PUBLIC ATTITUDES AND BEHAVIORS ABOUT COVID-19 IN THE UNITED STATES: A CASE STUDY IN ISSUE UNDERSTANDING IN A POLARIZED POLITICAL SYSTEM

How do citizens in a polarized political system react to an unexpected emergency like the COVID-19 pandemic and how do citizens process conflicting polarized narratives to for-mulate a public policy view of the threat of the pandemic? The emergence of the COVID-19 pandemic is a health emergency unlike anything in the United States since the polio epidemic 70 years ago, but the political climate of the U.S. in the 1950's was far more centrist and consensual than the deep divisions observed today. This paper will utilize data from a 35-year longitudinal study of Generation X young adults (now in their mid-40's) and a three-decade time series of national U.S. surveys to examine information acquisition behaviors to understand the new threat. Our analysis of the last 35 years of Generation X finds that polarized ideological partisanship was the strongest single predictor of individual votes in the 2020 election, but that individuals with a higher level of understanding of the corona-virus were more critical of the Trump Administration's handling of the COVID-19 pandemic and were more likely to vote for Bid-en than Trump. A parallel analysis of a national probability sample of U.S. adults in 2020 found the same pattern of influence from ideological partisanship, coronavirus understanding, and assessment of the Trump Administration's handling of the pan-demic. The results indicate that knowledge and understanding can provide a critical balancing effect in an evenly divided polarized political system. © 2022, CSIC Consejo Superior de Investigaciones Cientificas. All rights reserved.

Continuous Glucose Monitoring in a 71-year-old Man with Diabetes and COVID-19 During an Episode of Cardiac Arrest: Return of Spontaneous Circulation and Subsequent Death

We assessed real-time continuous glucose monitoring (rtCGM) data in an individual with type 2 diabetes who presented with severe symptoms of COVID-19, and suffered a fatal cardiac arrest during hospitalization. In this retrospective analysis, we used rtCGM to evaluate changes in blood glucose levels in a 71-year-old male with COVID-19 symptoms who suffered a fatal cardiac arrest. Blood glucose levels remained constant at 220–225 mg/dL after the first cardiac arrest, slowly decreased to 167 mg/dL after return of spontaneous circulation was achieved, and rose to 198 mg/dL prior to the second arrest. After the patient expired, glucose levels decreased to the 141 mg/dL over the first hour, but quickly declined to undetectable levels within the next 20 minutes. Wider adoption of rtCGM use in patients with COVID-19 may help identify blood glucose patterns and uncover new insights to various comorbidities and conditions

Atrial fibrillation is a cardiovascular risk factor for worse prognosis in covid-19

Background: In the presence of comorbid conditions, COVID-19 infections are known to require more advanced treatment, poorer outcomes and have longer-term sequelae. New-onset atrial fibrillation (AF) during COVID-19 infection has been associated with worse cardiovascular outcomes but not mortality. However, it remains unclear whether a prior history (hx) of atrial fibrillation is a cardiovascular risk factor predicting a worse outcome in COVID-19 patients. As such, we examined, using propensity matching accounting for possible confounders, the need for advanced treatment and subsequent major cardiovascular events (MACE) in patients with a prior hx of AF with COVID19 infection. Methods: From March 2020 to May 2021, patients testing positive for SARS-CoV-2 with a prior AF diagnosis (n=3119) were propensity matched for age, gender, race/ethnicity, prior coronary artery disease (CAD), prior heart failure (HF), prior stroke and hypertension to non-AF SARS-CoV-2 positive patients. Cox hazard regression analysis with multivariable adjustment was used to determine risk of subsequent MACE (all-cause death, myocardial infarction, HF and stroke). Results: Baseline characteristics, treatments, and outcomes stratified by AF status are shown in the Table. While the groups had similar baseline characteristics, AF COVID-19 patients were more likely to require hospitalization, ICU care, and ventilator support. Consistent with our hypothesis, composite MACE event rates were higher in the AF patients (HR=1.60, p<0.0001) secondary to increases in heart failure and all-cause mortality rates. Conclusions: These data support AF as a cardiovascular risk factor predicting worse outcomes in COVID-19 patients. Specifically, AF increases the need for advanced treatments such as hospitalization, ICU care and ventilator support resulting in an increase in subsequent heart failure and all-cause mortality.

Water insecurity compounds the global coronavirus crisis

Household water insecurity may exacerbate the COVID-19 pandemic and exact an even greater toll on people, especially in Africa, Asia and Latin America, simply because too many people do not have access to safe and secure water services, including water supply and sanitation, at home. Recent studies have shown that as many as a quarter of households in the Global South may be unable to practise necessary hand hygiene. Megacities may be at particular risk of being unable to manage the COVID-19 pandemic due to sheer population density as well as a lack of reliable clean water and sanitation. Problems of water insecurity are not restricted to the Global South but extend into higher-income countries as well. The steady decline in provision of public sanitation around the world, even in wealthy countries, makes adequate hygiene an even more intractable problem.