap) 2021; 4:455-467. [PMID: 38624661 PMCID: PMC8005368 DOI: 10.1007/s42398-021-00165-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/28/2021] [Accepted: 03/02/2021] [Indexed: 05/05/2023]
Abstract
Coronavirus disease (COVID-19) caused by severe acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2) has taken mankind by surprise with various unprecedented impacts on human life around the globe. This zoonotic pandemic is proving to be the most destructive disease outbreaks since decades. The increasing human population and anthropogenic activities have impacted the environment and have direct linkages with the current and other recent outbreaks of zoonotic diseases. Despite having a difference in their origin, major reasons behind the emergence and spread of zoonotic pandemics are related to activities such as habitat fragmentation, deforestation, biodiversity loss, intensive agriculture and livestock farming, uncontrolled urbanization, pollution, climate change and bushmeat hunting and trading. It is important to focus on environmental and climatic factors that are involved in the emergence of such pandemics involving novel human pathogens and viruses in particular. Research and data analysis, particularly in relation to COVID-19, has shown that meteorological factors along with population density and living conditions (particularly in the urban and semi-urban areas) play a crucial role in the intensity, evolution and spread of SARS-CoV-2. This particular virus is novel but coronaviruses have a long history and are known to cause disease outbreaks earlier as well. COVID-19 pandemic provides learning for the future, in particular the importance of environmental sustainability for controlling such outbreaks. A strategic plan can be developed involving policy-makers, organizations, and governments to control the onset and spread of the novel pathogens. This review-based study recommends that prevention of COVID-19 like pandemics from re-occurring is through tackling the issues related to the environment by controlling anthropogenic activities. It will also be important to track the lineage and future evolution course of such human pathogens so as to determine the nexus of environmental and biological factors in the development and spread of novel strains.
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Affiliation(s)
- Jitendra Mishra
- Department of Environmental Science, School for Earth and Environmental Sciences, Babasaheb Bhimrao Ambedkar (Central) University, Lucknow, 226025 India
| | - Priya Mishra
- Department of Environmental Science, School for Earth and Environmental Sciences, Babasaheb Bhimrao Ambedkar (Central) University, Lucknow, 226025 India
| | - Naveen Kumar Arora
- Department of Environmental Science, School for Earth and Environmental Sciences, Babasaheb Bhimrao Ambedkar (Central) University, Lucknow, 226025 India
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Abstract
We study the spread of COVID-19 across neighbourhoods of cities in the developing world and find that small numbers of neighbourhoods account for a majority of cases (k-index approx. 0.7). We also find that the countrywide distribution of cases across states/provinces in these nations also displays similar inequality, indicating self-similarity across scales. Neighbourhoods with slums are found to contain the highest density of cases across all cities under consideration, revealing that slums constitute the most at-risk urban locations in this epidemic. We present a stochastic network model to study the spread of a respiratory epidemic through physically proximate and accidental daily human contacts in a city, and simulate outcomes for a city with two kinds of neighbourhoods-slum and non-slum. The model reproduces observed empirical outcomes for a broad set of parameter values-reflecting the potential validity of these findings for epidemic spread in general, especially across cities of the developing world. We also find that distribution of cases becomes less unequal as the epidemic runs its course, and that both peak and cumulative caseloads are worse for slum neighbourhoods than non-slums at the end of an epidemic. Large slums in the developing world, therefore, contain the most vulnerable populations in an outbreak, and the continuing growth of metropolises in Asia and Africa presents significant challenges for future respiratory outbreaks from perspectives of public health and socioeconomic equity.
