Introduction The term "pandemic" indicates a disease with high levels of transmissibility, to the point of spreading at very high speed and affecting large geographical areas. The history of Mankind has been marked by several epidemics of bacterial or viral origin that have decimated entire populations in the World, leading the nations that were affected by from these to drastically decrease the movement of goods and people to slow down the rate of contagion. The first major documented epidemic is the so-called "Athens plague" (although it seems it was not a plague, but a type of typhoid fever) documented by the historian Thucydides who describes its onset during the second year of the Peloponnesian war (430 BC), and even then this disease had been identified as contagious, for transmission from sick to healthy. The damage to the epidemic is not only in medical and economic terms, but also leads to the disintegration of social cohesion, the loss of respect for laws and institutions, the loss of planning. Boccaccio, Manzoni and Camus described for example large plague epidemics in different places and eras (Florence, Milan, Oran), serious levels of social dysregulation are present in all three texts, where powerful episodes of isolation from the world by the most fearful, but also heavy cognitive avoidances by those who refuse to think about the possibility of contagion or who are already fatalistically devoted to accelerating their self-destruction. Although it has been clear since ancient times that crowds must be avoided in a place at risk in order to reduce physical contact, during these epidemics there have been several cases where, instead, people gathered in mass, to then create infectious outbreaks . This certainly was the result of ignorance or unscientific beliefs, sometimes as addressed to the institutions that sought to call to order. Reference models The following work moves within the bio-psycho-social model (Engel, 1977) , where the medical aspect is never removed from the context, but it is all within a series of contributing factors that influenced each other. The course moves along the line of prevention psychology, which is divided into 3 levels such as primary, secondary and tertiary (Bertini, 2012). This model is valid at both a psychological and social level and can be perfectly applied in a purely medical context.
- Primary prevention works on the management of the upstream dynamics that regulate the management of the health of the population, elements at high levels that function the normal functioning of the economy, educational and socio-health services. Systems that function in an orderly fashion are less vulnerable to psychosocial and medical issues.
- Secondary prevention works on sections of the population already at risk due to a series of geographical, cultural or socio-economic characteristics. We are talking about areas of population that are more at risk than others due to a series of deficiencies and vulnerabilities in different areas and secondary prevention works on this level, through when a potential criticality has already emerged and its deterioration is disadvantaged by enhancing the population in some cultural, psychosocial or empowering areas of the services to which they rely.
- Tertiary prevention is teorically a false prevention, as it works on already inverse problems with a more or less variable virulence. While the previous levels try to discourage the orgasm of the crisis, the crisis is already underway and needs to be contained, including new cases and, making it less problematic in cases already underway. What was missing in the management of the COVID-19 virus are these two elements, namely the use of the bio-psycho-social model for a suitable management of the epidemic in terms of primary and secondary prevention, taking us to the third level, of simple containment, which is otherwise unmanageable from a health point of view, because, being a more and more new virus, it cannot be treated by the drugs used. The aspect that has escaped in this case is the predominantly psychosocial nature of the epidemics, where the consequences, but also the causes, are not purely medical. Course objectives The main objectives of this work are 1) Provide a series of essential information on the functioning of the infection from a biological point of view 2) Restructuring the belief that epidemics are simply a medical phenomenon, when considering the psychosocial aspects would favor their containment and accelerate the disappearance of the disease 3) Reduce medicalization compared not only to epidemic-related crises, but also to daily life, as Medicine focuses on the cure, but very little on the prevention and promotion of Health, too much on the individual and little on the Community 4) Eliminate the feeling of confusion and despair resulting from the epidemic, as the masses have forgotten that it is not the first and not the last pandemic in history 5) Promote a series of Health skills and civic responsibility aspects which, in pandemic conditions, are lacking 6) Analyzing and promoting the increase in resilience in the face of highly stressful events through the enhancement and knowledge of both individual and group coping strategies 7) Promoting a local and European Sense of Community, which gives better resources to cope international sanitarian