Perspectives of public health professionals on border control practices for COVID-19 management in Europe.

OBJECTIVES: During the COVID-19 pandemic, internal European borders were temporarily re-established to mitigate the outbreak. Much research on pandemic border control measures has focused on quantifying their effectiveness for infectious disease control as well as on their social consequences for cross-border life in the European Union. However, little attention has been paid to the impacts for the practice and organisation of cross-border public health. To address this gap, the present study analysed the experiences and perspectives of public health professionals working in European border regions regarding border control measures in the pandemic. STUDY DESIGN: Qualitative interview-based study. METHODS: In total, 27 semistructured interviews with public health professionals were conducted in the border regions between Germany, the Netherlands and Belgium. Participants were asked about their perspectives on border control and the spread of COVID-19 in the region. Interviews were performed between December 2020 and April 2021 and carried out in German, English, Dutch and French. RESULTS: Before the COVID-19 pandemic, borders had become largely invisible with extensive cross-border social life and mobility. Participants were sceptical about the role of cross-border mobility as a pandemic driver and consequently the effectiveness of enforcing border control for reducing the spread of COVID-19 in their border regions. At the same time, participants raised concerns about the negative consequences for the social fabric and provision of cross-border public health. CONCLUSIONS: Public health professionals highlighted the uncertain role of border control measures for regional infectious disease control in border regions. Rather than border control, sustainable cross-border communication and collaboration is crucial to ensure effective pandemic management in border regions.

Complex narratives of health, stigma and control: Antimicrobial resistance screening among non-hospitalized refugees.

Antimicrobial resistance (AMR) is often presented as a major public health problem globally. Screening for AMR usually takes place in clinical settings. Recent developments in microbiology stimulated a series of studies focusing on AMR in communities, and particularly in travelers (any mobile individual), which was argued to be important for identifying potential public health risks. Against this background, microbiologists have become interested in non-hospitalized refugees as one of the traveler groups. However, this attention to refugees has provoked some professional debates on potential stigmatization of refugees as dangerous "others". To contribute to these debates, and to explore the idea of AMR screening of non-hospitalized refugees from different perspectives, we conducted a qualitative study among four groups of stakeholders who were chosen because of their associations with potential microbiological screening: microbiologists, public health physicians, public health nurses, and refugees. The study took place in a Dutch city from June to August 2016 and had 17 participants: five microbiologists, two public health nurses, four public health physicians, and six refugees. While microbiologists and public health physicians demonstrated a de-contextualized biomedical narrative in arguing that AMR screening among non-hospitalized refugees could be important for scientific research as well as for AMR prevention in communities, public health nurses displayed a more contextualized narrative bringing the benefits for individuals at the center and indicating that screening exclusively among refugees may provoke fear and stigmatization. Refugees were rather positive about AMR screening but stressed that it should particularly contribute to their individual health. We conclude that to design AMR prevention strategies, it is important to consider the complex meanings of AMR screening, and to design these strategies as a process of co-production by diverse stakeholders, including the target populations.