Proactive vs. reactive country responses to the COVID-19 pandemic shock

The infection caused by SARS-CoV-2, responsible for the COVID-19 pandemic, is characterized by an infectious period with either asymptomatic or pre-symptomatic phases, leading to a rapid surge of mild and severe cases putting national health systems under serious stress. To avoid their collapse, and in the absence of pharmacological treatments, during the early pandemic phase countries worldwide were forced to adopt strategies, from elimination to mitigation, based on non-pharmacological interventions which, in turn, overloaded social, educational and economic systems. To date, the heterogeneity and incompleteness of data sources does not allow to quantify the multifaceted impact of the pandemic at country level and, consequently, to compare the effectiveness of country responses. Here, we tackle this challenge from a complex systems perspective, proposing a model to evaluate the impact of systemic failures in response to the pandemic shock. We use health, behavioral and economic indicators for 44 countries to build a shock index quantifying responses in terms of robustness and resilience, highlighting the crucial advantage of proactive policy and decision making styles over reactive ones, which can be game-changing during the emerging of a new variant of concern.

The link between reported cases of COVID-19 and the Infodemic Risk Index: A worldwide perspective.

In this brief report we followed the evolution of the COVID-19 Infodemic Risk Index during 2020 and clarified its connection with the epidemic waves, focusing specifically on their co-evolution in Europe, South America, and South-eastern Asia. Using 640 million tweets collected by the Infodemic Observatory and the open access dataset published by Our World in Data regarding COVID-19 worldwide reported cases, we analyze the COVID-19 infodemic vs. pandemic co-evolution from January 2020 to December 2020. We find that a characteristic pattern emerges at the global scale: a decrease in misinformation on Twitter as the number of COVID-19 confirmed cases increases. Similar local variations highlight how this pattern could be influenced both by the strong content moderation policy enforced by Twitter after the first pandemic wave and by the phenomenon of selective exposure that drives users to pick the most visible and reliable news sources available.

The link between reported cases of COVID-19 and the Infodemic Risk Index: A worldwide perspective

In this brief report we followed the evolution of the COVID-19 Infodemic Risk Index during 2020 and clarified its connection with the epidemic waves, focusing specifically on their co-evolution in Europe, South America, and South-eastern Asia. Using 640 million tweets collected by the Infodemic Observatory and the open access dataset published by Our World in Data regarding COVID-19 worldwide reported cases, we analyze the COVID-19 infodemic vs. pandemic co-evolution from January 2020 to December 2020. We find that a characteristic pattern emerges at the global scale: a decrease in misinformation on Twitter as the number of COVID-19 confirmed cases increases. Similar local variations highlight how this pattern could be influenced both by the strong content moderation policy enforced by Twitter after the first pandemic wave and by the phenomenon of selective exposure that drives users to pick the most visible and reliable news sources available.

Experts vs. policymakers in the COVID-19 policy response.

We build an evolutionary game-theoretic model of the interaction between policymakers and experts in shaping the policy response to the COVID-19 pandemic. Players' decisions concern two alternative strategies of pandemic management: a "hard" approach, enforcing potentially unpopular measures such as strict confinement orders, and a "soft" approach, based upon voluntary and short-lived social distancing. Policymakers' decisions may also rely upon expert advice. Unlike experts, policymakers are sensitive to a public consensus incentive that makes lifting restrictions as soon as possible especially desirable. This incentive may conflict with the overall goal of mitigating the effects of the pandemic, leading to a typical policy dilemma. We show that the selection of strategies may be path-dependent, as their initial distribution is a crucial driver of players' choices. Contingent on cultural factors and the epidemiological conditions, steady states in which both types of players unanimously endorse the strict strategy can coexist with others where experts and policymakers agree on the soft strategy, depending on the initial conditions. The model can also lead to attractive asymmetric equilibria where experts and policymakers endorse different strategies, or to cyclical dynamics where the shares of adoption of strategies oscillate indefinitely around a mixed strategy equilibrium. This multiplicity of equilibria can explain the coexistence of contrasting pandemic countermeasures observed across countries in the first wave of the outbreak. Our results suggest that cross-country differences in the COVID-19 policy response need not be the effect of poor decision making. Instead, they can endogenously result from the interplay between policymakers and experts incentives under the local social, cultural and epidemiological conditions.

