Donald Trump: a political determinant of covid-19

Presidents and vaccines: head of state inoculation as a tool for vaccine promotion

Introduction

Vaccine hesitancy, an important threat to global health, has increased since the onset of the COVID-19 pandemic. The public vaccination of high-profile figures, such as heads of state, has been touted as a potential tool for increasing vaccine acceptance among the general population. However, systematic information on such role modelling is lacking and existing studies focus on a small number of high-income countries. We take advantage of the COVID-19 pandemic to fill this gap.

Methods

Through a systematic search of internet sources, we first document that most global leaders supported the vaccination campaign and actively communicated their vaccination status to the public. We then turn to a case study to provide experimental evidence on vaccine role modelling for a country in Africa - the region that is most lagging behind in achieving universal immunization coverage. We rely on a randomized survey experiment with 600 citizens in the Democratic Republic of Congo and take advantage of the fact that the Congolese President publicly received a COVID-19 vaccine during the survey period.

Results and discussion

Our findings demonstrate that the impact of political leader's role modelling is moderated by trust and depends on media outreach and access. When trust in leaders is lacking, or news on their actions is inaccessible, alternative ambassadors and effective communication methods become crucial in motivating and informing the public. This may be especially relevant in fragile states and remote regions.

A Content Analysis of Indoor Tanning Twitter Chatter During COVID-19 Shutdowns: Cross-Sectional Qualitative Study

BACKGROUND

Indoor tanning is a preventable risk factor for skin cancer. Statewide shutdowns during the COVID-19 pandemic resulted in temporary closures of tanning businesses. Little is known about how tanners reacted to losing access to tanning businesses.

OBJECTIVE

This study aimed to analyze Twitter (subsequently rebranded as X) chatter about indoor tanning during the statewide pandemic shutdowns.

METHODS

We collected tweets from March 15 to April 30, 2020, and performed a directed content analysis of a random sample of 20% (1165/5811) of tweets from each week. The 2 coders independently rated themes (κ=0.67-1.0; 94%-100% agreement).

RESULTS

About half (589/1165, 50.6%) of tweets were by people unlikely to indoor tan, and most of these mocked tanners or the act of tanning (562/589, 94.9%). A total of 34% (402/1165) of tweets were posted by users likely to indoor tan, and most of these (260/402, 64.7%) mentioned missing tanning beds, often citing appearance- or mood-related reasons or withdrawal. Some tweets by tanners expressed a desire to purchase or use home tanning beds (90/402, 22%), while only 3.9% (16/402) mentioned tanning alternatives (eg, self-tanner). Very few tweets (29/1165, 2.5%) were public health messages about the dangers of indoor tanning.

CONCLUSIONS

Findings revealed that during statewide shutdowns, half of the tweets about indoor tanning were mocking tanning bed users and the tanned look, while about one-third were indoor tanners reacting to their inability to access tanning beds. Future work is needed to understand emerging trends in tanning post pandemic.

COVID-19 health information trust and prejudicial attitudes predict healthcare disruptions in the first year of COVID-19 among people living with HIV

Cross-sectional studies have reported that people living with HIV experienced disruptions to social relationships and healthcare during the first year of the COVID-19 pandemic. Furthermore, individuals with less trust in public health sources of COVID-19 information as well as those who held greater COVID-19 prejudicial attitudes experienced greater healthcare disruptions in the early months of COVID-19. To examine changes in trust and prejudicial attitudes in relation to healthcare disruptions during the first year of COVID-19, we followed a closed cohort of 115 men and 26 women ages 18 to 36 living with HIV over the first year of the COVID-19 pandemic. Findings confirmed that a majority of individuals continued to experience disruptions to their social relationships and healthcare over the course of the first year of COVID-19. In addition, trust in COVID-19 information from the CDC and state health department diminished over the year as did COVID-19 prejudicial attitudes. Regression models showed that lower trust in the CDC and health department and greater prejudicial attitudes toward COVID-19 early in the pandemic predicted greater healthcare disruptions over the year. In addition, greater trust in the CDC and health department early in COVID-19 predicted better antiretroviral therapy adherence later in the year. Results support an urgent need to regain and sustain trust in public health authorities among vulnerable populations.

Public health leadership in the COVID-19 era: how does it fit? A scoping review

The COVID-19 pandemic has put a lot of pressure on all the world's health systems and public health leaders who have often found themselves unprepared to handle an emergency of this magnitude. This study aims to bring together published evidence on the qualities required to leaders to deal with a public health issue like the COVID-19 pandemic. This scoping literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. A search of relevant articles was performed in the PubMed, Scopus and Web of Science databases. A total of 2499 records were screened, and 45 articles were included, from which 93 characteristics of effective leadership were extrapolated and grouped into 6 clusters. The qualities most frequently reported in the articles were human traits and emotional intelligence (46.7%) and communication skills such as transparency and reliability (48.9%). Responsiveness and preparedness (40%), management skills (33.3%) and team working (35.6%) are considered by a significant percentage of the articles as necessary for the construction of rapid and effective measures in response to the emergency. A considerable proportion of articles also highlighted the need for leaders capable of making evidence-based decisions and driving innovation (31.1%). Although identifying leaders who possess all the skills described in this study appears complex, determining the key characteristics of effective public health leadership in a crisis, such as the COVID-19 pandemic, is useful not only in selecting future leaders but also in implementing training and education programmes for the public health workforce.

The politicized pandemic: Ideological polarization and the behavioral response to COVID-19

In a representative sample of the U.S. population during the first summer of the COVID-19 pandemic, we investigate how prosociality and ideology interact in their relationship with health-protecting behavior and trust in the government to handle the crisis. We find that an experimental measure of prosociality based on standard economic games positively relates to protective behavior. Conservatives are less compliant with COVID-19-related behavioral restrictions than liberals and evaluate the government's handling of the crisis significantly more positively. We show that prosociality does not mediate the impact of political ideology. This finding means that conservatives are less compliant with protective health guidelines - independent of differences in prosociality between both ideological camps. Behavioral differences between liberals and conservatives are roughly only one-fourth of the size of their differences in judging the government's crisis management. This result suggests that Americans were more polarized in their political views than in their acceptance of public health advice.

