In the face of Covid-19, the U.S. needs to change how it deals with mental illness

Jeffrey Geller
STAT NEWS
Originally posted 29 May 20

Here are two excerpts:

Frontline physicians, nurses, and other health care workers are looking death in the face every day. Shift workers in economically treacherous situations are forced to risk their health for a paycheck. Millions of Americans have lost their jobs. Still more are separated from the people they love, their daily routines have been disrupted, and they are making anxious choices every day that affect their physical and mental health.

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Second, Covid-19 has laid bare the severe doctor shortage across the United States, and that shortage includes psychiatrists. While every kind of mental health professional is necessary and indeed critical to responding to the crisis, psychiatrists bring unique expertise in serving some of the most severely compromised patients in psychiatric units and hospitals, long-term care facilities, homeless shelters, and jails and prisons. Forgiving some of the debt that students amass during medical school would incentivize more individuals to serve in these capacities, as would lifting caps on federal funding for new residency slots.

Third, we needed more psychiatric beds in hospitals before Covid-19, and need even more now as physical distancing continues — yet some hospitals have decreased the number of psychiatric beds by converting them to beds for individuals with Covid-19. Patients in psychiatric units who contract Covid-19 need to be separated from other patients. We currently do not have enough beds to treat everyone for the length of time they need. Without federal funding for psychiatric beds, we will have an increase in deaths from the mental health sequelae of Covid-19.

The info is here.

Scathing COVID-19 book from Lancet editor — rushed but useful

Stephen Buranyi
nature.com
Originally posted 18 June 20

Here is an excerpt:

Horton levels the accusation that US President Donald Trump is committing a “crime against humanity” for defunding the very World Health Organization that is trying to help the United States and others. UK Prime Minister Boris Johnson, in Horton’s view, either lied or committed misconduct in telling the public that the government was well prepared for the pandemic. In fact, the UK government abandoned the world-standard advice to test, trace and isolate in March, with no explanation, then scrambled to ramp up testing in April, but repeatedly failed to meet its own targets, lagging weeks behind the rest of the world. A BBC investigation in April showed that the UK government failed to stockpile neccessary personal protective equipment for years before the crisis, and should have been aware that the National Health Service wasn’t adequately prepared.

Politicians are easy targets, though. Horton goes further, to suggest that although scientists in general have performed admirably, many of those advising the government directly contributed to what he calls “the greatest science policy failure for a generation”.

Again using the United Kingdom as an example, he suggests that researchers were insufficiently informed or understanding of the crisis unfolding in China, and were too insular to speak to Chinese scientists directly. The model for action at times seemed to be influenza, a drastic underestimation of the true threat of the new coronavirus. Worse, as the UK government’s response went off the rails in March, ostensibly independent scientists would “speak with one voice in support of government policy”, keeping up the facade that the country was doing well. In Horton’s view, this is a corruption of science policymaking at every level. Individuals failed in their responsibility to procure the best scientific advice, he contends; and the advisory regime was too close to — and in sync with — the political actors who were making decisions. “Advisors became the public relations wing of a government that had failed its people,” he concludes.

The text is here.

Downloading COVID-19 contact tracing apps is a moral obligation

G. Owen Schaefer and Angela Ballantyne
BMJ Blogs
Originally posted 4 May 20

Should you download an app that could notify you if you had been in contact with someone who contracted COVID-19? Such apps are already available in countries such as Israel, Singapore, and Australia, with other countries like the UK and US soon to follow. Here, we explain why you might have an ethical obligation to use a tracing app during the COVID-19 pandemic, even in the face of privacy concerns.

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Vulnerability and unequal distribution of risk

Marginalized populations are both hardest hit by pandemics and often have the greatest reason to be sceptical of supposedly benign State surveillance. COVID-19 is a jarring reminder of global inequality, structural racism, gender inequity, entrenched ableism, and many other social divisions. During the SARS outbreak, Toronto struggled to adequately respond to the distinctive vulnerabilities of people who were homeless. In America, people of colour are at greatest risk in several dimensions – less able to act on public health advice such as social distancing, more likely to contract the virus, and more likely to die from severe COVID if they do get infected. When public health advice switched to recommending (or in some cases requiring) masks, some African Americans argued it was unsafe for them to cover their faces in public. People of colour in the US are at increased risk of state surveillance and police violence, in part because they are perceived to be threatening and violent. In New York City, black and Latino patients are dying from COVID-19 at twice the rate of non-Hispanic white people.

