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  1. Feb 2021
    1. After a year of unprecedented disaster and turbulence – the Covid-19 pandemic and economic crisis, the global outcry over systemic racism and political instability – the 2021 Edelman Trust Barometer reveals an epidemic of misinformation and widespread mistrust of societal institutions and leaders around the world. Adding to this is a failing trust ecosystem unable to confront the rampant infodemic, leaving the four institutions – business, government, NGOs and media – in an environment of information bankruptcy and a mandate to rebuild trust and chart a new path forward.
    1. The COVID-19 pandemic may have affected mental health in the general population. We examined if a higher proportion of people screened positive for depression and generalized anxiety disorder (GAD) during the first week of nationwide quarantine than in February 2019; if each disorder increased over six weeks of quarantine; and what predicted screening positive for depression or GAD across this period. Two nationally representative samples of Irish adults were collected using identical methods in February 2019 (N = 1020) and April 2020 (N = 1041). The latter were followed for six weeks during nationwide quarantine. Respondents completed the same measures of depression and GAD. A significantly greater proportion of people screened positive for depression in 2019 (29.8% 95% CI = 27.0, 32.6) than 2020 (22.8% 95% CI = 20.2, 25.3). There were no significant changes in the proportion of people who screened positive for depression or GAD across six weeks of quarantine. Screening positive for depression or GAD during the pandemic was predicted by female sex, younger age, and multiple psychological variables. We discuss the need to consider contextual factors to understand the mental health effects of COVID-19 and how these findings can inform responses to the pandemic.
    1. Introduction: In the absence of vaccines or causal therapies, behavioral measures such as wearing face masks and keeping distance are central to fighting Covid-19. Yet, their benefits are often questioned and adherence is variable. Methods: We examined in representative samples across eight countries (N = 7,568) whether adherence reported around June 1, 2020 predicted the increase in Covid-19 mortality by August 31, 2020. Results: Mortality increased 81.3% in low adherence countries (United States, Sweden, Poland, Russia), 8.4% in high adherence countries (Germany, France, Spain, United Kingdom). Across countries adherence and subsequent mortality increases correlated with r = -0.91. Limitations: No African or South American countries were included in the present study, which limits the generalizability of the findings. Conclusions: While reported Covid-19 mortality is likely to be influenced by other factors, the almost tenfold difference in additional mortality is significant, and may inform decisions when choosing whether to prioritize individual liberty rights or health-protective measures.
    1. Although young adults are not at great risk of becoming severely ill with COVID-19, their willingness to get vaccinated affects the whole community. Vaccine hesitancy has increased during recent years, and more research is needed on its situational determinants. This paper reports a preregistered experiment (N = 654) that examined whether communicating descriptive social norms – information about what most people do – is an effective way of influencing young people’s intentions and reducing their hesitancy to take the COVID-19 vaccine. We found weak support for our main hypothesis that conveying strong (compared to weak) norms leads to reduced hesitancy and stronger intentions. Furthermore, norms did not produce significantly different effects compared to standard vaccine information from the authorities. Moreover, no support was found for the hypothesis that young people are more strongly influenced by norms when the norm reference group consists of other young individuals rather than people in general. These findings suggest that the practical usefulness of signaling descriptive norms is rather limited, and may not be more effective than standard appeals in the quest of encouraging young adults to trust and accept a new vaccine.
    1. Empirical research on the Gateway Belief Model (GBM) has flourished in recent years. The model offers a dual-process account of how attitude change happens in response to normative cues about scientific agreement. A plethora of correlational and experimental evidence has emerged documenting the positive direct and indirect effects of communicating the scientific consensus on global warming. I review recent scholarship and argue that the next generation of research on the GBM should focus on better justifying the inclusion of moderators on both a theoretical and empirical level, explicitly manipulate motivations to process the consensus message, model how consensus cues operate in competitive information networks and test the model in field settings using causal chain experiments.
    1. We are at a very dangerous and unprecedented point in American politics today. As noted in my last post, something strange has happened to the Republican Party. It has been shifting from a party built around ideology and ideas, to one that resembles a cult of personality focused on one individual, former President Donald Trump. Its core support base is today furious about a fact that simply isn’t true: the notion that Trump won the Nov. 3 election by a landslide, and that it was stolen by “radical, far-Left Democrats” in one of the most outrageous frauds in American history. This is what Trump told the crowd before the January 6 storming of Congress, and why 43 Republican Senators were not willing to vote to impeach the former President in the vote last Saturday.
    1. A new study has identified early risk factors that predicted heightened anxiety in young adults during the coronavirus (COVID-19) pandemic. The findings from the study, supported by the National Institutes of Health and published in the Journal of the American Academy of Child and Adolescent Psychiatry, could help predict who is at greatest risk of developing anxiety during stressful life events in early adulthood and inform prevention and intervention efforts.
    1. We measured social contacts when schools were either open or closed, amongst other restrictions. We combined these data with estimates of the susceptibility and infectiousness of children compared with adults to estimate the impact of reopening schools on the reproduction number. Our results suggest that reopening all schools could increase R from an assumed baseline of 0.8 to between 1.0 and 1.5, or to between 0.9 and 1.2 reopening primary or secondary schools alone.
    1. A Nature survey shows many scientists expect the virus that causes COVID-19 to become endemic, but it could pose less danger over time.
    1. In precision medicine, a common question for researchers is whether patients can be classified with others who have similar risks and treatment responses. Such groupings can assist in predicting risk and matching patients with appropriate treatment strategies. The challenge is that it is often not easy to identify meaningful clusters of people with the observable data.
    1. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly across the globe, causing epidemics that range from quickly controlled local outbreaks (such as New Zealand) to large ongoing epidemics infecting millions (such as the United States). A tremendous volume of scientific literature has followed, as has vigorous debate about poorly understood facets of the disease, including the relative importance of various routes of transmission, the roles of asymptomatic and presymptomatic infections, and the susceptibility and transmissibility of specific age groups. This discussion may create the impression that our understanding of transmission is frequently overturned. Although our knowledge of SARS-CoV-2 transmission is constantly deepening in important ways, the fundamental engines that drive the pandemic are well established and provide a framework for interpreting this new information.
    1. An important step when designing a study is to justify the sample size that will be collected. The key aim of a sample size justification is to explain how the collected data is expected to provide valuable information given the inferential goals of the researcher. In this overview article six approaches are discussed to justify the sample size in a quantitative empirical study: 1) collecting data from (an)almost) the entire population, 2) choosing a sample size based on resource constraints, 3) performing an a-priori power analysis, 4) planning for a desired accuracy, 5) using heuristics, or 6) explicitly acknowledging the absence of a justification. An important question to consider when justifying sample sizes is which effect sizes are deemed interesting, and the extent to which the data that is collected informs inferences about these effect sizes. Depending on the sample size justification chosen, researchers could consider 1) what the smallest effect size of interest is, 2) which minimal effect size will be statistically significant, 3) which effect sizes they expect (and what they base these expectations on), 4) which effect sizes would be rejected based on a confidence interval around the effect size, 5) which ranges of effects a study has sufficient power to detect based on a sensitivity power analysis, and 6) which effect sizes are plausible in a specific research area. Researchers can use the guidelines presented in this article to improve their sample size justification, and hopefully, align the informational value of a study with their inferential goals.
    1. Epidemic preparedness depends on our ability to predict the trajectory of an epidemic and the human behavior that drives spread in the event of an outbreak. Changes to behavior during an outbreak limit the reliability of syndromic surveillance using large-scale data sources, such as online social media or search behavior, which could otherwise supplement healthcare-based outbreak-prediction methods. Here, we measure behavior change reflected in mobile-phone call-detail records (CDRs), a source of passively collected real-time behavioral information, using an anonymously linked dataset of cell-phone users and their date of influenza-like illness diagnosis during the 2009 H1N1v pandemic. We demonstrate that mobile-phone use during illness differs measurably from routine behavior: Diagnosed individuals exhibit less movement than normal (1.1 to 1.4 fewer unique tower locations; P<3.2×10−3P<3.2×10−3<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mi>P</mml:mi><mml:mo>&lt;</mml:mo><mml:mn>3.2</mml:mn><mml:mo>×</mml:mo><mml:mn>1</mml:mn><mml:msup><mml:mrow><mml:mn>0</mml:mn></mml:mrow><mml:mrow><mml:mo>−</mml:mo><mml:mn>3</mml:mn></mml:mrow></mml:msup></mml:math>), on average, in the 2 to 4 d around diagnosis and place fewer calls (2.3 to 3.3 fewer calls; P<5.6×10−4P<5.6×10−4<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mi>P</mml:mi><mml:mo>&lt;</mml:mo><mml:mn>5.6</mml:mn><mml:mo>×</mml:mo><mml:mn>1</mml:mn><mml:msup><mml:mrow><mml:mn>0</mml:mn></mml:mrow><mml:mrow><mml:mo>−</mml:mo><mml:mn>4</mml:mn></mml:mrow></mml:msup></mml:math>) while spending longer on the phone (41- to 66-s average increase; P<4.6×10−10P<4.6×10−10<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mi>P</mml:mi><mml:mo>&lt;</mml:mo><mml:mn>4.6</mml:mn><mml:mo>×</mml:mo><mml:mn>1</mml:mn><mml:msup><mml:mrow><mml:mn>0</mml:mn></mml:mrow><mml:mrow><mml:mo>−</mml:mo><mml:mn>10</mml:mn></mml:mrow></mml:msup></mml:math>) than usual on the day following diagnosis. The results suggest that anonymously linked CDRs and health data may be sufficiently granular to augment epidemic surveillance efforts and that infectious disease-modeling efforts lacking explicit behavior-change mechanisms need to be revisited.
    1. Although most young people do not become seriously ill from the coronavirus causing the COVID-19 disease, they do play a role in its spread. It is therefore important that they adhere to the recommended preventive behaviors, most importantly, physical distancing. This study aims to gain a better understanding of the psychosocial determinants of young people’s physical distancing behavior and the role that direct (i.e., interpersonal) and mediated communication (i.e., mass media, social media) about COVID-19 plays in this. A daily diary study was conducted among 481 Dutch adolescents (secondary school students; age range 10-18 years) and 404 young adults (university students; age range 17-25 years), involving 10 identical daily surveys administered on weekdays during a 2-week period during the first wave of the COVID-19 pandemic (May 2020). The hypotheses were tested with preregistered univariate and multivariate linear mixed-effects models. The perceived descriptive norm (i.e., what friends are doing) was the most important determinant of physical distancing behavior among both adolescents and young adults. The perceived injunctive norm, perceived response efficacy, and perceived severity were also positively associated with physical distancing, albeit less strong. Among adolescents, exposure to information about COVID-19 in the mass media increased their perceptions of the descriptive norm, which in turn increased their physical distancing behavior. For those involved in studying and designing COVID-19-related behavioral interventions and campaigns targeting youth, it is important to consider the social norms that they relate to, and to take into account their perceived severity and response efficacy.
    1. Full effects of Pfizer’s shots only kick in around a month after inoculation, but data from Israel shows there is a stark drop in infections even before that point
    1. The present study examines the role of personality traits, interpersonal relationships, and sociodemographic factors on perceived stress, related to COVID-19, and compliance with measures to mitigate the spread of the virus. Data were collected in the midst of the ‘first wave’ lockdown, with the survey completed in full by 963 participants. Importantly, we measured stress, directly related to the pandemic, rather than general stress, and were able to distinguish between symptoms of emotional, behavioural, cognitive, physical stress, and alienation with high concordance. We also included personality scoring with standardized T-scores, allowing for cross-study comparison, and a broader questionnaire on the participants’ support for COVID-19 mitigation measures. Results indicated that neuroticism, introversion, and conscientiousness, common conflicts with loved ones, and some demographics (female gender, middle age, existing chronic health problems) correspond to elevated stress. Neuroticism and conscientiousness were positively associated with total stress and some of its components, while extraversion was negatively correlated to total stress, its emotional and physical components, and alienation. Surprisingly, increased stress was not related to greater measure adherence. The present results shed new light on how personality, interpersonal relationships, and sociodemographic factors influence people’s stress response during a pandemic.
    1. Determine age-specific infection fatality rates for COVID-19 to inform public health policies and communications that help protect vulnerable age groups. Studies of COVID-19 prevalence were collected by conducting an online search of published articles, preprints, and government reports that were publicly disseminated prior to 18 September 2020. The systematic review encompassed 113 studies, of which 27 studies (covering 34 geographical locations) satisfied the inclusion criteria and were included in the meta-analysis. Age-specific IFRs were computed using the prevalence data in conjunction with reported fatalities 4 weeks after the midpoint date of the study, reflecting typical lags in fatalities and reporting. Meta-regression procedures in Stata were used to analyze the infection fatality rate (IFR) by age. Our analysis finds a exponential relationship between age and IFR for COVID-19. The estimated age-specific IFR is very low for children and younger adults (e.g., 0.002% at age 10 and 0.01% at age 25) but increases progressively to 0.4% at age 55, 1.4% at age 65, 4.6% at age 75, and 15% at age 85. Moreover, our results indicate that about 90% of the variation in population IFR across geographical locations reflects differences in the age composition of the population and the extent to which relatively vulnerable age groups were exposed to the virus. These results indicate that COVID-19 is hazardous not only for the elderly but also for middle-aged adults, for whom the infection fatality rate is two orders of magnitude greater than the annualized risk of a fatal automobile accident and far more dangerous than seasonal influenza. Moreover, the overall IFR for COVID-19 should not be viewed as a fixed parameter but as intrinsically linked to the age-specific pattern of infections. Consequently, public health measures to mitigate infections in older adults could substantially decrease total deaths.
    1. BackgroundA recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients.MethodsAll patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not.FindingsBy Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα.InterpretationThe 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies.
    1. The Debunking Handbook 2020 summarises the current state of the science of misinformation and its debunking. It was written by a team of 22 prominent scholars of misinformation and its debunking, and it represents the current consensus on the science of debunking for engaged citizens, policymakers, journalists, and other practitioners.
    1. Large-scale pandemic events have sent scientific communities scrambling to gather and analyze data to provide governments and policy makers with information to inform decisions and policies needed when imperfect information is all that may be available. Historical records from the 1918 influenza pandemic reflect how little improvement has been made in how government and policy responses are formed when large scale threats occur, such as the COVID-19 pandemic. This commentary discusses three examples of how metadata improvements are being, or may be made, to facilitate gathering and assessment of data to better understand complex and dynamic situations. In particular, metadata strategies can be applied in advance, on the fly or even after events to integrate and enrich perspectives that aid in creating balanced actions to minimize impacts with lowered risk of unintended consequences. Metadata can enhance scope, speed and clarity with which scholarly communities can curate their outputs for optimal discovery and reuse. Conclusions are framed within the Metadata 2020 working group activities that lay a foundation for advancement of scholarly communications to better serve all communities.
    1. Co-production of knowledge through research involves collaborations between researchers and end-users of research, including patients and the public, health professionals, health system managers, and policymakers. This approach is being advocated globally, and across sectors. But there remains uncertainty on what co-production of research entails, how to do it, when and when not to do it. More evidence on these issues is essential if the co-production of research is to deliver on its promise to produce knowledge and share power and responsibility from the start to the end of research and avoid wasting time, resources, and the good will of end-users. This BMJ collection on Increasing the Impact of Health Research through Co-production of Knowledge provides an overview of the evolution, potential, influence, learning and challenges in co-producing evidence to inform decision making in health policy and practice, and points to the core principles which should underpin it. In this collection, we define research co-production as where researchers work in partnership with knowledge users (comprising patients and caregivers, the public, clinicians, policy-makers, health system leaders and others) to identify a problem and produce knowledge, sharing power and responsibility from the start to the end of the research.
    1. Designing effective communication strategies for correcting vaccines misinformation requires an understanding of how the target group might react to information from different sources. The present study examined whether erroneous inferences about vaccination could be effectively corrected by a perceived credible (i.e. expert or trustworthy) source. Two experiments are reported using a standard continued influence paradigm, each featuring two correction conditions on vaccine misinformation. Participants were presented with a story containing a piece of information that was later retracted by a perceived credible or not so credible source. Experiment 1 showed that providing a correction reduced participants’ use of the original erroneous information, yet the overall reliance on misinformation did not significantly differ between the low- and high-expertise correction groups. Experiment 2 revealed that a correction from a high-trustworthy source decreased participants’ reliance on misinformation when making inferences; nonetheless, it did not positively affect the reported intent to vaccinate one’s child. Overall, source trustworthiness was more relevant than source expertise.
    1. Erroneous beliefs are difficult to correct. Worse, popular correction strategies, such as the myth-versus-fact article format, may backfire because they subtly reinforce the myths through repetition and further increase the spread and acceptance of misinformation. Here we identify five key criteria people employ as they evaluate the truth of a statement: They assess general acceptance by others, gauge the amount of supporting evidence, determine its compatibility with their beliefs, assess the general coherence of the statement, and judge the credibility of the source of the information. In assessing these five criteria, people can actively seek additional information (an effortful analytic strategy) or attend to the subjective experience of easy mental processing—what psychologists call fluent processing—and simply draw conclusions on the basis of what feels right (a less effortful intuitive strategy). Throughout this truth-evaluation effort, fluent processing can facilitate acceptance of the statement: When thoughts flow smoothly, people nod along. Unfortunately, many correction strategies inadvertently make the false information more easily acceptable by, for example, repeating it or illustrating it with anecdotes and pictures. This, ironically, increases the likelihood that the false information the communicator wanted to debunk will be believed later. A more promising correction strategy is to focus on making the true information as easy to process as possible. We review recent research and offer recommendations for more effective presentation and correction strategies.
    1. This study aims to explore differences between health misinformation and true information by comparing word usage, sentiments, and online popularity between pro- and anti-vaccine headlines (PVHs and AVHs). Text mining and sentiment analysis showed that AVHs were more likely to use negative sentiment words and trust-related words. PVHs were more likely to use words related to positive sentiments. Anti-vaccine messages (AVMs) were more popular online than pro-vaccine messages (PVMs). AVMs’ online popularity was not related to its emotion words usage. Among PVMs, those with more positive sentiment words were more likely to be shared, commented on, and reacted to online. Wordclouds and word networks were created to visualize the word usage and clustering. Future directions regarding message design and automatic detection and analysis techniques are provided.