Conspiracies, Misinformation and Resistance to Public Health Measures During COVID-19 in White Nationalist Online Communication

Recent studies documented alarming growth in antiscientific discourse among extremist groups online and especially the relatively high anti-vaccine attitudes among White Nationalists (WN). In light of accelerated politization of COVID-19 containment measures and the expansion of containment to lockdowns, masking, and more, we examine current sentiment, themes and argumentation in white nationalist discourse, regarding the COVID-19 vaccines and other containment measure. We use unsupervised machine learning approaches to analyze all conversations posted in the “Covid-19” sub-forum on Stormfront between January 2020 and December 2021 (N = 9642 posts). Additionally, we manually analyze sentiment and argumentation in 300 randomly sampled posts. We identified four discursive themes: Science, Conspiracies, Sociopolitical, and Containment. Anti-containment sentiment was substantially higher than what was found in prior work done before COVID-19regarding vaccines and other containment measures. The negativity was driven mostly by arguments adapted from the anti-vaccine movement and not by WN ideology.

Between rules and resistance: moving public health emergency responses beyond fear, racism and greed

In times of a public health emergency, lawyers and ethicists play a key role in ensuring that government responses, such as travel restrictions, are both legally and ethically justified. However, when travel bans were imposed in a broadly discriminatory manner against southern African countries in response to the Omicron SARS-CoV-2 variant in late 2021, considerations of law, ethics or science did not appear to guide politicians' decisions. Rather, these bans appeared to be driven by fear of contagion and electoral blowback, economic motivations and inherently racist assumptions about low-income and middle-income countries (LMICs). With a new pandemic treaty and amendments to the WHO's International Health Regulations (IHR) on the near-term horizon, ethics and international law are at a key inflection point in global health governance. Drawing on examples of bordering practices to contain contagion in the current pandemic and in the distant past, we argue that the current IHR is not adequately constructed for a just and equitable international response to pandemics. Countries impose travel restrictions irrespective of their need or of the health and economic impact of such measures on LMICs. While the strengthening and reform of international laws and norms are worthy pursuits, we remain apprehensive about the transformative potential of such initiatives in the absence of collective political will, and suggest that in the interim, LMICs are justified in seeking strategic opportunities to play the same stark self-interested hardball as powerful states.

Mistrust in public health institutions is a stronger predictor of vaccine hesitancy and uptake than Trust in Trump

STUDY GOAL

This study examines the sources of COVID-19 vaccine hesitancy and refusal in Americans by decomposing different forms of government trust/mistrust including trust in Trump and mistrust in public health institutions.

METHODS

Using linear panel regression models with data from 5,446 US adults (37,761 responses) from the Understanding America Survey, the likelihoods of vaccine hesitancy, uptake, and trust in various information sources were examined.

RESULTS AND CONCLUSION

We find that the likelihoods of hesitancy and having negative perceptions of COVID-19 vaccines were consistently much higher among PHI mistrusters, showing even a stronger hesitancy than Trump trusters. This tendency has persisted over time, resulting in only 49% of PHI mistrusters having been vaccinated in the most recent survey wave. However, a large portion of PHI mistrusters still trusted physicians, family, and friends. These findings suggest that mistrust in PHIs is a salient predictor of vaccine hesitancy and reduced uptake on its own, which is compounded by trust in Trump.

Assessing the effectiveness of COVID-19 vaccine lotteries: A cross-state synthetic control methods approach

Vaccines are the most effective means at combating sickness and death caused by COVID-19. Yet, there are significant populations within the United States who are vaccine-hesitant, some due to ideological or pseudo-scientific motivations, others due to significant perceived and real costs from vaccination. Given this vaccine hesitancy, twenty state governors from May 12th to July 21st 2021 implemented some form of vaccination lottery aiming to increase low vaccination rates. In the aftermath of these programs, however, the critical question of whether these lotteries had a direct effect on vaccination remains. Previous literature on financial incentives for public health behaviors is consistent: Financial incentives significantly increase incentivized behaviors. Yet, work done specifically on state vaccine lotteries is both limited in scope and mixed in its conclusions. To help fill this gap in the literature, we use synthetic control methods to analyze all 20 states and causally identify, for eighteen states, the effects of their lotteries on both first-dose and complete vaccination rates. Within those eighteen states, we find strong evidence that all but three states’ lotteries had positive effects on first-dose vaccination. We find for complete vaccinations, however, over half the states analyzed had negative or null effects. We explore possibilities related to these mixed results including the states’ overall partisanship, vaccine hesitancy, and the size of their lotteries finding null effects for each of these explanations. Therefore, we conclude that the design of these programs is likely to blame: Every state lottery only incentivized first-doses with no additional or contingent incentive based on a second dose. Our findings suggest that the design of financial incentives is critical to their success, or failure, but generally, these programs can induce an uptake in vaccination across diverse demographic, ideological, and geographic contexts in the United States.

Trust in COVID-19 public health information

Understanding the factors that influence trust in public health information is critical for designing successful public health campaigns during pandemics such as COVID-19. We present findings from a cross-sectional survey of 454 US adults-243 older (65+) and 211 younger (18-64) adults-who responded to questionnaires on human values, trust in COVID-19 information sources, attention to information quality, self-efficacy, and factual knowledge about COVID-19. Path analysis showed that trust in direct personal contacts (B = 0.071, p = .04) and attention to information quality (B = 0.251, p < .001) were positively related to self-efficacy for coping with COVID-19. The human value of self-transcendence, which emphasizes valuing others as equals and being concerned with their welfare, had significant positive indirect effects on self-efficacy in coping with COVID-19 (mediated by attention to information quality; effect = 0.049, 95% CI 0.001-0.104) and factual knowledge about COVID-19 (also mediated by attention to information quality; effect = 0.037, 95% CI 0.003-0.089). Our path model offers guidance for fine-tuning strategies for effective public health messaging and serves as a basis for further research to better understand the societal impact of COVID-19 and other public health crises.

