Going viral: doctors must tackle fake news in the covid-19 pandemic

Curbing the COVID-19 digital infodemic: strategies and tools

A problematic manifestation of the COVID-19 pandemic is a related digital 'infodemic' with widespread dissemination of rumors, conspiracy theories, and other misinformation about the impact of the crisis on aspects of political and socio-economic life. Those spreading the misleading information did so through social media. In response, public, private and non-government stakeholders around the world have proposed a wide range of e-government policy approaches to combat this new digital phenomenon. For this Viewpoint I identified, analyzed, and classified the most interesting strategies, platforms, and tools proposed or already used by public decision-makers to combat the spread of false information related to the pandemic in a digital society.

Disinformation about COVID-19 Preventions and Treatments: Analysis of USFDA Warning Letters

COVID-19 poses a challenge beyond the virus itself, in that lockdown has been associated increased use of the internet and social media. Disinformation about prevention and treatment strategies for COVID-19 can have lethal consequences. The United States Food and Drug Administration (USFDA) is currently monitoring the compliance of manufacturing firms as well as medicinal product advertisers to the Federal Food, Drug, and Cosmetic Act, 21 USC § 321(h) regulations. In the event of noncompliance in the form of advertising products without prior USFDA approval for specific indications, doses, or route of administration, warning letters (WLs) are issued. WLs are intended to address the concerns identified by USFDA and encourage the recipient to take corrective steps to avoid similar instances in the future. We analyzed 182 WLs that were issued for noncompliance with drugs/devices related to either treatment, prevention, or testing of COVID-19 infections. The medicinal product website was identified as the major source of disinformation, followed by disseminated information on Facebook, Twitter, and Instagram. Nearly four-fifths were related to drugs, followed by devices and biologicals. Several biologicals, as well as allopathic, herbal, and non-herbal drugs were identified in the WLs. We observed that noncompliance with the USFDA regulations in terms of advertising a variety of products for prevention and treatment of COVID-19 infection was widely prevalent. More efforts are required by the respective national drug regulatory authorities to initiate or continue their monitoring of disinformation that may have lethal consequences.

Rural/urban differences in mental health and social well-being among older US adults in the early months of the COVID-19 pandemic

OBJECTIVES

This study seeks to identify differences in mental health and social well-being during the early months of the COVID-19 pandemic among older adults by rural/urban location.

METHODS

We use data from the COVID-19 Coping Study, a nation-wide online study of U.S. adults aged 55 and older (n = 6,873) fielded during April-May, 2020. We investigated rural/urban differences in mental health (depressive symptoms and anxiety symptoms) and social well-being (loneliness and social isolation); concern about COVID-19; and types of social participation (e.g. phone/video calls, visits). We also used multivariable logistic regression models to assess the relationship of rurality with mental health, adjusting for socio-demographic correlates, COVID-19 history, and COVID-19 concern.

RESULTS

We found similar prevalence of mental health and social well-being outcomes for rural and urban respondents. Rural respondents reported lower concern about COVID-19 and more frequent use of social media than urban respondents.

CONCLUSION

Mental health and social well-being did not differ by rural/urban location in the early months of the COVID-19 pandemic. However, rural residents reported less concern about COVID-19 and more use of social media, potentially leading to greater risk of illness from the pandemic in later months.

The link between reported cases of COVID-19 and the Infodemic Risk Index: A worldwide perspective

In this brief report we followed the evolution of the COVID-19 Infodemic Risk Index during 2020 and clarified its connection with the epidemic waves, focusing specifically on their co-evolution in Europe, South America, and South-eastern Asia. Using 640 million tweets collected by the Infodemic Observatory and the open access dataset published by Our World in Data regarding COVID-19 worldwide reported cases, we analyze the COVID-19 infodemic vs. pandemic co-evolution from January 2020 to December 2020. We find that a characteristic pattern emerges at the global scale: a decrease in misinformation on Twitter as the number of COVID-19 confirmed cases increases. Similar local variations highlight how this pattern could be influenced both by the strong content moderation policy enforced by Twitter after the first pandemic wave and by the phenomenon of selective exposure that drives users to pick the most visible and reliable news sources available.

Life Satisfaction of Nurses during the COVID-19 Pandemic in Poland

BACKGROUND

Health care practitioners are at highest risk of COVID-19 disease. They experience an enormous overload of work and time pressures. The objective of the study was to assess nurses' life satisfaction.

METHOD

The study included professionally active nurses. The research method was an author's questionnaire and a standardized questionnaire, the Satisfaction with Life Scale (SWLS).

RESULTS

The study group included 361 working nurses. The mean raw score and the sten score of the nurses' responses to the statements on the SWLS questionnaire were 21.0 (SD ± 5.6, range = 5-35) and 5.73 (SD ± 1.94, range = 1-10), respectively. It was shown that lower life satisfaction was experienced by nurses aged 51 to 60 (raw score: p = 0.003, sten score: p = 0.005), as well as nurses with secondary and undergraduate nursing education (raw score: p = 0.061, sten score: p = 0.043). Nurses who had a higher self-evaluation of the level of knowledge about SARS-CoV-2 infection experienced greater life satisfaction (raw score: p = 0.008, sten score: p = 0.022).

CONCLUSIONS

The majority of Polish nurses surveyed during the COVID-19 pandemic had a low or medium level of life satisfaction. The low response rate to the survey was most likely due to work overloads during the pandemic. Working in a public service profession, a nurse is exposed to stressful conditions related to protecting human health. Constant difficult and stressful situations and total fatigue experienced by nursing professionals can be the cause of a lack of motivation, occupational burnout, listlessness and mental and physical disease. Further research is necessary to assess the factors positively influencing the level of life satisfaction.

Preventive practice, vaccine acceptance, and knowledge toward coronavirus disease-19: An online cross-sectional questionnaire-based report in Iranian dentists

BACKGROUND

The coronavirus disease (COVID) is predicted to cause serious mental health problems among healthcare providers (HCPs) especially dentists. Also understanding the influencing factors of the acceptance of COVID-19 vaccination among HCPs are important aspects in the design of effective strategies to improve the vaccine coverage rate. Therefore, this study aimed to assess the knowledge, vaccination acceptance, fear, and obsession, as well as the preventive practice behaviors of Iranian dentists and dental students in late 2020 toward COVID-19.

MATERIALS AND METHODS

A descriptive, web-based cross-sectional survey was conducted among Iranian dental students and dentists (general practitioners and specialists). All Iranian dentists and dental students living in the Islamic Republic of Iran regardless of their city and workplace were invited to participate in the study. The total number of dentists in Iran was estimated to be 54,927. The sample size was calculated 380. The questionnaires used in this study were adapted from previously published studies based on the authors' permission. The questionnaire consisted of four sections that sought to collect information on the respondents' vaccination acceptance, knowledge, preventive practice, fear, and obsession toward COVID-19. The relationship between the study variables was assessed using Pearson's correlation coefficient and also multiple linear regression tests.

RESULTS

Overall, 394 dentists were filled the questionnaire (65 dental students, 151 general dentists and 178 specialists). There were no differences in terms of vaccination acceptance, knowledge and also fear score in different designation groups. Dentists had significantly higher obsession and also preventive practice scores than other designation groups (P < 0.05). The majority of respondents had good knowledge (more than 9), acceptable preventive practice (more than 19), low fear-obsession (<2.7), and high acceptance of COVID-19 vaccination (more than 8.8).

CONCLUSIONS

Although obsession and fear scores were low in all designation groups, dentists had higher obsession and also preventive practice scores than other designation groups. More than half of respondents preferred imported COVID-19 vaccines. Finally, organizations such as the World Health Organization and the Ministry of Public Health in Iran should increase vaccine convenience and accessibility in terms of vaccine importing, distribution, supply, and immunization service.

