COVID-19 Health Emergency Research Articles

Rapid Environmental Monitoring, Capture, and Destruction Activities of SARS-CoV-2 and Bacterial Pathogens During the COVID-19 Health Emergency.

The SARS-CoV-2 pandemic is a health emergency for occupational healthcare workers at COVID-19 hospital wards in Italy. The objective of the study was to investigate the bioreactor's effectivity in monitoring and improving air quality via detection, capture, and destruction of the SARS-CoV-2 virus and bacterial pathogens, reducing the risk of transmission among healthcare workers. Bioreactors are a demonstrated effective biomonitoring system. We implemented a methodological approach wherein they were placed at various hospitals treating COVID-19 patients in Italy. The detection of the SARS-CoV-2 virus was achieved through rapid biomonitoring testing of the solutes from the AIRcel bioreactors via SARS-CoV-2 rapid test antigen and consecutive reverse transcription-polymerase chain reaction (RT-PCR) analysis with the multiplex platform (XABT) and the real-time PCR rotor-gene. The marked presence of the SARS-CoV-2 virus was found in multiple water samples via the detection of ORF1ab + N and/or E gene involved in gene expression and cellular signaling of the SARS-CoV-2 virus. The AIRcel bioreactors were able to neutralize the virus and bacterial pathogens effectively as traces of the viruses and bacteria were no longer found in multiple solute samples after an overnight period. Transmission of COVID-19 via bioaerosols, transmitted by infected patients, remains a viable threat for health workers. AIRcel bioreactors allow for rapid biomonitoring testing for early virus detection within the environment, reducing the risk of exponential contagion exposure and maintaining good air quality without endangering health workers. This sameprotocol can also be extended to public spaces as a bio-monitoring hotspot tool for early detection.

Retos y dificultades para los tomadores de decisiones del área de la salud durante la pandemia en Bogotá: perspectiva desde un abordaje fenomenológico interpretativo

Introduction and objectiveThe health emergency caused by COVID-19 presented a context of limited scientific evidence, scarcity of resources, and changes in work routines, for which health workers had to adapt to a transformation of medical practice. This study seeks to know in depth the experiences lived by the health professionals and decision makers of the hospital facing the management of the situations posed by the health emergency of COVID-19. MethodsWe conducted qualitative research with a phenomenological interpretative approach. The target population were the decision-making physicians. The tool used was the in-depth open interview. A thematic analysis was carried out according to the author Steiner Kvale, inductive, where an approximation to the interviews was made, finding the preponderant themes in a repeated way, considering them as categories for the analysis. Finally, the information was grouped to carry out its analysis, relating it to the evidence found in the literature. ResultsThree emerging categories were identified, the first corresponds to organizational changes during the pandemic, the second was organizational culture and the third was mental health perceived by the participants. Our main results were that much of the stress felt by healthcare workers came from making difficult decisions in a context of uncertainty and scarcity of resources. Also, front line workers identify other risk factors that contributed to generate a negative effect on their mental health reflected in some symptoms of anxiety and depression. However, we also showed that these affectations were addressed with various institutional strategies. ConclusionsDespite the limitation of the national context, collectively developed tools and plans were generated that allowed doctors to free themselves from the burden of situations posed by the health emergency, especially when making decisions, thus reducing risk factors that could threaten their mental health.

‘Being old’ and ‘feeling old’ in contemporary Italy: Active ageing and COVID-19

Over the last 20 years, ageing has been studied through the lens of an active ageing perspective, which considers older adults as responsible for their own conditions. However, the COVID-19 health emergency has highlighted its limits. Drawing on a sample of semi-structured interviews – collected before and during the pandemic – with people aged 65 years and above who are self-sufficient and live in Turin, Italy, this article explores the representations and perceptions of ageing, to highlight the possible effects of the COVID-19 emergency. The results show that representations of ageing revolve around two fundamental viewpoints: one considers older adults as a cost for the community because of their unproductiveness; the other overlaps the loss of self-sufficiency with a definition of ‘real’ old age. Furthermore, the interviews introduce a distinction between those who – considered productive despite their age – were called to provide a service to the community during the lockdown, and those who were judged vulnerable because of their age. Such ambiguous messages have raised new questions about an active and successful ageing imperative.