Institutional development and the government response to COVID-19 in China

As COVID-19 is pervasive across the globe, governments in different countries face the dilemma of restricting the transmission risk of the virus by social distancing while yet maintaining economic activity. Inadequate social distancing policies lead to more infection cases and deaths, while over stringent social distancing policies have significant economic cost implications. This study investigates the role of local government institutions in striking the balance between saving lives and economic recovery. We based our study on a sample of 28 provincial governments in China during the early outbreak of 2020 when the emergency responses of local governments were synchronous. The findings show that local governments in those provinces with lower degrees of marketization, which were accustomed to directly intervene in the social system, mandatorily quarantined many more close contacts for each confirmed case than those in the more market-oriented provinces whose social distancing policies took economic considerations into account. The 'overdone' (over stringent) social distancing policies in the more state-oriented provinces led to lower human mobility and economic growth. This study highlights the importance of taking economic considerations into account when adopting policies and strategies to combat the spread of COVID-19 and how different institution management cultures lead to different outcomes.

The role of social media during the COVID-19 pandemic: Salvaging its 'power' for positive social behaviour change in Africa

The ongoing coronavirus disease 2019 (COVID-19) pandemic remains a significant global public health crisis. The unique evolution of the COVID-19 pandemic has seen social media emerging and growing into an important vehicle for rapid information dissemination. This has in turn given rise to multiple sources of information, leading to what has come to be known as ‘infodemic’, associated with the plethora of misinformation and conspiracy theories. In this perspective, we explore the growth of the social media industry and the impact it has had during the ongoing COVID-19 crisis. We argue that while the multiple information pieces circulating on social media cause misinformation and panic, this might not necessarily and in all the cases influence sustained behaviours in the target population groups. We offer suggestions on how the power of social media can be harnessed and integrated into social and public health for a better digital balance for communication for development.

Not "My" crisis: Social identity and followers' crisis responses to COVID-19

Operationalizing social group identification as political partisanship, we examine followers' (i.e., US residents') affective experiences and behavioral responses during the initial COVID-19 outbreak in the United States (March to May 2020). In Study 1, we conducted content analyses on major news outlets' coverage of COVID-19 (N = 4319) to examine media polarization and how it plays a role in shaping followers' perceptions of the pandemic and leadership. News outlets trusted by Republicans portrayed US President Donald Trump as more effective, conveyed a stronger sense of certainty with less negative affective tone, and had a lower emphasis on COVID-19 prevention compared to outlets trusted by Democrats. We then conducted a field survey study (Study 2; N = 214) and found that Republicans perceived Trump as more effective, experienced higher positive affect, and engaged in less COVID-19 preventive behavior compared to Democrats. Using a longitudinal survey design in Study 3 (N = 251), we examined how emotional responses evolved in parallel with the pandemic and found further support for Study 2 findings. Collectively, our findings provide insight into the process of leadership from a social identity perspective during times of crisis, illustrating how social identity can inhibit mobilization of united efforts. The findings have implications for leadership of subgroup divides in different organizational and crisis contexts.

COVID-19, Querdenker und wissenschaftliche Fake News – Wann ist genug genug?

Die COVID-19-Pandemie ist die stärkste Pandemie seit der Spanischen Grippe vor 100 Jahren. Seit Ende 2019 hat SARS-CoV-2 über 5 Millionen Menschen getötet und weit über 200 Millionen infiziert 1. Aber anders als die Spanische Grippe findet die COVID-19-Pandemie in unserem modernen und vernetzten Zeitalter statt. Wir sind mit anderen Menschen auf dieser Welt vernetzt und können Informationen innerhalb von Sekunden international austauschen. Dadurch ist unser Planet spürbar kleiner geworden, und Entfernungen, die zur Zeit der Spanischen Grippe imposant erschienen, sind heute deutlich geringer. Aber gerade die aktuelle Pandemie zeigt auch, dass diese Entwicklung nicht nur positiv ist. Seit der Pandemie haben Fake News und Pseudowissenschaft einen Boom erlebt, der mittlerweile mehr als nur beunruhigend ist. So wurde das Virus schnell politisiert. Vor allem rechtskonservative Kreise nutzten den Ausbruch für ihre Zwecke. Der ehemalige US-Präsident Donald Trump nutzte das Virus für seinen zweiten Wahlkampf und verbreitete zum Teil gefährliche Falschaussagen 2. So pries er beispielsweise Bleich- und Desinfektionsmittel als mögliche Heilmittel an. Als Folge dieser Aussagen stieg die Zahl der Notrufe beim U.S. Poison Control Center deutlich an. Doch die Folgen, die Fake News über COVID-19 auslösen, gehen weit über medizinische Notrufe hinaus. Vor allem der Begriff „China-Virus“ in Verbindung mit verschiedenen Verschwörungstheorien über die mögliche Herkunft des Virus aus dem Labor führte zu einem deutlichen Anstieg der antiasiatischen Fremdenfeindlichkeit. Asiatische Bürger in verschiedenen Ländern (unabhängig von einer möglichen chinesischen Herkunft) sahen sich mit Vorurteilen und Rassismus konfrontiert, die in einigen Fällen weit über Beleidigungen hinausgingen 3 4. So wurde Asiaten beispielsweise der Zutritt zu Geschäften und Restaurants aufgrund ihrer Herkunft verweigert. Diese Entwicklung war nicht auf ländliche oder abgelegene Gebiete beschränkt, sondern betraf auch größere Städte. Ein Beispiel ist die deutsche Stadt Düsseldorf, wo Asiaten zu Beginn der Pandemie Hausverbot erhielten. Dies ist besonders bemerkenswert, weil Düsseldorf für seine Nähe zu asiatischem Leben und asiatischer Kultur bekannt ist. So leben beispielsweise 59% aller japanischen Einwohner in Nordrhein-Westfalen in Düsseldorf. Dieses Beispiel einer asienfreundlichen Stadt zeigt, wie akut dieses Problem zu Beginn der Pandemie war.

