Educator Perspectives on Stressors and Health: A qualitative study of U.S. K-12 educators in February 2022 (preprint)

Background The teaching profession, already characterized by high stress and burnout, experienced exacerbated challenges during the height of the COVID-19 pandemic. While educators faced changing job demands over the course of the pandemic with switches in remote and in-person teaching along with COVID-19 transmission prevention strategies, the demands and resulting impact in the years that follow are still being explored. We sought to understand the stressors and health impacts of U.S. educators in the 2021–2022 school year, 2 years following the acute phase of the pandemic.Methods Thirty-four certified educators based in Connecticut, USA participated in 4 virtual focus groups in February 2022. A semi-structured focus group script, designed by the research team and guided by the job demands-resources model, was administered to understand stress impacts and stressors. Data were transcribed and analyzed using the constant comparative method to identify themes and sub-themes. Themes were summarized by frequency as well as by individuals.Results The majority of respondents reported educator well-being impacts of stress fell into three categories: physical health impacts and behaviors (76%; e.g. poor sleep, physical exhaustion, lack of exercise, unhealthy eating), psychological health impacts (62%; e.g. emotional exhaustion, anxiety, negative self-evaluation); and social well-being impacts and behaviors (68%; e.g. connections with family or friends, connections with others, relationships with coworkers). Sources of reported stressors included the school or district (94%), personal (65%), situational (35%), and to a lesser extent parents (24%), other work factors (15%), community (12%), students (12%), and state or national level (9%) factors. At the school/district level, stressors were related to protocols/expectations (91%, e.g. excessive or increased demands, insufficient or decreased resources) or administrators (38%). Personal level stressors included personal life (41%); other personal factors (20%); and income (17%); situational factors included the pandemic (26%) and safety concerns (9%).Conclusion Focus groups allowed us to assess the health and working conditions of Connecticut’s public education workforce 2 years following the acute phase of the pandemic. Lasting effects are relevant in the post-pandemic era and continue to pose challenges as teacher shortages increase. Targeted interventions are needed to reduce school and district-related demands and to address stress-related educator well-being.

The Outcome of the Psychological and Therapeutical Care of Hospitalized COVID-19 Patients: National African Pilot Study (preprint)

Introduction: Hospitalization in a COVID-19 unit represents a significant source of stress and psychological distress for patients. Our study aims to determine the factors of psychological distress in the therapeutic and psychosocial management of patients hospitalized with a COVID-19 infection. Methods: This cross-sectional study was carried out over 8 months at the COVID-19 zone of the CHU HASSAN II of FES. 99 patients were evaluated within days of diagnosis by psychometric scales of anxiety, depression, and post-traumatic stress. In the course of this follow-up, we found the presence of psychological impacts in these patients, and we tried to find correlating factors between the occurrence of psychiatric disorders and the set of factors related to sociodemographic data, hospitalization course and treatments taken, as well as family support. Results: 35% of patients had scores in favor of post-traumatic stress disorder, 37% of the patients had definite depression and 50% had anxiety. Post-traumatic stress, depression, and anxiety were correlated with sociodemographic factors, hospitalization, treatments received, and length of stay. Conclusion: The prevalence of anxiety-depressive disorders and post-traumatic stress disorder was high in patients with COVID-19, hence the interest in providing psychological and psychosocial care in the emergency department.

Immune history influences SARS-CoV-2 booster impacts: the role of efficacy and redundancy (preprint)

Given the continued emergence of SARS-CoV-2 variants of concern as well as unprecedented vaccine development, it is crucial to understand the effect of the updated vaccine formulations at the population level. While bivalent formulations have higher efficacy in vaccine trials, translating these findings to real-world effectiveness is challenging due to the diversity in immune history, especially in settings with a high degree of natural immunity. Known socioeconomic disparities in key metrics such as vaccine coverage, social distancing, and access to healthcare have likely shaped the development and distribution of this immune landscape. Yet little has been done to investigate the impact of booster formulation in the context of host heterogeneity. Using two complementary mathematical models that capture host demographics and immune histories over time, we investigated the potential impacts of bivalent and monovalent boosters in low- and middle-income countries (LMICs). These models allowed us to test the role of natural immunity and cross-protection in determining the optimal booster strategy. Our results show that to avert deaths from a new variant in populations with high immune history, it is more important that a booster is implemented than which booster is implemented (bivalent vs. monovalent). However, in populations with low preexisting immunity, bivalent boosters can become optimal. These findings suggest that for many LMICs - where acquiring a new vaccine stock may be economically prohibitive - monovalent boosters can still be implemented as long as pre-existing immunity is high.