    1. Most members of the general public use the internet to research health topics. However, the quality of vaccine-related material available online is mixed and internet search engines often bring web users to low-quality anti-vaccine websites.We present a case study of a pro-vaccine information hub launched in 2011. Vaccines Today provides high-quality information about vaccines and diseases, expert interviews, answers to frequently asked questions, parent/patient stories and videos/infographics. Twitter, Facebook, YouTube and Instagram are used to share this content and to engage with various online audiences.This Commentary outlines what works in online communication about vaccines and offers proposals for improving the impact of online vaccine advocacy. The value of networking to boost visibility and search engine ranking is emphasised. Furthermore, we present the case for the sharing and application of best practice in online communication.
    1. Websites opposing vaccination are prevalent on the Internet. Web 2.0, defined by interaction and user-generated content, has become ubiquitous. Furthermore, a new postmodern paradigm of healthcare has emerged, where power has shifted from doctors to patients, the legitimacy of science is questioned, and expertise is redefined. Together this has created an environment where anti-vaccine activists are able to effectively spread their messages. Evidence shows that individuals turn to the Internet for vaccination advice, and suggests such sources can impact vaccination decisions – therefore it is likely that anti-vaccine websites can influence whether people vaccinate themselves or their children. This overview examines the types of rhetoric individuals may encounter online in order to better understand why the anti-vaccination movement can be convincing, despite lacking scientific support for their claims. Tactics and tropes commonly used to argue against vaccination are described. This includes actions such as skewing science, shifting hypotheses, censoring dissent, and attacking critics; also discussed are frequently made claims such as not being “anti-vaccine” but “pro-safe vaccines”, that vaccines are toxic or unnatural, and more. Recognizing disingenuous claims made by the anti-vaccination movement is essential in order to critically evaluate the information and misinformation encountered online.
    1. This guidance document provides basic broad principles for a spokesper-son of any health authority on how to respond to vocal vaccine deniers. The suggestions are based on psychological research on persuasion, on research in public health, communication studies and on WHO risk communication guidelines.
    1. Adverse events following immunizations (AEFI) are important to identify and manage effectively so as to sustain trust in vaccines and optimize health. The AEFI category related to “anxiety about the immunization” was considered problematic as it did not adequately capture the range of stress responses that can occur. The currently used term for this category, immunization stress-related responses (ISRR), is broader, including the full spectrum of signs and symptoms that can arise in response to stress. ISRR can include vasovagal reactions (fainting), hyperventilation and functional neurological symptoms (e.g. weakness, nonepileptic seizures). It is based on a biopsychosocial framework in which biological (e.g. age, sex), psychological (e.g. preparedness, previous experiences, anxiety) and social factors (e.g. response by others, social media) interact to create an individual’s stress response to the immunization process.New guidance is available on prevention, early detection and management of ISRRs which is summarized in the article.
    1. Background Though SARS-CoV-2 outbreaks have been documented in occupational settings and though there is speculation that essential workers face heightened risks for COVID-19, occupational differences in excess mortality have, to date, not been examined. Such information could point to opportunities for intervention, such as workplace modifications and prioritization of vaccine distribution.Methods and findings Using death records from the California Department of Public Health, we estimated excess mortality among Californians 18–65 years of age by occupational sector and occupation, with additional stratification of the sector analysis by race/ethnicity. During the COVID-19 pandemic, working age adults experienced a 22% increase in mortality compared to historical periods. Relative excess mortality was highest in food/agriculture workers (39% increase), transportation/logistics workers (28% increase), facilities (27%) and manufacturing workers (23% increase). Latino Californians experienced a 36% increase in mortality, with a 59% increase among Latino food/agriculture workers. Black Californians experienced a 28% increase in mortality, with a 36% increase for Black retail workers. Asian Californians experienced an 18% increase, with a 40% increase among Asian healthcare workers. Excess mortality among White working-age Californians increased by 6%, with a 16% increase among White food/agriculture workers.Conclusions Certain occupational sectors have been associated with high excess mortality during the pandemic, particularly among racial and ethnic groups also disproportionately affected by COVID-19. In-person essential work is a likely venue of transmission of coronavirus infection and must be addressed through strict enforcement of health orders in workplace settings and protection of in-person workers. Vaccine distribution prioritizing in-person essential workers will be important for reducing excess COVID mortality.
    1. The COVID-19 pandemic poses one of the largest behavioral change challenges in the last decades. Because currently, there is no widely available pharmaceutical treatment available to contain the spread of infection, governments worldwide rely – at least to some extent – on behavioral recommendations aimed at reducing spread. The success of this strategy is dependent on the number of people that follow the recommendations. Most recommendations need people to change their behavior or adopt a new behavior. We propose that such behavioral change, with direct costs and delayed benefits, is a source of conflict and mixed feelings. This ambivalence negatively affects adherence to such recommendations. We present three studies that support our hypotheses: the more ambivalent people are about the recommendations, the less they follow them. We also examined the effect of the mixed emotions of hope and worry on adherence and find that it positively relates to adherence. Our findings replicated both in a U.S. sample as well as a representative German sample. Our work is the first to investigate the role of ambivalence in large-scale behavior change and highlight the importance of understanding the conflict that comes with changing behavior. We discuss implications for policy and communication.
    1. Background: The social identity model of risk taking proposes that people take more risks with ingroup members because they trust them more. While this can be beneficial in some circumstances, in the context of the COVID-19 pandemic it has the potential to undermine an effective public health response if people underestimate the risk of contagion posed by ingroup members, or overestimate the risk of vaccines or treatments developed by outgroup members. Methods: Three studies (two prospective surveys, one experiment) with community-based adults tested the potential for the social identity model of risk taking to explain risk perception and risk taking in the context of COVID-19. Results: Study 1 was a two-wave study with a pre-COVID baseline, and found that people who identified more strongly as a member of their neighborhood pre-COVID tended to trust their neighbors more, and perceive interacting with them during lockdown restrictions as less risky. Study 2 (N=2033) replicated these findings in a two-wave nationally representative Australian sample. Study 3 (N=216) was a pre-registered experiment which found evidence that the tendency to trust ingroup members more could be harnessed to enhance the COVID-19 response. Specifically, people were more willing to take a vaccine and perceived it to be less risky when it was developed by an ingroup compared to an outgroup source. Conclusions: Across all three studies, ingroup members were trusted more and were perceived to pose less health risk. These findings are discussed with a focus on how group processes can be more effectively incorporated into public health policy, both for the current pandemic and for future contagious disease threats.
    1. In recent years behavioural science has quickly become embedded in national level policy making. As the contributions of behavioural science to the UK’s Covid-19 response policies in early 2020 became apparent, a debate emerged in the British media about its involvement. This served as a unique opportunity to capture public discourse and representation of behavioural science in fast-track, high-stake national policy making. Aimed at identifying elements which foster and detract from trust and credibility in emergent scientific contributions to policy making, in study 1 we use corpus linguistics and thematic analysis to map the narrative around the key behavioural science actors and concepts which were discussed in the 650 news articles extracted from the 15 most read British newspapers over the 12-week period surrounding the first hard UK lockdown from March 2020. We report and discuss 1) the salience of key concepts and actors as the debate unfolded, 2) quantified changes in the polarity of the sentiment expressed toward them and their policy application contexts, and 3) patterns of co-occurrence via network analysis. In Study 2, we investigate how salience and sentiment of key themes observed in traditional media discourse tracked on original Twitter chatter (N = 2,187). In Study 3, we complement these findings with a qualitative analysis of the subset of news articles which contained the most extreme sentiments (N = 111), providing an in-depth perspective of sentiments and discourse developed around keywords, as either promoting or undermining their credibility in, and trust toward behaviourally informed policy. We discuss our findings in light of the integration of behavioural science in national policy making under emergency constraints.
    1. The pandemic has presented doctors with legal and ethical challenges around how to treat patients in overstretched health services. Clare Dyer examines some of the key questions
    1. Countering misinformation can reduce belief in the moment, but corrective messages quickly fade from memory. We tested whether the longer-term impact of fact-checks depends on when people receive them. In two experiments (total N = 2,683), participants read true and false headlines taken from social media. In the treatment conditions, “true” and “false” tags appeared before, during, or after participants read each headline. Participants in a control condition received no information about veracity. One week later, participants in all conditions rated the same headlines’ accuracy. Providing fact-checks after headlines (debunking) improved subsequent truth discernment more than providing the same information during (labeling) or before (prebunking) exposure. This finding informs the cognitive science of belief revision and has practical implications for social media platform designers.
    1. Perceived social support represents an important predictor of healthy ageing. The global COVID-19 pandemic has dramatically changed the face of social relationships and exposed elderly as a particularly vulnerable population. Social distancing may represent a double-edged sword for older adults, protecting them against COVID-19 infection while also sacrificing personal interaction and attention at a critical time. Here, we consider the moderating role of social relationships as a potential influence on stress resilience, allostatic load, and vulnerability to infection and adverse health outcomes in the elderly population. Understanding the mechanisms how social support enhances resilience to stress and promotes mental and physical health into old age will enable new preventive strategies. Targeted social interventions may provide effective relief from the impact of COVID-19-related isolation and loneliness. In this regard, a pandemic may also offer a window of opportunity for raising awareness and mobilizing resources for new strategies that help build resilience for our ageing population and future generations.
    1. The Susceptible–Infectious–Recovered (SIR) model is the canonical model of epidemics of infections that make people immune upon recovery. Many of the open questions in computational epidemiology concern the underlying contact structure’s impact on models like the SIR model. Temporal networks constitute a theoretical framework capable of encoding structures both in the networks of who could infect whom and when these contacts happen. In this article, we discuss the detailed assumptions behind such simulations—how to make them comparable with analytically tractable formulations of the SIR model, and at the same time, as realistic as possible. We also present a highly optimized, open-source code for this purpose and discuss all steps needed to make the program as fast as possible.
    1. Evidence suggests that perseverative cognition (PC), the cognitive representation of past stressful events (rumination) or feared future events (worry), mediates the relationship between stress and physical disease. However, the experimental evidence testing methods to influence PC and the subsequent relationship with health outcomes has not been synthesised. Therefore, the current review addressed these gaps. Studies randomly assigning participants to treatment and control groups, measuring PC and a physical and/or behavioural health outcome after exposure to a non-pharmacological intervention, were included in a systematic review. Key terms were searched in Medline, PsycInfo and CINAHL databases. Of the screened studies (k = 10,703), 36 met the eligibility criteria. Random-effects meta-analyses revealed the interventions, relative to comparison groups, on average produced medium-sized effects on rumination (g = -.58), small-to-medium sized effects on worry (g = -.41) and health behaviours (g = .31), and small-sized effects on physical health outcomes (g = .23). Effect sizes for PC were positively associated with effect sizes for health behaviours (following outlier removal). Effect sizes for PC were significantly larger when interventions were delivered by healthcare professionals than when delivered via all other methods. No specific intervention type (when directly compared against other types) was associated with larger effect sizes for PC. Psychological interventions can influence PC. Medium-sized effect sizes for PC correspond with small, but positive, associations with health behaviours.
    1. A correlational study to test the relationship between socio-economic status and reactivity to threats.
    1. As the novel coronavirus (COVID-19) spread across Canada in March 2020, provinces imposed strict lockdowns causing restrictions and disruptions to health care. These changes impacted how pregnant individuals received prenatal care and experienced childbirth. The additional stress caused by these changes may negatively affect the well-being of pregnant individuals and the developing child. This study investigated the impact of the pandemic on prenatal care and birth plans of pregnant individuals in Canada and potential associations with maternal mental health. Data from 4604 participants was collected from English- and French-speaking Canadians between April 5-June 1, 2020 as part of the Canada-wide Pregnancy During the COVID-19 Pandemic study. Symptoms of maternal depression, general anxiety, and pregnancy-related anxiety were assessed. Participants also answered questions about disruptions and changes to prenatal care and their birth plans due to the COVID-19 pandemic. Logistic regression was used to estimate associations between prenatal care disruptions and maternal mental health. Cancellation of prenatal appointments and birth plan changes (specifically changes to childcare during birth and change of support person attending the birth) were significantly associated with greater odds of experiencing clinically-elevated depression, anxiety, and/or pregnancy-related anxiety symptoms. These results illustrate the need for reliable and accessible prenatal care during the pandemic, such as the integration of mental health screenings and co-ordination of prenatal care providers.
    1. Who thrives while socially distancing? For this descriptive, exploratory study, we polled a sample of over 500 participants from the United States on April 8, 2020—in the early stages of the COVID-19 pandemic when practicing social distancing was at its peak. Above and beyond other social and nonsocial activities, living and employment arrangements, personality traits, demographics, and other variables, people who spent more time interacting with close others—either in person or online—felt more socially connected. However, only interacting with close others in person, but not online, predicted greater positive affect. In contrast, people who spent more time interacting with weak ties online experienced greater negative affect and more stress. Looking at specific interaction partners, we found that people who interacted with their relatives, romantic partners, and even coworkers/classmates felt more socially connected. Living arrangements mattered little beyond people’s social interactions, except for living with one’s children, which predicted greater stress. Certain social online activities, including playing games with close ties and group/club meetings predicted greater positive affect. Amongst nonsocial activities, active leisure like exercise emerged as a robust predictor of positive affect, whereas passive leisure like watching TV predicted greater negative affect. Even during a historic pandemic and unprecedented conditions of social distancing, then, the factors that predict well-being are much the same as those already established in the literature. Indeed, much like in-person interactions, online social interactions predict greater social connectedness. However, unlike in-person interactions, online interactions simultaneously predict more negative affect and more stress.
    1. Pregnant women may be particularly sensitive to negative events (i.e., adversity) related to the COVID-19 pandemic and affective responses to these events (i.e., stress). We examined COVID-19-related stress and adversity in a sample of 725 pregnant women residing in the San Francisco Bay Area in March-May 2020, 343 of whom provided addresses in California that were geocoded and matched by census tract to measures of community-level risk factors. Women who were pregnant during the pandemic had substantially elevated depressive symptoms compared to matched women who were pregnant prior to the pandemic. Several individual- and community-level risk and protective factors were associated with women’s scores on two latent factors of COVID-19-related stress and adversity. Highlighting the role of subjective responses to the pandemic in vulnerability to prenatal depression and factors that influence susceptibility to COVID-19-related stress, these findings inform understanding of the psychosocial sequelae of disease outbreaks among pregnant women.
    1. An underlying concern about the COVID-19 pandemic is that the mental health of children will decline. The present study aimed to investigate whether a single school-based intervention, including self-monitoring and psychoeducation for COVID-19, effectively achieved its aim to promote children’s mental health. The study was conducted in a junior high school. We assigned the third grade as the intervention group, second grade as the announcement group, and first grade, the control group. We hypothesized that the intervention group would experience improved mental health and reduced fear of COVID-19, when compared to the announcement and control groups. Interaction effects were observed only for depression, indicating a significant intervention effect in the intervention group. These findings suggest that a single school-based intervention that includes self-monitoring and psychoeducation for COVID-19 can help to improve children’s mental health. It is suggested that school-based interventions that intend to raise children's awareness of COVID-19 promote healthy development and adaptation within the school.
    1. To slow down the spread of COVID-19 public compliance on social distancing policy is required. One of the factors that contribute to compliance on social distancing policy is awareness on COVID-19. This study aimed to examine the relationship between awareness on COVID-19 and compliance with social distancing policy. This study used an online survey through Google Form to 404 respondents aged 18 to 63 years (Mean = 27.17, SD = 8.468). The data were collected by using awareness on the COVID-19 scale and compliance with the social distancing scale. The data were analyzed using the Spearman correlation and Kruskal Wallis, followed up by Mann-Whitney U with Bonferroni correction. Based on Spearman correlation, the awareness on COVID-19 was significantly and positively associated with compliance with social distancing order (r=.460, p<.01). Further analysis based on demographic variables found that the awareness on COVID-19 was significantly higher in postgraduates than high school graduates (U=7242.5, p<.01). The awareness on COVID-19 was also significantly higher in working participants than jobless participants. The compliance with social distancing order was found higher in women than men (U=12031.5, p<.01). The study's primary result is that the awareness on COVID-19 positively correlates with public compliance on social distancing order.
    1. Imagination is relevant in many aspects of our lives, and has been associated with creativity and overall cognitive development, yet imagination may also have a dark side. In two studies we examined the link between imagination, anxiety, and loneliness during the COVID-19 pandemic. US college students (N = 101, Study 1) and participants from an international community sample (N = 61, Study 2) were tested around the time that rates of COVID-19 cases were escalating. Across both samples, we found that spending more time in one’s imagination was associated with elevated levels of anxiety. Furthermore, frequency of imagination interacted with loneliness in predicting changes in anxiety during, compared to before the pandemic. Specifically, lonely people who spent more time imagining experienced the largest increases in anxiety during, compared to before the pandemic. In Study 1 valence of imagination and changes in anxiety were also moderated by feelings of loneliness, although this effect was not replicated in Study 2. Results indicate that at least some features of imagination, particularly how much time people spend in imaginative states, may be associated with negative mood states, such as feelings of anxiety. Implications and future directions are discussed
    1. The initial wave of the COVID-19 pandemic disrupted the lives of people across the globe. The current research sought to understand how the pandemic affected people’s social and psychological states during the first three months after the first U.S. death was reported. How did people’s emotions, thought patterns, and social lives change as the pandemic unfolded? The Reddit language of 200,000+ people across 18 cities in the U.S. was analyzed along with surveys from 11,000+ people in the U.S. and Canada. Overall, large psychological shifts were found that reflected three distinct phases. As the first COVID warnings emerged but prior to the shelter-in-place directives, people’s attentional focus switched to the impending threat. Anxiety levels surged, and positive emotion and anger dropped. In parallel, people’s thinking became more immediate and intuitive rather than analytic. When cities began lockdowns, anxiety levels spiked and sadness increased, and language shifted in ways that revealed people’s attempts to make sense of the situation. Six weeks after the onset, people’s psychological states stabilized but the COVID-produced changes had not abated. Converging evidence from survey responses and natural language analysis indicated that people’s ties with family strengthened but that social ties to broader groups (friends, city, and country) weakened. The psychological shifts were amplified on days when the country’s and cities’ COVID infection growth rates were higher, marking the link between the pandemic and the observed psychological patterns. Together, the study underscores the large psychological impacts across the country during the first three months of the crisis.
