RESUMO
COVID-19 pandemic mitigation strategies are mainly based on social distancing measures and healthcare system reinforcement. However, many countries in Europe and elsewhere implemented strict, horizontal lockdowns because of extensive viral spread in the community which challenges the capacity of the healthcare systems. However, strict lockdowns have various untintended adverse social, economic and health effects, which have yet to be fully elucidated, and have not been considered in models examining the effects of various mitigation measures. Unlike commonly suggested, the dilemma is not about health vs wealth because the economic devastation of long-lasting lockdowns will definitely have adverse health effects in the population. Furthermore, they cannot provide a lasting solution in pandemic containment, potentially resulting in a vicious cycle of consecutive lockdowns with in-between breaks. Hospital preparedness has been the main strategy used by governments. However, a major characteristic of the COVID-19 pandemic is the rapid viral transmission in populations with no immunity. Thus, even the best hospital system could not cope with the demand. Primary, community and home care are the only viable strategies that could achieve the goal of pandemic mitigation. We present the case example of Greece, a country which followed a strategy focused on hospital preparedness but failed to reinforce primary and community care. This, along with strategic mistakes in epidemiological surveillance, resulted in Greece implementing a second strict, horizontal lockdown and having one of the highest COVID-19 death rates in Europe during the second wave. We provide recommendations for measures that will reinstate primary and community care at the forefront in managing the current public health crisis by protecting hospitals from unnecessary admissions, providing primary and secondary prevention services in relation to COVID-19 and maintaining population health through treatment of non-COVID-19 conditions. This, together with more selective social distancing measures (instead of horizontal lockdowns), represents the only viable and realistic long-term strategy for COVID-19 pandemic mitigation.
RESUMO
BACKGROUND: Recent changes in European food safety legislation have resulted in the implementation of statutory requirements regarding the traceability and labelling of 12 food allergens. This article describes research conducted to establish if current food labelling practices are perceived to be adequate by food-allergic consumers, and whether further policy changes need to be implemented in order to optimize consumer protection. METHODS: A total of 40 food-allergic consumers were recruited in both the Netherlands and Greece. Participants were people suffering from one or more of the three most common food-allergies, milk, egg, and/or peanut or tree nut. In a retail environment, participants were given a list of 15 potentially problematic food products which they were asked to buy as if for their own household. The participants were observed during the course of product selection and questioned about specific problems they experienced, as well as information preferences for food allergy information. RESULTS: Participants reported many problems linked to the readability of the label (e.g. font size, contrast). Not all packages contained relevant allergy information, and many participants reported that the ingredients list was insufficient for their needs. Personal experience of particular products was an important factor in the selection process. Dutch participants reported frustration regarding frequent changes in recipes of products available in the supermarket. CONCLUSIONS: In general, food-allergic consumers were not satisfied with the current labelling practices. Information was thought to be unclear or insufficient, which resulted in personal stress and feelings of insecurity. Further research is needed to identify how best allergy information might be provided.