Factors affecting the intention of healthcare workers and students to receive COVID-19 booster dose vaccination: a systematic review (preprint)

Background The COVID-19 pandemic has caused an unprecedented health, social and economic crisis worldwide, as the SARS-CoV-2 virus has managed to cause a major threat with significant morbidity and mortality in certain population groups. The risk of the virus is exacerbated by its easy transmission and continued spread, despite multilevel interventions, extensive containment measures and vaccination. Vaccine hesitancy refers to a person’s reluctance, delay in accepting or even refusing to be vaccinated despite available vaccination services.Objective To investigate the factors that influence health professionals and students of health sciences to accept, or not, a booster dose of a COVID-19 vaccine. Sub-objectives were to assess vaccine hesitancy, and specifically those of booster doses, and the presentation of views and attitudes in the above population groups.Methods The relevant bibliography was searched electronically in scientific databases such as PubMed, Embase, Cochrane Library and Scopus until August 2023. The main selection criteria were mainly descriptive studies, published in English and Greek. The subjects were human over 18 years old. The time frame of this search was the last four years.Results From the results of the systematic review, it was shown that many different factors influence the intention of both healthcare workers and students, as well as those in the general population, to accept a COVID-19 booster dose vaccine. At the same time, the health professionals and students of different countries and continents -that were studied- present diverse socio-demographic characteristics that influence their willingness, or not, to be vaccinated.Conclusions COVID-19 booster doses offer further immunity and reduce severe impacts of the disease, such as hospitalization and death. Since health professionals play a critical role in shaping local communities’ attitudes towards vaccines, their beliefs and attitudes play a crucial role. For this reason, it is recommended both training students and healthcare workers via competent institutions, as well as to mobilize and sensitize them, in order to base their attitudes on evidence-based practice. As new technologies and policies are built around COVID-19 vaccines, ongoing testing of their effectiveness, and updated guidelines according to the population group are proven vital to the impact of the disease. Further future studies are necessary.

Understanding Parkinson's Disease Conversations on Chinese Social Media: Themes, Trends, and Connections (preprint)

Parkinson's disease profoundly impacts patients' quality of life, yet public awareness is limited. As social networks reach broad audiences, they are vital platforms for health communication. This study analyzed Parkinson's disease (PD) topics on China's major social network, Weibo, to reveal public awareness and concerns. We found Parkinson's became a popular keyword due to its association with hand tremors, though this trend may impede public comprehensive understanding of this disease. Through time series analysis, marketing accounts were found to publish misinformation through concentrated posts during specific periods, but this false information had limited impact. Further analysis of communication network structures showed people focused more on mutual aid than acquiring Parkinson's disease knowledge. This indicates advanced technique should be develop to promote accurate Parkinson's knowledge through social media. Additionally, the COVID-19 pandemic over the past three years led people to pay more attention to Parkinson's, demonstrating social media's role in responding to health crises. Overall, this study details how people discuss diseases on social media, providing a basis for developing communication strategies to promote Parkinson's and other diseases, while also informing patient mutual aid systems. To our best knowledge, this is the first study revealing the communications characteristics of PD related contents on social network. The findings may also empower more effective health promotion and patient support worldwide through social networks.

G6PD deficiency mediated impairment of iNOS and lysosomal acidification affecting phagocytotic clearance in microglia in response to SARS-CoV-2 (preprint)

The glucose-6-phosphate dehydrogenase (G6PD) deficiency is X-linked and is the most common enzymatic deficiency disorder globally. It is a crucial enzyme for the pentose phosphate pathway and produces NADPH, which plays a vital role in the regulation of oxidative stress of many cell types. The deficiency of G6PD causes hemolytic anemia, diabetes, cardiovascular and neurological disorders. Notably, the patient with G6PD deficiency was severely affected by SARS-CoV-2 and showed prolonged COVID-19 symptoms, neurological impacts, and high mortality. However, the mechanism of COVID-19 severity in G6PD deficient patients is still ambiguous. Here, using a CRISPR-edited G6PD deficient human microglia cell culture model, we observed a significant reduction in NADPH and an increase in basal reactive oxygen species (ROS) in microglia. Interestingly, the deficiency of the G6PD-NAPDH axis impairs induced nitric oxide synthase (iNOS) mediated nitric oxide (NO) production which plays a fundamental role in inhibiting viral replication. Surprisingly, we also observed that the deficiency of the G6PD-NADPH axis reduced lysosomal acidification, which further abrogates the lysosomal clearance of viral particles. Thus, impairment of NO production and lysosomal acidification as well as redox dysregulation in G6PD deficient microglia altered innate immune response, promoting the severity of SARS-CoV-2 pathogenesis.