Mental Health and Access to Information in Times of COVID-19: The Role of Social Work

The confinements and limited social interactions that have derived from COVID-19 have aggravated the situation of people with previous pathologies. As a result, access to health and its rehabilitation or support resources has been limited and redirected toward online care. People with mental health problems have considerably suffered during the pandemic because, for many of them, accessing different information resources through telematic means proved to be a great difficulty in their everyday lives. This exploratory research work aims to establish which elements have successfully facilitated access to online information for people with mental health problems. This is especially urgent in times of COVID-19 when misinformation has significantly harmed this group. To do so, we followed the communicative methodology and held interviews with two professionals and nine users who participated in the case study. The main results show that, in developing digital communicative competencies in accessing information with this group, individualization of care to overcome barriers, the link with social workers as references of truthful information, and the importance of emotional work and interactions are critical elements.

Instagram travel influencers in #quarantine: Communicative practices and roles during COVID-19

The crisis arising from the COVID-19 pandemic has affected the entire tourism system, including communication and marketing practices. Of these practices, in recent years influencer marketing has been one of the more successful strategies for both destinations and tourism businesses. This research investigates the impacts of the COVID-19 crisis on travel content creators, their communicative practices, and their engagement with audiences, brands and health authorities. The study uses netnography based on immersion, interviews and social media content analysis. The results obtained show that the pandemic has transformed influencer marketing and has driven influencers to change their business strategies, content creation tactics and engagement mechanisms. The findings contribute to the crisis communication literature by illustrating that influencers constitute important allies for organisations when communicating during a crisis and have played a critical role in tourism recovery.

Dentists' situation and their needs during the COVID-19 pandemic in Nepal: an online questionnaire survey

Background

During the coronavirus disease (COVID-19) pandemic, ordinary dental services were sustained in Nepal. Because a dental practice is considered to involve a high risk of infection, the needs of dentists should be identified, and demand-driven support should be provided. The purpose of this study was to investigate the situation and needs of dentists during the COVID-19 pandemic in order to guide demand-driven support. First, we investigated how the situation of Nepali dentists differed according to their types of practices between private clinics and university/government hospitals. Second, we assessed the characteristics of dentists demanding four types of support: financial, material, technical, and guidelines/guidance support.

Methods

A cross-sectional online questionnaire survey was conducted between July 28th and August 7th 2020. Closed-ended questions were prepared regarding behavior, material availability, economic and psychological impacts, training, and the main support dentists wanted to receive. The situation of dentists between private clinics and university/government hospitals was determined using a chi-squared test for each variable. To examine the association between the characteristics of dentists and four types of support, multivariable logistic regression analyses were used to estimate adjusted odds ratios (ORs) with a 95% confidence interval (CI) for each variable.

Results

There were 352 dentists (137 males and 215 females) included in the analysis. Private clinic dentists experienced a bigger economic impact and demanded financial support that 45.5% of them did not receive a salary, compared to 18.9% in university/government hospitals. On the contrary, university/government hospitals experienced lack of PPE and demanded material support that 79.8% had personal protective equipment, compared to 92.5% in private clinics. Financial support was demanded significantly more by male than female dentists (ORs = 5.56; 95% CI = 2.96–10.45). Material support was demanded significantly more by dentists who received training regarding COVID-19 management (ORs = 1.96; 95% CI = 1.01–3.81). Technical support was demanded significantly less by male dentists (ORs = 0.44; 95% CI = 0.23–0.83). Guideline/guidance support was demanded significantly more by dentists who answered that Nepal Dental Association provided appropriate support (ORs = 2.21; 95% CI = 1.25–3.91).

Conclusion

This study articulated the diverse needs of Nepali dentists during the COVID-19 pandemic. Demand-driven support should be provided in the future.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-022-02139-9.

Online Information of COVID-19: Visibility and Characterization of Highest Positioned Websites by Google between March and April 2020-A Cross-Country Analysis

Background: The WHO has used the term “infodemic” to describe the vast amount of false and true information that was making it difficult for people to find reliable information when they needed it. The infodemic spreads faster than COVID-19 itself. The main objective of the study was to characterize and analyze content about COVID-19 returned by Google during the pandemic and compare it between countries. Methods: The study was conducted between 30 March and 27 April 2020. The information was searched through local Google websites using the “COVID-19”, “Coronavirus”, “SARS-CoV-2” and “fake news” keywords. The search was conducted in Australia, France, Germany, Italy, Poland, Singapore, Spain, UK and the USA. The total number of the analyzed webpages was 685. Results: The most frequent types were News websites 47% (324/685) and Governmental 19% (131/685) while the least were Health portals 2% (17/685) and Scientific journals 5% (35/635), p < 0.001. United States and Australia had the highest share of Governmental websites. There was a positive correlation between the amount of preventive information and a number of SARS-CoV-2 infections in countries. The higher the number of tests performed, the higher was the amount of information about prevention available online. Conclusions: Online information is usually available on news and government websites and refers to prevention. There were differences between countries in types of information available online. The highest positioned (the first 20) websites for COVID-19, Coronavirus and SARS-CoV-2 keywords returned by Google include true information.

The influence of the pandemic on fear of contagion, blood pressure management and adherence to medication in hypertensive older adults in Turkey

The study was conducted to identify the impact of the pandemic on hypertensive older people's COVID-19 fear, blood pressure control, and medication adherence. In this descriptive, correlational study, mean medication adherence was taken as 45.6 ± 6.06% based on the literature, with a 5% margin of error, and the sample size was determined as 292 with 95% confidence interval and 80% power. Data were collected from 419 older individuals using a sociodemographic information form, an infodemic-related questionnaire, Fear of COVID-19 Scale, and Medication Adherence Self-Efficacy Scale via Google Forms. The data were analyzed using IBM SPSS Statistics 23 software via independent sample t test, one-way variance analysis, χ² analysis, and the Pearson correlation coefficient. It was found that, rather than avoiding hospitals during a pandemic, one out of two older people had had their blood pressure checked. One out of every five had abnormal/uncontrolled blood pressure during the pandemic. The infodemic was found to increase concern levels, and those with high fear scores had abnormal/uncontrolled levels of blood pressure. Moreover, a low-level positive correlation was found between medication adherence and the level of fear of COVID-19. As the pandemic continues, older people with hypertension need support in terms of monitoring blood pressure and medication adherence as well as increased awareness about the pandemic.

Psychological Impact of the COVID-19 Pandemic on Pregnant Women: A Scoping Review

During the gestation period, pregnant women experience physical and psychological changes, which represent vulnerability factors that can boost the development of mental health conditions. The COVID-19 pandemic is producing new changes in the routines of the whole society, especially on lifestyle habits. The psychological impact associated with the COVID-19 pandemic and pregnant women remains unclear. A scoping review regarding the psychological impact of the COVID-19 pandemic on pregnant women was conducted. Searchers were conducted using the PubMed, Web of Science and CINAHL databases. Articles in Spanish, English and French were included. The search was conducted between November 2020 and September 2021. We identified 31 studies that evaluated 30,049 expectant mothers during the COVID-19 pandemic. Pregnant women showed high levels of anxiety and depression symptomatology. Fear of contagion and concerns regarding the health of the fetus were identified as the main variables related to psychological distress. An increase of the levels of depression, anxiety and stress during the COVID-19 pandemic amongst pregnant women has been observed. Moreover, an increased vulnerability of the fetus due to placental metabolic alterations is discussed. This review suggests that the COVID-19 pandemic is associated with a negative psychological impact on pregnant women. Thus, high levels of anxiety and depression symptoms suggest the need for a systematic approach.

