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Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy
Showing posts with label COVID-19. Show all posts
Showing posts with label COVID-19. Show all posts

Tuesday, August 1, 2023

When Did Medicine Become a Battleground for Everything?

Tara Haelle
Medscape.com
Originally posted 18 July 23

Like hundreds of other medical experts, Leana Wen, MD, an emergency physician and former Baltimore health commissioner, was an early and avid supporter of COVID vaccines and their ability to prevent severe disease, hospitalization, and death from SARS-CoV-2 infections.

When 51-year-old Scott Eli Harris, of Aubrey, Texas, heard of Wen's stance in July 2021, the self-described "5th generation US Army veteran and a sniper" sent Wen an electronic invective laden with racist language and very specific threats to shoot her.

Harris pled guilty to transmitting threats via interstate commerce last February and began serving 6 months in federal prison last fall, but his threats wouldn't be the last for Wen. Just 2 days after Harris was sentenced, charges were unsealed against another man in Massachusetts, who threatened that Wen would "end up in pieces" if she continued "pushing" her thoughts publicly.'

Wen has plenty of company. In an August 2022 survey of emergency doctors conducted by the American College of Emergency Physicians, 85% of respondents said violence against them is increasing. One in four doctors said they're being assaulted by patients and their family and friends multiple times a week, compared to just 8% of doctors who said as much in 2018. Sixty-four percent of emergency physicians reported receiving verbal assaults and threats of violence; 40% reported being hit or slapped, and 26% were kicked.

This uptick of violence and threats against physicians didn't come out of nowhere; violence against healthcare workers has been gradually increasing over the past decade. Healthcare providers can attest to the hostility that particular topics have sparked for years: vaccines in pediatrics, abortion in ob-gyn, and gender-affirming care in endocrinology.

But the pandemic fueled the fire. While there have always been hot-button issues in medicine, the ire they arouse today is more intense than ever before. The proliferation of misinformation (often via social media) and the politicization of public health and medicine are at the center of the problem.

"The People Attacking Are Themselves Victims'

The misinformation problem first came to a head in one area of public health: vaccines. The pandemic accelerated antagonism in medicine ― thanks, in part, to decades of anti- antivaccine activism.

The anti-vaccine movement, which has ebbed and flowed in the US and across the globe since the first vaccine, experienced a new wave in the early 2000s with the combination of concerns about thimerosal in vaccines and a now disproven link between autism and the MMR vaccine. But that movement grew. It picked up steam when activists gained political clout after a 2014 measles outbreak at Disneyland led California schools to tighten up policies regarding vaccinations for kids who enrolled. These stronger public school vaccination laws ran up against religious freedom arguments from anti-vaccine advocates.

Tuesday, July 11, 2023

Conspirituality: How New Age conspiracy theories threaten public health

D. Beres, M. Remski, & J. Walker
bigthink.com
Originally posted 17 June 23

Here is an excerpt:

Disaster capitalism and disaster spirituality rely, respectively, on an endless supply of items to commodify and minds to recruit. While both roar into high gear in times of widespread precarity and vulnerability, in disaster spirituality there is arguably more at stake on the supply side. Hedge fund managers can buy up distressed properties in post-Katrina New Orleans to gentrify and flip. They have cash on hand to pull from when opportunity strikes, whereas most spiritual figures have to use other means for acquisitions and recruitment during times of distress.

Most of the influencers operating in today’s conspirituality landscape stand outside of mainstream economies and institutional support. They’ve been developing fringe religious ideas and making money however they can, usually up against high customer turnover.

For the mega-rich disaster capitalist, a hurricane or civil war is a windfall. But for the skint disaster spiritualist, a public catastrophe like 9/11 or COVID-19 is a life raft. Many have no choice but to climb aboard and ride. Additionally, if your spiritual group has been claiming for years to have the answers to life’s most desperate problems, the disaster is an irresistible dare, a chance to make good on divine promises. If the spiritual group has been selling health ideologies or products they guarantee will ensure perfect health, how can they turn away from the opportunity presented by a pandemic?


Here is my summary with some extras:

The article argues that conspirituality is a growing problem that is threatening public health. Conspiritualists push the false beliefs that vaccines are harmful, that the COVID-19 pandemic is a hoax, and that natural immunity is the best way to protect oneself from disease. These beliefs can lead people to make decisions that put their health and the health of others at risk.

The article also argues that conspirituality is often spread through social media platforms, which can make it difficult to verify the accuracy of information. This can lead people to believe false or misleading information, which can have serious consequences for their health.  However, some individuals can make a profit from the spread of disinformation.

The article concludes by calling for more research on conspirituality and its impact on public health. It also calls for public health professionals to be more aware of conspirituality and to develop strategies to address it.
  • Conspirituality is a term that combines "conspiracy" and "spirituality." It refers to the belief that certain anti-science ideas (such as alternative medicine, non-scientific interventions, and spiritual healing) are being suppressed by a powerful elite. Conspiritualists often believe that this elite is responsible for a wide range of problems, including the COVID-19 pandemic.
  • The term "conspirituality" was coined by sociologists Charlotte Ward and David Voas in 2011. They argued that conspirituality is a unique form of conspiracy theory that is characterized by blending 1) New Age beliefs (religious and spiritual ideas) of a paradigm shift in consciousness (in which we will all be awakened to a new reality); and, 2) traditional conspiracy theories (in which an elite, powerful, and covert group of individuals are either controlling or trying to control the social and political order.)