Taxation, health system endowment and institutional quality: ‘Social media’ perceptions across Europe

In this paper we analyse how health system endowment and the quality of institutions impact perceptions towards taxation. We conduct a sentiment analysis of Twitter users' tweets to determine whether the impact of the Covid-19 health emergency has modified the attitudes of the citizens towards taxation in the four largest European countries: France, Germany, Italy and Spain. We use a difference-in-differences estimation strategy, comparing the average sentiments of individual tweets regarding taxation in different European NUTS-2 regions, before and after the spread of the Covid-19 pandemic. Our results highlight that in regions characterised by higher health system endowment people adopted more positive attitudes towards taxation with respect to those living in regions with low levels of health system endowment over the period 2019-2020. In addition, we show how higher quality institutions led to more positive perceptions in relative and absolute terms, suggesting a greater predisposition for a more progressive tax system.

Integration of Omics Data and Network Models to Unveil Negative Aspects of SARS-CoV-2, from Pathogenic Mechanisms to Drug Repurposing.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the COVID-19 health emergency, affecting and killing millions of people worldwide. Following SARS-CoV-2 infection, COVID-19 patients show a spectrum of symptoms ranging from asymptomatic to very severe manifestations. In particular, bronchial and pulmonary cells, involved at the initial stage, trigger a hyper-inflammation phase, damaging a wide range of organs, including the heart, brain, liver, intestine and kidney. Due to the urgent need for solutions to limit the virus' spread, most efforts were initially devoted to mapping outbreak trajectories and variant emergence, as well as to the rapid search for effective therapeutic strategies. Samples collected from hospitalized or dead COVID-19 patients from the early stages of pandemic have been analyzed over time, and to date they still represent an invaluable source of information to shed light on the molecular mechanisms underlying the organ/tissue damage, the knowledge of which could offer new opportunities for diagnostics and therapeutic designs. For these purposes, in combination with clinical data, omics profiles and network models play a key role providing a holistic view of the pathways, processes and functions most affected by viral infection. In fact, in addition to epidemiological purposes, networks are being increasingly adopted for the integration of multiomics data, and recently their use has expanded to the identification of drug targets or the repositioning of existing drugs. These topics will be covered here by exploring the landscape of SARS-CoV-2 survey-based studies using systems biology approaches derived from omics data, paying particular attention to those that have considered samples of human origin.

Perceived Role of the School Nurse in Providing Pertinent COVID-19 Information to the School Community: Experiences of Public Health Graduate Students With School-Aged Children.

The COVID-19 pandemic has been a major disruptor to school systems across the United States since March 2020. As a result, school nurses have had to adapt to these uncertain times. Previous research has demonstrated the impact of school nurses on student health; however, less is known about their role in educating the broader school community about COVID-19 prevention. In Spring 2022, four focus groups were conducted with public health graduate students with school-aged children, to assess perceptions of COVID-19 and public health emergency preparedness communication. MAXQDA was used for thematic analysis. School nurses were viewed as a credible source of COVID-19 information, especially for those who do not have access to healthcare services. While the primary role of school nurses is to provide health services to students, they also have the capacity to provide the community with vital public health emergency preparedness information.

COVID-19 medical care direct costs during the first year of pandemic in a hospital converted for increasing bed capacity.

COVID-19 health emergency caused an increase in the demand for hospitalization and high costs for the health system. To estimate COVID-19 care direct costs from the perspective of the healthcare provider in a secondary care hospital that underwent conversion during the first year of health emergency. Retrospective, observational study. Information on quantities of goods and services was obtained from the SINOLAVE and CVOED platforms and from hospital administrative sources. Four cost groups were defined and estimated with 2021 unit prices in US dollars. Mean hospital length of stay (n = 3,241 patients) was 10.8 ± 8.2 days. Average cost of care per patient was USD 6,557 ± 4,997. Respiratory therapy with assisted mechanical ventilation was used by 13% of patients. The costs of COVID-19 medical care represent a large amount of resources. Most part of the costs (95%) were derived from hospital stay, respiratory therapy without assisted mechanical ventilation and costs related to personal protective equipment, hygiene, infrastructure adaptation and payments to medical personnel.