Individual Differences in Belief in Fake News about Election Fraud after the 2020 U.S. Election

Fake news is a serious problem because it misinforms people about important issues. The present study examined belief in false headlines about election fraud after the 2020 U.S. presidential election. Belief in election fraud had dangerous consequences, including the deadly insurrection at the U.S. Capitol in January 2021. In the present study, participants rated the truthfulness of true and false headlines about the election, and then completed individual difference measures eight days after the election. Participants with more conservative ideology, greater presidential approval of the outgoing president, greater endorsement of general conspiracy narratives and poorer cognitive reflection demonstrated greater belief in false headlines about election fraud. Additionally, consuming more politically conservative election news was associated with greater belief in false headlines. Identifying the factors related to susceptibility to false claims of election fraud offers a path toward countering the influence of these claims by tailoring interventions aimed at decreasing belief in misinformation and decreasing conspiracy beliefs to those most susceptible.

A Cross-Sectional Survey of Knowledge, Attitude, and Practices of University Students in Pakistan Regarding COVID-19

The COVID-19 pandemic is striking the world with serious public health and socioeconomic complications. The pandemic has influenced all forms of daily life, including educational institutions. Therefore, this cross-sectional survey was conducted to understand knowledge, attitudes, and practices related to COVID-19 among the students of the University of Veterinary and Animal Sciences, Lahore. The data was collected using an online self-directed questionnaire. The survey form includes six items about sociodemographic characteristics, 14 knowledge-based questions, seven questions on attitude, and eight questions on practices. The sample number was calculated using the Raosoft sample size calculator. A total number of 3,854 students, including 1,823 men and 2,031 women, were engaged in this survey, having student representation from all the provinces in the country. The data were analyzed using a chi-square test. A total of 97% of the students knew that the etiological agent of COVID-19 is a virus and that it is a disease of the respiratory system (94%). Many students kept visiting their relatives during the lockdown (45%), and their relatives kept visiting them at home (59%). The responses from the students varied a lot on specific questions about the transmission of the virus. Women tended to have less information regarding precautionary travel measures (p < 0.01), but supplemental knowledge of prevention of disease transmission from positive patients (p < 0.01). Conclusively, the majority of the university students surveyed had imperative knowledge, a good attitude, and active practice in response to the COVID-19 outbreak. Moreover, the KAP scores have varied by demography, gender, and the number of family members. Therefore, continuous awareness of preventative behaviors should be disseminated regularly in emergencies.

COVID-19 news valence effects on emotion and its modulation by a relaxation: A randomized online experiment during COVID-19 pandemic

This study evaluated how news with positive and negative content about COVID-19, as well as a relaxation pause, affect the emotional state. We also investigated the association between emotional state and practicing meditation/yoga, physical activity or having a mental disease. For that, a sample of 717 participants, recruited through social media, were randomly assigned to listen to negative or positive news about COVID-19. After that, both groups were guided through a short relaxation pause. Their emotional state was measured before they listened to the audios and after each audio. Mixed linear models were used to evaluate the effects of news group, relaxation pause, mental health and well-being practices. Negative news worsened their emotional state, whereas positive news improved it. A brief relaxation pause improved the effects of negative news content and may mitigate the effects of this valence of information. Practicing physical activity, meditation/yoga was associated with better emotional responses.

Factors affecting willingness to comply with public health measures during the pandemic among sub-Sahara Africans

Background

The unprecedented outbreak of coronavirus disease (COVID-19) drastically spread worldwide, resulting in extraordinary measures put in place in various countries including Sub Saharan Africa (SSA) countries.

Objective

To assess the factors associated with compliance with the public health measures imposed by various SSA countries.

Method

Cross sectional study using self-administered surveys distributed on social media platforms between April 18th and May 16th, 2020, corresponding with the mandatory lockdown period in most SSA countries. Multivariate analysis examined the associated factors.

Results

The prevalence of hand hygiene, quarantine, self isolation practices, wearing of face mask and attending large gatherings during COVID-19 were 94%, 39%, 31%, 64% and 14%, respectively. In multivariate models, older age 49+ years: adjusted OR 2.13, 95%CI 1.22,3.71), females (OR 1.41,95%CI 1.03,1.93), Central African countries (OR 3.73,95%CI 2.02,6.87) were associated with wearing face mask. Living alone (aOR 1.52,95%CI 1.04,2.24) during the lockdown was associated with avoiding large gatherings including religious events. Female respondents (aOR 1.61, 95%CI 1.30, 2.00), married (aOR 1.71,95%CI 1.33,2.21) and unemployed (aOR 1.62,95%CI 1.25,2.09) SSAs were more likely to practice self-quarantine measures.

Conclusion

The low prevalence of mitigation practices suggest the need for targeted education campaign programs to sensitise the population

Objective Knowledge Mediates the Relationship between the Use of Social Media and COVID-19-Related False Memories

The exposure to relevant social and/or historical events can increase the generation of false memories (FMs). The Coronavirus Disease 2019 (COVID-19) pandemic is a calamity challenging health, political, and journalistic bodies, with media generating confusion that has facilitated the spread of fake news. In this respect, our study aims at investigating the relationships between memories (true memories, TMs vs. FMs) for COVID-19-related news and different individual variables (i.e., use of traditional and social media, COVID-19 perceived and objective knowledge, fear of the disease, depression and anxiety symptoms, reasoning skills, and coping mechanisms). One hundred and seventy-one university students (131 females) were surveyed. Overall, our results suggested that depression and anxiety symptoms, reasoning skills, and coping mechanisms did not affect the formation of FMs. Conversely, the fear of loved ones contracting the infection was found to be negatively associated with FMs. This finding might be due to an empathy/prosociality-based positive bias boosting memory abilities, also explained by the young age of participants. Furthermore, objective knowledge (i) predicted an increase in TMs and decrease in FMs and (ii) significantly mediated the relationships between the use of social media and development of both TMs and FMs. In particular, higher levels of objective knowledge strengthened the formation of TMs and decreased the development of FMs following use of social media. These results may lead to reconsidering the idea of social media as the main source of fake news. This claim is further supported by either the lack of substantial differences between the use of traditional and social media among participants reporting FMs or the positive association between use of social media and levels of objective knowledge. The knowledge about the topic rather than the type of source would make a difference in the process of memory formation.

Debunking Health Misinformation on Social Media: The Challenge of Dynamic Conversations (Preprint)

Background

The spread of false and misleading health information on social media can cause individual and social harm. Research on debunking has shown that properly designed corrections can mitigate the impact of misinformation, but little is known about the impact of correction in the context of prolonged social media debates. For example, when a social media user takes to Facebook to make a false claim about a health-related practice and a health expert subsequently refutes the claim, the conversation rarely ends there. Often, the social media user proceeds by rebuking the critic and doubling down on the claim.

Objective

The aim of this study was to examine the impact of such extended back and forth between false claims and debunking attempts on observers’ dispositions toward behavior that science favors. We tested competing predictions about the effect of extended exposure on people’s attitudes and intentions toward masking in public during the early days of the COVID-19 pandemic and explored several psychological processes potentially underlying this effect.

Methods

A total of 500 US residents took part in an online experiment in October 2020. They reported on their attitudes and intentions toward wearing masks in public. They were then randomly assigned to one of four social media exposure conditions (misinformation only vs misinformation+correction vs misinformation+correction+rebuke vs misinformation+correction+rebuke+second correction), and reported their attitudes and intentions for a second time. They also indicated whether they would consider sharing the thread if they were to see it on social media and answered questions on potential mediators and covariates.

Results

Exposure to misinformation had a negative impact on attitudes and intentions toward masking (β=–.35, 95% CI –.42 to –.29; P<.001). Moreover, initial debunking of a false claim generally improved attitudes and intentions toward masking (β=.35, 95% CI .16 to .54; P<.001). However, this improvement was washed out by further exposure to false claims and debunking attempts (β=–.53, 95% CI –.72 to –.34; P<.001). The latter result is partially explained by a decrease in the perceived objectivity of truth. That is, extended exposure to false claims and debunking attempts appear to weaken the belief that there is an objectively correct answer to how people ought to behave in this situation, which in turn leads to less positive reactions toward masking as the prescribed behavior.

