Altruism and the Link to Pro-social Pandemic Behavior

In the Corona pandemic, especially in the phase before vaccines were available, people's risk of infection with COVID-19 was dependent on the adherence to pandemic behaviors (e. g., wearing masks) of others around them. To explore whether altruistic individuals are more likely to engage in pro-social behaviors to protect others during the pandemic, we use data from the European COVID Survey (ECOS). The data was collected in September 2020 and consisted of a representative sample from seven European countries (N = 7,025). Altruism was measured as a deviation from purely self-interested behavior by asking respondents how much they would be willing to donate from an unexpected gain to the equivalent of 1000€. Respondents who were willing to donate more than 0 Euros (68.7%) were treated as altruistic;on average, respondents were willing to donate 11.7% (SD 17.9) of the gain. Controlling for country, sociodemographics, general risk aversion and COVID-specific risk aversion, we find that individuals classified as altruistic were more likely to behave pro-socially. More specifically, we find that altruistic respondents were more likely to wait at home for test results and wear a mask where it is recommended. They would also stay about 1 day longer under quarantine without symptoms after visiting a high-risk country and were less likely to go to a supermarket with COVID symptoms. We find no significant effect for wearing a mask in places where it is mandatory and for inviting more than six people into the house. Furthermore, we find that the subjective risk assessment of COVID-19 also plays a role in these behaviors. Our results support evidence from the literature that suggests that adherence to pro-social pandemic behaviors may be increased if public health officials emphasize the altruistic nature of these behaviors.

Altruism and the Link to Pro-social Pandemic Behavior.

In the Corona pandemic, especially in the phase before vaccines were available, people's risk of infection with COVID-19 was dependent on the adherence to pandemic behaviors (e. g., wearing masks) of others around them. To explore whether altruistic individuals are more likely to engage in pro-social behaviors to protect others during the pandemic, we use data from the European COVID Survey (ECOS). The data was collected in September 2020 and consisted of a representative sample from seven European countries (N = 7,025). Altruism was measured as a deviation from purely self-interested behavior by asking respondents how much they would be willing to donate from an unexpected gain to the equivalent of 1000€. Respondents who were willing to donate more than 0 Euros (68.7%) were treated as altruistic; on average, respondents were willing to donate 11.7% (SD 17.9) of the gain. Controlling for country, sociodemographics, general risk aversion and COVID-specific risk aversion, we find that individuals classified as altruistic were more likely to behave pro-socially. More specifically, we find that altruistic respondents were more likely to wait at home for test results and wear a mask where it is recommended. They would also stay about 1 day longer under quarantine without symptoms after visiting a high-risk country and were less likely to go to a supermarket with COVID symptoms. We find no significant effect for wearing a mask in places where it is mandatory and for inviting more than six people into the house. Furthermore, we find that the subjective risk assessment of COVID-19 also plays a role in these behaviors. Our results support evidence from the literature that suggests that adherence to pro-social pandemic behaviors may be increased if public health officials emphasize the altruistic nature of these behaviors.

Health-related quality of life in seven European countries throughout the course of the COVID-19 pandemic: evidence from the European COvid Survey (ECOS).

PURPOSE: To investigate health-related quality of life (HRQoL) over the course of the COVID-19 pandemic in seven European countries and its association with selected sociodemographic as well as COVID-19-related variables. METHODS: We used longitudinal data from nine quarterly waves collected between April 2020 and January 2022 (sample size per wave ranging from N = 7025 to 7300) of the European COvid Survey (ECOS), a representative survey of adults in Germany, United Kingdom, Denmark, Netherlands, France, Portugal and Italy. HRQoL was measured using the EQ-5D-5L. The association of self-reported COVID-19 infection, perceived health risk from COVID-19, selected sociodemographic variables and the COVID-19 stringency index with HRQoL was analyzed by logistic and linear fixed effects regressions. RESULTS: On average across all nine waves, the proportion of respondents reporting any problems in at least one of the EQ-5D dimensions ranged between 63.8% (Netherlands) and 71.0% (Denmark). Anxiety/depression was the most frequently affected EQ-5D dimension in four countries (Portugal: 52.0%; United Kingdom: 50.2%; Italy: 49.2%; France: 49.0%), whereas pain/discomfort ranked first in three countries (Denmark: 58.3%; Germany: 55.8%; Netherlands: 49.0%). On average across all nine waves, the EQ-VAS score ranged from 70.1 in the United Kingdom to 78.4 in Portugal. Moreover, the EQ-5D-5L index ranged from .82 in Denmark to .94 in France. The occurrence of COVID-19 infection, changes in the perceived risk to one's own health from COVID-19, the occurrence of income difficulties and an increase in the COVID-19 stringency index were associated with increased likelihood of problems in EQ-5D dimensions, reduced EQ-VAS score and reduced EQ-5D-5L index. CONCLUSIONS: Across seven European countries, we found large proportions of respondents reporting problems in HRQoL dimensions throughout the pandemic, especially for anxiety/depression. Various sociodemographic and COVID-19-related variables were associated with HRQoL in longitudinal analysis.