Remote monitoring as a surveillance method in patients on automated peritoneal dialysis for preventing complications and COVID-19 contagion

BackgroundDue to the health emergency of COVID-19, telemedicine has become more relevant. Remote monitoring conspicuous as a valuable tool for the clinical follow-up of kidney patients, in this case, who are treated with automated peritoneal dialysis. This study aims to describe the use of remote monitoring as a surveillance method in a cohort of patients on automated peritoneal dialysis prevent complications and COVID-19 contagion. MethodsStudy of a cohort of patients who initially participated in a randomized block clinical trial in which the use of Automated Peritoneal Dialysis with Remote Monitoring (APD-RM) was compared with conventional treatment. A descriptive analysis was performed of the rates of infection by COVID-19, the time of incidence until this, mortality, and rates of transfer to hemodialysis. In addition, survival was measured by survival curves. ResultsOf the 509 patients, 19 were positive for COVID-19 (incidence rate of 7.0 episodes/100 patient-year), and only six patients recovered from the infection; the death rate was 2.6 % compared to all-cause death of 9.8 %. The most affected group of patients were those over 50 years old, with 71.4 % mortality, in contrast to younger patients infected, with a mortality of 60 %. During the follow-up period, 21 patients were transferred to HD: six due to peritonitis, five due to UF failure, seven due to catheter dysfunction, one due to uremic syndrome, one due to COVID-19, and one by surgical intervention. ConclusionAPD-RM patients have a significant advantage over other dialysis therapies because the use of telemedicine not only provides continuity in the patient's clinical treatment but also favors the prevention of COVID-19 infection, the management and prevention of complications inherent to therapy and the preservation of the life of Peritoneal Dialysis patients.

Apprendimento digitale dell’italiano L2. Un approccio ludico

Digital Learning of Italian as a Foreign Language: A Playful Approach. Foreign language teaching has been more challenging than ever since the beginning of the Covid-19 health emergency. The transition from face-to-face to remote teaching has raised a series of problems for all stakeholders involved in foreign language teaching training, with particular reference to motivation and the management of the interaction between teachers and students, especially when it came to the assessment of skills acquired in this particular environment. The present contribution showcases a series of teaching activities and examples taken from a course of Italian as a second language, with a view to highlighting how digital tools and technologies can be leveraged with the aim of increasing interaction, involvement, and participation of learners, through a playful approach to task-based activities. A brief presentation of the methodological approach and the digital learning tools is complemented by authentic examples of activities that were implemented in the academic year 2020/21 at Università Cattolica del Sacro Cuore of Milano.

Food insecurity in Piura, Peru, in the context of post-earthquake and the COVID-19 pandemic.

Piura, located in a seismic zone, faces challenges related to food security. The aim of this study was to analyze aspects related to food insecurity in the region following the 6.1-magnitude earthquake that occurred in 2021, within the context of the COVID-19 pandemic. A secondary analysis was performed in 177 people exposed to the earthquake in Piura. Food insecurity was assessed with the Household Food Insecurity Access Scale. Its association with insomnia, resilience, anxiety/depressive symptoms, and general variables were determined using generalized linear models. Food insecurity was observed in 31.1% (95% CI: 24.3-38.4) of participants. This prevalence was higher in people with mild (PR: 1.73, 95% CI: 1.12-2.70) and moderate (PR: 1.55, 95% CI: 1.09-2.22) anxiety symptoms, severe depressive symptoms (PR: 2.74, 95% CI: 1.24-6.03), and previous exposure to the El Niño Phenomenon (PR: 1.72; 95% CI: 1.06-2.81). An income higher than 5000 Peruvian soles (approximately 1300 US dollars) was associated with a lower prevalence of food insecurity (PR: 0.22, 95% CI: 0.13-0.40). Overall, three out of 10 individuals experienced food insecurity after the 2021 earthquake in Piura. Food insecurity may be aggravated by mental disorders, previous exposure to the El Niño phenomenon, and the COVID-19 pandemic. Our study contributes to the field by exploring a range of variables related to food insecurity in a unique context: post-earthquake and during the COVID-19 health emergency in Peru. These findings enhance our understanding of food insecurity at the regional level and highlight the need for preventive food security programs in seismic events.

Life Experiences in Neuromuscular Tracheotomized Patients in Times of Covid-19.