Conclusions

Health professionals and science advocates face an underappreciated challenge in attempting to debunk misinformation on social media. Although engaging in extended debates with science deniers and other purveyors of bunk appears necessary, more research is needed to address the unintended consequences of such engagement.

The dangers of blind trust: Examining the interplay among social media news use, misinformation identification, and news trust on conspiracy beliefs

Since the beginning of the COVID-19 pandemic, misinformation has been circulating on social media and multiple conspiracy theories have since become quite popular. We conducted a U.S. national survey for three main purposes. First, we aim to examine the association between social media news consumption and conspiracy beliefs specific to COVID-19 and general conspiracy beliefs. Second, we investigate the influence of an important moderator, social media news trust, that has been overlooked in prior studies. Third, we further propose a moderated moderation model by including misinformation identification. Our findings show that social media news use was associated with higher conspiracy beliefs, and trust in social media news was found to be a significant moderator of the relationship between social media news use and conspiracy beliefs. Moreover, our findings show that misinformation identification moderated the relationship between social media news use and trust. Implications are discussed.

The causes, impacts and countermeasures of COVID-19 "Infodemic": A systematic review using narrative synthesis

An unprecedented infodemic has been witnessed to create massive damage to human society. However, it was not thoroughly investigated. This systematic review aims to (1) synthesize the existing literature on the causes and impacts of COVID-19 infodemic; (2) summarize the proposed strategies to fight with COVID-19 infodemic; and (3) identify the directions for future research. A systematic literature search following the PRISMA guideline covering 12 scholarly databases was conducted to retrieve various types of peer-reviewed articles that reported causes, impacts, or countermeasures of the infodemic. Empirical studies were assessed for risk of bias using the Mixed-Methods Appraisal Tool. A coding theme was iteratively developed to categorize the causes, impacts, and countermeasures found from the included studies. Social media usage, low level of health/eHealth literacy, and fast publication process and preprint service are identified as the major causes of the infodemic. Besides, the vicious circle of human rumor-spreading behavior and the psychological issues from the public (e.g., anxiety, distress, fear) emerges as the characteristic of the infodemic. Comprehensive lists of countermeasures are summarized from different perspectives, among which risk communication and consumer health information need/seeking are of particular importance. Theoretical and practical implications are discussed and future research directions are suggested.

Acceptability of and symptom findings from an online symptom check-in tool for COVID-19 outpatient follow-up among a predominantly healthcare worker population

INTRODUCTION

Health systems worldwide have had to prepare for a surge in volume in both the outpatient and inpatient settings since the emergence of COVID-19. Early international healthcare experiences showed approximately 80% of patients with COVID-19 had mild disease and therfore could be managed as outpatients. However, SARS-CoV-2 can cause a biphasic illness with those affected experiencing a clinical deterioration usually seen after day 4 of illness.

OBJECTIVE

We created an online tool with the primary objective of allowing for virtual disease triage among the increasing number of outpatients diagnosed with COVID-19 at our hospital. Secondary aims included COVID-19 education and the promotion of official COVID-19 information among these outpatients, and analysis of reported symptomatology.

METHODS

Outpatients with acute COVID-19 disease received text messages from the hospital containing a link to an online symptom check-in tool which they were invited to complete.

RESULTS

296 unique participants (72%) from 413 contacted by text completed the online check-in tool at least once, generating 831 responses from 1324 texts sent. 83% of text recipients and 91% of unique participants were healthcare workers. 7% of responses to the tool were from participants who admitted to a slight worsening of their symptoms during follow-up. Fatigue was the most commonly reported symptom overall (79%), followed by headache (72%). Fatigue, headache and myalgia were the most frequently reported symptoms in the first 3 days of illness. 8% of responses generated in the first 7 days of illness did not report any of the cardinal symptoms (fever, cough, dyspnoea, taste/smell disturbance) of COVID-19. Participants found the tool to be useful and easy to use, describing it as 'helpful' and 'reassuring' in a follow-up feedback survey (n=140). 93% said they would use such a tool in the future. 39% reported ongoing fatigue, 16% reported ongoing smell disturbance and 14% reported ongoing dyspnoea after 6 months.

CONCLUSION

The online symptom check-in tool was found to be acceptable to participants and saw high levels of engagement and satisfaction. Symptomatology findings highlight the variety and persistence of symptoms experienced by those with confirmed COVID-19 disease.

US Physicians' and Nurses' Motivations, Barriers, and Recommendations for Correcting Health Misinformation on Social Media: Qualitative Interview Study

BACKGROUND

Health misinformation is a public health concern. Various stakeholders have called on health care professionals, such as nurses and physicians, to be more proactive in correcting health misinformation on social media.

OBJECTIVE

This study aims to identify US physicians' and nurses' motivations for correcting health misinformation on social media, the barriers they face in doing so, and their recommendations for overcoming such barriers.

METHODS

In-depth interviews were conducted with 30 participants, which comprised 15 (50%) registered nurses and 15 (50%) physicians. Qualitative data were analyzed by using thematic analysis.

RESULTS

Participants were personally (eg, personal choice) and professionally (eg, to fulfill the responsibility of a health care professional) motivated to correct health misinformation on social media. However, they also faced intrapersonal (eg, a lack of positive outcomes and time), interpersonal (eg, harassment and bullying), and institutional (eg, a lack of institutional support and social media training) barriers to correcting health misinformation on social media. To overcome these barriers, participants recommended that health care professionals should receive misinformation and social media training, including building their social media presence.

CONCLUSIONS

US physicians and nurses are willing to correct health misinformation on social media despite several barriers. Nonetheless, this study provides recommendations that can be used to overcome such barriers. Overall, the findings can be used by health authorities and organizations to guide policies and activities aimed at encouraging more health care professionals to be present on social media to counteract health misinformation.

A Pilot Study of Medical Misinformation Perceptions and Training Among Practitioners in North Carolina (USA)

Medical misinformation (MM) is a problem for both medical practitioners and patients in the 21^st century. Medical practitioners have anecdotally reported encounters with patient-held misinformation, but to date we lack evidence that quantifies this phenomenon. We surveyed licensed practitioners in the state of North Carolina to better understand how often patients mention MM in the clinical setting, and if medical practitioners are trained to engage with patients in these specific conversations. We administered an anonymous, online survey to physicians and physician assistants licensed to practice in the state of North Carolina. Questions focused on demographics, clinical encounters with MM, and training to discuss MM with patients. We received over 2800 responses and analyzed 2183 after removing ineligible responses. Our results showed that most respondents encountered MM from patients (94.2% (2047/2183)), with no significant differences between clinical specialty, time spent in practice, or community type. When asked about specific training, 18% (380/2081) reported formal experiences and 39% (807/289) reported informal experiences. MM has been salient due to the COVID-19 pandemic; however, it was present before and will remain after the pandemic. Given that MM is widespread but practitioners lack training on engaging patients in these conversations, a sustained effort to specifically train current and future practitioners on how to engage patients about MM would be an important step toward mitigating the spread of MM.

The diversity of opinion among general practitioners regarding the threat and measures against COVID-19 - Cross-sectional survey

BACKGROUND

After the 'first wave' in spring 2020, opinions regarding the threat and measures against COVID-19 seemed to vary among German general practitioners (GPs).

OBJECTIVES

To systematically investigate opinions and to identify subgroups of GPs sharing similar views.

METHODS

A questionnaire was sent to all 210 practices accredited for undergraduate teaching of family medicine at the Medical Faculty of the Technical University of Munich. Questions addressed personal opinions regarding risks, dilemmas, restrictions and their relaxation associated with COVID-19, and personal fears, symptoms of depression and anxiety. Patterns of strong opinions ('archetypes') were identified using archetypal analysis, a statistical method seeking extremal points in the multidimensional data.