The Role of Stress and Cognitive Absorption in Predicting Social Network Addiction.

Nowadays, the use of social networks (SNs) is pervasive and ubiquitous. Among other things, SNs have become a key resource for establishing and maintaining personal relationships, as further demonstrated by the emergence of the pandemic. However, easy access to SNs may be a source of addictive behaviour, especially among the younger population. The literature highlights various psychological and physiological factors as possible predictors of vulnerability to SN addiction. This paper explores the joint effects of stress level and cognitive absorption, in the form of temporal dissociation while on SNs, on the addiction of university students to SNs. Here, 312 participants were involved in an online survey. About 14% of the sample presented a risk for SN addiction. Moreover, it was found that stress level predicted SN addiction both directly and indirectly through the effect of individual temporal dissociation, as experienced during SN usage. These results suggest a significant role of perceived stress level on addiction risk, while also pointing out additional vulnerability to SN addiction for cognitive profiles that are relatively more prone to temporal dissociation while online.

Curing is caring? Liability reforms, defensive medicine and malpractice litigation in a post-pandemic world

We analyze different scenarios of defensive medicine in a unique game theoretic framework, representing a healing relationship between a physician and a patient. The physician should choose between providing the optimal treatment or an inferior one, which can amount to practicing defensive medicine. The patient should choose whether to litigate or not, if an adverse event occurs. When both agents have no dominant strategy, we obtain four scenarios representing the positive and negative forms of defensive medicine, with or without physician's moral hazard. We find that certain legal parameters can have opposite effects on the probabilities that physicians practice defensive medicine and that patients litigate, depending respectively on the form of defensive medicine and on the presence of moral hazard. This result can explain the ambiguous results, reported in empirical literature, of legal reforms aimed at discouraging defensive medicine and medical malpractice litigation.

Emergence of knowledge communities and information centralization during the COVID-19 pandemic.

BACKGROUND: As COVID-19 spreads worldwide, an infodemic - i.e., an over-abundance of information, reliable or not - spreads across the physical and the digital worlds, triggering behavioral responses which cause public health concern. METHODS: We study 200 million interactions captured from Twitter during the early stage of the pandemic, from January to April 2020, to understand its socio-informational structure on a global scale. FINDINGS: The COVID-19 global communication network is characterized by knowledge groups, hierarchically organized in sub-groups with well-defined geo-political and ideological characteristics. Communication is mostly segregated within groups and driven by a small number of subjects: 0.1% of users account for up to 45% and 10% of activities and news shared, respectively, centralizing the information flow. INTERPRETATION: Contradicting the idea that digital social media favor active participation and co-creation of online content, our results imply that public health policy strategies to counter the effects of the infodemic must not only focus on information content, but also on the social articulation of its diffusion mechanisms, as a given community tends to be relatively impermeable to news generated by non-aligned sources.

Public health challenges and opportunities after COVID-19.

With hindsight, the main weakness behind the ineffective response to the coronavirus disease 2019 (COVID-19) pandemic in some countries has been the failure to understand, and take account of, the multilayered systemic interdependencies that spread the effects of the pandemic across social, technological, economic and health-care dimensions. For example, to respond to the COVID-19 pandemic, all people were required to rapidly adjust to social distancing and travel restrictions. Such a complex behavioural response entails adaptation to achieve a full recovery from the systemic shock. To capitalize on the positive effects of disruption to the status quo, much more complex socioeconomic modelling needs to be considered when designing and evaluating possible public health interventions that have major behavioural implications. We provide a simple example of how this reasoning may highlight generally unacknowledged connections and interdependencies and guide the construction of scenarios that can inform policy decisions to enhance the resilience of society and tackle existing societal challenges.

