Table 1 Selected equity-oriented interventions to tackle the incidence of COVID-19 and inequalities in Barcelona
Intervention | Description | Target population(s) | Activity indicators | Expected or measured impact | Calendar |
|---|---|---|---|---|---|
Addressed to a specific setting or the general population but with an orientation to equity | |||||
Interventions in Nursing homes | Activities for the prevention and control of COVID-19 in nursing homes. A joint office was created for management and organization | Residents, workers and administrators in nursing homes | Contingency plans in 229 nursing homes | Control of COVID-19 outbreaks in nursing homes | The office started at the end of March 2020 - present |
Interventions in schools | Activities for the surveillance, prevention and control of COVID-19 in schools. Strong support of school directors. Joint office was created for management and organization | Students, workers and administrators in school centers | Only 15% of classes and 7% of students confined to home or quarantined | That the majority of students could attend school in person. Control of COVID-19 outbreaks in schools | 9/14/2020–6/22/2021 |
Communicating risks and containment measures | Risk communication and community engagement strategies to increase the reach of valid information. A website with COVID-19 indicators and with all the public health information and recommendations related to COVID-19. | General population, professionals, decision-makers. | 13 press releases, 166 media requests answered and 783 media appearances | 958,690 visits vs. 412,225 visits in a comparative period. 76% new visitors. | March 2020 - present |
Directly targeted at addressing socioeconomic inequalities or socially deprived populations | |||||
Health hotels | Nine hotels converted into accommodation for mild COVID-19 cases, supervised by healthcare personnel | People infected with COVID and with inadequate housing conditions to follow isolation rules | 2881 people hosted | Accelerating hospital discharges, cutting transmission chains with cohabitants and community, providing social support to vulnerable populations | March 2020 - present |
Quarantine support program | Home delivery of food baskets or cooked meals, personal protective equipment, cleaning and personal hygiene products, home cleaning and disinfection service, waste disposal, dog walking | People infected with COVID and their contacts without resources or social networks | 8272 people received food baskets, 948 families received cooked meals | Cutting transmission chains with cohabitants and community, providing social support to vulnerable populations | 4/22/2020–7/16/2021 |
Special facility for homeless people with drug dependency problems | Residential center with harm reduction programs for drug use (supervised consumption spaces and controlled alcohol consumption program) | Homeless people with drug dependency, including alcohol | 70 beds; 182 different people have lived in the center to date | Improvement in quality of life of homeless and addicted people. A place for isolation if infected with the disease or becoming a close contact | 4/4/2020 - present |
Adapting community health interventions to tackle COVID-19 | Use the previous structure of the community health network, as well as a communication network, to detect needs or problems during periods of confinement; contact with participants and territorial agents to assess what to do and how; generate responses with community assets to the needs detected; adapt interventions to the “new normal” | Neighborhoods with the greatest socioeconomic deprivation, in which the Barcelona Health in the Neighborhoods program is implemented (25 of the 73 neighborhoods of Barcelona) | 13 community programs adapted to pandemic situation | Address determinants of health, such as social isolation, which are worsened by the pandemic | 2 stages: first: April 2020–September 2020 Second: October 2020 - to date |
Specifically designed as a response to the appearance of socioeconomic inequalities related to COVID-19 | |||||
Mass screening campaigns in high incidence areas | Opening of free, voluntary PCR testing points in community centers for residents in the whole neighborhood or in selected census tracts, for 2–3 days per point | Four neighborhoods with the highest incidence in the last 15 days | 5394 tests, 151 were positive | Cutting transmission chains. Sensitizing residents about the high incidence in the community | 8/15/2020–9/20/2020 |
Vaccination scheduling support points and street points for vaccination without appointment | Universal strategy (online self-scheduling) combined with strategy targeting groups with vulnerabilities (personal support points for online scheduling, and vaccination street points). A joint office was created for management and organization | Neighborhoods with lower vaccination coverage in the first weeks of vaccination | 25 support points/1689 users 19 street points/2081 vaccinated | Increase in vaccination coverage. Reduction of the gap between extreme coverages (32 to 15%) | 5/26/2021–11/22/2021 |