RESULTS

One hundred and sixty-one GPs sent back a questionnaire (response rate 77%); 143 (68%) with complete data for all 38 relevant variables could be included in the analysis. We identified four archetypes with subgroups of GPs tending in the direction of these archetypes: a small group of 'Sceptics' (n = 12/8%) considering threats of COVID-19 as overrated and measures taken as exaggerated; 'Hardliners' (n = 34/24%) considering threats high and supporting strong measures; 'Balancers' (n = 77/54%) who also rated the threats high but were more critical about potentially impairing the quality of life of elderly people and children; and 'Anxious' GPs (n = 20/14%) tending to report more fear, depressive and anxiety symptoms.

CONCLUSION

Among the participants in this survey, opinions regarding the threat and the measures taken against COVID-19 during the 'first wave' in Germany in spring 2020 varied greatly.

Emergence of knowledge communities and information centralization during the COVID-19 pandemic

Background

As COVID-19 spreads worldwide, an infodemic – i.e., an over-abundance of information, reliable or not – spreads across the physical and the digital worlds, triggering behavioral responses which cause public health concern.

Methods

We study 200 million interactions captured from Twitter during the early stage of the pandemic, from January to April 2020, to understand its socio-informational structure on a global scale.

Findings

The COVID-19 global communication network is characterized by knowledge groups, hierarchically organized in sub-groups with well-defined geo-political and ideological characteristics. Communication is mostly segregated within groups and driven by a small number of subjects: 0.1% of users account for up to 45% and 10% of activities and news shared, respectively, centralizing the information flow.

Interpretation

Contradicting the idea that digital social media favor active participation and co-creation of online content, our results imply that public health policy strategies to counter the effects of the infodemic must not only focus on information content, but also on the social articulation of its diffusion mechanisms, as a given community tends to be relatively impermeable to news generated by non-aligned sources.

Patient educational needs and challenges in psoriatic arthritis

PURPOSE OF REVIEW

To provide an overview of the recent research publications on educational needs of patients with psoriatic arthritis (PsA) and the associated challenges.

RECENT FINDINGS

The rate of good treatment adherence in PsA can be as low as 57.7% and successful patient education can help improve treatment adherence. Also, 78.7% of patients who stopped their disease modifying anti-rheumatic drugs during the first wave of the COVID-19 pandemic did so without the advice of their clinician. In delivering educational needs, the aspects of disease process, treatment, self-help measures, managing pain, movement, psychological and social needs should all be addressed, whilst at the same time, recognising that PsA patients with multidomain disease, are likely to be dealing with more than just pain. Arthritis self-care management education is potentially beneficial, but up to 11% of educational YouTube videos may contain misleading patient opinion and many existing apps do not meet the needs of the patients with PsA.

SUMMARY

Significant room for improvement exists in treatment adherence in PsA and patient education addressing the relevant educational needs could assist with this issue. However, patients should be advised to be wary of internet videos and other educational aids that were not created by health professionals.

Providing Effective Mental Health Support for Oncology Health-Care Workers in the COVID-19 Era: Responding Quickly but Carefully

Oncology health-care workers (HCWs) are facing substantial stressors during the current coronavirus disease 2019 pandemic, resulting in a wide range of acute stress responses. To appropriately meet the growing mental health needs of HCWs, it is imperative to differentiate expectable stress responses from posttraumatic stress disorder and mental illness, because traditional mental health interventions may pathologize healthy stress reactions and risk retraumatizing HCWs under acute duress. Further, HCWs are experiencing protracted forms of acute stress as the pandemic continues, including moral injury, and require mental health interventions that are flexible and can adapt as the acuity of stressors changes. Previously developed frameworks to support people experiencing acute stress, such as Psychological First Aid, are particularly relevant for HCWs in the ongoing pandemic. Acute stress interventions like Psychological First Aid are guided by the Stress Continuum Model, which conceptualizes stress reactions on a continuum, from a zone of normal readiness and expectable consequences to a zone of more persistent and extreme reactions such as posttraumatic stress disorder and major depression. Key principles of the Stress Continuum Model include the expectation that emotional reactivity does not lead to psychiatric problems, that interventions need to be appropriately targeted to symptoms along the stress continuum, and that people will return to normal recovery. Various core actions to reduce acute stress include delivering practical assistance, reducing arousal, mobilizing support, and providing targeted collaborative services. This nonpathologizing approach offers a valuable framework for delivering both individual and organizational-level interventions during the coronavirus disease 2019 pandemic.

The prevalence of psychiatric comorbidities during the SARS and COVID-19 epidemics: a systematic review and meta-analysis of observational studies

The coronavirus disease 2019 (COVID-19) and Severe Acute Respiratory Syndrome (SARS) are associated with various psychiatric comorbidities. This is a systematic review and meta-analysis comparing the prevalence of psychiatric comorbidities in all subpopulations during the SARS and COVID-19 epidemics. A systematic literature search was conducted in major international (PubMed, EMBASE, Web of Science, PsycINFO) and Chinese (China National Knowledge Internet [CNKI] and Wanfang) databases to identify studies reporting prevalence of psychiatric comorbidities in all subpopulations during the SARS and COVID-19 epidemics. Data analyses were conducted using the Comprehensive Meta-Analysis Version 2.0 (CMA V2.0). Eighty-two studies involving 96,100 participants were included. The overall prevalence of depressive symptoms (depression hereinafter), anxiety symptoms (anxiety hereinafter), stress, distress, insomnia symptoms, post-traumatic stress symptoms (PTSS) and poor mental health during the COVID-19 epidemic were 23.9% (95% CI: 18.4%-30.3%), 23.4% (95% CI: 19.9%-27.3%), 14.2% (95% CI: 8.4%-22.9%), 16.0% (95% CI: 8.4%-28.5%), 26.5% (95% CI: 19.1%-35.5%), 24.9% (95% CI: 11.0%-46.8%), and 19.9% (95% CI: 11.7%-31.9%), respectively. Prevalence of poor mental health was higher in general populations than in health professionals (29.0% vs. 11.6%; Q=10.99, p=0.001). The prevalence of depression, anxiety, PTSS and poor mental health were similar between SARS and COVID-19 epidemics (all p values>0.05). Psychiatric comorbidities were common in different subpopulations during both the SARS and COVID-19 epidemics. Considering the negative impact of psychiatric comorbidities on health and wellbeing, timely screening and appropriate interventions for psychiatric comorbidities should be conducted for subpopulations affected by such serious epidemics.

The Impact of a Global Pandemic on People Living with Dementia and Their Care Partners: Analysis of 417 Lived Experience Reports

Background:

The COVID-19 pandemic is impacting the physical and emotional health of older adults living with dementia and their care partners.

Objective:

Using a patient-centered approach, we explored the experiences and needs of people living with dementia and their care partners during the COVID-19 pandemic as part of an ongoing evaluation of dementia support services in British Columbia, Canada.

Methods:

A survey instrument was developed around the priorities identified in the context of the COVID-19 and Dementia Task Force convened by the Alzheimer Society of Canada.

Results:

A total of 417 surveys were analyzed. Overall, respondents were able to access information that was helpful for maintaining their own health and managing a period of social distancing. Care partners reported a number of serious concerns, including the inability to visit the person that they care for in long-term or palliative care. Participants also reported that the pandemic increased their levels of stress overall and that they felt lonelier and more isolated than they did before the pandemic. The use of technology was reported as a way to connect socially with their loved ones, with the majority of participants connecting with others at least twice per week.

Conclusion:

Looking at the complex effects of a global pandemic through the experiences of people living with dementia and their care partners is vital to inform healthcare priorities to restore their quality of life and health and better prepare for the future.

