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We introduce an extension to Kermack and McKendrick’s classic susceptible–infected–recovered (SIR) model in epidemiology, whose underlying mechanism of infection consists of individuals attending randomly generated social gatherings. This gives rise to a system of ordinary differential equations (ODEs) where the force of the infection term depends non-linearly on the proportion of infected individuals. Some specific instances yield models already studied in the literature, to which the present work provides a probabilistic foundation. The basic reproduction number is seen to depend quadratically on the average size of the gatherings, which may be helpful in understanding how restrictions on social gatherings affect the spread of the disease. We rigorously justify our model by showing that the system of ODEs is the mean-field limit of the jump Markov process corresponding to the evolution of the disease in a finite population.
For any emerging pathogen, the preferred approach is to drive it to extinction with non-pharmaceutical interventions (NPI) or suppress its spread until effective drugs or vaccines are available. However, this might not always be possible. If containment is infeasible, the best people can hope for is pathogen transmission until population level immunity is achieved, with as little morbidity and mortality as possible.
Methods:
A simple computational model was used to explore how people should choose NPI in a non-containment scenario to minimize mortality if mortality risk differs by age.
Results:
Results show that strong NPI might be worse overall if they cannot be sustained compared to weaker NPI of the same duration. It was also shown that targeting NPI at different age groups can lead to similar reductions in the total number of infected, but can have strong differences regarding the reduction in mortality.
Conclusions:
Strong NPI that can be sustained until drugs or vaccines become available are always preferred for preventing infection and mortality. However, if people encounter a worst-case scenario where interventions cannot be sustained, allowing some infections to occur in lower-risk groups might lead to an overall greater reduction in mortality than trying to protect everyone equally.
Older adults were particularly vulnerable to the COVID-19 pandemic, necessitating significant efforts to avoid contamination. This extraordinary situation posed an increased risk of mental pressure, and the ability to handle stressful situations is affected by several aspects. Therefore, this study aims to explore the coping strategies employed by older adults during the early months of the COVID-19 pandemic. A sample of 41 Swedish older adults aged 70–85 participated in phone interviews regarding their experiences with social distancing due to COVID-19. The interviews were conducted between April and May 2020, with nine follow-up interviews conducted in November and December 2020. The findings revealed results that despite the challenging circumstances, the participants demonstrated a strong mindset and resilience. Strategies utilised to improve their wellbeing and manage the situation included following recommendations, accepting the situation and maintaining a positive outlook. The influence of previous experiences on their coping strategies was evident. Additionally, the participants expressed a longing for their relatives and a need to adopt new technologies to manage their everyday lives. The follow-up interviews indicated no significant changes in worry or behaviour; if anything, participants were less worried at the beginning of the pandemic. This study contributes to the ongoing discussion on vulnerability among older adults by highlighting the diverse range of coping strategies employed during a prolonged crisis such as the COVID-19 pandemic. It demonstrated that though they are medically vulnerable, they are situationally resilient and, in many ways, well set to handle a challenging situation. During crises, older adults might need practical assistance. On the other hand, they can be a resource regarding mental preparedness during crises. Further research should explore the possibilities of balancing the needs of older adults and, at the same time, viewing them as a resource during long-time crises.
Early studies of common mental disorders (CMDs) during the COVID-19 pandemic mainly report increases; however, more recent findings have been mixed. Also, studies assessing the effects of restriction measures on CMDs show varied results. The aim of this meta-analysis was to assess changes in levels of CMDs from pre-/early to during the pandemic and the effects of restriction policies in the European population.
Methods
We searched for studies assessing both pre-pandemic and peri-pandemic self-reported emotional distress and symptoms of depression or anxiety among nationally/regionally representative samples in Europe and collected microdata from those studies. Estimates of corona containment index were related to changes in CMDs using random-effects meta-regression.
Results
Our search strategy resulted in findings from 15 datasets drawn from 8 European countries being included in the meta-analysis. There was no evidence of change in the prevalence of emotional distress, anxiety, or depression from before to during the pandemic; but from early pandemic periods to later periods, there were significant decreases in emotional distress and anxiety. Increased school restrictions and social distancing were associated with small increases in self-reported emotional distress.
