Researchers offer ways to address life under COVID-19

New analysis outlines evidence-based approaches to combat bias and fake news, increase cooperation, and cope with stress and isolation

April 30, 2020

Science Daily/New York University

An international team of researchers has outlined ways to manage different facets of life under the spread of the COVID-19 virus, ranging from how we can combat racially driven bias and fake news to how we can increase cooperation and better manage stress.

Its work, which appears in the journal Nature Human Behaviour, considers research stretching over the past half century to offer insights about how to address current circumstances.

"The COVID-19 pandemic represents a massive, global health crisis," observes Jay Van Bavel, an associate professor in New York University's Department of Psychology, who led the project with Stanford's Robb Willer. "Because the crisis requires large-scale behavior change and poses significant psychological burdens on individuals, insights from the social and behavioral sciences are likely going to be very helpful for optimizing pandemic response."

"This interdisciplinary review points to several ways in which research can be immediately applied to optimize response to this pandemic, but also points to several important gaps that researchers should move quickly to fill in the coming weeks and months," adds Willer, a sociologist.

The analysis, drawn from the expertise of over 40 researchers at more than 20 colleges and universities, focuses on phenomena linked to COVID-19, connecting existing scholarship to potential courses of action in several areas, including the following: "Group Threat," "Fake News and Misinformation," "Social Norms," and "Stress and Coping."

Group Threat

The authors, referring to recent attacks on ethnic Asians in predominantly white countries, note that "Europe's most deadly disease, the bubonic plague of the 14th century, unleashed massive violence, including the murder of Catalans in Sicily, clerics and beggars in some locations, and pogroms against Jews, with over a thousand communities eradicated."

However, they point to research that indicates pandemics may, in fact, present opportunities to reduce religious and ethnic prejudice: "coordinated efforts across individuals, communities, and governments to fight the spread of disease send strong signals of cooperation and shared values, which allow people to re-cast others who were previously considered out-group members as in-group members."

The authors recount cooperative acts currently unfolding: More than 20 countries donated medical supplies to China in February, and China has reciprocated. "Government officials can highlight events like these to improve out-group attitudes," they write, adding that other studies have shown that making people feel safer can reduce prejudice.

Fake News and Misinformation

Fake news and conspiracy theories about COVID-19 have undoubtedly proliferated on social media, but new research has explored social-science based solutions to counter the spread of fake news. Fact-checking and correction offer potential remedies, as does source expertise, bipartisanship in messaging, and messages from "unlikely sources" -- those who benefit from the original misinformation.

But the researchers acknowledge that fact-checking and corrections may not keep up with the vast amount of false information produced in moments of crisis like a pandemic and that approaches beyond debunking are necessary.

In response, they offer what scholars term a "pre-bunking approach," which centers on psychological inoculation. Studies have found that preemptively exposing people to small doses of misinformation techniques (including scenarios about COVID-19) can reduce susceptibility to fake news. Another preventative approach involves subtle prompts that emphasize accuracy (for instance, asking users to judge the veracity of a single neutral headline). Such prompts have been found in prior work to improve the quality of the content users share and could be easily implemented by social media platforms.

"To effectively counter fake news about COVID-19 around the world, governments and social media companies must rigorously develop and test interventions in collaboration with independent behavioral scientists," the authors advocate. "This includes identifying treatments that effectively reduce belief in misinformation, while not undermining belief in accurate information -- a particularly salient concern given evidence that most exposure to and sharing of fake news in the U.S. has been concentrated among relatively small sub-sections of the population."

Social Norms

"How much people change will be influenced by aspects of the social and cultural context," the researchers write. "The fact that people tend to follow social norms and cultural mores can sometimes have undesirable consequences. For example, continuous exposure to news examples of people going out might explain why it was difficult to convince Italians to stay at home after the COVID-19 lockdown of March 11." But they also report that "understanding these features of the social environment, such as social norms, social inequality, culture, and polarization, can help identify risk factors and successful messages and interventions."

Prior studies have found that our decisions are influenced by social norms -- what we perceive others are doing or approve/disapprove of -- and that "informational influence" occurs when people use others' behavior as input for reasonable interpretations and responses. Notably, this effect is stronger when people are uncertain and outcomes are important -- as in during a pandemic.

However, the authors caution that although we are influenced by perceptions of norms, research has shown that our estimates of behavior are frequently inaccurate. For example, people can underestimate the frequency others engage in health-promoting behaviors (e.g., hand washing) and overestimate their unhealthy ones (e.g., not properly covering one's mouth when coughing). In order to most effectively change behaviors by correcting misperceptions, the authors point to the importance of public messages that reinforce health-promoting norms (e.g., social distancing and hand-washing) and not highlighting extreme or uncommon behaviors, such as panic buying or young adults gathering.

Stress and Coping

Public health experts have said that one of the most vital strategies for slowing the spread of COVID-19 is "social distancing" -- a practice that, while beneficial, "clashes with the deep-seated human instinct to connect with others, especially during emotional times," the authors observe. Studies have shown social connection "helps people regulate affect, cope with stress, and remain resilient during difficult times" while other scholarship has revealed that "loneliness and social isolation worsen the burden of stress, and produce deleterious effects on mental, cardiovascular, and immune health."

However, the researchers list ways we can diminish the ill effects of isolation.

One, they advocate replacing the term "social distancing" -- when possible -- with "physical distancing." This change, they say, would "highlight the fact that deep social connection with a broader community is possible even when people are physically apart through the use of technology."