emergency Reference population The intervention model will inevitably be rooted in the territory, which in this case will be all the citizens concerned within the Municipality of an European city which adheres to projet. Since the epidemic is an endemic medical problem, the meetings will be dedicated to all citizens who intend to participate, regardless of gender or age. What was missing during the first steps of the COVID diffusion was a sense of Community among population (Zani, 2012), which bring to an individualist coping, which has neglected the common well-being, favoring the spread of virus. It was happened not only between the single inhabitants of different countries, but also within different European Countries, adopting nationalist strategies without common health guidelines. Intervention methodology The meetings will be organized in a "mixed" mode, alternating phases of the meeting which will follow a method of frontal lessons with moments in which the group of participants will be managed, who will be invited to participate and discuss the topic of health and issues related to social cohesion within the territorial community of the Municipality. The community psychology techniques that are thought to be activated during these meetings are as follows. Quality work = pieces of paper will be distributed to participants on which to insert up to a maximum of 4 adjectives, positive and / or negative. The leaflets will be delivered and then sorted on a blackboard and discussed Focus group = the group becomes a discussion group, where relationships are managed so that everyone can intervene with respect to the strengths and critical areas of the community, the quality of services and social cohesion. The discussion is managed by a conductor, in this case the psychologist, who simply facilitates the democratic discussion between the members Brainstorming = the group freely produces ideas regarding a theme proposed by the conductor, the different contributions grouped and elaborated in a more analytical way at a later time. Brain storming will focus on the functional modalities used in the management of a contagious disease Management of small groups = the large group of participants will be divided into small groups of 4-5 people to encourage participation, where each group has a representative appointed to facilitate the communication of the group itself and presentation of contributions in plenary session. The psychologist-facilitator circulates by checking the progress of each group and providing help in case of doubts about some of the group's management methods. Enhancing resilience = Participant groups are provided with the basic concepts of what coping strategies are, how to evaluate events and difficulties by focusing on the mode of positive thinking. Information will be provided on which coping strategies are to be considered non-productive in the comparison of stress situations, how effective communication is important in defining interactions and above all how identifying well-defined objectives can be effective in defining decision-making and implementation of problem-solving. Intervention articulation The training meeting should last 3 hours, of which a first part focused on triggering a discussion on the qualities of the municipality, which intends to provide the first stimulus for discussion by the focus group. This first part should last 60 minutes, followed by a short presentation, in frontal mode, on the functioning of the infection, both from a biological point of view and on the psychosocial side of the groups of people affected by it. At that point there will be the division into small groups, where each is represented by a member who also facilitates internal communications, where the strengths and critical areas of the host municipality will be discussed, each representative will have to present in plenary session what emerged in the his small group; this phase will take another 60 minutes, not to mention a small pause during the transition between work in small groups and the confrontation in the plenary session. The meeting will end with a brainstorming on health skills, in particular useful in the management of a contagious disease. Another 60 minutes will be dedicated to the knowledge of what are considered the most productive and least productive coping strategies, always keeping in mind that individuals use, even unwittingly, protective techniques aimed at promoting personal resilience. Evaluation Short questionnaires will be administered before and after the intervention, which highlight both the knowledge of good management of one's own health, with particular reference to hygiene knowledge and the sense of community, useful to bring the community to manage problems that endanger it , just like the spread of a contagious disease.
References Bertini, M., (2012). Psicologia della Salute. Raffaello Cortina Editore, MIlano. Engel GL (1977) The need for a new medical model. A challenge for biomedicine. Science 196:129-136 Zani, B. (2012). Psicologia di Comunità. Prospettive, idee, metodi. Carocci Editore, Roma. Zanini, L., Gambacorta-Passerini, M., B., Battezzati, P., M., (2016). La formazione alle soft skills nel Corso di laurea in Medicina: uno studio qualitativo sulle scritture riflessive di un campione di studenti. Educational Reflective practices, 2016, pp 9-25