The management of tracheotomy at home can be very complex, affecting the patient's quality of life. This case series study aimed to explore the experiences of patients affected by neuromuscular diseases (NMD) concerning tracheostomy and Invasive Mechanical Ventilation (IMV) management at home during the COVID-19 health emergency in Italy. Semi-structured interviews and the following instruments were used: Connor and Davidson Resilience Scale (CD-RISC-25); Acceptance and Action Questionnaire-II (AAQ-II); State-Trait Anxiety Inventory (STAI); Langer Mindfulness Scale (LMS). Descriptive analyses, correlations, and qualitative analyses were carried out. 22 patients [50% female, mean age = 50.2 (SD = 21.2)] participated in the study. Participants who showed high levels of dispositional mindfulness in terms of novelty-seeking (r = 0.736, p = 0.013) and novelty production (r = 0.644, p = 0.033) were those with higher resilience. The main emotion that emerged was the fear of contagion (19 patients, 86.36%), due to the previous fragile condition, leading to a significant sense of abandonment. The tracheostomy's perception is seen in extremes as a lifesaver or a condemnation. The relationship with the health professionals moves from satisfaction to a feeling of abandonment with a lack of preparation. The relationship between resilience, flexibility, state anxiety and dispositional mindfulness offers ways to reinforce tracheostomy management at home, even in critical periods when going to the hospital may be difficult.

Blended learning during the COVID-19 health emergency (2020-2021): case study in the East Zone of Manaus - Brazil and Nampula-Mozambique

The health emergency (Covid 19, 2020-2021) was an event that affected teaching practice in almost the entire world, including Africa and Brazil. It also highlighted the differences between social strata. It was no different in the east zone of Manaus, one of the poorest regions of the Amazonian capital. It was also like this in Nampula, in the north of Mozambique. In both locations there are precarious schools and students from needy families. In such conditions, teachers had to overcome major challenges brought about by the pandemic, adapting their practices to a new reality, that of Emergency Remote Teaching - ERE, a significant change in the way of teaching. In this context, a reflective analysis was carried out on remote teaching as an evolution in the way of teaching adopted during the pandemic period. The difficulties that teachers had to practice teaching during the adoption of the ERE are discussed, emphasizing the difficulties associated with the particular socioeconomic conditions of the East Zone of Manaus, capital of the State of Amazonas. It is a reflection on the future of teaching in formal education, considering several studies that addressed the new methods, developed, or that gained notoriety from the adoption of the ERE. Furthermore, the question remains: how will society be able to reduce inequalities in education, evidenced and accentuated by the pandemic?

Seasonal correlation of meteorological parameters and PM2.5 with the COVID-19 confirmed cases and deaths in Baghdad, Iraq

The COVID-19 pandemic was a serious global health emergency in 2020 and 2021. This study analyzed the seasonal association of weekly averages of meteorological parameters, such as wind speed, solar radiation, temperature, relative humidity, and air pollutant PM2.5, with confirmed COVID-19 cases and deaths in Baghdad, Iraq, a major megacity of the Middle East, for the period June 2020 to August 2021. Spearman and Kendall correlation coefficients were used to investigate the association. The results showed that wind speed, air temperature, and solar radiation have positive and strong correlations with the confirmed cases and deaths in the cold season (autumn and winter 2020–2021). The total COVID-19 cases negatively correlated with relative humidity but were not significant in all seasons. Besides, PM2.5 strongly correlated with COVID-19 confirmed cases for the summer of 2020. The death distribution by age group showed the highest deaths for those aged 60–69. The highest number of deaths was 41% in the summer of 2020. The study provided useful information about the COVID-19 health emergency and meteorological parameters, which can be used for future health disaster planning, adopting prevention strategies and providing healthcare procedures to protect against future infraction transmission.

COVID-19 communication management in Europe: a comparative analysis of the effect of information-seeking in the public’s sense-making in Italy, Spain and the United Kingdom