Monday, December 5, 2022

Social isolation and the brain in the pandemic era

Bzdok, D., and Dunbar, R.
Nat Hum Behav 6, 1333–1343 (2022).
https://doi.org/10.1038/s41562-022-01453-0

Abstract

Intense sociality has been a catalyst for human culture and civilization, and our social relationships at a personal level play a pivotal role in our health and well-being. These relationships are, however, sensitive to the time we invest in them. To understand how and why this should be, we first outline the evolutionary background in primate sociality from which our human social world has emerged. We then review defining features of that human sociality, putting forward a framework within which one can understand the consequences of mass social isolation during the COVID-19 pandemic, including mental health deterioration, stress, sleep disturbance and substance misuse. We outline recent research on the neural basis of prolonged social isolation, highlighting especially higher-order neural circuits such as the default mode network. Our survey of studies covers the negative effects of prolonged social deprivation and the multifaceted drivers of day-to-day pandemic experiences.

Conclusion

The human social world is deeply rooted in our primate ancestry. This social world is, however, extremely sensitive to the time we invest in it. Enforced social isolation can easily destabilize its delicate equilibrium. Many of the psychological sequalae of COVID-19 lockdowns are readily understood as resulting from the dislocation of these deeply rooted social processes. Indeed, many of these findings could have been anticipated long before the COVID-19 pandemic. For example, almost one in ten Europeans admitted never meeting friends or family outside of their own household in the course of an entire year, with direct consequences for their psychological and physical health. Solitary living made up >50% of households in a growing number of metropolitan cities worldwide and has long been thought to be the cause of increasing levels of depression and psychological dystopia. Indeed, aversive feelings of social isolation probably serve as a biological warning signal that alerts individuals to improve their social relationships.

Three key points emerge from our present assessment. One is that COVID-19 and associated public health restrictions to curb the spread of the virus are likely to have demonstrable mental health and psychosocial ramifications for years to come. This will inevitably place a significant burden on our health systems and societies. The impact may, however, be largely restricted to specific population strata. Older people, for example, are likely to face disproportionately adverse consequences. Worryingly, prolonged social isolation seems to invoke changes in the capacity to visualize internally centred thoughts, especially in younger sub-population. This may presage a switch from an outward to an inward focus that may exacerbate the experience of social isolation in susceptible individuals. The longer-term implications of this are, however, yet to be determined. Second, the experience of undergoing social isolation is known to have significant effects on the structure and function of the hippocampus and default network, long recognized as a primary neural pathway implicated in the pathophysiology of dementia and other major neurodegenerative diseases as well as in effective social function. The fact that these same brain regions turn up in the neuroanatomical consequences of COVID-19 infection is concerning. Our third key point is that social determinants that condition inequality in our societies have strong impacts on lived day-to-day pandemic experiences. This is highlighted by the negative outcomes from COVID-19 for families of lower socio-economic status, single-parent households, and those with racial and ethnic minority backgrounds.

As a note of caution, in our judgement, few datasets or methodological tools exist today to definitively establish causal directionality in many of the population effects we have surveyed in this review. For example, many of the correlative links do not allow us to infer whether loneliness directly causes depression and anxiety, as opposed to already depressed, anxious individuals being more prone to developing loneliness in times of adversity. Similarly, none of the reviewed findings can be used to tease apart whether changes in psychopathology during periods of mass social isolation are the chicken or the egg of the many biological manifestations. To fill knowledge gaps on mediating mechanisms for theoretical models, future research requires carefully designed and controlled longitudinal before-versus-after COVID-19 population investigations.

Saturday, October 1, 2022

COVID-19 and Politically Motivated Reasoning

Maguire, A., Persson, E., Västfjäll, D., & 
Tinghög, G. (2022). Medical Decision Making.
https://doi.org/10.1177/0272989X221118078

Abstract

Background
During the COVID-19 pandemic, the world witnessed a partisan segregation of beliefs toward the global health crisis and its management. Politically motivated reasoning, the tendency to interpret information in accordance with individual motives to protect valued beliefs rather than objectively considering the facts, could represent a key process involved in the polarization of attitudes. The objective of this study was to explore politically motivated reasoning when participants assess information regarding COVID-19.

Design
We carried out a preregistered online experiment using a diverse sample (N = 1500) from the United States. Both Republicans and Democrats assessed the same COVID-19–related information about the health effects of lockdowns, social distancing, vaccination, hydroxychloroquine, and wearing face masks.

Results
At odds with our prestated hypothesis, we found no evidence in line with politically motivated reasoning when interpreting numerical information about COVID-19. Moreover, we found no evidence supporting the idea that numeric ability or cognitive sophistication bolster politically motivated reasoning in the case of COVID-19. Instead, our findings suggest that participants base their assessment on prior beliefs of the matter.

Conclusions
Our findings suggest that politically polarized attitudes toward COVID-19 are more likely to be driven by lack of reasoning than politically motivated reasoning—a finding that opens potential avenues for combating political polarization about important health care topics.