Marginalized populations have historically been harmed by State health surveillance. For example, indigenous populations have been the victims of State data collection to inform and implement segregation, dispossession of land, forced migration, as well as removal and ‘re‐education’ of their children. Stigma and discrimination have impeded the public health response to HIV/AIDS, as many countries still have HIV-specific laws that prosecute people living with HIV for a range of offences.  Surveillance is an important tool for implementing these laws. Marginalized populations therefore have good reasons to be sceptical of health related surveillance.

My Bedside Manner Got Worse During The Pandemic. Here's How I Improved

Shahdabul Faraz
npr.org
Health Shots
Originally published 16 May 20

Here is an excerpt:

These gestures can be as simple as sitting in a veteran's room for an extra five minutes to listen to World War II stories. Or listening with a young cancer patient to a song by our shared favorite band. Or clutching a sick patient's shoulder and reassuring him that he will see his three daughters again.

These gestures acknowledge a patient's humanity. It gives them some semblance of normalcy in an otherwise difficult period in their lives. Selfishly, that human connection also helps us — the doctors, nurses and other health care providers — deal with the often frustrating nature of our stressful jobs.

Since the start of the pandemic, our bedside interactions have had to be radically different. Against our instincts, and in order to protect our patients and colleagues, we tend to spend only the necessary amount of time in our patients' rooms. And once inside, we try to keep some distance. I have stopped holding my patients' hands. I now try to minimize small talk. No more whimsical conversational detours.

Our interactions now are more direct and short. I have, more than once, felt guilty for how quickly I've left a patient's room. This guilt is worsened, knowing that patients in hospitals don't have family and friends with them now either. Doctors are supposed to be there for our patients, but it's become harder than ever in recent months.

I understand why these changes are needed. As I move through several hospital floors, I could unwittingly transmit the virus if I'm infected and don't know it. I'm relatively young and healthy, so if I get the disease, I will likely recover. But what about my patients? Some have compromised immune systems. Most are elderly and have more than one high-risk medical condition. I could never forgive myself if I gave one of my patients COVID-19.

The info is here.

The Answer to a COVID-19 Vaccine May Lie in Our Genes, But ...

Ifeoma Ajunwa & Forrest Briscoe
Scientific American
Originally posted 13 May 2020

Here is an excerpt:

Although the rationale for expanded genetic testing is obviously meant for the greater good, such testing could also bring with it a host of privacy and economic harms. In the past, genetic testing has also been associated with employment discrimination. Even before the current crisis, companies like 23andMe and Ancestry assembled and started operating their own private long-term large-scale databases of U.S. citizens’ genetic and health data. 23andMe and Ancestry recently announced they would use their databases to identify genetic factors that predict COVID-19 susceptibility.

Other companies are growing similar databases, for a range of purposes. And the NIH’s AllofUs program is constructing a genetic database, owned by the federal government, in which data from one million people will be used to study various diseases. These new developments indicate an urgent need for appropriate genetic data governance.

Leaders from the biomedical research community recently proposed a voluntary code of conduct for organizations constructing and sharing genetic databases. We believe that the public has a right to understand the risks of genetic databases and a right to have a say in how those databases will be governed. To ascertain public expectations about genetic data governance, we surveyed over two thousand (n=2,020) individuals who altogether are representative of the general U.S. population. After educating respondents about the key benefits and risks associated with DNA databases—using information from recent mainstream news reports—we asked how willing they would be to provide their DNA data for such a database.

The info is here.

Ethical road map through the COVID-19 pandemic

Zoe Fritz and others
BMJ 2020; 369
doi: https://doi.org/10.1136/bmj.m2033

The covid-19 pandemic has created profound ethical challenges in health and social care, not only for current decisions about individuals but also for longer term and population level policy decisions. Already covid-19 has generated ethical questions about the prioritisation of treatment, protective equipment, and testing; the impact of covid-19 strategies on patients with other health conditions; the approaches taken to advance care planning and resuscitation decisions; and the crisis in care homes.

Ethical questions continue to multiply as the pandemic progresses and new evidence emerges, including how best to distribute any new vaccines and treatments; how best to respond to evidence that disease severity and mortality are substantially greater in ethnic minority populations; how to prioritise patients for care as medical services re-open; how to manage assessment of immunity and its implications; and how the health system should be configured to manage any future peaks in cases.