Exploring the socioeconomic drivers of COVID-19 mortality across various spatial regimes

Identifying the socioeconomic drivers of COVID-19 deaths is essential for designing effective policies and health interventions. However, how the significance and impact of these factors varies across different spatial regimes has been scantly explored. In this ecological cross-sectional study, we apply the spatial lag by regimes regression model to examine how the socioeconomic and health determinants of COVID-19 death rate vary across (a) metropolitan vs. non-metropolitan, (b) shelter-in-place vs. no-shelter-in-place order, and (c) Democratic vs. Republican US counties. A total of 20 variables were studied across 3108 counties in the contiguous US for the first year of the pandemic (6 February 2020 to 5 February 2021). The results show that the COVID-19 death rate not only depends on a complex interplay of the population demographic, socioeconomic and health-related characteristics, but also on the spatial regime that the residents live, work and play. Household median income, household size, percentage of African Americans, percentage aged 40-59 and heart disease mortality are significant to metropolitan but not to non-metropolitan counties. We identified lack of insurance access as a significant driver across all regimes except for Democratic. We also showed that the political orientation of the governor might have impacted COVID-19 death rates due to the public response (i.e., shelter-in-place vs. no-shelter-in-place order). The proposed analysis allows for understanding the socioeconomic context in which public health policies can be applied, and importantly, it presents how COVID-19 death related factors vary across different spatial regimes.

How national leaders keep 'us' safe: A longitudinal, four-nation study exploring the role of identity leadership as a predictor of adherence to COVID-19 non-pharmaceutical interventions

OBJECTIVES

To investigate whether citizens' adherence to health-protective non-pharmaceutical interventions (NPIs) during the COVID-19 pandemic is predicted by identity leadership, wherein leaders are perceived to create a sense of shared national identity.

DESIGN

Observational two-wave study. Hypotheses testing was conducted with structural equation modelling.

SETTING

Data collection during the COVID-19 pandemic in China, Germany, Israel and the USA in April/May 2020 and four weeks later.

PARTICIPANTS

Adults in China (n=548, 66.6% women), Germany (n=182, 78% women), Israel (n=198, 51.0% women) and the USA (n=108, 58.3% women).

MEASURES

Identity leadership (assessed by the four-item Identity Leadership Inventory Short-Form) at Time 1, perceived shared national identification (PSNI; assessed with four items) and adherence to health-protective NPIs (assessed with 10 items that describe different health-protective interventions; for example, wearing face masks) at Time 2.

RESULTS

Identity leadership was positively associated with PSNI (95% CI 0.11 to 0.30, p<0.001) in all countries. This, in turn, was related to more adherence to health-protective NPIs in all countries (95% CI 0.03 to 0.36, 0.001≤p≤0.017) except Israel (95% CI -0.03 to 0.27, p=0.119). In Germany, the more people saw Chancellor Merkel as engaging in identity leadership, the more they adhered to health-protective NPIs (95% CI 0.04 to 0.18, p=0.002). In the USA, in contrast, the more people perceived President Trump as engaging in identity leadership, the less they adhered to health-protective NPIs (95% CI -0.17 to -0.04, p=0.002).

CONCLUSIONS

National leaders can make a difference by promoting a sense of shared identity among their citizens because people are more inclined to follow health-protective NPIs to the extent that they feel part of a united 'us'. However, the content of identity leadership (perceptions of what it means to be a nation's citizen) is essential, because this can also encourage people to disregard such recommendations.

Exposure Effects or Confirmation Bias? Examining Reciprocal Dynamics of Misinformation, Misperceptions, and Attitudes Toward COVID-19 Vaccines

This longitudinal study integrates exposure effects and confirmation bias under the theoretical framework of dynamic motivation activation (DMA) to examine the dynamic reciprocity of misinformation, misperceptions, and attitudes in the context of COVID-19 vaccination. Results from a three- national survey showed that misinformation exposure, misperceptions, and attitudes toward COVID-19 vaccines reinforced themselves over time. Further, misperceptions reduced subsequent pro-vaccine attitudes, and pro-vaccine attitudes in turn decreased subsequent misperceptions. Longitudinal mediation analysis also indicated that attitudes reinforced themselves through misperceptions. Surprisingly, we did not find a significant impact of misinformation exposure on subsequent misperceptions or effects of attitudes on subsequent misinformation exposure. These findings highlight the importance of addressing misperceptions regarding COVID-19 vaccines and provide insights for theoretical development in research on exposure effects and confirmation bias.

Reporting COVID-19 preprints: fast science in newspapers in the United States, the United Kingdom and Brazil

The COVID-19 pandemic accelerated the pace of science. Many scientific data are published on preprint repositories, prior to peer review, which raises questions about the credibility of the information not yet validated by other scientists. We analyzed 76 stories published from January to July 2020 by three newspapers (The New York Times - USA, The Guardian - UK and Folha de S. Paulo - Brazil), having as topic studies on COVID-19 published on preprint platforms. The objective was to analyze how the media covered non-peer-reviewed research, in countries marked by conflicting discourses prompted by the denialist attitude of their government leaders. The results show that the newspapers did not provide a detailed explanation of what a preprint platform is, how the process of publishing research results works, and the implications of a study that has not yet been peer reviewed. The analysis also reveals how these news outlets were guided by the anxiety from an unknown disease, focusing on research on drug trials and seroprevalence. The study leads us to reflect on the challenges and weaknesses of covering fast science and the need to broaden the public's understanding of the methods and processes of science.

