Marginalised groups are among people the hardest hit by the COVID-19 pandemic, and yet are among the least protected from it by governmental actions to date. Indeed, the COVID-19 crisis has brought into sharp focus the stark inequities that exist in access to health and social support services for marginalised people who live precariously in Europe, often outside formal healthcare systems and social, labour and legal protection measures.
The Nobody Left Outside coalition has developed this briefing paper for the WHO European Office for Investment for Health
(C-EHRN) report on the impact of COVID-19 on vital
harm reduction services seeks to bring these voices
of front-line workers at drug consumption rooms
(DCR’s), harm reduction outreach teams and
PWUD themselves to highlight their experiences
during the COVID-19 pandemic.
Prevalence studies of current smoking, among hospitalized COVID-19 patients, demonstrated an unexpectedly low prevalence among patients with COVID-19. The aim of the present study was to evaluate the effect of smoke from cigarettes on ACE-2 in bronchial epithelial cells. Normal bronchial epithelial cells (H292) were exposed to smoke by an air-liquid-interface (ALI) system and ACE-2 membrane protein expression was evaluated after 24 hours from exposure. Our transcriptomics data analysis showed a significant selective reduction of membrane ACE-2 expression (about 25%) following smoking exposure. Interestingly, we observed a positive direct correlation between ACE-2 reduction and nicotine delivery. Furthermore, by stratifying GSE52237 as a function of ACE-2 gene expression levels, we highlighted 1012 genes related to ACE-2 in smokers and 855 in non-smokers. Furthermore, we showed that 161 genes involved in the endocytosis process were highlighted using the online pathway tool KEGG. Finally, 11 genes were in common between the ACE-2 pathway in smokers and the genes regulated during endocytosis, while 12 genes with non-smokers. Interestingly, six in non-smokers and four genes in smokers were closely involved during the viral internalization process. Our data may offer a pharmaceutical role of nicotine as potential treatment option in COVID-19.
In some countries, there has been a positive recognition to the needs of people sleeping rough and their vulnerabilities during a public health emergency. It is incumbent upon governments to work with local partners to ensure that rapid responses to the housing of people sleeping rough addresses the often complex needs of such people through an interdisciplinary approach so that their immediate and longer-term medical, psycho-social and economic needs are integrated into the provision of accommodation. This can be accomplished through partnerships built with other stakeholders during normal times and by having multidisciplinary teams, that include mental health staff, working on the streets with people sleeping rough. Such responses to homelessness and rough sleeping during a public health emergency is an opportunity to advocate at all levels of government for a longerterm strategy to comprehensively and holistically address such issues, together with long-term sustainable funding to implement such a plan. Furthermore, it is vital to ensure that there is a buffer stock of vital medicines already in-country for at least the forthcoming 3-6 months; this applies to all sectors of society and particularly those medications most in need by vulnerable and marginalised individuals and communities – including the treatment of TB and HCV (especially Direct-Acting Antivirals) as well as for HIV (antiretrovirals) and Opioid Substitution Therapy (OST, meaning methadone and/or buprenorphine), as well as naloxone for opioid overdose.
Please note: there are various version of this report if you click on the file!
This is the second civil society-led monitoring report produced by Correlation – European Harm Reduction Network (C-EHRN). The purpose of this report is to enrich the information and knowledge base of harm reduction interventions in Europe from the viewpoint of civil society organisations. The Monitoring report gathers data on the experiences of harm reduction service providers and service users at ground level, building on a network of national Focal Points (FPs) in Europe. For the 2020 monitoring, C-EHRN includes 35 FPs in 34 countries. To get insight at the implementation level, and to profit from the experiences and expertise of FPs, the 2020 monitoring focuses mostly on cities rather than countries. The main areas monitored are: essential harm reduction services, overdose prevention, Hepatitis C, New drug Trends, Civil Society Involvement and COVID-19 impact on harm reduction services and people who use drugs.
A growing number of highly potent substances that pose a high risk of acute poisoning are also being reported. These include synthetic cannabinoids, opioids, benzodiazepines and a range of other substances.
The COVID-19 pandemic has brought into sharp focus the importance of ‘complex, transboundary, multifactorial’ approaches to tackling health challenges, the need to strengthen health security and the interconnected nature of health in our globalised world.
The effect of the pandemic on the drug situation, including the new psychoactive substances market, is likely to become increasingly important as countries in Europe face the second wave of the outbreak during autumn and winter 2020 and into 2021.
In the third in its series of rapid ‘trendspotter’ studies, the EMCDDA explores the impact of COVID-19 on the drug situation and responses to it. Revisiting and reviewing findings from two studies in 2020 on the effects of the pandemic on drug use and services, the report identifies new trends and developments which may have implications for policy and practice. The report explores the situation in the EU Member States from June 2020 to February 2021, particularly changes in drug markets, patterns of use, harms and drug services, both in the community and in prisons.