    1. Recently, theoreticians have hypothesized that diverse groups, as opposed to groups that are homogeneous, may have relative merits [S. E. Page, The Diversity Bonus (2019)]—all of which lead to more success in solving complex problems. As such, understanding complex, intertwined environmental and social issues may benefit from the integration of diverse types of local expertise. However, efforts to support this hypothesis have been frequently made through laboratory-based or computational experiments, and it is unclear whether these discoveries generalize to real-world complexities. To bridge this divide, we combine an Internet-based knowledge elicitation technique with theoretical principles of collective intelligence to design an experiment with local stakeholders. Using a case of striped bass fisheries in Massachusetts, we pool the local knowledge of resource stakeholders represented by graphical cognitive maps to produce a causal model of complex social-ecological interdependencies associated with fisheries ecosystems. Blinded reviews from a scientific expert panel revealed that the models of diverse groups outranked those from homogeneous groups. Evaluation via stochastic network analysis also indicated that a diverse group more adequately modeled complex feedbacks and interdependencies than homogeneous groups. We then used our data to run Monte Carlo experiments wherein the distributions of stakeholder-driven cognitive maps were randomly reproduced and virtual groups were generated. Random experiments also predicted that knowledge diversity improves group success, which was measured by benchmarking group models against an ecosystem-based fishery management model. We also highlight that diversity must be moderated through a proper aggregation process, leading to more complex yet parsimonious models.
    1. Facts are not what they used to be. Whether you are checking the news or opening the latest journal article, there is increasing evidence that people are more susceptible to misinformation and less receptive to factual arguments than we might hope. While fact checks can be effective in some domains (e.g., health), they prove to be a very weak antidote for misinformation when it comes to politics. This problem is exacerbated by increasing polarization in the U.S. and abroad, where partisans express a growing sense of distrust and moral animosity. But a new paper offers a strategy for bridging political divides. In an impressive series of 15 studies, they detail how expressions of personal experience can garner respect from people across the political aisle. Our paper describes why these might be an effective strategy for gaining respect, but also explain why this feature of human psychology can be exploited by propagandists and bad actors. Learning how to do this effectively, without weaponizing misinformation, will require great care and nuance.
    1. People struggle to stay motivated to work toward difficult goals. Sometimes the feeling of difficulty signals that the goal is important and worth pursuing; other times, it signals that the goal is impossible and should be abandoned. In this paper, we argue that how difficulty is experienced depends on how we perceive and experience the timing of difficult events. We synthesize research from across the social and behavioral sciences and propose a new integrated model to explain how components of time perception interact with interpretations of experienced difficulty to influence motivation and goal-directed behavior. Although these constructs have been studied separately in previous research, we suggest that these factors are inseparable and that an integrated model will help us to better understand motivation and predict behavior. We conclude with new empirical questions to guide future research and by discussing the implications of this research for both theory and intervention practice.
    1. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein (S) plays critical roles in host cell entry. Non-synonymous substitutions affecting S are not uncommon and have become fixed in a number of SARS-CoV-2 lineages. A subset of such mutations enable escape from neutralizing antibodies or are thought to enhance transmission through mechanisms such as increased affinity for the cell entry receptor, ACE2. Independent genomic surveillance programs based in New Mexico and Louisiana contemporaneously detected the rapid rise of numerous clade 20G (lineage B.1.2) infections carrying a Q677P substitution in S. The variant was first detected in the US on October 23, yet between 01 Dec 2020 and 19 Jan 2021 it rose to represent 27.8% and 11.3% of all SARS-CoV-2 genomes sequenced from Louisiana and New Mexico, respectively. Q677P cases have been detected predominantly in the south central and southwest United States; as of 03 Feb 2021, GISAID data show 499 viral sequences of this variant from the USA. Phylogenetic analyses revealed the independent evolution and spread of at least six distinct Q677H sub-lineages, with first collection dates ranging from mid August to late November, 2020. Four 677H clades from clade 20G (B.1.2) , 20A (B.1.234), and 20B (B.1.1.220, and B.1.1.222) each contain roughly 100 or fewer sequenced cases, while a distinct pair of clade 20G clusters are represented by 754 and 298 cases, respectively. Although sampling bias and founder effects may have contributed to the rise of S:677 polymorphic variants, the proximity of this position to the polybasic cleavage site at the S1/S2 boundary are consistent with its potential functional relevance during cell entry, suggesting parallel evolution of a trait that may confer an advantage in spread or transmission. Taken together, our findings demonstrate simultaneous convergent evolution, thus providing an impetus to further evaluate S:677 polymorphisms for effects on proteolytic processing, cell tropism, and transmissibility.
    1. New comprehensive economic modelling shows advanced economies stand to lose trillions of dollars through vaccine nationalism – more than previously thought Economic benefits of funding multilateral efforts to ensure equitable access to vaccines dwarf the costs Advanced economies with international linkages have the most to gain from global collaboration on vaccine access and distribution
    1. Case-control studies are commonly used to evaluate effectiveness of licensed vaccines after deployment in public health programs. Such studies can provide policy-relevant data on vaccine performance under ‘real world’ conditions, contributing to the evidence base to support and sustain introduction of new vaccines. However, case-control studies do not measure the impact of vaccine introduction on disease at a population level, and are subject to bias and confounding, which may lead to inaccurate results that can misinform policy decisions. In 2012, a group of experts met to review recent experience with case-control studies evaluating the effectiveness of several vaccines; here we summarize the recommendations of that group regarding best practices for planning, design and enrollment of cases and controls. Rigorous planning and preparation should focus on understanding the study context including healthcare-seeking and vaccination practices. Case-control vaccine effectiveness studies are best carried out soon after vaccine introduction because high coverage creates strong potential for confounding. Endpoints specific to the vaccine target are preferable to non-specific clinical syndromes since the proportion of non-specific outcomes preventable through vaccination may vary over time and place, leading to potentially confusing results. Controls should be representative of the source population from which cases arise, and are generally recruited from the community or health facilities where cases are enrolled. Matching of controls to cases for potential confounding factors is commonly used, although should be reserved for a limited number of key variables believed to be linked to both vaccination and disease. Case-control vaccine effectiveness studies can provide information useful to guide policy decisions and vaccine development, however rigorous preparation and design is essential.
    1. The Dahlem Workshop discussed the hierarchy of possible public health interventions in dealing with infectious diseases, which were deflned as control, elimination of disease, elimination of infections, eradication, and extinction. The indicators of eradicability were the availability of effective interventions and practical diagnostic tools and the essential need for humans in the life-cycle of the agent. Since health resources are limited, decisions have to be made as to whether their use for an elimination or eradication programme is preferable to their use elsewhere. The costs and beneflts of global eradication programmes concern direct effects on morbidity and mortality and consequent effects on the health care system. The success of any disease eradication initiative depends strongly on the level of societal and political commitment, with a key role for the World Health Assembly. Eradication and ongoing programmes constitute potentially complementary approaches to public health. Elimination and eradication are the ultimate goals of public health, evolving naturally from disease control. The basic question is whether these goals are to be achieved in the present or some future generation.
    1. Reporting information from single anonymous sources that turns out to be false could erode public confidence in the vaccines that are crucial to controlling the covid-19 pandemic.
    1. Infectious diseases and human behavior are intertwined. On one side, our movements and interactions are the engines of transmission. On the other, the unfolding of viruses might induce changes to our daily activities. While intuitive, our understanding of such feedback loop is still limited. Before COVID-19 the literature on the subject was mainly theoretical and largely missed validation. The main issue was the lack of empirical data capturing behavioral change induced by diseases. Things have dramatically changed in 2020. Non-pharmaceutical interventions (NPIs) have been the key weapon against the SARS-CoV-2 virus and affected virtually any societal process. Travels bans, events cancellation, social distancing, curfews, and lockdowns have become unfortunately very familiar. The scale of the emergency, the ease of survey as well as crowdsourcing deployment guaranteed by the latest technology, several Data for Good programs developed by tech giants, major mobile phone providers, and other companies have allowed unprecedented access to data describing behavioral changes induced by the pandemic. Here, I review some of the vast literature written on the subject of NPIs during the COVID-19 pandemic. In doing so, I analyze 348 articles written by more than 2518 of authors in the first 12 months of the emergency. While the large majority of the sample was obtained by querying PubMed, it includes also a hand-curated list. Considering the focus, and methodology I have classified the sample into seven main categories: epidemic models, surveys, comments/perspectives, papers aiming to quantify the effects of NPIs, reviews, articles using data proxies to measure NPIs, and publicly available datasets describing NPIs. I summarize the methodology, data used, findings of the articles in each category and provide an outlook highlighting future challenges as well as opportunities.
    1. Objective: Some gambling product messages are designed to inform gamblers about the long-run cost of gambling, e.g., “this game has an average percentage payout of 90%.” This message is in the “return-to-player” format and is meant to convey that for every £100 bet about £90 will be paid out in prizes. Some previous research has found that restating this information in the “house-edge” format, e.g., “this game keeps 10% of all money bet on average”, is better understood by gamblers and reduces gamblers’ perceived chances of winning. Here we additionally test another potential risk communication improvement: a “volatility statement” highlighting that return-to-player and house-edge percentages are long-run statistical averages, which may not be experienced in any short period of gambling. Method: Gambling information format and volatility statement presence were manipulated in an online experiment involving 2,025 UK gamblers. Results: The house-edge format and the presence of volatility statements both additively reduced gamblers’ perceived chances of winning. In terms of gamblers’ understanding, house-edge messages were understood the best, but no consistent effect of volatility statements was observed. Conclusions: The return-to-player gambling messages in current widespread use can be improved by switching to the house-edge format and via the addition of a volatility statement.
    1. Rising interest in online experiments for cognitive science research lies in the ability to reach a large number of participants in a short time at a relatively low cost. However, compared to controlled laboratory studies, online data is far more noisy. This is especially relevant when reliable response-timing at a millisecond-level is paramount, as it is the case for many decision-making tasks. In this paper we sought to replicate a well-validated cognitive effect -the distance effect in number comparisons- using an online mobile-friendly app developed with open-source tools in R-Shiny. In this task, adapted from (Dehaene et al., 1990), participants have to decide whether a number on the screen is larger or smaller than a standard (65 in our study). The distance effect stands for the fact that response time (RT) is significantly larger as the presented number is closer to the standard. A total of N=170 participants (110 with a mobile device, 60 on a desktop computer) completed 116 trials over a ~7-minute session. Using generalized linear mixed models estimated with Bayesian inference methods, we found a numerical distance effect strikingly consistent with the original study. Furthermore, we report systematic offsets in RTs that different OS, browsers and devices introduced. Our results demonstrate the reliability of R-Shiny for RT data collection. By doing so, our work paves the ground for a seamless and robust implementation of simple cognitive tasks in online studies over desktop and mobile devices using only R, a widely popular programming framework among cognitive scientists. See less
    1. From Monday 15 February, travellers arriving in England from a “red list” of 33 countries will be required to quarantine in a hotel for 10 days. But the ruling has been criticised as too little, too late, with not enough consistency to be effective.
    1. As vaccines are rolled out, massive logistical challenges are leading scientists and policymakers to consider alternative dosing strategies.But what does the science say? In this week’s episode of Coronapod, we discuss mixing and matching vaccines and lengthening the time between doses. Approaches like these could ease logistical concerns, but we ask what's known about their impact on vaccine efficacy – what is the science behind the decisions, and could they actually boost immune responses?
    1. Did the virus that caused a worldwide pandemic make the jump to humans via frozen food? That was one hypothesis put forward on 9 February by a joint World Health Organization and Chinese investigation into the origins of SARS-CoV-2.
    1. As many countries continue to struggle with a third wave of COVID-19—Hong Kong is suffering its fourth wave and is contemplating a fifth and sixth—all governments and public health authorities will need to remain open to new ideas for controlling the pandemic. This past week, Ilona Kickbusch, founding director of the Global Health Centre at the Graduate Institute of International and Development Studies in Geneva, shared a proposal being widely discussed in Germany. The approach devised by a group of clinicians and academics, which in addition to Kickbusch includes Melanie Brinkmann, Michael Hallek, Matthias Schneider, and others, is a “No-COVID strategy”.
    1. Survey spanning several countries finds encouraging trends, but researchers warn vaccine hesitancy could slow pandemic recovery.
    1. The COVID-19 outbreak has generated significant uncertainty about the future, especially for young adults. Health and economic threats, as well as more diffuse concerns about the consequences of COVID-19, can trigger feelings of anxiety, leading individuals to adopt uncertainty-reducing behaviours. We tested whether anxiety was associated with an increase in willingness to be exposed to the risk of COVID-19 infection (WiRE) using an online survey administered to 3,110 French individuals aged between 18 and 35 years old during the lockdown period (April 2020). Overall, 56.5% of the sample declared a positive WiRE. Unemployment was associated with a higher WiRE (+8.2 percentage points (pp); 95% CI +0.9-15.4 pp). One standard deviation increases in income (+1160€) and psychological state anxiety raised the WiRE by +2.7 pp (95% CI: +1.1-4.4 pp) and +3.9 pp (95% CI: +1.6-6.2 pp), respectively. A one standard deviation increase in perceived hospitalisation risk was associated with a -4.1 pp (95% CI: -6.2-2.1 pp) decrease in the WiRE. Overall, our results suggest that both the prospect of economic losses and psychological anxiety can undermine young adults’ adherence to physical distancing recommendations. Public policies targeting young adults must consider both their economic situation and their mental health, and they must use uncertainty-reducing communication strategies.
    1. In this brief reflection, I explore three key lessons learned from conducting a policy research placement during the COVID-19 pandemic. I explore how the placement changed my perspective on my PhD research, working life, and suggest how academics may better engage with policymakers in the future.
    1. The COVID-19 pandemic, caused by tens of millions of SARS-CoV-2 infections world-wide, has resulted in considerable levels of mortality and morbidity. The United States has been hit particularly hard having 20 percent of the world’s infections but only 4 percent of the world population. Unfortunately, significant levels of misunderstanding exist about the severity of the disease and its lethality. As COVID-19 disproportionally impacts elderly populations, the false impression that the impact on society of these deaths is minimal may be conveyed by some because elderly individuals are closer to a natural death. To assess the impact of COVID-19 in the US, I have performed calculations of person-years of life lost as a result of 194,000 premature deaths due to SARS-CoV-2 infection as of early October, 2020. By combining actuarial data on life expectancy and the distribution of COVID-19 associated deaths we estimate that over 2,500,000 person-years of life have been lost so far in the pandemic in the US alone, averaging over 13.25 years per person with differences noted between males and females. Importantly, nearly half of the potential years of life lost occur in non-elderly populations. Issues impacting refinement of these models and the additional morbidity caused by COVID-19 beyond lethality are discussed.
    1. Objective To derive and validate a risk prediction algorithm to estimate hospital admission and mortality outcomes from coronavirus disease 2019 (covid-19) in adults.Design Population based cohort study.Setting and participants QResearch database, comprising 1205 general practices in England with linkage to covid-19 test results, Hospital Episode Statistics, and death registry data. 6.08 million adults aged 19-100 years were included in the derivation dataset and 2.17 million in the validation dataset. The derivation and first validation cohort period was 24 January 2020 to 30 April 2020. The second temporal validation cohort covered the period 1 May 2020 to 30 June 2020.Main outcome measures The primary outcome was time to death from covid-19, defined as death due to confirmed or suspected covid-19 as per the death certification or death occurring in a person with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the period 24 January to 30 April 2020. The secondary outcome was time to hospital admission with confirmed SARS-CoV-2 infection. Models were fitted in the derivation cohort to derive risk equations using a range of predictor variables. Performance, including measures of discrimination and calibration, was evaluated in each validation time period.Results 4384 deaths from covid-19 occurred in the derivation cohort during follow-up and 1722 in the first validation cohort period and 621 in the second validation cohort period. The final risk algorithms included age, ethnicity, deprivation, body mass index, and a range of comorbidities. The algorithm had good calibration in the first validation cohort. For deaths from covid-19 in men, it explained 73.1% (95% confidence interval 71.9% to 74.3%) of the variation in time to death (R2); the D statistic was 3.37 (95% confidence interval 3.27 to 3.47), and Harrell’s C was 0.928 (0.919 to 0.938). Similar results were obtained for women, for both outcomes, and in both time periods. In the top 5% of patients with the highest predicted risks of death, the sensitivity for identifying deaths within 97 days was 75.7%. People in the top 20% of predicted risk of death accounted for 94% of all deaths from covid-19.Conclusion The QCOVID population based risk algorithm performed well, showing very high levels of discrimination for deaths and hospital admissions due to covid-19. The absolute risks presented, however, will change over time in line with the prevailing SARS-C0V-2 infection rate and the extent of social distancing measures in place, so they should be interpreted with caution. The model can be recalibrated for different time periods, however, and has the potential to be dynamically updated as the pandemic evolves.
    1. Our cities have been the centers of momentous change over the last seven months. From the global pandemic to mass demonstrations over racial injustice, cities have been transformed. Public space is taking on a significant role in our society as a place to demand justice, while public space also raises serious concerns about public health.
    1. The global outbreak of coronavirus disease 2019 (COVID-19) has seen a deluge of clinical studies, with hundreds registered on clinicaltrials.gov. But a palpable sense of urgency and a lingering concern that “in critical situations, large randomized controlled trials are not always feasible or ethical” (1) perpetuate the perception that, when it comes to the rigors of science, crisis situations demand exceptions to high standards for quality
    1. A two-track recovery is emerging from the country’s pandemic-driven economic contraction. Some workers, companies and regions show signs of coming out fine or even stronger. The rest are mired in a deep decline with an uncertain path ahead.