Science and values

The UK government repeatedly states that it is “following the science” by heeding the advice provided through the Scientific Advisory Group for Emergencies (SAGE). However, this implies that the science alone will tell us what to do. Not only does this rhetoric shift the responsibility for difficult decisions on to “the science”, it is also wrong. Science may provide evidence on which to base decisions, but our values will determine what we do with that evidence and how we select the evidence to use. It is disingenuous and misleading to imply that value-free science leads the way. Both science and policy are value laden.

Values questions are being addressed primarily by professional organisations, although the UK government has independent advice, for example, from the Moral and Ethical Advisory Group. Despite such efforts to plot an ethical path, the current approach is piecemeal, confusing, and risks needless duplication of effort. Concerns are mounting about a lack of transparency around the ethical agenda underpinning decisions, a lack of coordination, and the absence of clear national leadership.

The info is here.

Trust in Medical Scientists Has Grown in U.S.

C. Funk, B. Kennedy, & C. Johnson
Pew Research Center
Originally published 21 May 20

Americans’ confidence in medical scientists has grown since the coronavirus outbreak first began to upend life in the United States, as have perceptions that medical doctors hold very high ethical standards. And in their own estimation, most U.S. adults think the outbreak raises the importance of scientific developments.

Scientists have played a prominent role in advising government leaders and informing the public about the course of the pandemic, with doctors such as Anthony Fauci and Deborah Birx, among others, appearing at press conferences alongside President Donald Trump and other government officials.

But there are growing partisan divisions over the risk the novel coronavirus poses to public health, as well as public confidence in the scientific and medical community and the role such experts are playing in public policy.

Still, most Americans believe social distancing measures are helping at least some to slow the spread of the coronavirus disease, known as COVID-19. People see a mix of reasons behind new cases of infection, including limited testing, people not following social distancing measures and the nature of the disease itself.

These are among the key findings from a new national survey by Pew Research Center, conducted April 29 to May 5 among 10,957 U.S. adults, and a new analysis of a national survey conducted April 20 to 26 among 10,139 U.S. adults, both using the Center’s American Trends Panel.

Public confidence in medical scientists to act in the best interests of the public has gone up from 35% with a great deal of confidence before the outbreak to 43% in the Center’s April survey. Similarly, there is a modest uptick in public confidence in scientists, from 35% in 2019 to 39% today. (A random half of survey respondents rated their confidence in one of the two groups.)

The info is here.

'A coronavirus depression could be the great leveller'

Kyrill Hartog
The Guardian
Originally published 30 April 2020

Here is an excerpt:

So could the pandemic of our era, already considered the greatest global crisis since the second world war, turn out to be a great societal leveller?

Scheidel’s short answer is that the longer the pandemic wreaks havoc on the global economy, the greater the potential for radical equalising change. “It depends on how severe the crisis is going to be, how long it’s going to last and how much it’s ultimately going to interrupt supply chains.”

The pandemic has already exposed the limits of the market and highlighted the importance of effective state intervention and strong public healthcare provision. In the future this may well create a tolerance for higher and more progressive taxation. Governments have had to intervene to prop up businesses and jobs in ways that only months ago would have seemed unimaginable. The viability of a universal basic income — a dream for egalitarians worldwide — is once again part of the mainstream debate in many countries.

The response at EU level also shows a willingness for strong public intervention and an end to the fiscal restraint approach of the last decade — at least, temporarily.

As people start to believe in government intervention again, the post-corona political landscape may well provide fertile soil for reversing a situation where, since 1980, the richest 1% in the UK have tripled their share of household income and the wealth of the European top 1% grew twice as fast as the bottom 50%.

But Scheidel cautions that, while disasters are not uncommon, tectonic shifts are historical anomalies. In other words, it may take a disaster to usher in more equality, but not every disaster does.

The info is here.

Four concepts to assess your personal risk as the U.S. reopens

Leana Wen
The Washington Post
Originally posted 21 May 20

Here is an excerpt:

So what does that mean in terms of choices each of us makes — what’s safe to do and what’s not?

Here are four concepts from other harm-reduction strategies that can help to guide our decisions:

Relative risk. Driving is an activity that carries risk, which can be reduced by following the speed limit and wearing a seat belt. For covid-19, we can think of risk through three key variables: proximity, activity and time.

