Labels won’t solve all our problems, and design is only one part of them: Just as important is what gets labelled, and why. But getting features like noticeability, language and nudges right is a critical piece of the puzzle.

Third up: nudges. Nudges have been shown to help people think critically about what they’re sharing and reduce the spread of misinformation. TikTok nudges users towards pressing ‘Cancel’ with a strong red. The alternative says ‘share anyway’, and it's gray-ed out.

Second up: language. It’s important not to alienate people. First, TikTok opts for ‘video flagged’ to downplay who flagged it. It then avoids judgemental language by opting for ‘unverified’, preferring to say what it isn't, rather than making a claim about what it is.

First up: noticeability. A tricky line to tread here: too obvious, and you’ll attract attention to misinformation; too subtle, and people won’t notice the label. TikTok is clever here: grayscale, so not attention-grabby, but up top, so if you watch the video, you’ll see it.

When misinformation is seen by millions of people, the way we label it matters. Want to understand more? Let’s take a deep dive into TikTok’s new design.

Can we gather all covid tweets from large UK accounts, anonymise them put them on a website, let the public score them true to false then rank the accounts?

What risk do these new variants pose? How did they evolve? And how will they affect our vaccines?

Where did these COVID-19 variants come from – and what are they?

Statement from the Joint Committee on Vaccination and Immunisation (JCVI) about increasing the short-term impact of the COVID-19 vaccination programme.

Prioritising the first COVID-19 vaccine dose: JCVI statement

10.1073/pnas.2021830118

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.

Exhaled aerosol increases with COVID-19 infection, age, and obesity

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.

Estimated transmissibility and severity of novel SARS-CoV-2 Variant of Concern 202012/01 in England

Our latest lab data for B.1.1.7 prevalence in Pillar 2 samples, as determined by SGTF. Clearly now plateauing at 80-90%. Which to me suggests there are other lineages as transmissible as B.1.1.7.........

Nice healthy jump in @indeed US job postings: +2.4% above pre-pandemic baseline as of Feb 5. Was +0.7% one week earlier, on Jan 29. Accelerating improvement! 1.7 %pt weekly gain is similar to last summer's recovery pace. (Just a chart this week, no blogpost.)

Johnson and Johnson’s vaccine can be delivered in a single dose, but it’s also slightly less effective. Who should get it?

More Covid Vaccine Choices Mean New Equity Challenges

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.

Early Data Shows Striking Racial Disparities In Who's Getting The COVID-19 Vaccine

Nachman Ash had said single Pfizer/BioNTech dose was less effective than expected

Israeli Covid chief's claim single vaccine dose less effective 'inaccurate'

If you live in Gregg county, Texas or Terrebonne parish, Louisiana, you might be out of luck.

Do your neighbors want to get vaccinated?

10.1016/S0140-6736(19)31039-6

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.

The measles crisis in Europe—the need for a joined-up approach

10.31234/osf.io/qy2vu

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.

Association of COVID19-induced Anosmia and Ageusia with Depression and Suicidal Ideation

After Pfizer and Moderna, a slew of other candidates could fill gaps in efficacy, production or distribution

The Second-Generation COVID Vaccines Are Coming

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?

Facebook Is Taking Down Posts That Cause Imminent Harm — But Not Posts That Cause Inevitable Harm

10.1136/bmj.n314

After two million deaths, we must have redress for mishandling the pandemic

Covid-19: Social murder, they wrote—elected, unaccountable, and unrepentant

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.

COVID-19 Vaccination: Increasing Uptake

Many U.S. states aren’t rigorously tracking or investigating suspected cases of reinfection

Why the U.S. Is Underestimating COVID Reinfection

10.1136/bmj.n236

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.

Update to living systematic review on prediction models for diagnosis and prognosis of covid-19

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

After Wuhan mission on pandemic origins, WHO team dismisses lab leak theory

10.1101/2020.12.27.20248896

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.

Vaccination and Non-Pharmaceutical Interventions: When can the UK relax about COVID-19?

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).

SARS-CoV-2 Variant B.1.1.7 is Susceptible to Neutralizing Antibodies Elicited by Ancestral Spike Vaccines

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.

Report of 8% vaccine efficacy for elderly debunked by German government

10.1136/bmj.n91

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

Explaining covid-19 performance: what factors might predict national responses?

10.1038/s41562-021-01056-1

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

Measuring the impact of COVID-19 vaccine misinformation on vaccination intent in the UK and USA

10.2147/RMHP.S278774

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.

Does High Public Trust Amplify Compliance with Stringent COVID-19 Government Health Guidelines? A Multi-country Analysis Using Data from 102,627 Individuals

10.1136/bmj.m4425

When good science is suppressed by the medical-political complex, people die