The well-being and work-related stress of senior school leaders in Wales and Northern Ireland during the COVID-19 pandemic: A cross-sectional descriptive study (preprint)

The COVID-19 pandemic caused far-reaching societal changes, including significant educational impacts, affecting over 1.6 billion pupils and 100 million education practitioners globally. Senior school leaders were at the forefront; an occupation already reporting high work-related stress and large numbers leaving the profession preceding COVID-19, leaders were exposed to high demands relating to the numerous challenges they had to manage during a "crisis leadership" period. This cross-sectional descriptive study conducted through through the international COVID-HL network aimed to examine the well-being and work-related stress of senior school leaders (n=323) in Wales (n=172) and Northern Ireland (n=151) during COVID-19 (2021-2022). Findings suggest that senior school leaders reported high workloads (54.22{+/-}11.30 hours/week), low well-being (65.2% n=202, mean WHO-5 40.85{+/-}21.57), depressive symptoms (WHO-5 34.8% n=108) and high work-related stress (PSS-10: 29.91{+/-}4.92). High exhaustion (BAT: high/very high 89.0% n=285) and specific psychosomatic complaints (experiencing muscle pain 48.2% n=151) were also reported, and females had statistically higher outcomes in these areas. School leaders were engaging in self-endangering working behaviours; 74.7% (n=239) gave up leisure activities in favour of work and 63.4% (n=202) sacrificed sufficient sleep, which was statistically higher for females. These findings are concerning given that the UK is currently experiencing a "crisis" in educational leadership against a backdrop of pandemic-related pressures. Senior leaders high attrition rates further exacerbate this, proving costly to educational systems and placing additional financial and other pressures on educational settings and policy response. This has implications for senior leaders and pupil-level outcomes including health, well-being and educational attainment, requiring urgent tailored and targeted support from the education and health sectors. This is particularly pertinent for Wales and Northern Ireland as devolved nations in the UK, who are both implementing or contemplating major education system level reforms, including new statutory national curricula, requiring significant leadership, engagement and ownership from the education profession.

Participatory Approaches in Community Health in light of the COVID-19 Pandemic: A Scoping Review Protocol (preprint)

Background Participatory approaches are considered essential to ensure community health in the context of the COVID-19 pandemic. Previous reviews on community participation have explored different aspects of participation in specific contexts, such as public health emergencies, but none has examined participatory approaches both in depth and in breadth across diverse activities during the COVID-19 pandemic and considering diverse communities in all country contexts. This scoping review seeks to: (a) provide an overview of participatory approaches in terms of the features and depth of participation, the breadth of the communities and stakeholders involved, and for what types of activities and interventions in light of the COVID-19 pandemic across all country contexts; (b) explore the challenges and facilitators of participation processes; and (c) analyse to what extent participation impacts community health, including health equity, in the context of a public health emergency. Methods We developed this protocol following the latest JBI guidance on scoping reviews. A comprehensive search strategy combining the concepts of participation, community health, and COVID-19 was used to search the databases of Medline/Ovid, Embase.com, Cochrane CENTRAL, Web of Science, APA PsycInfo/Ovid, Global Health/Ovid, ERIC/OvidSP, CINAHL/EBSCOhost, ClinTrials.gov, and the grey literature through Google Scholar. At least two reviewers will perform screening of titles/abstracts and full text using the inclusion and exclusion criteria defined in this protocol. Article characteristics and data on participatory approaches and community health will be charted to provide an overview of the literature, map the variations in participatory approaches and community health, and explore patterns in the links between participation, community health, and the type of activities to address the challenges related to the COVID-19 pandemic. Discussion We anticipate that review findings will contribute to advance innovative thinking about community participation and facilitating better application and integration of participatory approaches to ensure community health in a future public health emergency or in building back better fairer in the new normal.