Highlights
  • Participants assessed numerical information regarding the effect of different COVID-19 policies.
  • We found no evidence in line with politically motivated reasoning when interpreting numerical information about COVID-19.
  • Participants tend to base their assessment of COVID-19–related facts on prior beliefs of the matter.
  • Politically polarized attitudes toward COVID-19 are more a result of lack of thinking than partisanship.

Tuesday, September 6, 2022

Confronting Health Worker Burnout and Well-Being

V. Murthy
NEJM, July 13, 2022
DOI: 10.1056/NEJMp2207252

Here is an excerpt:

Burnout manifests in individuals, but it’s fundamentally rooted in systems. And health worker burnout was a crisis long before Covid-19 arrived. Causes include inadequate support, escalating workloads and administrative burdens, chronic underinvestment in public health infrastructure, and moral injury from being unable to provide the care patients need. Burnout is not only about long hours. It’s about the fundamental disconnect between health workers and the mission to serve that motivates them.

These systemic shortfalls have pushed millions of health workers to the brink. Some 52% of nurses (according to the American Nurses Foundation) and 20% of doctors (Mayo Clinic Proceedings) say they are planning to leave their clinical practice. Shortages of more than 1 million nurses are projected by the end of the year (U.S. Bureau of Labor Statistics); a gap of 3 million low-wage health workers is anticipated over the next 3 years (Mercer). And we face a significant shortage of public health workers precisely when we need to strengthen our defenses against future public health threats. Health worker burnout is a serious threat to the nation’s health and economic security.

The time for incremental change has passed. We need bold, fundamental change that gets at the roots of the burnout crisis. We need to take care of our health workers and the rising generation of trainees.

On May 23, 2022, I issued a Surgeon General’s Advisory on health worker burnout and well-being, declaring this crisis a national priority and calling the nation to action with specific directives for health systems, insurers, government, training institutions, and other stakeholders. The advisory is also intended to broaden awareness of the threat that health worker burnout poses to the nation’s health. Public awareness and support will be essential to ensuring sustained action.

Addressing health worker well-being requires first valuing and protecting health workers. That means ensuring that they receive a living wage, access to health insurance, and adequate sick leave. It also means health workers should never again go without adequate personal protective equipment (PPE) as they have during the pandemic. Current Biden administration efforts to enhance domestic manufacturing of PPE and maintain adequate supplies in the Strategic National Stockpile will continue to be essential. Furthermore, we need strict workplace policies to protect staff from violence: according to National Nurses United, 8 in 10 health workers report having been subjected to physical or verbal abuse during the pandemic.

Second, we must reduce administrative burdens that stand between health workers and their patients and communities. One study found that in addition to spending 1 to 2 hours each night doing administrative work, outpatient physicians spend nearly 2 hours on the electronic health record and desk work during the day for every 1 hour spent with patients — a trend widely lamented by clinicians and patients alike. The goal set by the 25×5 initiative of reducing clinicians’ documentation burden by 75% by 2025 is a key target. To help reach this goal, health insurers should reduce requirements for prior authorizations, streamline paperwork requirements, and develop simplified, common billing forms. Our electronic health record systems need human-centered design approaches that optimize usability, workflow, and communication across systems. Health systems should regularly review internal processes to reduce duplicative, inefficient work. One such effort, Hawaii Pacific Health’s “Getting Rid of Stupid Stuff” program, has saved 1700 nursing hours per month across the health system.

Monday, April 4, 2022

Pushed to Their Limits, 1 in 5 Physicians Intends to Leave Practice

Abbasi J.
JAMA. Published online March 30, 2022.
doi:10.1001/jama.2022.5074

Here is an excerpt:

Worsening staffing issues are now the biggest stressor for clinicians. Health care worker shortages, especially in rural and otherwise underserved areas of the country, have reached critical and unsustainable levels, according to the National Institute for Occupational Safety and Health (NIOSH).

“The evidence shows that health workers have been leaving the workforce at an alarming rate over the past 2 years,” Thomas R. Cunningham, PhD, a senior behavioral scientist at NIOSH, wrote in a statement emailed to JAMA.

In the absence of national data, Etz says the Green Center data point to a meaningful reduction in the primary care workforce during the pandemic. In the February 2022 survey, 62% of 847 clinicians had personal knowledge of other primary care clinicians who retired early or quit during the pandemic and 29% knew of practices that had closed up shop. That’s on top of a preexisting shortage of general and family medicine physicians. “I think we have a platform that is collapsed, and we haven’t recognized it yet,” Etz said.

In fact, surveys indicate that a “great clinician resignation” lies ahead. A quarter of clinicians said they planned to leave primary care within 3 years in Etz’s February survey. The Coping With COVID study predicts a more widespread clinician exodus: in the pandemic’s first year, 23.8% of the more than 9000 physicians from various disciplines in the study and 40% of 2301 nurses planned to exit their practice in the next 2 years. (The Coping With COVID study was funded by the American Medical Association, the publisher of JAMA.)

A lesson that’s been underscored during the pandemic is that physician wellness has a lot to do with other health workers’ satisfaction. “The ‘great resignation’ is affecting a lot of our staff, who don’t feel necessarily cared for by their organizations,” Linzer said. “The staff are leaving, which leaves the physicians to do more nonphysician work. So really, in order to solve this, we need to pay attention to all of our health care workers.”

