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      COVID-19 COPING-PREVENTION STRATEGIES FOR FEMALE SEXUAL WORKERS IN THE CONTEXT OF VARIOUS COUNTRIES Translated title: ESTRATEGIAS DE AFRONTAMIENTO Y PREVENCIÓN DEL COVID-19 PARA TRABAJADORAS DEL SEXO EN VARIOS PAÍSES Translated title: ESTRATÉGIAS DE ENFRENTAMENTO E PREVENÇÃO À COVID-19 PARA TRABALHADORAS SEXUAIS, NO CONTEXTO DE DIVERSOS PAÍSES

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          Abstract

          ABSTRACT Objective: to analyze the scientific evidence on COVID-19 coping and prevention strategies implemented to female sex workers in the context of several countries. Methods: this is an integrative literature review, with data collected in the PubMed, Scopus, Virtual Health Library and Google Scholar databases using the Boolean descriptors “COVID-19” and “sex workers” and “Delivery of Health Care”, with a time frame from 2019 to 2020. A priori, 215 publications were found. After selection, anchored in the inclusion criteria and in the answer to the guiding question, 19 articles were used, whose information was organized in a synoptic table, and the texts were analyzed using semantic content. Results: after content analysis of actions implemented or recommended in different countries, so that female sex workers can prevent contamination by Sars-CoV-2, four categories were highlighted: programmatic/governmental actions and responses from society; combating the stigmas involved in sex work; health education through technological/digital and media resources; adjustment of health services. Conclusion: gender, race and class inequalities, as well as social stigmas, have been maintained by states governed by patriarchy and, therefore, are the main barriers for female sex workers to adopt strategies to combat COVID-19. Even so, intersectoral actions have been implemented/recommended in several countries such as the adjustment of sexual health services, financial incentives to improve the services of signal operators and digital technologies to implement effective actions to promote health education and enable the distribution of inputs for individual protection and prevention.

          Translated abstract

          RESUMEN Objetivo: analizar la evidencia científica sobre las estrategias de afrontamiento y prevención del COVID-19 implementadas a las trabajadoras sexuales, en el contexto de varios países. Métodos: revisión integradora de la literatura, con datos recopilados en las bases de datos PubMed, Scopus, Virtual Health Library y Google Scholar utilizando los descriptores booleanos “COVID-19” and “sex workers” and “Delivery of Health Care”, con un marco temporal de 2019 a 2020. A priori, se encontraron 215 publicaciones. Tras la selección, anclada en los criterios de inclusión y en la respuesta a la pregunta orientadora, se utilizaron 19 artículos, cuya información se organizó en la tabla sinóptica y los textos se analizaron a través del contenido semántico. Resultados: luego del análisis de contenido de las acciones implementadas o recomendadas en diferentes países, para que las trabajadoras sexuales puedan prevenir la contaminación por Sars-CoV-2, se destacaron cuatro categorías: acciones programáticas/gubernamentales y respuestas de la sociedad; combatir los estigmas relacionados con el trabajo sexual; educación para la salud a través de recursos tecnológicos/digitales y mediáticos; reajuste de los servicios de salud. Conclusión: las inequidades de género, raza y clase, así como los estigmas sociales, han sido mantenidos por estados gobernados por el patriarcado y, por lo tanto, son las principales barreras para que las trabajadoras sexuales adopten estrategias para enfrentar el COVID-19. Aun así, se han implementado/recomendado acciones intersectoriales en varios países como el reajuste de los servicios de salud sexual, incentivos financieros para mejorar los servicios de los operadores de señales y tecnologías digitales para implementar acciones efectivas que promuevan la educación en salud y permitan la distribución de insumos para la protección y prevención individual.

          Translated abstract

          RESUMO Objetivo: analisar as evidências científicas sobre as estratégias de enfrentamento e prevenção à COVID-19 implementadas às trabalhadoras sexuais, no contexto de diversos países. Métodos: revisão integrativa de literatura, com dados coletados nas bases PubMed, Scopus, Biblioteca Virtual em Saúde e Google Scholar usando os descritores booleanos “COVID-19” and “sex workers” and “Delivery of Health Care”, com recorte temporal de 2019 a 2020. Encontrou-se, a priori, 215 publicações. Após a seleção, ancorada nos critérios de inclusão e na resposta à pergunta norteadora, aproveitaram-se 19 artigos, cujas informações foram organizadas no quadro sinóptico e os textos analisados mediante o conteúdo semântico. Resultados: após análise de conteúdo das ações implementadas ou recomendadas nos diversos países, para que as profissionais do sexo possam se prevenir da contaminação pelo SARS-Cov-2, foram evidenciadas quatro categorias: ações programáticas/governamentais e respostas da sociedade; combate aos estigmas envoltos do trabalho sexual; educação em saúde através de recursos tecnológicos/digitais e midiáticos; readequação dos serviços de saúde. Conclusão: as iniquidades de gênero, raça e classe, bem como os estigmas sociais têm sido mantidas por Estados regidos pelo patriarcado e, por isso, são as principais barreiras para adoção de estratégias de enfrentamento à COVID-19 por parte das trabalhadoras sexuais. Ainda assim, ações intersetoriais foram implementadas/recomendadas em diversos países como a readequação dos serviços de saúde sexual, incentivos financeiros para melhoria dos serviços das operadoras de sinal e tecnologias digitais para implementação de ações efetivas à promoção da educação em saúde e possibilitar a distribuição de insumos para proteção e prevenção individual.

