| 1 | Critical medical ecology and SARS-COV-2 in the urban environment:a pragmatic,dynamic approach to explaining and planning for research and practice显示文摘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. | Timothy De Ver Dye Erin Muir Lorne Farovitch Shazia Siddiqi Saloni Sharma | 2020 | Infectious Diseases of Poverty2020，9，3： | 1 |
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