Effects of Age, Gender, Health Status, and Political Party on COVID-19-Related Concerns and Prevention Behaviors: Results of a Large, Longitudinal Cross-sectional Survey

Background

With conflicting information about COVID-19, the general public may be uncertain about how to proceed in terms of precautionary behavior and decisions about whether to return to activity.

Objective

The aim of this study is to determine the factors associated with COVID-19–related concerns, precautionary behaviors, and willingness to return to activity.

Methods

National survey data were obtained from the Democracy Fund + UCLA Nationscape Project, an ongoing cross-sectional weekly survey. The sample was provided by Lucid, a web-based market research platform. Three outcomes were evaluated: (1) COVID-19–related concerns, (2) precautionary behaviors, and (3) willingness to return to activity. Key independent variables included age, gender, race or ethnicity, education, household income, political party support, religion, news consumption, number of medication prescriptions, perceived COVID-19 status, and timing of peak COVID-19 infections by state.

Results

The data included 125,508 responses from web-based surveys conducted over 20 consecutive weeks during the COVID-19 pandemic (comprising approximately 6250 adults per week), between March 19 and August 5, 2020, approved by the University of California, Los Angeles (UCLA) Institutional Review Board for analysis. A substantial number of participants were not willing to return to activity even after the restrictions were lifted. Weighted multivariate logistic regressions indicated the following groups had different outcomes (all P<.001): individuals aged ≥65 years (COVID-19–related concerns: OR 2.05, 95% CI 1.93-2.18; precautionary behaviors: OR 2.38, 95% CI 2.02-2.80; return to activity: OR 0.41, 95% CI 0.37-0.46 vs 18-40 years); men (COVID-19–related concerns: OR 0.73, 95% CI 0.70-0.75; precautionary behaviors: OR 0.74, 95% CI 0.67-0.81; return to activity: OR 2.00, 95% CI 1.88-2.12 vs women); taking ≥4 medications (COVID-19–related concerns: OR 1.47, 95% CI 1.40-1.54; precautionary behaviors: OR 1.36, 95% CI 1.20-1.555; return to activity: OR 0.75, 95% CI 0.69-0.81 vs <3 medications); Republicans (COVID-19–related concerns: OR 0.40, 95% CI 0.38-0.42; precautionary behaviors: OR 0.45, 95% CI 0.40-0.50; return to activity: OR 2.22, 95% CI 2.09-2.36 vs Democrats); and adults who reported having COVID-19 (COVID-19–related concerns: OR 1.24, 95% CI 1.12-1.39; precautionary behaviors: OR 0.65, 95% CI 0.52-0.81; return to activity: OR 3.99, 95% CI 3.48-4.58 vs those who did not).

Conclusions

Participants’ age, party affiliation, and perceived COVID-19 status were strongly associated with their COVID-19–related concerns, precautionary behaviors, and willingness to return to activity. Future studies need to develop and test targeted messaging approaches and consider political partisanship to encourage preventative behaviors and willingness to return to activities.

Coping with the burden of the COVID-19 pandemic: a cross-sectional study of community pharmacists from Serbia

Background

Rapid spread of COVID-19 forced the public to turn to community pharmacies as the most accessible points of primary healthcare, overloading pharmacy services. The objectives of this research were to detect and describe the changes in work environment of community pharmacists in Vojvodina during the state of emergency due to COVID-19 pandemic. Moreover, the COVID-19 pandemic effects on job related stress were assessed.

Methods

Community pharmacists from Vojvodina completed an online questionnaire on work environment changes related to COVID-19 (cross-sectional study).

Results

Out of the 1574 licenced pharmacists in Vojvodina, 392 completed the survey. Workload increase, reported by 90.8% of pharmacists, was caused mostly by higher demand for safety equipment, antiseptics and disinfectants, dietary products and medicines. Most pharmacists (93.1%) considered pharmacy workflow to be more complex than before the pandemic. Clients’ behavior was described as less pleasant since the start of the pandemic by 67.6% of the community pharmacists. Many were concerned for their health and the health of their families (68.9%). Community pharmacists rated their stress levels higher if they i) were working in larger chains, ii) experienced clients’ behavior as less pleasant or/and iii) were concerned for their/their family health.

Conclusions

Current research pointed out the need for a more robust healthcare system which would allow rapid introduction of new activities and roles for community pharmacists that could possibly decrease job-related stress. Legal steps to improve the work environment in community pharmacies are necessary and urgent in order to fully utilize their skills and knowledge.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-06327-1.

Impact of a Serious Game (Escape COVID-19) on the Intention to Change COVID-19 Control Practices Among Employees of Long-term Care Facilities: Web-Based Randomized Controlled Trial

BACKGROUND

Most residents of long-term care facilities (LTCFs) are at high risk of complications and death following SARS-CoV-2 infection. In these facilities, viral transmission can be facilitated by shortages of human and material resources, which can lead to suboptimal application of infection prevention and control (IPC) procedures. To improve the dissemination of COVID-19 IPC guidelines, we developed a serious game called "Escape COVID-19" using Nicholson's RECIPE for meaningful gamification, as engaging serious games have the potential to induce behavioral change.

OBJECTIVE

As the probability of executing an action is strongly linked to the intention of performing it, the objective of this study was to determine whether LTCF employees were willing to change their IPC practices after playing "Escape COVID-19."

METHODS

This was a web-based, triple-blind, randomized controlled trial, which took place between November 5 and December 4, 2020. The health authorities of Geneva, Switzerland, asked the managers of all LTCFs under their jurisdiction to forward information regarding the study to all their employees, regardless of professional status. Participants were unaware that they would be randomly allocated to one of two different study paths upon registration. In the control group, participants filled in a first questionnaire designed to gather demographic data and assess baseline knowledge before accessing regular online IPC guidelines. They then answered a second questionnaire, which assessed their willingness to change their IPC practices and identified the reasons underlying their decision. They were then granted access to the serious game. Conversely, the serious game group played "Escape COVID-19" after answering the first questionnaire but before answering the second one. This group accessed the control material after answering the second set of questions. There was no time limit. The primary outcome was the proportion of LTCF employees willing to change their IPC practices. Secondary outcomes included the factors underlying participants' decisions, the domains these changes would affect, changes in the use of protective equipment items, and attrition at each stage of the study.

RESULTS

A total of 295 answer sets were analyzed. Willingness to change behavior was higher in the serious game group (82% [119/145] versus 56% [84/150]; P<.001), with an odds ratio of 3.86 (95% CI 2.18-6.81; P<.001) after adjusting for professional category and baseline knowledge, using a mixed effects logistic regression model with LTCF as a random effect. For more than two-thirds (142/203) of the participants, the feeling of playing an important role against the epidemic was the most important factor explaining their willingness to change behavior. Most of the participants unwilling to change their behavior answered that they were already applying all the guidelines.

CONCLUSIONS

The serious game "Escape COVID-19" was more successful than standard IPC material in convincing LTCF employees to adopt COVID-19-safe IPC behavior.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/25595.

Reliability and Quality of YouTube Contents Pertaining to Pancreatic Cancer

OBJECTIVE

In our study, we aim to evaluate in terms of patients the quality and reliability of the most relevant and most-watched videos uploaded on YouTube about pancreatic cancer.

METHOD

Before starting the study, YouTube^TM search terms were determined by consensus by two General Surgeons. Then, on 10/10/2020, the terms such as "pancreatic cancer", "diagnosis of pancreatic cancer" and "treatment of pancreatic cancer" were entered separately in the search bar of YouTube, "relevance" was selected among the filtering options and the most viewed videos were listed. The videos were evaluated with the Global Quality Scale (GQS), the DISCERN scoring system (Quality Criteria for Consumer Health Information, http://www.discern.org.uk), and video power index.