The highest-risk scenario is if you are in close proximity with someone who is infected, in an indoor space, for an extended period of time. That’s why when one person in the household becomes ill, others are likely to get infected, too.

Also, certain activities, such as singing, expel more droplets; in one case, a single infected person in choir practice spread covid-19 to 52 people, two of whom died.

The same goes for gatherings where people hug one another — funerals and birthdays can be such “superspreader” events. Conversely, there are no documented cases of someone acquiring covid-19 by passing a stranger while walking outdoors.

You can decrease your risk by modifying one of these three variables. If you want to see friends, avoid crowded bars, and instead host in your backyard or a park, where everyone can keep their distance.

Use your own utensils and, to be even safer, bring your own food and drinks.

Skip the hugs, kisses and handshakes. If you go to the beach, find areas where you can stay at least six feet away from others who are not in your household. Takeout food is the safest. If you really want a meal out, eating outdoors with tables farther apart will be safer than dining in a crowded indoor restaurant.

Businesses should also heed this principle as they are reopening, by keeping up telecommuting and staggered shifts, reducing capacity in conference rooms, and closing communal dining areas. Museums can limit not only the number of people allowed in at once, but also the amount of time people are allowed to spend in each exhibit.

Pooled risk. If you engage in high-risk activity and are around others who do the same, you increase everyone’s risk. Think of the analogy with safe-sex practices: Those with multiple partners have higher risk than people in monogamous relationships. As applied to covid-19, this means those who have very low exposure are probably safe to associate with one another.

This principle is particularly relevant for separated families that want to see one another. I receive many questions from grandparents who miss their grandchildren and want to know when they can see them again. If two families have both been sheltering at home with virtually no outside interaction, there should be no concern with them being with one another. Families can come together for day care arrangements this way if all continue to abide by strict social distancing guidelines in other aspects of their lives. (The equation changes when any one individual resumes higher-risk activities — returning to work outside the home, for example.)

The info is here.

Discussing the ethics of hydroxychloroquine prescriptions for COVID-19 prevention

Sharon Yoo
KARE11.com
Originally published 19 May 20

President Donald Trump said on Monday that he's been taking hydroxychloroquine to protect himself against the coronavirus. It is a drug typically used to treat malaria and lupus.

The Federal Drug Administration issued warnings that the drug should only be used in clinical trials or for patients at a hospital under the Emergency Use Authorization.

"Yeah, a White House doctor, didn't recommend—I asked him what do you think—and he said well, if you'd like it and I said yeah, I'd like it, I'd like to take it," President Trump said, when a reporter asked him if a White House doctor recommended that he take hydroxychloroquine on Monday.

In a statement, the President's physician, Dr. Sean Conley said after discussions, they've concluded the potential benefit from treatment outweighed the relative risks. All this, despite the FDA warnings.

University of Minnesota bioethics professor Joel Wu said this is problematic.

"It's ethically problematic if the President is being treated for COVID specifically by hydroxychloroquine because our understanding based on the current evidence is not safe or effective in treating or preventing COVID," Wu said.

The info is here.

Ethics of controlled human infection to study COVID-19

Shah, S.K, Miller, F.G., and others
Science  07 May 2020
DOI: 10.1126/science.abc1076

Abstract

Development of an effective vaccine is the clearest path to controlling the coronavirus disease 2019 (COVID-19) pandemic. To accelerate vaccine development, some researchers are pursuing, and thousands of people have expressed interest in participating in, controlled human infection studies (CHIs) with severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) (1, 2). In CHIs, a small number of participants are deliberately exposed to a pathogen to study infection and gather preliminary efficacy data on experimental vaccines or treatments. We have been developing a comprehensive, state-of-the-art ethical framework for CHIs that emphasizes their social value as fundamental to justifying these studies. The ethics of CHIs in general are underexplored (3, 4), and ethical examinations of SARS-CoV-2 CHIs have largely focused on whether the risks are acceptable and participants could give valid informed consent (1). The high social value of such CHIs has generally been assumed. Based on our framework, we agree on the ethical conditions for conducting SARS-CoV-2 CHIs (see the table). We differ on whether the social value of such CHIs is sufficient to justify the risks at present, given uncertainty about both in a rapidly evolving situation; yet we see none of our disagreements as insurmountable. We provide ethical guidance for research sponsors, communities, participants, and the essential independent reviewers considering SARS-CoV-2 CHIs.

