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1. COVID-19 risk perception and vaccine acceptance in individuals with self-reported chronic respiratory or autoimmune conditions

   https://doi.org/10.1186/s13223-023-00791-6  

   Smith, Brianna A. ; Ricotta, Emily E. ; Kwan, Jennifer L. ; Evans, Nicholas G. ( May 2023 , Allergy, Asthma & Clinical Immunology)

   COVID-19 disproportionately affects those with preexisting conditions, but little research has determined whether those with chronic diseases view the pandemic itself differently - and whether there are differences between chronic diseases. We theorized that while individuals with respiratory disease or autoimmune disorders would perceive greater threat from COVID-19 and be more supportive of non-pharmaceutical interventions (NPIs), those with autoimmune disorders would be less likely to support vaccination-based interventions.

   We conducted a two-wave online survey conducted in February and November 2021 asking respondents their beliefs about COVID-19 risk perception, adoption and support of interventions, willingness to be vaccinated against COVID-19, and reasons for vaccination. Regression analysis was conducted to assess the relationship of respondents reporting a chronic disease and COVID-19 behaviors and attitudes, compared to healthy respondents adjusting for demographic and political factors.

   In the initial survey, individuals reporting a chronic disease had both stronger feelings of risk from COVID-19 as well as preferences for NPIs than healthy controls. The only NPI that was still practiced significantly more compared to healthy controls in the resample was limiting trips outside of the home. Support for community-level NPIs was higher among individuals reporting a chronic disease than healthy controls and remained high among those with respiratory diseases in sample 2. Vaccine acceptance produced more divergent results: those reporting chronic respiratory diseases were 6% more willing to be vaccinated than healthy controls, while we found no significant difference between individuals with autoimmune diseases and healthy controls. Respondents with chronic respiratory disease and those with autoimmune diseases were more likely to want to be vaccinated to protect themselves from COVID-19, and those with an autoimmune disease were more likely to report fear of a bad vaccine reaction as the reason for vaccine hesitancy. In the resample, neither those with respiratory diseases nor autoimmune diseases reported being more willing to receive a booster vaccine than healthy controls.

   It is not enough to recognize the importance of health in determining attitudes: nuanced differences between conditions must also be recognized.

    

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2. Reliability but not bias: Developing a scale to measure preferred channels for risk information during the COVID pandemic

   https://doi.org/10.1111/risa.14035  

   Lachlan, Kenneth A. ; Gilbert, Christine ( September 2022 , Risk Analysis)

   To develop a new measure of preferred sources for risk information, two studies asked respondents to indicate what channels they were reliant on for information about COVID‐19, from 25 news channels ranging across the political spectrum. Unexpectedly, dependencies clustered around level of reliability rather than the political orientation of the news channel. In other words, each cluster included media channels from both the left and right side of the political spectrum, while dependencies clustered into sources that varied by the degree to which their content is reliable. Participants who turned to lower reliability channels indicated lower risk perceptions, less accurate probability estimations, reduced vaccination intentions, and lower protective behavioral intentions. Those inclined to use higher reliability channels indicated higher risk perceptions, more accurate probability estimations, increased vaccination intentions, and higher protective behavioral intentions. These relationships are discussed in terms of implications for our understanding of source reliance and risk perception, information sufficiency, and implications for both future research and public health interventions.

    

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3. Structured reflection increases intentions to reduce other people’s health risks during COVID-19

   https://doi.org/10.1093/pnasnexus/pgac218  

   Ramos, Jairo ; Grant, Marrissa D. ; Dickert, Stephan ; Eom, Kimin ; Flores, Alex ; Jiga-Boy, Gabriela M. ; Kogut, Tehila ; Mayorga, Marcus ; Pedersen, Eric J. ; Pereira, Beatriz ; et al ( October 2022 , PNAS Nexus)

   People believe they should consider how their behavior might negatively impact other people, Yet their behavior often increases others’ health risks. This creates challenges for managing public health crises like the COVID-19 pandemic. We examined a procedure wherein people reflect on their personal criteria regarding how their behavior impacts others’ health risks. We expected structured reflection to increase people's intentions and decisions to reduce others’ health risks. Structured reflection increases attention to others’ health risks and the correspondence between people's personal criteria and behavioral intentions. In four experiments during COVID-19, people (N  = 12,995) reported their personal criteria about how much specific attributes, including the impact on others’ health risks, should influence their behavior. Compared with control conditions, people who engaged in structured reflection reported greater intentions to reduce business capacity (experiment 1) and avoid large social gatherings (experiments 2 and 3). They also donated more to provide vaccines to refugees (experiment 4). These effects emerged across seven countries that varied in collectivism and COVID-19 case rates (experiments 1 and 2). Structured reflection was distinct from instructions to carefully deliberate (experiment 3). Structured reflection increased the correlation between personal criteria and behavioral intentions (experiments 1 and 3). And structured reflection increased donations more among people who scored lower in cognitive reflection compared with those who scored higher in cognitive reflection (experiment 4). These findings suggest that structured reflection can effectively increase behaviors to reduce public health risks.