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          A new coronavirus associated with human respiratory disease in China

          Emerging infectious diseases, such as severe acute respiratory syndrome (SARS) and Zika virus disease, present a major threat to public health 1–3 . Despite intense research efforts, how, when and where new diseases appear are still a source of considerable uncertainty. A severe respiratory disease was recently reported in Wuhan, Hubei province, China. As of 25 January 2020, at least 1,975 cases had been reported since the first patient was hospitalized on 12 December 2019. Epidemiological investigations have suggested that the outbreak was associated with a seafood market in Wuhan. Here we study a single patient who was a worker at the market and who was admitted to the Central Hospital of Wuhan on 26 December 2019 while experiencing a severe respiratory syndrome that included fever, dizziness and a cough. Metagenomic RNA sequencing 4 of a sample of bronchoalveolar lavage fluid from the patient identified a new RNA virus strain from the family Coronaviridae, which is designated here ‘WH-Human 1’ coronavirus (and has also been referred to as ‘2019-nCoV’). Phylogenetic analysis of the complete viral genome (29,903 nucleotides) revealed that the virus was most closely related (89.1% nucleotide similarity) to a group of SARS-like coronaviruses (genus Betacoronavirus, subgenus Sarbecovirus) that had previously been found in bats in China 5 . This outbreak highlights the ongoing ability of viral spill-over from animals to cause severe disease in humans.
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            Preparedness and vulnerability of African countries against importations of COVID-19: a modelling study

            Summary Background The novel coronavirus disease 2019 (COVID-19) epidemic has spread from China to 25 countries. Local cycles of transmission have already occurred in 12 countries after case importation. In Africa, Egypt has so far confirmed one case. The management and control of COVID-19 importations heavily rely on a country's health capacity. Here we evaluate the preparedness and vulnerability of African countries against their risk of importation of COVID-19. Methods We used data on the volume of air travel departing from airports in the infected provinces in China and directed to Africa to estimate the risk of importation per country. We determined the country's capacity to detect and respond to cases with two indicators: preparedness, using the WHO International Health Regulations Monitoring and Evaluation Framework; and vulnerability, using the Infectious Disease Vulnerability Index. Countries were clustered according to the Chinese regions contributing most to their risk. Findings Countries with the highest importation risk (ie, Egypt, Algeria, and South Africa) have moderate to high capacity to respond to outbreaks. Countries at moderate risk (ie, Nigeria, Ethiopia, Sudan, Angola, Tanzania, Ghana, and Kenya) have variable capacity and high vulnerability. We identified three clusters of countries that share the same exposure to the risk originating from the provinces of Guangdong, Fujian, and the city of Beijing, respectively. Interpretation Many countries in Africa are stepping up their preparedness to detect and cope with COVID-19 importations. Resources, intensified surveillance, and capacity building should be urgently prioritised in countries with moderate risk that might be ill-prepared to detect imported cases and to limit onward transmission. Funding EU Framework Programme for Research and Innovation Horizon 2020, Agence Nationale de la Recherche.
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              Refugee and migrant health in the COVID-19 response