Depression and anxiety in later COVID-19 waves across Europe: New evidence from the European COvid Survey (ECOS)

We aimed to investigate the prevalence of probable depression and anxiety and their correlates during later stages of the COVID-19 pandemic in eight European countries. Longitudinal data (wave 7 in June/July 2021: n=8,032;wave 8 in September 2021: n=8,250;wave 9 in December 2021/January 2022: n=8,319) were used from the European COvid Survey – a representative sample of community-dwelling adults from several European countries (Germany, United Kingdom, Denmark, Netherlands, France, Portugal, Italy and Spain). In wave 7 (wave 8;wave 9), 23.8% (22.0%;24.3%) of all respondents had probable depression and 22.6% (22.1%;23.7%) had probable anxiety. These prevalence rates substantially differed between the European countries. Regressions showed that emerging difficulties with the income were associated with both increases in depressive symptoms and anxiety symptoms. An increase in one's own perceived risk of getting infected with the SARS-CoV-2, the birth of a child and an increase in the Covid-19 stringency index were associated with increases in depressive symptoms. The significance of probable depression and anxiety during later stages of the COVID-19 pandemic in eight European countries was highlighted. Avoiding income difficulties may also contribute to mental health.

Psychometric evaluation of the Mental Health Quality of Life (MHQoL) instrument in seven European countries.

INTRODUCTION: To make efficient use of available resources, decision-makers in healthcare may assess the costs and (health) benefits of health interventions. For interventions aimed at improving mental health capturing the full health benefits is an important challenge. The Mental Health Quality of Life (MHQoL) instrument was recently developed to meet this challenge. Evaluating the pyschometric properties of this instrument in different contexts remains important. METHODS: A psychometric evaluation of the MHQoL was performed using existing international, cross-sectional data with 7155 respondents from seven European countries (Denmark, France, Germany, Italy, Portugal, The Netherlands, Portugal and the United Kingdom). Reliability was examined by calculating Cronbach's alpha, a measure of internal consistency of the seven MHQoL dimensions, and by examining the association of the MHQoL sum scores with the MHQoL-VAS scores. Construct validity was examined by calculating Spearman's rank correlation coefficients between the MHQoL sum scores and EQ-5D index scores, EQ-VAS scores, EQ-5D anxiety/depression dimension scores, ICECAP-A index scores and PHQ-4 sum scores. RESULTS: The MHQoL was found to have good internal consistency for all seven countries. The MHQoL sum score and the MHQoL-VAS had a high correlation. Spearman's rank correlation coefficients were moderate to very high for all outcomes. CONCLUSION: Our results, based on data gathered in seven European countries, suggest that the MHQoL shows favourable psychometrical characteristics. While further validation remains important, the MHQoL may be a useful instrument in measuring mental health-related quality of life in the Western European context.

Prevalence and determinants of probable depression and anxiety during the COVID-19 pandemic in seven countries: Longitudinal evidence from the European COvid Survey (ECOS).

BACKGROUND: Our aim was to present data on the prevalence of probable depression and anxiety and to determine their correlates during the COVID-19 pandemic in seven European countries using a longitudinal approach. METHODS: Longitudinal data (wave 4 in November 2020: n = 7,115; wave 5 in January 2021: n = 7,068; wave 6 in April 2021: n = 7,204) were taken from the European COvid Survey (ECOS), a representative sample of non-institutionalized inhabitants from Germany, United Kingdom, Denmark, Netherlands, France, Portugal and Italy aged 18+. Probable depression and anxiety were quantified using the established and validated PHQ-4 (2-item depression scale, PHQ-2 / 2-item anxiety scale, GAD-2). RESULTS: In wave 4 (wave 5; wave 6), 26.6% (25.5%; 23.8%) of all respondents had probable depression and 25.7% (23.6%; 22.1%) had probable anxiety. Prevalence rates for probable depression and probable anxiety differed significantly between countries. Among all countries and waves, particularly high prevalence rates were found among individuals aged 18 to 29 years. Longitudinal analysis showed that the likelihood of probable depression was positively associated with increasing age, great income difficulties and lower health-related quality of life. The likelihood of probable anxiety was positively associated with income difficulties, and lower health-related quality of life. LIMITATIONS: Screening tool was used to quantify the outcomes. CONCLUSION: The magnitude of probable depression and anxiety during the COVID-19 pandemic in European countries was highlighted. Moreover, determining the factors associated with probable depression or anxiety (e.g., income difficulties, worse health-related quality of life) may assist in identifying individuals at increased risk.

Blood donation in times of crisis: Early insight into the impact of COVID-19 on blood donors and their motivation to donate across European countries.