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Affiliation(s)
- Anand Sahasranaman
- Division of Sciences and Division of Social Sciences, Krea University, Sri City, AP 517646, India
- Centre for Complexity Science and Department of Mathematics, Imperial College London, London SW72AZ, UK
| | - Henrik Jeldtoft Jensen
- Centre for Complexity Science and Department of Mathematics, Imperial College London, London SW72AZ, UK
- Institute of Innovative Research, Tokyo Institute of Technology, 4259, Nagatsuta-cho, Yokohama 226-8502, Japan
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Jones DL, Baluja MQ, Graham DW, Corbishley A, McDonald JE, Malham SK, Hillary LS, Connor TR, Gaze WH, Moura IB, Wilcox MH, Farkas K. Shedding of SARS-CoV-2 in feces and urine and its potential role in person-to-person transmission and the environment-based spread of COVID-19. Sci Total Environ 2020; 749:141364. [PMID: 32836117 PMCID: PMC7836549 DOI: 10.1016/j.scitotenv.2020.141364] [Citation(s) in RCA: 223] [Impact Index Per Article: 55.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 04/14/2023]
Abstract
The recent detection of SARS-CoV-2 RNA in feces has led to speculation that it can be transmitted via the fecal-oral/ocular route. This review aims to critically evaluate the incidence of gastrointestinal (GI) symptoms, the quantity and infectivity of SARS-CoV-2 in feces and urine, and whether these pose an infection risk in sanitary settings, sewage networks, wastewater treatment plants, and the wider environment (e.g. rivers, lakes and marine waters). A review of 48 independent studies revealed that severe GI dysfunction is only evident in a small number of COVID-19 cases, with 11 ± 2% exhibiting diarrhea and 12 ± 3% exhibiting vomiting and nausea. In addition to these cases, SARS-CoV-2 RNA can be detected in feces from some asymptomatic, mildly- and pre-symptomatic individuals. Fecal shedding of the virus peaks in the symptomatic period and can persist for several weeks, but with declining abundances in the post-symptomatic phase. SARS-CoV-2 RNA is occasionally detected in urine, but reports in fecal samples are more frequent. The abundance of the virus genetic material in both urine (ca. 102-105 gc/ml) and feces (ca. 102-107 gc/ml) is much lower than in nasopharyngeal fluids (ca. 105-1011 gc/ml). There is strong evidence of multiplication of SARS-CoV-2 in the gut and infectious virus has occasionally been recovered from both urine and stool samples. The level and infectious capability of SARS-CoV-2 in vomit remain unknown. In comparison to enteric viruses transmitted via the fecal-oral route (e.g. norovirus, adenovirus), the likelihood of SARS-CoV-2 being transmitted via feces or urine appears much lower due to the lower relative amounts of virus present in feces/urine. The biggest risk of transmission will occur in clinical and care home settings where secondary handling of people and urine/fecal matter occurs. In addition, while SARS-CoV-2 RNA genetic material can be detected by in wastewater, this signal is greatly reduced by conventional treatment. Our analysis also suggests the likelihood of infection due to contact with sewage-contaminated water (e.g. swimming, surfing, angling) or food (e.g. salads, shellfish) is extremely low or negligible based on very low predicted abundances and limited environmental survival of SARS-CoV-2. These conclusions are corroborated by the fact that tens of million cases of COVID-19 have occurred globally, but exposure to feces or wastewater has never been implicated as a transmission vector.
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Affiliation(s)
- David L Jones
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK; UWA School of Agriculture and Environment, The University of Western Australia, Perth, WA 6009, Australia.
| | | | - David W Graham
- School of Engineering, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - Alexander Corbishley
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, Easter Bush Campus Midlothian, EH25 9RG, UK
| | - James E McDonald
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK
| | - Shelagh K Malham
- School of Ocean Sciences, Bangor University, Menai Bridge, Anglesey LL59 5AB, UK
| | - Luke S Hillary
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK
| | - Thomas R Connor
- Organisms and Environment Division, School of Biosciences, Cardiff University, Cardiff CF10 3AX, UK; Public Health Wales, University Hospital of Wales, Cardiff CF14 4XW, UK
| | - William H Gaze
- European Centre for Environment and Human Health, University of Exeter Medical School, ESI, Penryn Campus, TR10 9FE, UK
| | - Ines B Moura
- Leeds Institute for Medical Research, Faculty of Medicine and Health, University of Leeds, Leeds LS1 3EX, UK
| | - Mark H Wilcox
- Healthcare Associated Infections Research Group, Leeds Teaching Hospitals NHS Trust and University of Leeds, Leeds, UK
| | - Kata Farkas
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK; School of Ocean Sciences, Bangor University, Menai Bridge, Anglesey LL59 5AB, UK
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Jones DL, Baluja MQ, Graham DW, Corbishley A, McDonald JE, Malham SK, Hillary LS, Connor TR, Gaze WH, Moura IB, Wilcox MH, Farkas K. Shedding of SARS-CoV-2 in feces and urine and its potential role in person-to-person transmission and the environment-based spread of COVID-19. Sci Total Environ 2020; 749:141364. [PMID: 32836117 DOI: 10.20944/preprints202007.0471.v1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 05/18/2023]
Abstract