How social learning shapes the efficacy of preventative health behaviors in an outbreak

The global pandemic of COVID-19 revealed the dynamic heterogeneity in how individuals respond to infection risks, government orders, and community-specific social norms. Here we demonstrate how both individual observation and social learning are likely to shape behavioral, and therefore epidemiological, dynamics over time. Efforts to delay and reduce infections can compromise their own success, especially when disease risk and social learning interact within sub-populations, as when people observe others who are (a) infected and/or (b) socially distancing to protect themselves from infection. Simulating socially-learning agents who observe effects of a contagious virus, our modelling results are consistent with with 2020 data on mask-wearing in the U.S. and also concur with general observations of cohort induced differences in reactions to public health recommendations. We show how shifting reliance on types of learning affect the course of an outbreak, and could therefore factor into policy-based interventions incorporating age-based cohort differences in response behavior.

Curating the Contemporary: A Case for National and Local COVID-19 Collections

With its rapid spread, intensity, duration, global geographic reach and cross-sectorial disruption, the impact of the COVID-19 pandemic is so profound that it will become the focus of public exhibitions in the future. Now is the time is to collect examples of material culture associated with COVID-19. Some of the material is generic to healthcare, but some is specific to responses to COVID-19 in the medical and community sphere (e.g. social distancing). A substantive number of objects only exist in the digital sphere. Expanding on concepts initially developed for the collection of items associated with natural disasters and terrorist events, this paper (i) outlines the need for the establishment of local and national collections before items become too scarce and (ii) provides a sample multi-phase collections and collections management framework.

SARS-CoV-2 Vaccination Hesitancy and Behaviors in a National Sample of People Living with HIV

As COVID-19 vaccinations became available in early 2021, we collected data from a US national sample of 496 people living with HIV (PLWH) to assess COVID-19 vaccination uptake and attitudes. The study was cross-sectional, and data were collected using an online survey between March and May 2021. At the time, 64% of the participants received at least one dose of a COVID-19 vaccine. Vaccine uptake was associated with older age and more years living with HIV, higher educational attainment, less vaccine hesitancy, and higher perceived COVID-19 vulnerability. Rates of vaccination uptake were highest among sexual and gender minority (SGM) cisgender men and transgender participants as well as those more likely to report undetectable viral load. Among the 166 unvaccinated, intention to receive the vaccine was related to older age and years living with HIV as well as lower vaccine hesitancy. Among the unvaccinated, SGM individuals demonstrated higher intent than non-SGM individuals. Findings indicate relatively high levels of vaccination in PLWH, although uptake and intent are not monolithic in the population. Patterns of vaccination are consistent with the health behavior literature in so much as those with higher levels of perceived heath vulnerability due to age as well as higher levels of proactivity about their HIV health are more likely to be vaccinated or intend to be vaccinated. Ongoing vigilance is required to vaccinate the US population, particularly those with underlying conditions such as HIV, as is the need to tailor health messaging to the highly diverse population of PLWH, with particular emphasis on the intersection of HIV and SGM status.

Evaluating the Association of Face Covering Mandates on COVID-19 Severity by State

Objective:

During the COVID-19 pandemic in the United States, mitigation measures were implemented on a state-by-state basis. Governors were responsible for establishing interventions appropriate for their states and the timing of implementation. This paper evaluated the association between the presence and timing of a mask mandate and the severity of the COVID-19 epidemic by state.

Methods:

The states were divided into 3 categories based on when the governors of each state implemented a mask mandate: Early (mask mandate implemented between March 2020 and June 2020), Late (July 2020-December 2020), and Never (no mask mandate implemented). The rates of hospitalizations and mortality (per 100 000) were assessed at the different time points during the pandemic across these categories from March to December 2020.

Results:

The mortality rates across all 3 groups were observed to be highest in the beginning and toward the end of the pandemic in 2020 with the peak observed in the Early group between April and May 2020. Also, the rates of hospitalization increased steadily across all groups. The Early mask group was comprised of 86.7% and 13.3% states with Democratic and Republican governors respectively, and no states in the Never category had Democratic governors.

Conclusion:

These results support the benefit of implementing a mask mandate to minimize the impact of the COVID-19 pandemic and the role of political affiliation of governors on that impact.

Political polarization on COVID-19 pandemic response in the United States

Despite calls for political consensus, there is growing evidence that the public response to the COVID-19 pandemic has been politicized in the US. We examined the extent to which this polarization exists among the US public across two national studies. In a representative US sample (N = 699, March 2020) we find that liberals (compared to conservatives) perceive higher risk, place less trust in politicians to handle the pandemic, are more trusting of medical experts such as the WHO, and are more critical of the government response. We replicate these results in a second, pre-registered study (N = 1000; April 2020), and find that results are similar when considering partisanship, rather than political ideology. In both studies we also find evidence that political polarization extends beyond attitudes, with liberals consistently reporting engaging in a significantly greater number of health protective behaviors (e.g., wearing face masks) than conservatives. We discuss the possible drivers of polarization on COVID-19 attitudes and behaviors, and reiterate the need for fostering bipartisan consensus to effectively address and manage the COVID-19 pandemic.

The Response of Governments and Public Health Agencies to COVID-19 Pandemics on Social Media: A Multi-Country Analysis of Twitter Discourse

During the COVID-19 pandemic, information is being rapidly shared by public health experts and researchers through social media platforms. Whilst government policies were disseminated and discussed, fake news and misinformation simultaneously created a corresponding wave of “infodemics.” This study analyzed the discourse on Twitter in several languages, investigating the reactions to government and public health agency social media accounts that share policy decisions and official messages. The study collected messages from 21 official Twitter accounts of governments and public health authorities in the UK, US, Mexico, Canada, Brazil, Spain, and Nigeria, from 15 March to 29 May 2020. Over 2 million tweets in various languages were analyzed using a mixed-methods approach to understand the messages both quantitatively and qualitatively. Using automatic, text-based clustering, five topics were identified for each account and then categorized into 10 emerging themes. Identified themes include political, socio-economic, and population-protection issues, encompassing global, national, and individual levels. A comparison was performed amongst the seven countries analyzed and the United Kingdom (Scotland, Northern Ireland, and England) to find similarities and differences between countries and government agencies. Despite the difference in language, country of origin, epidemiological contexts within the countries, significant similarities emerged. Our results suggest that other than general announcement and reportage messages, the most-discussed topic is evidence-based leadership and policymaking, followed by how to manage socio-economic consequences.