Conclusions
Despite initial concerns of increased emotional distress and mental illness due to the COVID-19 pandemic, the results from this meta-analysis indicate that there was a decrease in emotional distress and no change in anxiety or depression in the general population in Europe. Overall, our findings support the importance of strong governance when implementing periodic and robust restriction measures to combat the spread of COVID-19.
Country-wide social distancing and suspension of non-emergency medical care due to the COVID-19 pandemic will undoubtedly have affected public health in multiple ways. While non-pharmaceutical interventions are expected to reduce the transmission of several infectious diseases, severe disruptions to healthcare systems have hampered diagnosis, treatment, and routine vaccination. We examined the effect of this disruption on meningococcal disease and vaccination in the UK. By adapting an existing mathematical model for meningococcal carriage, we addressed the following questions: What is the predicted impact of the existing MenACWY adolescent vaccination programme? What effect might social distancing and reduced vaccine uptake both have on future epidemiology? Will catch-up vaccination campaigns be necessary? Our model indicated that the MenACWY vaccine programme was generating substantial indirect protection and suppressing transmission by 2020. COVID-19 social distancing is expected to have accelerated this decline, causing significant long-lasting reductions in both carriage prevalence of meningococcal A/C/W/Y strains and incidence of invasive meningococcal disease. In all scenarios modelled, pandemic social mixing effects outweighed potential reductions in vaccine uptake, causing an overall decline in carriage prevalence from 2020 for at least 5 years. Model outputs show strong consistency with recently published case data for England.
A mix of guidance and mandated regulations during the coronavirus disease (COVID-19) pandemic served to reduce the number of social contacts, to ensure distancing in public spaces, and to maintain the isolation of infected individuals. Individual variation in compliance to social distancing in Germany, relating to age, gender, or the presence of pre-existing health conditions, was examined using results from a total of 39 375 respondents to a web-based behavioral survey.
Older people and females were more willing to engage in social distancing. Those with chronic conditions showed overall higher levels of compliance, but those with cystic fibrosis, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), and epilepsy showed less adherence to general social distancing measures but were significantly more likely to isolate in their homes. Behavioral differences partly lie in the nature of each condition, especially with those conditions likely to be exacerbated by COVID-19. Compliance differences for age and gender are largely in line with previous studies.
In order to minimize the risk of infection during the Covid-19 pandemic, peopleare recommended to keep interpersonal distance (e.g., 1 m, 2 m, 6 feet), washtheir hands frequently, limit social contacts and sometimes to wear a face mask.We investigated how people judge the protective effect of interpersonal distanceagainst the Corona virus. The REM model, based on earlier empirical studies,describes how a person’s virus exposure decreases with the square of thedistance to another person emitting a virus in a face to face situation. In acomparison with model predictions, most participants underestimated theprotective effect of moving further away from another person. Correspondingly,most participants were not aware of how much their exposure would increase ifthey moved closer to the other person. Spectral analysis of judgments showedthat a linear ratio model with the independent variable = (initialdistance)/(distance to which a person moves) was the most frequently usedjudgment rule. It leads to insensitivity to change in exposure compared with theREM model. The present study indicated a need for information about the effectsof keeping interpersonal distance and about the importance of virus carryingaerosols in environments with insufficient air ventilation. Longer conversationsemitting aerosols in a closed environment may lead to ambient concentrations ofaerosols in the air that no distance can compensate for. The results of thestudy are important for risk communications in countries where people do notwear a mask and when authorities consider removal of a recommendation or arequirement to wear a face mask.
This paper introduces a novel theoretical model and measure of strategic thinking in social decision making. The model distinguishes four strategic orientations: egocentric (thinking about how one’s actions shape one’s outcomes), impact (thinking about how one’s actions shapes others’ outcomes), dependency (thinking about how others’ actions shape one’s outcomes), and altercentric (thinking about how others’ actions shape their outcomes). Applying this model to explain social behavior in the context of the COVID-19 pandemic, an exploratory study finds that the more people think about how their actions shape others’ outcomes, the more likely they are to: (a) comply with social distancing restrictions designed to curb the spread of the virus, and (b) donate money they received in the study to charitable organizations. These findings advance understanding of the multifaceted nature of strategic thinking and highlight the usefulness of the Strategic Thinking Scale for explaining social behavior.
The present study aims to delineate the role of preexisting depression for changes in common mental health problems during the COVID-19 pandemic.