The recent detection of SARS-CoV-2 RNA in feces has led to speculation that it can be transmitted via the fecal-oral/ocular route. This review aims to critically evaluate the incidence of gastrointestinal (GI) symptoms, the quantity and infectivity of SARS-CoV-2 in feces and urine, and whether these pose an infection risk in sanitary settings, sewage networks, wastewater treatment plants, and the wider environment (e.g. rivers, lakes and marine waters). A review of 48 independent studies revealed that severe GI dysfunction is only evident in a small number of COVID-19 cases, with 11 ± 2% exhibiting diarrhea and 12 ± 3% exhibiting vomiting and nausea. In addition to these cases, SARS-CoV-2 RNA can be detected in feces from some asymptomatic, mildly- and pre-symptomatic individuals. Fecal shedding of the virus peaks in the symptomatic period and can persist for several weeks, but with declining abundances in the post-symptomatic phase. SARS-CoV-2 RNA is occasionally detected in urine, but reports in fecal samples are more frequent. The abundance of the virus genetic material in both urine (ca. 102-105 gc/ml) and feces (ca. 102-107 gc/ml) is much lower than in nasopharyngeal fluids (ca. 105-1011 gc/ml). There is strong evidence of multiplication of SARS-CoV-2 in the gut and infectious virus has occasionally been recovered from both urine and stool samples. The level and infectious capability of SARS-CoV-2 in vomit remain unknown. In comparison to enteric viruses transmitted via the fecal-oral route (e.g. norovirus, adenovirus), the likelihood of SARS-CoV-2 being transmitted via feces or urine appears much lower due to the lower relative amounts of virus present in feces/urine. The biggest risk of transmission will occur in clinical and care home settings where secondary handling of people and urine/fecal matter occurs. In addition, while SARS-CoV-2 RNA genetic material can be detected by in wastewater, this signal is greatly reduced by conventional treatment. Our analysis also suggests the likelihood of infection due to contact with sewage-contaminated water (e.g. swimming, surfing, angling) or food (e.g. salads, shellfish) is extremely low or negligible based on very low predicted abundances and limited environmental survival of SARS-CoV-2. These conclusions are corroborated by the fact that tens of million cases of COVID-19 have occurred globally, but exposure to feces or wastewater has never been implicated as a transmission vector.
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Affiliation(s)
- David L Jones
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK; UWA School of Agriculture and Environment, The University of Western Australia, Perth, WA 6009, Australia.
| | | | - David W Graham
- School of Engineering, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - Alexander Corbishley
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, Easter Bush Campus Midlothian, EH25 9RG, UK
| | - James E McDonald
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK
| | - Shelagh K Malham
- School of Ocean Sciences, Bangor University, Menai Bridge, Anglesey LL59 5AB, UK
| | - Luke S Hillary
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK
| | - Thomas R Connor
- Organisms and Environment Division, School of Biosciences, Cardiff University, Cardiff CF10 3AX, UK; Public Health Wales, University Hospital of Wales, Cardiff CF14 4XW, UK
| | - William H Gaze
- European Centre for Environment and Human Health, University of Exeter Medical School, ESI, Penryn Campus, TR10 9FE, UK
| | - Ines B Moura
- Leeds Institute for Medical Research, Faculty of Medicine and Health, University of Leeds, Leeds LS1 3EX, UK
| | - Mark H Wilcox
- Healthcare Associated Infections Research Group, Leeds Teaching Hospitals NHS Trust and University of Leeds, Leeds, UK
| | - Kata Farkas
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK; School of Ocean Sciences, Bangor University, Menai Bridge, Anglesey LL59 5AB, UK
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Jones DL, Baluja MQ, Graham DW, Corbishley A, McDonald JE, Malham SK, Hillary LS, Connor TR, Gaze WH, Moura IB, Wilcox MH, Farkas K. Shedding of SARS-CoV-2 in feces and urine and its potential role in person-to-person transmission and the environment-based spread of COVID-19. Sci Total Environ 2020. [PMID: 32836117 DOI: 10.1016/j.scitotenv.2020.141364pmid-32836117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The recent detection of SARS-CoV-2 RNA in feces has led to speculation that it can be transmitted via the fecal-oral/ocular route. This review aims to critically evaluate the incidence of gastrointestinal (GI) symptoms, the quantity and infectivity of SARS-CoV-2 in feces and urine, and whether these pose an infection risk in sanitary settings, sewage networks, wastewater treatment plants, and the wider environment (e.g. rivers, lakes and marine waters). A review of 48 independent studies revealed that severe GI dysfunction is only evident in a small number of COVID-19 cases, with 11 ± 2% exhibiting diarrhea and 12 ± 3% exhibiting vomiting and nausea. In addition to these cases, SARS-CoV-2 RNA can be detected in feces from some asymptomatic, mildly- and pre-symptomatic individuals. Fecal shedding of the virus peaks in the symptomatic period and can persist for several weeks, but with declining abundances in the post-symptomatic phase. SARS-CoV-2 RNA is occasionally detected in urine, but reports in fecal samples are more frequent. The abundance of the virus genetic material in both urine (ca. 102-105 gc/ml) and feces (ca. 102-107 gc/ml) is much lower than in nasopharyngeal fluids (ca. 105-1011 gc/ml). There is strong evidence of multiplication of SARS-CoV-2 in the gut and infectious virus has occasionally been recovered from both urine and stool samples. The level and infectious capability of SARS-CoV-2 in vomit remain unknown. In comparison to enteric viruses transmitted via the fecal-oral route (e.g. norovirus, adenovirus), the likelihood of SARS-CoV-2 being transmitted via feces or urine appears much lower due to the lower relative amounts of virus present in feces/urine. The biggest risk of transmission will occur in clinical and care home settings where secondary handling of people and urine/fecal matter occurs. In addition, while SARS-CoV-2 RNA genetic material can be detected by in wastewater, this signal is greatly reduced by conventional treatment. Our analysis also suggests the likelihood of infection due to contact with sewage-contaminated water (e.g. swimming, surfing, angling) or food (e.g. salads, shellfish) is extremely low or negligible based on very low predicted abundances and limited environmental survival of SARS-CoV-2. These conclusions are corroborated by the fact that tens of million cases of COVID-19 have occurred globally, but exposure to feces or wastewater has never been implicated as a transmission vector.