BACKGROUND: In this survey, we aimed to provide early insight into the impact of COVID-19 on blood donors and their motivation to donate during the crisis. STUDY DESIGN AND METHODS: We asked representative samples in 7 European countries (Denmark, France, Germany, Italy, Portugal, the Netherlands and the UK) about their blood donation activity and motivation to donate using an online survey. We analysed donor turnout during the COVID-19 period descriptively and using logistic regression. RESULTS: Of the 7122 people that responded to the survey, 1205 (16·9%) blood donors were identified, with 33·8% donating during the first 4-5 months of the COVID-19 period. We observed that around half of donors donated less than normal. The vast majority of donors that did donate made a special effort to do so in response to COVID-19. The majority of donors were also not aware of their blood being tested for COVID-19 antibodies. Although the perceived risk of infection among all respondents whilst donating blood was relatively low, those who anticipated a high risk of infection were much less likely to donate (OR = 0·540; P-value = 0·006). Furthermore, those that were adherent to COVID guidelines were also less likely to donate (OR = 0·583; P-value = 0·000). DISCUSSION: We suggest that blood collection services consider specialist campaigns that focus on the altruistic motivation of donors during the crisis and that they continue to communicate the additional safety measures in place with the aim of reducing the fear of infection whilst donating blood.

Risk communication during COVID-19: A descriptive study on familiarity with, adherence to and trust in the WHO preventive measures.

BACKGROUND: Risk communication is a key component of public health interventions during an outbreak. As the coronavirus pandemic unfolded in late 2019, the World Health Organization (WHO) was at the forefront in the development of risk communication strategies. The WHO introduced a range of activities with the purpose of enabling the public to avail verified and timely information on COVID-19 prevention behaviors. Given the various WHO activities to protect the public health during COVID-19, it is important to investigate the extent of familiarity and uptake of the WHO recommendations among the public during the first wave of the pandemic. METHODS: To do this, we conducted a large-scale Pan-European survey covering around 7500 individuals that are representative of populations from seven European countries, collected online during April 2-April 15, 2020. We use descriptive statistics including proportions and correlations and graphical representations such as bar charts to analyze and display the data. RESULTS: Our findings suggest that information from the WHO in the context of COVID-19 is well trusted and acted upon by the public. Overall familiarity and adherence were quite high in most countries. Adherence was higher for social distancing recommendations compared to hygiene measures. Familiarity and adherence were higher among older, female, and highly educated respondents. However, country level heterogeneities were observed in the level of trust in information from the WHO, with countries severely affected by the pandemic reporting lower levels of trust. CONCLUSION: Our findings call for efforts from health authorities to get regular feedback from the public on their familiarity and compliance with recommendations for preventive measures at all stages of the pandemic, to further develop and adapt risk communication as the pandemic evolves.

Simplified Mathematical Modelling of Uncertainty: Cost-Effectiveness of COVID-19 Vaccines in Spain

When exceptional situations, such as the COVID-19 pandemic, arise and reliable data is not available at decision-making times, estimation using mathematical models can provide a reasonable reckoning for health planning. We present a simplified model (static but with two-time references) for estimating the cost-effectiveness of the COVID-19 vaccine. A simplified model provides a quick assessment of the upper bound of cost-effectiveness, as we illustrate with data from Spain, and allows for easy comparisons between countries. It may also provide useful comparisons among different vaccines at the marketplace, from the perspective of the buyer. From the analysis of this information, key epidemiological figures, and costs of the disease for Spain have been estimated, based on mortality. The fatality rate is robust data that can alternatively be obtained from death registers, funeral homes, cemeteries, and crematoria. Our model estimates the incremental cost-effectiveness ratio (ICER) to be 5132 € (4926–5276) as of 17 February 2021, based on the following assumptions/inputs: An estimated cost of 30 euros per dose (plus transport, storing, and administration), two doses per person, efficacy of 70% and coverage of 70% of the population. Even considering the possibility of some bias, this simplified model provides confirmation that vaccination against COVID-19 is highly cost-effective.

United but divided: Policy responses and people's perceptions in the EU during the COVID-19 outbreak.

To understand the public sentiment toward the measures used by policymakers for COVID-19 containment, a survey among representative samples of the population in seven European countries was carried out in the first two weeks of April 2020. The study addressed people's support for containment policies, worries about COVID-19 consequences, and trust in sources of information. Citizens were overall satisfied with their government's response to the pandemic; however, the extent of approval differed across countries and policy measures. A north-south divide in public opinion was noticeable across the European states. It was particularly pronounced for intrusive policy measures, such as mobile data use for movement tracking, economic concerns, and trust in the information from the national government. Considerable differences in people's attitudes were noticed within countries, especially across individual regions and age groups. The findings suggest that the epidemic acts as a stressor, causing health and economic anxieties even in households that were not directly affected by the virus. At the same time, the burden of stress was unequally distributed across regions and age groups. Based on the data collected, we draw lessons from the containment stage and identify several insights that can facilitate the design of lockdown exit strategies and future containment policies so that a high level of compliance can be expected.