Citizens’ Attitudes to Contact Tracing Apps

Citizens’ concerns about data privacy and data security breaches may reduce the adoption of COVID-19 contact tracing mobile phone applications, making them less effective. We implement a choice experiment (conjoint experiment) where participants indicate which version of two contact tracing apps they would install, varying the apps’ privacy-preserving attributes. Citizens do not always prioritise privacy and prefer a centralised National Health Service system over a decentralised system. In a further study asking about participants’ preference for digital-only vs human-only contact tracing, we find a mixture of digital and human contact tracing is supported. We randomly allocated a subset of participants in each study to receive a stimulus priming data breach as a concern, before asking about contact tracing. The salient threat of unauthorised access or data theft does not significantly alter preferences in either study. We suggest COVID-19 and trust in a national public health service system mitigate respondents’ concerns about privacy.

Adoption and continued use of mobile contact tracing technology: Multilevel explanations from a three-wave panel survey and linked data (preprint)

Objective To identify the key individual-level (demographics, attitudes, mobility) and contextual (Covid-19 case numbers, tiers of mobility restrictions, urban districts) determinants of adopting the NHS Covid-19 contact tracing app and continued use over-time. Design and setting A three-wave panel survey conducted in England in July 2020 (background survey), November 2020 (first measure of mobile app adoption), and March 2021 (continued use of app and new adopters) linked with official data. Primary outcome Repeated measures of self-reported app usage. Participants N = 2,500 adults living in England, representative of England’s population in terms of regional distribution, age, and gender (2011 census). Results We observe initial app uptake at 41%, 95% CI [0.39,0.43], in November 2020 with a 12% dropout rate by March 2021, 95% CI [0.10,0.14]. We also found that 7% of nonusers as of wave 2 became new adopters by wave 3, 95% CI [0.05,0.08]. Initial uptake (or failure to use) of the app associated with social norms, privacy concerns, and misinformation about third-party data access, with those living in postal districts with restrictions on mobility less likely to use the app. Perceived lack of transparent evidence of effectiveness was associated with drop out of use. In addition, those who trusted the government were more likely to adopt in wave 3 as new adopters. Conclusions Successful uptake of the contact tracing app should be evaluated within the wider context of the UK Government’s response to the crisis. Trust in government is key to adoption of the app in wave 3 while continued use is linked to perceptions of transparent evidence. Providing clear information to address privacy concerns could increase uptake, however, the disparities in continued use among ethnic minority participants needs further investigation as differences are not fully explained via attitudinal measures. Article summary Strengths and limitations of this study Our data captures reported behaviour at two points to assess within-subject changes over time; Results: based on a large, nationally representative sample rather than the convenience, non-probability and/or limited- N samples of previous contact tracing studies; Integrating demographic/structural and attitudinal explanations relating to technology acceptance with questions adopted from the results of a deliberative poll; Limitation: studied population is England (see Section 2.3) where overall mobility is restricted in wave 3 during national lockdown, allowing for limited opportunities for app usage e.g. venue check-ins; Drawing on our findings, an ethnic minority booster sample will in the future allow us to better understand inequalities across and within diverse ethnic populations.

A Bayesian reanalysis of the effects of hydroxychloroquine and azithromycin on viral carriage in patients with COVID-19.

Gautret and colleagues reported the results of a non-randomised case series which examined the effects of hydroxychloroquine and azithromycin on viral load in the upper respiratory tract of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients. The authors reported that hydroxychloroquine (HCQ) had significant virus reducing effects, and that dual treatment of both HCQ and azithromycin further enhanced virus reduction. In light of criticisms regarding how patients were excluded from analyses, we reanalysed the original data to interrogate the main claims of the paper. We applied Bayesian statistics to assess the robustness of the original paper's claims by testing four variants of the data: 1) The original data; 2) Data including patients who deteriorated; 3) Data including patients who deteriorated with exclusion of untested patients in the comparison group; 4) Data that includes patients who deteriorated with the assumption that untested patients were negative. To ask if HCQ monotherapy was effective, we performed an A/B test for a model which assumes a positive effect, compared to a model of no effect. We found that the statistical evidence was highly sensitive to these data variants. Statistical evidence for the positive effect model ranged from strong for the original data (BF+0 ~11), to moderate when including patients who deteriorated (BF+0 ~4.35), to anecdotal when excluding untested patients (BF+0 ~2), and to anecdotal negative evidence if untested patients were assumed positive (BF+0 ~0.6). The fact that the patient inclusions and exclusions are not well justified nor adequately reported raises substantial uncertainty about the interpretation of the evidence obtained from the original paper.

Unpacking Pandora From Its Box: Deciphering the Molecular Basis of the SARS-CoV-2 Coronavirus.

An enigmatic localized pneumonia escalated into a worldwide COVID-19 pandemic from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). This review aims to consolidate the extensive biological minutiae of SARS-CoV-2 which requires decipherment. Having one of the largest RNA viral genomes, the single strand contains the genes ORF1ab, S, E, M, N and ten open reading frames. Highlighting unique features such as stem-loop formation, slippery frameshifting sequences and ribosomal mimicry, SARS-CoV-2 represents a formidable cellular invader. Hijacking the hosts translational engine, it produces two polyprotein repositories (pp1a and pp1ab), armed with self-cleavage capacity for production of sixteen non-structural proteins. Novel glycosylation sites on the spike trimer reveal unique SARS-CoV-2 features for shielding and cellular internalization. Affording complexity for superior fitness and camouflage, SARS-CoV-2 challenges diagnosis and vaccine vigilance. This review serves the scientific community seeking in-depth molecular details when designing drugs to curb transmission of this biological armament.

Treatment for Severe Coronavirus Disease 2019 With the Seraph-100 Microbind Affinity Blood Filter.

To determine whether Seraph-100 (Exthera Medical Corporation, Martinez, CA) treatment provides clinical benefit for severe coronavirus disease 2019 cases that require mechanical ventilation and vasopressor support. DATA SOURCES: The first two patients in the United States treated with the novel Seraph-100 device. These cases were reviewed by the Food and Drug Administration prior to granting an emergency use authorization for treatment of coronavirus disease 2019. STUDY SELECTION: Case series. DATA EXTRACTION: Vasopressor dose, mean arterial pressure, temperature, interleukin-6, C-reactive protein, and other biomarker levels were documented both before and after Seraph-100 treatments. DATA SYNTHESIS: Vasopressor dose, temperature, interleukin-6, and C-reactive protein levels declined after Seraph-100 treatments. Severe acute respiratory syndrome coronavirus 2 viremia was confirmed in the one patient tested and cleared by the completion of treatments. CONCLUSIONS: Seraph-100 use may improve hemodynamic stability in coronavirus disease 2019 cases requiring mechanical ventilation and vasopressor support. These findings warrant future study of a larger cohort with the addition of mortality and total hospital day outcomes.