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Affiliation(s)
- David L Jones
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK; UWA School of Agriculture and Environment, The University of Western Australia, Perth, WA 6009, Australia.
| | | | - David W Graham
- School of Engineering, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - Alexander Corbishley
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, Easter Bush Campus Midlothian, EH25 9RG, UK
| | - James E McDonald
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK
| | - Shelagh K Malham
- School of Ocean Sciences, Bangor University, Menai Bridge, Anglesey LL59 5AB, UK
| | - Luke S Hillary
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK
| | - Thomas R Connor
- Organisms and Environment Division, School of Biosciences, Cardiff University, Cardiff CF10 3AX, UK; Public Health Wales, University Hospital of Wales, Cardiff CF14 4XW, UK
| | - William H Gaze
- European Centre for Environment and Human Health, University of Exeter Medical School, ESI, Penryn Campus, TR10 9FE, UK
| | - Ines B Moura
- Leeds Institute for Medical Research, Faculty of Medicine and Health, University of Leeds, Leeds LS1 3EX, UK
| | - Mark H Wilcox
- Healthcare Associated Infections Research Group, Leeds Teaching Hospitals NHS Trust and University of Leeds, Leeds, UK
| | - Kata Farkas
- Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW, UK; School of Ocean Sciences, Bangor University, Menai Bridge, Anglesey LL59 5AB, UK
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Mishra SV, Gayen A, Haque SM. COVID-19 and urban vulnerability in India. Habitat Int 2020; 103:102230. [PMID: 32834301 PMCID: PMC7434393 DOI: 10.1016/j.habitatint.2020.102230] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/30/2020] [Accepted: 08/01/2020] [Indexed: 05/19/2023]
Abstract
The global pandemic has an inherently urban character. The UN-Habitat's publication of a Response Plan for mollification of the SARS-CoV-2 based externalities in the cities of the world testifies to that. This article takes the UN-Habitat report as the premise to carry out an empirical investigation in the four major metro cities of India. The report's concern with the urban character of the pandemic has underlined the role of cities in disease transmission. In that wake, the study demarcates factors at the sub-city level that tend to jeopardize the two mandatory precautionary measures during COVID-19 - Social Distancing and Lockdown. It investigates those factors through a Covid Vulnerability Index. The Index devised with the help of Analytic Hierarchy Process demarcates the low, moderate, high, and very high vulnerable city sub-units. Secondly, UN-Habitat's one of the major action areas is evidence-based knowledge creation through mapping and its analysis. In our study, we do it at a granular scale for arriving at a more nuanced understanding. Thus, in harmony with the UN-habitat's we take the urban seriously and identify the gaps that need to be plugged for the pandemic cities of now and of the future.
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Affiliation(s)
- Swasti Vardhan Mishra
- Department of Geography, University of Calcutta, 35, B. C. Road, Kolkata, 700019, India
- Department of Geography, West Bengal State University, Kolkata, India
- Department of Geography, Rabindra Bharati University, Kolkata, India
| | - Amiya Gayen
- Department of Geography, University of Calcutta, 35, B. C. Road, Kolkata, 700019, India
- Department of Geography, Midnapore College (Autonomous), Vidyasagar University, Midnapore, India
| | - Sk Mafizul Haque
- Department of Geography, University of Calcutta, 35, B. C. Road, Kolkata, 700019, India
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