Nurses who said they intended to leave their positions within 6 months cited 3 main drivers in an American Nurses Foundation survey: work negatively affecting their health and well-being, insufficient staffing, and a lack of employer support during the pandemic.

“Health care is a team sport,” L. Casey Chosewood, MD, MPH, director of the NIOSH Office for Total Worker Health, wrote in the agency’s emailed statement. “When nurses and other support personnel are under tremendous strain or not able to perform at optimal levels, or when staffing is inadequate, the impact flows both upstream to physicians who then face a heavier workload and loss of efficiency, and downstream impacting patient care and treatment outcomes.”

Wednesday, March 23, 2022

Moral Injury, Traumatic Stress, and Threats to Core Human Needs in Health-Care Workers: The COVID-19 Pandemic as a Dehumanizing Experience

Hagerty, S. L., & Williams, L. M. (2022)
Clinical Psychological Science. 
https://doi.org/10.1177/21677026211057554

Abstract

The pandemic has threatened core human needs. The pandemic provides a context to study psychological injury as it relates to unmet basic human needs and traumatic stressors, including moral incongruence. We surveyed 1,122 health-care workers from across the United States between May 2020 and August 2020. Using a mixed-methods design, we examined moral injury and unmet basic human needs in relation to traumatic stress and suicidality. Nearly one third of respondents reported elevated symptoms of psychological trauma, and the prevalence of suicidal ideation among health-care workers in our sample was roughly 3 times higher than in the general population. Moral injury and loneliness predict greater symptoms of traumatic stress and suicidality. We conclude that dehumanization is a driving force behind the psychological injury resulting from moral incongruence in the context of the pandemic. The pandemic most frequently threatened basic human motivations at the foundational level of safety and security relative to other higher order needs.

From the General Discussion

A subset of respondents added context to their experiences of moral injury in the form of narrative responses. These powerful accounts of the lived experiences of health-care workers provided us with a richer understanding of the construct of moral injury, especially as it relates to the novel context of the pandemic. Although betrayal is a known facet of moral injury from prior work (Bryan et al., 2016), our qualitative analysis suggests that dehumanization may also be a key phenomenon that underlies pandemic-related moral injury. Given our findings, we suggest that it may be important to attend to both betrayal and dehumanization when researching or intervening on the psychological sequelae of the pandemic. Our results support this because experiences of dehumanization in our sample were associated with greater symptoms of traumatic stress.

Another lens through which to view the experiences of health-care workers in the pandemic is through unsatisfied basic human motivations. Given the obvious barriers the pandemic presents to human connection (Hagerty & Williams, 2020), we had an a priori interest in studying loneliness. Our results indeed suggest that need of social connection appears relevant to the mental-health experiences of health-care workers during the pandemic such that loneliness was associated with greater traumatic stress, moral injury, and suicidal ideation. Echoing the importance of this social factor are findings from prior research suggesting that social connectedness buffers the association between moral injury and suicidality (Kelley et al., 2019) and buffers the impact of PTSD symptoms on suicidal behavior (Panagioti et al., 2014). Thus, our work further highlights lack of social connection as possible risk factor among individuals who face moral injury and traumatic stress and demonstrates its relevance to the mental health of health-care workers during the pandemic.

Wednesday, January 26, 2022

Threat Rejection Fuels Political Dehumanization

Kubin, E., Kachanoff, F., & Gray, K. 
(2021, December 4).

Abstract

Americans disagree about many things, including what threats are most pressing. We suggest people morally condemn and dehumanize opponents when they are perceived as rejecting the existence or severity of important perceived threats. We explore perceived “threat rejection” across five studies (N=2,404) both in the real-world COVID-19 pandemic and in novel contexts. Americans morally condemned and dehumanized policy opponents when they seemed to reject realistic group threats (e.g., threat to the physical health or resources of the group). Believing opponents rejected symbolic group threats (e.g., to collective identity) was not reliably linked to condemnation and dehumanization. Importantly, the political dehumanization caused by perceived threat rejection can be soothed with a “threat acknowledgement” intervention.

General Discussion 

Does perceived threat rejection sow political divisions? Results suggest perceiving the “other side” as rejecting realistic (more than symbolic) threat increases moral condemnation and dehumanization, lending support to the asymmetry hypothesis. DuringCOVID-19, those who relatively favored social distancing saw opponents as rejecting realistic threats and morally judged and dehumanized them. In contrast, support for social distancing did not reliably relate to perceiving the other side as rejecting symbolic threat—and symbolic threat was not robustly associated with moral judgment or dehumanization.

Within a novel threat context, people who were more willing to sacrifice their group’s culture to prevent realistic threats to health or resources viewed opponents as rejecting realistic threats and in turn morally condemned and dehumanized them. Similarly, people who were more willing to endure realistic threat to protect their culture, viewed opponents as rejecting symbolic threats, in turn morally condemning and dehumanizing them, yet these effects were significantly weaker than for realistic threat rejection. Our findings are consistent with research suggesting people condemn behaviors which are perceived as causing concrete (realistic) harm rather than abstract (symbolic) harm (Schein & Gray 2018).