Complexity of the COVID-19 pandemic in Maringa (preprint)

While extensive literature exists on the COVID-19 pandemic at regional and national levels, understanding its dynamics and consequences at the city level remains limited. This study investigates the pandemic in Maring\'a, a medium-sized city in Brazil's South Region, using data obtained by actively monitoring the disease from March 2020 to June 2022. Despite prompt and robust interventions, COVID-19 cases increased exponentially during the early spread of COVID-19, with a reproduction number lower than that observed during the initial outbreak in Wuhan. Our research demonstrates the remarkable impact of non-pharmaceutical interventions on both mobility and pandemic indicators, particularly during the onset and the most severe phases of the emergency. However, our results suggest that the city's measures were primarily reactive rather than proactive. Maring\'a faced six waves of cases, with the third and fourth waves being the deadliest, responsible for over two-thirds of all deaths and overwhelming the local healthcare system. Excess mortality during this period exceeded deaths attributed to COVID-19, indicating that the burdened healthcare system may have contributed to increased mortality from other causes. By the end of the fourth wave, nearly three-quarters of the city's population had received two vaccine doses, significantly decreasing deaths despite the surge caused by the Omicron variant. Finally, we compare these findings with the national context and other similarly sized cities, highlighting substantial heterogeneities in the spread and impact of the disease.

Improving modelling for epidemic responses: reflections from members of the UK infectious disease modelling community on their experiences during the COVID-19 pandemic (preprint)

The COVID-19 pandemic both relied and placed significant burdens on the experts involved from research and public health sectors. The sustained high pressure of a pandemic on responders, such as healthcare workers, can lead to lasting psychological impacts including acute stress disorder, post-traumatic stress disorder, burnout, and moral injury, which can impact individual wellbeing and productivity. As members of the infectious disease modelling community, we convened a reflective workshop to understand the professional and personal impacts of response work on our community and to propose recommendations for future epidemic responses. The attendees represented a range of career stages, institutions, and disciplines. This piece was collectively produced by those present at the session based on our collective experiences. Key issues we identified at the workshop were lack of institutional support, insecure contracts, unequal credit and recognition, and mental health impacts. Our recommendations include rewarding impactful work, fostering academia-public health collaboration, decreasing dependence on key individuals by developing teams, increasing transparency in decision-making, and implementing sustainable work practices. Despite limitations in representation, this workshop provided valuable insights into the UK COVID-19 modelling experience and guidance for future public health crises. Recognising and addressing the issues highlighted here is crucial, in our view, for ensuring the effectiveness of epidemic response work in the future.

A database on the socioeconomic and behavioral impact in Sri Lanka through multiple waves of COVID-19 (preprint)

Objectives: The impact of the COVID-19 pandemic was diverse and disproportionate among nations and population segments. The impacts of the disease and the containment strategies adopted are broad and cut across multiple facets of life, society, and the economy, which are intimately interlinked. To ascertain the socioeconomic impact and human behavior changes due to the pandemic and the containment strategies adopted a large household survey was conducted covering all the provinces in Sri Lanka. Data description: We conducted a cross-sectional Household survey covering all 9 provinces, including 20 districts in Sri Lanka from August 2021 to September 2021. This dataset consists of the data collected from 3020 households, on the impact of the pandemic through three distinctly identified pandemic waves in Sri Lanka. The questionnaire was designed to capture COVID-19 impact in 2 primary sections (socioeconomic impact and behavioral impact) which were further divided into 8 sub-sections: educational impact, impact on mobility, access to health services, economic impact, human interactions, food consumption, religious and cultural, and psychological impact. This dataset will enable researchers and policymakers to analyze the impact of the pandemic through a multifaceted perspective enabling a more holistic approach to decision-making.

The Covid Response Study (COVRES) Protocol: a comprehensive genomic, immunological, proteomic and phenotypic comparison of hospitalised versus non-hospitalised SARS-CoV-2 patients in Northern Ireland (preprint)