    1. Understanding the concept of “flattening the curve” in connection with the COVID-19 crisis requires an understanding of which curve needs to be flattened – but how well do ordinary Americans understand the relationship between the various curves presented in the media? Based on prior research, we hypothesized that ordinary Americans will have difficulty comprehending the link between the two most commonly used graphs: graphs of new daily cases and cumulative cases, and this lack of understanding would shape attitudes towards enforcing social-distancing. To investigate this, we collected data from 594 Amazon MTurk participants. We found that: a) indeed, most people have a poor understanding of the link between new daily cases and cumulative cases, b) people also have unjustified high confidence in their judgments and c) their judgments and their confidence are systematically related to their policy attitudes. We also show that a simple training intervention can significantly improve this understanding.
    1. To reduce the spread of COVID-19 transmission, government agencies in the United States (US) have recommended COVID prevention guidelines, including wearing masks and social distancing. However, compliance with these guidelines have been inconsistent. This study examined whether individual differences in decision-making and motivational propensities predicted compliance with COVID-19 preventative behaviors in a representative sample of US adults (N=225). Participants completed an online study in September 2020 that included a risky choice decision-making task, temporal discounting task, and measures of appropriate mask wearing, social distancing, and perceived risk of engaging in public activities. Linear regression results indicated that greater risky decision-making behavior and temporal discounting were associated with less appropriate mask-wearing behavior and social distancing. Additionally, demographic factors, including political affiliation and income level, were also associated with differences in COVID-19 preventative behaviors. Path analysis results showed that risky decision-making behavior, temporal discounting, and risk perception collectively predicted 61% of the variance in appropriate mask-wearing behavior. Individual differences in general decision-making patterns are therefore highly predictive of who complies with COVID-19 prevention guidelines.
    1. Fear and anxiety about COVID-19 has swept across the globe. Understanding the factors that contribute to increasing emotional distress regarding the pandemic is paramount—especially as experts warn about rising cases. Despite large amounts of data, it remains unclear which variables are essential for predicting who will be most affected by the distress of future waves. We collected cross-sectional data on a multitude of socio-psychological variables from a sample of 948 United States participants during the early stages of the pandemic. Using a cross-validated hybrid stepwise procedure, we developed a descriptive model of COVID-19 emotional distress. Results reveal that trait anxiety, gender, and social (but not government) media consumption were the strongest predictors of increasing emotional distress. In contrast, commonly associated variables, such as age and political ideology, exhibited much less unique explanatory power. Together, these results can help public health officials identify which populations will be especially vulnerable to experiencing COVID-19 related emotional distress.
    2. Fear and anxiety about COVID-19 has swept across the globe. Understanding the factors that contribute to increasing emotional distress regarding the pandemic is paramount—especially as experts warn about rising cases. Despite large amounts of data, it remains unclear which variables are essential for predicting who will be most affected by the distress of future waves. We collected cross-sectional data on a multitude of socio-psychological variables from a sample of 948 United States participants during the early stages of the pandemic. Using a cross-validated hybrid stepwise procedure, we developed a descriptive model of COVID-19 emotional distress. Results reveal that trait anxiety, gender, and social (but not government) media consumption were the strongest predictors of increasing emotional distress. In contrast, commonly associated variables, such as age and political ideology, exhibited much less unique explanatory power. Together, these results can help public health officials identify which populations will be especially vulnerable to experiencing COVID-19 related emotional distress.
    1. Introduction: The COVID-19 pandemic has impacted biopsychosocial health and wellbeing globally. Pre-pandemic studies suggest a high prevalence of common mental disorders, including anxiety and depression in South Asian countries, which may aggravate during this pandemic. This systematic meta-analytic review was conducted to estimate the pooled prevalence of anxiety and depression in South Asian countries during the COVID-19 pandemic. Method: We systematically searched for cross-sectional studies on eight major bibliographic databases and additional sources up to October 12, 2020, that reported the prevalence of anxiety or depression in any of the eight South Asian countries. A random-effects model was used to calculate the pooled proportion of anxiety and depression. Results: A total of 35 studies representing 41,402 participants were included in this review. The pooled prevalence of anxiety in 31 studies with a pooled sample of 28,877 was 41.3% (95% confidence interval [CI]: 34.7-48.1, I2 = 99.18%). Moreover, the pooled prevalence of depression was 34.1% (95% CI: 28.9-39.4, I2 = 99%) among 37,437 participants in 28 studies. Among the South Asian countries, India had a higher number of studies, whereas Bangladesh and Pakistan had a higher pooled prevalence of anxiety and depression. No studies were identified from Afghanistan, Bhutan, and Maldives. Studies in this review had high heterogeneity and varying prevalence across sub-groups. Conclusion: South Asian countries have high prevalence rates of anxiety and depression, suggesting a heavy psychosocial burden during this pandemic. Clinical and public mental health interventions should be prioritized alongside improving the social determinants of mental health in these countries. Lastly, a low number of studies with high heterogeneity requires further research exploring the psychosocial epidemiology during COVID-19, which may inform better mental health policymaking and practice in South Asia.
    1. For over two centuries researchers have been criticized for using research practices that makes it easier to present data in line with what they wish to be true. With the rise of the internet it has become easier to preregister the theoretical and empirical basis for predictions, the experimental design, the materials, and the analysis code. Whether the practice of preregistration is valuable depends on your philosophy of science. Here, I provide a conceptual analysis of the value of preregistration for psychological science from an error statistical philosophy (Mayo, 2018). Preregistration has the goal to allow others to transparently evaluate the capacity of a test to falsify a prediction, or the severity of a test. Researchers who aim to test predictions with severity should find value in the practice of preregistration. I differentiate the goal of preregistration from positive externalities, discuss how preregistration itself does not make a study better or worse compared to a non-preregistered study, and highlight the importance of evaluating the usefulness of a tool such as preregistration based on an explicit consideration of your philosophy of science.gister the theoretical and empirical basis for predictions, the experimental design, the materials, and the analysis code
    1. In recent times, many alarm bells have begun to sound: the metaphorical presentation of the COVID-19 emergency as a war might be dangerous, because it could affect the way people conceptualize the pandemic, and react to it, leading citizens to endorse authoritarianism and limitations to civil liberties. The idea that conceptual metaphors actually influence reasoning has been corroborated by Thibodeau and Boroditsky, who showed that when crime is metaphorically presented as a beast, readers become more enforcement-oriented than when crime is metaphorically framed as a virus. Recently, Steen, Reijnierse and Burgers replied that this metaphorical framing effect does not seem to occur and suggested that the question should be rephrased about the conditions under which metaphors do or do not influence our reasoning. In this paper, we investigate whether presenting the COVID-19 pandemic as a war has an effect on people’s reasoning about the pandemic. Data collected suggest that when the metaphorical framing effect occurs, it is mediated by socio-political individual variables such as speakers’ political orientation and their kind of source of information: right wings participants and those relying on independent sources of information are those more conditioned by the COVID-19 war metaphor in reasoning and opinion formation.
    1. Could fear and anxiety play a functional role during the COVID-19 pandemic by driving greater information sharing about the viral threat? To explore whether anxiety may serve as a unique emotional indicator of sharing information in response to the COVID-19 pandemic, we used a representative sample of the United States from the American Trends Panel (N=9,188) conducted April 20th-26th, 2020. Participants reported how they have felt in the past week, where they got their news about the outbreak from, and whether they had posted COVID-19 news on social media or discussed the pandemic with others. Even after controlling for other emotions, news sources, and a range of demographic measures, feeling anxious—more so that other negative emotions, such as feeling depressed—predicted greater information sharing on social media (𝛽 = .05, p < .001) and beyond (𝛽 = .14, p < .001). These findings are consistent with functionalist theories of emotion, which predict that fear and anxiety play a unique role in both identifying and communicating threats to oneself and to others.
    1. A defining feature of liberal democracy is the respect for and protection of core civil liberties. Yet, major crises, such as wars, natural disasters and pandemics, can provide a pretext to undermine liberal democratic norms. This raises questions of whether citizens are willing to support policies that violate their civil liberties in a crisis and whether some individuals are more likely to a support such encroachments. We conducted a series well-powered preregistered conjoint and vignette experiments in the US and UK during the first wave of the COVID-19 pandemic. We find that people’s attitudes are relatively malleable and that endorsements by an in-group party and trusted experts can shift support for measures that erode civil liberties. However, the evidence also reveals resistance to certain illiberal policy measures, including banning protests and indefinitely postponing elections. This indicates the presence of liberal democratic norms, even when partisan elites promote illiberal policies.
    1. Since 2016, the amount of academic research with the keyword "misinformation" has more than doubled [2]. This research often focuses on article headlines shown in artificial testing environments, yet misinformation largely spreads through images and video posts shared in highly-personalized platform contexts. A foundation of qualitative research is necessary to begin filling this gap to ensure platforms' visual misinformation interventions are aligned with users' needs and understanding of information in their personal contexts, across platforms. In two studies, we combined in-depth interviews (n=15) with diary and co-design methods (n=23) to investigate how a broad mix of Americans exposed to misinformation during COVID-19 understand their visual information environments, including encounters with interventions such as Facebook fact-checking labels. Analysis reveals a deep division in user attitudes about platform labeling interventions for visual information which are perceived by many as overly paternalistic, biased, and punitive. Alongside these findings, we discuss our methods as a model for continued independent qualitative research on cross-platform user experiences of misinformation that inform interventions.
    1. The Science Media Centre (SMC) was formed in 2002 after a Select Committee report found confidence and public trust in science were being eroded by sensationalised and inaccurate press coverage. The centre helps journalists access leading experts and encourages scientists to engage with the media, and in 2020 had its busiest ever year, organising hundreds of briefings and round-ups of expert opinion on COVID-19. Its director, Fiona Fox, talks to Tom Ireland about how the press have handled the extraordinary deluge of scientific information and public health messages produced during the pandemic.
    1. Coronavirus disease 2019 (COVID-19)vaccine shortages have led some experts and countries to consider untested dosing regimens. We studied antibody responses to a single dose of the Pfizer-BioNTech or Moderna vaccines in healthcare workers (HCW) with laboratory-confirmed COVID-19 infection and compared to them to antibodyresponses of HCW who were IgG negative to SARS-CoV-2 spike protein.HCW with prior COVID-19showed clear secondary antibody responses to vaccination with IgG spike binding titers rapidly increasing by 7 days and peaking by days 10 and 14 post-vaccination. At all time points tested, HCW with prior COVID-19 infection showed statistically significant higher antibody titers of binding and functional antibodycompared to HCW without prior COVID-19 infection (p<.0001for each of the time points tested). In times of vaccine shortage, and until correlates of protection are identified, our findings preliminarily suggest the following strategy as more evidence-based: a) a single doseof vaccine for patients already having had laboratory-confirmed COVID-19; and b) patients who have had laboratory-confirmed COVID-19 can be placed lower on the vaccination priority list.
    1. Statement from the Joint Committee on Vaccination and Immunisation (JCVI) about increasing the short-term impact of the COVID-19 vaccination programme.
    1. These interim recommendations apply to AZD1222 (ChAdOx1-S [recombinant]) vaccine against COVID-19 developed by Oxford University (United Kingdom) and AstraZeneca as well as to ChAdOx1-S [recombinant] vaccines against COVID-19 produced by other manufacturers that rely on the AstraZeneca core clinical data, following demonstrated equivalence in their regulatory review and once emergency use listing (EUL) has been obtained from WHO.

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    1. Why do we adopt new rules, such as social distancing? Although human sciences research stresses the key role of social influence in behaviour change, most COVID‐19 campaigns emphasize the disease’s medical threat. In a global data set (n = 6,674), we investigated how social influences predict people’s adherence to distancing rules during the pandemic. Bayesian regression analyses controlling for stringency of local measures showed that people distanced most when they thought their close social circle did. Such social influence mattered more than people thinking distancing was the right thing to do. People’s adherence also aligned with their fellow citizens, but only if they felt deeply bonded with their country. Self‐vulnerability to the disease predicted distancing more for people with larger social circles. Collective efficacy and collectivism also significantly predicted distancing. To achieve behavioural change during crises, policymakers must emphasize shared values and harness the social influence of close friends and family.
    1. Since the beginning of the COVID-19 pandemic we've calculated Rt, which has been a useful measure of how quickly the virus is spreading. However, we believe other metrics are now a better way to track the virus. With that, we suggest you visit the following organizations which have alternative metrics:
    1. Scopus has stopped adding content from most of the flagged titles, but the analysis highlights how poor-quality science is infiltrating literature.
    1. This report looks at attitudes towards a COVID-19 vaccine in 15 countries between November 2020 and mid-January 2021. Countries included are Australia, Canada, Denmark, Finland, France, Germany, Italy, Japan, Netherlands, Norway, Singapore, South Korea, Spain, Sweden and the United Kingdom. The total sample is of ~13,500 people.
    1. Every policy has direct and indirect effects of intended and unintended consequences. Policies that require people to stay at home to reduce the morbidity and mortality from Covid-19 will have effects beyond the virus. For example, they will adversely affect mental health and economic prospects for many. They will also affect people’s willingness and ability to access health and social services. This is likely to result in increases in morbidity and mortality from otherwise curable diseases, such as cancer, acute myocardial infarction and stroke. A comparison between Covid-19 deaths prevented and excess cancer deaths caused shows it is possible that preventing Covid-19 deaths through lockdowns might result in more life-years being lost than saved.
    1. COVID-19 transmits by droplets generated from surfaces of airway mucus during processes of respiration within hosts infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. We studied respiratory droplet generation and exhalation in human and nonhuman primate subjects with and without COVID-19 infection to explore whether SARS-CoV-2 infection, and other changes in physiological state, translate into observable evolution of numbers and sizes of exhaled respiratory droplets in healthy and diseased subjects. In our observational cohort study of the exhaled breath particles of 194 healthy human subjects, and in our experimental infection study of eight nonhuman primates infected, by aerosol, with SARS-CoV-2, we found that exhaled aerosol particles vary between subjects by three orders of magnitude, with exhaled respiratory droplet number increasing with degree of COVID-19 infection and elevated BMI-years. We observed that 18% of human subjects (35) accounted for 80% of the exhaled bioaerosol of the group (194), reflecting a superspreader distribution of bioaerosol analogous to a classical 20:80 superspreader of infection distribution. These findings suggest that quantitative assessment and control of exhaled aerosol may be critical to slowing the airborne spread of COVID-19 in the absence of an effective and widely disseminated vaccine.
    1. A novel SARS-CoV-2 variant, VOC 202012/01, emerged in southeast England in November 2020 and is rapidly spreading towards fixation. Using a variety of statistical and dynamic modelling approaches, we assessed the relative transmissibility of this novel variant. Depending on the analysis, we estimate that VOC 202012/01 is 43–82% (range of 95% credible intervals 38–106%) more transmissible than preexisting variants of SARS-CoV-2. We did not find clear evidence that VOC 202012/01 results in greater or lesser severity of disease than preexisting variants. Nevertheless, the increase in transmissibility is likely to lead to a large increase in incidence. To assess the potential impact of VOC 202012/01, we fitted a two-strain mathematical model of SARS-CoV-2 transmission to observed COVID-19 hospital admissions, hospital and ICU bed occupancy, and deaths; SARS-CoV-2 PCR prevalence and seroprevalence; and the relative frequency of VOC 202012/01. We find that without stringent control measures, COVID-19 hospitalisations and deaths are projected to reach higher levels in 2021 than were observed in 2020. Control measures of a similar stringency to the national lockdown implemented in England in November 2020 are unlikely to reduce the effective reproduction number Rt to less than 1, unless primary schools, secondary schools, and universities are also closed. We project that large resurgences of the virus are likely to occur following easing of control measures. It may be necessary to greatly accelerate vaccine roll-out to have an appreciable impact in suppressing the resulting disease burden.
    1. Objective. This study aims to explore students’ adherence and reasons behind the (non)adherence to the COVID-19-regulations within a university setting. Methods. A total of 33 students participated in on-site and online focus group interviews (k=8). Discussed topics included the general COVID-19-guidelines of the university, including keeping ≥1.5 m distance, staying at home and getting tested when having symptoms, and wearing facemasks. Additionally, education and psychosocial wellbeing in the times of COVID-19 were discussed. We also conducted online interviews with stewards (2 focus group interviews and 1 individual interview) and security/crowd control officials (1 focus group interview) to learn more about students’ (non)adherence behaviors. Results. The findings of this study show that the interviewed students were willing to adhere to the guidelines within the university buildings. They mentioned several facilitators (e.g., the infrastructure of the buildings and staff) and barriers (e.g., being together with friends and difficulties with telling others to follow the regulations) for their compliance behaviors. Some students also stated that they are not afraid of COVID-19 because they are young, while others adhered to the regulations to protect vulnerable people. Conclusion. To create a safe environment within the university and alleviate the spread of the virus, future interventions require targeting the determinants of students’ non-adherence behaviors, such as lower risk perception (e.g., being young and no perceived threat/low vulnerability) and lower self-efficacy (e.g., for keeping distance, to determine symptoms for testing/isolating and to correct others).
    1. Slightly more than 6% of American adults have received at least the first dose of the COVID-19 vaccine — but a disproportionately small number of them are Black and Hispanic people.