Using a threat-acknowledgement-intervention, we decreased the tendency of people who tended to prioritize protecting the group from realistic threat (i.e., those who tended to support social distancing)to morally judge and dehumanize opponents who prioritized protecting the group from symbolic threat (i.e., those who tended to resist social distancing). Our intervention did not require opponents to compromise their stance –this intervention worked by simply having opponents acknowledge both realistic and symbolic threats when providing a rationale for their position. 

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Note: Helpful research when working with politically intense patients who frequently bring in partisan information to discuss in psychotherapy.

Monday, October 4, 2021

Reactance, morality, and disgust: the relationship between affective dispositions and compliance with official health recommendations during the COVID-19 pandemic

Díaz, R., & Cova, F. (2021). 
Cognition & emotion, 1–17. 
https://doi.org/10.1080/02699931.2021.1941783

Abstract

Emergency situations require individuals to make important changes in their behavior. In the case of the COVID-19 pandemic, official recommendations to avoid the spread of the virus include costly behaviors such as self-quarantining or drastically diminishing social contacts. Compliance (or lack thereof) with these recommendations is a controversial and divisive topic, and lay hypotheses abound regarding what underlies this divide. This paper investigates which psychological traits separate people who comply with official recommendations from those who don't. In four pre-registered studies on both U.S. and French samples, we found that individuals' self-reported compliance with official recommendations during the COVID-19 pandemic was partly driven by individual differences in moral values, disgust sensitivity, and psychological reactance. We discuss the limitations of our studies and suggest possible applications in the context of health communication.

From the General Discussion

However, results for semi-partial correlations paint a different   picture. First, perspective-taking is no longer a significant predictor of past compliance, but only of future compliance. Moreover, correlations coefficients for care values and perspective-taking were no longer the highest:correlations were in the same order of magnitude for care values than for pathogen disgust and psychological reactance, and quite low (<.10) for perspective-taking. This suggests  that, compared to the  effect of pathogen disgust  and  psychological  reactance,  the effect of care values and perspective-taking was for a great part explainable by other variables. On the contrary,  the overall effect of Pathogen Disgust seemed mostly unaffected by  the introduction of other variables, suggesting that its effect is not explained by these other variables.

The effect of perspective-taking on past and future compliance was particularly low for Study 2a, compared to Studies 1a and 1b. What could explain this difference? A first possible explanation is the nature of our sample: two US samples in Studies 1a and 1b, and a French sample  for  Study  2a.  However, it is not  clear why  this  should make a difference to the relationship between perspective-taking and compliance. A second explanation might be that Study  2a  included fewer predictors  than  Studies1a and 1b.  However,  this  seems  unlikely, because the zero-order correlations for perspective-taking were also smaller in Study 2 a third explanation might be timing: as mentioned earlier,Studies 1a and 1 were conducted in the middle of the first wave, while Study 2a was conducted between the first and second French waves, at a time where victims of COVID-19 were far fewer and less present and salient in medias. In absence of actual persons to take the perspective of, perspective-taking might have been less likely to motivate compliance.

Wednesday, September 22, 2021

COVID Medical Coverage is Over: Insurers are restoring deductibles and co-pays, leaving patients with big bills

Christopher Rowland
The Washington Post
Originally posted 18 Sept 21

Here is an excerpt:

But this year, most insurers have reinstated co-pays and deductibles for covid patients, in many cases even before vaccines became widely available. The companies imposed the costs as industry profits remained strong or grew in 2020, with insurers paying out less to cover elective procedures that hospitals suspended during the crisis.

Now the financial burden of covid is falling unevenly on patients across the country, varying widely by health-care plan and geography, according to a survey of the two largest health plans in every state by the nonprofit and nonpartisan Kaiser Family Foundation.

If you’re fortunate enough to live in Vermont or New Mexico, for instance, state mandates require insurance companies to cover 100 percent of treatment. But most Americans with covid are now exposed to the uncertainty, confusion and expense of business-as-usual medical billing and insurance practices — joining those with cancer, diabetes and other serious, costly illnesses.

(Insurers continue to waive costs associated with vaccinations and testing, a pandemic benefit the federal government requires.)

A widow with no children, Azar, 57, is part of the unlucky majority. Her experience is a sign of what to expect if covid, as most scientists fear, becomes endemic: a permanent, regular health threat.

Monday, September 6, 2021

Paranoia and belief updating during the COVID-19 crisis

Suthaharan, P., Reed, E.J., Leptourgos, P. et al. 
Nat Hum Behav (2021). 
https://doi.org/10.1038/s41562-021-01176-8

Abstract

The COVID-19 pandemic has made the world seem less predictable. Such crises can lead people to feel that others are a threat. Here, we show that the initial phase of the pandemic in 2020 increased individuals’ paranoia and made their belief updating more erratic. A proactive lockdown made people’s belief updating less capricious. However, state-mandated mask-wearing increased paranoia and induced more erratic behaviour. This was most evident in states where adherence to mask-wearing rules was poor but where rule following is typically more common. Computational analyses of participant behaviour suggested that people with higher paranoia expected the task to be more unstable. People who were more paranoid endorsed conspiracies about mask-wearing and potential vaccines and the QAnon conspiracy theories. These beliefs were associated with erratic task behaviour and changed priors. Taken together, we found that real-world uncertainty increases paranoia and influences laboratory task behaviour.