Two, they cite the value of online forums, which have long served as hubs for mutual support -- in particular, among individuals with rare illnesses -- and psychological well-being. Other technologies, such as FaceTime and Zoom, have been found to be valuable in generating empathy and connection.

Van Bavel and Willer recognize potential barriers to these tools for seniors.

"Special attention should be placed on helping older adults -- who might be less familiar with these technologies -- to learn and acclimate to the potential richness of digital connections. COVID-19 will leave many of us confused, anxious, and lonely," they write.

Conclusion

"Urgent action is needed to mitigate the potential devastation of COVID-19, and drawing from existing knowledge can help ensure we are taking constructive steps," Van Bavel says. "In addition, the lessons from past studies should be relevant to future pandemics and other public health crises. Whether policy makers are trying to increase vaccination rates or reduce the harm of climate change, they will be fundamentally facing many of the same issues in the future."

"By applying the knowledge gained from earlier research, we hope that public health experts will be better equipped to communicate effectively and drive behavior change in a manner that yields global benefits," adds Willer.

https://www.sciencedaily.com/releases/2020/04/200430113048.htm

Understanding how COVID-19 affects children vital to slowing pandemic

March 19, 2020

Science Daily/University of Virginia Health System

Though COVID-19 so far appears to be largely sparing children, researchers are cautioning that it is critical to understand how the virus affects kids to model the pandemic accurately, limit the disease's spread and ensure the youngest patients get the care they need.The warning comes from Steven L. Zeichner, MD, PhD, the head of UVA Health's Division of Pediatric Infectious Diseases, and Andrea T. Cruz, MD, MPH, a pediatric emergency medicine physician at Houston's Baylor College of Medicine. They have authored a commentary in the journal Pediatrics accompanying a new article that reveals a small percentage of infected children become seriously ill. Those at greatest risk include babies and preschoolers.

"Many infectious diseases affect children differently than adults and understanding those differences can yield important insights," the commentary authors write. "This will likely be true for COVID-19, just as it was for older infectious diseases."

Assessing COVID-19 Risks

Zeichner and Cruz note that there are subgroups of children who appear to be at greater risk of COVID-19 complications, particularly those who are younger, immunocompromised or have other pulmonary health problems.

However, the presence of other viral infections in up to two-thirds of childhood coronavirus cases makes it very difficult to assess the true effect of COVID-19 on children, they state. (This figure is based on prior studies of children with coronaviruses detectable in the respiratory tract.)

While much remains unknown, Cruz and Zeichner caution that children, even asymptomatic children, could play a "major role" in disease transmission. For example, they cite a study that found the virus remained in children's stool for several weeks after diagnosis. That, combined with other routes of transmission such as nasal secretions, could pose a major challenge for schools, day care centers and the children's families, they note.

"Since many children infected with COVID-19 appear to have have mild symptoms, or even no symptoms at all, it is important to practice all the social distancing, hygiene and other precautions being recommended by public health authorities to minimize transmission from children to others, including family members who may be at greater risk from the infection, such as grandparents or family members with chronic medical conditions," said Zeichner, who is working on innovative potential COVID-19 vaccines in his lab. "In addition, studies of the reasons why children are affected differently than adults by the infection may yield insights that can be helpful in understanding the disease and ways to treat or prevent it."

https://www.sciencedaily.com/releases/2020/03/200319125201.htm

Median incubation period for COVID-19

March 17, 2020

Science Daily/University of Massachusetts Amherst

A new study calculates that the median incubation period for COVID-19 is just over 5 days and that 97.5% of people who develop symptoms will do so within 11.5 days of infection.

A University of Massachusetts Amherst biostatistician who directs the UMass-based Flu Forecasting Center of Excellence was invited by the White House Coronavirus Task Force to participate Wednesday morning in a coronavirus modeling webinar.

The four-hour, virtual gathering will include 20 of the world's leading infectious disease and pandemic forecasting modelers, from researchers at Harvard, Johns Hopkins and the Centers for Disease Control and Prevention (CDC) in the U.S. to those based at institutions in England, Hong Kong, South Africa and the Netherlands.

According to the White House Coronavirus Task Force coordinator Dr. Charles Vitek, "This webinar is designed to highlight for the Task Force what modeling can tell us regarding the potential effects of mitigation measures on the coronavirus outbreak. The unprecedented speed and impact of the nCoV-19 epidemic requires the best-informed public health decision-making we can produce."

Nicholas Reich, associate professor in the School of Public Health and Health Sciences, heads a flu forecasting collaborative that has produced some of the world's most accurate models in recent years. He and postdoctoral researcher Thomas McAndrew have been conducting weekly surveys of more than 20 infectious disease modeling researchers to assess their collective expert opinion on the trajectory of the COVID-19 outbreak in the U.S. The researchers and modeling experts design, build and interpret models to explain and understand infectious disease dynamics and the associated policy implications in human populations.

Reich is co-author of a new study in the Annals of Internal Medicine that calculates that the median incubation period for COVID-19 is just over five days and that 97.5 percent of people who develop symptoms will do so within 11.5 days of infection. The incubation period refers to the time between exposure to the virus and the appearance of the first symptoms.

The study's lead author is UMass Amherst biostatistics doctoral alumnus Stephen Lauer, a former member of the Reich Lab and current postdoctoral researcher at the Johns Hopkins Bloomberg School of Public Health.

The researchers examined 181 confirmed cases with identifiable exposure and symptom onset windows to estimate the incubation period of COVID-19. They conclude that "the current period of active monitoring recommended by the U.S. Centers for Disease Control and Prevention [14 days] is well supported by the evidence."

https://www.sciencedaily.com/releases/2020/03/200317175438.htm