    1. Measles elimination in Europe is in crisis. More than 80 000 confirmed cases were reported in 2018 in the 53 countries in the WHO European Region,1Zimmerman LA Muscat M Singh S et al.Progress toward measles elimination—European Region, 2009–2018.MMWR Morb Mortal Wkly Rep. 2019; 68: 396-401Crossref PubMed Scopus (14) Google Scholar the highest figure for 20 years. 14 countries in the region reported more than 500 confirmed cases, including four countries that were previously deemed to have eliminated measles (Greece, Albania, Israel, and the UK), meaning interrupted transmission for 3 years. New strategies are urgently needed to put measles elimination in Europe back on track.In theory, controlling measles should be straightforward. Two doses of the measles, mumps, and rubella (MMR) vaccine provide highly efficacious protection that is long lasting.2LeBaron CW Beeler J Sullivan BJ et al.Persistence of measles antibodies after 2 doses of measles vaccine in a postelimination environment.Arch Pediatr Adolesc Med. 2007; 161: 294-301Crossref PubMed Scopus (75) Google Scholar Yet, in practice, achieving elimination has proven challenging. One of the most contagious diseases, measles can strike susceptible pockets even if vaccination coverage on a national level is high. Although asserting elimination status for individual nations might serve as a motivational tool, countries can experience large outbreaks even after several years of interrupted transmission. Countries such as Greece, Germany, and Kyrgyzstan reported consistently high MMR uptake over the past decade but are still experiencing outbreaks. Moreover, outbreaks do not occur in isolation: they traverse country borders, sometimes lasting years, and affecting different countries at different times.3Mankertz A Mihneva ZR Gold H et al.Spread of measles virus D4-Hamburg, Europe, 2008–2011.Emerg Infect Dis. 2011; 17: 1396-1401Crossref PubMed Scopus (61) Google ScholarIn light of these issues, there is a need to link efforts across the continent. The Pan American Health Organization4Eurosurveillance editorial teamExpert committee declares WHO Region of the Americas measles-free.Euro Surveill. 2016; 21: 30360Crossref Scopus (4) Google Scholar interrupted measles transmission in the early 2000s through combined strategies, including high routine immunisation, catch-up campaigns during periods of low transmission, and follow-up campaigns ensuring high levels of immunity at the age of school entry, all applied uniformly across the Americas. Applying a similar joined-up approach in Europe would serve the dual purpose of increasing immunity in the general population while reducing the chance of imported cases reaching susceptible pockets.Epidemiological investigation would also benefit from combined efforts. Linking genetic and case data to better understand chains of transmission has proven successful for other diseases2LeBaron CW Beeler J Sullivan BJ et al.Persistence of measles antibodies after 2 doses of measles vaccine in a postelimination environment.Arch Pediatr Adolesc Med. 2007; 161: 294-301Crossref PubMed Scopus (75) Google Scholar and might reveal the interconnectivity of measles across Europe.5Jombart T Cori A Didelot X Cauchemez S Fraser C Ferguson N Bayesian reconstruction of disease outbreaks by combining epidemiologic and genomic data.PLoS Comput Biol. 2014; 10: e1003457Crossref PubMed Scopus (104) Google Scholar Subnational seroprevalence studies could be used to better identify pockets of susceptibles.6Vasylyeva TI Friedman SR Paraskevis D Magiorkinis G Integrating molecular epidemiology and social network analysis to study infectious diseases: towards a socio-molecular era for public health.Infect Genet Evol. 2016; 46: 248-255Crossref PubMed Scopus (23) Google Scholar Improved vaccine supply, advocacy, and communication to population groups found to be most at risk could help increase immunity to the levels required.7Metcalf CJE Farrar J Cutts FT et al.Use of serological surveys to generate key insights into the changing global landscape of infectious disease.Lancet. 2016; 388: 728-730Summary Full Text Full Text PDF PubMed Scopus (89) Google Scholar Such efforts would come at a fraction of the cost of responding to outbreaks.8Carrillo-Santisteve P Lopalco PL Measles still spreads in Europe: who is responsible for the failure to vaccinate?.Clin Microbiol Infect. 2012; 18: 50-56Summary Full Text Full Text PDF PubMed Scopus (51) Google Scholar The Americas have shown that elimination of measles is feasible through a combination of political willpower, targeted interventions, and concerted effort. If Europe can sustain a similar approach, it might still follow suit.
    1. Background. Clinical reports from patients suffering from the novel coronavirus (COVID-19) reflect a high prevalence of sensory deprivation or loss pertaining to smell (dysosmia/anosmia) and/or taste (dysgeusia/ageusia). Given the importance of the senses to daily functioning and personal experience, the mental health consequences of these symptoms warrant further attention. Methods. A cohort of Reddit users posting within the /r/covid19positive subforum (N=15,821) was leveraged to analyze instantaneous risk of transition to a state of suicidal ideation or depression using Cox proportional-hazards models. Risk transition was defined by posts made in suicide- or depression-related forums, or mentions of relevant phrases with and without mention of anosmia/ageusia in /r/covid19positive. Self-diagnosis of COVID-19 was also modeled as a separate and simultaneous predictor of mental health risk. Results. Mention of anosmia/ageusia was significantly associated with transition to a risk state. Users with a history of anosmia/ageusia-related posts and who self-identified as COVID-19 positive had 30% higher instantaneous risk relative to others. The highest increase in instantaneous risk of suicidal ideation or depression occurred more than 100 days after first posting in /r/covid19positive. Limitations. Use of self-diagnosed disease as well as a broad array of anosmia/ageusia-related terminology may entail both information bias and overestimates of symptom incidence. Conclusions. The specific effects of COVID-19 on the senses may have long-term implications for patient mental health well-being beyond the primary recovery period. Future work is needed to investigate the longitudinal mental health burden of residual COVID-19 symptom presentation.
    1. Our national pandemic health protection response in the UK has been undermined at every turn by misinformation and disinformation from self styled “libertarians,” “lockdown sceptics,” “truth seekers,” covid deniers, conspiracy theorists, and professional attention seekers—whether high-profile media commentators, politicians, and lobbyists, or organised groups on social media. 
    1. The unprecedented COVID-19 pandemic in the US required organizations to make their own decisions regarding prevention policies, such as whether to require and enforce mask wearing, in the absence of regulations and norms. In five pre-registered studies, we investigate whether people support strict COVID-19 prevention policies and whether that support is underestimated, across business types, types of policy cues (stated and viral videos), and types of policies (required mask-wearing and vaccination). We consistently find that people strongly favor organizations with strict policies, such that the risks of both losing customers and of negative consumer perceptions are higher for lax policies (e.g., recommended mask-wearing) than for strict policies (requiring and enforcing mask-wearing). Nevertheless, customers and managers alike underestimate public support for strict policies, with negative consequences for word-of-mouth behavior. The underappreciation of support for public health measures that we document can impede the establishment of norms and the adoption of strict policies, undermining efforts to combat public health crises such as COVID-19.
    1. This article discusses the latest research that reveals that children seem to be facing new risks of sexual violence in Kenya during the COVID-19 pandemic. Patterns of sex offending against children coinciding with the implementation of lockdowns, curfews, and school closures may be shifting since the pandemic began. In particular, emerging evidence from Kenya suggests that child victims are younger, more likely to be victimized by a neighbor in a private residence, and in the daytime, compared to pre-pandemic. We conclude that situational crime prevention strategies that focus on providing alternative safe venues to reduce offending opportunities must be a central part of a public health approach to reduce children’s vulnerability during crises such as COVID-19.
    1. As COVID-19 continues to disrupt pre-tertiary education provision and examinations in the UK, urgent consideration must be given to how best to support the 2021-2022 cohort of incoming undergraduate students to Higher Education. In this paper, we draw upon the ‘Five Sense of Student Success’ model to highlight five key evidence-based considerations that Higher Education educators should be attentive to when preparing for the next academic year. These include: the challenge in helping students to reacclimatise to academic work following a period of prolonged educational disruption, supporting students to access the ‘hidden curriculum’ of Higher Education, negotiating mental health consequences of COVID-19, and remaining sensitive to inequalities of educational provision that students have experienced as a result of COVID-19. We provide evidence-based recommendations to each of these considerations.
    1. The social media platform is siding with scientists to stop the spread of harmful misinformation about the pandemic. If it can do it now, why wasn't it doing it all along?
    1. Researchers don’t understand exactly how the disease might trigger Type 1 or Type 2 diabetes, or whether the cases are temporary or permanent. But 14 percent of those with severe covid-19 developed a form of the disorder, one analysis found.
    1. In the fight against COVID-19, disease modelers have struggled with misunderstanding and misuse of their work. They have also come to realize how unready the state of modeling was for this pandemic.
    1. The COVID-19 pandemic and associated “Stay-Home” restrictions in the United States have disrupted employees’ lives. We leverage the change brought on by the Stay-Home restrictions to examine corresponding changes in employees’ commitment to their workgroup. Specifically, we advance and test a model predicting that the Stay-Home restrictions prevented workgroups from engaging in rigidly performed, meaningful workplace activities (i.e., ritualistic workplace activities), which subsequently made members feel that the group was less cohesive and ultimately reduced members’ workgroup commitment. We also compare changes in workgroup commitment to changes in workgroup identification, hypothesizing that commitment to one’s group erodes more than identification when workgroups are perceived to be less cohesive. We test our model in a four-wave panel survey of 772 U.S. employees at the onset of the Stay-Home restrictions, which allows us to examine within-person changes to commitment over time. Consistent with our hypotheses, commitment decreased as the duration of Stay-Home restrictions increased, which was mediated by corresponding declines in engaging in ritualistic workplace activities and perceptions of the workgroup’s cohesiveness. Further, commitment to one’s workgroup declined more than did identification with the workgroup, due to the stronger relationship between perceived group cohesion and commitment (vs. identification). We replicated these results in a separate, preregistered cross-sectional survey. Our findings shed light on the mechanisms underlying workgroup commitment, demonstrating that engagement in ritualistic activities, which enhance workgroup cohesion, is linked to stronger commitment— more so than identification—over time.
    1. Until very recently, I was a fit, healthy ex-rower with no past medical history. I was a highly active scientist in pathogen genomics. But then I developed COVID-19, which progressed to Long-COVID. Here, I give an account of my experience to raise awareness of this debilitating illness.
    1. In this Methods Showcase, we outline a workflow for running behavioral experiments online, with a focus on linguistic experiments. The workflow that we describe here relies on three tools: OpenSesame/ OSWeb (open source) provides a user-friendly graphical interface for developing experiments; JATOS (open source) is server software for hosting experiments; and Prolific (commercial) is a platform for recruiting participants. These three tools integrate well with each other, and together they provide a workflow that requires little technical expertise. We discuss several challenges that are associated with running online experiments, including temporal precision, the ability to implement counterbalancing, and data quality. We conclude that these problems are real but surmountable, and that in many cases online experiments are a viable alternative to laboratory-based experiments.
    1. The mandate of the Independent Panel for Pandemic Preparedness and Response is to “provide an evidence-based path for the future, grounded in lessons of the present and the past to ensure countries and global institutions, including specifically WHO, effectively address health threats.”1 These lessons are starting to emerge with the publication of the panel’s second progress report.2 Unsurprisingly, the report touches several key problems in the global governance of covid-19: WHO’s position, structure, and lack of financing; excessive focus on metrics to the detriment of political analysis; a lack of coordinated and sufficient financing for pandemic preparedness and response; global vaccine inequities; and the role of the broader global health architecture.
    1. Here’s a graph that doesn’t get shown in the mass media, and that I’m sure all those who want you to stay fearful of covid don’t want you to see. It shows the share of the tested population with antibodies to covid in Sweden week by week, beginning in the 28th week of 2020 (the first week for which the Swedish Public Health Authority provides data on the share of tests coming back positive).
    1. As the rollout of the COVID-19 vaccine programme continues to accelerate, Dr Michelle Constable, Head of the Behaviour Change Unit at Hertfordshire County Council, outlines their approach to countering vaccine hesitancy.
    1. The latest version of this living systematic review critically appraises 232 prediction models for diagnosis and prognosis of coronavirus disease 2019 (covid-19), of which 87 were added in the latest update. Summary statistics on study characteristics, model availability, and model quality are also presented. All extracted data per model are publicly available at https://www.covprecise.org/living-review/. The quality of published prediction models is gradually improving but all models remain at high or unclear risk of bias, suggesting that their reported performance is likely optimistic and might not be met if these models are applied in daily medical practice. This update shows two promising prediction models (the Jehi et al diagnostic model and the prognostic 4C Mortality Score), both derived from large databases, which should be validated by independent researchers.
    1. It is sometimes said that an effect of the COVID-19 pandemic will be heightened appreciation of the importance of scientific research and expertise. We test this hypothesis by examining how exposure to previous epidemics affected trust in science and scientists. Building on the “impressionable years hypothesis” that attitudes are durably formed during the ages 18–25, we focus on individuals exposed to epidemics in their country of residence at this particular stage of the life course. Combining data from a 2018 Wellcome Trust survey of more than 75,000 individuals in 138 countries with data on global epidemics since 1970, we show that such exposure has no impact on views of science as an endeavor but that it significantly reduces trust in scientists and in the benefits of their work. We also illustrate that the decline in trust is driven by the individuals with little previous training in science subjects. Finally, our evidence suggests that epidemic-induced distrust translates into lower compliance with health-related policies in the form of negative views towards vaccines and lower rates of child vaccination.
    1. After a 12-day visit, a World Health Organization mission to Wuhan appeared no closer Tuesday to solving the mystery of the pandemic's origins, reiterating that the coronavirus likely spread to humans from an animal and casting doubt on theories it leaked from a lab
    1. Despite the availability of multiple safe vaccines, vaccine hesitancy may present a challenge to successful control of the COVID-19 pandemic. As with many human behaviors, people's vaccine acceptance may be affected by their beliefs about whether others will accept a vaccine (i.e., descriptive norms). However, information about these descriptive norms may have different effects depending on people's baseline beliefs and the relative importance of conformity, social learning, and free-riding. Here, using a large, pre-registered, randomized experiment (N=305,694) embedded in an international survey, we show that accurate information about descriptive norms can substantially increase intentions to accept a vaccine for COVID-19. These positive effects (e.g., reducing by 5% the fraction of people who are "unsure" or more negative about accepting a vaccine) are largely consistent across the 23 included countries, but are concentrated among people who were otherwise uncertain about accepting a vaccine. Providing this normative information in vaccine communications partially corrects individuals' apparent underestimation of how many other people will accept a vaccine. These results suggest that public health communications should present information about the widespread and growing intentions to accept COVID-19 vaccines.
    1. The spread of SARS-CoV-2 will only slow if people who test positive for the virus self-isolate. But expecting them to do so is a bigger ask than governments seem to realise. Chris Stokel-Walker reports
    1. What is the social, emotional, and academic impact of attending school remotely rather than in person? We address this urgent policy issue using survey data collected from N = 6,576 high school students in a large, demographically diverse school district that allowed families to choose either format in fall 2020. Controlling for baseline measures of well-being collected one month before the onset of the COVID-19 pandemic, as well as student demographics and other administrative data from official school records, students who attended school remotely reported lower levels of social, emotional, and academic well-being (ES = 0.10, 0.08, and 0.07 standard deviations, respectively) than classmates who attended school in person—differences that were consistent across gender, race and ethnicity, and socioeconomic status subgroups but significantly wider for older compared to younger students.
    1. We social animals must balance the need to avoid infections with the need to interact with conspecifics. To that end we have evolved, alongside our physiological immune system, a suite of behaviors devised to deal with potentially contagious individuals. Focusing mostly on humans, the current review describes the design and biological innards of this behavioral immune system, laying out how infection threat shapes sociality and sociality shapes infection threat. The paper shows how the danger of contagion is detected and posted to the brain; how it affects individuals’ mate choice and sex life; why it strengthens ties within groups but severs those between them, leading to hostility toward anyone who looks, smells, or behaves unusually; and how it permeates the foundation of our moral and political views. This system was already in place when agriculture and animal domestication set off a massive increase in our population density, personal connections, and interaction with other species, amplifying enormously the spread of disease. Alas, pandemics such as COVID-19 not only are a disaster for public health, but, by rousing millions of behavioral immune systems, could prove a threat to harmonious cohabitation too.
    1. Objective: The present study rapidly reviewed and meta-analyzed the worldwide prevalence of depression and anxiety among pregnant women during the COVID-19 pandemic. Methods: A systematic search of the literature and meta-analyses were conducted. Results: Fifteen studies with 11,091 participants met inclusion criteria. Depression was assessed in 11 studies, with a pooled prevalence of .265 or 26.5% and anxiety in 12 studies, with a pooled prevalence of .335 or 33.5%. Conclusions: Rates of depression and anxiety during pregnancy are elevated during the pandemic. There is an urgent need to ensure screening and treatment for depression and anxiety during pregnancy.
    1. Between 1921 and 1956, French colonial governments organized medical campaigns to treat and prevent sleeping sickness. Villagers were forcibly examined and injected with medications with severe, sometimes fatal, side effects. We digitized thirty years of archival records to document the locations of campaign visits at a granular geographic level for five central African countries. We find that greater campaign exposure reduces vaccination rates and trust in medicine– as measured by willingness to consent to a blood test. We examine relevance for present day health initiatives; World Bank projects in the health sector are less successful in areas with greater exposure
    1. Over the past 2 weeks numerous states have announced a major shift in coronavirus disease 2019 (COVID-19) vaccination programs—from a textured approach that includes individual risk factors for morbidity and mortality (eg, age and high-risk medical conditions), occupational risk factors for exposure (eg, first responders and correctional officers), and other societal priorities (eg, essential workers such as teachers, grocery store employees, and public transportation workers) to an approach focused on vaccinating all individuals aged 65 years and older. Concerns have been raised that the more detailed approach has been difficult to implement, thus slowing the rollout of vaccines, and may leave decisions regarding who gets vaccinated to people not adequately trained to make such a decision.
    1. This article is part of a series in which OECD experts and thought leaders — from around the world and all parts of society — address the COVID-19 crisis, discussing and developing solutions now and for the future. Aiming to foster the fruitful exchange of expertise and perspectives across fields to help us rise to this critical challenge, opinions expressed do not necessarily represent the views of the OECD.
    1. The line charts the world is obsessing over these days aren’t a race to flatten the curve. Instead, our attention is focused on a race to a herd immunity threshold that promises a return to some semblance of normalcy.