War Against COVID-19: How Is National Identification Linked With the Adoption of Disease-Preventive Behaviors in China and the United States?

Fighting the COVID-19 pandemic requires large numbers of citizens to adopt disease-preventive practices. We contend that national identification can mobilize and motivate people to engage in preventive behaviors to protect the collective, which in return would heighten national identification further. To test these reciprocal links, we conducted studies in two countries with diverse national tactics toward curbing the pandemic: (1) a two-wave longitudinal survey in China (Study 1, N = 1200), where a national goal to fight COVID-19 was clearly set, and (2) a five-wave longitudinal survey in the United States (Study 2, N = 1001), where the national leader, President Trump, rejected the severity of COVID-19 in its early stage. Results revealed that national identification was associated with an increase in disease-preventive behaviors in both countries in general. However, higher national identification was associated with greater trust in Trump's administration among politically conservative American participants, which then was associated with slower adoption of preventive behaviors. The reciprocal effect of disease-preventive behaviors on national identification was observed only in China. Overall, our findings suggest that although national identification may serve as a protective factor in curbing the pandemic, this beneficial effect was reduced in some political contexts.

Not everything is as it seems: Digital technology affordance, pandemic control, and the mediating role of sociomaterial arrangements

An overly favorable narrative has developed around the role played by digital technologies in containing Covid-19, which oversimplifies the complexity of technology adoption. This narrative takes sociomaterial arrangements for granted and conceptualizes technology affordance - the problem-solving capability of a technology - as a standard built-in feature that automatically activates during technology deployment, leading to undiversified and predetermined collective benefits. This paper demonstrates that not everything is as it seems; implementing a technology is a necessary but insufficient condition for triggering its potential problem-solving capability. The potential affordance and effects of a technology are mediated by the sociomaterial arrangements that users assemble to connect their goals to the materiality of technological artifacts and socio-organizational context in which technology deployment takes place. To substantiate this argument and illustrate the mediating role of sociomaterial arrangements, we build on sociomateriality and technology affordance theory, and we present the results of a systematic review of Covid-19 literature in which 2187 documents are examined. The review combines text data mining, co-occurrence pattern recognition, and inductive coding, and it focuses on four digital technologies that public authorities have deployed as virus containment measures: infrared temperature-sensing devices; ICT-based surveillance and contact-tracing systems; bioinformatic tools and applications for laboratory testing; and electronic mass communications media. Reporting on our findings, we add nuances to the academic debate on sociomateriality, technology affordance, and the governance of technology in public health crises. In addition, we provide public authorities with practical recommendations on how to strengthen their approach to digital technology deployment for pandemic control.

Self‐protection by fact‐checking: How pandemic information seeking and verifying affect preventive behaviours

The COVID‐19 pandemic has witnessed the proliferation of a plethora of (mis)information on various media platforms and inconsistent crisis instructions from different sources. People consume crisis information from multiple channels and sources to better understand the situation and fact‐check COVID‐19 information. This study elucidates how Americans determine their preventive behaviours based on their information seeking and verifying behaviours during the pandemic. Our results were based on a US nationally representative sample (N = 856), and showed that proactive preventive behaviours (e.g., washing hands frequently) were positively affected by information‐seeking through interpersonal channels, news media, and the government, whereas avoidance preventive behaviours (e.g., avoiding social gatherings) were only positively affected by information‐seeking through news media. Crisis information verifying had positive effects on all types of preventive behaviours. Crisis managers are recommended to reach out to the public using appropriate channels and sources and facilitate individual's ability and motivation in verifying pandemic information.

The Spatiotemporal Interaction Effect of COVID-19 Transmission in the United States

(1) Background: Human mobility between geographic units is an important way in which COVID-19 is spread across regions. Due to the pressure of epidemic control and economic recovery, states in the United States have adopted different policies for mobility limitations. Assessing the impact of these policies on the spatiotemporal interaction of COVID-19 transmission among counties in each state is critical to formulating epidemic policies. (2) Methods: We utilized Moran’s I index and K-means clustering to investigate the time-varying spatial autocorrelation effect of 49 states (excluding the District of Colombia) with daily new cases at the county level from 22 January 2020 to 20 August 2020. Based on the dynamic spatial lag model (SLM) and the SIR model with unreported infection rate (SIRu), the integrated SLM-SIRu model was constructed to estimate the inter-county spatiotemporal interaction coefficient of daily new cases in each state, which was further explored by Pearson correlation test and stepwise OLS regression with socioeconomic factors. (3) Results: The K-means clustering divided the time-varying spatial autocorrelation curves of the 49 states into four types: continuous increasing, fluctuating increasing, weak positive, and weak negative. The Pearson correlation analysis showed that the spatiotemporal interaction coefficients in each state estimated by SLM-SIRu were significantly positively correlated with the variables of median age, population density, and proportions of international immigrants and highly educated population, but negatively correlated with the birth rate. Further stepwise OLS regression retained only three positive correlated variables: poverty rate, population density, and highly educated population proportion. (4) Conclusions: This result suggests that various state policies in the U.S. have imposed different impacts on COVID-19 transmission among counties. All states should provide more protection and support for the low-income population; high-density populated states need to strengthen regional mobility restrictions; and the highly educated population should reduce unnecessary regional movement and strengthen self-protection.

What factors underlie attitudes regarding protective mask use during the COVID-19 pandemic?

Two studies examine psychological and demographic factors that predict attitudes toward mask-wearing during the COVID-19 pandemic. These studies differentiate pro-mask from anti-mask attitudes. Political conservatism, younger age, and gender predicted anti-mask attitudes but were unrelated to pro-mask attitudes. Psychological reactance was associated with anti-mask attitudes, over and above demographic variables. Empathy, trust in healthcare professionals, and perceived normativity of mask wearing were associated with pro-mask attitudes, over and above demographic variables. These studies suggest that demographic variables such as political orientation and age are associated with anti-mask but not pro-mask attitudes, but also that psychological factors differentially predict anti- and pro-mask attitudes over and above demographic factors.

