Sociocultural determinants of global mask-wearing behavior.

Behavioral responses influence the trajectories of epidemics. During the COVID-19 pandemic, nonpharmaceutical interventions (NPIs) reduced pathogen transmission and mortality worldwide. However, despite the global pandemic threat, there was substantial cross-country variation in the adoption of protective behaviors that is not explained by disease prevalence alone. In particular, many countries show a pattern of slow initial mask adoption followed by sharp transitions to high acceptance rates. These patterns are characteristic of behaviors that depend on social norms or peer influence. We develop a game-theoretic model of mask wearing where the utility of wearing a mask depends on the perceived risk of infection, social norms, and mandates from formal institutions. In this model, increasing pathogen transmission or policy stringency can trigger social tipping points in collective mask wearing. We show that complex social dynamics can emerge from simple individual interactions and that sociocultural variables and local policies are important for recovering cross-country variation in the speed and breadth of mask adoption. These results have implications for public health policy and data collection.

Personal hardship narrows the partisan gap in COVID-19 and climate change responses.

The COVID-19 pandemic in the United States was characterized by a partisan gap. Democrats were more concerned about this novel health threat, more willing to socially distance, and more likely to support policies aimed at mitigating the spread of the virus than Republicans. In cross-sectional analyses of three nationally representative survey waves in 2020, we find that adverse experience with COVID-19 is associated with a narrowing of the partisan gap. The mean difference between Republicans and Democrats in concern, policy support, and behavioral intentions narrows or even disappears at high levels of self-reported adverse experience. Reported experience does not depend on party affiliation and is predicted by local COVID-19 incidence rates. In contrast, analyses of longitudinal data and county-level incidence rates do not show a consistent relationship among experience, partisanship, and behavior or policy support. Our findings suggest that self-reported personal experience interacts with partisanship in complex ways and may be an important channel for concern about novel threats such as the COVID-19 pandemic. We find consistent results for self-reported experience of extreme weather events and climate change attitudes and policy preferences, although the association between extreme weather and experience and climate change is more tenuous.

Examining evidence for the Finite Pool of Worry and Finite Pool of Attention hypotheses

The Finite Pool of Worry (FPW) hypothesis states that humans have finite emotional resources for worry, so that when we become more worried about one threat, worry about other threats decreases. Despite its relevance, no conclusive empirical evidence for the hypothesis exists. We leverage the sudden onset of new worries introduced by the COVID-19 pandemic as a natural experiment to test the FPW hypothesis and a related hypothesis, the Finite Pool of Attention (FPA) hypothesis. The FPA hypothesis proposes that when we pay more attention to one threat, our attention to other threats decreases. To test these two hypotheses, we assessed self-reported attention, self-reported worries, and Twitter/news attention to various threats (climate change, terrorism, economic problems, and others) throughout the pandemic in three countries (USA, Italy, and China). We find that as attention to and worry about COVID-19 increases, attention to climate change decreases, but worry does not. Our results are confirmed by further analysis of a large, longitudinal U.S. sample. We find that public perceptions that COVID-19 and climate change are related do not fully explain the positive relationship in worry between the two hazards. In summary, our findings suggest that while there may be a Finite Pool of Attention to threats, there is limited evidence for a Finite Pool of Worry.

Cardiogenic shock with highly complicated course after influenza A virus infection treated with vva-ECMO and Impella CP (ECMELLA): a case report.

BACKGROUND: The value of mechanical circulatory support (MCS) in cardiogenic shock, especially the combination of the ECMELLA approach (Impella combined with ECMO), remains controversial. CASE PRESENTATION: A previously healthy 33-year-old female patient was submitted to a local emergency department with a flu-like infection and febrile temperatures up to 39 °C. The patient was tested positive for type-A influenza, however negative for SARS-CoV-2. Despite escalated invasive ventilation, refractory hypercapnia (paCO2: 22 kPa) with severe respiratory acidosis (pH: 6.9) and a rising norepinephrine rate occurred within a few hours. Due to a Horovitz-Index < 100, out-of-centre veno-venous extracorporeal membrane oxygenation (vv-ECMO)-implantation was performed. A CT-scan done because of anisocoria revealed an extended dissection of the right vertebral artery. While the initial left ventricular function was normal, echocardiography revealed severe global hypokinesia. After angiographic exclusion of coronary artery stenoses, we geared up LV unloading by additional implantation of an Impella CP and expanded the vv-ECMO to a veno-venous-arterial ECMO (vva-ECMO). Clinically relevant bleeding from the punctured femoral arteries resulted in massive transfusion and was treated by vascular surgery later on. Under continued MCS, LVEF increased to approximately 40% 2 days after the initiation of ECMELLA. After weaning, the Impella CP was explanted at day 5 and the vva-ECMO was removed on day 9, respectively. The patient was discharged in an unaffected neurological condition to rehabilitation 25 days after the initial admission. CONCLUSIONS: This exceptional case exemplifies the importance of aggressive MCS in severe cardiogenic shock, which may be especially promising in younger patients with non-ischaemic cardiomyopathy and potentially reversible causes of cardiogenic shock. This case impressively demonstrates that especially young patients may achieve complete neurological restoration, even though the initial prognosis may appear unfavourable.

Our future in the Anthropocene biosphere.

The COVID-19 pandemic has exposed an interconnected and tightly coupled globalized world in rapid change. This article sets the scientific stage for understanding and responding to such change for global sustainability and resilient societies. We provide a systemic overview of the current situation where people and nature are dynamically intertwined and embedded in the biosphere, placing shocks and extreme events as part of this dynamic; humanity has become the major force in shaping the future of the Earth system as a whole; and the scale and pace of the human dimension have caused climate change, rapid loss of biodiversity, growing inequalities, and loss of resilience to deal with uncertainty and surprise. Taken together, human actions are challenging the biosphere foundation for a prosperous development of civilizations. The Anthropocene reality-of rising system-wide turbulence-calls for transformative change towards sustainable futures. Emerging technologies, social innovations, broader shifts in cultural repertoires, as well as a diverse portfolio of active stewardship of human actions in support of a resilient biosphere are highlighted as essential parts of such transformations.