    1. Background: Immunization is regarded as one of the most significant medical achievements of all time. Recently, increasing attention has been paid to the pain resulting from routine childhood immunizations.Objective: This narrative review summarizes existing knowledge about: (1) the epidemiology of childhood immunization pain; (2) the pain experience of children undergoing immunization; (3) current analgesic practices; (4) barriers to practicing pain management in children; and (5) recommendations for improvements in pain management during immunization.Methods: We conducted a search of MEDLINE, PsycINFO, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials for primary research and review articles published from inception of the databases through October 2008. Key search terms included immunization, pain, child/infant, vaccine, and intervention. Additional studies were identified through searches of the reference lists in the retrieved articles. No language restrictions were imposed regarding the type of article (eg, full article, abstract) or language.Results: Vaccine injections are the most common iatrogenic procedure performed in childhood and a major source of distress for children (of all ages), their parents, and the participating health care professionals, as well as a direct cause of vaccine nonadherence. In addition, lack of adequate pain management during immunization exposes children to unnecessary suffering and the potential for long-term consequences, such as fear of needles. Numerous pain management strategies are available to reduce vaccine injection pain, including: (1) physical interventions and injection techniques; (2) psychological interventions; and (3) phar-macologic and combined interventions. However, adoption of pain-relieving techniques into clinical practice has been suboptimal. The underutilization of pain management strategies can be attributed to a lack of knowledge about pain and effective pain prevention strategies, and the persistence of attitudes about pain that interfere with optimal clinical practices. Current analgesic practices could be improved substantially if all stakeholders involved in immunization (eg, policy makers, practitioners, consumers) participate in efforts to reduce pain. Treating pain during childhood immunization has the potential to reduce distress during the procedure and greatly improve satisfaction with the immunization experience through more positive experiences for children and their families. Other potential benefits include improved adherence to immunization schedules and reduced sequelae of untreated pain.Conclusion: Immunization is a global health priority. Medical care can be improved if pain management becomes a routine aspect of the delivery of vaccine injections.
    1. Human papillomavirus (HPV) has been linked to genital warts and multiple cancers affecting both men and women. Despite college students’ high risk for HPV, their vaccination rates remain suboptimal. The current observational study examined the relationship between social norms and HPV vaccine intentions and potential mechanisms underlying this relationship among undergraduates. Participants (N = 190; 66.8% female) completed a survey assessing HPV vaccine social norms, attitudes, self-efficacy, and intentions. Three mediation analyses were conducted to examine whether self-efficacy and attitudes mediated the relationship between social norms (i.e., parents, friends, doctor) and intentions, controlling for demographic and health care covariates. Social norms were indirectly related to intentions through self-efficacy and attitudes in multiple models (ps < .05). Specifically, perceiving greater support for HPV vaccination from one’s friends, parents, and doctor was related to greater HPV vaccine self-efficacy, which, in turn, was related to increased vaccine intentions. In addition, perceiving greater parental and doctor support for HPV vaccination was related to more favorable attitudes towards the vaccine, which, in turn, were related to increased vaccine intentions. Findings suggest potential targets for future interventions to promote HPV vaccination among young adults.
    1. RationaleChildhood vaccination is a safe and effective way of reducing infectious diseases. Yet, public confidence in vaccination is waning, driven in part by the ‘manufacture of doubt’ by anti-vaccination activists and websites. However, there is little research examining the psychological underpinnings of anti-vaccination rhetoric among parents.ObjectivesHere, we examined the structure and moral roots of anti-vaccination attitudes amongst Australian parents active on social media parenting sites.MethodsParticipants (N = 296) completed questionnaires assessing their vaccination attitudes, behavioural intentions, and moral preferences.ResultsUsing Latent Profile Analysis, we identified three profiles (i.e., groups), interpretable as vaccine “accepters”, “fence sitters”, and “rejecters”, each characterised by a distinct pattern of vaccination attitudes and moral preferences. Accepters exhibited positive vaccination attitudes and strong intentions to vaccinate; rejecters exhibited the opposite pattern of responses; whilst fence sitters exhibited an intermediate pattern of responses. Compared to accepters, rejecters and fence sitters exhibited a heightened moral preference for liberty (belief in the rights of the individual) and harm (concern about the wellbeing of others). Compared to acceptors and fence sitters, rejecters exhibited a heightened moral preference for purity (an abhorrence for impurity of body), and a diminished moral preference for authority (deference to those in positions of power).ConclusionGiven the sensitivity of fence sitters and rejecters to liberty-related moral concerns, our research cautions against the use of adversarial approaches—e.g., No Jab, No Pay legislation—that promote vaccination uptake by restricting parental freedoms, as they may backfire amongst parents ambivalent toward vaccination.
    1. Clusters of unvaccinated children are particularly susceptible to outbreaks of vaccine-preventable disease1,2. Existing messaging interventions demonstrate short-term success, but some may backfire and worsen vaccine hesitancy3. Values-based messages appeal to core morality, which influences the attitudes individuals then have on topics like vaccination4,5,6,7. We must understand how underlying morals, not just attitudes, differ by hesitancy type to develop interventions that work with individual values. Here, we show in two correlational studies that harm and fairness foundations are not significantly associated with vaccine hesitancy, but purity and liberty foundations are. We found that medium-hesitancy parents were twice as likely as low-hesitancy parents to highly emphasize purity (adjusted odds ratio: 2.08; 95% confidence interval: 1.27–3.40). High-hesitancy respondents were twice as likely to strongly emphasize purity (adjusted odds ratio: 2.15; 95% confidence interval: 1.39–3.31) and liberty (adjusted odds ratio: 2.19; 95% confidence interval: 1.50–3.21). Our results demonstrate that endorsement of harm and fairness—ideas often emphasized in traditional vaccine-focused messages—are not predictive of vaccine hesitancy. This, combined with significant associations of purity and liberty with hesitancy, indicates a need for inclusion of broader themes in vaccine discussions. These findings have the potential for application to other health decisions and communications as well. <div class="c-nature-box c-nature-box--side c-nature-box--mobile" data-component="entitlement-box"> <div class="js-access-button"> <a href="https://wayf.springernature.com?redirect_uri&#x3D;https%3A%2F%2Fwww.nature.com%2Farticles%2Fs41562-017-0256-5" class="c-article__button" data-test="ra21" data-track="click" data-track-action="institution access" data-track-label="button"> <svg class="u-icon" width="18" height="18" aria-hidden="true" focusable="false"><use href="#global-icon-institution"></use></svg> <span class="c-article__button-text">Access through your institution</span> </a> </div> <div class="js-buy-button"> <a href="#access-options" class="c-article__button c-article__button--inverted" data-test="ra21" data-track="click" data-track-action="buy or subscribe" data-track-label="button"> <span>Buy or subscribe</span> </a> </div> </div> Access this article via University of Bath Access through your institution Change institution Buy or subscribe
    1. Background The announcement of efficacious vaccine candidates against SARS-CoV-2 has been met with worldwide acclaim and relief. Many countries already have detailed plans for vaccine targeting based on minimising severe illness, death and healthcare burdens. Normally, relatively simple relationships between epidemiological parameters, vaccine efficacy and vaccine uptake predict the success of any immunisation programme. However, the dynamics of vaccination against SARS-CoV-2 is made more complex by age-dependent factors, changing levels of infection and the potential relaxation of non-pharmaceutical interventions (NPIs) as the perceived risk declines.Methods In this study we use an age-structured mathematical model, matched to a range of epidemiological data in the UK, that also captures the roll-out of a two-dose vaccination programme targeted at specific age groups.Findings We consider the interaction between the UK vaccination programme and future relaxation (or removal) of NPIs. Our predictions highlight the population-level risks of early relaxation leading to a pronounced wave of infection, hospital admissions and deaths. Only vaccines that offer high infection-blocking efficacy with high uptake in the general population allow relaxation of NPIs without a huge surge in deaths.Interpretation While the novel vaccines against SARS-CoV-2 offer a potential exit strategy for this outbreak, this is highly contingent on the infection-blocking (or transmission-blocking) action of the vaccine and the population uptake, both of which need to be carefully monitored as vaccine programmes are rolled out in the UK and other countries.Evidence before this study Vaccination has been seen as a key tool in the fight against SARS-CoV-2. The vaccines already developed represent a major technological achievement and have been shown to generate significant immune responses, as well as offering considerable protection against disease. However, to date there is limited information on the degree of infection-blocking these vaccines are likely to induce. Mathematical models have already successfully been used to consider age- and risk-structured targeting of vaccination, highlighting the importance of prioritising older and high-risk individuals.Added value of this study Translating current knowledge and uncertainty of vaccine behaviour into meaningful public health messages requires models that fully capture the within-country epidemiology as well as the complex roll-out of a two-dose vaccination programme. We show that under reasonable assumptions for vaccine efficacy and uptake the UK is unlikely to reach herd immunity, which means that non-pharmaceutical interventions cannot be released without generating substantial waves of infection.Implications of all the available evidence Vaccination is likely to provide substantial individual protection to those receiving two doses, but the degree of protection to the wider population is still uncertain. While substantial immunisation of the most vulnerable groups will allow for some relaxation of controls, this must be done gradually to prevent large scale public health consequences.
    1. Background During epidemic crises, some of the information the public receives on social media is misinformation. Health organizations are required to respond and correct the information to gain the public’s trust and influence it to follow the recommended instructions. Objectives (1) To examine ways for health organizations to correct misinformation concerning the measles vaccination on social networks for two groups: pro-vaccination and hesitant; (2) To examine the types of reactions of two subgroups (pro-vaccination, hesitant) to misinformation correction; and (3) To examine the effect of misinformation correction on these two subgroups regarding reliability, satisfaction, self-efficacy and intentions. Methods A controlled experiment with participants divided randomly into two conditions. In both experiment conditions a dilemma was presented as to sending a child to kindergarten, followed by an identical Facebook post voicing the children mothers’ concerns. In the third stage the correction by the health organization is presented differently in two conditions: Condition 1 –common information correction, and Condition 2 –recommended (theory-based) information correction, mainly communicating information transparently and addressing the public’s concerns. The study included (n = 243) graduate students from the Faculty of Social Welfare and Health Sciences at Haifa University. Results A statistically significant difference was found in the reliability level attributed to information correction by the Health Ministry between the Control condition and Experimental condition (sig<0.001), with the average reliability level of the subjects in Condition 2 (M = 5.68) being considerably higher than the average reliability level of subjects in Condition 1 (4.64). A significant difference was found between Condition 1 and Condition 2 (sig<0.001), with the average satisfaction from the Health Ministry’s response of Condition 2 subjects (M = 5.75) being significantly higher than the average satisfaction level of Condition 1 subjects (4.66). Similarly, when we tested the pro and hesitant groups separately, we found that both preferred the response presented in Condition 2. Conclusion It is very important for the organizations to correct misinformation transparently, and to address the emotional aspects for both the pro-vaccination and the hesitant groups. The pro-vaccination group is not a captive audience, and it too requires a full response that addresses the public's fears and concerns.
    1. The SARS-CoV-2 Spike glycoprotein mediates virus entry and is a major target for neutralizing antibodies. All current vaccines are based on the ancestral Spike with the goal of generating a protective neutralizing antibody response. Several novel SARS-CoV-2 variants with multiple Spike mutations have emerged, and their rapid spread and potential for immune escape have raised concerns. One of these variants, first identified in the United Kingdom, B.1.1.7 (also called VUI202012/01), contains eight Spike mutations with potential to impact antibody therapy, vaccine efficacy and risk of reinfection. Here we employed a lentivirus-based pseudovirus assay to show that variant B.1.1.7 remains sensitive to neutralization, albeit at moderately reduced levels (~2-fold), by serum samples from convalescent individuals and recipients of two different vaccines based on ancestral Spike: mRNA-1273 (Moderna) and protein nanoparticle NVX-CoV2373 (Novavax). Some monoclonal antibodies to the receptor binding domain (RBD) of Spike were less effective against the variant while others were largely unaffected. These findings indicate that B.1.1.7 is not a neutralization escape variant that would be a major concern for current vaccines, or for an increased risk of reinfection.Funding: Original data and specimens for Protocol 20-0003 were supported by the Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases. KW and BK were supported by LANL LDRD 20190441ER. DCM, XS, HT, and CM were supported bythe COVID-19 Prevention Network (CoVPN) and the National Institute of Health. DL, BFH, and KOS were supported by a grant from the State of North Carolina from federal CARES Act funds, and NIAID grant AI142596.Conflict of Interest: Rolando Pajon is an employee of Moderna, Inc. Filip, Dubovsky, Gale Smith and Gregory M. Glenn are employees of Novavax, Inc. The remaining authors have no competing interests.Ethical Approval: Clinical trials described in this manuscript were approved by the appropriate Institutional Review Boards (IRBs).
    1. As the coronavirus crisis goes on, an increasing number of us are feeling worn out and unable to cope. Here’s how you can tell if this is burnout, and what you can do to protect yourself
    1. Professor Kevin McConway and Professor Sir David Spiegelhalter discuss their experiences of communicating statistical research to the media and offer 12 tips for researchers to effectively engage with the media.
    1. Covid vaccines being given to millions of people in the UK are extremely safe, with mild expected side-effects, says the country's drugs regulator.
    1. What was claimed The German federal government only expects the AstraZeneca Covid-19 vaccine to have an effectiveness of eight percent among the over 65s. Our verdict The German government said it couldn’t confirm the report which may have misunderstood the proportion of trial participants aged 56-69 as the efficacy rate among over 65s. Public data shows older adults had a similar immune response to the vaccine as younger adults.
    1. Key messagesThe Global Health Security Index predicted that the world in general was not well prepared for the pandemic but did not predict individual country preparednessTen factors seem to have contributed to the index failing to predict country responses, including overlooking political, economic, and social contexts and the role of civil societyFuture assessments of pandemic preparedness need to take these 10 factors into account by adopting a systems approach which enables a focus on critical system components
    1. The scientific enterprise has great potential to benefit all aspects of society, as well as to increase our understanding of the world and how it is changing in response to our actions. The advances brought about by research are too many to enumerate; one only needs to think of our successes in identifying the causes of disease and developing appropriate treatments, or the myriad technological advances that are part of our daily lives. For research to serve its purpose of benefitting society, however, it needs to engender something that is as important as it is fragile—trust. Trust in science is essential for it to effectively inform policy and more fully benefit society.
    1. The family of seven known human coronaviruses are known for their impact on the respiratory tract, not the heart. However, the most recent coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has marked tropism for the heart and can lead to myocarditis (inflammation of the heart), necrosis of its cells, mimicking of a heart attack, arrhythmias, and acute or protracted heart failure (muscle dysfunction)
    1. Face masks became the symbol of the global fight against the coronavirus. While face masks’ medical benefits are clear, little is known about their psychological consequences. Drawing on theories of the social functions of emotions and rapid trait impressions, we tested hypotheses on face masks’ effects on emotion-recognition accuracy and social judgments (perceived trustworthiness, likability, and closeness). Our preregistered study with 191 German adults revealed that face masks diminish people’s ability to accurately categorize an emotion expression and make target persons appear less close. Exploratory analyses further revealed that face masks buffered the negative effect of negative (vs. non-negative) emotion expressions on perceptions of trustworthiness, likability, and closeness. Associating face masks with the coronavirus’ dangers predicted higher perceptions of closeness for masked but not for unmasked faces. By highlighting face masks’ effects on social functioning, our findings inform policymaking and point at contexts where alternatives to face masks are needed.
    1. A lot of conspiracy theories and fake news surrounding the pandemic are doing the rounds. Among the disinformation is a suggestion that COVID-19 vaccines might cause infertility in women.
    1. Black Americans are still receiving covid vaccinations at dramatically lower rates than white Americans even as the chaotic rollout reaches more people, according to a new KHN analysis.
    1. Widespread acceptance of a vaccine for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) will be the next major step in fighting the coronavirus disease 2019 (COVID-19) pandemic, but achieving high uptake will be a challenge and may be impeded by online misinformation. To inform successful vaccination campaigns, we conducted a randomized controlled trial in the UK and the USA to quantify how exposure to online misinformation around COVID-19 vaccines affects intent to vaccinate to protect oneself or others. Here we show that in both countries—as of September 2020—fewer people would ‘definitely’ take a vaccine than is likely required for herd immunity, and that, relative to factual information, recent misinformation induced a decline in intent of 6.2 percentage points (95th percentile interval 3.9 to 8.5) in the UK and 6.4 percentage points (95th percentile interval 4.0 to 8.8) in the USA among those who stated that they would definitely accept a vaccine. We also find that some sociodemographic groups are differentially impacted by exposure to misinformation. Finally, we show that scientific-sounding misinformation is more strongly associated with declines in vaccination intent. Download PDF
    1. Purpose: To examine how public trust mediates the people’s adherence to levels of stringent government health policies and to establish if these effects vary across the political regimes.Methods: This study utilizes data from two large-scale surveys: the global behaviors and perceptions at the onset of COVID-19 pandemic and the Oxford COVID-19 Government Response Tracker (OxCGRT). Linear regression models were used to estimate the effects of public trust and strictness of restriction measures on people’s compliance level. The model accounted for individual and daily variations in country-level stringency of preventative measures. Differences in the dynamics between public trust, the stringent level of government health guidelines and policy compliance were also examined among countries based on political regimes.Results: We find strong evidence of the increase in compliance due to the imposition of stricter government restrictions. The examination of heterogeneous effects suggests that high public trust in government and the perception of its truthfulness double the impact of policy restrictions on public compliance. Among political regimes, higher levels of public trust significantly increase the predicted compliance as stringency level rises in authoritarian and democratic countries.Conclusion: This study highlights the importance of public trust in government and its institutions during public health emergencies such as the COVID-19 pandemic. Our results are relevant and help understand why governments need to address the risks of non-compliance among low trusting individuals to achieve the success of the containment policies.
    1. Gerardo Gutierrez, 70, died from complications related to COVID-19. A lawsuit filed by his family says he contracted the virus while working at a Publix deli counter during a period the grocer forbid workers from using masks. [ The Gutierrez family ]
    1. Vaccines, when available, will likely become our best tool to control the COVID-19 pandemic. Even in the most optimistic scenarios, vaccine shortages will likely occur. Using an age-stratified mathematical model paired with optimization algorithms, we determined optimal vaccine allocation for four different metrics (deaths, symptomatic infections, and maximum non-ICU and ICU hospitalizations) under many scenarios. We find that a vaccine with effectiveness ≥50% would be enough to substantially mitigate the ongoing pandemic, provided that a high percentage of the population is optimally vaccinated. When minimizing deaths, we find that for low vaccine effectiveness, irrespective of vaccination coverage, it is optimal to allocate vaccine to high-risk (older) age groups first. In contrast, for higher vaccine effectiveness, there is a switch to allocate vaccine to high-transmission (younger) age groups first for high vaccination coverage. While there are other societal and ethical considerations, this work can provide an evidence-based rationale for vaccine prioritization.