Discussion

The COVID-19 pandemic has been associated with increased paranoia. The increase was less pronounced in states that enforced a more proactive lockdown and more pronounced at reopening in states that mandated mask-wearing. Win-switch behaviour and volatility priors tracked these changes in paranoia with policy. We explored cultural variations in rule following (CTL) as a possible contributor to the increased paranoia that we observed. State tightness may originate in response to threats such as natural disasters, disease, territorial and ideological conflict. Tighter states typically evince more coordinated threat responses. They have also experienced greater mortality from pneumonia and influenza throughout their history. However, paranoia was highest in tight states with a mandate, with lower mask adherence during reopening. It may be that societies that adhere rigidly to rules are less able to adapt to unpredictable change. Alternatively, these societies may prioritize protection from ideological and economic threats over a public health crisis or perhaps view the disease burden as less threatening.

Wednesday, August 25, 2021

As a doctor in a COVID unit, I’m running out of compassion for the unvaccinated. Get the shot

Anita Sircar
The Los Angeles Times
Originally published 17 Aug 21

Here is an excerpt:

The burden of this pandemic now rests on the shoulders of the unvaccinated. On those who are eligible to get vaccinated but choose not to, a decision they defend by declaring, “Vaccination is a deeply personal choice.” But perhaps never in history has anyone’s personal choice affected the world as a whole as it does right now. When hundreds and thousands of people continue to die — when the most vulnerable members of society, our children, cannot be vaccinated — the luxury of choice ceases to exist.

If you believe the pandemic is almost over and I can ride it out, without getting vaccinated, you could not be more wrong. This virus will find you.

(cut)

If you believe if I get infected I’ll just go to the hospital and get treated, there is no guarantee we can save your life, nor even a promise we’ll have a bed for you.

If you believe I’m pregnant and I don’t want the vaccine to affect me, my baby or my future fertility, it matters little if you’re not alive to see your newborn.

If you believe I won’t get my children vaccinated because I don’t know what the long-term effects will be, it matters little if they don’t live long enough for you to find out.

If you believe I’ll just let everyone else get vaccinated around me so I don’t have to, there are 93 million eligible, unvaccinated people in the “herd” who think the same way you do and are getting in the way of ending this pandemic.

If you believe vaccinated people are getting infected anyway, so what’s the point?, the vaccine was built to prevent hospitalizations and deaths from severe illness. Instead of fatal pneumonia, those with breakthrough infections have a short, bad cold, so the vaccine has already proved itself. The vaccinated are not dying of COVID-19.

SARS-CoV-2, the virus that causes COVID-19, has mutated countless times during this pandemic, adapting to survive. Stacked up against a human race that has resisted change every step of the way — including wearing masks, social distancing, quarantining and now refusing lifesaving vaccines — it is easy to see who will win this war if human behavior fails to change quickly.

Saturday, August 14, 2021

How does COVID affect the brain? Two neuroscientists explain

T. Kilpatrick & S. Petrou
The Conversation
Originally posted 11 Aug 21

Here is an excerpt:

In a UK-based study released as a pre-print online in June, researchers compared brain images taken of people before and after exposure to COVID. They showed parts of the limbic system had decreased in size compared to people not infected. This could signal a future vulnerability to brain diseases and may play a role in the emergence of long-COVID symptoms.

COVID could also indirectly affect the brain. The virus can damage blood vessels and cause either bleeding or blockages resulting in the disruption of blood, oxygen, or nutrient supply to the brain, particularly to areas responsible for problem solving.

The virus also activates the immune system, and in some people, this triggers the production of toxic molecules which can reduce brain function.

Although research on this is still emerging, the effects of COVID on nerves that control gut function should also be considered. This may impact digestion and the health and composition of gut bacteria, which are known to influence the function of the brain.

The virus could also compromise the function of the pituitary gland. The pituitary gland, often known as the “master gland”, regulates hormone production. This includes cortisol, which governs our response to stress. When cortisol is deficient, this may contribute to long-term fatigue.

Sunday, August 8, 2021

Spreading False Vax Info Might Cost You Your Medical License

Ryan Basen
Medpagetoday.com
Originally posted 3 Aug 21

Physicians who intentionally spread misinformation or disinformation about the COVID-19 vaccines could be disciplined by state medical boards and may have their licenses suspended or taken away, said the Federation of State Medical Boards (FSMB).

Due "to a dramatic increase in the dissemination of COVID-19 vaccine misinformation and disinformation by physicians and other health care professionals on social media platforms, online and in the media," the FSMB, a national nonprofit representing medical boards that license and discipline allopathic and osteopathic physicians, issued the following statement:
Physicians who willfully generate and spread COVID-19 vaccine misinformation or disinformation are risking disciplinary action by state medical boards, including the suspension or revocation of their medical license. Due to their specialized knowledge and training, licensed physicians possess a high degree of public trust and therefore have a powerful platform in society, whether they recognize it or not. They also have an ethical and professional responsibility to practice medicine in the best interests of their patients and must share information that is factual, scientifically grounded and consensus driven for the betterment of public health. Spreading inaccurate COVID-19 vaccine information contradicts that responsibility, threatens to further erode public trust in the medical profession and puts all patients at risk.