Objective  The Covid Response Study (COVRES, NCT05548829) aims to carry out an integrated multi-omic analysis of factors contributing to host susceptibility to SARS-CoV-2 among a patient cohort of 1000 people from the geographically isolated island of Ireland. Background  Health organisations and countries around the world have found it difficult to control the spread of the coronavirus disease 2019. To minimise the impact on the NHS and improve patient care, there is a drive for rapid tests capable of detecting individuals who are at high risk of contracting severe COVID-19. Early work focused on single omic approaches, highlighting a limited amount of information. Study Design The protocol below describes the study to be carried out in Northern Ireland (NI-COVRES) by Ulster University, the Republic of Ireland component will be described separately. All participants (n = 519) were recruited from the Western Health and Social Care Trust, Northern Ireland, forty patients are also being followed up at 1, 3, 6 and 12 months to assess the longitudinal impact of infection on symptoms, general health, and immune response, this is ongoing. Methods Data will be sourced from whole blood, saliva samples, and clinical data from the Northern Ireland Electronic Care Record, general health questionnaire, and the GHQ12 mental health survey. Saliva and blood samples were processed for DNA and RNA prior to whole genomic sequencing, RNA sequencing, DNA methylation, microbiome, 16S, and proteomic analysis. Multi-omics data will be combined with clinical data to produce sensitive and specific prognostic models of severity risk. Results An initial profile of the cohort has been completed: n = 249 hospitalised and n = 270 non-hospitalised patients were recruited, 64% were female, the mean age was 45 years. High levels of comorbidity were evident in the hospitalised cohort, with cardiovascular disease and metabolic and respiratory disorders (P < 0.001) being the most significant. Conclusion This study will provide a comprehensive opportunity to study multi-omic mechanisms of COVID-19 severity in re-contactable participants. Trial Registration - The trial has been registered as an observational study on clinicaltrials.gov as NCT05548829. An outline of the trial protocol is included; SPIRIT checklist (Supplementary Fig. 1).

The Federal Reserve’s Response to the Global Financial Crisis and Its Long-Term Impact: An Interrupted Time-Series Natural Experimental Analysis (preprint)

This paper examines the monetary policies the Federal Reserve implemented in response to the Global Financial Crisis. More specifically, it analyzes the Federal Reserve’s quantitative easing (QE) programs, liquidity facilities, and forward guidance operations conducted from 2007 to 2018. The essay’s detailed examination of these policies culminates in an interrupted time-series (ITS) analysis of the long-term causal effects of the QE programs on U.S. inflation and real GDP. The results of this formal design-based natural experimental approach show that the QE operations positively affected U.S. real GDP but did not significantly impact U.S. inflation. Specifically, it is found that, for the 2011Q2-2018Q4 post-QE period, real GDP per capita in the U.S. increased by an average of 231 dollars per quarter relative to how it would have changed had the QE programs not been conducted. Moreover, the results show that, in 2018Q4, ten years after the beginning of the QE programs, real GDP per capita in the U.S. was 14% higher relative to what it would have been during that quarter had there not been the QE programs. These findings contradict Williamson’s (2017) informal natural experimental evidence and confirm the conclusions of VARs and new Keynesian DSGE models that the Federal Reserve’s QE policies positively affected U.S. real GDP. The results suggest that the current U.S. and worldwide high inflation rates are likely not because of the QE programs implemented in response to the financial crisis that accompanied the COVID-19 pandemic. They are likely due to the unprecedentedly large fiscal stimulus packages used, the peculiar nature of the financial downturn itself, the negative supply shocks from the war in Ukraine, or a combination of these factors. To the best of my knowledge, this paper is the first study to measure the macroeconomic effects of QE using a design-based natural experimental approach.

The Federal Reserve's Response to the Global Financial Crisis and Its Long-Term Impact: An Interrupted Time-Series Natural Experimental Analysis (preprint)

This paper examines the monetary policies the Federal Reserve implemented in response to the Global Financial Crisis. More specifically, it analyzes the Federal Reserve's quantitative easing (QE) programs, liquidity facilities, and forward guidance operations conducted from 2007 to 2018. The essay's detailed examination of these policies culminates in an interrupted time-series (ITS) analysis of the long-term causal effects of the QE programs on U.S. inflation and real GDP. The results of this formal design-based natural experimental approach show that the QE operations positively affected U.S. real GDP but did not significantly impact U.S. inflation. Specifically, it is found that, for the 2011Q2-2018Q4 post-QE period, real GDP per capita in the U.S. increased by an average of 231 dollars per quarter relative to how it would have changed had the QE programs not been conducted. Moreover, the results show that, in 2018Q4, ten years after the beginning of the QE programs, real GDP per capita in the U.S. was 14% higher relative to what it would have been during that quarter had there not been the QE programs. These findings contradict Williamson's (2017) informal natural experimental evidence and confirm the conclusions of VARs and new Keynesian DSGE models that the Federal Reserve's QE policies positively affected U.S. real GDP. The results suggest that the current U.S. and worldwide high inflation rates are likely not because of the QE programs implemented in response to the financial crisis that accompanied the COVID-19 pandemic. They are likely due to the unprecedentedly large fiscal stimulus packages used, the peculiar nature of the financial downturn itself, the negative supply shocks from the war in Ukraine, or a combination of these factors. This paper is the first study to measure the macroeconomic effects of QE using a design-based natural experimental approach.