    1. City centres lying empty because so many people are working from home have received considerable media attention since the pandemic took hold. As the picture of a post-COVID world slowly comes into focus, it seems we are unlikely to return to the office in the same numbers as before. Large companies such as Aviva, Dropbox and Facebook have already committed to continuing remote working in the years to come. This has important implications for where economic activity takes place. Not only will it affect city centres, it also means that many residential neighbourhoods are likely to change permanently.
    1. COVID-19 has challenged health-care systems in an unprecedented manner. As recorded deaths exceed 2 million worldwide, countries continue to grapple with policies that balance health care and economic stresses. Strategic international coordination and cooperation remain haphazard. Here we reflect on our experiences in delivering a non-invasive respiratory support device that highlights the need for a more responsive, harmonised approach.Countries with restricted technological or manufacturing capacities depend heavily on imports to maintain health-care delivery. In early 2020, self-interest took hold, with nearly 80 countries imposing restrictions on the export of medical supplies.1United Nations Conference on Trade and DevelopmentExport restrictions: fighting COVID-19 with hands tied.https://unctad.org/news/export-restrictions-fighting-covid-19-hands-tiedDate: April 28, 2020Date accessed: December 4, 2020Google Scholar Available equipment was often sold at hugely inflated prices, as unscrupulous manufacturers sought to profit, and more prosperous countries were prepared to outbid others to secure scarce resources, such as ventilators and personal protective equipment.2National Audit OfficeInvestigation into how government increased the number of ventilators available to the NHS in response to COVID-19.https://www.nao.org.uk/report/increasing-ventilator-capacity-in-response-to-covid-19/Date: Sept 30, 2020Date accessed: December 4, 2020Google Scholar These issues disproportionately exposed low-income and middle-income countries (LMICs) and some of the most vulnerable of the global population to poor COVID-19 health outcomes.
    1. In the absence of pharmaceutical interventions, social distancing is being used worldwide to curb the spread of COVID-19. The impact of these measures has been inconsistent, with some regions rapidly nearing disease elimination and others seeing delayed peaks or nearly flat epidemic curves. Here we build a stochastic epidemic model to examine the effects of COVID-19 clinical progression and transmission network structure on the outcomes of social distancing interventions. Our simulations show that long delays between the adoption of control measures and observed declines in cases, hospitalizations, and deaths occur in many scenarios. We find that the strength of within-household transmission is a critical determinant of success, governing the timing and size of the epidemic peak, the rate of decline, individual risks of infection, and the success of partial relaxation measures. The structure of residual external connections, driven by workforce participation and essential businesses, interacts to determine outcomes. We suggest limited conditions under which the formation of household “bubbles” can be safe. These findings can improve future predictions of the timescale and efficacy of interventions needed to control second waves of COVID-19 as well as other similar outbreaks, and highlight the need for better quantification and control of household transmission.
    1. The paper investigates the influence of ideology on trust in scientists. We assume that during a pandemic, ideology is linked to levels of trust in scientists, such that those espousing left- (vs. right-) wing beliefs place more trust in the scientific profession. We posit that the negative perception of scientists, a feature of right-wing narratives in the country of study, underlies this effect. Additionally, we argue that ideology has an indirect impact, via levels of trust in scientists, on beliefs and attitudes towards vaccines and vaccine policy. To test these hypotheses, we conducted three studies (total N = 1155): one pre-pandemic study and two studies during a pandemic. The results confirm the hypotheses; however, we observed varied effects at the outset of the pandemic versus later stages. The findings contribute to the ongoing discussion around the ideological underpinnings of trust in scientists and carry implications for public health measures.
    1. Up to 100 children a week are being hospitalised with a rare disease that can emerge weeks after Covid-19, leaving them in intensive care, doctors have said.In a phenomenon that is worrying paediatricians, 75% of the children worst affected by paediatric inflammatory multi-system syndrome (PIMS) were black, Asian or ethnic minority (BAME). Almost four out of five children were previously healthy, according to an unpublished snapshot of cases.
    1. Seasonal influenza is responsible for thousands of deaths and billions of dollars of medical costs per year in the United States, but influenza vaccination coverage remains substantially below public health targets. One possible obstacle to greater immunization rates is the false belief that it is possible to contract the flu from the flu vaccine. A nationally representative survey experiment was conducted to assess the extent of this flu vaccine misperception. We find that a substantial portion of the public (43%) believes that the flu vaccine can give you the flu. We also evaluate how an intervention designed to address this concern affects belief in the myth, concerns about flu vaccine safety, and future intent to vaccinate. Corrective information adapted from the Centers for Disease Control and Prevention (CDC) website significantly reduced belief in the myth that the flu vaccine can give you the flu as well as concerns about its safety. However, the correction also significantly reduced intent to vaccinate among respondents with high levels of concern about vaccine side effects – a response that was not observed among those with low levels of concern. This result, which is consistent with previous research on misperceptions about the MMR vaccine, suggests that correcting myths about vaccines may not be an effective approach to promoting immunization.
    1. OBJECTIVES: To test the effectiveness of messages designed to reduce vaccine misperceptions and increase vaccination rates for measles-mumps-rubella (MMR).METHODS: A Web-based nationally representative 2-wave survey experiment was conducted with 1759 parents age 18 years and older residing in the United States who have children in their household age 17 years or younger (conducted June–July 2011). Parents were randomly assigned to receive 1 of 4 interventions: (1) information explaining the lack of evidence that MMR causes autism from the Centers for Disease Control and Prevention; (2) textual information about the dangers of the diseases prevented by MMR from the Vaccine Information Statement; (3) images of children who have diseases prevented by the MMR vaccine; (4) a dramatic narrative about an infant who almost died of measles from a Centers for Disease Control and Prevention fact sheet; or to a control group.RESULTS: None of the interventions increased parental intent to vaccinate a future child. Refuting claims of an MMR/autism link successfully reduced misperceptions that vaccines cause autism but nonetheless decreased intent to vaccinate among parents who had the least favorable vaccine attitudes. In addition, images of sick children increased expressed belief in a vaccine/autism link and a dramatic narrative about an infant in danger increased self-reported belief in serious vaccine side effects.CONCLUSIONS: Current public health communications about vaccines may not be effective. For some parents, they may actually increase misperceptions or reduce vaccination intention. Attempts to increase concerns about communicable diseases or correct false claims about vaccines may be especially likely to be counterproductive. More study of pro-vaccine messaging is needed.
    1. When faced with vaccine hesitancy, public health authorities are looking for effective strategies to address this issue. In this paper, the findings of 15 published literature reviews or meta-analysis that have examined the effectiveness of different interventions to reduce vaccine hesitancy and/or to enhance vaccine acceptance are presented and discussed. From the literature, there is no strong evidence to recommend any specific intervention to address vaccine hesitancy/refusal. The reviewed studies included interventions with diverse content and approaches that were implemented in different settings and targeted various populations. Few interventions were directly targeted to vaccine hesitant individuals. Given the paucity of information on effective strategies to address vaccine hesitancy, when interventions are implemented, planning a rigorous evaluation of their impact on vaccine hesitancy/vaccine acceptance will be essential.
    1. Objective: Strengthening of antivaccination movements in recent decades has coincided with unprecedented increases in the incidence of some communicable diseases. Many intervention programs work from a deficit model of science communication, presuming that vaccination skeptics lack the ability to access or understand evidence. However, interventions focusing on evidence and the debunking of vaccine-related myths have proven to be either nonproductive or counterproductive. Working from a motivated reasoning perspective, we examine the psychological factors that might motivate people to reject scientific consensus around vaccination. To assist with international generalizability, we examine this question in 24 countries. Methods: We sampled 5,323 participants in 24 countries, and measured their antivaccination attitudes. We also measured their belief in conspiracy theories, reactance (the tendency for people to have a low tolerance for impingements on their freedoms), disgust sensitivity toward blood and needles, and individualistic/hierarchical worldviews (i.e., people's beliefs about how much control society should have over individuals, and whether hierarchies are desirable). Results: In order of magnitude, antivaccination attitudes were highest among those who (a) were high in conspiratorial thinking, (b) were high in reactance, (c) reported high levels of disgust toward blood and needles, and (d) had strong individualistic/hierarchical worldviews. In contrast, demographic variables (including education) accounted for nonsignificant or trivial levels of variance. Conclusions: These data help identify the "attitude roots" that may motivate and sustain vaccine skepticism. In so doing, they help shed light on why repetition of evidence can be nonproductive, and suggest communication solutions to that problem. (PsycINFO Database Record
    1. Objectives Despite continuous efforts to improve influenza vaccination coverage, uptake among high-risk groups remains suboptimal. We aimed to identify policy amenable factors associated with vaccination and to measure their importance in order to assist in the monitoring of vaccination sentiment and the design of communication strategies and interventions to improve vaccination rates.Setting The USA, the UK and France.Participants A total of 2412 participants were surveyed across the three countries.Outcome measures Self-reported influenza vaccination.Methods Between March and April 2014, a stratified random sampling strategy was employed with the aim of obtaining nationally representative samples in the USA, the UK and France through online databases and random-digit dialling. Participants were asked about vaccination practices, perceptions and feelings. Multivariable logistic regression was used to identify factors associated with past influenza vaccination.Results The models were able to explain 64%–80% of the variance in vaccination behaviour. Overall, sociopsychological variables, which are inherently amenable to policy, were better at explaining past vaccination behaviour than demographic, socioeconomic and health variables. Explanatory variables included social influence (physician), influenza and vaccine risk perceptions and traumatic childhood experiences.Conclusions Our results indicate that evidence-based sociopsychological items should be considered for inclusion into national immunisation surveys to gauge the public’s views, identify emerging concerns and thus proactively and opportunely address potential barriers and harness vaccination drivers.
    1. Suboptimal vaccine uptake in both childhood and adult immunisation programs limits their full potential impact on global health. A recent progress review of the Global Vaccine Action Plan stated that “countries should urgently identify barriers and bottlenecks and implement targeted approaches to increase and sustain coverage”. However, vaccination coverage may be determined by a complex mix of demographic, structural, social and behavioral factors. To develop a practical taxonomy to organise the myriad possible root causes of a gap in vaccination coverage rates, we performed a narrative review of the literature and tested whether all non-socio-demographic determinants of coverage could be organised into 4 dimensions: Access, Affordability, Awareness and Acceptance. Forty-three studies were reviewed, from which we identified 23 primary determinants of vaccination uptake. We identified a fifth domain, Activation, which captured interventions such as SMS reminders which effectively nudge people towards getting vaccinated. The 5As taxonomy captured all identified determinants of vaccine uptake. This intuitive taxonomy has already facilitated mutual understanding of the primary determinants of suboptimal coverage within inter-sectorial working groups, a first step towards them developing targeted and effective solutions.
    1. Misinformation, the circulation of misleading and false information, deepened the crisis by delaying authoritative response to the pandemic by weeks, if not months. Public declarations of misinformation, such as COVID is a hoax, bleach is a COVID cure, wearing a mask increases your chances of getting COVID, caused a delay that cost many American lives. According to a recent study, had the U.S. imposed social distancing one week earlier than it did in March 2020, at least 36,000 fewer people would have died (Pei 2020).
    1. Our report, Moving the Needle, looks at the importance of vaccination through childhood, working-age adulthood, and later life, and explores the barriers to uptake at different stages of the life course.
    1. The manuscript presents a summary of the results of the linguistic semantics study of Covid-19 related quarantine. Research conducted on a sample of Russian speaking Ukrainians. Found content and structure of the respective discursive field. Described features of inter-discourse connections. Established that the actualization of some discourses is accompanied by the deactivation of others, what makes quarantine semantics biased. Also, it was suggested that some of the discourses are indirectly positively associated and form the semantic core of the quarantine concept.
    1. A crucial question in the governance of infectious disease outbreaks is how to ensure that people continue to adhere to mitigation measures for the longer duration of the pandemic. The present paper examines this question by means of a nationally representative cross-sectional set of studies conducted in the United States in May, June, and July 2020. It seeks to understand to what extent Americans continued to adhere to social distancing measures in the period after the first lockdown ended during the first wave of COVID-19. Moreover, it seeks to uncover which situational and motivational variables sustained (or undermined) adherence. Our findings reveal a mix of situational and motivational variables that contributed to adherence in the period after the first lockdown: individuals’ knowledge of social distancing measures, their practical capacity to adhere to them, their opportunities for not doing so, and their impulsivity (situational influences), as well as their moral alignment with mitigation measures against the virus, perceptions of its health threat, and perceived norms for adherence in their community (motivational influences). The results also reveal, however, that adherence among Americans declined during this period, as did important situational and motivational processes that sustained this. The findings show that adherence does not just originate in motivations and that situational variables play a central role. Moreover, they show that adherence is dynamic, as the core variables that sustain can change over a short period of time. These insights help to advance understanding of pandemic governance, as well as illuminating the interaction between rules and human conduct and compliance more generally. Moreover, they identify important avenues for policy to promote and sustain adherence to mitigation measures during the COVID-19 pandemic and in future outbreaks.
    1. Our study aimed to assess the change in the sleep patterns during the Coronavirus lockdown in five regions (Austria/Germany, Ukraine, Greece, Cuba and Brazil), using online surveys, translated in each language. Part of the cohort was collected directly during lockdown, to which retrospective cross-sectional data from and after lockdown (retrospective) questionnaires ware added. We investigated sleep times and sleep quality changes from before to during lockdown and found that, during lockdown, participants had (i) worse perceived sleep quality for those who reported to be worried by COVID-19, (ii) a shift of bedtimes to later hours during workdays, and (iii) a sleep loss on free days (resulting from more overall sleep during workdays), leading to (iv) a marked reduction of social jetlag across all cultures. For further analyses we then split the participants by job (system relevant or not) because it was assumed that the nature of the lockdown’s consequences is dependent upon system relevance. System relevant jobs were found to have earlier wake-up times as well as shorter total sleep times on workdays, leading to a higher social jetlag for people in system relevant jobs. Cultural differences revealed a general effect that participants from Greece and Ukraine had later bedtimes (on both work and free days) and wake-up times (on workdays) than Cuba, Brazil and Austria, irrespective of COVID-19 lockdown restrictions.
    1. Objectives: To examine the subjective wellbeing of Australian parents raising children and adolescents (0-18 years) during ‘stage three’ COVID-19 restrictions (April 2020), in comparison with subjective wellbeing in parents assessed over an 18-year period prior to the pandemic. We also aimed to examine socio-demographic and COVID-19 predictors of subjective wellbeing during the pandemic. Methods: Cross-sectional data were from: (1) the COVID-19 Pandemic Adjustment Survey (CPAS, N=2,365 parents of a child 0-18 years, 8-28th April, 2020); and, (2) a pre-pandemic database bringing together over 18-years of national data on subjective wellbeing (N=17,529 adults living with children, collected in annual surveys over 2002-2019). Results: Levels of subjective wellbeing during the pandemic were considerably lower than ratings prior to the pandemic (Personal Wellbeing Index, mean [SD]=65.3 [17.0]; compared to [SD]=75.8 [11.9], p<0.001). Within the pandemic data, subjective wellbeing was lower in parents with low education, language other-than-English, receiving income assistance (i.e., a government benefit), single parents, and young parents. Subjective wellbeing was also lower in fathers, parents raising a child with a neurodevelopmental condition, parents with physical or mental health problems, and parents reporting COVID-related stressors, such as employment changes, financial strain, negative feelings/attributions about COVID-19, and supervising children while working-from-home. Unexpectedly, parent engagement with news media about the pandemic was associated with higher subjective wellbeing. Conclusion: Subjective wellbeing in parents raising children aged 0-18 years appears to be disproportionately impacted by the COVID-19 pandemic and associated social restrictions in Australia. Specific at-risk groups, for which government intervention may be warranted, include parents in socially disadvantaged contexts, parents with pre-existing mental health difficulties, and parents facing significant COVID-19 related work changes.
    1. Publishing studies using standardized, machine-readable formats will enable machines to perform meta-analyses on-demand. To build a semantically-enhanced technology that embodies these functions, we developed the Cooperation Databank (CoDa) – a databank that contains 2,641 studies on human cooperation (1958-2017) conducted in 78 countries involving 356,680 participants. Experts annotated these studies for 312 variables, including the quantitative results (13, 959 effect sizes). We designed an ontology that defines and relates concepts in cooperation research and that can represent the relationships between individual study results. We have created a research platform that, based on the dataset, enables users to retrieve studies that test the relation of variables with cooperation, visualize these study results, and perform (1) metaanalyses, (2) meta-regressions, (3) estimates of publication bias, and (4) statistical power analyses for future studies. We leveraged the dataset with visualization tools that allow users to explore the ontology of concepts in cooperation research and to plot a citation network of the history of studies. CoDa offers a vision of how publishing studies in a machine-readable format can establish institutions and tools that improve scientific practices and knowledge.
    1. The NIHR-supported Novavax COVID-19 vaccine is 89.3% effective at preventing COVID-19, shown from interim analysis of its Phase III study data, including effectiveness against the new variants of concern.
    1. Messaging from authorities about COVID-19 has been widely divergent. This research aims to clarify popular perceptions of the threat of COVID-19 and its effects on victims. In four studies with over 4,100 U.S. participants, we consistently found that people perceive the threat of COVID-19 to be substantially greater than that of several other causes of death to which it has recently been compared, including the seasonal flu and automobile accidents. Participants were less willing to help COVID-19 victims, who they considered riskier to help, more contaminated, and more responsible for their condition. Additionally, politics and demographic factors predicted attitudes about victims of COVID-19 above and beyond moral values; whereas attitudes about the other kinds of victims were primarily predicted by moral values. The results indicate that people perceive COVID-19 as an exceptionally severe disease threat, and despite prosocial inclinations, do not feel safe offering assistance to COVID-19 sufferers.