The info is here.

A pandemic plan was in place. Trump abandoned it - and science

Jason Karlawish
statnews.com
Originally posted 17 May 20

Here is an excerpt:

And then on Jan. 21, 2017, Donald Trump became president.

Beginning the morning after his inauguration, a spectacular science-related tragedy has unfolded. The Trump administration has systematically dismantled the executive branch’s science infrastructure and rejected the role of science to inform policy, essentially reversing both Republican and Democrat presidential administrations since World War II, when Vannevar Bush, an engineer, advised Presidents Franklin D. Roosevelt and Harry S. Truman.

President Trump’s pursuit of anti-science policy has been so effective that as the first cases of Covid-19 were breaking out in Wuhan, China, no meaningful science policy infrastructure was in place to advise him. As a consequence, America is suffering from a pandemic without a plan. Our responses are ineffectual and inconsistent. We are increasingly divided by misinformation and invidious messaging. And it’s not even over.

Facts will drive scientific decisions, not the other way around

On April 27, 2009, on the eve of his 100th day in office, Obama made a five-block trip from the White House to 2101 Constitution Ave. There, in the Great Hall of the National Academy of Sciences, he spoke about his administration’s commitment to science.

“Science is more essential for our prosperity, our security, our health, our environment, and our quality of life than it has ever been before,” he announced. He introduced the members of PCAST and explained how his administration would engage the scientific community directly in the work of public policy.

“I want to be sure that facts are driving scientific decisions — and not the other way around,” the president said. The audience broke into laughter.

Obama explained that his science advisers were already briefing him daily on the emerging threat of swine flu, which some were projecting could kill thousands of Americans.

The info is here.

Cultural evolution, Covid-19, and preparing for what’s next

Michael Muthukrishna

London School of Economics
and Political Science
Originally posted 22 April 2020

Here is an excerpt:

A recent analysis suggests that countries with efficient governments and tight, norm-enforcing cultures have the slowest rate of increase in Covid-19 cases adjusted for population size and the fewest deaths controlling for GDP per capita, inequality, and median age, weighting for time. Together, these explain 41% of the variance. Put another way, societies with institutions that advocate behaviours that reduce caseloads and citizens who conform to those behaviours are successful in managing this outbreak. Countries with institutions with behaviours that do not reduce caseloads and citizens who conform, and countries with institutions who advocate appropriate behaviours, but citizens who do not conform have worse outcomes. In addition to general government efficiency and a tendency to enforce norms, past research has implicated a package of behaviours classed as “collectivism” as having evolved as an adaptation to material insecurity, including pathogen prevalence, and other pressures that required avoiding individualistic behaviours that threatened the group welfare or challenges that required collective action. That is, collectivist cultures may have evolved a suite of behaviours that are well adapted to epidemics: less mouth-to-mouth romantic kissing and physical affection in general, more vigilance of others, even in-group members, social learning, conformity, obedience to authority, avoidance orientation, and so on. Indeed, a quick and dirty re-analysis of Gelfand et al’s models replacing tightness with collectivism, shows that collectivism alone predicts 36% of the variance, and together with the controls, predicts 48% of the variance (see Table 1).

The info is here.

Veil-of-Ignorance Reasoning Favors Allocating Resources to Younger Patients During the COVID-19 Crisis

Huang, K., Bernhard, R., and others
(2020, April 22).
https://doi.org/10.31234/osf.io/npm4v

Abstract

The COVID-19 crisis has forced healthcare professionals to make tragic decisions concerning which patients to save. 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? Veil-of-ignorance reasoning is a decision procedure designed to produce fair outcomes. 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. These findings provide concrete guidance to healthcare policymakers and front line personnel charged with allocating scarce medical resources during times of crisis.

