Individual risk perception and empirical social structures shape the dynamics of infectious disease outbreaks.

The dynamics of a spreading disease and individual behavioral changes are entangled processes that have to be addressed together in order to effectively manage an outbreak. Here, we relate individual risk perception to the adoption of a specific set of control measures, as obtained from an extensive large-scale survey performed via Facebook-involving more than 500,000 respondents from 64 countries-showing that there is a "one-to-one" relationship between perceived epidemic risk and compliance with a set of mitigation rules. We then develop a mathematical model for the spreading of a disease-sharing epidemiological features with COVID-19-that explicitly takes into account non-compliant individual behaviors and evaluates the impact of a population fraction of infectious risk-deniers on the epidemic dynamics. Our modeling study grounds on a wide set of structures, including both synthetic and more than 180 real-world contact patterns, to evaluate, in realistic scenarios, how network features typical of human interaction patterns impact the spread of a disease. In both synthetic and real contact patterns we find that epidemic spreading is hindered for decreasing population fractions of risk-denier individuals. From empirical contact patterns we demonstrate that connectivity heterogeneity and group structure significantly affect the peak of hospitalized population: higher modularity and heterogeneity of social contacts are linked to lower peaks at a fixed fraction of risk-denier individuals while, at the same time, such features increase the relative impact on hospitalizations with respect to the case where everyone correctly perceive the risks.

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.

Assessing the risks of 'infodemics' in response to COVID-19 epidemics.

During COVID-19, governments and the public are fighting not only a pandemic but also a co-evolving infodemic-the rapid and far-reaching spread of information of questionable quality. We analysed more than 100 million Twitter messages posted worldwide during the early stages of epidemic spread across countries (from 22 January to 10 March 2020) and classified the reliability of the news being circulated. We developed an Infodemic Risk Index to capture the magnitude of exposure to unreliable news across countries. We found that measurable waves of potentially unreliable information preceded the rise of COVID-19 infections, exposing entire countries to falsehoods that pose a serious threat to public health. As infections started to rise, reliable information quickly became more dominant, and Twitter content shifted towards more credible informational sources. Infodemic early-warning signals provide important cues for misinformation mitigation by means of adequate communication strategies.

Diathermy haemorrhoidectomy: reasons for a therapeutic choice.

BACKGROUND: Diathermy haemorrhoidectomy is an effective technique for the management of 2nd, 3rd and 4th degree haemorrhoids. The anal cushions are excised by use of diathermy without ligature of the vascular pedicles. The aim of the present study is to evaluate the efficacy and tolerability of this technique. METHODS: Between September 1999 and September 2003, 84 patients with 2nd, 3rd, and 4th degree haemorrhoids underwent diathermy haemorrhoidectomy. Patients were discharged the same day or the day after. All the patients were asked to complete two questionnaires one on the level of pain they experienced and the other on their expectation of pain. Patients were followed-up for 1 to 4 years (range 12-48 months, mean 20.5). RESULTS: The average pain severity score on a visual analogue scale (0-10) was 3.06 +/- 0.38 and consistently lower than expected. The majority of patients returned to their usual daily activities within 4 days and all of them returned to work within 11 days. A mild residual secretion persisted for 4 to 5 weeks. None of our patients experienced postoperative haemorrhage, complete stenosis or sphincteric disturbances. CONCLUSIONS: Diathermy haemorrhoidectomy appears to be a safe, low cost and effective technique for the treatment of haemorrhoids. It is well tolerated by patients.