              In a continued effort to curb the spread of coronavirus disease 2019 (COVID-19), countries have been tightening borders and putting travel restrictions in place. These actions have affected refugees and migrants worldwide. The International Organization for Migration and UNHCR announced on March 10, 2020, that resettlement travel for refugees will be temporarily suspended, although the agencies have appealed to states to ensure emergency cases are exempted. 1 The COVID-19 pandemic has prompted some countries to take steps towards further reducing population movement that affects humanitarian corridors around the world. At the same time, there could be cases of refoulement with asylum seekers being returned to their countries of origin, where they are at risk of persecution and in an apparent breach of international law. As of March 29, 2020, WHO reported 146 countries and territories with cases of COVID-19 from local transmission of severe acute respiratory syndrome coronavirus 2, many of which have large refugee populations. 2 Search and rescue operations in the central Mediterranean, where more than 16 000 migrants have died since 2015, 3 have been suspended due to logistical difficulties caused by COVID-19. The few search and rescue operations conducted before the COVID-19 nationwide lockdowns led to the immediate quarantine of migrants in reception centres. These measures were taken even though there was no confirmed case of COVID-19 in Africa at that time. In fact, some refugees and migrants are travelling from countries not yet substantially affected by COVID-19 and entering countries with increasing numbers of COVID-19 cases. Measures to respond to the COVID-19 pandemic are a focus of communities in countries, but preparedness plans should consider refugees and migrants and their needs. Evidence shows that this vulnerable population has a low risk of transmitting communicable diseases to host populations in general. 4 However, refugees and migrants are potentially at increased risk of contracting diseases, including COVID-19, because they typically live in overcrowded conditions without access to basic sanitation. The ability to access health-care services in humanitarian settings is usually compromised and exacerbated by shortages of medicines and lack of health-care facilities. Moreover, refugees typically face administrative, financial, legal, and language barriers to access the health system. 4 Conditions in refugee camps are concerning. Many people who have been affected by humanitarian crises live in camps or camp-like settings in host countries. These camps usually provide inadequate and overcrowded living arrangements that present a severe health risk to inhabitants and host populations. The absence of basic amenities, such as clean running water and soap, insufficient medical personnel presence, and poor access to adequate health information are major problems in these settings. Basic public health measures, such as social distancing, proper hand hygiene, and self-isolation are thus not possible or extremely difficult to implement in refugee camps. If no immediate measures to improve conditions are put in place, the concern about an outbreak of COVID-19 in the camps cannot be overstated. Site-specific epidemiological risk assessments must be done to determine the extent of the risk of COVID-19 introduction and transmission in such settlements, together with case management protocols and rapid deployment of outbreak response teams if needed. Migrants and refugees are particularly vulnerable to the impact of COVID-19 in the wider community. They are over-represented among the homeless population in most member states—a growing trend in EU-15 and border and transit countries. 5 Living conditions for homeless refugees and migrants can undermine the ability to follow public health advice, including basic hygiene measures, quarantine, or self-isolation, because many people are in close contact and gather in large groups. Furthermore, international migrant workers and refugees can be affected by income loss, health-care insecurity, and the ramifications that come with postponement of decisions on their legal status or reduction of employment, legal, and administrative services. There is also scarce culturally and linguistically accessible information about COVID-19 and how to protect oneself and others, which further increases risks to refugees and migrants as well as host populations. © 2020 Alkis Konstantinidis/Reuters 2020 Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. Additionally, states of emergency and lockdowns to deal with the pandemic have affected refugee and migrant volunteer community service provision for this population group. An inclusive approach to refugee and migrant health that leaves no one behind during the COVID-19 pandemic should guide our public health efforts. As governments tighten border controls and implement other measures in response to COVID-19, they need to consider the impacts on refugees and migrants and ensure that such actions do not prevent people from accessing safety, health-care services, and information. There must be no forced returns and refoulement justified by or based on fears or suspicion of COVID-19 transmission, especially because there is estimated to be low risk of transmitting communicable disease from refugee and migrant populations to host populations in the WHO European region. 4 Yet migrants and refugees are often stigmatised and unjustly discriminated against for spreading disease and such unacceptable attitudes further risk wider public health outcomes, including for host populations, since refugees and migrants could be fearful to seek treatment or disclose symptoms. 6 Refugees and migrants must be included in national public health systems, with no risk of financial or legal consequences for them. This approach is of the utmost importance, as there can be no public health without refugee and migrant health.
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                Author and article information

                Journal
                tce
                Texto & Contexto - Enfermagem
                Texto contexto - enferm.
                Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem (, SC, Brazil )
                0104-0707
                1980-265X
                2021
                : 30
                : e20200560
                Affiliations
                [2] Guanambi Bahia orgnameCentro de Ensino Superior de Guanambi Brasil
                [1] Jequié orgnameUniversidade Estadual do Sudoeste da Bahia orgdiv1Programa de Pós-Graduação em Enfermagem e Saúde Brazil
                [4] Salvador Bahia orgnameUniversidade do Estado da Bahia orgdiv1Programa de Pós-Graduação Mestrado Profissional em Saúde Coletiva Brazil
                [3] Rio de Janeiro Rio de Janeiro orgnameUniversidade do Estado do Rio de Janeiro orgdiv1Programa de Pós-Graduação em Enfermagem Brazil
                Article
                S0104-07072021000100207 S0104-0707(21)03000000207
                10.1590/1980-265x-tce-2020-0560
                66ef4d00-2e22-4167-ab20-56113cf40640

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 20 October 2020
                : 13 January 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 36, Pages: 0
                Product

                SciELO Brazil

                Categories
                Special Section COVID-19

                Pandemics,Coronavirus infections,Salud de la mujer,Género,Trabajadores sexuales,Pandemias,Infecciones por coronavirus,Saúde da mulher,Gênero,Profissionais do sexo,Infecções por coronavírus,Women’s health,Gender,Sex workers

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