The FSMB is aiming to remind physicians that words matter, that they have a platform, and that misinformation and disinformation -- especially within the context of the pandemic -- can cause harm, said president and CEO Humayun Chaudhry, DO. "I hope that physicians and other licensees get the message," he added.

The info is here.

Monday, May 3, 2021

Are Conspiracy Theories Harmless?

Douglas, K. M.
The Spanish Journal of Psychology
(2021). 24, e13, 1-7.

Abstract

In recent years, there has been an increasing interest in the consequences of conspiracy theories and the COVID–19 pandemic raised this interest to another level. In this article, I will outline what we know about the consequences of conspiracy theories for individuals, groups, and society, arguing that they are certainly not harmless. In particular, research suggests that conspiracy theories are associated with political apathy, support for non-normative political action, climate denial, vaccine refusal, prejudice, crime, violence, disengagement in the workplace, and reluctance to adhere to COVID–19 recommendations. In this article, I will also discuss the challenges of dealing with the negative consequences of conspiracy theories, which present some opportunities for future research.

Conclusions

Conspiracy theories are associated with a range of negative consequences for political engagement, political behavior, climate engagement, trust in science, vaccine uptake, civic behavior, work-related behavior, inter-group relations, and more recently the COVID-19 response.  A significant challenge for researchers is to learn how to deal with conspiracy theories and their associated effects.

Saturday, March 27, 2021

Veil-of-ignorance reasoning mitigates self-serving bias in resource allocation during the COVID-19 crisis

Huang, K. et al.
Judgment and Decision Making
Vol. 16, No. 1, pp 1-19.

Abstract

The COVID-19 crisis has forced healthcare professionals to make tragic decisions concerning which patients to save. Furthermore, The COVID-19 crisis has foregrounded the influence of self-serving bias in debates on how to allocate scarce resources. A utilitarian principle favors allocating scarce resources such as ventilators toward younger patients, as this is expected to save more years of life. Some view this as ageist, instead favoring age-neutral principles, such as “first come, first served”. Which approach is fairer? The “veil of ignorance” is a moral reasoning device designed to promote impartial decision-making by reducing decision-makers’ use of potentially biasing information about who will benefit most or least from the available options. Veil-of-ignorance reasoning was originally applied by philosophers and economists to foundational questions concerning the overall organization of society. Here we apply veil-of-ignorance reasoning to the COVID-19 ventilator dilemma, asking participants which policy they would prefer if they did not know whether they are younger or older. Two studies (pre-registered; online samples; Study 1, N=414; Study 2 replication, N=1,276) show that veil-of-ignorance reasoning shifts preferences toward saving younger patients. The effect on older participants is dramatic, reversing their opposition toward favoring the young, thereby eliminating self-serving bias. These findings provide guidance on how to remove self-serving biases to healthcare policymakers and frontline personnel charged with allocating scarce medical resources during times of crisis.

Wednesday, December 23, 2020

Beyond burnout: For health care workers, this surge of Covid-19 is bringing burnover

Wendy Dean & Simon G. Talbot
statnews.com
Originally posted 25 Nov 20

Covid-19 is roaring back for a third wave. The first two substantially increased feelings of moral injury and burnout among health care workers. This one is bringing burnover.

Health care systems are scrambling anew. The crises of ICU beds at capacity, shortages of personal protective equipment, emergency rooms turning away ambulances, and staff shortages are happening this time not in isolated hot spots but in almost every state. Clinicians again face work that is risky, heart-rending, physically exhausting, and demoralizing, all the elements of burnout. They have seen this before and are intensely frustrated it is happening again.

Too many of them are leaving health care long before retirement. The disconnect between what health care workers know and how the public is behaving, driven by relentless disinformation, is unbearable. Paraphrasing a colleague, “How can they call us essential and then treat us like we are disposable?”

It is time for leaders of hospitals and health care systems to add another, deeper layer of support for their staff by speaking out publicly and collectively in defense of science, safety, and public health, even if it risks estranging patients and politicians.

Long before the pandemic emerged, the relationships between health care organizations and their staffs were already strained by years of cost-cutting that trimmed staffing levels, supplies, and space to the bone. Driven by changes in health care reimbursement structures, systems were “optimized” to the point that they were continually running at what felt like full capacity, with precious little slack to accommodate minor surges, much less one the magnitude of a global pandemic.

Tuesday, December 1, 2020

Using Machine Learning to Generate Novel Hypotheses: Increasing Optimism About COVID-19 Makes People Less Willing to Justify Unethical Behaviors

Sheetal A, Feng Z, Savani K. 
Psychological Science. 2020;31(10):
1222-1235. 
doi:10.1177/0956797620959594

Abstract

How can we nudge people to not engage in unethical behaviors, such as hoarding and violating social-distancing guidelines, during the COVID-19 pandemic? Because past research on antecedents of unethical behavior has not provided a clear answer, we turned to machine learning to generate novel hypotheses. We trained a deep-learning model to predict whether or not World Values Survey respondents perceived unethical behaviors as justifiable, on the basis of their responses to 708 other items. The model identified optimism about the future of humanity as one of the top predictors of unethicality. A preregistered correlational study (N = 218 U.S. residents) conceptually replicated this finding. A preregistered experiment (N = 294 U.S. residents) provided causal support: Participants who read a scenario conveying optimism about the COVID-19 pandemic were less willing to justify hoarding and violating social-distancing guidelines than participants who read a scenario conveying pessimism. The findings suggest that optimism can help reduce unethicality, and they document the utility of machine-learning methods for generating novel hypotheses.