Methods
Using mixed-effects linear regression models, we analyzed data on the course of depressive (Patient Health Questionnaire-2) and anxiety (Generalized Anxiety Disorder-2) symptoms as well as loneliness (three-item UCLA Loneliness Scale) in a subset of the Socio-Economic Panel Study, a large and nationally representative household panel study from Germany. Participants were assessed during the first COVID-19 wave in Germany (March 31 to July 4, 2020; n = 6,694) and prospectively followed up at the peak of the second COVID-19 wave (January 18 to February 15, 2021; n = 6,038).
Results
Overall, anxiety and depressive symptoms decreased, whereas loneliness increased from the first to the second COVID-19 wave. However, depressive symptoms increased and the surge in loneliness was steeper in those with versus without clinically relevant depressive symptoms in 2019 or a history of a depressive disorder before the COVID-19 pandemic. Anxiety symptoms remained stable throughout the pandemic in individuals with versus without clinically relevant depressive symptoms in 2019. Pre-pandemic depression was associated with overall higher depressive and anxiety symptoms and loneliness across both assessments. The stringency of lockdown measures did not affect the results.
Conclusions
Our findings suggest that individuals with a history of depressive symptoms before the COVID-19 pandemic are at increased risk to experience an escalation of mental health problems due to the COVID-19 pandemic. Therefore, they might particularly profit from targeted prevention and early intervention programs.
This study aimed to assess the feasibility and acceptability of implementing non-pharmaceutical interventions (NPIs) reserved for influenza pandemics (voluntary home quarantine, use of face masks by ill persons, childcare facility closures, school closures, and social distancing at schools, workplaces, and mass gatherings).
Methods:
Public health officials in all 50 states (including Washington, DC) and 8 territories, and a random sample of 822 local health departments (LHDs), were surveyed in 2019.
Results:
The response rates for the states/ territories and LHDs were 75% (44/ 59) and 25% (206/ 822), respectively. Most of the state/ territorial respondents stated that the feasibility and acceptability of implementing NPIs were high, except for K-12 school closures lasting up to 6 weeks or 6 months. The LHD respondents also indicated that feasibility and acceptability were lowest for prolonged school closures. Compared to LHD respondents in suburban or urban areas, those in rural areas expressed lower feasibility and acceptability. Barriers to implementing NPIs included financial impact, compliance and difficulty in enforcement, perceived level of disease threat, and concerns regarding political implications.
Conclusion:
Proactive strategies to systematically address perceived barriers and promote disease prevention ahead of a new pandemic are needed to increase receptivity and consistent adoption of NPIs and other evidence-based countermeasures.
When followed, there is evidence that social distancing measures play a major role in reducing the transmission of viruses such as COVID-19. However, not all individuals follow the guidance. We explored barriers and facilitators to compliance with UK social distancing guidelines during the COVID-19 pandemic through semi-structured interviews with 116 adults. Data were analysed using reflexive thematic analysis and themes mapped to the Capability, Opportunity and Motivation Model of Behaviour (COM-B). Barriers to compliance included inconsistent rules, caring responsibilities, fatigue, unintended consequences of control measures, and the need for emotional support. Facilitators were informational support and social responsibility. Six themes were both a barrier and a facilitator: lived environment, beliefs about consequences of non-compliance, influence of others, practical support, and trust in government. Reflective motivation, psychological capability, and social opportunity were important drivers for compliance. Measures that enable social support alongside strategies to maintain motivation to comply, provide clear guidance and optimise social cohesion should be promoted.
People with personality disorders (PD) share some impairments in personality functioning (e.g. identity, intimacy, empathy) that are also associated with inner or interpersonal conflicts, and sometimes also with different strategies of moral disengagement (MD). It is unclear whether MD strategies are related to individuals with/without PD and their willingness to have social contacts with representatives of otherness (like minorities, physically handicapped, etc.).
Objectives
Comparison of the differences in MD strategies and social distance to the otherness of healthy controls and people with PD, and the influence of personality functioning.
Methods
Moral Disengagement Scale which measures eight MD strategies, the Semi-Structured Interview for Personality Functioning DSM-5 assessing the Self and Interpersonal functioning, and Bogardus Social Distance Scale measuring perceived social distance toward various representatives of otherness are applied in two samples (general population and personality disorders).
