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

查看全文 作　　者：Timothy De Ver [1]Dye;Erin [1]Muir;Lorne [1]Farovitch;Shazia [1]Siddiqi;Saloni [1]Sharma

机构地区：[1]Department of Obstetrics and Gynecology,University of Rochester School of Medicine and Dentistry,601 Elmwood Avenue,Rochester,New York 14642,USA

出　　处：《Infectious Diseases of Poverty》索引2020年第9卷第3期,共7页

基　　金：Mr.Farovitch and Dr.Sharma are trainees in the University of Rochester's Translational Biomedical Science PhD Program,which is supported by Grant TL1 TR002000 from the National Center For Advancing Translational Sciences,National Institutes of Health(Dye,PI);Additionally,Mr.Farovitch receives stipend and tuition support from BWF1014095(Dewhurst/Bennett,PI)from the Burroughs Wellcome Fund;Dr.Siddiqi Research is supported by the National Institute of General Medical Sciences of the National Institute of Health under Award Number K12GM106997. 摘　　要：Background:Practitioners and researchers in the midst of overwhelming coronavirus disease 2019(COVID-19)outbreaks are calling for new ways of looking at such pandemics,with an emphasis on human behavior and holistic considerations.Viral outbreaks are characterized by socio-behaviorally-oriented public health efforts aimed at reducing exposure and prevention of morbidity/mortality once infected.These efforts involve different points-ofview,generally,than do those aimed to understand the virus’natural history.Rampant spread of SARS-CoV-2 infection in cities clearly signals that urban areas contain conditions favorable for rapid transmission of the virus.Main text:The Critical Medical Ecology model is a multidimensional,multilevel way of viewing pandemics comprehensively,rooted simultaneously in microbiology and in anthropology,with shared priority for evolution,context,stressors,homeostasis,adaptation,and power relationships.Viewing COVID-19 with a Critical Medical Ecological lens suggests three important interpretations:1)COVID-19 is equally-if not more-a socially-driven disease as much as a biomedical disease,2)the present interventions available for primary prevention of transmission are social and behavioral interventions,and 3)wide variation in COVID-19 hospitalization/death rates is not expected to significantly be attributable to a more virulent and rapidly-evolving virus,but rather to differences in social and behavioral factors-and power dynamics-rather than(solely)biological and clinical factors.Cities especially are challenged due to logistics and volume of patients,and lack of access to sustaining products and services for many residents living in isolation.Conclusions:In the end,SARS-CoV-2 is acting upon dynamic social human beings,entangled within structures and relationships that include but extend far beyond their cells,and in fact beyond their own individual behavior.As a comprehensive way of thinking,the Critical Medical Ecology model helps identify these elements and dynamics in the context of ecological processes that create,shape,and sustain people in their multidimensional,intersecting environments. 关键词：COVID-19 SARS-CoV-2 CRITICAL MEDICAL ECOLOGY model

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

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