RESULTS

 Among the 50 videos analysed, 19 videos were uploaded by hospital channels, 17 videos by health channels, seven videos by patients, four videos by blog channels, and three videos by doctors. The mean GQS score of the first researcher was 3.24 ± 0.99 and the mean GQS score of the second researcher was 3.18 ± 0.88 with a significantly high agreement between them (r= 0.628). The mean DISCERN score of the first researcher was 3.48 ± 0.77 and the mean DISCERN score of the second researcher was 3.46 ± 1.09 with a significantly high agreement between them (r= 0.814).

CONCLUSION

 In our study, the majority of the videos were found to be of moderate quality. Healthcare professionals should be encouraged to upload more videos with useful content. However, we think that the uploaded videos should definitely go through a professional peer-review process before they are published.

Use of bot and content flags to limit the spread of misinformation among social networks: a behavior and attitude survey

The COVID-19 infodemic is driven partially by Twitter bots. Flagging bot accounts and the misinformation they share could provide one strategy for preventing the spread of false information online. This article reports on an experiment (N = 299) conducted with participants in the USA to see whether flagging tweets as coming from bot accounts and as containing misinformation can lower participants’ self-reported engagement and attitudes about the tweets. This experiment also showed participants tweets that aligned with their previously held beliefs to determine how flags affect their overall opinions. Results showed that flagging tweets lowered participants’ attitudes about them, though this effect was less pronounced in participants who frequently used social media or consumed more news, especially from Facebook or Fox News. Some participants also changed their opinions after seeing the flagged tweets. The results suggest that social media companies can flag suspicious or inaccurate content as a way to fight misinformation. Flagging could be built into future automated fact-checking systems and other misinformation abatement strategies of the social network analysis and mining community.

Vaccination strategies against COVID-19 and the diffusion of anti-vaccination views

Misinformation is usually adjusted to fit distinct narratives and propagates rapidly through social networks. False beliefs, once adopted, are rarely corrected. Amidst the COVID-19 crisis, pandemic-deniers and people who oppose wearing face masks or quarantine have already been a substantial aspect of the development of the pandemic. With the vaccine for COVID-19, different anti-vaccine narratives are being created and are probably being adopted by large population groups with critical consequences. Assuming full adherence to vaccine administration, we use a diffusion model to analyse epidemic spreading and the impact of different vaccination strategies, measured with the average years of life lost, in three network topologies (a proximity, a scale-free and a small-world network). Then, using a similar diffusion model, we consider the spread of anti-vaccine views in the network, which are adopted based on a persuasiveness parameter of anti-vaccine views. Results show that even if anti-vaccine narratives have a small persuasiveness, a large part of the population will be rapidly exposed to them. Assuming that all individuals are equally likely to adopt anti-vaccine views after being exposed, more central nodes in the network, which are more exposed to these views, are more likely to adopt them. Comparing years of life lost, anti-vaccine views could have a significant cost not only on those who share them, since the core social benefits of a limited vaccination strategy (reduction of susceptible hosts, network disruptions and slowing the spread of the disease) are substantially shortened.

Experiences of Australian podiatrists working through the 2020 coronavirus (COVID-19) pandemic: an online survey

Background

On the 19th of January, 2020, the Chief Medical Officer of Australia issued a statement about a novel coronavirus, or SARS-CoV-2. Since this date, there have been variable jurisdictional responses, including lockdowns, and restrictions on podiatry practice. This study aimed to describe impacts of the SARS-CoV-2 pandemic on the podiatry profession in Australia.

Methods

This was a cross sectional study of Australian podiatrists using demographic data collected between 2017 and 2020, and pandemic-related question responses collected between 30th March and 31st August, 2020. Data were collected online and participants described their work settings, patient funding types, business decisions and impacts, and information sources used to guide practice decisions during this time-period. Inductive thematic analysis was used to analyse open-ended questions about their practice impact of SARS-CoV-2.

Results

There were 732 survey responses, with 465 Australian podiatrists or podiatric surgeons providing responses describing pandemic impact. From these responses, 223 (49% of 453) podiatrists reported no supply issues, or having adequate supplies for the foreseeable future with personal protective equipment (PPE) or consumables to support effective infection prevention and control. The most frequent responses about employment, or hours of work, impact were reported in the various categories of “business as usual” (n = 312, 67%). Participants described most frequently using the local state and territory Department of Health websites (n = 347, 75%), and the Australian Podiatry Association (n = 334, 72%) to make decisions about their business. Overarching themes which resounded through open-ended comments was that working through the pandemic was likened to a marathon, and not a sprint. Themes were: (i) commitment to do this, (ii) it’s all in the plan, but not everything goes to plan, (iii) my support team must be part of getting through it, (iv) road blocks happen, and (v) nothing is easy, what’s next?

Conclusion

Podiatrists in Australia reported variable pandemic impact on their business decisions, PPE stores, and their valued sources of information. Podiatrists also described their “marathon” journey through the pandemic to date, with quotes describing their challenges and highlights. Describing these experiences should provide key learnings for future workforce challenges, should further restrictions come into place.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13047-021-00449-9.

Succumbing to the COVID-19 Pandemic-Healthcare Workers Not Satisfied and Intend to Leave Their Jobs

Healthcare workers are under such a tremendous amount of pressure during the COVID-19 pandemic that many have become concerned about their jobs and even intend to leave them. It is paramount for healthcare workers to feel satisfied with their jobs and lives during a pandemic. This study aims to examine the predictors of job satisfaction, life satisfaction, and turnover intention of healthcare workers during the COVID-19 pandemic. Between 10 and 30 April 2020, 240 healthcare workers in Bolivia completed a cross-sectional online survey, which assessed their job satisfaction, life satisfaction, and turnover intention in the ongoing COVID-19 pandemic. The results revealed that their number of office days predicted job satisfaction, life satisfaction, and turnover intention, but the relationships varied by their age. For example, healthcare workers’ office days negatively predicted job satisfaction for the young (e.g., at 25 years old: b = − 0.21; 95% CI: − 0.36 to − 0.60) but positively predicted job satisfaction for the old (e.g., at 65 years old: b = 0.25; 95% CI: 0.06 to 0.44). These findings provide evidence to enable healthcare organizations to identify staff concerned about job satisfaction, life satisfaction, and turnover intention to enable early actions so that these staffs can remain motivated to fight the prolonged COVID-19 pandemic.

Healthcare professionals' acts of correcting health misinformation on social media

BACKGROUND

Health misinformation on social media is a public health concern, and healthcare professionals can help correct it. However, research on how they correct health misinformation on social media is rare.

OBJECTIVE

To develop a conceptual model that demonstrates how healthcare professionals correct health misinformation on social media.

METHODS

In-depth semi-structured interviews were conducted between January and March 2020 with 30 U.S. healthcare professionals (15 registered nurses and 15 medical doctors). Participants were recruited through purposive and snowball sampling and interviewed via mobile phone calls (using their mobile phone number) or apps (via Zoom or Skype). Interview data were analyzed using a grounded theory approach.

RESULTS

This study presents a two-phased conceptual model that shows healthcare professionals' acts of correcting health misinformation on social media (e.g., Twitter and Facebook). The first phase involves acts of authentication by which healthcare professionals verify health-related social media posts to be true or not. They undergo the process of internal acts of authentication (i.e., checking the author, checking for cues, checking the topic) and, if needed, external acts of authentication (i.e., examining the author and examining the content). When social media posts are deemed to contain health misinformation, they proceed to the second phase - acts of correction. In this phase, they undergo correction preparation (i.e., reflect, reveal, relate, and respect) and correction dissemination (i.e., private priming, public priming, public rebuttal, and private rebuttal).

CONCLUSIONS

The study proposed a conceptual model that shows how healthcare professionals correct health misinformation on social media. The findings can guide healthcare professionals when identifying and correcting health misinformation on and off social media, and can guide health authorities when developing campaigns against health misinformation.