Results
People with PD showed a significantly higher propensity to use various MD strategies than healthy controls with moderate effect size (.34–.49). Moral disengagement is facilitated by different aspects of personality functioning in both samples, sharing the impairments in maintaining close relationships. Both samples differed in MD strategies connected with higher social distancing.
Conclusions
People with PD are more prone to moral disengagement than healthy adults. MD appears to be facilitated by different aspects of personality functioning in both samples. Some representants of otherness are more related to specific MD strategies. We hypothesize that understanding of specific MD strategies used by people with PD can provide insight and explain some of their behavior.
The Group of Studies and Research on Psychology and Cognition (GEPESPSI) in Brazil has developed important academic and clinical actions on mental health in contexts of difficult psychological handling.
Objectives
GEPESPSI organized a symposium to discuss the psychological effects of isolation due to the strict measures of social distancing.
Methods
11 psychologists and one speech language pathologist discussed possible contributions to face social distancing in their specific fields of expertise in a virtual symposium of two days. The themes were: university teaching; support to the development of social and emotional competencies among children; the threat of the death of dreams in a phenomenological perspective; resilience and self-esteem; the repercussions of the lack of the school space for socialization; psychological tools for facing isolation; the challenges and perspectives of women who are victims of violence; online therapy for children; the health of workers; suicidal behavior; formulation of educational policies for remote learning and family mental health.
Results
1094 people were enrolled with an average of 400 people participating in each period. 91,1% of which were graduate students of a university. 55,7% were students of Psychology, 12,8% of Pedagogy, 6% of Physical Therapy among other courses. 39,8% of them were from the city of Santos, the others were from different regions of the country.
Conclusions
The feedback given by the participants was positive and involved gains such as sharing experience and knowledge but mainly creating connections to exchange psychological tools as a way of facing the difficulties of social distancing among researchers and graduate students.
COVID-19 is a respiratory disease and its main symptoms are fever, dry cough and difficulty breathing. It spread to several countries, which led the World Health Organization to decree, on March 11, 2020, a pandemic state that deeply affected Brazil. Due to the impossibility of leaving the house, the routine of children with autism was changed. Children in Autism Spectrum Disorder (ASD) have a qualitative deficit in social interaction. Clinical and daily observations reinforce several scientific studies that defend the importance of maintaining a routine as stable as possible for people with ASD, without this stability they may become emotionally disorganized, feel discomfort or even irritability.
Objectives
Investigate the impact caused by social distancing on the development of children and adolescents with autism.
Methods
An online questionnaire based on the DIR/Floortime basic map of emotional functional capacity development was distributed in Brazil from April to May, 2020. The results were analyzed using SPSS software.
Results
Results obtained from 122 questionnaires showed that after 30 days of quarantine 20% of children no longer had the characteristic of being able to remain calm and organized for at least 2 minutes; 11% no longer initiates interactions with their parents; 27% demonstrated more protests and anger than before the social distancing; 18% demonstrated more emotions such as anger, fear and intimacy, 28% began to understand their limits and 12% of the children are using greater facial expression during the social distancing.
Conclusions
This study brings results that can help to understand the processes in a child with autism.
In response to the spread of COVID-19, many Brazilian therapists faced the challenge of taking their practices online considering legal and ethical issues, besides learning to handle new technologies in a way the therapeutic setting was maintained. The cooperation of the family is fundamental for the creation and maintenance of an adequate therapeutic setting. Children are not sufficiently mature to speak clearly about what bothers them or to talk about how they feel and why, so, drawing, pretend playing, story telling, playing games are the common tools for children’s communication during therapy.
Objectives
Evaluating if online therapy for children can support therapeutic play tools and be effective in a virtual environment preserving the therapeutic setting.
Methods
Two children aged 6 to 11 attended the psychological sessions that were conducted through video calls.The family should provide a silent and private room for those sessions. The children were free to choose the toy they would like to play with and that was available at home such as board games, comic and story books. Mimicry, drawing, an adaptation of the Winnicott Squiggle Game were used, as well as electronic games through screen sharing.
Results
The emotional conflicts were expressed either through conventional games and play or electronic games. Playing with children online was possible as well as maintaining the therapeutic alliance in order to carry on with the treatment in a proper therapeutic setting.
Conclusions
Online therapy for kids showed to be an effective form of service delivery, under strict measures of social distancing in Brazil.