From the General Discussion

In two pre-registered studies, we show that veil-of-ignorance reasoning favors allocating scarce medical resources to younger patients during the COVID-19 crisis. A strong majority of participants who engaged in veil-of-ignorance reasoning concluded that a policy of maximizing the number of life-years saved is what they would want for themselves if they did not know whom they were going to be.Importantly, engaging in veil-of-ignorance reasoning subsequently produced increased moral approval of this utilitarian policy. These findings, though predicted based on prior research(Huang, Greene, &Bazerman, 2019), make three new contributions. First, they apply directly to an ongoing crisis in which competing claims to fairness must be resolved. While the ventilator shortage in the developed world has been less acute than many feared, it may reemerge in greater force as the COVID-19 crisis spreads to the developing world (Woodyatt, 2020). Second, the dilemma considered here differs from those considered previously because it concerns maximizing the number of life-years saved, rather than the number of lives saved.Finally, the results show the power of the veil to eliminate self-serving bias. In the control condition, few older participants (33%) favored prioritizing younger patients. But after engaging in veil-of-ignorance reasoning, most older participants (62%) favored doing so, just like younger participants.

The research is here.

What To Do If You Need to See Patients In Office?

If you are a mental health professional who continues to see (some) patients in the office because of patient needs, the following chart may be helpful.  

To protect my patients, I imagine I am a carrier, even though I have no way of knowing because our government lacks the capacity for adequate COVID-19 testing.

Why some nurses have quit during the coronavirus pandemic

Safia Samee Ali
nbcnews.com
Originally posted 10 May 20

Here is an excerpt:

“It was an extremely difficult decision, but as a mother and wife, the health of my family will always come first. In the end, I could not accept that I could be responsible for causing one of my family members to become severely ill or possibly die.”

As COVID-19 has infected more than one million Americans, nurses working on the front lines of the pandemic with little protective support have made the gut-wrenching decision to step away from their jobs, saying they were ill-equipped and unable to fight the disease and feared not only for their own safety but also for that of their families.

Many of these nurses, who have faced backlash for quitting, say new CDC protocols have made them feel expendable and have not kept their safety in mind, leaving them no choice but to walk away from a job they loved.

'We're not cannon fodder, we’re human beings'

As the nation took stock of its dwindling medical supplies in the early days of the pandemic, CDC guidance regarding personal protective equipment quickly took a back seat.

N95 masks, which had previously been the acceptable standard of protective care for both patients and medical personnel, were depleting so commercial grade masks, surgical masks, and in the most extreme cases homemade masks such as scarves and bandanas were all sanctioned by the CDC -- which did not return a request for comment -- to counter the lacking resources.

The info is here.

US 'Deaths of Despair' From COVID-19 Could Top 75,000, Experts Warn

Megan Brooks
MedScape.com
Originally posted 8 May 20

An additional 75,000 Americans could die by suicide, drugs, or alcohol abuse because of the COVID-19 pandemic, projections from a new national report released today suggest.

The number of "deaths of despair" could be even higher if the country fails to take bold action to address the mental health toll of unemployment, isolation, and uncertainty, according to the report from the Well Being Trust (WBT) and the Robert Graham Center for Policy Studies in Family Medicine and Primary Care.

"If nothing happens and nothing improves ― ie, the worst-case scenario ― we could be looking at an additional 150,000 people who died who didn't have to," Benjamin Miller, PsyD, WBT chief strategy officer, told Medscape Medical News.

"We can prevent these deaths. We know how and have a bevy of evidence-based solutions. We lack the resources to really stand this up in a way that can most positively impact communities," Miller added.

Slow Recovery, Quick Recovery Scenarios

For the analysis, Miller and colleagues combined information on the number of deaths from suicide, alcohol, and drugs from 2018 as a baseline (n = 181,686). They projected levels of unemployment from 2020 to 2029 and then used economic modeling to estimate the additional annual number of deaths.

Across nine different scenarios, the number of additional deaths of despair range from 27,644 (quick recovery, smallest impact of unemployment on suicide, alcohol-, and drug-related deaths) to 154,037 (slow recovery, greatest impact of unemployment on these deaths), with 75,000 being the most likely.

The info is here.

Social-media companies must flatten the curve of misinformation

Joan Donovan
nature.com
Originally posted 14 April 20

Here is an excerpt:

After blanket coverage of the distortion of the 2016 US election, the role of algorithms in fanning the rise of the far right in the United States and United Kingdom, and of the antivax movement, tech companies have announced policies against misinformation. But they have slacked off on building the infrastructure to do commercial-content moderation and, despite the hype, artificial intelligence is not sophisticated enough to moderate social-media posts without human supervision. Tech companies acknowledge that groups, such as The Internet Research Agency and Cambridge Analytica, used their platforms for large-scale operations to influence elections within and across borders. At the same time, these companies have balked at removing misinformation, which they say is too difficult to identify reliably.