Trust in health information sources and its associations with COVID-19 disruptions to social relationships and health services among people living with HIV

BACKGROUND

SARS-CoV-2 infection (COVID-19) is potentially severe for individuals with compromised immune systems, including people living with HIV. Along with the direct health threats of COVID-19, there are disruptions to social relationships and health services resulting from mitigation efforts instituted by public health authorities. This study examined the relationship between trust in the government and trust in COVID-19 health information from the US CDC, state health departments, and social media on the experience of COVID-19 social and health services-related disruptions.

METHODS

People living with HIV (N = 459) recruited through social media advertisements and chain referrals completed confidential surveys delivered through an online platform.

RESULTS

Participants experienced high-levels of disruptions to social relationships and health services attributable to COVID-19 mitigation efforts. We also observed high-rates of inaccurate information and low-levels of trust in government and sources of COVID-19 information. Greater disruptions to social relationships were predicted by more concern about oneself and others contracting COVID-19, whereas disruptions to health services were predicted by greater concern for oneself contracting COVID-19, greater general medical mistrust, and less trust in information from the CDC.

CONCLUSIONS

Findings have implications for the necessity of rebuilding public trust in credible sources of health information and stepping up efforts to counter sources of inaccurate information.

A Failure to Communicate? How Public Messaging Has Strained the COVID-19 Response in the United States

A pandemic, especially when caused by a novel virus, induces tremendous uncertainty, fear, and anxiety. To mitigate panic and encourage appropriate behavioral action, communication is critical. The US Centers for Disease Control and Prevention's Crisis and Emergency Risk Communication (CERC) guidance is designed to assist public health authorities, government officials, and other stakeholders in using risk communication during an emergency. For each of the 6 core communication principles outlined in the CERC guidance, we describe the use or nonuse of these principles at critical points during the coronavirus disease 2019 (COVID-19) pandemic by US public health and government officials. With the knowledge that the pandemic will continue to rage for some time and that new communication challenges will arise, including issues related to vaccination and treatment options, many lessons are to be learned and shared. To reduce fear and uncertainty among those living in the United States, COVID-19 communication should be rapid and accurate, while building credibility and trust and showcasing empathy-all with a unified voice.

Missing clinical trial data: the evidence gap in primary data for potential COVID-19 drugs

Background

Several drugs are being repurposed for the treatment of the coronavirus disease 2019 (COVID-19) pandemic based on in vitro or early clinical findings. As these drugs are being used in varied regimens and dosages, it is important to enable synthesis of existing safety data from clinical trials. However, availability of safety information is limited by a lack of timely reporting of overall clinical trial results on public registries or through academic publication. We aimed to analyse the evidence gap in this data by conducting a rapid review of results posting on ClinicalTrials.gov and in academic publications to quantify the number of trials missing results for drugs potentially being repurposed for COVID-19.

Methods

ClinicalTrials.gov was searched for 19 drugs that have been identified as potential treatments for COVID-19. Relevant clinical trials for any prior indication were listed by identifier (NCT number) and checked for results and for timely result reporting (within 395 days of the primary completion date). Additionally, PubMed and Google Scholar were searched to identify publications of results not listed on the registry. A second, blinded search of 10% of trials was conducted to assess reviewer concordance.

Results

Of 3754 completed trials, 1516 (40.4%) did not post results on ClinicalTrials.gov or in the academic literature. Tabular results were available on ClinicalTrials.gov for 1172 (31.2%) completed trials. A further 1066 (28.4%) had published results in the academic literature, but did not report results on ClinicalTrials.gov. Key drugs missing clinical trial results include hydroxychloroquine (37.0% completed trials unreported), favipiravir (77.8%) and lopinavir (40.5%).

Conclusions

There is an important evidence gap for the safety of drugs being repurposed for COVID-19. This uncertainty could cause unnecessary additional morbidity and mortality during the pandemic. We recommend caution in experimental drug use for non-severe disease and urge clinical trial sponsors to report missing results retrospectively.

Mental health consequences of COVID-19 media coverage: the need for effective crisis communication practices

During global pandemics, such as coronavirus disease 2019 (COVID-19), crisis communication is indispensable in dispelling fears, uncertainty, and unifying individuals worldwide in a collective fight against health threats. Inadequate crisis communication can bring dire personal and economic consequences. Mounting research shows that seemingly endless newsfeeds related to COVID-19 infection and death rates could considerably increase the risk of mental health problems. Unfortunately, media reports that include infodemics regarding the influence of COVID-19 on mental health may be a source of the adverse psychological effects on individuals. Owing partially to insufficient crisis communication practices, media and news organizations across the globe have played minimal roles in battling COVID-19 infodemics. Common refrains include raging QAnon conspiracies, a false and misleading "Chinese virus" narrative, and the use of disinfectants to "cure" COVID-19. With the potential to deteriorate mental health, infodemics fueled by a kaleidoscopic range of misinformation can be dangerous. Unfortunately, there is a shortage of research on how to improve crisis communication across media and news organization channels. This paper identifies ways that legacy media reports on COVID-19 and how social media-based infodemics can result in mental health concerns. This paper discusses possible crisis communication solutions that media and news organizations can adopt to mitigate the negative influences of COVID-19 related news on mental health. Emphasizing the need for global media entities to forge a fact-based, person-centered, and collaborative response to COVID-19 reporting, this paper encourages media resources to focus on the core issue of how to slow or stop COVID-19 transmission effectively.

Populism, pestilence and plague in the time of coronavirus

Purpose

This paper aims to explore right wing populist government responses to the coronavirus pandemic.

Design/methodology/approach

This paper is a narrative overview of right-wing populist policies and strategies, which is loosely structured around fascistic themes set out in Albert Camus’ allegorical novel, The Plague.