The Effect of the COVID-19 Pandemic on the Decision-making Process of Mandibular Impacted Third Molar Extraction.

Objectives: In this study, we investigated the impact of the COVID-19 pandemic on the decision-making process for impacted mandibular third molar removal and related clinical teaching. Methods: From April 21 to April 28, 2020, we distributed a self-constructed survey via the Wenjuanxing software platform to oral clinicians engaged in the extraction of mandibular third molars. Results: We received 321 valid responses. Overall, 22.4% of clinicians were temporarily not performing tooth extractions in outpatient clinics and 50.2% of clinicians were temporarily not performing impacted tooth extractions. The main reason cited was that aerosol-generating high-speed handpieces were not recommended for use during the pandemic, opting instead for the surgical handpiece with copious saline irrigation as the main method for bone removal; the hammer-and-chisel method was considered to be too traumatic and posed too high of a risk for iatrogenic injury. Conclusions: The implementation of disease control measures during the COVID-19 pandemic significantly affected clinical decision-making regarding impacted mandibular third molar extractions; the main reason cited was the contraindication of using aerosol-generating high-speed handpieces. The hammer-and-chisel method may represent a valuable surgical application under the requirements for epidemic prevention and control. We provide a new idea for the extraction of interrupted permanent molars in the context of epidemic prevention and control is provided.

The Impact of COVID-19 Pandemic on Antimicrobial Resistance and Management of Bloodstream Infections (preprint)

Introduction: The reduced implementation of surveillance programs and limited bedside infectious diseases consultations due to the pressure of COVID-19 pandemic in healthcare systems led to increased rates of irrational use of antimicrobials and incidence of infections by multidrug-resistant microorganisms. The aim of the present study is to evaluate the incidence of antimicrobial resistance and the management of bloodstream infections before and during COVID-19 pandemic at the University General Hospital of Alexandroupolis (Greece). Material-Methods: This is a retrospective study conducted from January 2018 to December 2022. Data were collected from the University Microbiology Laboratory per semester regarding the isolated strains of Gram positive and negative bacteria in blood cultures and respiratory samples in hospitalized patients in medical and surgical wards and in the Intensive Care Unit (ICU). Additionally, bloodstream infections with requested infectious diseases consultation were reported (n=400), determining whether these were carried out via telephone contact or at the patient's bedside. Demographic data, comorbidities, focus of infection, antimicrobial regimen, duration of treatment, length of hospitalization and clinical outcome were analysed. Results: A total of 4569 strains of Gram positive and negative bacteria were isolated. An increasing trend was reported compared to the pre-pandemic period in the incidence of resistant Gram-negative bacteria, particularly in ICUs. Prior antimicrobial use and the rate of hospital-acquired infections were increased significantly during the pandemic. In the pre-pandemic period 2018-2019, a total of 246 infectious diseases consultations were carried out, while during the period 2020-2022 154, with the percentage of telephone consultations 15% and 76% respectively. Detection of the source of infection and timely administration of appropriate antimicrobial agents were more frequently recorded before the pandemic and 28-day mortality was significantly reduced in cases with bedside consultations. Conclusion: Empowering of infectious diseases surveillance programs and committees, rational use of antimicrobials agents and bedside infectious diseases consultations are vital in order to reduce the impact of infections caused by multidrug-resistant strains.

Anxiety, Knowledge, Misconceptions, Behavioral Intentions and Prevention Practices in COVID-19 First Year of Pandemic: Network or Psychometric Model? (preprint)

The SARS-CoV-2 pandemic has spread rapidly worldwide, being life-changing and affecting anxiety, misconceptions, knowledge, and people's health behavioral intentions, which is related to COVID-19 prevention practices adherence. Thus, it is relevant to test whether related measures would have a factor or network model in different populations, and know its’ relations as complex systems. The goal of this research is to test whether the Fear and Health-Seeking Behavioral Intentions Scales follow a network or factor model in a Brazilian sample, in addition to an attempt to understand COVID-19 psychological impacts and its relations in a Brazilian sample during the first year of the pandemic. To do so, we used recent developments in the field of network and psychometrics, with a sample of 476 Brazilians collected during the first pandemic year. We found evidence for a network model using two approaches. In addition, we used the network model to see the relationship between those variables, and the findings are discussed. We highlighted the importance of COVID-19 knowledge, misinformation, and prevention practices adherence relation in the network structure.