Moderating content after something goes wrong is too late. Preventing misinformation requires curating knowledge and prioritizing science, especially during a public crisis. In my experience, tech companies prefer to downplay the influence of their platforms, rather than to make sure that influence is understood. Proper curation requires these corporations to engage independent researchers, both to identify potential manipulation and to provide context for ‘authoritative content’.

Early this April, I attended a virtual meeting hosted by the World Health Organization, which had convened journalists, medical researchers, social scientists, tech companies and government representatives to discuss health misinformation. This cross-sector collaboration is a promising and necessary start. As I listened, though, I could not help but to feel teleported back to 2017, when independent researchers first began uncovering the data trails of the Russian influence operations. Back then, tech companies were dismissive. If we can take on health misinformation collaboratively now, then we will have a model for future efforts.

The info is here.

The coming battle for the COVID-19 narrative

Samule Bowles & Wendy Carlin
voxeu.org
Originally posted 10 April 20

The COVID-19 pandemic is a blow to self-interest as a value orientation and laissez-faire as a policy paradigm, both already reeling amid mounting public concerns about climate change.  Will the pandemic change our economic narrative, expressing new everyday understandings of how the economy works and how it should work? 

We think so. But it will not be simply a shift to the left on the now anachronistic one-dimensional markets-versus-government continuum shown in Figure 1. A position along the blue line represents a mix of public policies – nationalisation of the railways, for example, towards the left; deregulation of labour markets, for example, towards the right.

COVID-19, for better or worse, brings into focus a third pole in the debate: call it community or civil society. In the absence of this third pole, the conventional language of economics and public policy misses the contribution of social norms and of institutions that are neither governments nor markets – like families, relationships within firms, and community organisations.

There are precedents for the scale of changes that we anticipate. The Great Depression and WWII changed the way we talked about the economy: left to its own devices it would wreak havoc on people’s lives (massive unemployment), “heedless self-interest [is] bad economics” (FDR),1 and governments can effectively pursue the public good (defeat fascism, provide economic security). As the memories of that era faded along with the social solidarity and confidence in collective action that it had fostered, another vernacular took over: “there is no such thing as society” (Thatcher) – you get what you pay for, government is just another special interest group.

Another opportunity for a long-needed fundamental shift in the economic vernacular is now unfolding. COVID-19, along with climate change, could be the equivalent of the Great Depression and WWII in forcing a sea change in economic thinking and policy.

The info is here.

Measuring Two Distinct Psychological Threats of COVID-19 and their Unique Impacts on Wellbeing and Adherence to Public Health Behaviors

Kachanoff, F., Bigman, Y., Kapsaskis, K., &
Gray, K.  (2020, April 2).
https://doi.org/10.31234/osf.io/5zr3w

Abstract

COVID-19 threatens lives, livelihoods, and civic institutions. Although public health initiatives (i.e., social distancing) help manage its impact, these initiatives can further sever our connections to people and institutions that affirm our identities. Three studies (N=1,195) validated a brief 10-item COVID-19 threat scale that assesses 1) realistic threats to physical or financial safety, and 2) symbolic threats to one’s sociocultural identity. Studies reveal that both realistic and symbolic threat predict higher anxiety and lower wellbeing, and demonstrate convergent validity with other measures of threat sensitivity. Importantly, the two kinds of threat diverge in their relationship to public health behaviors (e.g., social distancing): Realistic threat predicted greater self-reported compliance, whereas symbolic threat predicted less self-reported compliance to these social-disconnection initiatives. Symbolic threat also predicted using creative ways to affirm identity even in isolation. Our findings highlight how social psychological theory can be leveraged to understand and predict people’s behavior in pandemics.

From the General Discussion:

Symbolic and realistic threats also had significant yet different consequences for self-reported adherence to and support of public health initiatives essential to stopping the spread of the virus (i.e., social distancing, hand washing). People who perceived high levels of realistic threat to their (and their group’s) physical and financial security reported greater adherence and support for such practices. In direct contrast, people who perceived more symbolic threat to what it means to be an American, reported less support for and adherence to public health guidelines. However, if people do engage in social distancing, symbolic threat is positively associated with finding creative ways to enact and express their social (e.g., national) identity even in isolation.