Symptoms and Stereotypes: Perceptions and Responses to Covid-19 in Malawi and Zambia

A large literature documents Covid-19's health and economic effects. We focus instead on its political impact and its potential to exacerbate identity divisions, in particular. Psychologists argue that contagious disease increases threat perceptions and provokes policing of group boundaries. We explore how insider-outsider status and symptoms of illness shape perceptions of infection, reported willingness to help, and desire to restrict free movement of an ailing neighbor using a phone-based survey experiment administered three times in two neighboring African countries during different stages of the pandemic: Malawi, from May 5 to June 2, 2020 (n = 4,641);Zambia, from July 2 to August 13, 2020 (n = 2,198);and Malawi again, from March 9 to May 1, 2021 (n = 4,356). We study identities that are salient in Malawi and Zambia but have not induced significant prior violence, making our study a relatively hard test of disease threat theories. We find that symptoms more strongly shape perceptions and projected behavior than insider-outsider status in both countries and across time, suggesting that there are limits to the ability of pandemics to independently provoke identity politics de novo. [ FROM AUTHOR]

The ABCs of Covid-19 prevention in Malawi: Authority, benefits, and costs of compliance.

A wide array of authorities-from religious leaders to government ministers-call upon citizens to take preventative measures against Covid-19. Which authorities can most effectively gain public compliance, and which measures will the public take up? Moreover, do people comply with authorities out of respect for their legitimacy, due to their expertise, or for fear of sanctioning? Answers to these questions are important for development practitioners, who need to understand how different partnerships might affect health behavior, and for scholars interested in understanding authority, legitimacy, and compliance. We explore these questions using a conjoint experiment embedded in a telephone survey of 641 Malawians. Individuals in our sample are more likely to say that they will comply with precautionary measures when the costs are low and expected benefits are high. Respondents view both traditional authorities and hospital heads as legitimately issuing directives and having the ability to monitor and sanction non-compliance, but appear to comply more with hospital heads and to do so out of respect for their expertise. These results emphasize how who issues directives affects whether individuals comply and provides insights as to why they do so. The findings also reflect individuals' cost-benefit calculations when considering precautionary measures, highlighting the importance of steps that can reduce costs (e.g., food security or income measures) or accurately reflect risks (e.g., information signaling the prevalence of Covid-19). The study not only helps to address the Coronavirus crisis but also has important implications for broader questions of authority and compliance.

Elections in the time of covid-19: the triple crises around Malawi's 2020 presidential elections

In June 2020, in the midst of the Covid-19 pandemic, Malawians went to the polls and voted to replace the incumbent government. Much like other natural disasters, the Covid-19 pandemic and accompanying economic and political shocks had the potential to shake voters' confidence in the government, reduce turnout, and/or reduce support for the incumbent if voters associated them with the ills of the pandemic. In this paper, we examine the extent to which the Coronavirus pandemic influenced Malawi's 2020 elections. We consider how fear of infection and economic distress affected citizens' trust and confidence in President Mutharika's government, their willingness to turn out to vote, and their choices at the polls using data collected pre- and post-Covid. We find that fears about the virus and its economic impact did influence trust and confidence in the government to handle Covid but had little to no effect on either abstention or vote choice. [ABSTRACT FROM AUTHOR] Copyright of Journal of Elections, Public Opinion & Parties is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Emergency medicine airway leads: a rapid response distributed educational model for emergency department COVID-19 airway management.

With the first case of COVID-19 confirmed in Canada in early 2020, our country joined in the fight against a novel pathogen in a global pandemic. The stress of uncertainty and practice change was most apparent in the emergency department when it came to managing known or suspected COVID-19 patients requiring airway management. Recognizing the need for a coordinated approach, a province wide rapid response distributed model of continuing professional development for airway management was developed utilizing Airway Leads to help prepare front-line medical personnel providing airway management for these patients. Airway Leads worked with local physicians to deliver consistent, high quality airway education across the province during the initial surge of cases. Education included both in person and virtual sessions along with real time ongoing support through provincial guidelines, videos, and other documents. Physician reported "stress level" pre- and post-Airway Lead support declined from a median score of 9 to 7 (on a 10-point Likert Scale).

RéSUMé: Le premier cas de COVID-19 ayant été confirmé au Canada au début de 2020, notre pays s'est joint à la lutte contre un nouveau pathogène dans une pandémie mondiale. Le stress de l'incertitude et du changement de pratique était plus évident au service d'urgence lorsqu'il s'agissait de gérer les patients connus ou soupçonnés de la COVID-19 qui avaient besoin d'une prise en charge des voies respiratoires. Reconnaissant la nécessité d'une approche coordonnée, un modèle de développement professionnel continu distribué à l'échelle de la province pour la gestion des voies aériennes a été élaboré en utilisant les Airway Leads pour aider à préparer le personnel médical de première ligne qui assure la gestion des voies aériennes de ces patients. Airway Leads a travaillé avec les médecins locaux pour dispenser un enseignement cohérent et de haute qualité sur les voies aériennes dans toute la province lors de l'augmentation initiale du nombre de cas. L'éducation comprenait à la fois des sessions en personne et virtuelles ainsi qu'un soutien continu en temps réel par le biais de directives provinciales, de vidéos et d'autres documents. Le "niveau de stress" déclaré par le médecin avant et après l'intervention de Airway Lead a diminué, passant d'un score médian de 9 à 7 (sur une échelle de Likert de 10 points).

Stigma, Trust, and procedural integrity: Covid-19 testing in Malawi.

An emerging consensus in public health views testing for Covid-19 as key to managing the pandemic. It is often assumed that citizens have a strong desire to know their Covid-19 status, and will therefore take advantage of testing opportunities. This may not be the case in all contexts, however, especially those where citizens perceive stigma associated with the Covid-19, have low trust in health institutions, and doubt the procedural integrity of the testing process. This article explores willingness to receive a free Covid-19 test via a vignette experiment (conjoint design) embedded in a phone survey conducted in Malawi in May 2020. The experiment varied test provider (public clinic versus international health organization), proximity to illness, and reassurance of confidentiality. We find that Malawians expect higher uptake of testing in their community when the international health organization offered the test rather than a public clinic, an effect we attribute to higher trust in the organization and/or perceptions of greater capacity to ensure procedural integrity. The confidentiality reassurance did not substantially alter beliefs about the privacy of results, but did increase doubts about the willingness of community members to get tested in a public health clinic. Our findings suggest the importance of considering the demand side of testing in addition to well-known challenges of supply.