Avec le recul, le principal motif d'inefficacité dans la lutte contre la pandémie de maladie à coronavirus 2019 (COVID-19) dans certains pays trouve son origine dans l'incapacité à comprendre les interdépendances systémiques à de multiples niveaux et à en tenir compte. Ces dernières répercutent les effets de la pandémie sur plusieurs dimensions: sociale, technologique, économique et sanitaire. Pour tenter de contenir la pandémie de COVID-19, la population a notamment été contrainte de se conformer rapidement aux mesures de distanciation physique et aux restrictions de voyage. Un changement de comportement aussi abrupt requiert un temps d'adaptation afin de se remettre totalement d'un tel choc structurel. Si l'on souhaite profiter de l'impact positif qu'exerce ce bouleversement de situation, des modèles socio-économiques bien plus complexes doivent être envisagés au moment de concevoir et d'évaluer les interventions de santé publique potentielles ayant des conséquences majeures sur le comportement. Dans le présent document, nous citons un exemple simple qui montre comment ce raisonnement pourrait mettre en lumière des connexions et interdépendances souvent méconnues, mais aussi guider l'élaboration de scénarios qui serviront à étayer les décisions politiques, accroître la résilience de la société et aborder les enjeux sociétaux actuels.

En retrospectiva, el principal punto débil de la ineficacia de la respuesta a la pandemia de la enfermedad por coronavirus 2019 (COVID-19) en algunos países ha sido la incapacidad de comprender y tener en cuenta las interdependencias sistémicas de varios niveles que difundieron los efectos de la pandemia en las dimensiones social, tecnológica, económica y sanitaria. Por ejemplo, para responder a la pandemia de la COVID-19, todas las personas tuvieron que adaptarse rápidamente al distanciamiento social y a las restricciones de movilidad. Una respuesta conductual tan compleja conlleva la adaptación para lograr una recuperación total del choque sistémico. Para aprovechar los efectos positivos de la alteración del statu quo, es necesario tener en cuenta una modelización socioeconómica mucho más compleja a la hora de diseñar y evaluar posibles intervenciones de salud pública que tengan importantes implicaciones conductuales. Aportamos un ejemplo sencillo de cómo este razonamiento puede poner de manifiesto conexiones e interdependencias generalmente no reconocidas y guiar la construcción de escenarios que puedan informar las decisiones políticas para mejorar la resiliencia de la sociedad y abordar los retos sociales existentes.

Framework for Managing the COVID-19 Infodemic: Methods and Results of an Online, Crowdsourced WHO Technical Consultation.

BACKGROUND: An infodemic is an overabundance of information-some accurate and some not-that occurs during an epidemic. In a similar manner to an epidemic, it spreads between humans via digital and physical information systems. It makes it hard for people to find trustworthy sources and reliable guidance when they need it. OBJECTIVE: A World Health Organization (WHO) technical consultation on responding to the infodemic related to the coronavirus disease (COVID-19) pandemic was held, entirely online, to crowdsource suggested actions for a framework for infodemic management. METHODS: A group of policy makers, public health professionals, researchers, students, and other concerned stakeholders was joined by representatives of the media, social media platforms, various private sector organizations, and civil society to suggest and discuss actions for all parts of society, and multiple related professional and scientific disciplines, methods, and technologies. A total of 594 ideas for actions were crowdsourced online during the discussions and consolidated into suggestions for an infodemic management framework. RESULTS: The analysis team distilled the suggestions into a set of 50 proposed actions for a framework for managing infodemics in health emergencies. The consultation revealed six policy implications to consider. First, interventions and messages must be based on science and evidence, and must reach citizens and enable them to make informed decisions on how to protect themselves and their communities in a health emergency. Second, knowledge should be translated into actionable behavior-change messages, presented in ways that are understood by and accessible to all individuals in all parts of all societies. Third, governments should reach out to key communities to ensure their concerns and information needs are understood, tailoring advice and messages to address the audiences they represent. Fourth, to strengthen the analysis and amplification of information impact, strategic partnerships should be formed across all sectors, including but not limited to the social media and technology sectors, academia, and civil society. Fifth, health authorities should ensure that these actions are informed by reliable information that helps them understand the circulating narratives and changes in the flow of information, questions, and misinformation in communities. Sixth, following experiences to date in responding to the COVID-19 infodemic and the lessons from other disease outbreaks, infodemic management approaches should be further developed to support preparedness and response, and to inform risk mitigation, and be enhanced through data science and sociobehavioral and other research. CONCLUSIONS: The first version of this framework proposes five action areas in which WHO Member States and actors within society can apply, according to their mandate, an infodemic management approach adapted to national contexts and practices. Responses to the COVID-19 pandemic and the related infodemic require swift, regular, systematic, and coordinated action from multiple sectors of society and government. It remains crucial that we promote trusted information and fight misinformation, thereby helping save lives.