Findings

Although individual responses to the coronavirus pandemic among right-wing populists differ, they appear to coalesce around four central themes: initial denial and then mismanagement of the pandemic; the disease being framed as primarily an economic rather than a public health crisis; a contempt for scientific and professional expertise; and the “othering” of marginal groups for political ends. Populist responses to the pandemic have given rise to increased levels of xenophobia, the violation of human rights and the denigration of scientific expertise.

Research limitations/implications

This is a narrative overview from a personal viewpoint.

Originality/value

Drawing on themes in Camus' novel The Plague, this is a personal perspective on right wing populist government responses to the coronavirus pandemic. Populist responses to the pandemic have given rise to increased levels of intolerance and xenophobia and the violation of human rights and civil liberties.

'Any and every cure for COVID-19': an imminent epidemic of alternative remedies amidst the pandemic?

The magnitude of the COVID-19 pandemic is unprecedented, causing lots of apprehension among scientists, industry actors, politicians, and the general populace. Adverse health, social and economic effects of the pandemic have triggered an urgency among policy makers to seek an effective panacea. In this commentary, we examine the covert outbreak of a demand for alternative remedies with limited scientific evidence on their effectiveness to manage COVID-19 in Africa. Similar demands have been displayed in previous epidemics, though the ubiquity of social media in this current clime fuels such demands even more. We describe the attendant consequences of this demand surge on ongoing public health efforts to mitigate the spread of COVID-19 and highlight its future repercussions which may continue to plague health systems beyond the present outbreak. Going forward, governments must be proactive in surveillance of this covert epidemic, actively engage community influencers in knowledge transfer and implement targeted health promotion interventions.

Racism and the Political Economy of COVID-19: Will We Continue to Resurrect the Past?

COVID-19 is not spreading over a level playing field; structural racism is embedded within the fabric of American culture, infrastructure investments, and public policy and fundamentally drives inequities. The same racism that has driven the systematic dismantling of the American social safety net has also created the policy recipe for American structural vulnerability to the impacts of this and other pandemics. The Bronx provides an important case study for investigating the historical roots of structural inequities showcased by this pandemic; current lived experiences of Bronx residents are rooted in the racialized dismantling of New York City's public infrastructure and systematic disinvestment. The story of the Bronx is repeating itself, only this time with a novel virus. To address the root causes of inequities in cases and deaths due to COVID-19, we need to focus not just on restarting the economy but also on reimagining the economy, divesting of systems rooted in racism, and the devaluation of Black and Brown lives.

Twitter Communication During an Outbreak of Hepatitis A in San Diego, 2016-2018

Objectives. To examine how and what information is communicated via social media during an infectious disease outbreak.Methods. In the context of the 2016 through 2018 hepatitis A outbreak in San Diego County, California, we used a grounded theory-based thematic analysis that employed qualitative and quantitative approaches to uncover themes in a sample of public tweets (n = 744) from Twitter, a primary platform used by key stakeholders to communicate to the public during the outbreak.Results. Tweets contained both general and hepatitis A-specific information related to the outbreak, restatements of policy and comments critical of government responses to the outbreak, information with the potential to shape risk perceptions, and expressions of concern regarding individuals experiencing homelessness and their role in spreading hepatitis A. We also identified misinformation and common channels of content driving themes that emerged in our sample.Conclusions. Public health professionals may identify real-time public risk perceptions and concerns via social media during an outbreak and target responses that fulfill the informational needs of those who seek direction and reassurance during times of uncertainty.

Evidence, rationality, and ignorance: Agnotological issues in COVID-19 science

Two decades ago, Robert Proctor coined the term agnotology to refer to the study of ignorance that stems from scientific research. Amid the coronavirus disease pandemic, the world is witnessing the greatest natural experiment ever, and countries have adopted different response strategies. An evaluation of the effectiveness of different policies will play a valuable role in preparing for future public health emergencies. However, controversial issues such as the timing and pathways of viral emergence, the effectiveness of social distancing and lockdown strategies, and the use of antimalarial drugs as therapy have still not been fully resolved. This serves as a fertile breeding ground for agnotological strategies, whereby scientific studies are deliberately or unintentionally designed to create distractions or draw conclusions that are not supported by research findings. Researchers, public health authorities, and healthcare workers should be equipped to identify such agnotological strategies, distinguish them from scientific fraud, and avoid drawing misleading inferences based on an irrational adherence to hypotheses and a lack of criticism of implausible results.

Translating Scientific Knowledge to Government Decision Makers Has Crucial Importance in the Management of the COVID-19 Pandemic

In times of epidemics and humanitarian crises, it is essential to translate scientific findings into digestible information for government policy makers who have a short time to make critical decisions. To predict how far and fast the disease would spread across Hungary and to support the epidemiological decision-making process, a multidisciplinary research team performed a large amount of scientific data analysis and mathematical and socioeconomic modeling of the COVID-19 epidemic in Hungary, including modeling the medical resources and capacities, the regional differences, gross domestic product loss, the impact of closing and reopening elementary schools, and the optimal nationwide screening strategy for various virus-spreading scenarios and R metrics. KETLAK prepared 2 extensive reports on the problems identified and suggested solutions, and presented these directly to the National Epidemiological Policy-Making Body. The findings provided crucial data for the government to address critical measures regarding health care capacity, decide on restriction maintenance, change the actual testing strategy, and take regional economic, social, and health differences into account. Hungary managed the first part of the COVID-19 pandemic with low mortality rate. In times of epidemics, the formation of multidisciplinary research groups is essential for policy makers. The establishment, research activity, and participation in decision-making of these groups, such as KETLAK, can serve as a model for other countries, researchers, and policy makers not only in managing the challenges of COVID-19, but in future pandemics as well.

SARS-CoV-2 pandemic: An overview

By the end of May 2020, SARS-CoV-2 pandemic caused more than 350,000 deaths worldwide. In the first months, there have been uncertainties on almost any area: infection transmission route, virus origin and persistence in the environment, diagnostic tests, therapeutic approach, high-risk subjects, lethality, and containment policies. We provide an updated summary of the current knowledge on the pandemic, discussing the available evidence on the effectiveness of the adopted mitigation strategies.