    1. Coincident with the global rise in concern about the spread of misinformation on social media, there has been influx of behavioural research on so-called “fake news” (fabricated or false news headlines that are presented as if legitimate) and other forms of misinformation. These studies often present participants with news content that varies on relevant dimensions (e.g., true v. false, politically consistent v. inconsistent, etc.) and ask participants to make judgments (e.g., accuracy) or choices (e.g., whether they would share it on social media). This guide is intended to help researchers navigate the unique challenges that come with this type of research. Principle among these issues is that the nature of news content that is being spread on social media (whether it is false, misleading, or true) is a moving target that reflects current affairs in the context of interest. Steps are required if one wishes to present stimuli that allow generalization from the study to the real-world phenomenon. Furthermore, the selection of content to include can be highly consequential for the study’s outcome, and researcher biases can easily result in biases in a stimulus set. As such, we advocate for pretesting materials and, to this end, report our own pretest of 225 recent true and false news headlines, both relating to U.S. political issues and the COVID-19 pandemic. These headlines may be of use in the short term, but, more importantly, the pretest is intended to serve as an example of best practices in a quickly evolving area of research.
    1. Misinformation on social media has become a major focus of research and concern in recent years. Perhaps the most prominent approach to combating misinformation is the use of professional fact-checkers. This approach, however, is not scalable: Professional fact-checkers cannot possibly keep up with the volume of misinformation produced every day. Furthermore, many people see fact-checkers as having a liberal bias and thus distrust them. Here, we explore a potential solution to both of these problems: leveraging the “wisdom of crowds'' to identify misinformation at scale using politically-balanced groups of laypeople. Using a set of 207 news articles flagged for fact-checking by an internal Facebook algorithm, we compare the accuracy ratings given by (i) three professional fact-checkers after researching each article and (ii) 1,128 Americans from Amazon Mechanical Turk after simply reading the headline and lede sentence. We find that the average rating of a politically-balanced crowd of 10 laypeople is as correlated with the average fact-checker rating as the fact-checkers’ ratings are correlated with each other. Furthermore, the layperson ratings can predict whether the majority of fact-checkers rated a headline as “true” with high accuracy, particularly for headlines where all three fact-checkers agree. We also find that layperson cognitive reflection, political knowledge, and Democratic Party preference are positively related to agreement with fact-checker ratings; and that informing laypeople of each headline’s publisher leads to a small increase in agreement with fact-checkers. Our results indicate that crowdsourcing is a promising approach for helping to identify misinformation at scale.
  2. Jan 2021
    1. Objective: Vaccination yields a direct effect by reducing infection, but also has the indirect effect of herd immunity: If many individuals are vaccinated, the immune population will protect unvaccinated individuals (social benefit). However, due to a vaccination's costs and risks, individual incentives to free-ride on others' protection also increase with the number of individuals who are already vaccinated (individual benefit). The objective was to assess the consequences of communicating the social and/or individual benefits of herd immunity on vaccination intentions. We assume that if social benefits are salient, vaccination intentions increase (prosocial behavior), whereas salience of individual benefits might decrease vaccination intentions (free-riding). Methods: In an online-experiment (N = 342) the definition of herd immunity was provided with one sentence summarizing the gist of the message, either making the individual or social benefit salient or both. A control group received no information about herd immunity. As a moderator, we tested the costs of vaccination (effort in obtaining the vaccine). The dependent measure was intention to vaccinate. Results: When a message emphasized individual benefit, vaccination intentions decreased (free-riding). Communication of social benefit reduced free-riding and increased vaccination intentions when costs to vaccinate were low. Conclusions: Communicating the social benefit of vaccination may prevent free-riding and should thus be explicitly communicated if individual decisions are meant to consider public health benefits. Especially when vaccination is not the individually (but instead collectively) optimal solution, vaccinations should be easily accessible in order to reach high coverage.
    1. Vaccines—often lauded as one of the greatest public health interventions—are losing public confidence. Some vaccine experts have referred to this decline in confidence as a crisis. We discuss some of the characteristics of the changing global environment that are contributing to increased public questioning of vaccines, and outline some of the specific determinants of public trust. Public decision making related to vaccine acceptance is neither driven by scientific nor economic evidence alone, but is also driven by a mix of psychological, sociocultural, and political factors, all of which need to be understood and taken into account by policy and other decision makers. Public trust in vaccines is highly variable and building trust depends on understanding perceptions of vaccines and vaccine risks, historical experiences, religious or political affiliations, and socioeconomic status. Although provision of accurate, scientifically based evidence on the risk–benefit ratios of vaccines is crucial, it is not enough to redress the gap between current levels of public confidence in vaccines and levels of trust needed to ensure adequate and sustained vaccine coverage. We call for more research not just on individual determinants of public trust, but on what mix of factors are most likely to sustain public trust. The vaccine community demands rigorous evidence on vaccine efficacy and safety and technical and operational feasibility when introducing a new vaccine, but has been negligent in demanding equally rigorous research to understand the psychological, social, and political factors that affect public trust in vaccines.
    1. Background: Some believe that vaccinating young women against human papillomavirus (HPV) will increase their risky behavior. In more formal terms, vaccination lowers risk perception, and people compensate for their lower perceived risk by reducing other preventive behaviors.Purpose: We test several predictions from the risk compensation hypothesis in the context of vaccination behavior.Methods: We obtained a random sample of adults (N=705), interviewing them by phone just as the Lyme disease vaccine first became available to the public and again 18 months later. Analyses controlled for age, sex, education, and race.Results: Vaccinated respondents were less likely to continue engaging in two of five protective behaviors after vaccination. The frequency of these protective behaviors did not dip below that among the unvaccinated respondents.Conclusions: We found some evidence of regression (protective behaviors dropping, after vaccination, to levels reported by the unvaccinated cohort). However, we did not finddisinhibition (exceeding the risk taking of the unvaccinated cohort), the greater threat to public health. Although we will not know for several years what effect HPV vaccination has on other behaviors, if any, data on other vaccinations can offer critically important information in the interim.
    1. A community-level vaccine coverage of 80+% will be required to protect the community from infection, dependent on the vaccine efficacy and duration of protection. • Public expectations urgently need to be managed to prepare for a longer-term transition where non-pharmaceutical interventions remain in place. • Behavioural factors underpinning vaccine uptake are: (1) complacency, (2) trust and confidence in efficacy and safety, (3) convenience, (4) sources of information; and, (5) socio-demographic variation.• COVID-19 vaccine deployment faces an unprecedented degree of uncertainty and complexity, which is difficult to communicate, such as immune response, duration of immunity, repeated vaccination, transmission dynamics, microbiological and clinical characteristics and multiple vaccines.• Priority groups for vaccine deployment need transparent public debate to build support for ethical principles.• Current seasonal flu uptake is low in certain groups, suggesting vaccination challenges, which include: high risk groups under the age of 65 (40 - 50%), support staff in health care organisations (as low as 37%) and London and even variation amongst key workers such as Doctors (40 - 100%). • Deployment and tracking should build on existing immunisation programmes such as primary care by GPs to identify comorbidities, track vaccinations and reminders for additional boosters.• COVID-19 vaccine deployment faces an infodemic with misinformation often filling the knowledge void, characterised by: (1) distrust of science and selective use of expert authority, (2) distrust in pharmaceutical companies and government, (3) straightforward explanations, (4) use of emotion; and, (5) echo chambers. • A narrow focus on misinformation disregards the fact that there are genuine knowledge voids, necessitating public dialogue about vaccine concerns and hesitancy rather than providing passive one-way communication strategies.
    1. In Turkey, primary care staffs have observed an increased rate of vaccination refusal in recent years. The aim of the present study was to determine the prevalence of vaccination refusal and hesitancy in Turkey, in addition to the demographic features and underlying reasons. The present descriptive cross-sectional study was conducted in İstanbul and Tekirdağ, two big Turkish cities that are exposed to widespread internal migration. To reflect Turkey’s demographic structure, 1004 participants were selected using cluster sampling based on birthplace, age, and level of education, from all individuals who attended family medicine outpatient clinics at Namık Kemal University and Şişli Hamidiye Etfal Training and Research Hospital. A face-to-face questionnaire method was used. Data show that this decline was mainly the result of the increasing rate of vaccine rejection and hesitation, for which the most important reason was found to be distrust of vaccine companies. It can be concluded that individuals who display vaccine refusal and hesitation are mostly born in the developed geographical regions of Turkey and have high income and educational levels. According to these results, we anticipate that vaccination rates may fall in Turkey in the coming years.
    1. Vaccine confidence depends on trust in vaccines as products and trust in the system that produces them. In the US, this system consists of a complex network connecting pharmaceutical companies, government agencies, and the healthcare system. We explore narratives from White and African American adults describing their trust in these institutions, with a focus on influenza vaccine. Our data were collected between 2012 and 2014 as part of a mixed-methods investigation of racial disparities in influenza immunization. We interviewed 119 adults, primarily in Maryland and Washington, DC, in three stages utilizing semi-structured interviews (12), focus groups (9, n=91), and in-depth interviews (16). Analysis was guided by grounded theory. Trust in institutions emerged as a significant theme, with marked differences by race. In 2018, we contextualized these findings within the growing scholarship on trust and vaccines. Most participants distrusted pharmaceutical companies, which were viewed to be motivated by profit. Trust in government varied. Whites described implicit trust of federal institutions but questioned their competency. African Americans were less trusting of the government and were more likely to doubt its motives. Trust in institutions may be fragile, and once damaged, may take considerable time and effort to repair.
    1. BackgroundThe current outbreak of Ebola in eastern DR Congo, beginning in 2018, emerged in a complex and violent political and security environment. Community-level prevention and outbreak control measures appear to be dependent on public trust in relevant authorities and information, but little scholarship has explored these issues. We aimed to investigate the role of trust and misinformation on individual preventive behaviours during an outbreak of Ebola virus disease (EVD).MethodsWe surveyed 961 adults between Sept 1 and Sept 16, 2018. We used a multistage sampling design in Beni and Butembo in North Kivu, DR Congo. Of 412 avenues and cells (the lowest administrative structures; 99 in Beni and 313 in Butembo), we randomly selected 30 in each city. In each avenue or cell, 16 households were selected using the WHO Expanded Programme on Immunization's random walk approach. In each household, one adult (aged ≥18 years) was randomly selected for interview. Standardised questionnaires were administered by experienced interviewers. We used multivariate models to examine the intermediate variables of interest, including institutional trust and belief in selected misinformation, with outcomes of interest related to EVD prevention behaviours.FindingsAmong 961 respondents, 349 (31·9%, 95% CI 27·4–36·9) trusted that local authorities represent their interest. Belief in misinformation was widespread, with 230 (25·5%, 21·7–29·6) respondents believing that the Ebola outbreak was not real. Low institutional trust and belief in misinformation were associated with a decreased likelihood of adopting preventive behaviours, including acceptance of Ebola vaccines (odds ratio 0·22, 95% CI 0·21–0·22, and 1·40, 1·39–1·42) and seeking formal health care (0·06, 0·05–0·06, and 1·16, 1·15–1·17).InterpretationThe findings underscore the practical implications of mistrust and misinformation for outbreak control. These factors are associated with low compliance with messages of social and behavioural change and refusal to seek formal medical care or accept vaccines, which in turn increases the risk of spread of EVD.FundingThe Harvard Humanitarian Initiative Innovation Fund.
    1. Operation Warp Speed and global vaccine research efforts have succeeded in rapidly launching three vaccine candidates for coronavirus disease 2019 (COVID-19) into Phase III clinical trials. A recent letter from Centers for Disease Control and Prevention (CDC) Director Redfield underscored the possibility of “large-scale” distribution of a coronavirus vaccine as early as November 1, 2020. However, recent polling reveals that the majority of Americans remain skeptical of both the safety and efficacy of a potential Covid-19 vaccine. Even more troublesome is the fact that a comprehensive, collaborative vaccine marketing campaign has not been initiated to educate the U.S. public on and encourage widespread Covid-19 vaccination. Accordingly, this article lays out a plan of action, utilizing proven immunization marketing strategies and novel approaches, that could be used to combat vaccine hesitancy toward Covid-19. A vaccine may indeed be our ticket out of this pandemic, but targeted marketing is needed to increase public optimism toward that fact.
    1. The demand for vaccination against infectious diseases involves a choice between vaccinating and not vaccinating, in which there is a trade-off between the benefits and costs of each option. The aim of this paper is to investigate these trade-offs and to estimate how the perceived prevalence and severity of both the disease against which the vaccine is given and any vaccine associated adverse events (VAAE) might affect demand. A Discrete Choice Experiment (DCE) was used to elicit stated preferences from a representative sample of 369 UK mothers of children below 5 years of age, for three hypothetical vaccines. Cost was included as an attribute, which enabled estimation of the willingness to pay for different vaccines having differing levels of the probability of occurrence and severity of both the infection and VAAE. The results suggest that the severity of the health effects associated with both the diseases and VAAEs exert an important influence on the demand for vaccination, whereas the probability of these events occurring was not a significant predictor. This has important implications for public health policy, which has tended to focus on the probability of these health effects as the main influence on decision making. Our results also suggest that anticipated regrets about the consequences of making the wrong decision also exert an influence on demand.
    1. The SAGE Working Group on Vaccine Hesitancy concluded that vaccine hesitancy refers to delay in acceptance or refusal of vaccination despite availability of vaccination services. Vaccine hesitancy is complex and context specific, varying across time, place and vaccines. It is influenced by factors such as complacency, convenience and confidence. The Working Group retained the term ‘vaccine’ rather than ‘vaccination’ hesitancy, although the latter more correctly implies the broader range of immunization concerns, as vaccine hesitancy is the more commonly used term. While high levels of hesitancy lead to low vaccine demand, low levels of hesitancy do not necessarily mean high vaccine demand. The Vaccine Hesitancy Determinants Matrix displays the factors influencing the behavioral decision to accept, delay or reject some or all vaccines under three categories: contextual, individual and group, and vaccine/vaccination-specific influences.
    1. Suboptimal childhood vaccination uptake results in disease outbreaks, and in developed countries is largely attributable to parental choice. To inform evidence-based interventions, we conducted a systematic review of factors underlying parental vaccination decisions. Thirty-one studies were reviewed. Outcomes and methods are disparate, which limits synthesis; however parents are consistently shown to act in line with their attitudes to combination childhood vaccinations. Vaccine-declining parents believe that vaccines are unsafe and ineffective and that the diseases they are given to prevent are mild and uncommon; they mistrust their health professionals, Government and officially-endorsed vaccine research but trust media and non-official information sources and resent perceived pressure to risk their own child's safety for public health benefit. Interventions should focus on detailed decision mechanisms including disease-related anticipated regret and perception of anecdotal information as statistically representative. Self-reported vaccine uptake, retrospective attitude assessment and unrepresentative samples limit the reliability of reviewed data – methodological improvements are required in this area.
    1. ObjectiveRisk beliefs are central to most theories of health behavior, yet many unanswered questions remain about an increasingly studied risk construct, anticipated regret. We sought to better understand anticipated regret’s role in motivating health behaviors.MethodsWe systematically searched electronic databases for studies of anticipated regret and behavioral intentions or health behavior. We used random effects meta-analysis to synthesize effect sizes from 81 studies (n=45,618).ResultsAnticipated regret was associated with both intentions (r+= .50, p<.001) and health behavior (r+= .29, p<.001). Greater anticipated regret from engaging in a behavior (i.e., action regret) predicted weaker intentions and behavior, while greater anticipated regret from not engaging in a behavior (i.e., inaction regret) predicted stronger intentions and behavior. Anticipated action regret had smaller associations with behavioral intentions related to less severe and more distal hazards, but these moderation findings were not present for inaction regret. Anticipated regret generally was a stronger predictor of intentions and behavior than other anticipated negative emotions and risk appraisals.ConclusionsAnticipated inaction regret has a stronger and more stable association with health behavior than previously thought. The field should give greater attention to understanding how anticipated regret differs from similar constructs, its role in health behavior theory, and its potential use in health behavior interventions.
    1. ObjectiveVaccination is an effective preventive measure to reduce influenza transmission, especially important in a pandemic. Despite the messages encouraging vaccination during the last pandemic, uptake remained low (37.6% in clinical risk groups). This study investigated the effect of different types of messages regarding length, content type, and framing on vaccination intention.MethodAn online experiment was conducted in February 2015. A representative sample of 1424 people living in England read a mock newspaper article about a novel influenza pandemic before being randomised to one of four conditions: standard Department of Health (DoH) (long message) and three brief theory-based messages - an abridged version of the standard DoH and two messages additionally targeting pandemic influenza severity and vaccination benefits (framed as risk-reducing or health-enhancing, respectively). Intention to be vaccinated and potential mediators were measured.ResultsThe shortened DoH message increased vaccination intention more than the longer one, by increasing perceived susceptibility, anticipated regret and perceived message personal relevance while lowering perceived costs, despite the longer one being rated as slightly more credible. Intention to be vaccinated was not improved by adding information on severity and benefits, and the health-enhancing message was not more effective than the risk-reducing.ConclusionA briefer message resulted in greater intention to be vaccinated, whereas emphasising the severity of pandemic influenza and the benefits of vaccination did not. Future campaigns should consider using brief theoretically-based messages, targeting knowledge about influenza and precautionary measures, perceived susceptibility to pandemic influenza, and the perceived efficacy and reduced costs of vaccination.
    1. A popular view, supported by several studies, is that liberals are more concerned than conservatives about COVID-19. This is puzzling given the strong pandemic responses from some conservative nations, and the well-established link between conservatism and threat-sensitivity. We argue a resolution is provided by the dual evolutionary foundations of political ideology, which track trade-offs between: (1) threat-driven group conformity (social conservatism or right-wing authoritarianism [RWA]) vs. individual autonomy (social progressivism); and (2) a competitive motivation for hierarchy (economic conservatism or social dominance orientation [SDO]) vs. cooperation (economic progressivism). Using longitudinal data from a UK sample (n=433), we show that social (RWA), but not economic (SDO), conservatism significantly increased following the pandemic, and self-reported worry about the pandemic predicts this effect. Moreover, both social conservatives and economic progressives display strong responses to COVID-19, but for different reasons. While social conservatives generally display more worried and conformist/norm-enforcing responses, economic progressives display more cooperative, empathic responses and only worried or conformist/norm-enforcing responses related to empathy. These findings provide an explanation for apparently inconsistent results of prior work, support the dual foundations model of political ideology, and offer insight into divergent motives across the ideological landscape that may be useful for managing pandemic response.