PurposeGovernments around the world have shown poor capabilities in responding effectively to the COVID-19 health emergency outbreaks. After the declaration of COVID-19 as an international pandemic by the World Health Organization on January 31, 2020, three countries experienced the greatest initial impact in Europe. Sequentially Italy, Spain and the United Kingdom (UK) were hit by the highest numbers of contagion and death in the first few months in Europe. The aim of this paper is to assess how information channels and sources influenced the public’s evaluation of the three government’s communication response strategies.Design/methodology/approachAn online survey was conducted between March 14 and April 14, 2020, during the first wave of lockdowns and declarations of States of Emergency in the three countries.FindingsFindings show particularities for the different countries, but also similarities in response and reactions of the public in the three scenarios. The response strategy of the UK Government was the most untrusted and criticized by citizens. In contrast, the Italian and Spanish Governments, which both chose to respond with the severest restrictions, attracted more support from citizens, especially in Italy, which was the first to close borders and impose lockdowns for the population.Research limitations/implicationsDespite the national differences in the preference of information channels and sources, overall, an empirical relationship between government communication assessment and media use were found in all the scenarios.Practical implicationsThis empirical study has theoretical and practical implications. Theoretically, findings will add evidence of implications of the Channel Complementary Theory to the field of risk, crisis and emergency communication. The results also provide insights for communication practitioners in the public sector on how forms of information and trust in sources influence the public’s assessment of authorities’ communication.Originality/valueImplications for theory and empirical research about communication during a health pandemic are identified and discussed.HighlightsCitizens engage at a high level and synchronize their use of multiple media and platforms in all the three national scenarios.Stronger criticism is provided by online media, especially social media and online press in the different national contexts.Results corroborate that factors related to media choice need to be operationalized for risk and crisis communication research.When public health depends on people understanding the actions they need to take, the possibility of disobedience is highly dependent on trust.Compared with Spain and the United Kingdom (UK), trust in government institutions in Italy was stronger and could be explained by the higher use of owned media for information-seeking.

Implementation of a teleprehabilitation program for oncosurgical patients during the COVID-19 pandemic: perspectives and user satisfaction.

Many rehabilitation services in the face of the COVID-19 health emergency have had to adapt face-to-face interventions with remote care through teleprehabilitation. We aim to describe the implementation of a teleprehabilitation program during the COVID-19 pandemic for patients who are candidates for elective cancer surgery in a low-income Chilean public hospital. Secondarily, describe the perspectives and satisfaction of patients with the program. Correspond to a descriptive and retrospective pre-habilitation telemedicine intervention study. Implementation was measured in terms of, recruitment rate, retention, dropouts, and occurrence of adverse events. User perspectives and satisfaction were evaluated through a survey composed of nine items on a Likert scale with five response options. Descriptive analyses were considered with mean, standard deviation, minimum, maximum, as well as absolute and relative frequency. For patients' perspectives on the program, a qualitative analysis was considered to describe them. The most relevant domains were identified in a text box to illustrate the results. One hundred fifty-five patients were referred to the teleprehabilitation program, with 99.3% recruitment, a retention rate of 46.7%, and no adverse events reported. In relation to user satisfaction, in general, patients showed good satisfaction with the teleprehabilitation program except items related to "access to the teleprehabilitation program connection" and "number of sessions." Thirty-three patients reported their perspectives on the intervention, represented in 12 domains. It is possible to implement a teleprehabilitation program for oncosurgical patients in the context of preoperative care during the COVID-19 pandemic, with good user satisfaction. Likewise, this study provides guidance for other health institutions that wish to implement a teleprehabilitation program.

Intervention with EMDR on a sample of healthcare workers in the nephrology and dialysis service during the COVID-19 emergency: from immediate treatment effect to long-term maintenance.

During the COVID-19 pandemic, psychological support was provided to healthcare workers in Nephrology and Dialysis Operative Unit of the Azienda Ospedaliera Bassini using an EMDR group protocol to decrease posttraumatic stress symptoms in the medium and long term. The aim of this study was to demonstrate the effectiveness of EMDR treatment to reduce post-traumatic stress symptoms at the end of the first pandemic wave and its progress over time in the subsequent phases of the health emergency. The sample of study consisted of 43 healthcare workers from the Nephrology and Dialysis Service who spontaneously decided to take part in the Brief EMDR treatment. Statistical analyses were carried out to compare the data collected with the IES-R, the Emotion Thermometer and the Post-Traumatic Growth Scale. The comparisons covered pre-treatment, post-treatment and follow-up. The results show a significant clinical improvement in reducing PTSD symptoms following the Brief EMDR group treatment. The comparison between PRE and POST treatment (DELTA1) regarding the scores from IES-R and Emotion Thermometer, highlighted the important statistically change that occurred in terms of symptomatology reduction (p < 0.001). By comparing POST and FU (DELTA2), it was observed that all variables except avoidance show a significant weakening of the effect with time (p < 0.001), but the magnitude of this effect is much smaller than the improvement found in DELTA1. DELTA 3 analysis finally made it possible to highlight how the treatment effect is maintained almost intact at follow-up. In fact, the maintenance of a better situation at follow-up was observed, in the course of re-traumatization linked to the new wave, compared to the initial data (p < 0.001). The COVID-19 health emergency has significantly impacted hospital healthcare workers, leading to a high risk of developing PTSD symptoms. A psychological intervention aimed at the operators themselves is therefore of great importance.