    

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4. Prevalence and Correlates of Long COVID Symptoms Among US Adults

   https://doi.org/10.1001/jamanetworkopen.2022.38804  

   Perlis, Roy H. ; Santillana, Mauricio ; Ognyanova, Katherine ; Safarpour, Alauna ; Lunz Trujillo, Kristin ; Simonson, Matthew D. ; Green, Jon ; Quintana, Alexi ; Druckman, James ; Baum, Matthew A. ; et al ( October 2022 , JAMA Network Open)

   Persistence of COVID-19 symptoms beyond 2 months, or long COVID, is increasingly recognized as a common sequela of acute infection.

   To estimate the prevalence of and sociodemographic factors associated with long COVID and to identify whether the predominant variant at the time of infection and prior vaccination status are associated with differential risk.

   This cross-sectional study comprised 8 waves of a nonprobability internet survey conducted between February 5, 2021, and July 6, 2022, among individuals aged 18 years or older, inclusive of all 50 states and the District of Columbia.

   Long COVID, defined as reporting continued COVID-19 symptoms beyond 2 months after the initial month of symptoms, among individuals with self-reported positive results of a polymerase chain reaction test or antigen test.

   The 16 091 survey respondents reporting test-confirmed COVID-19 illness at least 2 months prior had a mean age of 40.5 (15.2) years; 10 075 (62.6%) were women, and 6016 (37.4%) were men; 817 (5.1%) were Asian, 1826 (11.3%) were Black, 1546 (9.6%) were Hispanic, and 11 425 (71.0%) were White. From this cohort, 2359 individuals (14.7%) reported continued COVID-19 symptoms more than 2 months after acute illness. Reweighted to reflect national sociodemographic distributions, these individuals represented 13.9% of those who had tested positive for COVID-19, or 1.7% of US adults. In logistic regression models, older age per decade above 40 years (adjusted odds ratio [OR], 1.15; 95% CI, 1.12-1.19) and female gender (adjusted OR, 1.91; 95% CI, 1.73-2.13) were associated with greater risk of persistence of long COVID; individuals with a graduate education vs high school or less (adjusted OR, 0.67; 95% CI, 0.56-0.79) and urban vs rural residence (adjusted OR, 0.74; 95% CI, 0.64-0.86) were less likely to report persistence of long COVID. Compared with ancestral COVID-19, infection during periods when the Epsilon variant (OR, 0.81; 95% CI, 0.69-0.95) or the Omicron variant (OR, 0.77; 95% CI, 0.64-0.92) predominated in the US was associated with diminished likelihood of long COVID. Completion of the primary vaccine series prior to acute illness was associated with diminished risk for long COVID (OR, 0.72; 95% CI, 0.60-0.86).

   This study suggests that long COVID is prevalent and associated with female gender and older age, while risk may be diminished by completion of primary vaccination series prior to infection.

    

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5. Community Mobility and Depressive Symptoms During the COVID-19 Pandemic in the United States

   https://doi.org/10.1001/jamanetworkopen.2023.34945  

   Perlis, Roy H. ; Lunz Trujillo, Kristin ; Safarpour, Alauna ; Quintana, Alexi ; Simonson, Matthew D. ; Perlis, Jasper ; Santillana, Mauricio ; Ognyanova, Katherine ; Baum, Matthew A. ; Druckman, James N. ; et al ( September 2023 , JAMA Network Open)

   Marked elevation in levels of depressive symptoms compared with historical norms have been described during the COVID-19 pandemic, and understanding the extent to which these are associated with diminished in-person social interaction could inform public health planning for future pandemics or other disasters.

   To describe the association between living in a US county with diminished mobility during the COVID-19 pandemic and self-reported depressive symptoms, while accounting for potential local and state-level confounding factors.

   This survey study used 18 waves of a nonprobability internet survey conducted in the United States between May 2020 and April 2022. Participants included respondents who were 18 years and older and lived in 1 of the 50 US states or Washington DC.

   Depressive symptoms measured by the Patient Health Questionnaire-9 (PHQ-9); county-level community mobility estimates from mobile apps; COVID-19 policies at the US state level from the Oxford stringency index.

   The 192 271 survey respondents had a mean (SD) of age 43.1 (16.5) years, and 768 (0.4%) were American Indian or Alaska Native individuals, 11 448 (6.0%) were Asian individuals, 20 277 (10.5%) were Black individuals, 15 036 (7.8%) were Hispanic individuals, 1975 (1.0%) were Pacific Islander individuals, 138 702 (72.1%) were White individuals, and 4065 (2.1%) were individuals of another race. Additionally, 126 381 respondents (65.7%) identified as female and 65 890 (34.3%) as male. Mean (SD) depression severity by PHQ-9 was 7.2 (6.8). In a mixed-effects linear regression model, the mean county-level proportion of individuals not leaving home was associated with a greater level of depression symptoms (β, 2.58; 95% CI, 1.57-3.58) after adjustment for individual sociodemographic features. Results were similar after the inclusion in regression models of local COVID-19 activity, weather, and county-level economic features, and persisted after widespread availability of COVID-19 vaccination. They were attenuated by the inclusion of state-level pandemic restrictions. Two restrictions, mandatory mask-wearing in public (β, 0.23; 95% CI, 0.15-0.30) and policies cancelling public events (β, 0.37; 95% CI, 0.22-0.51), demonstrated modest independent associations with depressive symptom severity.

   In this study, depressive symptoms were greater in locales and times with diminished community mobility. Strategies to understand the potential public health consequences of pandemic responses are needed.

    

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