Notícias falsas em tempos de pandemia pelo novo coronavírus: uma análise documental

Introdução: A infodemia, ou fluxo elevado de informações, apresenta comportamento similar aos vírus, disseminam-se de pessoa a pessoa e representam um novo desafio às autoridades de saúde. Objetiva-se analisar as notícias falsas veiculadas no contexto da pandemia pelo novo coronavírus. Materiais e métodos: Pesquisa documental realizada com base no portal de notícias do Ministério da Saúde do Brasil intitulado "Saúde sem Fake News". Foram identificadas as publicações ocorridas de dezembro/2019 a março/2020, por meio das seguintes palavras-chave: coronavírus e COVID-19. Para a apreciação dos dados, foi adotada a análise de conteúdo proposta por Bardin. Resultados: Foram identificadas 66 publicações, com o total de 92 fake news. A análise revelou as características comuns às fake news, dentre elas: manchetes e imagens chamativas, dados alarmantes e disseminação cíclica. Além disso, as mídias sociais despontaram como importante via de disseminação e, para conferir efeito de verdade ao dito, a atribuição da autoria a órgãos ou profissionais da saúde foi comum. As notícias foram categorizadas em seis grupos temáticos: métodos para prevenção (32,6%) e história natural da doença (28,2%) foram os mais frequentes. Discussão: Observa-se o interesse crescente por temas relacionados à disseminação de informações sobre o novo coronavírus e as investigações ao redor do mundo destacam a importância da atuação do Governo e dos órgãos da saúde na identificação e combate às notícias falsas. Conclusões: As fake news relacionadas ao novo coronavírus ameaçam a saúde individual e coletiva, abordam temáticas diversas e apresentam potencial de dano à saúde física e mental.

The Need for Ongoing Antimicrobial Stewardship during the COVID-19 Pandemic and Actionable Recommendations

The coronavirus disease (COVID-19) pandemic, which has significant impact on global health care delivery, occurs amid the ongoing global health crisis of antimicrobial resistance. Early data demonstrated that bacterial and fungal co-infection with COVID-19 remain low and indiscriminate use of antimicrobials during the pandemic may worsen antimicrobial resistance It is, therefore, essential to maintain the ongoing effort of antimicrobial stewardship activities in all sectors globally.

Infodemia: Another Enemy for Romanian Frontline Healthcare Workers to Fight during the COVID-19 Outbreak

Background and Objectives: The population has been overwhelmed with false information related to the Coronavirus disease (COVID-19) crisis, spreading rapidly through social media and other channels. We aimed to investigate if frontline healthcare workers affected by infodemia show different psychological consequences than frontline clinicians who do not declare to be affected by false news related to the COVID-19 pandemic. Materials and Methods: One hundred twenty-six frontline healthcare workers from the Intensive Care Unit (ICU) and Emergency Departments in Romania completed a survey to assess stress, depression, anxiety, and sleep disorders, between March and April 2020. We split the sample of frontline healthcare workers into two groups based on the self-evaluated criteria: if they were or were not affected by infodemia in their activity. Results: Considering limitations such as the cross-sectional design, the lack of causality relationship, and the sample size, the results show that, the frontline medical workers who declared to be affected by false news were significantly more stressed, felt more anxiety, and suffered more from insomnia than healthcare workers who are not affected by false information related to pandemic time. Conclusions: The infodemia has significant psychological consequences such as stress, anxiety, and insomnia on already overwhelmed doctors and nurses in the outbreak of the COVID-19 crisis. These findings suggest that medical misinformation’s psychological implications must be considered when different interventions regarding frontline healthcare workers during the COVID-19 pandemic are implemented.

Individual differences in susceptibility to false memories for COVID-19 fake news

Exposure to 'fake news' can result in false memories, with possible consequences for downstream behaviour. Given the sharp rise in online misinformation during the coronavirus pandemic, it is important to understand the factors that influence the development of false memories. The present study measured susceptibility to false memories following exposure to fabricated news stories about the pandemic in a sample of 3746 participants. We investigated the effect of individual differences in (1) knowledge about COVID-19, (2) engagement with media or discussion about the coronavirus, (3) anxiety about COVID-19 and (4) analytical reasoning. Notably, objectively and subjectively assessed knowledge about COVID-19 were not significantly correlated. Objectively assessed knowledge was associated with fewer false memories but more true memories, suggesting a true discrimination between true and fake news. In contrast, participants who merely believed themselves to be very knowledgeable were more likely to report a memory for true stories, but showed no reduction in false memories. Similarly, individuals who reported high levels of media engagement or anxiety about COVID-19 reported an increase in true (but not false) memories. Finally, higher levels of analytical reasoning were associated with fewer memories for both true and fabricated stories, suggesting a stricter threshold for reporting a memory for any story. These data indicate that false memories can form in response to fake COVID-19 news and that susceptibility to this misinformation is affected by the individual's knowledge about and interaction with COVID-19 information, as well as their tendency to think critically.

The changes in the effects of social media use of Cypriots due to COVID-19 pandemic

Social media is the leading medium which is used for communication during the COVID-19 pandemic. The research conducted aims to fill the gap of literature related to social media use during the COVID-19 pandemic. This research aims at uncovering the influences of social media use in several dimensions during lockdown(s). The study aims to answer the research question of: Are the influences of social media use different from normal times? The online questionnaire has been completed by six hundred and sixty-eight users within the period of lockdown. The author prepared the questionnaire, which is composed of 22 positive statements in order to evaluate the effects of social media use during the COVID-19 pandemic. A 5 point Likert scale was used, where reliability and validity were calculated by the Cronbach's alpha value, which was 0.751. Findings highlight that users have more information about COVID-19, and they follow recent information via social media, which shows the shift towards digital medium. Findings also indicate that users are aware of fake news, and they follow official sources. Social media is powerful to affect decision-makers, and respondents' social media use did not create any panic or anxiety amongst them. This research indicates that respondents' social media use during COVID-19 is different from normal times as a common purpose triggers this, survival. Before the COVID-19 pandemic, most of social media shares were like a dream or a strong desire that may cause anxiety in others. During the pandemic, people are in lockdown and share similar feelings and follow similar behavioural patterns. As there is a common purpose and struggle via users, psychological well-being is not affected negatively.

Genèse d’un site d’information sur le bon usage du médicament au cours de la pandémie

Dans le contexte de la Covid-19, la Société française de pharmacologie et de thérapeutique a ouvert, dès le 17 mars 2020, un site de questions-réponses pour répondre de façon claire et fiable aux interrogations des patients concernant le traitement de leurs pathologies chroniques, informer le grand public sur le bon usage du médicament et lutter contre la désinformation. Le 13 mai, 152 questions-réponses étaient publiées et mises à jour sur ce site qui avait reçu plus de 154 000 visites en deux mois.

Proliferation of Papers and Preprints During the Coronavirus Disease 2019 Pandemic: Progress or Problems With Peer Review?

The coronavirus disease 2019 (COVID-19) pandemic has spread exponentially throughout the world in a short period, aided by our hyperconnected world including global trade and travel. Unlike previous pandemics, the pace of the spread of the virus has been matched by the pace of publications, not just in traditional journals, but also in preprint servers. Not all publication findings are true, and sifting through the firehose of data has been challenging to peer reviewers, editors, as well as to consumers of the literature, that is, scientists, healthcare workers, and the general public. There has been an equally exponential rise in the public discussion on social media. Rather than decry the pace of change, we suggest the nephrology community should embrace it, making deposition of research into preprint servers the default, encouraging prepublication peer review more widely of such preprint studies, and harnessing social media tools to make these actions easier and seamless.

The "Pandemic" of Disinformation in COVID-19

In recent years, mass media and social networks have played an important role in disseminating information regarding public health. During the COVID-19 epidemic, misinformation and fake news have represented an important issue generating confusion and insecurity among the population. In our analysis, we investigate the role of mass media as a critical element during the SARS-CoV-2 outbreak that has influenced the public perception of risk.