Analysis of COVID-19 first wave in the US based on demographic, mobility, and environmental variables (preprint)

COVID-19 had a strong and disruptive impact on our society, and yet further analyses on most relevant factors explaining the spread of the pandemic are needed. Interdisciplinary studies linking epidemiological, mobility, environmental, and socio-demographic data analysis can help understanding how historical conditions, concurrent social policies and environmental factors impacted on the evolution of the pandemic crisis. This work deals with a regression analysis linking COVID-19 mortality to socio-demographic, mobility, and environmental data in the US during the first half of 2020, i.e., during the COVID-19 pandemic first wave. This study can provide very useful insights about risk factors enhancing mortality rates before non-pharmaceutical interventions or vaccination campaigns took place. Our cross-sectional ecological regression analysis demonstrates that, when considering the entire US area, the socio-demographic variables globally play the most important role with respect to environmental and mobility variables in describing COVID-19 mortality. Compared to the complete generalized linear model considering all socio-demographic, mobility, and environmental data, the regression based only on socio-demographic data provides a better approximation and proves to be a better explanatory model when compared to the mobility-based and environmental-based models. However, when looking at single entries within each of the three groups, we see that the mobility data can become relevant descriptive predictors at local scale, as in New Jersey where the time spent at work is one of the most relevant explanatory variables, while environmental data play contradictory roles.

Feasible intervention combinations for achieving a safe exit of the Zero-COVID policy in China and its determinants: an individual- based model study (preprint)

Background Although several pathways have been proposed as the prerequisite for a safe phase-out in China, it is not clear which of them are the most important for keeping the mortality rate low, what thresholds should be achieved for these most important interventions, and how do the thresholds change with the assumed key epidemiological parameters and population characteristics.Methods We developed an individual-based model (IBM) to simulate the transmission of the Omicron variant in the synthetic population, accounting for the age-dependent probabilities of severe clinical outcomes, waning vaccine-induced immunity, increased mortality rates when hospitals are overburdened, and reduced transmission when self-isolated at home after testing positive. We applied machine learning algorithms on the simulation outputs to examine the importance of each intervention parameter and the feasible intervention parameter combinations for safe exits, which is defined as having mortality rates lower than that of influenza in China (14.3 per 100, 000 persons).Results We identified vaccine coverage in those above 70 years old, number of ICU beds per capita, and the availability of antiviral treatment as the most important interventions for safe exits across all studied locations, although the thresholds of them required for safe exits vary remarkably with the assumed vaccine effectiveness, as well as the age structure, age-specific vaccine coverage, community healthcare capacity of the studied locations.Conclusions The analytical framework developed here can provide the basis for further policy decisions that incorporate considerations about economic costs and societal impacts. Achieving safe exits from the Zero-COVID policy is possible, but challenging for China’s cities. When planning for safe exits, local realities such as the age structure and current age-specific vaccine coverage must be taken into consideration.

A Large-Scale Analysis of Persian Tweets Regarding Covid-19 Vaccination (preprint)

The Covid-19 pandemic had an enormous effect on our lives, especially on people's interactions. By introducing Covid-19 vaccines, both positive and negative opinions were raised over the subject of taking vaccines or not. In this paper, using data gathered from Twitter, including tweets and user profiles, we offer a comprehensive analysis of public opinion in Iran about the Coronavirus vaccines. For this purpose, we applied a search query technique combined with a topic modeling approach to extract vaccine-related tweets. We utilized transformer-based models to classify the content of the tweets and extract themes revolving around vaccination. We also conducted an emotion analysis to evaluate the public happiness and anger around this topic. Our results demonstrate that Covid-19 vaccination has attracted considerable attention from different angles, such as governmental issues, safety or hesitancy, and side effects. Moreover, Coronavirus-relevant phenomena like public vaccination and the rate of infection deeply impacted public emotional status and users' interactions.