https://twitter.com/bateswalsall1/status/1264308701269233665?s=20
The twitter link above shows a video of a foodbank near where I live in London in a shopping centre in Elephant and Castle. This is a foodbank queue for the unemployed and those receiving benefits. This is not a queue for the homeless. It also shows close proximity and in some places the inability to distance and follow national guidance.
"Currently, there are no studies on the survival of the COVID-19 virus in drinking-water or sewage. The morphology and chemical structure of this virus are similar to those of other coronavirusesa for which there are data about both survival in the environment and effective inactivation measures. This guidance draws on the existing evidence base and current WHO guidance on how to protect against viruses in sewage and drinking-water."
and
"The COVID-19 virus is enveloped and thus less stable in the environment compared to non-enveloped human enteric viruses with known waterborne transmission (such as adenoviruses, norovirus, rotavirus and hepatitis A). "
Link: Water, sanitation, hygiene, and waste management for the COVID-19 virus, Interim guidance, 23 April 2020 by WHO and UNICEF: https://www.who.int/publications-detail/water-sanitation-hygiene-and-wa…
These excerpts from WHO regs, relate to Aalok Khandekar’s draft commentary, “Heat and Contagion in the Off-Grid City” in relation to mentioning hepatitis.
And, also to a comment in previous weeks around air transmission and sewage across the border in north and south America made by Kim Fortun
The authors are Paul E. Farmer, Bruce Nizeye, Sara Stulac, and Salmaan Keshavjee. All of the authors are involved with the nonprofit organization Partners in Health in some capacity, with experience working with rural or poverty stricken areas. Paul E Farmer, the primary author of the article is a medical doctor also working for the United Nations who has published many other articles on similar topics.
The main argument is that susceptibility to certain diseases is not only determined by biology but also social conditions, leading to a disproportionate disease rate among the poor, and minority groups without access to medical services. The author shows that addressing these social conditions leads to a decrease in disease when combining treatment and prevention plans.
The argument is supported through a combination of historical information including rates of AIDS in the early 1990’s and a study done in Baltimore in an effort to reduce AIDS rates in African Americans, who were more likely to be in poverty, by addressing monetary barriers to heath care. Two more recent cases are also used to support the main argument, implementing a method created by the Partners in Health to prevent transmission and provide AIDS care in rural Haiti and rural Rwanda. Throughout the article references were made to the current medical professional’s dilemma, where they are in a position to see the social inequalities contributing to disease rates but not trained to report or change common social contributing factors. This makes the article more relatable to the reader that may have experience in the medical field which elps to support the argument.
“Pioneers of modern public health during the nineteenth century, such as Rudolph Virchow, understood that epidemic disease and dismal life expectancies were tightly linked to social conditions [55,56].” (Farmer 5)
“…large-scale social forces—racism, gender inequality, poverty, political violence and war, and sometimes the very policies that address them—often determine who falls ill and who has access to care.” (Farmer 1)
“In an attempt to address these ethnic disparities in care, researchers and clinicians in Baltimore reported how racism and poverty— forms of structural violence, though they did not use these specific terms—were embodied [33,34] as excess mortality among African Americans without insurance.” (Farmer 2)
Data collected from a study done in Baltimore in the 1990’s, including statistics and observations is used to support the main argument. The methods used in Haiti and Rwanda as well as the results from implementing those methods are also used as examples for the claim that social conditions greatly impact disease susceptibility.
Emergency response is addressed in terms of both long term response and future emergency prevention. The method used by the PIH in both Haiti and Rwanda were implemented in response to high rates of disease in those places, showing that an emergency can occur gradually and the response may require creating a permanent system. Prevention is also discussed as a portion of emergency response, that it is important not only to deal with emergencies as they occur but also to identify the causes and change the system to prevent the same emergency in the future.
The article has primarily been referenced in later works by Paul E. Farmer who has written several other papers and articles on both the medical state of Haiti and Rwanda as well as structural violence in many capacities. The article was initially published in 2006 and has since been published in journals, books, as well as open online collections for use by the sts community.
The bibliography shows references to several papers by many of the same authors, showing it was produced as a continuation of previous ideas but showing new information learned through the PIH’s activities in Haiti and Rwanda. The bibliography also shows many references from the early to mid 1990’s showing similar thoughts to initial research done in Baltimore and other places with high rates of AIDS.