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Persons experiencing addiction may be at very high risk of infectious disease like COVID-19 due to high rates of smoking, recent imprisonment, conditions like HIV/AIDS, and high-risk behaviors (Ezzati et al. 2002; Farhoudian, et al. 2020). During the COVID-19 pandemic, most courts have shuttered, and treatment center admissions have halted, yet the opioid crisis rages on. Addiction intersects with material hardship, trauma, broken institutions, and human frailty in a multidimensional web of disadvantage (Desmond and Western 2018)—a process illustrated by COVID-19.
An official in Cairo, Illinois dispatched a message to his counterparts in Washington, DC. He warned, the “country below is in the hands of a howling mob.” Locals not yet touched by the disease went into lockdown. In the absence of permanent public health officials or institutions, coalitions of citizens and elected officials living in uninfected areas took up arms to impose “shotgun” quarantines to fend off outsiders.