Moral Narratives Around the Vaccination Debate on Facebook (preprint)

Vaccine hesitancy is a complex issue with psychological, cultural, and even societal factors entangled in the decision-making process. The narrative around this process is captured in our everyday interactions; social media data offer a direct and spontaneous view of peoples' argumentation. Here, we analysed more than 500,000 public posts and comments from Facebook Pages dedicated to the topic of vaccination to study the role of moral values and, in particular, the understudied role of the Liberty moral foundation from the actual user-generated text. We operationalise morality by employing the Moral Foundations Theory, while our proposed framework is based on recurrent neural network classifiers with a short memory and entity linking information. Our findings show that the principal moral narratives around the vaccination debate focus on the values of Liberty, Care, and Authority. Vaccine advocates urge compliance with the authorities as prosocial behaviour to protect society. On the other hand, vaccine sceptics mainly build their narrative around the value of Liberty, advocating for the right to choose freely whether to adhere or not to the vaccination. We contribute to the automatic understanding of vaccine hesitancy drivers emerging from user-generated text, providing concrete insights into the moral framing around vaccination decision-making. Especially in emergencies such as the Covid-19 pandemic, contrary to traditional surveys, these insights can be provided contemporary to the event, helping policymakers craft communication campaigns that adequately address the concerns of the hesitant population.

SARS-CoV-2 genomic characterization and clinical manifestation of the COVID-19 outbreak in Uruguay (preprint)

COVID-19 is a respiratory illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and declared by the World Health Organization as a global public health emergency. Among the severe outbreaks across South America, Uruguay has become known for curtailing SARS-CoV-2 exceptionally well. To understand the SARS-CoV-2 introductions, local transmissions, and associations with genomic and clinical parameters in Uruguay, we sequenced the viral genomes of 44 outpatients and inpatients in a private healthcare system in its capital, Montevideo, from March to May 2020. We performed a phylogeographic analysis using sequences from our cohort and other studies that indicate a minimum of 23 independent introductions into Uruguay, resulting in five major transmission clusters. Our data suggest that most introductions resulting in chains of transmission originate from other South American countries, with the earliest seeding of the virus in late February 2020, weeks before the borders were closed to all non-citizens and a partial lockdown implemented. Genetic analyses suggest a dominance of S and G clades (G, GH, GR) that make up >90% of the viral strains in our study. In our cohort, lethal outcome of SARS-CoV-2 infection significantly correlated with arterial hypertension, kidney failure, and ICU admission (FDR < 0.01), but not with any mutation in a structural or non-structural protein, such as the spike D614G mutation. Our study contributes genetic, phylodynamic, and clinical correlation data about the exceptionally well-curbed SARS-CoV-2 outbreak in Uruguay, which furthers the understanding of disease patterns and regional aspects of the pandemic in Latin America.

Too Small to Fail: The Role of Medicaid in Mitigating Pandemic-Related Fiscal Strain on Local Governments (preprint)

Local governments across the U.S. have had a prominent role in financing the pandemic response during the ongoing COVID-19 outbreak and economic recession. Yet, such governments are increasingly facing budgetary strain as sources of tax revenue evaporate. If the financial burden on such governments can be eased, they may better address those aspects of pandemic response to which they are uniquely suited, such as coordinating resources and re-allocating space within their communities. This paper investigates the role of Medicaid, traditionally the default insurer of the unemployed, as a stabilizing force on local government budgets. Using panel data from county governments during the Great Recession (2006-2012), we estimate the effect of state Medicaid generosity on local government finances. We find that Medicaid mitigates the effect of unemployment shocks on county government expenditures, specifically safety net programs and debt. We apply these point estimates to extrapolate predictions based on contemporary state Medicaid generosity and local unemployment rates. In this way, we show that Medicaid continues to mitigate the financial strain on local government during the COVID-19 pandemic.