Through the application of the Health Belief Model, this study sought to explore how relationships between perceived susceptibility, severity, and benefits of social distancing recommendations, as well as psychological factors, may impact compliance with COVID-19 social distancing recommendations in the United States.
Methods:
Between October and November 2020, a convenience sample of English-speaking adults in the United States completed an online, cross-sectional survey which included items assessing beliefs around threats (e.g., perceived susceptibility and severity), response efficacy (e.g., perceived benefits), psychological factors (e.g., stress and COVID-specific anxiety), and compliance with social distancing measures (e.g., avoiding social gatherings).
Results:
Social distancing compliance was positively associated with perceived susceptibility of COVID-19 (b = 0.42, P < 0.05) and perceived benefits of social distancing recommendations (b = 0.81, P < 0.01). No significant associations were found between perceived severity of COVID-19 (P = 0.38), general stress (P = 0.28), COVID-19-related anxiety (P = 0.12), and compliance.
Conclusions:
Findings suggest that perceived susceptibility to COVID-19 and perceived benefits of social distancing measures significantly increased compliance with social distancing recommendations in this convenience sample of U.S. adults.
An often overlooked strategy for fighting the COVID-19 pandemic is group testing. Its main advantage is that it can scale, enabling the regular testing of the whole population. We argue that another advantage is that it can induce social distancing. Using a simple model, we show that if a group tests positive and its members are in close social proximity, then they will rationally choose not to meet. The driving force is the uncertainty about who has the virus and the fact that the group cares about its collective welfare. We therefore propose identifying socially connected groups, such as colleagues, friends and neighbours, and testing them regularly.
Disease transmission and behaviour change are both fundamentally social phenomena. Behaviour change can have profound consequences for disease transmission, and epidemic conditions can favour the more rapid adoption of behavioural innovations. We analyse a simple model of coupled behaviour change and infection in a structured population characterised by homophily and outgroup aversion. Outgroup aversion slows the rate of adoption and can lead to lower rates of adoption in the later-adopting group or even behavioural divergence between groups when outgroup aversion exceeds positive ingroup influence. When disease dynamics are coupled to the behaviour-adoption model, a wide variety of outcomes are possible. Homophily can either increase or decrease the final size of the epidemic depending on its relative strength in the two groups and on R0 for the infection. For example, if the first group is homophilous and the second is not, the second group will have a larger epidemic. Homophily and outgroup aversion can also produce dynamics suggestive of a ‘second wave’ in the first group that follows the peak of the epidemic in the second group. Our simple model reveals dynamics that are suggestive of the processes currently observed under pandemic conditions in culturally and/or politically polarised populations such as the USA.
Growing research shows a correlation between gender, benevolent sexism, partisanship, and COVID-19 public health compliance. We show first that women are more likely than men to engage in protective behaviors to slow the spread of COVID-19. We also find that while Republicans and Independents are less likely to comply with these measures, benevolent sexism moderates the effect of partisanship and can increase compliance. These results suggest that framing public health directives in terms of chivalry and protection activates benevolent sexism, potentially offsetting patterns of noncompliance associated with partisanship. We discuss the negative consequences of these results and posit a need for bipartisan messages to reduce reliance on benevolent sexism in the future.
Google's ‘Community Mobility Reports’ (CMR) detail changes in activity and mobility occurring in response to COVID-19. They thus offer the unique opportunity to examine the relationship between mobility and disease incidence. The objective was to examine whether an association between COVID-19-confirmed case numbers and levels of mobility was apparent, and if so then to examine whether such data enhance disease modelling and prediction. CMR data for countries worldwide were cross-correlated with corresponding COVID-19-confirmed case numbers. Models were fitted to explain case numbers of each country's epidemic. Models using numerical date, contemporaneous and distributed lag CMR data were contrasted using Bayesian Information Criteria. Noticeable were negative correlations between CMR data and case incidence for prominent industrialised countries of Western Europe and the North Americas. Continent-wide examination found a negative correlation for all continents with the exception of South America. When modelling, CMR-expanded models proved superior to the model without CMR. The predictions made with the distributed lag model significantly outperformed all other models. The observed relationship between CMR data and case incidence, and its ability to enhance model quality and prediction suggests data related to community mobility could prove of use in future COVID-19 modelling.