Here is how the research article begins:

Unethical behaviors can have substantial consequences in times of crisis. For example, in the midst of the COVID-19 pandemic, many people hoarded face masks and hand sanitizers; this hoarding deprived those who needed protective supplies most (e.g., medical workers and the elderly) and, therefore, put them at risk. Despite escalating deaths, more than 50,000 people were caught violating quarantine orders in Italy, putting themselves and others at risk. Governments covered up the scale of the pandemic in that country, thereby allowing the infection to spread in an uncontrolled manner. Thus, understanding antecedents of unethical behavior and identifying nudges to reduce unethical behaviors are particularly important in times of crisis.

Here is part of the Discussion

We formulated a novel hypothesis—that optimism reduces unethicality—on the basis of the deep-learning model’s finding that whether people think that the future of humanity is bleak or bright is a strong predictor of unethicality. This variable was not flagged as a top predictor either by the correlational analysis or by the lasso regression. Consistent with this idea, the results of a correlational study showed that people higher on dispositional optimism were less willing to engage in unethical behaviors. A following experiment found that increasing participants’ optimism about the COVID-19 epidemic reduced the extent to which they justified unethical behaviors related to the epidemic. The behavioral studies were conducted with U.S. American participants; thus, the cultural generalizability of the present findings is unclear. Future research needs to test whether optimism reduces unethical behavior in other cultural contexts.

Wednesday, September 16, 2020

There are no good choices

Ezra Klein
vox.com
Originally published 14 Sept 20

Here is an excerpt:

In America, our ideological conflicts are often understood as the tension between individual freedoms and collective actions. The failure of our pandemic response policy exposes the falseness of that frame. In the absence of effective state action, we, as individuals, find ourselves in prisons of risk, our every movement stalked by disease. We are anything but free; our only liberty is to choose among a menu of awful options. And faced with terrible choices, we are turning on each other, polarizing against one another. YouTube conspiracies and social media shaming are becoming our salves, the way we wrest a modicum of individual control over a crisis that has overwhelmed us as a collective.

“The burden of decision-making and risk in this pandemic has been fully transitioned from the top down to the individual,” says Dr. Julia Marcus, a Harvard epidemiologist. “It started with [responsibility] being transitioned to the states, which then transitioned it to the local school districts — If we’re talking about schools for the moment — and then down to the individual. You can see it in the way that people talk about personal responsibility, and the way that we see so much shaming about individual-level behavior.”

But in shifting so much responsibility to individuals, our government has revealed the limits of individualism.

The risk calculation that rules, and ruins, lives

Think of coronavirus risk like an equation. Here’s a rough version of it: The danger of an act = (the transmission risk of the activity) x (the local prevalence of Covid-19) / (by your area’s ability to control a new outbreak).

Individuals can control only a small portion of that equation. People can choose safer activities over riskier ones — though the language of choice too often obscures the reality that many have no economic choice save to work jobs that put them, and their families, in danger. But the local prevalence of Covid-19 and the capacity of authorities to track and squelch outbreaks are collective functions.

The info is here.

Monday, September 14, 2020

Trump lied about science

H. Holden Thorp
Science
Originally published 11 Sept 20

When President Donald Trump began talking to the public about coronavirus disease 2019 (COVID-19) in February and March, scientists were stunned at his seeming lack of understanding of the threat. We assumed that he either refused to listen to the White House briefings that must have been occurring or that he was being deliberately sheltered from information to create plausible deniability for federal inaction. Now, because famed Washington Post journalist Bob Woodward recorded him, we can hear Trump’s own voice saying that he understood precisely that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was deadly and spread through the air. As he was playing down the virus to the public, Trump was not confused or inadequately briefed: He flat-out lied, repeatedly, about science to the American people. These lies demoralized the scientific community and cost countless lives in the United States.

Over the years, this page has commented on the scientific foibles of U.S. presidents. Inadequate action on climate change and environmental degradation during both Republican and Democratic administrations have been criticized frequently. Editorials have bemoaned endorsements by presidents on teaching intelligent design, creationism, and other antiscience in public schools. These matters are still important. But now, a U.S. president has deliberately lied about science in a way that was imminently dangerous to human health and directly led to widespread deaths of Americans.

This may be the most shameful moment in the history of U.S. science policy.

In an interview with Woodward on 7 February 2020, Trump said he knew that COVID-19 was more lethal than the flu and that it spread through the air. “This is deadly stuff,” he said. But on 9 March, he tweeted that the “common flu” was worse than COVID-19, while economic advisor Larry Kudlow and presidential counselor Kellyanne Conway assured the public that the virus was contained. On 19 March, Trump told Woodward that he did not want to level with the American people about the danger of the virus. “I wanted to always play it down,” he said, “I still like playing it down.” Playing it down meant lying about the fact that he knew the country was in grave danger.

The info is here.