Influence of age, gender, previous SARS-CoV-2 infection, and pre-existing diseases in antibody response after COVID-19 vaccination: A review.

Vaccines induce specific long-term immunological memory against pathogens, preventing the worsening of diseases. The COVID-19 health emergency has caused more than 6 million deaths and started a race for vaccine development. Antibody response to COVID-19 vaccines has been investigated primarily in healthcare workers. The heterogeneity of immune responses and the behavior of this response in particular groups were still very little explored. In this review, we discuss whether antibody responses after vaccination are influenced by age, gender, previous SARS-CoV-2 infection, or pre-existing diseases.

Quality management System adaptation process in a crisis situation: An assessment from a Change Management perspective

The upholding of a Quality Management System (QMS) during situations requiring emergency changes is challenging for organizations. Change management may help ensure these changes are carried out in ways that, while achieving their objectives, promote the appropriate improvements in each context. In a QMS, according to ISO IEC 17025:2017, the change and improvement promoting sources are well-established and their actions occur in a planned manner. But what happens when the working conditions change abruptly, putting at risk the quality of the organization’s core activity? In order to answer this question the internal audit process was chosen as a example for the changes induced by the COVID-19 health emergency. The process of turning the annual internal audit from an in-person activity into the remote modality was evaluated. The ADKAR change management model was applied to assess motivational and perceptual aspects among participants of the 2020 and the 2021 remote audits. The conclusion was that Change Management adoption may assist processes improvement when risk assessment does not have enough data to conduct an accurate analysis.

Integrated vector management program in the framework of the COVID-19 pandemic in Medellin, Colombia

Introduction: The COVID-19 pandemic pressured health care systems to remain alert and active in their vector-borne disease control and prevention programs, leading to changes in vector control strategies in urban areas affected by dengue, Zika and chikungunya. Objective: To describe the adaptations made to the vector control and surveillance program in Medellín during the COVID-19 health emergency. Materials and methods: Once the health emergency started, biosecurity protocols were developed. Entomological surveillance was strengthened from the institutional environment instead of homes. Data was collected in Medellín from 2018 to 2021 during the vector control and surveillance program activities, which included epidemiological and entomovirological surveillance, entomological index survey, ovitrap monitoring, community mobilization, search and elimination of mosquito breading sites, and chemical control. These actions were adapted and/or increased to promote self-care among communities in total and partial confinement, and to develop prevention and control measures. Results: Mosquito monitoring was increased by 40% using ovitraps, entomological virological surveillance showed an increase in 2020 of 34,4% compared to 2019 and virtual media was used to keep and improve contact with the community. Conclusion: The COVID-19 pandemic had a significant impact on arbovirus prevention and control programs. The city of Medellín quickly adapted its entomo-virological surveillance activities, control measures, and the contact with the community during the pandemic, which allow the Integrated Vector Management program to remain active in the city.

Environmental Health Rights and Concepts of Vulnerability of Immigration Detainees in Europe Before and Beyond COVID-19

Abstract The global COVID-19 health emergency has radically changed detention spaces, by heightening state and provider obligations to provide humane conditions and protect those detained against disease and subsequent ill-health. Using a socio-legal lens, this policy and practice note focuses broadly on the balance of European immigration detention regulations, and the actual conditions and treatment of immigrant detainees, putting an emphasis on developments before and after COVID-19. The special protections afforded to detainees assessed as vulnerable is unclear in the Global Compact for Safe, Orderly and Regular Migration. While cognisant of aspects of legal positivism by outlining relevant legal provisions and extant European Court of Human Rights (ECtHR) jurisprudence where conditions of detention have violated Article 3, a socio-legal argument is presented around state obligations to protect the health of all immigration detainees; the challenges in using simplistic/categorical definitions of vulnerability; and the imperatives to broaden considerations to include health vulnerability in the context of contagion and future pandemics. By analogy extant ECtHR jurisprudence on the rights of prisoners relating to right to health and disease mitigation (human immune-deficiency, tuberculosis) may offer additional protections. Broad consideration of environmental health factors in light of threats of disease in detention spaces warrant further consideration when establishing the threshold of the severity of conditions and when assessing detainee vulnerability (not limited to age, gender or health status). A public health rights-based argument can shape effective immigration detention policy reform by enhancing protective parameters based on broad definitions of health vulnerability within immigration detention spaces.